Prescription auditing and observational study in a tertiary care hospital

Background: Prescription is an important document written by a doctor which if not written properly can lead to various problems such as adverse drug reactions in patients, incompatibility to follow the instructions to take timely medications and sometimes over dosage due to improper prescription can even lead to death of the patient.Methods: This prospective observational cross-sectional study was conducted over a period of 6 months. The study was conducted in Rajendra Institute of Medical Sciences, Ranchi. Various prescriptions were collected from outpatient care facilities of a tertiary care hospital. Results were analyzed and assessed on 150 prescriptions collected.Results: Total 150 prescriptions were evaluated out of which 49.3% were males and 50.7% were females. Various parameters were assessed during the study which showed that there is still a scope of improvement in prescribing patterns in areas of writing complete prescriptions, prescribing generic medications and mentioning drug dosage forms as well as time of administration in each prescription.Conclusions: The results showed there is still a scope of improvement in writing practices of prescription. The doctor should incur the habit of writing generic names of drug in every prescription. They should adopt proper handwriting skills and no mistakes should be done in a prescription. A good prescription written by a doctor will help in legible practice and will also be very helpful in patient’s care

A comparative assessment of safety and tolerability of metoprolol versus carvedilol in patients of chronic stable angina

Background: Angina pectoris is a clinical manifestation characterized by chest pain typically in substerum radiating to left arm, jaw, back lasting for 1-5 minutes and is relieved by rest. Beta blockers are one of the drugs indicated in angina. The aim of the study is to compare safety and tolerability of metoprolol and carvedilol in patients of chronic stable angina.Methods: The study done is randomized, open label, parallel type where tablet carvedilol and tab metoprolol is given in a group of 50 patients each. The patients were followed thereafter on 8th, 16th, 24th week to study safety in terms of haematological parameters like complete blood count, liver function tests, renal function tests, serum sodium, serum potassium, fasting blood glucose, 2 hours post prandial blood glucose, HbA1C, and Lipid profile and tolerability in terms of side effects. The study was conducted for one year and the data was assessed by relevant statistical analysis where p value <0.05 was considered significant.Results: It was seen that the disease was most common in the age group of 51-60 years with male preponderance, and carvedilol was found to cause non-significant decrease in Serum Triglyceride with no change in total cholesterol, HDL-C, LDL-C was found. No significant changes were observed in metoprolol group. There was no significant difference observed when blood sugar profile and other haematological parameters were considered. Both drugs were considered to be equally tolerable.Conclusions: Compared with carvedilol and metoprolol in patients of chronic stable angina, carvedilol resulted in better lipid profile whereas metoprolol showed no changes in lipid parameters

Evaluation of prescribing pattern of antidiabetic drugs in medicine outpatient clinic of a tertiary care teaching hospital

Background: Diabetes is rapidly gaining the status of a potential epidemic in India with more than 62 million diabetics currently diagnosed with the disease. Drug utilization studies are of paramount importance for the optimization of drug therapy and promote rational drug use among health care providers. The aim of this study was to investigate the drug utilization pattern in type-2 diabetic patients. The objective of the study was to analyse the prescribing pattern of anti-diabetic drugs in a tertiary care hospital.Methods: A prospective, cross-sectional study was carried out in medicine outpatient clinic of tertiary care hospital, RIMS Ranchi for a period of 7 months. The data was analysed using WHO core indicators and Microsoft Excel 2013.Results: The total number of encounters surveyed was 94. Avg no of drugs per prescription was 3.04. Percentage of drugs prescribed by generic name was found to be 34.2%. Percentage of prescriptions was a) with antibiotics was 27.6%, b) with insulin was 14.89%, c) from essential drugs list 44.05%. Most common co morbid disease was found to be hypertension present in 27.6% cases.Most commonly use drug was found to be metformin followed by glimepiride.Conclusions: Implementation of WHO core prescribing indicators by the prescribers would help us to reduce the cost, to recognize and prevent potentially dangerous drug- drug interaction and antibiotic resistance

Case Report Rosai Dorfman Syndrome with Extranodal Manifestation

Abstract Rosai Dorfman Syndrome (RDS) is a benign condition and a rare cause of cervical lymphadenopathy. It usually occurs in the first decade of life and manifest as massive enlargement of cervical lymph nodes. The disease has a benign course and involvement of the nasal cavity as an extranodal site is exceptional. A 22-year-old male presented as progressive massive bilateral cervical lymphadenopathy accompanied with nasal obstruction and occasional episodes of epistaxis. A FNAC from cervical lymph node and biopsy from nasal mass was compatible with RDS.