AN ASSESSMENT OF POTENTIAL DRUG-DRUG INTERACTIONS IN HYPERTENSIVE PATIENTS IN A TERTIARY CARE HOSPITAL

Objective: To an assessment of potential drug-drug interactions in hypertensive patients in a tertiary care hospital. Methods: A prospective, observational study was conducted at a tertiary care hospital, Erode for a period of 8 mo. A sample of 480 patients was assessed for PDDIs using drug checker in Micromedex®-2.7. Results: A total of 430 patients were analyzed and it was found to be 396 (82.50%) hypertensive patients had PDDIs, and a sum total of 1160 PDDIs were observed. Potential drug-drug interactions (PDDIs) higher in female hypertensive patients [255 (64.39%)] compared to males. Incidences of PDDIs were found to be higher in the age group of 60-70 y were [177 (44.69%)] and incidences of interactions based on the duration of (4-6 d) hospital stays were 272 (68.68%). Moreover, 49.24% of patients were found to be prescribed with more than 7 drugs, with higher incidences of PDDIs. Some of the most common drug interacting pair was between aspirin and clopidogrel combination observed in 325 PDDIs in the major, with pharmacodynamics in nature. Conclusion: Clinical pharmacist ought to have the role of regular monitoring of drug therapy in identifying and preventing the medications that have the potential to cause drug-drug interactions, thereby minimizing the undesirable outcomes in drug medical care and improving the quality of care

ASSESSMENT OF POTENTIAL DRUG INTERACTIONS AMONG HOSPITALIZED PATIENTS AT THE CARDIAC AND PULMONARY DEPARTMENTS IN TERTIARY CARE HOSPITALS

Objective: The aim of this study was to assess the potential drug interactions among hospitalized patients in cardiac and pulmonary wards in three tertiary care hospitals.Methods: A prospective, observational study was carried out for 12 months. A sample of 1150 patients were assessed for potential drug-drug interactions (pDDIs) using Micromedex®- 2.7 and Drugs.com.Results: A total of 1150 patients were analyzed, and it was found that 685 were cardiac and 465 were pulmonary patients. The study identified 524 (76.49%) cardiac patients and 345 (74.19%) pulmonary patients, with pDDIs higher in male cardiac (298 [56.87%]) and male pulmonary (199 [57.68%]) patients, compared to females. Incidences of pDDIs were found to be higher in the age group of 60–70 years in cardiac (193 [36.83%]) and pulmonary (146 [42.31%]) patients and incidences of interactions based on duration of 4–6 days' hospital stays in cardiac were 380 (72.53%) and 215 (62.31%) in pulmonary patients, respectively. Moreover, 51.90% of cardiac patients and 56.52% of pulmonary patients were found to be prescribed with more number of drugs (cardiac 7 drugs and pulmonary 5–6 drugs) causing higher incidences of pDDIs. Some of the most common drug interacting pair was aspirin and clopidogrel combination observed in 245 cardiac patients, whereas in the pulmonary department, it was ranitidine-theophylline combination with a frequency of 195 pDDIs. Drug-food interactions were found with atorvastatin–citrus fruits in cardiac and theophylline–caffeine in pulmonary patients. The most common drug-disease interaction was found to be isosorbide dinitrate–myocardial infarction in cardiac and diazepam–COPD in pulmonary, respectively.Conclusion: Pharmacists must take responsibility in the monitoring of drug interactions and notifying the physician and patient about potential problems. With their detailed knowledge of drugs, pharmacists have the ability to relate unexpected symptoms experienced by patients to possible adverse effects of their drug therapy

