DRUG UTILIZATION STUDY IN POST-OPERATIVE PATIENTS IN THE SURGERY WARD OF A TERTIARY CARE TEACHING HOSPITAL IN SOUTH INDIA

Objectives: Pharmacotherapy with multiple agents before, during, and after surgery is marked in the present day indoor hospital setting. The main objective of our research is to evaluate the prescribing and drug utilization patterns using the World Health Organization (WHO) indicators in post-operative patients in the surgery ward of Raichur Institute of Medical Sciences (RIMS) teaching hospital - Raichur, which will help us to use the medicines rationally and decrease the adverse effects in surgical patients.Methods: A retrospective study was done on post-operative patients of surgery ward in RIMS teaching hospital - Raichur. A total of 574 patients prescriptions/case record forms were collected over a period of 15 months from January 2015 to March 2016 from the medical record section of the hospital for analysis and rationalization. We analyzed the data using the various drug use indicators given by the WHO.Results: The average number of drugs per encounter was 7.04. Ranitidine, analgesics, antibiotics, and intravenous fluids accounted for majority of the drugs prescribed. Appendicectomy (34.84%) was most commonly performed surgical procedure. Percentage of encounters in which an antibiotic prescribed was 99.8%. Percentage of encounters with an injection prescribed was 100%. Percentage of drugs prescribed by generic name was 43.93%. Percentage of drugs prescribed from National List of Essential Medicines 2015 was 99.3%.Conclusion: Our study gave us an in general pattern about the use of drugs in post-operative patients in the surgical ward of a tertiary care hospital. Widespread polypharmacy, particularly in case of the antibiotics, lack of generic prescribing are some concerns that need to be addressed to conform to rational drug therapy. However, prescribing according to the national essential list of medicines is good in our study

Non-adherence to anti- diabetic therapy and its consequences among type-2 diabetic patients in a tertiary care hospital

Background: Despite the extensive therapy options available for various stages of type 2 diabetes, studies have indicated that less than 50% of patients achieve the glycemic goals. Failure to attain the desired therapeutic goal might be related to inadequate adherence. Objectives of present study were to determine the extent of non-adherence to antidiabetic medications and identify reasons for the same.Methods: A cross-sectional, observational, questionnaire-based study was conducted to assess the level of non-adherence to antidiabetic therapy among type 2 diabetics attending medicine outpatient department or admitted to the wards of a tertiary care hospital from Jan 2015 to Jan 2016. A pretested and validated questionnaire was used to assess the level of adherence. Reasons for missing medications were also elicited. Data thus collected was analysed using a suitable statistical software.Results: Out of the 210 study participants, 55.2% were females. Most participants were in the age group of 51-60. The mean duration of diabetes was 8.17± 5.39. The most common diabetes-related complication was Diabetic Keto Acidosis (DKA), followed by diabetic foot ulcer. The average number of drugs per prescription was 1.98 ± 1.05. Poor glycemic control was observed in 58% and non-adherence to treatment in 45.2% of study participants.Conclusions: Good adherence to antidiabetic therapy is fundamental for good glycemic control which in turn prevents the occurrence of short and long-term complications of diabetes. Poor doctor-patient intercommunication and inadequacy on part of physicians to adjust medications negatively affect adherence. Active participation of the patient is also equally important

DRUG UTILIZATION STUDY AMONG GERIATRIC PATIENTS IN A TERTIARY CARE TEACHING HOSPITAL IN SOUTH INDIA

Objectives: The objective of our study is to evaluate the drug utilization pattern among geriatric patients in a tertiary care teaching hospital in South India and analyze the prescription pattern. Methods:  Retrospective medical record analysis was performed for indoor cases of the geriatric patients (aged ≥65 years) admitted in medicine wards of Raichur Institute of Medical Sciences teaching hospital, Raichur, from June 2015 to May 2016. They were analyzed for demo graphics, disease pattern  by  system  involved,  disease  diagnosed,  comorbidity  pattern,  most  commonly  prescribed  drugs,  distribution  of  drugs  according  to  their  therapeutic class, evaluation of polypharmacy, route of administration, fixed-dose combinations, and the World Health Organization core prescribing indicators. Results: A total of 400 prescriptions of geriatrics patients admitted in inpatient medicine department were randomly selected and all the required data for the study were collected and evaluated. The majority of patients were found to be in the age group of 65–70 years (70.25%). It was noticed that females (51.75%) were more compared to males (48.25%). The drugs prescribed were analyzed. Ranitidine, ceftriaxone, theophylline, and salbutamol were prescribed to majority of the patients in this study group. The average number of drugs per prescription was 7.42; drugs prescribed by generic name were 33.62%. Among the drugs prescribed, 88.69% were from the National List of Essential Medicines. Total encounters having inject table  preparations were 100% and total encounters having antibiotic prescribed were 91%. The prevalence of cardiovascular disorders (32.5%) was high followed by respiratory disorders (32.25%). Conclusion: This study provides insight into the patterns of drug use in our tertiary care hospital on geriatric patients as well as various diseases prevalent  among  geriatric  patients.  Widespread  polypharmacy,  high  use  of  antibiotics  and  injections,  and  lack  of  generic  prescribing  are  some  concerns that need to be addressed to promote rational usage of drugs

