DRUG UTILIZATION STUDY IN THE ORTHOPEDICS OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL IN MAHARASHTRA

Objective: The objective of this study was to analyze the pattern of drug utilization in outpatients of orthopedics department from a tertiary care hospital.Material and Methods: In this retrospective study, prescriptions of randomly selected patients attending orthopedics clinic were screened to analyze a number of medicines per prescription. Number and percentages of prescribed medicines were calculated.Results: In this study, 512 patients (male 260 [50.8%] and females 252 [49.2%]) were included in the study. The total number of prescribed medicines was 1562, accounting for 3.1 medicines per patient. A total number of oral, parenteral, and topical medicines were 1375 (88%), 176 (11.3%), and 11 (0.7%), respectively. Nonsteroidal anti-inflammatory agents (NSAIDs), antacid/anti-ulcerants, and antimicrobial agents were 641 (41%), 371 (23.8%), and 102 (6.5%), respectively. A total of 54 (52.9%), 29 (28.4%), 9 (8.8%), 6 (5.9%), 3 (2.9%), and 1 (1%) patients were prescribed fluoroquinolones, beta-lactam antibiotics, metronidazole, trimethoprim plus sulfamethoxazole, macrolides, and doxycycline, respectively. For 371 (23.8%) patients, anti-ulcerant and antiulcer were prescribed, among which ranitidine was the most common prescription [353 (95.1%)]Conclusion: Number of medicines prescribed per patient in orthopedic clinic was 3.1. NSAIDs and antacid/anti-ulcerants were the most commonly prescribed medicines

Improved Third Party Auditing Approach For Shared Data In The Cloud With Efficient Revocation of User

Verify the integrity of the shared information publically, users within the cluster to ensure that shared information all got to figure out the signatures on blocks. Sharing information by different users in different blocks of information typically changes entirely by individual users are signed. Once a user has canceled the cluster, for security reasons, blocks that antecedently the revoked by signed by associate an existing user must sign in nursing again. The Direct transfer of information sharing that same methodology, half and this user to sign in again over the cancellation of existing user in nursing associate permits, mostly due to the size of share data within is disabled. Over the course of this paper, we share information with the user in mind affordable revocation is a completely unique integrity of public auditing mechanisms to propose is a trend. Proxy re-signature thought of using signatures we didn’t order that transfer existing user and blocks by themselves again to sign on behalf of the current cloud blocks users. User to sign in again over are knowledge with the rest of the latest version of the cluster is the cancellation, to allow for a trend. In addition, a public vouchers are often part of the shared although some information has been signed by the cloud while cannot share to retrieve information from the cloud, complete information to audit the integrity of is ready. In addition, our systems at the same time by multiple auditing functions to support verification, auditing is in batch. Experimental results show that our system fairly can improve the efficiency of user cancellation. DOI: 10.17762/ijritcc2321-8169.15073

Drug utilization study of antiepileptic drugs in tertiary care hospital

Background: Study of the epidemiology of epilepsy and is of immense value in understanding the causes, outcome and prevention of epilepsy. It is also useful in planning proper services for persons with epilepsy and improving their quality of life. There is an urgent need for studies regarding incidence of epilepsy, prevalence of epilepsy syndromes, risk factors, and pharmacotherapy data from developing countries such as India.Methods: A prospective observational study. All ages, either gender receiving Antiepileptic prescription in epilepsy OPD. 6 months study duration.Results: Prescription of 562 patients was studied. The demographic data revealed that number of male and female patients were 53% and 47% respectively. Generalized tonic-clonic seizures accounted for almost 62%, followed by partial seizures, myoclonic seizures and others (traumatic, infectious, systemic disorder, metabolic derangement). Monotherapy was used in majority of patients.Conclusions: Drug utilization studies have always helped in modifying the prescription guidelines according to the pattern of diseases coming to the healthcare centres. These kinds of studies have an important role in studying and making rational prescription and making drug utilization at most useful to the patients

Seroprevalence of hepatitis B antigenemia among dental students in a private South Indian dental institution

