International Journal of Basic & Clinical Pharmacology
Not a member yet
3901 research outputs found
Sort by
Influence of reserve antimicrobial indent form in antimicrobial utilization pattern in intensive care unit of tertiary care hospital in North India
Get PDFBackground: Misuse and overuse of antimicrobials in intensive care units is of particular concern as it creates selective evolutionary pressure and thereby enables antimicrobial resistant bacteria to increase rapidly resulting in loss of antimicrobial effectiveness. The aim of the present study was to evaluate influence of Reserve Antimicrobial Indent form in Strengthening the antimicrobial stewardship in intensive care unit of tertiary care hospital, Rajasthan.
Methods: An observational study was conducted over a period of 18 months, and the data was obtained from MRD and from the ICU after introduction of reserve antimicrobial indent form, of a tertiary care hospital. All the data was tabulated in summery sheets and were analyzed by using computer software SPSS version 20 and Microsoft Excel 2019.
Results: A total 257 cases were reviewed during the study period, among these 46.77% were males and 53.23% were females in MRD group, out of 124 cases and 53.38% were males and 46.62% were females in MICU group, out of 133 cases. Total number of reserve drug prescribed was 444 out of which in MRD group Amoxicillin /Clavulanic acid were commonly prescribed followed by piperacillin/tazobactumand in ICU group Meropenem were commonly prescribed followed by piperacillin/tazobactum.
Conclusions: Study showed reducing trend in overall consumption of reserve antimicrobial drugs, which also gave an overview of antimicrobial consumption pattern in intensive care unit
Evaluation of prescription pattern of antifungal drugs in the dermatology department of a tertiary care teaching hospital
Get PDFBackground: In general, fungal infections are one of the contributors of disease burden in the community, but irrational use of antifungal drugs can result in unwanted adverse events or antifungal drugs resistance. The present study was designed to analyze the prescription pattern of antifungal drugs prescribed in the dermatology department of a tertiary care teaching hospital.
Methods: After getting permission from the ethics committee, this prospective observational cross-sectional study was conducted by analysis of prescriptions of 900 voluntary participant patients over a period of seven months in the dermatology outpatient department of a tertiary care teaching hospital in western India. Prescribed medicines’ parameters were analyzed as per WHO/INRUD prescription indicators.
Results: Overall 900 prescriptions were analyzed, and among them around 50% patients were having tinea corporis and tinea cruris, making it the most common fungal infection. The most commonly prescribed antifungals were Clotrimazole (34.59%), followed by Fluconazole (31.61%) and Luliconazole (23.52%). Percentage of drugs prescribed from the WHO model list of essential medicines was 71.22%. Average number of antifungal drugs per prescription was 2.83 ± 0.57%.
Conclusions: This study indicates prescribing practices of anti-fungal drugs and supportive medicines at tertiary care hospital that can be further improved by promoting prescribing by generic names. Overall final list of essential medicines at district level, state level and national level may vary as compared to the WHO list for anti-fungal drugs and doctors can consider alternative drugs as per domestic resistant pattern
Thoracic segmental spinal anaesthesia vs general anaesthesia for laparoscopic cholecystectomy: a comparative study
Get PDFBackground: Regional anaesthesia techniques are now being preferred over General anaesthesia in patients with major medical problems and those at high risk for GA. Thoracic segmental spinal anaesthesia has recently gained popularity because of its safety and efficacy in procedures like laparoscopic cholecystectomy, breast surgeries etc.
Methods: A comparative study involving 50 patients of ASA grade I & II of both genders with age group of 25-55 years, weighing between 50-85 kg posted for lap. Cholecystectomy in GGH, Kakinada for a study period of 5 months. 50 Patients were divided into Group A & Group B with 25 patients in each group. After taking informed & written conscent, Group A patients were given Thoracic Segmental Spinal Anaesthesia at T10 level with Inj.0.5% isobaric Levo-bupivacaine 1.75 ml (13.75 mg) with Inj. Fentanyl 0.25 ml (25 mcg) and Group B patients were given GA with fentanyl, propofol, sevoflurane, succinylcholine and vecuronium.
Results: conscious patients with less hemodynamic variability, greater duration of post operative analgesia, greater duration for first rescue analgesia were observed in Group A. Whereas greater hemodynamic variability, intubation response, more requirement of intraoperative opioid, less duration of post operative analgesia, lesser time for first rescue analgesia were observed in Group B.
Conclusions: TSSA is safe alternative as it provides excellent analgesia. With TSSA, GA can be avoided in patents with comorbidities
Drug utilization study of urinary tract infections in obstetrics and gynecology department
Get PDFBackground: The aim of study was to determine the utilization pattern of antimicrobial agents in obstetrics and gynaecology department. Antimicrobial agents are one of the most commonly used drugs word wide and has main contribution in human health system. UTI infection is one of the most widespread bacterial infections of genitourinary tract which can be treated by AMAs. The main aim of this study is; to identify the pattern of drug utilisation of antimicrobials in prescriptions, to analyse the utilisation of different classes of drugs and to identify the outcome of the treatment.
