Dr.Yogendra Keche | All India Institute of Medical Sciences, Raipur (original) (raw)
Papers by Dr.Yogendra Keche
Korean Journal of Nosocomial Infection Control, 2014
Background: This study aimed to evaluate the quality of surgical antibiotic prophylaxis (SAP) in ... more Background: This study aimed to evaluate the quality of surgical antibiotic prophylaxis (SAP) in a tertiary hospital. Methods: Medical, anesthetic, and nursing records from the 27,320 procedures conducted in a tertiary hospital during 2012 were retrospectively reviewed. Three clinical performance indicators of SAP (selection of antibiotic, timing of the first administration, duration of prophylaxis) were included as part of the National Hospital Evaluation Program (NHEP) of the Health Insurance Review and Assessment Service. In addition, 2 other parameters were assessed according to recent guidelines (weight-based initial dosing for obesity, intraoperative re-dosing for excessive blood loss, and prolonged duration of procedures). Results: Prophylactic antibiotics were administered in 19,637 (71.8%) of 27,320 total procedures. Quality of the 3 performance indicators was higher in the types of operations included in NHEP than in other procedures. However, additional doses were administered in 15 (1.2%) of 1,299 surgical procedures that lasted more than twice the half-life of the antibiotic used, and in 9 (3.3%) of 273 procedures with excessive blood loss greater than 1,500 mL. NHEP and non-NHEP results did not differ significantly. Conclusion: Three SAP quality indicators showed more improvement in NHEP surgical procedures than in non-NHEP, but the other parameters did not perform well regardless of NHEP assessment. Therefore, more measures to improve the appropriateness of SAP should be developed.
Cureus, Jan 29, 2023
Poorly published trials may result in biased and erroneous healthcare decisions. We conducted thi... more Poorly published trials may result in biased and erroneous healthcare decisions. We conducted this systematic review to evaluate the reporting quality of drug-related randomized controlled trials (RCTs) conducted in India and published in MEDLINE-indexed Indian journals over a decade (between January 1, 2011, and December 31, 2020), as per the Consolidated Standards of Reporting Trials (CONSORT) Checklist 2010. An extensive literature search was conducted using the terms "Randomized controlled trial AND India." The full-length papers were extracted for RCTs related to drugs. Two independent investigators assessed each article against the checklist containing 37 criteria. Each article was scored 1 or 0 against each criterion which was finally summed up and evaluated. None of the articles fulfilled all 37 criteria. A compliance rate of >75% was seen in only 15.5% of articles. More than 75% of articles fulfilled a minimum of 16 criteria. Major checklist points observed to be deficient were "important changes to methods after trial commencement" (7%), "interim analysis and stopping guidelines" (7%), and "description of similarity of interventions while blinding" (4%). There remains ample room for improvement regarding research methodology and manuscript preparation in India. Moreover, journals should stringently implement the CONSORT Checklist 2010 to enhance the standard and quality of publications.
OBM Geriatrics
The COVID-19 pandemic had imposed a city-level quarantine, local lockdown, and border closures fo... more The COVID-19 pandemic had imposed a city-level quarantine, local lockdown, and border closures for patient-level isolation to control virus spread. There is a lack of studies on the health-related quality of life (HRQoL) in the elderly in countries like India during COVID-19. After obtaining written informed consent from the elderly patients, data was recorded in the case record form-cum-questionnaire. The quality of life was assessed with the help of Centers for disease control and prevention (CDC) HRQoL-14 measures, which are based on general health improvement, physical and mental health, and its effect on usual activities like self-care, work, or play, sadness, depression, worry, tension, or anxiety, and rest or sleep. A total of 331 patients were screened and 234 were enrolled in this study, with 220 patients completing their follow-up. Among them, 55.43% were retired elderly, 31.82% were unemployed and 21.36% were living alone. After one month, 49 patients had days of poor phy...
International Journal of Research in Medical Sciences, 2017
Background: Staphylococcus aureus is a pathogen causing wide spectrum of infections. It has tende... more Background: Staphylococcus aureus is a pathogen causing wide spectrum of infections. It has tendency for the development of multidrug resistance thereby exposing the selection of appropriate treatment. Therefore, the present study was undertaken to find out the antibiotic susceptibility pattern of Staphylococcus aureus isolated from various clinical samples in teaching tertiary hospital.Methods: Total 85 Staphylococcus aureus was isolated from clinical samples (pus, urine, sputum and blood) tested. Identification of Staphylococcus aureus was done by standard conventional microbiological methods. Antibiotic susceptibility testing was done by using disk diffusion method as per CLSI guidelines.Results: Staphylococcus aureus was isolated maximum from pus samples followed by urine samples. Antibiotic susceptibility testing showed highest resistance against Penicillin (69%) and Erythromycin (51%) followed by Cotrimoxazole (50%) & Nitrofurantoin (50%). All the strains were sensitive to Van...
