ObjectivesTo analyse and present the occurrence and severity of spontaneous adverse drug reaction (ADR) reports prospectively registered at an ADR monitoring centre (AMC) in Central India.Setting and dataThe survey was conducted between 2013 and 2019 at an ADR Monitoring Centre in Central India. ADRs were recorded using the standard ‘Suspected ADR Reporting form’.Outcome measuresThe causality of the ADRs were categorised using the WHO causality assessment scale to assess the relationship between a drug and the occurrence of an ADR.ResultsTotally 1980 spontaneous ADRs were reported involving 960 patients and 1316 drugs prescriptions. The occurrence of ADRs was common among male patients (64%) and patients of age between 19 and 65 years (81%). Antimicrobials caused 29% ADRs, followed by drugs of antiretroviral therapy (19%). Zidovudine caused most ADRs (88%) followed by ethambutol and ciprofloxacin. The ADRs of skin and subcutaneous tissue disorders (28%) were most common among all system organ classes followed by gastrointestinal systems (18%). Four per cent of all reported ADRs were severe. A peak of ADR reports was attained in 2016 with 224 reports, which decreased to 127 in 2019.ConclusionA high number of ADRs caused by antimicrobials is an alarming situation, which adds up to antimicrobial resistance. Judicious use of antimicrobials is yet again proven as need of the hour. Under-reporting of ADRs is evident in our study and is a major factor for the delay in the withdrawal of drugs responsible for causing ADRs. Interventions in terms of training and feedback are suggested to encourage and improve ADR reporting.

Background: Cancer is one of the most expensive and lethal noncommunicable diseases globally. Availability and affordability of anticancer drugs are the most important factors on which management of cancer depends. The objective of the study was to evaluate the variation of cost among different brands of anti-cancer drugs available in the Indian market.Methods: “Current Index of Medical Specialties” July-October 2018 and “Drug Update” Sept - 2018 were used to obtain cost in INR* (Indian National Rupees) of anticancer drugs manufactured by different pharmaceutical companies in India, in the same strength and dosage form. Percentage cost variations were calculated by minimum and maximum costs of anticancer drug of different brands.Results: Percentage variation in cost was analyzed for 41 different formulations of 27 anticancer drugs. Highest cost variability seen with Alkylating agent Carboplatin 150 mg injection (1100%) and lowest with Antimetabolite anticancer agent Cytarabine 500 mg injection (6.56%). Three formulations showed more than 500% cost variation, largest with Carboplatin 150 mg injection (1100%) followed by Anastrozole 1 mg tablet (870%) and Letrozole 1 mg tablet (508.42%).Conclusions: Present study finding showed significant cost variation in different brand of many anticancer drugs in India. These results indicated that greater price transparencies required. This price variation issue requires a much more in-depth analysis of the health care system.

Background: Drug utilization study can increase our understanding of how drugs are being used. This study was done to evaluate the current drug prescribing trend in management of indoor patient of orthopaedic department and to comment on rationality of the prescribed medicines.Methods: This is a prospective observational study conducted for 12 months, in Chandrikaben Rashmikant Gardi Hospital, a 600 bedded tertiary care rural based, teaching hospital. Total 611 patients were included in this study.Results: Total 5416 drugs were prescribed in 611 prescriptions. Average number of drugs per prescription was 8.86. Average duration of prescription was 10.7 days. Percentage of drugs prescribed by generic name was 28.8%. Percentage of encounter with an Antibiotic prescribed was 60.23% i.e. out of 611 prescriptions antibiotics were prescribed in 368. Percentage of encounter with an Injection prescribed was 63% which means out of 611 prescriptions, injectables were prescribed in 385. Percentage of drugs prescribed from National Essential Medicine List was 52.63%. Percentage of drugs prescribed from WHO model List was 32.46%. Diclofenac (14.25%) was most commonly prescribed drug. Incidence of polypharmacy was quite high in context of Analgesics. Almost 40% of prescriptions had 2 drugs. Orally prescribed Analgesics were 62.6%, Injectables 34.38% and Topical 3.02%.Conclusions: This study reveals that the pattern of prescription in terms of rationality is poor. Special attention needs to be given to the irrational prescribing in terms of polypharmacy and long duration. Continuing medical education regarding appropriate use of drugs, knowledge of adverse effects and standard prescription guidelines will play pivotal role in rational prescription of drugs.

Objective: The true prevalence of peripheral arterial disease (PAD) in individuals with diabetes has been difficult to determine because of the lack of symptoms and insensitive diagnosis. We estimated the prevalence of PAD and its association with age and gender in Type 2 diabetes mellitus (DM) who were asymptomatic for PAD. Methods: Total 150 Type 2 DM patients were screened and examined for PAD using Ankle Brachial Index and Color Doppler. Prevalence of PAD was further studied and statistically analyzed to find its association with age and gender. Results: Prevalence of PAD in our study was 16%. Out of total 150 Type 2 DM patients, 24 patients were diagnosed to have PAD by Color Doppler. The prevalence was 12.0% in the fifth and sixth decade followed by 3.3% in seventh and eighth decade and 0.7% in <40 years age group. Out of total 150 cases, there were 83 males and among them 15 (18.1%) had PAD and out of 67 females, 9 (13.4%) had PAD. After application of Chi-square test to the above observations, there was no statistically significant association of age and gender with PAD in our study population. Conclusion: In the present study, the prevalence of PAD was 16%; 10% and 6% in males and in females, respectively. There was no statistically significant correlation of PAD with age and gender.