Methods: This prospective, observational and analytical study was conducted in patients of obstetrics and gynaecology department of MMIMSR, Mullana after obtaining approval from institutional ethical committee. Demographic data, medical history, prescribed treatment details (drug name, dose, frequency, dosage form etc) and diagnosis, type of UTI, laboratory investigations and outcome of treatment was evaluated.
Results: A total 242 female patients were registered, out of which 200 were included in the study as 42 were dropouts. Majority of female patients were belonging to the age group of 18-37 (63%). Most of the female patients had uncomplicated UTI 188 (94%) (p value=0.35), 186 (93%) had significant pyuria and 64 (32%) had urine culture positive (p value= 0.01). Burning micturation and frequency were the most common symptoms observed in 146 (73%). In the study 67(33.5%) females were pregnant and 133 (66.5%) were non pregnant (p value= 0.01). Out of 200 patients 64 (32%) had positive urine cultures and 136 (68%) had negative urine culture reports. E. coli 28 (14%) was the most common bacteria isolated followed by Klebsiella 16 (8%). Average number of drugs prescribed per prescription to non-pregnant was 3.97 and to pregnant were 4.67. In majority of prescriptions, the drugs were prescribed by oral routes (51%) and most of the drugs prescribed were generic (57%). Most of the patients (93%) were recovered from UTIs in 5-7 days of treatment.
Conclusions: Our study concluded that the uses of AMAs for UTI were found to be rational and according to the causative organism and susceptibility pattern.
Predictors and coping strategies for stress, anxiety and depression among medical undergraduates and postgraduates in Puducherry
Get PDFBackground: Higher proportion of medical students experience stress, anxiety and depression than compared to general population in Indian settings which are often underdiagnosed. This study aim was to assess the frequency, predictors and coping strategies of stress, anxiety and depression among the medical undergraduates and postgraduates of a tertiary care teaching hospital.
Methods: Questionnaire based online cross-sectional study was conducted among 350 medical undergraduates and post graduate students from June to July, 2021. Sociodemographic profile, questions from the depression, anxiety, stress scale-4 and details of coping strategies were collected. The data were analysed using SPSS 21.0 Descriptive statistics, Chi square test and Multinomial logistic regression analysis were used. P value <0.05 was considered statistically significant.
Results: The mean age of the participants was 21.5±3.1 years. Majority (63.1%) belonged to upper middle class. 92.3% joined the medical course with personal interest. The frequency of severe depression, anxiety and stress was 22.4%, 16.2% and 18% respectively. The frequency of extremely severe depression, anxiety and stress was 16.4%, 23.2% and 9% respectively. Acceptance, self-distraction and positive reframing were commonly followed coping strategies. Substance abuse and behavioural disengagement were the least followed. Significant association was observed between Emotion focused and avoidant coping with depression, anxiety and stress.
Conclusions: Higher frequency of depression (47.1%), anxiety (52.9%), and stress (38%), was observed among the students. Acceptance, positive reframing and self-distraction were commonly used coping strategies. Significant association seen with depression, anxiety and stress with emotion- focused and avoidant coping strategies
Gasotransmitters: a review
Get PDFThe gaseous molecules produced endogenously with several physiological functions are called gasotransmitters. Even though initially, they were predominantly thought to be of neuronal origin, recent research has clarified that they have roles far beyond that. Their primary function is maintaining the integrity of the cardiovascular system and many other parts. From the available knowledge, we have just started to learn about their roles in physiological systems that could be translated to pharmacological drug development and therapeutics. Most of the process that remains in the form of preclinical research has to go a long way toward utilizing them in therapeutics. This review addresses the various levels at which they could be potentially exploited as therapeutics and their recent entry into clinical trials
Comparative efficacy of polyethylene glycol 3350 monotherapy against polyethylene glycol 3350 plus sodium picosulfate combined therapy in treating fecal impaction in pediatric functional constipation patients
Get PDFBackground: Functional constipation (FC) is a common pediatric problem worldwide. The management of FC comprises of a short initial disimpaction phase followed by long-term maintenance phase. Currently, polyethylene glycol (PEG) is considered as standard disimpaction therapy in pediatric FC patients. The aim of our study was to compare the efficacy of polyethylene glycol 3350 monotherapy with polyethylene glycol 3350 and sodium picosulfate combined therapy in treating fecal impaction in pediatric FC patients.
Methods: All children (aged >1 year) diagnosed with FC as per ROME IV criteria and presenting to the out-patient department of pediatric gastroenterology, hepatology and nutrition unit of a tertiary health centre in north Indian Himalayan state were randomized into two open label, prospective, parallel groups, namely group A (receiving PEG 3350 monotherapy) and group B (receiving combined PEG 3350 plus sodium picosulfate therapy), over a period of 13 months. The outcome was evaluated as successful disimpaction with onset of loose/watery stools (Type-7 of Bristol stool chart scale). The success rates and mean time to disimpaction for two groups were computed and compared.
