International Journal of Basic & Clinical Pharmacology
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A study of drug prescription patterns, disease-therapy awareness and of quality of life among patients with migraine visiting a tertiary care hospital in Mumbai, India
Get PDFBackground: Migraine is one of the leading causes of disability globally. There is scarcity of data on disease -therapy awareness and its correlation with demographic factors. Hence its was of interest to assess those along with quality of life in these patients.
Methods: A Cross-sectional observational study was conducted in108 patients attending the Neurology and headache OPD at a tertiary care hospital between March 2017 and August 2018. Disease and therapy awareness among patients were evaluated using validated questionnaires and correlation was done with demographic factors. The severity of the disease and its impact on the patients' quality of life were assessed using the migraine disability assessment scale.
Results: The mean disease and therapy awareness scores were 9 and 7 respectively. Both had a positive correlation with education and socioeconomic factors. The quality of life was affected moderately in 48.1% of the patients followed by severely 32.4% of the patients. The average number of drugs prescribed per encounter was 3.05. NSAIDS were used more commonly as compared to Triptans for acute attacks.
Conclusions: The disease and therapy awareness were fair and positively correlated with education/ socioeconomic status. However, a significant disability was found among patients even with treatment. This highlights the need for educating these patients for effectively controlling the disability
Comparison of various decalcifying agents to evaluate their efficacy
Get PDFBackground: Bone is a biological complex structure primarily comprising collagen and minerals. It is important to demineralize these mineralized tissues to remove their calcium apatite crystals for analysing the sub-cellular, cellular, and fibrillar architecture. Six demineralizing agents’ efficacy was examined by assessing their duration, ease of handling tissue, staining, and histological criteria. The present study aimed to evaluate six commonly used demineralizing agents to identify the best decalcifying agent.
Methods: Twenty resected hard tissue specimens (1 cm × 1 cm x 1 cm) from the archives were used in the study. These segments were decalcified by solutions namely 10% nitric acid, 10% formic acid, 14% ethylene di amine tetra acetic acid (EDTA), a mixture of formic acid and hydrochloric acid (formic + HCL) 4% each, and a mixture of formic acid and nitric acid 4% each (formic + HNO3), 10% formal nitric acid further subjected to radiographic endpoint test.
Results: The present study confirmed the fact that samples treated with EDTA showed the best overall impression in terms of tissue integrity and histology followed by 10% formal nitric acid which gave fairly good cellular details and was also rapid in the action.
Conclusions: Based on the present study findings, we suggest that 10% formal nitric acid is the better decalcifying agent available, considering time and tissue integrity as two main factors
A cross sectional study of various types of acute poisoning; pharmacological management and their outcome in a tertiary care hospital
Get PDFBackground: Acute poisoning is a common and life-threatening crisis, leading to serious complications and death of patients. Poisoning may be due to self-consumption, accidental exposure of chemical compounds, medications and poisonous animal bites/stings. Aim of current study was to investigate the pattern of drug utilization, poisoning agents and outcome in patients with acute poisoning treated at a tertiary care teaching hospital, Vadodara, Gujarat.
Methods: This prospective cross-sectional study was done on patients of acute poisoning admitted in emergency department, SSG Hospital during August 2021-March 2022.
Results: 400 patients were enrolled during the study, from which 262 (65.50%) were male and 138 (34.50%) were female. Mean age of patients was 30.30 ± 13.79 years. The commonest mode of poisoning observed was Suicidal (66.25%). The most common cause of poisoning was due to Pesticides (33.25%), followed by venomous animal exposures (30.75%). Death was recorded in 53 (13.25%) patients with highest number seen in suicidal poisoning (14.34%) compared to accidental poisonings (11.19%). Mainly, multivitamins (19.03%), Antimicrobials (16.65%), Proton Pump Inhibitors (15.85%) and Antiemetics (11.10%) were prescribed. Antidotes used were Atropine (4.81%), Pralidoxime (4.46%) and Anti-snake venom (2.80%). Median number of drugs per patient was 8; range: 2-25.
Conclusions: Pattern and magnitude of poisoning are multidimensional and demand multi-sectoral approach for facing this problem. Due to high incidence of snakebites, hospital stockpiles should be regularly checked for availability of antivenom. There is a need for stringent pesticide regulation laws, counselling and training programs to reduce incidence of poisonings and deaths due to it
A review on antibiotics induced nephrotoxicity
Get PDFOne of the common causes of acute kidney injury (AKI) is drug nephrotoxicity. AKIs around 20-60% in hospitalised patients are caused by drug-induced nephrotoxicity, which is also linked to higher morbidity and death both in children and adults. Antibiotics are one of the most frequently prescribed drug classes worldwide and, also one of the leading contributors to nephrotoxicity. Nephrotoxicity has been related to a wide range of antimicrobial medications, although the characteristics of kidney damage vary depending on the agent, the site of toxicity and the mechanism of injury within the renal. Acute tubular necrosis, acute interstitial nephritis, crystal nephropathy, and proximal/distal tubulopathy with electrolyte problems are the most frequent mechanisms. Pre-existing chronic renal disease and concurrent use of medications with nephrotoxic potential are two general risk factors for antimicrobial-induced AKI. The various types of antimicrobial-induced nephrotoxicity especially antibiotics will be discussed in this review and offer guidance on how to prevent AKI and recognize it early in order to reduce it and prevent morbidity
Prescription pattern in ischemic heart disease inpatients at B. P. Koirala Institute of Health Sciences: a cross sectional study
Get PDFBackground: Drug utilization pattern studies seek to screen, evaluate and suggest appropriate modifications in prescription practices. It would help to make patient care rational and cost effective. Objective was to analyze the drug prescribing pattern for treatment of ischemic heart disease (IHD).