Background: Hepatitis B is the most important infectious occupational disease for the dental health care workers (DHCWs). DHCWs frequently come in contact with blood and saliva and hence are at risk for Hepatitis B virus (HBV) exposure. Studies indicate that DHCWs, through occupational exposure, may have a 10 times greater risk of becoming a chronic hepatitis B carrier than the average citizen.The study was conducted to estimate the seroprevalence of HBV infection among dental students enrolled at a private dental institution in Mysuru, Karnataka, India.Methods: A cross sectional seroprevalencestudy was conducted which included dental students who were enrolled in the dental institution. Data were collected by administering a standard questionnaire to every student regarding their personal health information. Their blood samples were collected and tested by Enzyme Linked Immunosorbent assay (ELISA) for Hepatitis B surface antigen.Results: 352 dental students who gave consent were screened out of a total of 453 dental students. Out of 352 students, 163 (46%) were vaccinated and 189 (54%) were non-vaccinated. All the dental students were found to be seronegative for HBV infection.Conclusions: Though a low rate of HBV infection was observed among dental students, a significant number of dental students were non-vaccinated which suggests a need for proactive implementation of HBV vaccination programme.

Retrospective analysis of prescriptions in the management of lepra reactions: Results of a single center study from tertiary hospital in Maharashtra

Objective: To examine pattern of lepra reaction andmedicines used in the treatment of lepra reactions in a tertiary hospital.Material methods: In this retrospective study, prescriptions of patients treated for the lepra reactions were reviewed to find out prevalence of type 1 and type 2 reactions and medicines used in the treatment of lepra reactions.Results:A total of66 patients (male 59.1%; female 40.9%) with mean age of 36.6 (+13.1) years were included in the study. Multibacillary leprosy was present in 93.7% patients.  A total of 39 (60%) patients had type 2 reaction whereas 26 (40%) had type 1 reaction. Mean number of medicines per patients was 7.5. Prednisolone was used in 62 (93.9%) patients with mean duration of 33.32 (+33.2) days whereas chloroquine was used in 52 (78.8%) patients for 36.6 (+27.9) days. Thalidomide was used in 25 (37.9%) patients. Analgesic and anti-inflammatory and anti-acidity drugs were used in 63 (95.4%) patients each whereas paracetamol was given to 41 (62.1%) patients. Antihistamine, antimicrobial agent and vitamins were given to 27 (40.9%), 27 (40.9%) and 35 (53.0%) patients respectively.Conclusion:Lepra 2 reaction is more common than lepra 1 reaction.  Prednisolone and chloroquine are the two most commonly used medicines in the treatment of lepra reaction. Similarly, thalidomide, older drug has emerged as common treatment for lepra reaction

Drug utilization study in medicine intensive care unit in tertiary care hospital

Background: The medical intensive care unit (MICU) is a setting were patients who are critically ill are admitted and thus usually receive a large number of drugs of different pharmacological classes due to life threatening illnesses which may be fatal. The various drugs used in MICU and there clinical outcome was investigated in this study.Methods: Patients admitted between January 2017 to June 2018 in Medicine ICU of GMC Aurangabad were included in this study.Results: Total of 351 prescriptions was analyzed from the medicine intensive care unit. Out of 351 patients 243 (69.23%) were male, while 108 (30.77%) were female. The mean age of the patients admitted in MICU was 42.78±18.14 years. The most common type of patients admitted in MICU have the diagnosis of organophosphorous poisoning (25.36%), followed by cerebrovascular accident (15.95%), pneumonitis (10.26%), snake bite (7.12%), chronic kidney disease (5.98%), diabetic ketoacidosis (5.70%) and seizure disorder (3.42%). The most common drugs used were ranitidine (99.71%) and ondansetron (99.43%). Among antibiotics cephalosporins were most commonly used, ceftriaxone (39.03%), cefotaxim (40.46%), cefoperazone and sulbactum (24.22%). Other antibiotics most commonly used were metronidazole (61.25%), amoxicillin and potassium clavulanate (26.78%), piperacillin and tazobactum (11.68%), meropenem (11.40%).Conclusions: In conclusion, we found that in MICU utilization rate of gastroprotective (ranitidine), antiemetic (ondansetron) and antibiotics (cephalosporins) was high. The present study provides valuable insight about the overall pattern of drugs used in medicine intensive care unit

