International Journal of Basic & Clinical Pharmacology
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A study on the contents of prescription of the in-patients of a tertiary care hospital, Manipur
Get PDFBackground: Appropriate medications are the backbone for effective control of infections and diseases. Objective of the study was to analyse the prescriptions relating to national list of essential medicines (NLEM) of a tertiary care hospital.
Methods: Data was collected from 525 case sheets of the surgical in-patients for a period of 1 year which included total number of drugs prescribed, single (NLEM/non-NLEM) drugs, fixed dose combinations (NLEM/non-NLEM) drugs, most common drugs (NLEM/non-NLEM), route of administration, ADR/ADE and herbal drugs. Descriptive statistics was used for analysis of the data.
Results: The total number of drugs observed in the case sheets was 2575. Out of the total drugs, 1942 drugs (75.4%) were from the list of NLEM (2022) while 633(24.6%) drugs were of non-NLEM. 266 drugs (10.33%) were generic drugs and 2309 drugs (89.67%) were proprietary drugs. The total number of single drug was 1839 (NLEM, 1805 + non-NLEM, 34) and that of the total FDC was 736 (NLEM, 137 + non-NLEM, 599). The most common drugs which were prescribed were analgesics: paracetamol 517 (NLEM); diclofenac supp.14 (non-NLEM), antibiotics: ceftriaxone 258 (NLEM, 14.5%), cefpodoxime proxetil 3 (non-NLEM, 8.9%), antihypertensive: telmisartan 13 (NLEM, 0.7%), non-NLEM nil, anti-diabetics: metformin 15 (NLEM, 0.8%), dapagliflozin 6 (non-NLEM, 16.7%), and gastroprotective drugs: pantoprazole 493 (NLEM, 27%), non-NLEM nil.
Conclusions: Non-NLEM drugs should be prescribed only when there is definite advantages of the same over the NLEM drugs. Prescription of proprietary FDC drugs, factors for non-availability and under-prescription of NLEM drugs should be highlighted through CME coupled with awareness about the aim and objectives of the NLEM during clinical practice to the prescribers
Comparison of efficacy of methylprednisolone with dexamethasone in moderate to severe COVD-19 patients in a tertiary care hospital
Get PDFBackground: The aim was to compare efficacy of methylprednisolone with dexamethasone in moderate to severe COVID-19 patients in a tertiary care hospital.
Method: A retrospective observational study was conducted by collecting data of moderate to severe COVID-19 patients admitted to covid wards of a tertiary care hospital for a period of six months. Demographic data, information about SpO2 changes, duration of hospitalization, marker status and ventilation status were parameters collected and used to compare between two groups.
Results: Total number of patients in this study were 130. Out of which 65 patients who were on Methylprednisolone belonged to group A and 65 patients taking dexamethasone belonged to group B. In group A 56 (86.2%) were males and 9 (13.8%) were females. In group B 51 (78.5%) were males and 14 (21.5%) were females. Mean age in group A was 54.75±14.96 (age range b/w 25-80 years) and in group B was 55.43±15.83 (age range between 23-84 years). Patients in group A showed more presence of comorbidity (44.6%) as compared to group B (32.3%). Mean SpO2 level on day 1 in group A was 86.37±7.58 and in group B was 88.11±4.38. On day of discharge mean SpO2 level was 95.05±1.54 in group A and 94.63±2.09 in group B. Mean length of hospital stay in group A was 9.78±7.38 and in group B was 7.88±4.76. Improvement in marker status for group A was 100% and for group B 95.4%. Ventilation status in both groups showed 100% improvement.
Conclusions: Both steroids are effective in management of moderate to severe COVID-19 patients
Hemovigilance: knowledge, attitude and practice among postgraduates and interns of a tertiary care hospital
Get PDFBackground: Adverse reactions due to transfusion of blood and blood products should be reported for the betterment of patients health and to minimize such effects in the future. A Program was initiated to report and reduce incidence of adverse reactions to blood products which is hemovigilance program of India. Aim was to evaluate the knowledge, attitude and practice of haemovigilance among postgraduates and interns.
Methods: This was a cross-sectional questionnaire-based study conducted among 159 participants of a tertiary care hospital for a period of 1 month.
Results: Results obtained were analysed using descriptive and qualitative statistics. About 83.6% of the participants were aware about the concept of Haemovigilance. Only 23 out of the 159 had reported transfusion reactions in the past but the attitude towards this concept was satisfactory.
