International Journal of Basic & Clinical Pharmacology
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Prescribing pattern of analgesics used for postoperative pain and its correlate with patient and doctor satisfaction:
Get PDFBackground: Post operative pain is difficult to assessment and its management has been neglected at times. Moreover, the drug treatment involves administration of drug on as and when basis which leads to inadequate control.
Methods: This observational, prospective study was conducted in 100 post-operative patients i.e., 50 each from surgery and orthopedics departments. Investigator enrolled post-operative patients within 24 hours of surgery and followed them for next 5 days or till hospital discharge, whichever was earlier. Analgesic prescribing pattern, self-assessment of pain, patient and doctor satisfaction using ASSIST questionnaire were recorded in Case Record Form and analysed.
Results: Out of 100 patients, average number of analgesics prescribed post-operatively was 1.49±0.5 (baseline and all follow-up). 76.5% patients received NSAIDs which included diclofenac (44.29%) and paracetamol (30.87%). Opioids in the form of tramadol were prescribed in 23.49% patients. Mean least pain experienced by patients on day 1 was 2±0.75 which decreased to 1.32±0.63 on day 5. Mean worst pain decreased from 6.64±1.43 on day 1 to 3.38±1.17 on day 5. Average percentage of duration of severe pain was 35.2%±16.48 on day 1 which successively decreased to 16.32±8.26 on day 5. Average pain relief observed in 62.3% patients on day one increased to 80.88% on day 5. Patient satisfaction increased as pain score decreased (r=-0.73) and a strong positive correlation was observed between doctor satisfaction and patient satisfaction (r=0.91).
Conclusions: Inadequate control of post-operative pain affects effective patient management and recovery. Incorporation of effective pain assessment scores in pain management is desirable
Evaluation of educational intervention on awareness of adverse drug reaction reporting among geriatric population in a tier II city of India
Get PDFBackground: Adverse drug reactions in the geriatric population are a growing concern, given their susceptibility to medication-related complications. However, underreporting of ADRs remains a significant challenge in India. This study aimed to evaluate the impact of an educational intervention on ADR reporting awareness among the geriatric population in a Tier II city of India.
Methods: A pre-post intervention study was conducted in a Tier II city, involving a sample of geriatric individuals aged 60 and above. An educational intervention, consisting of workshops, pamphlets, and interactive sessions, was designed to enhance awareness of ADR reporting procedures. Pre-intervention and post-intervention assessments were conducted to measure changes in ADR reporting knowledge and willingness to report ADRs.
Results: A total of 71 responses were received. All participants demonstrated an increased understanding of the importance of reporting ADRs and were more willing to report such incidents to health care authorities after the intervention. The educational intervention significantly improved awareness of ADR reporting procedures among the geriatric population
Conclusions: The intention of the study was to assess the effectiveness of an educational programme on geriatric patients' awareness of the need to report adverse drug reactions to pharmacovigilance centres given that this age group is more prone to use multiple therapies. A large number of participants felt that increasing pharmacovigilance awareness and knowledge sharing will benefit society
Evaluation of the use of antibiotics using the anatomical therapeutic chemical/defined daily dose and Gyssens methods in pneumonia patients at a tertiary care general hospital in Medan
Get PDFBackground: The impact of irrational antibiotic usage in pneumonia patients is an increase in resistance, an increase in drug side effects, and a failure of therapy that causes patients' health to deteriorate, lowering their quality of life and raising their treatment costs. The primary objective of this study is to assess the extent to which antibiotics are being used rationally in the inpatient facility of a private tertiary care hospital located in Medan.
Methods: The present study employs an observational design with a prospective cross-sectional approach, carried out within the timeframe of September to November 2022. The evaluation of antibiotic utilization was conducted utilizing the anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology and the Gyssens methodology.
Results: The findings of the study indicate that a significant proportion of individuals diagnosed with pneumonia fell between the age range of 46 to 55 years, comprising 23.4% of the overall patient population. Moreover, the male gender was found to be the most prevalent, accounting for 55.81% of the 278 patients who satisfied the inclusion criteria. The findings from the evaluation of antibiotic utilization, employing the ATC classification system and DDD methodology, yielded a rate of 145.72 DDD per 100 days of care. Ceftriaxone exhibited the highest value, reaching 87.59 DDD/100 days of treatment. The evaluation of the Gyssens approach yielded a total of 254 patients who were administered antibiotics in an appropriate manner (category 0), while 24 patients were found to have received unsuitable antibiotics (categories I-VI).
Conclusions: Based on the findings of this study, it can be inferred that the utilization of antibiotics within the hospital under investigation remains inadequate in terms of both quantity and quality
A cross-sectional study to assess the drug utilization pattern and pharmacotherapeutic adherence among patients with schizophrenia and quality of life of patient’s caregiver in a tertiary care teaching hospital
Get PDFBackground: Schizophrenia is a chronic severe psychiatric illness affecting nearly 0.4 to 1.4% of people in India. Many newer anti-psychotic drugs are used now-a-days in schizophrenia. Poor adherence to the treatment given to patients of schizophrenia is observed very often. Although, the quality of life of schizophrenia patients is very much compromised; at the same time, quality of life of the caregiver is also compromised.