Prescribing pattern of nutraceuticals in pediatric outpatient department at tertiary care teaching hospital

Background: Nutraceuticals use is increasing in a health-conscious society. Because of varying lifestyle diseases, people have changed their outlook towards nutraceuticals. The objective of the study was to study the prescription pattern of nutraceuticals by doctors in paediatric outpatient department of government medical college and hospital, Aurangabad, Maharashtra, India.Methods: This study was done between November 2018 to March 2019. Total of 156 patients were included in the study after obtaining written informed consent from parents of patients. The data was gathered, analysed and results were concluded.Results: Total 156 patients were prescribed nutraceuticals in paediatric outpatient department of which 51.92% female patients and 48.78% male patients received nutraceuticals. In this study, 62% patients received vitamins and 38% patients received vitamins and minerals. 67.31% patient receiving nutraceuticals were above the age of 6 years and 32.69% patients were under the age of 6 years. Among patients receiving nutraceuticals, B complex was received 55.77%. After that calcium lactate + vitamin D tablet were prescribed 21.80%. Ferrous sulfate + folic acid was received by 8.33% patients. Calcium carbonate + vitamin D3 were received by 7.69% patients. Folic acid tablet was received by 5.13% patients and poly-vitamin tablet by 1.28% patients. 100% prescriptions were prescribed in generic names.Conclusions: Nutraceuticals are being increasingly perceived as beneficial to health and are being continuously used in the treatment. The future of nutraceuticals is bright and can transform healthcare in a developing country like India

Drugs in pregnancy and lactation

Drug use during pregnancy and lactation is an almost inevitable event. Some of the drugs may have adverse effects on the baby on exposure. It is therefore necessary for the physician to be aware of the changes in pharmacokinetics and pharmacodynamics during pregnancy. Knowledge about the known teratogens and drugs safe to be used during pregnancy is essential on the part of the prescribing physician. There are many factors affecting drug passage into the milk and thus affecting the child in some cases. There are also some drugs affecting lactation. All this data needs to be carefully studied by the physician

DRUG UTILIZATION STUDY IN TRAUMA INTENSIVE CARE UNIT

Objective: Trauma is defined as major public health problem worldwide and associated with significant morbidity and mortality both in developed and developing countries and to study prescription pattern in TICU among head trauma patients. Methods: The study was conducted in Trauma Intensive Care Unit of Department of Surgery in a Tertiary Care Hospital. This was a prospective, observational study done at a Tertiary Care Teaching Hospital. A total of 637 patients enrolled in the present study with fulfilling inclusion and exclusion criteria. Patient’s data recorded in case report form and analyzed to study the prescription pattern. Results: A total of 637 cases were enrolled in this study. Trauma was more common in 499 (78.34%) male followed by 138 (21.66%) female. The average duration of stay in TICU was 3.62±1.38 days. In this study, mortality rate in study was 17.27 %. In the current study, the total numbers of drugs prescribed per prescription in TICU are most commonly between 5 and 8 (55.26%) drugs followed by between 9 and 12 drugs were 37.83%. The present study states that the most common prescribed drugs used were ranitidine (100%) followed by ondansetron (89.64%). Among antimicrobials cephalosporins were most commonly used ceftriaxone (31.08%) and cefotaxime (27.63%). Conclusions: The aim of study is monitoring and evaluation of the prescribers as well as recommends necessary modifications to achieve rational medical care. Study outcomes suggesting that admission to TICU is more in middle age group with mean age of 40.2 years. Average numbers of drugs prescribed were 8.76 drugs per patients which shows the trends of polypharmacy in the prescriptions