Pediatric dentistry, Jan 15, 2017
The purpose of this study was to evaluate macroscopically and ultrastructurally the effect of cal... more The purpose of this study was to evaluate macroscopically and ultrastructurally the effect of calcium hydroxide cement (CH) and resin-modified glass ionomer cement (RMGIC) compared with gutta percha (control) as a lining material on carious dentin after partial caries removal and sealing. Twenty-seven permanent molars with deep carious lesions underwent partial caries removal with the application of CH, RMGIC, or gutta percha (control) and were then sealed for three months. After a partial caries removal and sealing period, the dentin was macroscopically assessed (for color, consistency, and humidity) and further analyzed by scanning electron microscope to assess the ultrastructural changes in dentin (lumen size, mineralization of tubules, occlusion of tubules by cements, and bacterial ingress). The effect of treatment in each group was statistically analyzed. Dentin darkening and hardening were observed after the sealing period in all groups. However, there was no difference in the...
Objective: To find out self medication pattern of antimicrobials in Pune. Methods: II MBBS studen... more Objective: To find out self medication pattern of antimicrobials in Pune. Methods: II MBBS students collected the information of names of antimicrobials self medication, dose, frequency of administration, health related problem for use of self medication, source of information of self medication and information about ADRs with the help of semi-structured questionnaire. Students also educated the population about ADRs to antimicrobial with the help of ADR checklist. Medical shopkeeper’s knowledge about ADRs and reasons for not providing information of ADRs to population had been explored. Results: Macrolides and fluroquinolones were commonly self medicated in Pune and fluroquinolones groups caused ADRs in about 66 %. Drugs like levofloxacin, roxithromycin, ampicillin were taken less than WHO DDD and some antimicrobials were taken less than 3 days period. 70-80% population was ignorant about ADRs to antimicrobials. About 85 % medical shopkeepers did not provided information of ADRs to...
Efficacy and safety of Livwin (polyherbal formulation) in patients with acute viral hepatitis: A ... more Efficacy and safety of Livwin (polyherbal formulation) in patients with acute viral hepatitis: A controlled clinical trial
Journal of Family Medicine and Primary Care
Background and Objectives: Adverse Drug Reactions (ADRs) can lead to significant morbidity, rarel... more Background and Objectives: Adverse Drug Reactions (ADRs) can lead to significant morbidity, rarely mortality and financial burden over the patient. ADRs that can be prevented can be considered as form of medication error sometimes. This study assessed the preventability, predictability and severity of ADRs using different assessment scales. Methods: ADR Monitoring Centre under newly established teaching hospital in Chhattisgarh collected ADR reports from different healthcare professionals during the period from November 2016 to November 2018. Analysis of the reported ADRs was done for their causality assessment, demographic details of patients, most common drug class responsible for the ADR. Seriousness and preventability of ADRs were analysed by using WHO Causality Scale and Modified Schumock and Thornton Scale respectively. Severity of ADRs was assessed by Modified Hartwig and Siegel Scale. Results: Totally 288 ADRs were reported in a 2-year period. 92.01% ADRs were non serious. 44.8% were mild, 53.81% moderate and 1.39% were severe ADRs. Causality assessment showed: 5.21% certain, 54.86% probable, 39.24% possible and 0.69% unlikely ADRs. Around 26% ADRs were definitely and probably preventable and 27.78% ADRs were predictable. The highest number (32.29%) of ADRs were reported to antimicrobials. 11.15% ADRs were reported to NSAIDs, in that 37.5% ADRs were due to NSAIDs combination. Conclusion: Many ADRs in this study are non-serious, preventable and predictable. Management of such ADRs through therapeutic interventions would be beneficial in a better patient outcome. Multidisciplinary strategies involving physicians, pharmacists, other healthcare professionals and patient education and awareness about ADRs are needed for prevention of ADRs.
