Complementary and alternative medicine: practice and perspective of allopathic doctors at a tertiary care hospital

2016-09-23T23-25-50Z
Source: International Journal of Basic & Clinical Pharmacology
Dharani Sundarmurthy, Vijayalakshmi Devarashetty, Narayana Reddy S..
Background: Complementary and alternative medicine (CAM) has been defined as a group of diverse healthcare systems, not considered to be a part of conventional (allopathic) medicine. Approximately 80% of general population use traditional medicines (WHO). Thus, patients using CAM and its associated adverse effects may be encountered in practice of modern medicine. Hence it is necessary to assess the knowledge, attitude and practices of CAM among health care professionals (HCPs). Methods: After obtaining IEC approval, the cross-sectional study was conducted in doctors at Bangalore Medical College and its attached hospitals. 200 doctors who gave informed consent were included in the study. Results: 61.5% of the HCPs were aware that CAM includes AYUSH. 53% of the HCPs used CAM for self, especially for respiratory disorders (28.3%) and chronic painful conditions (21.6%). The common adverse effects attributed to use of CAM among patients which required consultation of the HCPs were hepatic (42.5%) and renal impairment (32.5%), allergy (10%), relapse (10%), and metal intoxication (5%). 71% didnt prefer suggesting CAM for patients. 70% opined that CAM therapies be subjected to clinical trials. Conclusions: HCPs had used CAM therapy for self at least once especially for respiratory disorders and chronic painful conditions. However majority of the HCPs didnt prefer suggesting CAM to patients and as many as 70% of the HCPs insisted that CAM therapies be subjected to scientific evaluation including clinical trials in view of patient safety before integrating them with conventional medicine.


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Price analysis of antianginal drugs available in Indian market

2016-09-23T23-25-50Z
Source: International Journal of Basic & Clinical Pharmacology
Vihang S. Chawan, Sagar V. Badwane, Kalpesh V. Gawand, Maheshi U. Chhaya.
Background: Coronary artery disease (CAD) is one of the most common causes of cardiovascular mortality and morbidity in developing countries like India. Initial management includes use of many antianginal drugs. There is wide variation in market prices of these drugs. This study was planned to analyse the percentage variation in prices amongst monotherapy and combination therapy of antianginal drugs manufactured and sold under different brand names in Indian market. Methods: Price of antianginal drugs manufactured by different pharmaceutical companies, in the same strength and dosage forms was obtained from "Current Index of Medical Specialties (CIMS)" January-April 2016 and "Indian Drug Review (IDR)" Vol. XXII, Issue No.1, 2016. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in price per 10 tablets was calculated. Results: Percentage variation in price for antianginal drugs marketed in India was found to be amlodipine (5 mg) 1128.57% followed by amlodipine (10 mg) 1040% and amlodipine (2.5 mg) 780% as a monotherapy. Whereas atenolol (25 mg), atenolol (50 mg) and nicorandil (10 mg) also showed significant percentage variation in prices 525%, 426.66% and 350.84% respectively. For combination therapy, percentage variation in prices were seen with amlodipine + atenolol (5 + 50 mg) 700%, followed by atenolol + hydrochlorothiazide (50 + 12.5 mg) 362.5% and Isosorbide dinitrate + aspirin (5 + 75 mg) 300%. Conclusions: There is a wide variation in the price of different brands of antianginal drugs available in India. The clinicians prescribing these drugs should be aware of these variations to reduce the financial burden of drug therapy.


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A prospective cohort study to evaluate the correlates of polypharmacy and its association with depression among elderly patients

2016-09-23T23-25-50Z
Source: International Journal of Basic & Clinical Pharmacology
Shweta Srivatsa, Debdipta Bose, Sushma M, Jayanthi C.R..
Background: Polypharmacy is a reliable indicator of irrational prescribing particularly among elderly. Polypharmacy increases the risk of adverse drug reactions (ADRs) exponentially imposing higher economic burden. Addressing and evaluating the prescribing practices in elderly will rationalize the drug utilization leading to improvement in quality of health care. The present study was taken to evaluate the determinants of polypharmacy and its association with depression, defined as a 15 item geriatric depression scale (GDS) >6, in elderly patients. Methods: This prospective cohort study was conducted at department of medicine, Victoria hospital, Bengaluru 100 patients aged 60 and above years was enrolled. Relevant data regarding patients demographic details, smoking and alcohol consumption, medical diagnosis and drug details were collected. Geriatric Depression Scale was used to diagnose depression. Results: Out of 100 patients screened, 36% were males and 64% were females. Polypharmacy was noted in 73% of the elderly, of which 43% had cumulative co morbidity (≥4 diagnoses). 68% were found to have a GDS score of ≥6, which corresponded to Depression. Patients with depression (GDS score ≥6) had 1.54 (OR-1.54, 95% CI-0.59-4.01) times more risk of encountering polypharmacy (≥4 drugs). Cumulative co-morbidity (OR-1.52, 95% CI-1.082.11, p


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Study to assess knowledge, attitude and practice regarding swine flu vaccine amongst medical students

