Mixed dyslipidemia is characterized by increased low-density lipoprotein cholesterol (LDL-C) elevated triglycerides (TGs) and decrease high-density lipoprotein cholesterol (HDL-C). It is more common in diabetes and is associated with an increased risk of coronary artery disease. Monotherapy with statins or fibrates may not effectively control all lipid parameters. The atorvastatin-fenofibrate combination has been shown to have highly beneficial effect on lipid parameters in type 2 diabetes associated with combined hyperlipidemia (CHL). In an open-label study, we evaluated the efficacy of atorvastatin alone and in combination with fenofibrate in 60 types 2 diabetes mellitus patients associated with hyperlipidemia. Patients were randomly assigned to receive atorvastatin 10 mg (Group 1) or combination of atorvastatin 10 mg and fenofibrate 145 mg (Group 2) once daily for 12 weeks. The effect of drugs on lipid profile was evaluated before and after treatment. After 12 weeks, the reduction in total cholesterol (TC), TGs, LDL-C, VLDL-C was 28%, 20%, 37% and 20% in Group 1 (P < 0.001 for all) as compared with 31%, 39%, 33% and 40% in Group 2 (P < 0.001 for all). There was insignificant rise in HDL-C in Group 1 (P = 0.71) and insignificant decrease in HDL-C (P = 0.70) in Group 2. During the combination therapy, the decrease in TC, TGs and VLDL-C was greater than atorvastatin alone. The combination of atorvastatin with fenofibrate in type 2 diabetes patients with CHL may have a favorable effect on some major coronary artery disease risk factors.

Background: In India, end-stage renal disease incidence is 100 patients/million population/year, which means every year for a population of 1 billion almost more than 100,000 new patients will occur. Nowadays, the prevalence of chronic kidney disease (CKD) is augmenting due to the advancement of age, polypharmacy, and drug interactions. Drug utilization studies determine the rational prescription of drugs. Aim and Objectives: The aims of this study were to determine the drug utilization pattern among CKD patients who were on maintenance hemodialysis and to identify the comorbidities among them. Materials and Methods: After obtaining approval from the Institutional Ethics Committee a prospective, observational study was conducted by the Department of Pharmacology, Guntur Medical College, Guntur, from January to June 2022. The details of demographic, biochemical, clinical data, and drugs prescribed in CKD patients undergoing maintenance hemodialysis were recorded in a structured case report form. To analyze the data, descriptive statistics were used. Results: Among 100 patients evaluated, males and females were 72 and 28, respectively. Their mean ages were 47.55 ± 11.49 years and 39.82 ± 13.56 years, respectively. The majority of the patients received hematinics followed by multivitamins, anti-hypertensives, drugs used in gastrointestinal disorders, antioxidants, respiratory drugs, CNS drugs, diuretics, and antibiotics. The most common comorbidity was hypertension followed by diabetes, epilepsy, tuberculosis, and HIV. Among the prescribed drugs, 74% were from the Indian national list of essential medicine and only 3% were by generic name. About 74% of patients received five or more drugs. Conclusion: This study describes the pattern of drug utilization in CKD patients undergoing maintenance hemodialysis. As polypharmacy is more prevalent, among them elements such as adverse drug reactions and adherence to therapy must be investigated further to minimize drug interactions and to improve patient quality life.

Background: Antibiotics have been one of the most significant discoveries in the history of medicine, as they saved countless lives and prevented many serious complications from bacterial infections. Antibiotics are usually safe and effective in treating bacterial infections but can result in adverse drug reactions (ADRs) in some patients. Antibiotics are the most common class of drugs which implicate a greater number of ADRs, because of overuse and misuse of antibiotics, antibiotic resistance, and decreased efficacy. Aims and Objectives: The aims and objectives of the study are to determine clinical symptoms, causality, and severity of antibiotic-associated ADRs. Materials and Methods: A retrospective study was carried out from January 2021 to June 2022; data were collected from Adverse Drug Monitoring Center, GMC/Government General Hospital, Guntur. Prior Institutional Ethics Committee Approval and Permission from Indian Pharmacopoeia Commission, Ghaziabad, were taken. The collected reports were analyzed for ADR pattern, drug groups, causality, and severity. Descriptive statistics were used. Results: Out of 847 ADRs reported, 119 (14%) ADRs were related to antibiotics. The majority of ADRs (65%) were reported in males. A greater number of ADRs were reported in mean age group 31–40 years. Anti-tubercular drugs (27%) were the most commonly implicated antibiotics followed by cephalosporins (22%). Most commonly affected system was cutaneous system (45%) followed by gastrointestinal system (21%). Most common ADRs reported were pruritus (20%), followed by rash (14%). 93% of ADRs were possible and 7% were probable. 87% of ADRs were mild, 12% were moderate, and 2% were severe ADRs. Conclusion: ADRs can be prevented by taking proper action at an early stage. Implementation of antibiotic guideline policy for the hospital and strict adherence to it should be ensured to promote their rational and safe use.

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