This study analyzes the self medication use in Pune city and also assesses the rationality of sel... more This study analyzes the self medication use in Pune city and also assesses the rationality of self medication. This was a cross sectional study. With the help of semi-structured questionnaire data was collected by II MBBS students for this study. Information about the names of the self medications, diagnosis for the use of self medication, source of information for self medication use and adverse effects reported to self medications was collected. The drugs that are commonly self medicated in Pune city were: analgesics (28.68%), antibiotics (13.18%), vitamins (10.85%) and GIT ailment drugs (14.34). Apart from this, herbal drugs and skin problem drugs are predominantly self medicated in Pune city. Information about the self medication was predominantly obtained from previous prescription of doctors (62.41%) and from chemists (18.99%) and advertisement was 3 important source of self medication in Pune (9.69%). Antibiotics self medication use was associated 29.41 % ADRs. The adverse ef...
Objective: Earlier identifying drug interactions may help in risk reduction in elderly patients. ... more Objective: Earlier identifying drug interactions may help in risk reduction in elderly patients. Methods: Drug prescription data of 212 elderly patients of tertiary health care center had been analyzed for possible drug interactions with investigational drugs for COVID-19 treatment. Drug interaction had been checked from Stockley's Drug Interaction 2019 and Martindale the Complete Drug Reference 2017 and standard reference books of Pharmacology. Findings: Different types of drugs prescribed in the elderly were 260 and out of which 68 (26.36%) were in the category of fixed-dose combinations. Around 150 (70.75%) elderly patients were having one or more associated comorbidities. Thirty-five drugs prescribed to elderly had been found to cause drug interaction with investigational drugs for COVID-19. Possible drug interactions are mediated through CYP3A4 (eighteen patients), CYP2D6 (seven patients) isoenzymes, or P glycoproteins transporters (three patients). Conclusion: Possible dru...
International Journal of Research in Medical Sciences
Background: Surgical site infections are associated with prolonged hospital stays and increased c... more Background: Surgical site infections are associated with prolonged hospital stays and increased cost of therapy. Prophylactic use of antimicrobials is to prevent the incidence of postoperative wound infection. To generate data on postoperative use of antimicrobials this study was planned.Methods: The information was collected in semi-structured questionnaire format from the patient’s case paper. Information regarding the antimicrobials prescribed by surgeon, including drug combinations, duration of therapy, frequency of drug administration, and diagnosis for the surgery was collected. Surgical wounds were classified based on National Research Council (NRC) criteria.Results: Mean duration of antibiotic use was 3.71 days for clean surgeries (70%) and ranging from 2.67 days to 6 days for clean contaminated, contaminated and dirty types of surgeries. average number of antimicrobials prescribed for surgical antimicrobial prophylaxis was 3 per patients. Ceftriaxone, cefixime, ofloxacin, l...
The study was planned to evaluate the efficacy and safety of Livwin (polyherbal formulation) in a... more The study was planned to evaluate the efficacy and safety of Livwin (polyherbal formulation) in acute viral hepatitis. In this study, there were 29 patients in each group, receiving either Livwin or placebo. Livwin capsules contains Terminalia arjuna-100 mg, Withania somnifera-100 mg, Phyllanthus niruri-100 mg, Berberis aristata-50 mg, Tinospora cordofolia-75 mg, Picrorhiza kurroa-50 mg, Boerhaavia diffusa-50 mg. Placebo capsules contains lactose 500 mg. Both drugs were given orally, two capsules 2 times a day for 8 weeks followed by treatment free period of 4 weeks. Recovery of patients assessed by clinical parameters: fever, weakness, icterus and tender, enlarged liver and by biochemical parameters: serum bilirubin, SGOT (Serum glutamate oxaloacetate transaminase), SGPT (Serum glutamate pyruvate transaminase), serum alkaline phosphatase at baseline, 2 weeks, 4 weeks, 8 weeks and 12 weeks. Significant clinical recovery was observed in the form of icterus and weakness with Livwin as compared to placebo at 2 and 4 weeks (P < 0.001). There was significant reduction in mean levels of serum bilirubin, SGOT and SGPT at 2 weeks, 4 weeks, and 8 weeks with Livwin as compared with placebo (P < 0.001). Significant reduction in mean levels of serum alkaline phosphatase with Livwin at 2 weeks (P < 0.01) and 4 weeks (P < 0.05) as compared with placebo. Mean serum bilirubin reduced by 6.72 mg/dl with Livwin and with placebo reduced by 3.64 mg/dl at 2 weeks (P < 0.001). Mean SGOT reduced by 609.11 IU/ L with Livwin and with placebo reduced by 240.34 IU/L at 2 weeks (P < 0.001). Mean SGPT reduced by 920.65 IU/L with Livwin and with placebo reduced by 326.96 IU/L at 2 weeks (P < 0.001). Livwin had shown good efficacy in patients of acute viral hepatitis. Adverse events like epigastric pain and diarrhoea were recorded with Livwin treatment and were not significant as compared to placebo.
Bangladesh Journal of Pharmacology, 2015
This study was conducted to observe the effect of vitamin B12 supplementation on glycemic control... more This study was conducted to observe the effect of vitamin B12 supplementation on glycemic control in poorly controlled hyperhomocysteinemic type 2 diabetic patients by measuring HbA1c levels at baseline and 4 weeks. Patient having serum homocysteine more than 15 µmol/L or vitamin B12 less than 223 pg/mL were enrolled in this study. One group received methylcobalamin 500 µg daily with their usual anti-diabetic therapy and the other group received only suitable anti-diabetic drug therapy. Methylcobalamin 500 µg was given daily for period of 4 weeks. Glycemic control was measured by levels of HbA1c, blood sugar at baseline and at 4 weeks. Serum homocysteine levels was reduced from 21.5 ± 2.6 to 15.4 ± 6.4 (p=0.04) with vitamin B12 supplementation at 4 weeks. At 4 weeks, HbA1c decreased from 9.9 ± 0.9 to 8.7 ± 0.5 (p<0.01) in vitamin B12 deficient patients after vitamin B12 supplementation. There is role of vitamin B12 in glycemic control in poorly controlled type 2 diabetic patients.
Asian Journal of Biomedical and Pharmaceutical Sciences, Sep 7, 2013
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology
International Journal of Basic & Clinical Pharmacology, 2013
Background: This study was carried out in various hospitals to analyze the use of rational fixed ... more Background: This study was carried out in various hospitals to analyze the use of rational fixed dose combinations (FDCs) in Pune. Methods: 279 prescriptions were evaluated in this study. Information about age, sex, names of the all the drugs prescribed by doctor/ physician, diagnosis for the use of prescriptions and adverse effects were noted in the audit form from the prescriptions of the patients. Rationality of fixed dose combination is evaluated according to WHO Model List of Essential Drugs, 17th updated version, 2011. Results: 56.98 % doctor's prescriptions in this study were containing of fixed dose combinations and out of this 10.69 % prescriptions were including two or more FDCs in their prescriptions. Only 13.20% FDCs were in accordance with WHO Model List of Essential Drugs. FDCs from antiinflammatory and antirheumatic products, vitamins, minerals, antianaemic preparations, drugs for acid related disorders, antibacterials for systemic use and cough and cold preparations were used more by private non teaching hospitals as compared to SKNMC & GH teaching hospital. 64.61 % prescriptions of private hospitals and 34.08 % prescriptions of teaching hospital were containing more than one drug. Conclusions: This study has shown that about every alternate prescription contains FDC. More than 80 % of prescribed FDCs are not in accordance with Essential Drugs List. Vitamins, minerals, antianaemic preparation FDCs should be prescribed judiciously as they are not free from ADRs. More number of drugs (poly-pharmacy) and FDCs were prescribed by non teaching private hospitals.
International Journal of Medicine and Public Health, 2012
This study was carried to analyze the self medication pattern in rural areas of Pune. Method: Sem... more This study was carried to analyze the self medication pattern in rural areas of Pune. Method: Semi-structured questionnaire was used for collection of data. Information about age, sex, name of the self medication, diagnosis for the use of self medication, source of information about the self medication and adverse effects reported to self medications was collected. Results: NSAIDs (33.33), antibiotics (10.32), vitamins (14.08) and GIT ailment drugs (13.61) are most commonly used as self medication in rural areas. Other drugs that self medicated are: drugs for upper respiratory tract infection, antibiotics, antihypertensives, anticonvulsants and diuretics. Information about the self medication was predominantly obtained from previous prescription of doctors (64.32%) and from chemists (23%). Antibiotics like macrolides, fluoroquinolones, cephalosporins, antihelminthics, and furazolidine were taken as self medication in rural areas. 50% of antibiotics used as self medication was associated with development of ADRs. The adverse effects reported with antibiotics self medication were: vomiting, hyperacidity, gastrointestinal discomfort. 21.13% of persons reported adverse effects with NSAIDs self medication. Adverse effects reported with analgesic use in this study were: hyperacidity, skin rashes, nausea. Conclusions: NSAIDs, antibiotics, vitamins and GIT ailment drugs are commonly self medicated in rural areas of Pune. The self medication of antibiotics is disturbing, as these are liable for drug resistance and severe ADRs and hence should be taken under supervision only. Pharmacists, key person in rural areas, can provide information about adverse effects of self medicated drugs and also can guide about proper precautions to be taken for self medication.
