A questionnaire-based survey among clinicians and postgraduates regarding knowledge, awareness and practice of p-drug in Government General Hospital, Rangaraya Medical College, Kakinada

Background: P-drug is a personal or preferred or priority choice drug of a clinician. The aim of the study is to evaluate knowledge, awareness, practice of p-drug which helps the clinician to prescribe drugs rationally.Methods: The study was a prospective cross-sectional pre-validated questionnaire-based study conducted in Government General Hospital, Rangaraya Medical College, Kakinada. During the study period a total of 300 members were enrolled and instructed to fill the questionnaire forms. These filled forms were collected and data were analyzed.Results: Out of 300 members, 240 filled the questionnaire, and these forms were evaluated. Among them 16.6% were aware of p-drug, 27.5% were aware of P treatment, 32.5% were not including FDC’s in their p drug list, 28.33% were aware of advantages of prescribing P drug and 82% felt that teaching programs were needed for preparing p drug list.Conclusions: For promoting and achieving rational use of medicine, P drug concept is one of the milestones. As few were aware of p-drug concept, institutional teaching review board should conduct teaching programs regarding p drug concept

Randomized double blind comparative study on efficacy and safety of oral oxaceprol 200 mg versus oral diclofenac 50 mg in patients with moderate osteoarthritis

Background: Osteoarthritis of knee is the most common form of arthritis globally, approximately 250 million people are suffering from osteoarthritis of the knee alone throughout the world. It is a chronic joint disease leading to cause cartilage degradation that involves synovial Inflammation, Subchondral bone remodelling, and Formation of osteophyte pathologically, which leads to cause pain, joint destruction and difficulty in walking. Aim of the current study was to compare the safety and efficacy of oxaceprol 200 mg versus diclofenac 50 mg in patients with moderate osteoarthritis and to determine cost-effectiveness between these two drugsMethods: this is a randomized controlled study, in our study total of 94 patients were screened, of which 85 patients met inclusion & exclusion criteria. In this, 78 members gave written informed consent, they were randomly assigned by double-blind fashion into two treatment groups (oxaceprol and diclofenac). Results were analyzed by applying paired and unpaired student t-test by using SPSS softwareResults: In our study, both oxaceprol and diclofenac were extremely significant in reducing joint pain and joint stiffness and improving physical activity, but when comparing with one another oxaceprol group showed better results in improving physical activityConclusions: From our study, it is concluded that oxaceprol is equally efficacious as diclofenac in reducing knee pain, joint stiffness but more efficacious than diclofenac in improving physical activity of patients by enhancing bone remodelling

A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression