22 research outputs found
A study of drug utilization pattern in post-acute coronary syndrome (ACS) patients at tertiary care teaching hospital: a prospective unicentric study
No full textBackground: The main objective of drug utilization research is to assess the rationality of drug use for specific disease. Long term survival in post-ACS patients depends largely on how well post ACS period is managed. Our aim is to record drug utilization pattern in post ACS patients after discharge and during follow-up visits.Methods: Prospective unicentric study was conducted in 200 patients suffering from ACS at Cardiology OPD of GCS Medical College, Hospital and Research Centre, Ahmedabad. Prescriptions issued to study subjects at the time of discharge and during follow-up who had recently suffered from ACS were intercepted after consultation and data recorded as per WHO guidelines as how to investigate drug use. Data were collected in the structured proforma (Case Record Form-CRF) which includes patient’s demographic details, registration number, diagnosis and the drug prescribed. Each prescription was analyzed using WHO core prescribing indicators to evaluate the rationality of the prescriptions.Results: Out of 200, 104 (52%) suffered from unstable angina, 84(42%) suffered from STEMI and 12(6%) were suffered with NSTEMI. Male patients of 114(57%) were more prone to ACS than female patients of 86 (43%). Out of 200 patients, 193 (97%) received antiplatelet, 187 (94%) received antihypertensive, 184 (92%) received anticoagulants, 180 (90%) received lipid lowering drugs and 119 (60%) received Nitrates. As per WHO core prescribing indicators, the average number of drugs encountered per prescription was 7.96. The prescription showed a high usage of drugs from NLEM i.e. 72.20% in post-ACS patients. However the percentage of drugs prescribed by generic name was only 10.68%. The frequency of use of injectable preparations in post-ACS patients was found to be 17.84% which was in accordance with WHO reference value. Out of 17.84% injectable preparations, only 0.82% accounted for antibiotic injection.Conclusions: Although generic prescribing indicator shows a low range of usage, it is interesting to notice that prescription pattern has a high usage of drugs from NLEM (78.2%) in ACS. Thus present study provides valuable insight about the overall pattern of drugs used in post-Acute Coronary syndrome
Recent advances in pharmacotherapy of acute coronary syndrome
No full textAcute coronary syndrome (ACS) describes the range of myocardial ischemic states that includes unstable angina, non-ST elevated myocardial infarction (MI), or ST-elevated MI. ACS is associated with substantial morbidity and mortality and places a large financial burden on the health care system. The diagnosis of ACS begins with a thorough clinical assessment of a patient’s presenting symptoms, electrocardiogram and cardiac troponin levels as well as a review of past medical history. Early risk stratification can assist clinicians in determining whether an early invasive management strategy or an initial conservative strategy should be pursued and can help determine appropriate pharmacologic therapies. Key components in the management of ACS include coronary revascularization when indicated; prompt initiation of dual antiplatelet therapy and anticoagulation; and consideration of adjuvant agents including beta blockers, inhibitors of the renin angiotensin system, and HmG-coenzyme A reductase inhibitors. It is essential for clinicians to take an individualized approach to treatment and consider long-term safety and efficacy when managing patients with a history of ACS after hospital discharge. This review identifies promising new or emerging techniques, as well as established tools, and reviews their current or potential role in clinical practice
AN OBSERVATIONAL STUDY TO EVALUATE KNOWLEDGE, ATTITUDE, AND PRACTICE OF PHARMACOVIGILANCE AMONG THE HEALTHCARE PROFESSIONALS AND UNDERGRADUATE MEDICAL STUDENTS
No full textObjective: The importance of pharmacovigilance (Pv) is to ensure the safe and rational use of medicines. Targeting healthcare professionals (HCPs) and undergraduate (UG) medical students (visiting hospitals) for sensitization towards pharmacovigilance is the key to implementing the practice of adverse drug reaction (ADR) reporting in clinical practice. Education and training are the most recognized means of improving ADR reporting. The objective was to evaluate the knowledge, attitude, and practices (KAP) of pharmacovigilance among HCPs and UG medical students.
Methods: This was a cross-sectional, observational, questionnaire-based study carried out for a period of four months (September to December 2023). The case record form includes demographic characteristics and a KAP questionnaire that focuses on the reporting of adverse drug reactions (ADRs). A KAP survey was analyzed question-wise, and statistical analysis was performed using Microsoft Excel Office 365.
Results: The results indicated that HCPs demonstrated a higher level of knowledge (78.14%) compared to UG medical students (70.2%). Both groups demonstrated an equally positive attitude towards pharmacovigilance, with a mean score of 93%. However, a significant difference was observed in the practice domain, where HCPs scored 70.9%, which was markedly higher than the 41.68% recorded among UG medical students.
Conclusion: The study reveals that more sensitization programs on pharmacovigilance practice are required in tertiary care hospitals to ensure ADR reporting to the pharmacovigilance centre, which will strengthen the health care setup
Corticosteroids in Dentistry
No full textGlucocorticosteroids are used extensively in dentistry for their anti-inflammatory and immunosuppressive effects. Most of the diseases for which steroids are used are characterized by inflammation, which appears secondary to a hypersensitivity reaction against auto components. Glucocorticoids do not interfere with the primary disease mechanisms but they are used because of their anti-inflammatory and immunosuppressive effects. It seems reasonable to profit from steroids as palliatives in acute phases of the diseases and/or as long-term suppressors of the general host defense. The article deals with the use of corticosteroids in the treatment of the various conditions and diseases affecting oral cavity
Analysis of Package Inserts Available in the Indian Market
No full textMedicine has advanced, necessitating access to accurate drug information. Package inserts (PIs) are crucial sources, approved by authorities, providing essential and updated drug details. Package inserts significantly impact patient compliance and drug effectiveness in chronic therapy. This study examines Indian market PIs, evaluating information quality and accessibility to improve medication safety. A prospective observational cross-sectional study was carried out. A total of 300 package inserts were collected from various pharmacies situated across different sites in Ahmedabad. Package inserts were scored out of 21 based on assessment criteria, expressed as percentages, and analysed descriptively. A total of 300 package inserts were analysed, among them 130 were tablets, 81 were injections, 17 were capsules, 15 were eye drops and the rest includes syrup, ear drops, nasal drops, suppositories, powder, ointment, gel, cream, lotion and suspension. 209 PIs were single drug preparations while 91 were fixed dose combinations. More than 90% of the score was achieved by 37 PIs. 96 PIs had scored between range 81% to 90%, while 86 PIs had scored between 71% to 80%. Only 6 PIs had scored below 50%. Most commonly missing information was the average duration of treatment (83% of PIs), excipients (93% of PIs), and shelf life (81% of PIs). The finding of this study revealed that, although only 2% of PIs had scored below 50%, some crucial information was lacking from a major number of PIs. Regular review and collaboration among stakeholders ensure updated, reliable and comprehensive information, benefiting patient care and healthcare delivery. Keywords: Drug information, Package insert, Indian marke
Antimicrobial activity of ginger and honey on isolates of extracted carious teeth during orthodontic treatment
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A retrospective and prospective chart review with implementations: preventing non-urgent emergency department visits from a primary care practice
No full textPurpose: Often there are patients who visit the emergency department for non-urgent complaints that can be treated in the primary care setting. This can lead to overcrowding of the emergency department, increased costs, and delay in treatment times. Providers need to advise or educate patients on the use of the emergency department versus the primary care practice. Doing so may lead to better use of the primary care providers, decrease non-urgent visits to the emergency departments and improve patient outcomes.
Methodology: A retrospective chart review with implementation of a handout was on display at a privately owned primary care practice in northern New Jersey. The handout displayed examples of services available in the emergency department versus those in the primary care practice. Prospective evaluation via a chart review of patient utilization of the emergency department was collected after handout has been available to patients. Data was analyzed for a decrease in patients utilizing the emergency department. The retrospective chart review, implementation of patient viewing handouts, and prospective chart review was utilized to develop recommendations based on the findings to promote primary care use and help decrease non-urgent emergency department visits.
Results: The statistical results revealed that most of the emergency department visits were emergent. Although emergency department visits after the implementation, the results were not statistically significant due to small sample size.
Implications for Practice: One time evaluation of patient Rapid Estimate of Adult Literacy in Medicine (REALM) score to determine baseline healthcare literacy. This will assist in educating of the patient and providers to determine what level of counseling they can provide the patient. Recommendations for additional practice hours as well as having additional providers to assist with patient volume. Utilization of call service when office is closed. Documentation of counseling of the patient for reimbursement.D.N.P.Includes bibliographical reference
Author response
No full textA well-characterized metabolic landmark for aggressive cancers is the reprogramming from oxidative phosphorylation to aerobic glycolysis, referred to as the Warburg effect. Models mimicking this process are often incomplete due to genetic complexities of tumors and cell lines containing unmapped collaborating mutations. In order to establish a system where individual components of oncogenic signals and metabolic pathways can be readily elucidated, we induced a glycolytic tumor in the Drosophila wing imaginal disc by activating the oncogene PDGF/VEGF-receptor (Pvr). This causes activation of multiple oncogenic pathways including Ras, PI3K/Akt, Raf/ERK, Src and JNK. Together this network of genes stabilizes Hifα (Sima) that in turn, transcriptionally up-regulates many genes encoding glycolytic enzymes. Collectively, this network of genes also causes inhibition of pyruvate dehydrogenase (PDH) activity resulting in diminished ox-phos levels. The high ROS produced during this process functions as a feedback signal to consolidate this metabolic reprogramming
Comparative studies on structural properties and antimicrobial potential of spinel ferrite nanoparticles synthesized using various methods
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