PHARMACIST INTERVENTION ON IDENTIFICATION OF DRUG INTERACTIONS IN TERTIARY CARE HOSPITALS

Objective: The aim of this study was to assess the potential drug interactions (pDIs) among hospitalized patients in cardiac and neurology wards in 3 tertiary care hospitals.Methods: A prospective, observational study was carried out for a period of 12 mo. A sample of 1330 patients was assessed for pDDIs using Micromedex®-2.7and drugs.com and www.dugs.com.Results: A total of 1330 patients were analyzed and it was found that 685 were cardiac and 645 were neurology patients. The study identified 524 (76.49%) cardiac patients and 425 (65.89%) neurology patients, with potential drug-drug interactions (pDDIs) higher in male cardiac [298 (56.87%)] and male neurology [235 (55.29%)] patients, compared to females. Incidences of pDDIs were found to be higher in the age group of 60-70 y in cardiac [193 (36.83%)] and neurology [165 (38.84%)] patients and incidences of interactions based on duration of (4-6 d) hospital stays in cardiac were 380 (72.53%) and 275 (64.70%) in neurology patients respectively. Moreover, 51.90% cardiac patients and 57.41% neurology patients were found to be prescribed with more number of drugs in cardiac and neurology (7 drugs) patients, were found to have developed higher incidences of pDDIs. The most common drug interacting pair was between aspirin and clopidogrel combination, observed in 245 cardiac and 316 in neurology patients. Drug-food interactions (DFIs) were found with between atorvastatin-citrus fruits in cardiac and phenytoin-protein rich foods in neurology patients. The most common drug-disease interaction (D-DIs) was found to between isosorbide dinitrate–myocardial infarction in cardiac and carbamazepine-seizuresin neurology respectively.Conclusion: It is recommended that physicians should be aware of the interactions among those drugs while prescribing, and careful monitoring is also required

A comprehensive review on the role of dopamine in the pathophysiology of tardive dyskinesia

Tardive dyskinesia (TD) is a neurological syndrome characterized by involuntary, repetitive, and unusual movements that primarily impact the orofacial region while also extending to other body parts, encompassing chorea, dystonia, tics, buccolingual stereotypy, and akathisia. This condition stems from iatrogenic factors, particularly the chronic administration of medications that obstruct dopamine receptors. Predominantly implicated are antipsychotic drugs, utilized primarily for schizophrenia and bipolar disorder treatment. These drugs modulate dopamine levels, yet prolonged usage can induce alterations in dopamine receptor sensitivity and disruptions in dopaminergic pathways, consequently fostering TD. Dopamine, a pivotal neurotransmitter governing motor control, motivation, reward processing, and emotional regulation, exerts its effects through distinct dopamine receptor types, of which the D2 subtype assumes particular significance in TD development. The persistent blockade of D2 receptors by antipsychotics prompts a compensatory surge in receptor numbers and sensitivity, ultimately contributing to TD's emergence. In essence, TD reflects a complex interplay between medical intervention and neurological intricacies. The protracted influence of antipsychotics on dopamine receptors highlights the delicate equilibrium essential for optimal brain function. The unconventional movements characterizing TD underscore the intricate role of dopamine and its receptors in orchestrating neural equilibrium

IMPACT OF PHARMACIST INTERVENTION IN SCREENING AND EDUCATION ON BLOOD PRESSURE IN A RURAL AREA IN SOUTHERN INDIA

ABSTRACTObjective: Hypertension (HTN) expends a consequential public health concern on cardiovascular health status and health-care systems in India. Theeffectuation of the pharmaceutical care program in the health care is an extremely important need to achieve the optimum therapeutic effect. Theobjective of the study was to assess the impact of pharmacist intervention on patient's blood pressure (BP) level, quality of life (QOL), and knowledge,attitude, and practice (KAP) of hypertensive patients.Methods: A randomized controlled pilot study was carried out for 6 months. The hypertensive patients were randomized into control and interventiongroup based on age, and both the groups were interviewed using KAP and WHO QOL-BREF questionnaires, screened BP, respectively, at baseline andeach follow-up after post counseling section to the intervention group. The effect of pharmacist intervention on QOL and KAP among control andintervention was statistically analyzed by paired t-test using SPSS version 16.Results: The total sample studied was 60, of which 20 (33.33%) were males and 40 (66.67%) were females. In our study, the QOL score for eachdomain of both intervention and control groups were almost poor (p˃0.05) at baseline and for the intervention group, a highly significant improvement(p<0.001) was observed for all domains in final follow-up. KAP score of intervention group also showed a significant improvement (p<0.001) frombaseline to final follow-up. In this study, intervention group showed a significant mean reduction of systolic BP from baseline 150.13±25.670 to finalfollow-up 145.33±12.914.Conclusion: The results of the study showed a significant improvement in the patient's KAP toward different aspects of HTN and QOL followingpharmacist mediated counseling. Involvement of pharmacy practitioners in the management of HTN significantly improves QOL and KAPs.Keywords: Hypertension, Quality of life, Knowledge, Attitude and practice, Pharmacist intervention, Patient counseling

