Awareness and impact of educational intervention regarding kangaroo mother care among pediatricians of Marathwada region of Maharashtra

Objective: The objective of the study was to compare knowledge and attitudes toward kangaroo mother care (KMC) among pediatric practitioners in Marathwada region before and after a workshop on KMC. Material and Methods: A prospective comparative study was conducted among 40 pediatricians practising in the rural area of Marathwada region. Clinicians having at least Level 2 neonatal intensive care unit setup at their place were enrolled in the study. Every pediatrician satisfying the selection criteria and willing to participate was enrolled in the study. They were given a questionnaire, consisting 25 questions, which were supposed to be answered at the time of enrolment, i.e., pre-test. After that, the participant was given a short booklet on KMC to read, and then after a gap of 7 days, the participant attended a workshop on KMC for 4 h, in which details regarding KMC, advantages of KMC, and videos showing actual practice of KMC were shown to participants. After completion of workshop, participants were given the same questionnaire and pre- and post-test scores were calculated. Results: The mean score in basic knowledge was 2

Study of potential drug interactions between prescribed drugs in geriatric patients attending outpatient department in a government tertiary care hospital in Maharashtra

Background: A drug interaction is defined as a modification of the effect of a drug when it is administered with other drugs. Geriatric population is exposed to multiple drugs and consequently suffers many drug interactions (DIs). The objective of this study was to assess the potential drug interactions (PDI) in the geriatric population attending out-patient department (OPD) in a tertiary care hospital.Methods: A cross sectional observational study was carried out from July to September 2015. Patients of either gender, age 60 years or more, attending OPD in tertiary care hospital and prescribed two or more drugs, were included in the study. Prescriptions of medical officers were screened for PDIs with Medscape drug interaction software available on the website www.medscape.com.Results: In the present study, out of 600 prescriptions, 48.50% were identified having at least one drug interaction. Total 584 PDIs were found in 111 drug pairs. 29.62% PDIs were pharmacodynamic, 42.80% pharmacokinetic type and 10.78% PDIs were found affecting serum potassium level. Majority of PDIs (61.81%) were found significant followed by minor (36.98%) and severe (1.19%). Ranitidine and cyanocobalamin was the most common pair showing PDI (105) followed by aspirin and enalapril (44). Aspirin was found to be the most common single drug amongst pairs to cause PDI in the present study.Conclusions: In the present study, PDIs were studied in geriatric population. Knowledge of the prevalence and predictors of clinically important PDIs will help physicians and pharmacists identify patients at higher risk of adverse drug interactions requiring more cautious pharmacotherapy

DRUG UTILIZATION PATTERN IN GERIATRIC PATIENTS ATTENDING OUT PATIENT DEPARTMENT AT RURAL TERTIARY CARE HOSPITAL IN MAHARASHTRA.

Objective: To observe a prescription pattern in elderly patients attending outpatient department (OPD) and evaluating prescriptions according to theWorld Health Organization (WHO) prescription indicators.Methods: A cross-sectional observational study was conducted from July to September 2015. Patients of either gender, age 60 years or more, attending OPD in tertiary care hospital were included in the study. Prescriptions of medical practitioners were collected and evaluated for demographic data and the WHO drug prescribing indicators.Results: A total of 600 patients were enrolled in the study. The majority of the patients were in the age group 60-69 years (66.33%) with male preponderance (61%). The average number of drugs per prescription was 3.41. Out of 2045 drugs prescribed, 1261 drugs (61.66%) were prescribed by their generic name and 784 drugs (38.33%) were prescribed by their brand name. 1700 drugs (83.12%) prescribed were from the WHOs essential medicines list 2015. Total encounters involving injectable usage were 0.15%. Drugs acting on the cardiovascular system (21.12%) were the most frequently prescribed, followed by nonsteroidal anti-inflammatory drugs (NSAIDs) (20%). Ranitidine (16.62%) is the most frequently prescribed drug. Conclusions: In this study, drug prescription pattern was rational as per the WHO drug prescribing indicators. However, issues such as polypharmacy and inaccuracies of dose and duration were seen.Keywords: Drug utilization study, Geriatric, Outpatient department, Rational use of medicines