Anti-inflammatory activity of roots of Cichorium intybus due to its inhibitory effect on various cytokines and antioxidant activity

Background: Cichorium intybus L. commonly known as chicory is one of the important medicinal plants commonly used in Ayurvedic system of medicine. It is commonly used for the treatment of diseases involving a khapa and pitta doshas. Traditionally, C. intybus is used for the treatment of inflammatory conditions, but there are only few in vitro studies reporting the anti-inflammatory activity of roots of chicory. Objective: Evaluation of anti-inflammatory activity of roots of chicory and mechanisms involved in it using in vivo models of inflammation. Materials and Methods: Albino Wistar rats of either sex weighing 150-200 g were used. Ethanolic and aqueous extracts of roots of chicory were prepared with the help of Soxhlet′s apparatus. The anti-inflammatory activity was studied using carrageenan-induced paw edema method and cotton pellet granuloma method. Levels of cytokines such as tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and IL-1 and activity of antioxidant enzymes such as catalase (CAT) and glutathione peroxidase (GPx) were estimated. Results: Chicory roots demonstrated significant dose-dependent decrease in paw edema in carrageenan-induced paw edema method. Chicory roots diminished the serum TNF-α, IL-6, and IL-1 levels. They also significantly attenuated the malonylaldehyde levels and increased the activities of CAT and GPx in paw tissue. Similarly, chicory roots demonstrated a significant decrease in granuloma formation in cotton pellet induced granuloma method. Conclusion: Chicory roots possess anti-inflammatory activity, and this might be due to the inhibition of various cytokines, antioxidant effects, and their free radical scavenging activity

Effect of <i>M</i>. <i>philippensis</i> leaves on neutrophil infiltration in rat paw after carrageenan injection.

<p>Values are expressed as Mean±S.E.M. *indicates p<0.05, ** indicates p <0.001 when compared to the control group Aspirin-100mg/kg, Normal Control- Normal saline 1ml/kg, ME-Methanol extract 500mg/kg, EF-Ethylacetate fraction 500 mg/kg, A 4– Active compound of <i>M</i>. <i>philippensis</i> (50mg/kg),.</p

Effects of <i>M</i>. <i>philippensis</i> on MDA, CAT and GPx activities.

<p>Effects of <i>M</i>. <i>philippensis</i> on MDA, CAT and GPx activities.</p

Effect of <i>M</i>. <i>philippensis</i> on dry weight of cotton pellet granuloma.

<p>Values are expressed as Mean±S.E.M. *indicates p<0.05, ** indicates p <0.001 when compared to the control group Aspirin-100mg/kg, Normal Control- Normal saline 1ml/kg, ME300—Methanol extract 300mg/kg, ME500-Methanol extract 500mg/kg, EF300-Ethylacetate fraction 300 mg/kg, EF500-Ethylacetate fraction 500 mg/kg, A 4– Active compound of <i>M</i>. <i>philippensis</i> (50mg/kg),.</p

Effect of <i>M</i>. <i>philippensis</i> on Carrageenan induced paw edema.

<p>Effect of <i>M</i>. <i>philippensis</i> on Carrageenan induced paw edema.</p

Histological examination of paw sections after 3 h of carrageenan injection.

<p>(A) Control group (Normal saline 1ml/kg), (B) Acetylsalicylic acid group(100mg/kg), (C) Ethylacetate fraction group (500mg/kg), (D) Methanol Extract group (500mg/kg), (E) Active Compound 4 group (50mg/kg).</p