Background: Prescription audit is one of the methods to assess the drug utilization pattern and rational use of drugs. In our country the value of drugs prescribed is in crores but a significant proportion of drugs is prescribed irrationally. This is probably due to defect in prescription pattern, lack of knowledge in health care personnel, pressure from drug manufacturing companies and many more. To promote rational use of drugs, standard policies must be set and this can be achieved only after auditing current prescription practices.Methods: A prospective study was carried out in Medical college hospital, Raigarh in the month of January 2018. Around 1000 prescriptions were collected randomly from pharmacy and the prescriptions were analysed on various parameters like patient’s demography, parts of a prescription, information related to doctor and drugs.Results: In this study, we found that percentage of generic drugs were 58.02% and 70.43% drugs were from essential drug list. Only 13.19% FDCs were used. 34 prescriptions were illegible and capital letters were used only in 26 prescriptions. We also found deficiency in parts of a prescription like inscription part (13.3%), subscription part (26.9%) and in doctor’s identity (33.2%). The majority of drugs were antimicrobials (23.81%) followed by anti-inflammatory and analgesics (21.1%).Conclusions: This study shows that the use of generic drugs and essential drugs is on the lower side as compared to standard guidelines. The prescription pattern was defective in many prescriptions. This study shows incompleteness of prescriptions and proper steps are needed to guide the physicians to promote rational use of drugs.
Background: Prescription error and irrational prescribing are the avoidable problems imposed on health care delivery system from prescriber side which must be addressed. Periodic prescription audit helps to curtail the error and irrational prescribing.Methods: A prospective observational study was conducted on patients visiting various Outpatient Department of RIMS, Ranchi, Jharkhand on all working days at 11:00 AM to 12:00 PM from 1 August 2018 to 31 July 2019. Various aspects of collected prescriptions were analyzed by using World Health Organization (WHO) prescribing indicators.Results: In this study, out of 700 prescriptions collected, 76 were excluded. Out of total 624 patients analyzed, 382 (61.28%) were male and 242 (38.72%) were female. 48 (7.69%) patients belonged to ≤18, 464 (74.36%) to 19-64 and 112 (17.95%) to ≥65 years of age group. Tablet (71%) was the most common dosage form. None of prescriptions were having registration number of the doctor. 242 (38.78%) prescriptions did not have a diagnosis duly written. The total no. of drugs prescribed in 624 prescriptions was 2176. Only 32 (5.13%) prescriptions were found to have medicines prescribed in block letters. Antibiotics (29%) were the most common class of drugs prescribed. Average number of drugs per prescription was 3.47. Only 48 (2.20%) drugs were prescribed by their generic name while total of injectables prescribed were 102 (4.68%). Total number of drugs from NLEM was 848 (38.97%). 196 (9.00%) drugs were fixed-dose combination.Conclusions: In our study, we found deficiencies in various parts of prescriptions. Prescribing pattern was not in accordance with WHO recommendation for prescribing practice.
BACKGROUND : The aim of this study was to compare effectiveness, safety and tolerability of azilsartan and telmisartan in terms of their blood pressure lowering capacity, effect on hematological and biochemical profile and side effects respectively in patients of essential hypertension. METHODS : This was an observational, prospective, open label, randomized, parallel study. The study was conducted after getting approval from the ethics committee at RIMS, Ranchi. Total sample size was 108. Blood pressure recordings, hematologic and biochemical investigations were done at the beginning of study and at every visit according to study design. The first group was prescribed tablet azilsartan 40mg once daily and the other tablet telmisartan 40 mg once daily at the beginning. Each patient was followed for 12 weeks and total study duration was 1 year. RESULTS : The treatment arms showed significant reduction (p<0.05) in both systolic and diastolic blood pressure at the end of study period, although while doing inter-group comparison, the difference was not significant. Safety profile of both drugs was similar. Notable side-effects included fatigue and dizziness apart from headache. CONCLUSION : Azilsartan and telmisartan reduced the blood pressure significantly in 12 weeks when compared from the baseline, but the reduction was similar when an intergroup comparison was done. The drugs did not adversely affect the haematologic and biochemical parameters. Few side-effects were reported but these were mild in nature and did not require any specific intervention. KEYWORDS : Angiotensin receptor blocker, Azilsartan, Effectiveness, Essential hypertension, Randomized, Safety, Telmisartan, Tolerability