Korean Journal of Nosocomial Infection Control, 2014
Background: This study aimed to evaluate the quality of surgical antibiotic prophylaxis (SAP) in ... more Background: This study aimed to evaluate the quality of surgical antibiotic prophylaxis (SAP) in a tertiary hospital. Methods: Medical, anesthetic, and nursing records from the 27,320 procedures conducted in a tertiary hospital during 2012 were retrospectively reviewed. Three clinical performance indicators of SAP (selection of antibiotic, timing of the first administration, duration of prophylaxis) were included as part of the National Hospital Evaluation Program (NHEP) of the Health Insurance Review and Assessment Service. In addition, 2 other parameters were assessed according to recent guidelines (weight-based initial dosing for obesity, intraoperative re-dosing for excessive blood loss, and prolonged duration of procedures). Results: Prophylactic antibiotics were administered in 19,637 (71.8%) of 27,320 total procedures. Quality of the 3 performance indicators was higher in the types of operations included in NHEP than in other procedures. However, additional doses were administered in 15 (1.2%) of 1,299 surgical procedures that lasted more than twice the half-life of the antibiotic used, and in 9 (3.3%) of 273 procedures with excessive blood loss greater than 1,500 mL. NHEP and non-NHEP results did not differ significantly. Conclusion: Three SAP quality indicators showed more improvement in NHEP surgical procedures than in non-NHEP, but the other parameters did not perform well regardless of NHEP assessment. Therefore, more measures to improve the appropriateness of SAP should be developed.
Cureus, Jan 29, 2023
Poorly published trials may result in biased and erroneous healthcare decisions. We conducted thi... more Poorly published trials may result in biased and erroneous healthcare decisions. We conducted this systematic review to evaluate the reporting quality of drug-related randomized controlled trials (RCTs) conducted in India and published in MEDLINE-indexed Indian journals over a decade (between January 1, 2011, and December 31, 2020), as per the Consolidated Standards of Reporting Trials (CONSORT) Checklist 2010. An extensive literature search was conducted using the terms "Randomized controlled trial AND India." The full-length papers were extracted for RCTs related to drugs. Two independent investigators assessed each article against the checklist containing 37 criteria. Each article was scored 1 or 0 against each criterion which was finally summed up and evaluated. None of the articles fulfilled all 37 criteria. A compliance rate of >75% was seen in only 15.5% of articles. More than 75% of articles fulfilled a minimum of 16 criteria. Major checklist points observed to be deficient were "important changes to methods after trial commencement" (7%), "interim analysis and stopping guidelines" (7%), and "description of similarity of interventions while blinding" (4%). There remains ample room for improvement regarding research methodology and manuscript preparation in India. Moreover, journals should stringently implement the CONSORT Checklist 2010 to enhance the standard and quality of publications.
OBM Geriatrics
The COVID-19 pandemic had imposed a city-level quarantine, local lockdown, and border closures fo... more The COVID-19 pandemic had imposed a city-level quarantine, local lockdown, and border closures for patient-level isolation to control virus spread. There is a lack of studies on the health-related quality of life (HRQoL) in the elderly in countries like India during COVID-19. After obtaining written informed consent from the elderly patients, data was recorded in the case record form-cum-questionnaire. The quality of life was assessed with the help of Centers for disease control and prevention (CDC) HRQoL-14 measures, which are based on general health improvement, physical and mental health, and its effect on usual activities like self-care, work, or play, sadness, depression, worry, tension, or anxiety, and rest or sleep. A total of 331 patients were screened and 234 were enrolled in this study, with 220 patients completing their follow-up. Among them, 55.43% were retired elderly, 31.82% were unemployed and 21.36% were living alone. After one month, 49 patients had days of poor phy...