Methods: A cross-sectional Observational study was conducted among patients already diagnosed with Schizophrenia and on treatment, after ethical approval. Data relevant to study variables was collected in a pre-designed case record form. Evaluation of drug utilization pattern was done by WHO core drug prescribing indicators. Medication adherence was assessed through modified Morisky scale. Quality of life of relative or caregiver was assessed through WHO-QOL BREF questionnaire scale.
Results: Patients of 18 years and above were enrolled. Among them, average age was 35.8±5.5 years. In my study, female patients were 64.7% and male patients were 35.3%. Average number of drugs per prescription was 3.8. Drugs prescribed by generic name were around 86.2%. Around 56.9% of drugs were prescribed from national list of essential medicines. Atypical antipsychotics were prescribed in 32% of all prescriptions for Schizophrenia; Whereas Benzodiazepines were prescribed in 19% of all prescriptions. Average Medication adherence score using MMS scale was 3.7±2.2. Patients with high adherence to the medications prescribed were nearly 71% and patients with low adherence to the medications prescribed were 29%. Mean total WHOQOL-BREF score was 75.2±6.5 out of 120.
Conclusions: Most prescribed class of drugs was atypical anti-psychotics. Pharmacotherapeutic adherence among patients with schizophrenia was relatively high. Quality of life of patients’ relative or caregiver was impaired to some extent, more impaired in physical health and social relationships domain
Probable fluoxetine-induced hepatomegaly: a case report
Get PDFDepressive disorder is a common behavioural, psychiatric disorder. Among various antidepressants selective serotonin reuptake inhibitors (SSRIs) are preferred drugs for the treatment of depression. When second-generation antidepressants SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) are used to treat depression, 0.5–1% of patients develop mildly altered liver function without any symptoms. Various degrees of organ dysfunction are linked with drug-induced liver injury, which is unpredictable and might result from exposure to a drug. We reported suspected fluoxetine-induced hepatomegaly secondary to nine weeks of treatment with an SSRI fluoxetine. Upon cessation of the agent, the patient recovered symptomatically. The evidence is vital that the hepatomegaly in this patient was caused by fluoxetine
Use of liraglutide in the patient with obesity and type 2 diabetes mellitus: a literature review
Get PDFObesity and type 2 diabetes mellitus represent two of the most pressing public health challenges globally. In recent decades, an alarming increase in the prevalence of both conditions has been observed, which has led to a significant increase in the burden of disease and an increased search for effective therapeutic strategies. As evidence accumulates on the efficacy and safety of Liraglutide in this patient population, a comprehensive review of the available scientific literature is necessary. The objective of this literature review is to analyze and synthesize relevant studies investigating the use of liraglutide in patients with obesity and type 2 diabetes mellitus, in order to provide a comprehensive view on its effectiveness, indications, complications and management. In conclusion, the use of liraglutide in patients with obesity and type 2 diabetes mellitus has been shown to be an effective therapeutic option to improve glycemic control, promote weight loss and reduce cardiovascular risk. This drug, as a GLP-1 receptor agonist, stimulates insulin secretion, suppresses excessive glucagon release and delays gastric emptying, which contributes to the improvement in glycemic control
A prospective study on antibiotic resistance pattern in patients with urinary tract infection
Get PDFBackground: Antibiotics are a blessing to the mankind in the realm of medical treatment. Quite contrary to that fact, they may cause risks in medical treatments of patients if these antibiotics are not taken under medical guidelines. In the current scenario it is a huge challenge for selecting appropriate antibacterial agents for the treatment of UTI. This study aims to evaluate the prescription & resistance pattern of antibiotics in patients with urinary tract infection.
Methods: A prospective observational study was carried out for a period of 1 year. Data on 100 research participants' reports and the results of their tests for antibiotic resistance were taken from the microbiology department's records, evaluated, and represented as percentages. Observations were made and meticulously recorded.
Results: Out of 100 study participants, Escherichia coli was the most common pathogen with a total of (35%) followed by Klebsiella (17%), Enterococcus with (16%). E. coli were highly resistant to Ampicillin (88.6%) and Cefazolin (88.6%), Ceftraixone (85.3%). Klebsiella were highly resistant to Ampicillin (100%) Cefazolin (93.3%), Cefuroxime (85.7%). Enterococcus were highly resistant to Tetracycline (92.9%) Ciprofloxacin (85.7%), Levofloxacin (81.8%). Where, E. coli were highly sensitive to Amikacin, Imipenem, Ertapenam. Klebsiella were highly sensitive to Meropenem, Cefoperazone/Sulbactam, Amikacin. Enterococcus was highly sensitive to Linezolid, Teicoplanin, Vancomycin.
