Comprehensive analysis of theory exam question papers of 2nd MBBS Pharmacology subject in Rajiv Gandhi University of Health Sciences, Karnataka, India

Background: Assessment is the backbone of curriculum development and an important component of medical education. Written exams are frequently used in medical education and question papers are important instruments of assessment of medical education. The present study is summative question paper based analysis study where the content validity, level of cognition, cognitive domains, marks distribution and time weightage in theory question papers were analyzed.Methods: Retrospective analysis of II MBBS pharmacology question papers (n=18) of RGUHS, Bengaluru from the year 2010 to 2018 was done. The data was analyzed according to modified Blooms levels of taxonomy, cognitive domains, areas of importance and weightage given to different topics in Paper 1 and 2 in comparison to university syllabus and with regard to time allotted in university syllabus.Results: Analysis of question papers revealed that topics like GIT, respiratory system, uterine drugs, antiseptics and disinfectants, immunosuppressant were consistently underrepresented in question papers. Also, majority of questions (68.06%) did not have any verbs associated with Blooms level of taxonomy and hence did not meet criteria of standard question paper. Comparison of time allocation to weightage of topics in syllabus revealed no significant variations in percentage distribution.Conclusions: Assessment in medical education should not be used merely for classification, grading and certification rather it should become an instrument for promoting growth of knowledge. For this the university should frame standard blueprint for question paper setters and the question paper setters should follow those guidelines strictly and ensure that weightage given for different topics is maintained

Analysis of adverse drug reactions in a tertiary care teaching hospital in Southern India

Background: Medication use has been there since time immemorial. Also, it was well known that all medications carry risk of adverse drug events. Hence regular and periodic monitoring of medications for adverse events has assumed importance. With this background pharmacovigilance has an important role to play in monitoring of adverse events to medications. Hence the present study was undertaken to analyze the pattern of adverse events reported to a tertiary care teaching hospital in Southern India (Shivamogga Institute of Medical Sciences (SIMS), Shimoga).Methods: This study is a retrospective observational study of 150 adverse drug events reported at McGann teaching hospital, SIMS, Shimoga. The adverse events reported were analyzed for their age and gender distribution, drugs causing ADRs, organ systems affected, causality, type, severity and preventability of ADRs.Results: Patients in age groups of 21-40 were most commonly affected by ADRs with a slight increase in male population affected. Cutaneous ADRs were most common and beta lactam antibiotics were most common drug group implicated in causing these ADRs. Probable/likely category most common WHO-UMC causality category, with type A ADRs being most common. Majority of ADRs were of moderate severity and nearly 86% of ADRs were of not preventable category.Conclusions: Antimicrobials were most commonly involved in causation of ADRs with cutaneous ADRs being most common. Most of ADR were not preventable category, majority of ADRs were of moderate severity and causality grading was probable/likely category

Cost analysis study of price variation among the various brands of antiepileptics available in India

Background: One of the major cost that the patient has to bear during therapy is medication cost Different brands of the same mediations are available leading to considerable price variation. This can affect medication compliance by the patient. The present study was undertaken to evaluate the variation in costs of antiepileptic’s available in India.Methods: Cost of all antiepileptics (tablets/capsules) available in India was obtained from CIMS July to Oct 2016 and from IDR Vol XXII issue No 3, 2016. The percentage cos ratio and percentage variation in cost were calculated and compared.Results: The highest cost ratio and percentage price variation was found with carbamazepine 200mg (1:12 and 1100) followed by acetazolamide 250mg (1:11.38 and 1037.68). Other significant cost variations (>100%) were seen with carbamazepine 100mg, phenobarbital 30mg, divalproex sodium 25mg, lorazepam 1mg, clonazepam 1mg and valproic acid 500mg. Lowest percentage cost variation was seen with oxcarbazepine 450mg (1.09), lacosamide 50mg (2.56), pregabalin 50mg (3.51) and zonisamide 50mg (4.21).Conclusions: The Government of India regulates prices of essential drugs through Drug Price Control Order (DPCO) and this is implemented by National Pharmaceutical Pricing Policy (NPPA). However nearly 80% of medications donot fall into this category. This leads to considerable economic burden on poor patients. There is still considerable price difference among various brands of antiepileptic available in India. The Government of India should take a firm decision and implement them with regard to pricing of medications so as to make them more affordable, especially for diseases which require long term treatment such as epilepsy