Prescribing pattern and pharmacoeconomic analysis of antidiabetic drugs

Background: Diabetes Mellitus is a worldwide growing problem causing threat to patient's health because of its association with various complications and comorbidities. It is a chronic disease requiring lifelong medication which further adds to the economic burden. The objective of this study was to evaluate the prescribing pattern and to do pharmacoeconomic analysis of prescribed antidiabetic drugs.Methods: This observational cross sectional study was conducted for 12 months duration in Outpatient Pharmacy of tertiary care hospital. Prescriptions with antidiabetic drugs were captured and evaluation of prescribing pattern along with pharmacoeconomic analysis of antidiabetic drugs was done.Results: A total of 611 prescriptions with antidiabetic drugs were analyzed. There were total 4034 drugs in all prescriptions with a mean of 6.6 drugs per prescription. 4.28% of drugs were prescribed by generic name and 58.9% of prescribed drugs were from essential drug list. Dual drug therapy was prescribed in maximum number of patients (42.2%) followed by monotherapy (28.8%). More commonly prescribed class of antidiabetic drugs was biguanides as monotherapy (n=119) and its combination with sulfonylureas was prescribed maximally among dual drug therapy (n=158). Cost of monthly therapy for antidiabetic drugs prescribed as monotherapy was least with Biguanides (₹ 98.89/ month) whereas combination of biguanides and thiazolidinediones was least expensive among dual drug therapy (₹ 216/ month).Conclusions: Biguanides was the most common prescribed class of antidiabetic drugs among monotherapy and its combination with sulfonylureas was most prescribed as dual drug therapy and both of these therapies were economical

Variation in the serum bilirubin levels in newborns according to gender and seasonal changes

Introduction: Bilirubin is a substance that is produced during the process of hemolysis. Gender influences on neonatal illnesses and outcomes have remained a topic of debate and investigation. Empirical neonatological experience suggests that prevalence and degree of neonatal jaundice might be dependent on seasonal variation also. The aim of our study is to interpret the bilirubin levels in newborns according to gender and seasonal variation. Materials and Methods: The study was done from October 2012 to July of 2013 (differentiated by seasonal variation). A total of 1000 jaundiced newborn (500 of each sex diagnosed clinically and divided equally in summer and winter season) were studied to assess the total, direct and indirect serum bilirubin levels using colorimetry. Results: Out of total 1676 deliveries (439 were caesarean, 13 were assisted and rest were normal) during winter season and 1475 deliveries (399 were Cesarean, 14 were assisted and rest were normal) during summer season, 500 male newborn and 500 female newborn were analysed, divided equally in both seasons. Serum bilirubin was higher in males in summers and mainly comprised unconjugated bilirubin while direct bilirubin was higher in females in winters. Raised indirect bilirubin was more common in males born in summer than those born in winters (P = 041). In winters raised direct bilirubin was more common in females as compared to males (P = 0.019). Among female neonates total and indirect bilirubin was significantly raised in those born in summers (P = < 0.001 and <0.001, respectively) while direct was raised in those born in winters (P = 0.003). Conclusion: Physiological and pathologic phenomena associated with male gender must be integrated in the frame of understanding of both susceptibility and protection of the male newborn which has not been available for adequate investigation in the past. The higher temperature during the summer, with a greater influence of higher breastfeeding cause more severe hyperbilirubinemia

Prevalence of Diabetes in Haryana

BackgroundDiabetes will pose a severe burden on the already fragile and under resourced health care system in India. As there is limited data available regarding prevalence of diabetes in northern India, the present study was undertaken to estimate the prevalence of diabetes mellitus and to study the association of risk factors in an urban population of Rohtak.Method  A cross-sectional survey of 1000 eligible persons. A pre-tested semi-structured interview schedule was deployed.ResultsThe prevalence of diabetes in the study population was 8.1% which was higher in females (9.8%) as compared to males (6.1%). Results of impaired fasting glucose showed prevalence of pre diabetics to be 10.3% which was again higher in females (13.3%) as against 6.7% in males. 67% of pre-diabetic and 49.4% of diabetic have family history of diabetes mellitus in first degree relationship while 1.8% of non-diabetic had a family history of diabetes. prevalence of diabetes increased with increasing age up to 70 years. Moreover the prevalence of diabetes was high in two extremes of socio economic classes, being more in low socioeconomic class.ConclusionWe conclude that prevalence of diabetes in urban Haryana is lower than other states. Also the prevalence of diabetes is higher in females. Prevalence is influenced by age, education, occupation, socioeconomic status and marital status