Study of drug prescription pattern in ischemic heart disease patients

Background: Drug utilization pattern studies helps to screen, assess and propose appropriate modifications in prescription practices, this would help to make patient care rational and cost effective. Study was intended to analyse the drug prescribing pattern for treatment of Ischemic heart disease using WHO indicators.Methods: This is a cross sectional observational study conducted on ischemic heart disease patients admitted at inpatient department of medicine in a tertiary care teaching hospital. The study consisted of analysis of drug utilization pattern of prescribed drugs.Results: IHD was more commonly seen in males (70.06%) than females (29.94%). IHD was most commonly seen in patients of age group of 61-70 year. Drugs prescribed to patients belong to various therapeutic classes ranging from anti-platelets, anticoagulants, anti-anginal, antithrombin, thrombolytic, hypolipidemics. The most commonly prescribed therapeutic class of drugs was antiplatelet (86.26%) followed by hypolipidemic (82.25%) and ACE inhibitors drugs (46.60%). Average number of drugs per encounter was 7.70. Drugs were prescribed by their generic names were 29.99%. Out of total study group 22.06% patients were prescribed at least one antibiotic. Injections were prescribed only in 1392 (27.86%) out of 4995 drugs. Of total drugs 3270 (65.45%) of drugs were from National List of Essential Medicines-2016 (NLEM -2016) and 2774 (55.53%) drugs prescribed were from WHO-EML-2016.Conclusions: Risk of artery disease increased with increasing age. IHD was more common in males than females. The most commonly prescribed drug classes in Ischemic heart disease were anti-platelet drugs followed by hypolipidemic agents

Study of drug prescription pattern among COPD patients admitted to medicine in-patient department of tertiary care hospital

Background: Drug utilization studies can provide insights into a pattern, quality, determinants and outcomes of drug use. COPD is one of the leading causes of death among Indian population and there is a lack of drug utilization studies in this field.Methods: A prospective, observational study was conducted among the patients admitted in inpatient department of medicine ward of Tertiary care hospital. Data has collected from COPD patients admission records. Parameters like demographic profile, common associated diseases, WHO core drug indicators and commonly prescribed drugs were assessed from the prescriptions.Results: A total 284 inpatient records were scrutinized. Out of 284 patients, 66.19% were male and 33.80% were female. Average numbers of drugs per prescription were 7. Mean age was 66.9 years. Antimicrobials (88.7%) were most commonly prescribed drugs followed by inhaled bronchodilators (84.5%).Conclusions: Study data highlights that average numbers of drugs prescribed were higher than WHO norms, antibiotics were commonly used, and drugs prescribed with brand names were higher than the generic names

Drug utilization pattern in geriatric out patient in tertiary care hospital

Background: Inappropriate drug prescribing is a global problem affecting the healthcare system. Aim and objective of the study was to study the drug utilization pattern in geriatric patient at rural tertiary care hospital.Methods: This was a cross- sectional observational study involving 600 geriatric outpatient. This study was carried out from Nov 2015 to May 2016. The data were collected using predesigned proforma specially designed for this purpose. Relevant information was obtained by analyzing prescription for World Health Organization (WHO) core drug indicators.Results: Total number 600 prescriptions analyzed at the end of six months were from general medicine department. The mean age of the patients was 63.9 years in which male (61.33%) outnumber the female. Total number 2598 drugs were prescribed to 600 patients for different diseases. The mean number of drugs per prescription were 4.33, drugs were prescribed by generic name 26.42%. drugs were prescribed from WHO essential drug list86.33. The type of formulations used were tablets and capsules in 88.5%, syrups in 5%, injections 3.5 % and inhalers 2%. Drug for Cardiovascular diseases were the most common (29.66) followed gastrointestinal (16.67), vitamins and minerals (14.66). Analgesic and NSAIDS (14.13) also prescribed commonly. Antimicrobial drugs prescribed in (7.46%) and common antibiotic prescribed were Amoxicillin ciprofloxacin and metronidazole.Conclusions: This study also effectively provides very useful baseline data also demonstrates the prescribing patterns of drugs in the geriatric patients

Experimental evaluation of analgesic activity of PPAR γ agonists: pioglitazone and rosiglitazone

Background: To evaluate analgesic activity of pioglitazone and rosiglitazone by tail flick method in rats and acetic acid induced writhing method in mice.Methods: Albino wistar rats of either sex weighing 180-200 g and Swiss mice weighing 25-30 g were used. Study was conducted after approval from the Institutional Animal Ethics Committee. The tail flick method in rats described by D’Amour and Smith (1941) and acetic acid induced writhing in mice were used. The dose of pioglitazone and rosiglitazone were 20 mg/kg and 10 mg/kg respectively.Results: In tail flick method of analgesia, both, pioglitazone and rosiglitazone have analgesic activity which was statistically comparable to aspirin. In acetic acid induced writhing model of analgesia, the action of pioglitazone and rosiglitazone was significantly greater than the control group but it was less when compared to aspirin.Conclusions: Analgesic activity of pioglitazone and rosiglitazone was comparable to aspirin in tail flick model of analgesia in rats while it was significantly less when compared to tramadol. Analgesic activity of pioglitazone and rosiglitazone was significantly less than aspirin in acetic acid induced writhing method

STUDY OF GENERALISED ANXIETY DISORDER AND FACTORS AFFECTING IT DURING POSTNATAL PERIOD.