Results: Eighty-one patients were randomized into two groups. The mean time to disimpaction was found to be significantly lower (p<0.001) for group B (2.37±1.16 days) when compared to group A (4.00±1.43 days). There was successful resolution of impaction in both groups. No adverse events were reported in either group.
Conclusions: Combined PEG 3350 and sodium picosulfate therapy significantly reduces the disimpaction time when compared with PEG 3350 monotherapy in pediatric population, however both the therapies appear similar in achieving successful disimpaction
The effect of vitamin D on haemoglobin, patient assessed disease activity and endoscopic assessment in ulcerative colitis patients with anaemia
Get PDFBackground: Anemia has a dramatic impact on patient's quality of life, yet anemia in patients with UC is still underdiagnosed and undertreated. Hepcidin has been identified to be a central regulator of iron absorption from the intestines and of plasma iron levels. In this study we evaluated the effect of vitamin D supplementation on haemoglobin levels, patient assessed disease activity and endoscopic assessment in ulcerative colitis (UC).
Methods: In this prospective, open-labeled, parallel-group, randomized, comparative clinical study, we assigned newly diagnosed cases of UC with haemoglobin levels between 8-11 gm/dL to receive either standard therapy for 12 weeks or to receive oral 4000IU vitamin D3 along with standard therapy for 12 weeks.
Results: Data from 60 patients were analyzed after 12 weeks. Supplementation with vitamin D3 significantly raised haemoglobin level in treatment group from (9.09±0.20) (Mean ± SEM) at baseline to 9.62±0.22 (Mean ± SEM) at 12 weeks. On assessment of abdominal pain with NRS scale at the end of treatment at 12 weeks the reduction in NRS score was to 3.47±0.29 in group I and to 2.23±0.21 in group II (p=0.0012) which was highly significant. There was also a statistically significant reduction in the Likert scale at the end of 4, 8 and 12 weeks in both groups. At week 12, there was no statistical difference between the two groups in improving the endoscopy score.
Conclusions: Daily high dose vitamin D supplementation is beneficial in ameliorating UC symptoms like abdominal pain and has a positive effect on haemoglobin levels
Prescription pattern of antimicrobial agents prescribed in outpatient department of dermatology in a tertiary care hospital in India
Get PDFBackground: Skin diseases contribute largely to global disease burden. Antimicrobial agents are used for treatment of various skin diseases of microbial aetiology caused by fungi, bacteria, viruses and ectoparasites. The primary objective of this study was to study the prescription pattern of antimicrobial agents in dermatology, to provide insights into the disease patterns, profile of the drugs used and their rationality.
Methods: Cross-sectional observational study was conducted in dermatology outpatient department of T. N. M. C. and B. Y. L. Nair Charitable Hospital, Mumbai for period of 6 months. 372 prescriptions containing an antimicrobial agent (AMA) were analysed. Demographic data, disease pattern, associated comorbidities and prescription details were recorded after taking written informed consent.
Results: Fungal infections were the most common (48%) followed by bacterial infections (31%). The most encountered condition was dermatophytosis. Average number of AMA per prescription was 2.33±0.73. Percentage of AMA prescribed by generic name was 48%. Percentage of AMA prescribed from National list of essential medicines 2015 (NLEM) was 32.60%. 87.9% of AMA were prescribed as combination therapy and 12.10% were prescribed as monotherapy. The commonest prescribed drugs were antifungals followed by antibiotics. Topical creams were the commonest prescribed dosage form.
Conclusions: The most common class of antimicrobial agents prescribed was antifungal agents. Prescribing combination of oral antimicrobials with topical antimicrobials was found to be high. This study provides a framework for continuous prescription audit of antimicrobials in an outpatient setting and thus can help in rational use of antimicrobials in dermatological prescribing
Perceptions of undergraduate medical students of old traditional and new CBME curriculum about pharmacovigilance and adverse drug reactions reporting at a tertiary care teaching hospital: a comparative study
Get PDFBackground: National pharmacovigilance program is an ongoing program to monitor the adverse drug reactions and reporting at the earliest. The effectiveness and success of any pharmacovigilance system depends highly on the participation of all health care professionals. As medical students are future health-care givers, this study is aimed to measure perceptions on Pharmacovigilance and ADR reporting among medical students of two different curriculum.
Methods: A validated and standardized KAP Questionnaire based cross sectional study. It consists of 22 questions divided into four sections of total of 22 items (six related to Personal details, eight related to knowledge, four related to attitude, and four related to practice) The filled questionnaires were collected and analyzed by MS excel
Results: A comparative sample of 100 from old (phase 4) and 100 from New CBME (phase 3) curriculum undergraduate medical students of Government Medical College are included in our study. The average score of phase 3 and phase 4 medical students for knowledge was 85.37% and 75.87%, for attitude was 95.5% and 84% and for practices was 88.75% and 67.5% respectively.
Conclusions: The overall knowledge, attitude and practices of new curriculum students found to be better than old curriculum students as CBME curriculum was introduced from the academic year 2019–2020 in all Medical Institutions of India to impart knowledge, communication and leadership skills using various teaching–learning methods among students