International Journal of Research in Medical Sciences, 2017
Background: Staphylococcus aureus is a pathogen causing wide spectrum of infections. It has tende... more Background: Staphylococcus aureus is a pathogen causing wide spectrum of infections. It has tendency for the development of multidrug resistance thereby exposing the selection of appropriate treatment. Therefore, the present study was undertaken to find out the antibiotic susceptibility pattern of Staphylococcus aureus isolated from various clinical samples in teaching tertiary hospital.Methods: Total 85 Staphylococcus aureus was isolated from clinical samples (pus, urine, sputum and blood) tested. Identification of Staphylococcus aureus was done by standard conventional microbiological methods. Antibiotic susceptibility testing was done by using disk diffusion method as per CLSI guidelines.Results: Staphylococcus aureus was isolated maximum from pus samples followed by urine samples. Antibiotic susceptibility testing showed highest resistance against Penicillin (69%) and Erythromycin (51%) followed by Cotrimoxazole (50%) & Nitrofurantoin (50%). All the strains were sensitive to Van...
Pediatric dentistry, Jan 15, 2017
The purpose of this study was to evaluate macroscopically and ultrastructurally the effect of cal... more The purpose of this study was to evaluate macroscopically and ultrastructurally the effect of calcium hydroxide cement (CH) and resin-modified glass ionomer cement (RMGIC) compared with gutta percha (control) as a lining material on carious dentin after partial caries removal and sealing. Twenty-seven permanent molars with deep carious lesions underwent partial caries removal with the application of CH, RMGIC, or gutta percha (control) and were then sealed for three months. After a partial caries removal and sealing period, the dentin was macroscopically assessed (for color, consistency, and humidity) and further analyzed by scanning electron microscope to assess the ultrastructural changes in dentin (lumen size, mineralization of tubules, occlusion of tubules by cements, and bacterial ingress). The effect of treatment in each group was statistically analyzed. Dentin darkening and hardening were observed after the sealing period in all groups. However, there was no difference in the...
Objective: To find out self medication pattern of antimicrobials in Pune. Methods: II MBBS studen... more Objective: To find out self medication pattern of antimicrobials in Pune. Methods: II MBBS students collected the information of names of antimicrobials self medication, dose, frequency of administration, health related problem for use of self medication, source of information of self medication and information about ADRs with the help of semi-structured questionnaire. Students also educated the population about ADRs to antimicrobial with the help of ADR checklist. Medical shopkeeper’s knowledge about ADRs and reasons for not providing information of ADRs to population had been explored. Results: Macrolides and fluroquinolones were commonly self medicated in Pune and fluroquinolones groups caused ADRs in about 66 %. Drugs like levofloxacin, roxithromycin, ampicillin were taken less than WHO DDD and some antimicrobials were taken less than 3 days period. 70-80% population was ignorant about ADRs to antimicrobials. About 85 % medical shopkeepers did not provided information of ADRs to...
Efficacy and safety of Livwin (polyherbal formulation) in patients with acute viral hepatitis: A ... more Efficacy and safety of Livwin (polyherbal formulation) in patients with acute viral hepatitis: A controlled clinical trial
Journal of Family Medicine and Primary Care
Background and Objectives: Adverse Drug Reactions (ADRs) can lead to significant morbidity, rarel... more Background and Objectives: Adverse Drug Reactions (ADRs) can lead to significant morbidity, rarely mortality and financial burden over the patient. ADRs that can be prevented can be considered as form of medication error sometimes. This study assessed the preventability, predictability and severity of ADRs using different assessment scales. Methods: ADR Monitoring Centre under newly established teaching hospital in Chhattisgarh collected ADR reports from different healthcare professionals during the period from November 2016 to November 2018. Analysis of the reported ADRs was done for their causality assessment, demographic details of patients, most common drug class responsible for the ADR. Seriousness and preventability of ADRs were analysed by using WHO Causality Scale and Modified Schumock and Thornton Scale respectively. Severity of ADRs was assessed by Modified Hartwig and Siegel Scale. Results: Totally 288 ADRs were reported in a 2-year period. 92.01% ADRs were non serious. 44.8% were mild, 53.81% moderate and 1.39% were severe ADRs. Causality assessment showed: 5.21% certain, 54.86% probable, 39.24% possible and 0.69% unlikely ADRs. Around 26% ADRs were definitely and probably preventable and 27.78% ADRs were predictable. The highest number (32.29%) of ADRs were reported to antimicrobials. 11.15% ADRs were reported to NSAIDs, in that 37.5% ADRs were due to NSAIDs combination. Conclusion: Many ADRs in this study are non-serious, preventable and predictable. Management of such ADRs through therapeutic interventions would be beneficial in a better patient outcome. Multidisciplinary strategies involving physicians, pharmacists, other healthcare professionals and patient education and awareness about ADRs are needed for prevention of ADRs.