ABSTRACT   Background: Anxiety disorders remain the commonest mental disorder in general population. Both these disorders are common in pregnant women and postpartum period and are underdiagnosed. There is a paucity of research on mental disorders and their risk factors among women during postnatal period in India. This study aims to estimate the incidence of generalised anxiety disorder (GAD) and depression and explore the common associated factors among postnatal women in India. Aim: The present study aims to study the incidence and risk factors of generalised anxiety disorders among mothers attending the outpatient department clinic (OPD) for vaccination of their children or gynaecology OPD for follow up. Methods: Total of 180 women of postpartum period, up to 6 months, was randomly selected and assessed using self-report questionnaire GAD-7 for GAD. General demographic details were obtained via a revalidated proforma. Incidence and risk factors for both these mental disorders were assessed. Results: The incidence of GAD was found to be 31.11%. Primigravida mothers scored higher on GAD-7 score than multigravida mothers and incidence of GAD was also higher in primigravidas mothers (p=0.042). There was no significant association between age of mother, socioeconomic status of mother, and sex of the child born, with development of GAD in the postnatal period. Substance abuse in husband was significantly related to development of GAD in women in postnatal period. Conclusion: A significant proportion of women had generalised anxiety disorder. Pregnancy for the first time was associated with increased risk of GAD. Substance abuse by husband is significantly associated with development of GAD and depression during postnatal period

ANALGESIC PROPERTY OF ANGIOTENSIN AT1 RECEPTOR ANTAGONIST: CANDESARTAN IN RATS AND MICE

  Objective: The objective was to evaluate analgesic activity of candesartan in graded dose in tail flick method in rats and acetic acid-induced writhing in mice.Methods: Wistar Albino rats of either sex weighing 200-250 g or Swiss Albino mice of either sex weighing 20-25 g. Analgesic activity of candesartan (5 mg/kg, 10 mg/kg, 15 mg/kg.) was evaluated in graded dose and compared with tramadol (10 mg/kg) and aspirin (100 mg/kg) using tail flick response method and acetic acid-induced writhing of analgesia. Study was conducted after approval from the Institutional Animal Ethics Committee, which is an approved body by Committee for the Purpose of Control and Supervision of Experiments on Animals letter no. 78 dated October 18, 2012.Results: In the present study, oral administration of candesartan showed analgesic activity at high dose compared to the control and less analgesic activity as compared to the standard in analgesic methods. In tail-flick method, after 30-90 minutes of drug administration, tail flick latency of candesartan (15 mg/kg) was significant (p<0.05) compared with control but less than that of tramadol and aspirin. In acetic acid induced writhing method, the analgesic activity of candesartan was significant only at high dose (15 mg/kg) compared to the control.Conclusion: Candesartan possesses analgesic activity only at high dose. However, further studies need to be carried out to see underlying mechanism candesartan in analgesia and to know the extent of analgesia.Keywords: Acetic acid induced writhing method, Angiotensin II receptor blockers, Candesartan, Tail flick metho

Medication errors, what healthcare providers think? A Knowledge, Attitude and Practice survey.

Objective: Evaluation of knowledge, attitude and practice of healthcare providers about Medication errors.   Method: It was a KAP survey conducted with the help of specially designed and pre-validated questionnaire. Doctors', nurses' and pharmacists' awareness and perception about Medication errors were assessed. KAP survey questionnaire was analyzed and their question-wise percentage value was calculated. Data was analysed with One-way ANOVA followed by Dunnets post-hoc test and descriptive statistics were applied whenever necessary.   Results: Response rate amongst healthcare providers was satisfactory. Doctors' knowledge and practice were significantly higher compared to the nurses and the pharmacists. Their perception when analysed, revealed that most of the participants consider medication error as an important problem which can be prevented. There is a difference of opinions as regards to the liability for legal punishment to the personnels responsible for such incidences, thus considering it as a crime.   Conclusion: There is awareness regarding Medication errors, yet certain circumstances which significantly contribute in occurrence of these events need to be overcome. Regardless of the availability of few solutions, as this area of practice is least approached, further research is warranted in various interventions to deal with the same. Key words: Awareness, Doctors, Medication errors, Nurses, Pharmacists