Conclusions: Overall the participants had a less satisfactory overview of this concept and hence educational interventions can aid in serving the purpose
Nivolumab-induced immune mediated eczematous dermatitis in patient with carcinoma of buccal mucosa
Get PDFAn elderly man undergoing treatment for carcinoma of left buccal mucosa experienced the appearance of skin lesions on his chest, both upper limbs, and both lower limbs after receiving the first cycle of nivolumab therapy. A biopsy report confirmed that the patient had eczematous dermatitis, which was believed to be induced by nivolumab. Patient received symptomatic treatment with Prednisolone, Clobetasol propionate and Fusidic acid. The Skin lesions improved, and subsequently Framycetin cream was recommended, resulting in no further recurrence of lesion. Clinicians should remain vigilant about development of T-cell activation-related skin disorders when administrating immune checkpoint inhibitors, such as nivolumab
A descriptive study on awareness and attitude of medical undergraduates about the transgender population and their healthcare needs
Get PDFBackground: Medical education in transgender health care can empower physicians to identify and change the systemic barriers to care that cause transgender inequities as well as improve knowledge about transgender specific care. The objective of this study is to estimate the awareness among medical students about the terms related to transgender and their healthcare needs, to create an environment of inclusivity and educate the undergraduate MBBS students to provide highest level of care and advocacy for transgender population and to stress on the fact that the transgender education in the medical curriculum is an inevitable one in the modern medical practice.
Methods: Knowledge questionnaire and TABS scale questionnaire was distributed to the 150 students through Google forms and their responses were collected. Knowledge questionnaire was given a score as 1 point for each (28 points). TABS questionnaire was assessed with Likert scale.
Results: 52.6 percentage of the students have scored below the median and remaining 48.4 percentage of students have scored above the median score. The undergraduate students have a basic understanding about the healthcare needs of the transgender population and attitude towards transgender is on par with population of similar age group
Conclusions: It is been observed that more knowledge regarding the terms about transgender population and their healthcare needs is needed for undergraduate students. A good curriculum to teach about basic health needs of transgender population has to be discussed
Comparison of medication adherence in patients with type 2 diabetes mellitus: a pre and post study
Get PDFBackground: Type 2 diabetes mellitus refers to a group of heterogeneous disorders with the common elements of chronic hyperglycemia. Diabetes medications play a crucial role in lowering blood sugar levels. The study aims to compare medication adherence in patients with type 2 diabetes mellitus from urban and rural areas during pre and post visit.
Methods: This pre and post-study was conducted from March to August 2022. A total of 104 participants were enrolled. Details have been obtained through data collection form. Medication adherence was measured using Hill-Bone medication adherence scale, and patient education was provided through leaflet.
Results: The study included 54 females and 50 males. The correlation between medication adherence versus disease knowledge and drug knowledge was found out using Pearson’s correlation and the result is statistically significant. The medication adherence was found to be increased by 17.3% and 21.2% in rural and urban areas respectively. Inadequate follow-up and financial barriers were most accounted for medication non-adherence.
Conclusions: The majority of type 2 diabetes patients have suboptimal treatment adherence which is associated with poor blood sugar control. We clinical pharmacists can tackle this problem of adherence through quality patient education
Impact of pharmacist counseling on the clinical outcomes in the management of type 2 diabetes mellitus outpatients admitted to a hospital
Get PDFBackground: Type 2 Diabetes mellitus remains a global health problem due to its poor clinical outcomes, high morbidity, and mortality caused by many complicated problems, one of which is the ineffective role of pharmacists in providing counselling to DM patients
Methods: This pre and post cohort study analyzed the impact of pharmacist counselling on the blood glucose level and glycosylated hemoglobin (HbA1C) of T2DM outpatients (n=88) admitted to Asahan General Hospital period June to December 2022. Counselling provided comprised the importance of medication adherence and non-pharmacological approaches. Characteristics, BGLs and HbA1C of the patients were extracted from their medical records before and after counselling using a predetermined questionnaire. Characteristics of the patients were descriptively analyzed.
Results: The significance of the counselling on these outcomes was analyzed by applying Wilcoxon test (p <0.05 was considered significant). The mean age of the patients was 57.89±9.75 (years). Most (57.95%) of them were female. Proportion of the patients with controlled BGLs (%): before counselling, 27.7; after counselling, 89.8. Proportion of the patients with controlled HbA1C (%): before counselling, 27.3; after counselling, 89.8. Pharmacist counselling significantly improved the clinical outcomes of T2DM patients, p=0.000.
