Diabetes mellitus (DM) is a common metabolic disorder. It is associated with complications which will affect the quality of life. Failure to control elevated blood sugar or inadequate treatment of diabetes could cause many complications.  A prospective observational study is used to assess the prevalence of diabetic vascular complications in 105 types of II diabetic patients. A date was collected regarding patient's demographic and clinical characteristics. Based on our study criteria, males were more when compared to females in getting vascular complications & also. Complications were more prominent in the age group of 50-65years. Of all microvascular complications, Nephropathy was major, whereas, in macro-vascular complications, CAD was prominent. Poor glycemic control and a long length of ailment appear to be the most significant danger factors for these complexities. Doctors assume a significant function to endorse hostile to diabetic meds and Pharmacist plays a sharp task to assess the medicine design so as to accomplish fruitful treatment. The currently anti-diabetic drugs are effective, but a lot of factors such as patient adherence, education related to diabetes, lifestyle modification, cost and type of medication have an association with glycemic control. The commonly prescribed anti-diabetic drug was Insulin. Metformin was the most preferred drug both as monotherapy and combination therapy.  Although polypharmacy was observed, drug utilization pattern can be rational owing to a higher prevalence of complications. Minimization of the occurrence of complications should be courage by early diagnosis, intensive blood glucose control and rational drug selections.

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Background: Cigarettes and other tobacco products (COTPA) Act is a legislation passed to curb tobacco use in India by imposing restrictions on tobacco products. This study appraised knowledge and attitudes regarding COTPA Act among adults in a rural area and elicited socio-demographic predictors of knowledge and attitudes regarding COTPA Act among study participants.Methods: A cross-sectional study was conducted from September to December 2014 on adults (aged ≥18 years) in a rural area of Coastal Karnataka. A pre-designed, pre-tested proforma was used to collect information from study participants regarding their knowledge and attitudes about COTPA Act. Knowledge and attitude scores were computed. A score of ≥4 was good knowledge and ≥3 was regarded as positive attitudes.Results: Nearly 49.14% had good knowledge, while 51.29% displayed positive attitudes. Those belonging to upper and upper middle socio-economic class (Class I+Class II) had higher odds for good knowledge (AOR=2.09, 95% CI=0.82-5.92), when compared to their counterparts belonging to other socio-economic classes. Age ≥60 years (AOR=3.80, 95% CI= 0.30-9.98), education beyond primary school (AOR=2.88, 95% CI=1.24-6.19), upper and upper middle class socio-economic status (AOR=3.68, 95% CI=1.34-7.02) were the key predictor variables for positive attitudes.Conclusions:Nearly half the study participants had good knowledge and positive attitudes towards COTPA Act. High socio-economic status could predict good knowledge, while age ≥60 years, education beyond primary school and a high socio-economic status were the key variables predicting positive attitudes. Educational campaigns can help improve knowledge. Assessment of knowledge and attitude is imperative prior to implementation of policies to ensure effectiveness.

Objectives: Antimuscarinic agents are known to have poor persistence because of bothersome adverse events and insufficient efficacy. Mirabegron is a new agent served as the treatment for patients with overactive bladder (OAB). In the absence of head-to-head trials, we evaluated comparative cost-effectiveness of mirabegron versus solifenacin in OAB patients from national health system (NHS) perspective in Iran. Methods: In this study a Markov model with a 5-year time horizon was developed consisted of five health states and OAB patients with an average age of 60 years. Transition probabilities were based on published clinical trials and network meta-analyses. Resource use and costs included those for medications and adverse events were extracted from literature and tariff book and presented in 2018 US dollars discounted at the rate of 5%. Cost-effectiveness ratios and quality-adjusted life years (QALYs) were computed for the agents. Both deterministic and probabilistic sensitivity analysis (PSA) was used to test the robustness of results. Results: Average per patient treatment costs was $2,168and $2,194 for solifenacin and mirabegron, respectively. Mirabegron is expected to produce QALYs than solifenacin (3.500 vs 3.489). In consequence, the incremental cost-effectiveness ratio of mirabegron was found to be $2,562 compared to solifenacin. Deterministic sensitivity analyses showed that the model is sensitive to changes in drug acquisition cost and urinary pad prices. In addition, the probability of mirabegron being cost-effective was found to be 74% of 1000 simulations at the threshold of $5,400 per QALY. Conclusions: Compared to solifenacin, mirabegron was indicated to be cost-effective in patients with overactive bladder for the Iranian healthcare system.

Objectives: Parental attitude is one of the important factors that affect medication use and adherence among pediatrics. Our study aims to assess the Knowledge, Attitude and Practice (KAP) of caregivers regarding medication use in children. Methods: A cross sectional study was conducted in the inpatient and outpatient pediatrics department at a tertiary care hospital over 6 months. We surveyed caregivers with children under age 18 to determine the medication administration practices. A validated questionnaire was administered to assess the Knowledge, Attitude and Practices (KAP) of the study population and responses were obtained. Correlations analysis was performed to assess correlation among various domains. Results: A total of 149 caregivers were enrolled in the study. Majority of the primary caregivers surveyed were illiterate (65%), homemaker mothers (64%). 64% and 82.7% were unaware about 1 teaspoon and 1 tablespoon dosing respectively. Caregivers frequently reported stoppage of medicines once the child feels better (50%). Dissolving of solid oral dosage forms and mixing them with milk (61.7%) was the most frequently reported method of administration. 34.9% caregivers reported use of nonstandardized liquid dosing instruments. Spearman's correlation analysis showed significant correlation between education of caregiver and knowledge (p,0.01; 0.34) as well as attitude (p,0.01; 0.44). Medication errors were reported significantly more in the outpatient setting. Conclusions: The caregivers of pediatric population had poor knowledge regarding medicine administration and measurement of dosage forms. Active patient counselling sessions by healthcare professionals can make an impact among caregivers regarding medication utilization practices of pediatric dosage forms.