Context:Epilepsy is a neurological disorder affecting 70 million worldwide. The high incidence of relapse can be attributed to nonadherence, thus increasing the incidence of refractory epilepsy to 10%–20%.Aims:This study was planned to determine rate of adherence and factors affecting adherence using Antiepileptic Adherence Questionnaire and Baseline Adherence Questionnaire.Materials and Methods:A cross-sectional, questionnaire-based study was carried out at a rural hospital from May to September 2015. Patients of either gender aged 18–60 years, diagnosed with epilepsy were interviewed after they consented. Patient details, responses to questionnaires were collected and analyzed using descriptive statistics.Results:Among the participants, 67.8% were males and 32.2% were females with the mean age of 38.3 ± 13.9 years. The response rate was 75% (90/120). The majority were literate (64.4%) and employed (58.9%). The duration of disease was <5 years in most individuals; 50% were highly, 21.1% moderately, and 28.9% nonadherent to treatment. Among the highly adherent, 66.7% never skipped medications because they had knowledge of the disease and treatment. More than 97% were satisfied with the social support, and 89% expressed that their family and friends reminded them to take medications. Patients who were nonadherent to treatment attributed it to the lack of knowledge of the disease (57%) and treatment (96%). Reasons for nonadherence were patients assumed drug was harmful, felt cured of the disease, and wanted to avoid side effects.Conclusion:Nearly, 70% expressed the lack of satisfactory support from the social circle. We observed that nearly seventy percent epileptic patients were moderate-highly adherent. Nonadherence was attributed to patient feeling cured of disease and assuming medications to be harmful. Counseling of patients will help in adherence to treatment.

BackgroundEffective control of pain postoperatively is essential in providing enhanced patient care and a cost-effective hospital stay. Though many treatment modalities exist for postoperative pain management in orthopedic surgeries they are often accompanied by adverse effects. This study was carried out to assess the efficacy of flupirtine and piroxicam in postoperative pain reduction using visual analog scale (VAS) score.Materials and methodsAn open-label, parallel group, comparative study was conducted on patients undergoing lower limb orthopedic surgery, randomized into two groups of 38 patients each. They received either flupirtine 100 mg or piroxicam 20 mg 6 hours after surgery and then twice daily orally for 5 days. Pain was measured using VAS score, total pain relief score (TOTPAR24), and patient satisfaction score (PSS); the other scales used were behavioral pain assessment scale (BPAS) and functional activity score (FAS). Rescue medication used was tramadol 100 mg intravenously. WHO causality scale was used for assessing adverse effects. Descriptive and inferential statistics were used for assessment of various parameters.ResultsA total of 76 patients with mean ± standard deviation age of 35.08±10.3 years were recruited; 34 in the flupirtine and 37 in the piroxicam groups completed the study. Patients in both groups were comparable in baseline characteristics. Flupirtine and piroxicam reduced VAS score 48 hours postoperatively compared to baseline (p=0.006 and 0.001) and piroxicam produced significant reduction in pain at 8, 12, and 120 hours compared to flupirtine (p=0.028, 0.032, 0.021). TOTPAR24 and PSS at 24 hours were comparable between the treatments. BPAS scores at 24 hours were reduced significantly in patients receiving either drug (p=0.001). FAS improved at 72 hours in patients receiving piroxicam. Adverse effects were similar with both the medications.ConclusionFlupirtine and piroxicam reduced pain effectively but the onset of pain relief was earlier with piroxicam.

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