Conclusions: Most of the identified bacteria were resistant to several of the popular antibiotics used in clinical settings. Consequently, it is vital to prescribe antibiotics rationally both before and after culture reports
A case report on Beckwith-Wiedemann syndrome with macroglossia
Get PDFBeckwith-Wiedemann syndrome (BWS) is a genetic disorder characterized by the overgrowth of various body parts and an increased risk of certain types of cancer. One of the physical features of BWS is macroglossia or an enlarged tongue. In some cases, macroglossia can cause difficulty with speaking, eating, and breathing. A case report on BWS with macroglossia and reduction glossectomy would describe the patient's symptoms and medical history, as well as the diagnosis, treatment, and outcome of the condition. The patient, a 6 -year-old female, presented with symptoms of macroglossia, which was confirmed by physical examination. The patient also had a history of BWS, which had been diagnosed at birth. The patient's macroglossia was causing difficulty with speaking and eating regurgitation of food through the nose and was also putting her at risk for sleep apnoea. After a thorough evaluation, the decision was made to perform a reduction glossectomy, which is a surgical procedure that involves removing a portion of the tongue in order to reduce its size. The surgery was performed under general anaesthesia and was successful in reducing the size of the patient's tongue and improving his ability to speak and eat. The patient recovered well from the surgery and was discharged from the hospital after 3 days of admission. At the 3 months follow-up appointment, the patient had no difficulty with speech, or eating and did not have sleep apnoea. This case report highlights the importance of early diagnosis and treatment of BWS, as well as the potential benefits of reduction glossectomy in managing the symptoms of macroglossia in this condition
Comparative study between ultrasound guided modified pectoral nerve block versus erector spinae block in breast surgeries-prospective randomised comparative study
Get PDFBackground: Breast cancer is the most common cancer in women, comprising approximately 25% of all cases. Failure to provide effective pain control is associated with poor quality of recovery & chronic postsurgical pain after breast surgery. According to a recently published PROSPECT guideline, pectoral nerve (PECS) blocks seem to be an effective alternative to PVB for postsurgical pain management in breast surgery. In order to relieve post-operative pain in patients undergoing MRM, in this study we compared the efficacy of modified pectoral nerve block versus erector spinae plane block for breast cancer surgeries.
Methods: A comparative study was conducted among 80 female patients of age 25-65 years scheduled for modified radical mastectomy surgery with ASA class I and II after obtaining approval from ethical committee. Written informed consent was obtained and research process were explained to the patients. They were randomly allocated into two groups of 40 each. Group 1: was assigned to receive 0.2% Ropivacaine 25ml for Erector spinae block and Group 2: Was assigned to receive 0.2% ropivacaine 25 ml for modified pectoral nerve block, p value <0.05 was considered statistically significant.
Results: In patients receiving modified pectoral nerve block (PEC 2) there was considerably lesser opioid consumption, Ionger duration of analgesia and lesser postoperative pain score as compared to patients receiving erector spinae block (ESP) for modified radical mastectomy surgeries.
Conclusions: Modified Pectoral nerve block is a potential analgesic technique in breast surgeries since it has less perioperative opioid consumption, proIonged duration of anaIgesia, Iesser postoperative pain score when compared to Erector Spinae block
Evaluation of sesamol for anxiolytic activity in 72 hours sleep deprivation model in C57BL/6 mice
Get PDFBackground: In our study, we explored anxiolytic activity of sesamol in C57BL/6 mice. Anxiety was induced in mice after 72 hours of sleep deprivation. Anxiety was assessed by three behavioural tests as Open field test, hole board test and light dark chamber test.
Methods: In our study, sesamol was evaluated in C57BL/6 mice for anxiolytic activity. Anxiety was induced by flower pot technique, in which sleep deprivation was done in mice for 72 hours. After 72 hours of sleep deprivation, the animals were subjected to three behavioural tests, as open field test, Hole board test and Light dark chamber test. In the Open field test, parameter assessed was time spent in central square, that was considered as a measure of anxiolytic activity. In hole board test, increase in number of head dips was indicative of anxiolytic activity. Anxiety assessment was also done by light dark chamber test, where more time spent in light chamber is considered as indicative of anxiolytic activity.
Results: In open field test, sesamol 20 mg/kg group, the time spent in central square was statistically significant (p<0.05) in post hoc comparison, suggesting that sesamol exhibited anxiolytic effect in animals. In hole board test, sesamol 20 mg/kg group showed significant increase (p<0.05) in number of head dips indicating its anxiolytic activity in the said model. In light dark chamber test, there is significant increase in anxiolytic activity in diazepam group as compared to control group, while not significant with sesamol in either dose in light dark chamber test.
Conclusions: So, to conclude, sesamol exhibited statistically significant anxiolytic activity in the dose of 20 mg/kg in open field test and hole board test