Methods: A prospective cross-sectional observational study was conducted in patients of IHD admitted in intensive coronary care unit and medicine ward for the period of six months. Data were collected in preformed case record form. The data were analyzed for drug use indicators, demographic parameters, morbidities, pattern of drug use using Microsoft excel 2010.
Results: A total of 145 patients were enrolled out of that 89 (61.38%) were males. The mean age was 60.01±12.71 years and majority (26.89%) belonged to age group of 61-70 years. A total of 1208 drugs were prescribed in 145 patients. Most frequently prescribed drugs were antiplatelet group of drugs 100% encounters, followed by hypo-lipidemics (98.62%). Average number of drugs per encounter was 8.33 and percentage of drugs prescribed by generic name was 5.04%.
Conclusions: IHD was more common in males than females. The most commonly prescribed drug classes were anti-platelet drugs followed by hypolipidemic agents
Evaluation of anti-inflammatory effects of the aqueous extract of Stephania rotunda in experimental animals
Get PDFBackground: The objective of the current study was to analyse the anti-inflammatory effects of the aqueous extract of Stephania rotunda in experimental animals.
Methods: It was an experimental study conducted in the experimental laboratory with 30 acclimatized healthy albino rats and mice divided into 5 groups namely A, B, C, D, and E fed with the aqueous extract of Stephania rotunda in laboratory conditions to assess the anti-inflammatory property using Carrageenan induced rat paw oedema for acute inflammation, granuloma pouch for sub-acute inflammation and Formaldehyde induced arthritis for chronic inflammation from 17th December 2019 to 22nd January 2021. Aspirin was taken as the standard drug. Data was analysed using Chi-square test.
Results: In assessment for acute inflammation, the aqueous extract of Stephania rotunda in the doses of 500 mg/kg, 1000 mg/kg and 2000 mg/kg for groups B, C and D respectively produced 17.12%, 17.12% and 18.78% inhibition of paw oedema which was statistically significant when compared to 22.65% inhibition produced by 100mg/kg of the standard drug aspirin in group E. The groups B, C and D with the extract doses of 500mg/kg, 1000mg/kg and 2000mg/kg produced 43%, 60% and 77% inhibitions of exudate formation respectively which statistically was significant as compared to the Standard aspirin of group E which produced 62% inhibition of exudate formation. In chronic inflammation testing, both the extract and standard drugs produced highly significant inhibition of paw oedema when compared to inhibition produced by the Control.
Conclusions: The aqueous extract of Stephania rotunda was found to be a potent anti-inflammatory drug when compared with Aspirin. Further tests are required in a larger scale so as to ascertain the effects for human consumption
Antibiotic utilization profile in surgical ward at secondary government hospital
Get PDFBackground: This study aimed to determine the profile of the antibiotic utilization in defined daily dose (DDD) units and DU 90% at surgical ward of secondary government hospital in Indonesia within six months period of study.
Methods: A retrospective cross-sectional study was conducted over six months on surgical ward patients prescribed with at least one oral or parenteral antibiotic during hospitalization. Data were collected from pharmacy dispensing data and evaluated using World Health Organization (WHO) DDD. Antibiotics DDD were analysed using DU 90% segmentation in order to know the 90 percent cumulative of antibiotic consumption in surgical ward. WHO prescribing indicators were used to examine the antibiotic prescribing pattern in DU 90% segment.
Results: Out of 319 antibiotic prescribed to surgical ward patients, 219 prescriptions were belonging to DU 90% segment including ceftriaxone (38.94%), moxifloxacin (16.41%), fosfomycin (14.06%), metronidazole (12.43%), and gentamicin (7.69%) in decreasing fashioned. Of the five groups of antibiotics belong to DU90%, ceftriaxone was the highest in DDD (272.5). The average number of antibiotic prescribed to patients were 1.64±0.92. The percentage of antibiotic prescribed by its generic name as well the prescribing of antibiotic from National list of essential medicines were 70.79% and 72.51%, respectively (optimal value 100%).