Background: Diabetes is one of the largest global health emergencies of the 21st century and its co-existence with hypertension is frequent. These conditions often require polypharmacy with possible risk of drug interaction. This study is conducted to investigate the effect of amlodipine on blood glucose level in euglycemic and diabetic rats and its pharmacodynamic interaction with glibenclamide.Methods: Rats were divided into six groups of 6 rats in each group. Group 1 and 3 were non-diabetic given 1% Gum acacia and amlodipine respectively. Group 2, 4, 5 and 6 were made diabetic by using nicotinamide and streptozotocin injection intra peritoneally and given 1% Gum acacia, glibenclamide, amlodipine and amlodipine + glibenclamide respectively for the period of 28 days. Fasting Blood Glucose (FBG) levels were measured before induction of diabetes, 72 hrs after the induction, on day 0, 7th, 14th, 21st and 28th day.Results: Amlodipine produced no significant effect on FBG level in non-diabetic rats but in diabetic rats statistically significant hyperglycemia were observed on day 21st and 28th of study with the ‘p’ value (<0.05). Glibenclamide treated rats shows better controlled FBG level throughout study than concomitant administration of glibenclamide with amlodipine. Significant rise in blood FBG level with ‘P’ value (<0.05) were observed in amlodipine + glibenclamide treated group on 21st and 28th day of study.Conclusions: This study suggest amlodipine produce no effect on the FBG level of normal rats but causes significant hyperglycemia in diabetic rats. Hypoglycemic effect of glibenclamide gets blunted when co-administered with amlodipine.
INTRODUCTIONDiabetes mellitus refers to a group of common metabolic disorders that share the phenotype of hyperglycaemia. Various distinct types of DM are caused by a complex interaction of genetics and environmental factors. Depending on the aetiology of DM factors contributing to hyperglycaemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production. When fully expressed diabetes is characterized by fasting hyperglycaemia. The effects of diabetes mellitus include long term damage, dysfunction and failure of various organs especially heart, kidneys, eyes and blood vessels. Diabetes may present with characteristic symptoms such as thirst, polyurea, blurring of vision, polyphagia, and weight loss and in its most severe form diabetic ketoacidosis and non ketotic hyperosmolar state, which in absence of effective intervention lead to stupor, coma and death. At present, India is considered as the diabetic capital of the world by WHO. There are approximately 3.5 crore diabetics in India, and this figure is expected to increase up to 5.2 crore by 2025. Every fifth patient visiting a consulting physician is a diabetic. By the year 2025 it is predicted that India will have a rise of 59 percent of diabetics in the population -which is the highest number of diabetic patients in the world. 2 ABSTRACTBackground: Thiamine is a member of the vitamin B family. Thiamine is necessary for normal insulin synthesis and secretion. In diabetes thiamine and its derivative benfotiamine showed promising results in prevention of microvascular complications. Some experimental and clinical studies have shown the antihyperglycaemic effect of thiamine. This study compared the antihyperglycaemic effect of thiamine with metformin in streptozotocinnicotinamide induced diabetic albino rats. Methods: 24 albino rats were taken and divided into four groups of six rats in each group. The groups were normal control, diabetic control, diabetic rats treated with thiamine, diabetic rats treated with metformin. Diabetes was induced in three groups by intraperitoneal injection of Streptozotocin in the dose of 60 mg/kg. To have an ideal type 2 diabetes model nicotinamide was administered 120 mg/ kg intraperitoneally fifteen minutes before streptozotocin administration. After successful induction of diabetes thiamine and metformin were given to the respective group for a period of 6 weeks. Fasting blood glucose was estimated on day 0, 7, 14, 21, 28, 35, 42 of treatment. Results: In this study both thiamine and metformin showed significant antihyperglycaemic effect (p<0.05). Further studies are needed to evaluate and compare the antihyperglycaemic effect of thiamine with other established anti diabetic drugs. Conclusions: From this study we concluded that individually both thiamine and metformin were effective in controlling hyperglycaemia but metformin was better in achieving normal mean FBS. Further studies are required to validate the antihyperglycaemic effect of thiamine. Study taking different doses of thiamine ...
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