Conclusions: Pharmacist counselling plays an important role to improve BGLs and HbA1C in T2DM patients which can finally improve their quality of life
Knowledge and attitude towards pharmacovigilance among healthcare students at a medical college in Nepal
Get PDFBackground: Pharmacovigilance is the science and activities relating to the detection, assessment, understanding, and prevention of adverse drug reactions (ADRs) and any other possible drug-related problems. Under reporting of adverse drugs reactions are the global health problem. The adequate knowledge and skills towards pharmacovigilance and adverse drugs reactions reporting are crucial for the health care students to ensure patients’ medication safety. This study aims to assess the knowledge and attitude of the health care students towards pharmacovigilance and ADRs.
Methods: A closed ended, structured, self-administered questionnaire was administered to 204 undergraduate health care students to collect the data. Data were analyzed using SPSS version 21. Non-parametric tests (Mann Whitney U test and Kruskal Wallis test) were used for analysis.
Results: Among 204 respondents, the majority of them had a poor knowledge (91.18%) and positive attitude (87.25%) towards Pharmacovigilance. The inter quartile range (median) score of the respondents’ knowledge was 5.0±2.211 and attitude was 27.0±2.88 towards Pharmacovigilance and ADRs reporting. The main reason for under reporting of ADRs was difficulty to decide whether ADR has occurred or not (32.4%) due to the lack of appropriate knowledge and training. There is a poor knowledge and positive attitude towards Pharmacovigilance.
Conclusions: Adequate coverage of Pharmacovigilance and ADRs reporting issues should be covered in the curriculum as well as hand on training and workshop should be conducted to increase the knowledge and confidence in detecting, monitoring and reporting ADR in their clinical posting
Polymyxins leading to nephrotoxicity
Get PDFDrug resistance gram-negative bacteria are the most hazardous type of germ because they cause life-threatening illnesses. Polymyxins are cyclic lipodecapeptide antibiotics that are effective against gram-negative bacteria like Acinetobacter, Pseudomonas, and other Enterobacteriaceae (such Klebsiella, Escherichia coli, and Serratia). Polymyxins kill bacteria by rupturing the bacterial outer membrane (OM). The main side effect of this antibiotic class is the development of kidney damage. Transposable genetic elements, such as MCR genes, can encode bacterial resistance to polymyxins. Colistin's prodrug is colistimethate sodium (CMS). Polymyxin dosage should be modified based on renal function. Polymyxins have demonstrated excellent clinical results, which have aided in the development of a better dosage regimen. Monte Carlo simulations were used to determine the most effective polymyxin dosages. Polymyxin resurgence has resulted in the eradication of multidrug resistant gram negative bacteria
Comparing the antiepileptic effects of atorvastatin, celecoxib, ashwagandha, clove oil, and Sodium valproate on chemo-shock induced seizures in male Wistar albino rats
Get PDFBackground: Antiepileptic potential of statins, COX inhibitors and other herbal medications are to be evaluated in experimental animals so that the most efficacious can be translated for human use as an adjunct to the commonly used anti-epileptic drugs.
Methods: This experimental animal study grouped 30 male Wistar albino rats into 6 groups with each containing 5 rats of which one group was control, one was the standard drug and the other 4 were treatment groups which received Atorvastatin, Celecoxib, Ashwagandha and Clove oil. These drugs were administered 30 minutes prior to administering Pentylene-tetrazole which induced convulsions and the various seizure parameters were analysed. The blood samples of the animals were also assessed for anti-oxidant activity by measuring superoxide dismutase and catalase levels in the blood.
Results: The onset of seizure was significantly delayed by Ashwagandha (2.55±0.94), similar to the latency shown by the standard drug (2.09±1.21). The duration of convulsions was very significantly reduced in all the 5 drug groups in comparison to the control (p<0.001). The clonic jerk duration was not reduced as effectively as the standard drug. The duration of recovery time amongst the various groups was also significant (p<0.05). The SOD and Catalase levels of no groups showed any possible association between the anti-epileptic efficacy of these drugs and the anti-oxidant enzyme levels.
Conclusions: Ashwagandha has good anti-epileptic efficacy not less than the standard drug when the various drug groups were compared