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Diabetes is a chronic and potentially disabling disease that represents an important public health and clinical concern. The study was designed to assess the drug utilization evaluation of anti-diabetic medications through prescription monitoring in a tertiary care hospital at capital city Dehradun in a northern state Uttarakhand. Prescriptions from patients of diabetes were selected for the study and data was collected from patients using a questionnaire format. All the necessary and relevant information will be collected from out-patient prescriptions, laboratory data reports and also by verbal communication with patients. Out of total 100 prescriptions of diabetic patients, it was found that gender wise distribution of diabetic patients was more in females (64%) as compared to males (36%). Among 100 patients, type 1 diabetes occurred in 16% patients and type 2 diabetes occurred in 84% patients. It was also analyzed that both type 1 and type 2 diabetes were mostly occurred in females. Among type 2 diabetes patients, Glimepiride were mostly prescribed in 42% patients, followed by Metformin in 22% patients and Gliclazide in 20% while in type 1 diabetes patients, Human Insulin were prescribed in 16% patients. Prescription analysis showed that maximum prescriptions (50%) contain two drugs per prescription while six drugs per prescription were shown by only 2% prescriptions. This study may provide further help to prescribers for improvement in current prescribing trends in the management of diabetes mellitus.  

Background: Antibiotic prophylaxis is the prevention and in incidence of surgical site infection. This study evaluates the rational use of antibiotics prophylaxis prior to surgery amongst hospitalized patients. Objectives of the study were to investigate the utilization and evaluation pattern of antibiotics for surgical prophylaxis in surgery department.Methods: A prospective observational study was conducted on 100 patients receiving antibiotics in the Department of Surgery of Brijesh Hospital Ramnagar (Nainital) Uttarakhand. Patient undergoing antibiotic prophylaxis treatment were included in the study, exclusion of those patients who had age less than 18, patients with psychiatric disease and those patients not willing to sign on inform consent form.Results: The result observed in 100 patients follow up 8 weeks and evaluate the appropriate use of prophylaxis of antibiotics majority of patients were age group 18-30 years, followed by 41-50 years, 51-60 years, majority were reported in female patients than male, higher utilization of cephalosporins were commonly prescribed due to their relatively lower toxicity and broader spectrum activity and broader coverage of organism for several serious gram negative infection 30 (30%) patients were prescribed penicillin with aminoglycosides, 10 (10%) patients were prescribed with nitroimidazole antibiotics.Conclusions: The overall scenario of antibiotic usage in a Hospital was as per standard recommendations and all the antibiotics used were according to their standard adult and titrated doses and frequencies. In this study we found that Cephalosporines, Penicillins, Aminoglycosides and Nitroimidazole were mostly used classes of drug. Adverse Drug Reactions were minor and well managed.

Anti-tubercular therapy induced liver injury (ATTILI) is the most important risk for the past many years. Many pre-existing factors and conditions like persisting liver injury, female gender, alcohol abuse etc. are important risk factors for the ATT induce liver injury. I read many case reports and literature review for the drugs induce liver injury, and concluded the results, ATT drugs are the most responsible for the liver injury during the therapy periods. The present case was 42-year-old male patient and known case of pulmonary tuberculosis, patients were on the ATT drugs therapy in the last 14 days. After few days of therapy, he produced signs of vomiting (multiple episode), fever (high grade), abdomen pain, coughing, loss of appetite, epigastric discomforts & generalized weakness. On general examination the patient was found to produce signs of Jaundice with yellowish appearance of the sclera. Pulmonologist had firstly withdrawal the anti-tubercular drugs therapy and started the modified anti-tubercular drugs therapy. As a Clinical pharmacist we advise the patients & patients relatives, proper monitoring of liver and renal function test should also be carried out by the health care professional specialist from time to time in order to avoid critical situations. Keywords: Anti-tubercular therapy, Anti-tubercular therapy induced liver injury, Pulmonologist, Hepatotoxicity.

Aim: The aim of the present study was to investigate the association between hypothyroidism and non-alcoholic fatty liver disease (NAFLD). Methods: In a prospective observational study, the hypothyroidism patients were evaluated for NAFLD using ultrasonography. The participant’s characteristics such as age, gender, thyroid profile, history of diabetes, hypertension, ischemic heart disease (IHD) were recorded using a data gathering form. Results: A total of 51 participants were included in this study. From 51 participants, 47 (92.18%) individuals were females whereas 4 (7.82%) individuals were males. Out of 51 participants 27 individuals had NAFLD. There was statistically significant difference in FT4 levels with the participants with NAFLD. Conclusion: Results from this study suggested that low FT4 concentration is associated with increased risk of NAFLD. Keywords: Hypothyroidism, NAFLD, ultrasonography, FT4.