This study analyzes the self medication use in Pune city and also assesses the rationality of sel... more This study analyzes the self medication use in Pune city and also assesses the rationality of self medication. This was a cross sectional study. With the help of semi-structured questionnaire data was collected by II MBBS students for this study. Information about the names of the self medications, diagnosis for the use of self medication, source of information for self medication use and adverse effects reported to self medications was collected. The drugs that are commonly self medicated in Pune city were: analgesics (28.68%), antibiotics (13.18%), vitamins (10.85%) and GIT ailment drugs (14.34). Apart from this, herbal drugs and skin problem drugs are predominantly self medicated in Pune city. Information about the self medication was predominantly obtained from previous prescription of doctors (62.41%) and from chemists (18.99%) and advertisement was 3 important source of self medication in Pune (9.69%). Antibiotics self medication use was associated 29.41 % ADRs. The adverse ef...
Objective: Earlier identifying drug interactions may help in risk reduction in elderly patients. ... more Objective: Earlier identifying drug interactions may help in risk reduction in elderly patients. Methods: Drug prescription data of 212 elderly patients of tertiary health care center had been analyzed for possible drug interactions with investigational drugs for COVID-19 treatment. Drug interaction had been checked from Stockley's Drug Interaction 2019 and Martindale the Complete Drug Reference 2017 and standard reference books of Pharmacology. Findings: Different types of drugs prescribed in the elderly were 260 and out of which 68 (26.36%) were in the category of fixed-dose combinations. Around 150 (70.75%) elderly patients were having one or more associated comorbidities. Thirty-five drugs prescribed to elderly had been found to cause drug interaction with investigational drugs for COVID-19. Possible drug interactions are mediated through CYP3A4 (eighteen patients), CYP2D6 (seven patients) isoenzymes, or P glycoproteins transporters (three patients). Conclusion: Possible dru...
International Journal of Research in Medical Sciences
Background: Surgical site infections are associated with prolonged hospital stays and increased c... more Background: Surgical site infections are associated with prolonged hospital stays and increased cost of therapy. Prophylactic use of antimicrobials is to prevent the incidence of postoperative wound infection. To generate data on postoperative use of antimicrobials this study was planned.Methods: The information was collected in semi-structured questionnaire format from the patient’s case paper. Information regarding the antimicrobials prescribed by surgeon, including drug combinations, duration of therapy, frequency of drug administration, and diagnosis for the surgery was collected. Surgical wounds were classified based on National Research Council (NRC) criteria.Results: Mean duration of antibiotic use was 3.71 days for clean surgeries (70%) and ranging from 2.67 days to 6 days for clean contaminated, contaminated and dirty types of surgeries. average number of antimicrobials prescribed for surgical antimicrobial prophylaxis was 3 per patients. Ceftriaxone, cefixime, ofloxacin, l...
The study was planned to evaluate the efficacy and safety of Livwin (polyherbal formulation) in a... more The study was planned to evaluate the efficacy and safety of Livwin (polyherbal formulation) in acute viral hepatitis. In this study, there were 29 patients in each group, receiving either Livwin or placebo. Livwin capsules contains Terminalia arjuna-100 mg, Withania somnifera-100 mg, Phyllanthus niruri-100 mg, Berberis aristata-50 mg, Tinospora cordofolia-75 mg, Picrorhiza kurroa-50 mg, Boerhaavia diffusa-50 mg. Placebo capsules contains lactose 500 mg. Both drugs were given orally, two capsules 2 times a day for 8 weeks followed by treatment free period of 4 weeks. Recovery of patients assessed by clinical parameters: fever, weakness, icterus and tender, enlarged liver and by biochemical parameters: serum bilirubin, SGOT (Serum glutamate oxaloacetate transaminase), SGPT (Serum glutamate pyruvate transaminase), serum alkaline phosphatase at baseline, 2 weeks, 4 weeks, 8 weeks and 12 weeks. Significant clinical recovery was observed in the form of icterus and weakness with Livwin as compared to placebo at 2 and 4 weeks (P < 0.001). There was significant reduction in mean levels of serum bilirubin, SGOT and SGPT at 2 weeks, 4 weeks, and 8 weeks with Livwin as compared with placebo (P < 0.001). Significant reduction in mean levels of serum alkaline phosphatase with Livwin at 2 weeks (P < 0.01) and 4 weeks (P < 0.05) as compared with placebo. Mean serum bilirubin reduced by 6.72 mg/dl with Livwin and with placebo reduced by 3.64 mg/dl at 2 weeks (P < 0.001). Mean SGOT reduced by 609.11 IU/ L with Livwin and with placebo reduced by 240.34 IU/L at 2 weeks (P < 0.001). Mean SGPT reduced by 920.65 IU/L with Livwin and with placebo reduced by 326.96 IU/L at 2 weeks (P < 0.001). Livwin had shown good efficacy in patients of acute viral hepatitis. Adverse events like epigastric pain and diarrhoea were recorded with Livwin treatment and were not significant as compared to placebo.