Conclusions: Our findings on using drug utilization 90% and prescribing indicators are practical for assessing the most widely used antibiotics in ward or hospital setting and to evaluate the quality of prescribing pattern. The antibiotic utilization profile in this study can be used to provide comparative data between hospital and beneficial for future policy making to improve prescribing practice
Comparison of efficacy of azilsartan with olmesartan in patients of hypertension: randomized controlled trial
Get PDFBackground: Azilsartan and olmesartan are members of ARBs, used in the management of hypertension. Objective was to evaluate efficacy of azilsartan with olmesartan in patients of hypertension.
Methods: A randomized, prospective, open label, comparative study was carried out in Pharmacology and Medicine department at Dr. RPGMC Kangra at Tanda, HP. The study stretched over one year and blood pressure was monitored at first, third and sixth month. Out of 69 patients, 35 patients in group A were prescribed tablet azilsartan 40 mg/day and 34 patients in group B patients were prescribed tablet olmesartan 20 mg/day. Tablet chlorthalidone 12.5 mg/day was add on in both the groups. Data was presented as mean+SD. Student’s t test was used and p value <0.05 was considered significant.
Results: In group A, systolic blood pressure (SBP) values improved from baseline of 153±10 mmHg to 111±18 mmHg (p<0.001) at 3 months and 109±6.1 mmHg (p<0.001) at 6 months and diastolic blood pressure (DBP) values from baseline of 87±7 mmHg to 67.1±4.6 mmHg (p<0.001) at 3 months and 67.6±2.5 mmHg (p < 0.001) at 6 months. In group B, SBP values improved from baseline of 154±8.5 mmHg to 127±3.6 mmHg (p<0.001) at 3 months and 123±4 mmHg (p<0.001) at 6 months and DBP values from baseline of 85±6.5mm Hg to 75.7±3.3 mmHg (p<0.001) at 3 months and 73±3.3 mmHg (p<0.001) at 6 months. On intergroup comparison improvement in hypertension was better in azilsartan group (p<0.001).
Conclusions: The study concluded that azilsartan is significantly better than olmesartan in controlling the hypertension
Comparative observational study between Atorvastatin and Rosuvastatin based on HbA1c levels of patients diagnosed with acute coronary syndrome and heart failure
Get PDFBackground: Our study aims to compare HbA1c levels in hospitalized acute coronary syndrome and heart failure patients treated with atorvastatin versus rosuvastatin
Methods: This is a retrospective, prospective observational study in which the study population includes ACS and HF Hospitalized patients, the study subjects are divided based on patients prescribed with Atorvastatin and Rosuvastatin based on the medication chart, and those patients' previous history of statin use is collected from history chart, patient case notes, doctors notes, laboratory data is collected and documented in data collection form, lab data includes HbA1c, finally compared Atorvastatin and Rosuvastatin using excel and JASP descriptive analysis.
Results: Overall, we collected data for 132 cases, of which 55% are males and 45% females, 59.10% are above 61 years of age, 39.39% are diagnosed with ACS and 23.48% are diagnosed with HF, among 67 patients who are using Atorvastatin, there was a significant mean decrease in HbA1c% from 8.359% to 7.901%, and among 65 Rosuvastatin users there was an increase in mean HbA1c% from 8.386% to 8.389%. Additionally for non-diabetic individuals, there was an increase in Hba1c% from 6.339% to 6.387%.
Conclusions: We concluded that Atorvastatin is a more effective statin than Rosuvastatin which will reduce the risk of new-onset Diabetes Mellitus in non- diabetic individuals and reduce the risk of increasing complications of diabetes mellitus in patients who are Diabetic
Determination of antioxidant activity, total phenolic and total flavonoid contents in tamarillo (Solanum betaceum) peel's ethanolic extracts
Get PDFBackground: Free radicals are chemical species a molecule, atom with unpaired electrons and reactive as oxidizing agent which cause oxidize stress in tissue. Antioxidants are substances that can protect cells from free radicals by releasing electrons to neutralize free radicals. Tamarillo peel contains phenolic and flavonoid compounds which have antioxidant activity. The aim of this study was to determine the antioxidant activity, total phenolic and flavonoid content of the ethanol extract of tamarillo peel.
Methods: In this research, the maceration method was used to extract phenolic and flavonoid components from tamarillo peel with ethanol 70% solvent. Total phenolic and flavonoid content was determined with UV-vis spectrophotometer. Total phenolic content determined using the Folin-Ciocalteu reagent and expressed in GAE (Garlic acid equivalent) and the total flavonoid content used the AlCl-3 reagent and expressed in QE (Quersetin equivalent). Then, tamarillo peel ethanol extract was tested the antioxidant activity using the DPPH method.
Result: The results showed that the total polyphenol content was 66.6242 mg GAE/g extract or 6.66% w/v extract, total flavonoid content was 0.74246 % w/v or 7.4246 mg QE/g extract. Antioxidant activity in IC50 value was 47.9460 ppm.
Conclusions: From the results of the research conducted, it can be seen that the ethanol extract of tamarillo can provide an antioxidant effect in the very strong category