EPIDEMIOLOGICAL STUDY OF PREVALENCE OF ANEMIA AND ASSOCIATED RISK FACTORS IN A RURAL COMMUNITY; A HOME-BASED SCREENING

Objective: The prevalence of anemia is disproportionately high in developing countries due to poverty, inadequate diet, certain diseases, pregnancy and lactation, and poor access to health services. It is a risk factor for cardiovascular health and early death in adult.  To estimate the prevalence of anemia and its associated risk factors in a rural a community in India.Methodology: Based on inclusion and exclusion criteria, an observational house-to-house survey was conducted for a period of 6 months, by screening for anemia, using digital strip type hemoglobin meter. Result: Out of 200 people, 146 were anemic of which 77 were with mild anemia, 67 with moderate anemia and only 3 had severe anemia. There were more number of anemic patients in the group of normal and underweight (Normal=86, 58.90%; Underweight=27, 18.49%) than that of overweight and obese (Overweight=22, 15.06%; Obese=11, 7.53%). The newly diagnosed cases of anemia were 138 and previously diagnosed cases of anemia were 8. Out of 146 anemic populations, 13 were hyperlipidemics, 20 were hypertensives, 18 were diabetics, 5 were thyroid patients and 4 were cardiac patients. Conclusion: This screening program helps to diagnose anemia in a selected population and benefit avoiding further complications by offering adequate patient counseling. Study population was enriched with information on nutrition intake and importance of maintaining hemoglobin concentration at normal level in day-to-day life of an individual.Keywords: Anemia, Nutrition, Screening, Hemoglobin

ASSESSMENT ON PREVALENCE OF HYPERTENSION AND ITS ASSOCIATED RISK FACTORS ALONG WITH MMAS SCORE IN A RURAL COMMUNITY: A HOME BASED SCREENING

Objectives: In India, a study on hypertension (HTN) prevalence conducted in a community over a period of 3–6 decades showed an increase of 30% in urban population and 10% in rural population. The study aimed to assess the prevalence of HTN and pre-HTN in a rural community and also to find the significance of risk factors which precipitate to it.Methods: This cross-sectional study was conducted in a rural community of Salem district, Tamil Nadu, India. HTN and pre-HTN was defined by the Joint National Committee 8th report guidelines. Patient data's (sociodemographic variables, lifestyle factors, and medical reports) were collected with the help of questionnaire. Identified hypertensive patients were assessed with MMAS-8 questionnaire.Results: During the study period of 8 months, 425 subjects were screened and studied for HTN and pre-HTN. More than half (69.4%) of the study group were found to be hypertensive. Of the 295 reported cases, 228 (53.6% of 425) were known†cases of HTN and 67 (15.8% of 425) were newly diagnosed cases. A positive association (p<0.05) was observed between HTN and age, body mass index (BMI), alcohol, and tobacco use other than smoking. 75 patients were found to be prehypertensive, in that 57.3% (43 cases) were male and 42.7% (32 cases) were female. Majority of hypertension patients (66%) were with low adherence than 24% medium and 10% high adherence towards their medications.Conclusion: Our study concluded that the prevalence of pre-HTN and HTN was higher among the study population, so there is a need for screening of individuals at the early age group. Further studies are needed to observe and confiscate the reasons why majority of hypertensive patients with low medication adherence