2016-09-23T23-25-50Z
Source: International Journal of Basic & Clinical Pharmacology
Rajvardhan R. Solunke, Shrikant C. Dharmadhikari, Jugalkishore B. Jaju, Ganesh R. Pawar, Aruna Gurung.
Background: Due to recurrent outbreak and associated high mortality of swine flu there is panic amongst medical students also because of higher risk of getting infected. Vaccination for swine flu is the best preventive measure. So this study was undertaken. The aim of the present study was to assess the knowledge, attitude and practice regarding swine flu vaccine amongst medical students of government medical college and provide data to improve awareness about swine flu vaccine Methods: This was a cross sectional observational study carried out amongst 250 medical students during period of April-June 2015. A pre designed and pre tested, multiple choice questionnaires was used to assess KAP regarding swine flu vaccine and descriptive analysis was done. Results: Knowledge of participants regarding Swine flu vaccine was high as the mean score of correct answers marked was 152.5. But Only 21.8% participants had knowledge about cost of vaccine and 33.2% about the adverse drug reactions to the vaccine. Internet was the most common source of information amongst participants. Attitude of participants toward vaccination was favourable (mean score -128.4) but attitude for vaccination during pregnancy (30.8%) and with other vaccines (32.8%) was unfavourable. Only 30(12%) candidates have taken the vaccine which shows very poor practice. Conclusions: This study shows high knowledge, favourable attitude but poor practice towards Swine flu vaccination amongst medical students. So there is need to increase awareness for vaccination of swine flu amongst medical students by continuous health education and also need to increase the availability of vaccine in government hospitals.


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To study the pattern of adverse drug reactions among patients hospitalized in the medical wards of a tertiary care hospital

2016-09-23T23-25-50Z
Source: International Journal of Basic & Clinical Pharmacology
Anup Kumar, Dinesh Kansal, Parveen Kumar Sharma, Amit Bhardwaj, Sushma Sawaraj.
Background: ADRs have a major impact on public health, quality of life. ADRs are a recognized hazard of drug therapy. Although some ADRs are minor and resolve without squeal, others can cause permanent disability or death. Despite the methodological rigor of clinical trials, it is generally not possible to identify all safety issues associated with drugs during the pre-marketing research phase. The only way to find out such occurrences is to be on active-look out for adverse events over a long time horizon in large population and in different host conditions. The information may be useful in identifying and minimizing preventable ADRs, while generally enhancing the knowledge of the prescribers to deal with them more efficiently. Methods: This retro-prospective study was conducted in a tertiary care hospital for one year. Data of those patients who experienced ADRs was recorded in detail from internal Medicine ward. An assessment of causality was done. Data was evaluated to determine the class of drugs and the organ systems frequently associated with ADR within the settings of the institute. Results: The total incidence of ADRs was 7.59% in hospitalized patients with male predominance. Most common system involved was GIT followed by CNS and CVS. Antibiotics were most common culprits for ADRs followed by NSAIDS and hypoglycemic agents. In causality assessment probable ADRs were much more than possible ADRs. Severity of reaction in most of the patients was moderate. Majority of ADRs were Type A and maximum were probably preventable. Conclusions: There is need to explore the reasons for this relatively low incidence rate of ADRs in the Indian population. Under­reporting is one of the major factors with a lack of proper pharmacovigilance system which is still in budding state in India.


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Single dose metronidazole, tinidazole and ornidazole in the treatment of bacterial vaginosis - a comparative study

2016-09-23T23-25-50Z
Source: International Journal of Basic & Clinical Pharmacology
Banapura Ambika, Mamatha K. R., Geetha Shivamurthy.
Background: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge. There is a lack of consensus on the etiologic agents or agents associated with BV, due to polymicrobial nature. There is high recurrence rate of BV and it is difficult to treat. Metronidazole is the drug of choice but newer nitroimidazoles are better alternatives with long half-lives and better tolerability. Methods: This was a prospective, comparative, randomized, single blinded study on 120 diagnosed cases of bacterial vaginosis, with symptomatic or asymptomatic abnormal vaginal discharge. Amsel's criteria were used to diagnose bacterial vaginosis as well as to assess the response and classify the patients as cured, partially cured and not cured. Statistical analysis was done by Chi square test. The cure rate was compared considering metronidazole cure rate as gold standard. Results: At 1 week, the cure rate of tinidazole and ornidazole was 89.5% in both the groups, and at 4 weeks, it was 84.5% for both drugs (P


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Comparative assessment of the pattern of anti-hypertensive drugs prescribed in medicine and cardiology outpatient department

2016-09-23T23-25-50Z
Source: International Journal of Basic & Clinical Pharmacology
Bhargav Gaikwad, Sagar Bhagat, Ketaki Patil.
Background:Hypertension or High blood pressure is one of the strongest modifiable risk factors for cardiovascular and renal diseases and is a condition that afflicts almost 1 billion people worldwide Objective: To compare the prescribing pattern of antihypertensive drugs in patient attending medicine and cardiology OPD Methodology: observational, cross sectional study conducted in the department of pharmacology in collaboration with the medicine and the cardiology department. Results :The present study which was conducted for a period of 6 months in the medicine and cardiology OPD showed unequal distribution of the patients in the medicine and cardiology OPD, with 223 patients attended medicine OPD while 434 patients attended cardiology OPD. Amongst the patients attending medicine OPD, majority of the patients (61.88%) were stage 1 hypertensive (>140/90mmHg) according to JNC VII classification whereas majority (69.38%) of those attending cardiology OPD were stage II hypertensive (>160/100). calcium channel blockers (CCB) were the most commonly prescribed drug in medicine OPD followed by angiotensin converting enzyme inhibitors (ACEI) whereas beta blockers (BB) were most commonly prescribed in cardiology OPD followed by ACEI.


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