PREVALENCE OF DIAGNOSED AND UNDIAGNOSED DIABETES IN A RURAL COMMUNITY: A HOME-BASED SCREENING

Objectives: Diabetes is one of the main global risks of mortality and is seen with a drastic rise in developing nations in accordance with rise in age. The main aim of the study is to find the prevalence of diabetes and pre-diabetes and its associated risk factors among the rural community based on diagnostic criteria.Methods: This cross-sectional study was conducted in a rural community of Salem district, Tamil Nadu, India. Patient data (demographics, lifestyle factors, and medical reports) were collected with the help of a questionnaire.Results: Of 780 populations, 425 were included for the screening of diabetes based on inclusion criteria. Of the 425 screened samples, 224 (52.7%) were diagnosed with diabetes. From these 224 diabetic cases, 133 (31.3%) were known cases of diabetes, 26 (6.1%) were newly diagnosed diabetic cases, and 65 (15.3%) were pre-diabetic cases. Most of the diabetic patients 140 (62.5%) were illiterate, and 159 (71%) were never had physical activities. A positive association (p<0.05) was observed between diabetes and age, body mass index (BMI) and tobacco use other than smoking. 65 patients were found to be pre-diabetes, among which 41.5% (27 cases) were male and 58.5% (38 cases) were female. A positive association (p<0.05) was observed between pre-diabetes and age, family history of diabetes and HTN, BMI, and lifestyle factors such as tobacco use, alcohol consumption, and smoking.Conclusion: Our study demonstrated that the burden of diabetes was observed to be increasing in India and it is becoming common among communities. Patient awareness and timely diagnosis and intervention may limit the progression of the disease

A PROSPECTIVE EVALUATION OF CAUSES AND TREATMENT OF INFERTILITY IN A TERTIARY CARE HOSPITAL, ERODE

 Objective: Infertility has a serious impact on the psychosocial well-being of women in the developing world. The objective of the study was to evaluate the causes and treatment pattern of infertility patients in a tertiary care hospital.Methods: The prospective observational study focused on the sociodemographic properties of infertile patients, causes of infertility, and various treatments carried out in a tertiary care hospital, Erode, Tamil Nadu.Results: Of 200 cases, the majority was due to female factor (45.5%), followed by male factors (26%), both gender factors (25.5%), and unexplained etiology (6%). It was observed that major causes of male infertility (MI) were oligoasthenoteratozoospermia (OATS - 48.42%), followed by asthenozoospermia (17.89%), azoospermia (11.57%), erectile dysfunction (7.36%), oligoasthenozoospermia (5.26%), varicocele (3.15%), oligospermia (2.10%), necrozoospermia (2.10%), asthenoteratozoospermia (1.05%), and asthenozoospermia+erectile dysfunction (1.05%). In cases of female infertility (FI), the pattern of causes was polycystic ovarian disease (PCOD) (29.6%), followed by tubular block (13.23%), cyst (6.66%), hypothyroidism (4.44%), endometriosis (4.44%), hormonal problems (4.44%), fibroid (3.7%), fibroid+cyst (3.7%), premature ovarian failure (2.96%), thin endometrium (2.96%), multifollicularovary (2.96%), PCOD+hormonalproblems (2.96%), and hypothyroidism+hormonal problems (2.22%). Intrauterine insemination was the most commonly assisted reproductive technology employed, followed by in vitro fertilization and intracytoplasmic sperm injection. Of 200 infertile couples, 57 (28.5%) were unable to conceive within 6 months and 72 (36%) after 6 months following first consultation, 44 (22%) defaulted/lost follow-up/were still under consultation, 13 (6.5%) conceived with the help of assisted reproductive treatment, 10 (5%) conceived with the help of drug treatment, anddd 4 (2%) had spontaneous pregnancy.Conclusion: The major cause of infertility was found to be PCOD in females and OATS in males. The most commonly prescribed drugs were antioxidants for males and progesterone for females