Bangladesh Journal of Pharmacology, 2015
This study was conducted to observe the effect of vitamin B12 supplementation on glycemic control... more This study was conducted to observe the effect of vitamin B12 supplementation on glycemic control in poorly controlled hyperhomocysteinemic type 2 diabetic patients by measuring HbA1c levels at baseline and 4 weeks. Patient having serum homocysteine more than 15 µmol/L or vitamin B12 less than 223 pg/mL were enrolled in this study. One group received methylcobalamin 500 µg daily with their usual anti-diabetic therapy and the other group received only suitable anti-diabetic drug therapy. Methylcobalamin 500 µg was given daily for period of 4 weeks. Glycemic control was measured by levels of HbA1c, blood sugar at baseline and at 4 weeks. Serum homocysteine levels was reduced from 21.5 ± 2.6 to 15.4 ± 6.4 (p=0.04) with vitamin B12 supplementation at 4 weeks. At 4 weeks, HbA1c decreased from 9.9 ± 0.9 to 8.7 ± 0.5 (p<0.01) in vitamin B12 deficient patients after vitamin B12 supplementation. There is role of vitamin B12 in glycemic control in poorly controlled type 2 diabetic patients.
Asian Journal of Biomedical and Pharmaceutical Sciences, Sep 7, 2013
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology
International Journal of Basic & Clinical Pharmacology, 2013
Background: This study was carried out in various hospitals to analyze the use of rational fixed ... more Background: This study was carried out in various hospitals to analyze the use of rational fixed dose combinations (FDCs) in Pune. Methods: 279 prescriptions were evaluated in this study. Information about age, sex, names of the all the drugs prescribed by doctor/ physician, diagnosis for the use of prescriptions and adverse effects were noted in the audit form from the prescriptions of the patients. Rationality of fixed dose combination is evaluated according to WHO Model List of Essential Drugs, 17th updated version, 2011. Results: 56.98 % doctor's prescriptions in this study were containing of fixed dose combinations and out of this 10.69 % prescriptions were including two or more FDCs in their prescriptions. Only 13.20% FDCs were in accordance with WHO Model List of Essential Drugs. FDCs from antiinflammatory and antirheumatic products, vitamins, minerals, antianaemic preparations, drugs for acid related disorders, antibacterials for systemic use and cough and cold preparations were used more by private non teaching hospitals as compared to SKNMC & GH teaching hospital. 64.61 % prescriptions of private hospitals and 34.08 % prescriptions of teaching hospital were containing more than one drug. Conclusions: This study has shown that about every alternate prescription contains FDC. More than 80 % of prescribed FDCs are not in accordance with Essential Drugs List. Vitamins, minerals, antianaemic preparation FDCs should be prescribed judiciously as they are not free from ADRs. More number of drugs (poly-pharmacy) and FDCs were prescribed by non teaching private hospitals.
International Journal of Medicine and Public Health, 2012
This study was carried to analyze the self medication pattern in rural areas of Pune. Method: Sem... more This study was carried to analyze the self medication pattern in rural areas of Pune. Method: Semi-structured questionnaire was used for collection of data. Information about age, sex, name of the self medication, diagnosis for the use of self medication, source of information about the self medication and adverse effects reported to self medications was collected. Results: NSAIDs (33.33), antibiotics (10.32), vitamins (14.08) and GIT ailment drugs (13.61) are most commonly used as self medication in rural areas. Other drugs that self medicated are: drugs for upper respiratory tract infection, antibiotics, antihypertensives, anticonvulsants and diuretics. Information about the self medication was predominantly obtained from previous prescription of doctors (64.32%) and from chemists (23%). Antibiotics like macrolides, fluoroquinolones, cephalosporins, antihelminthics, and furazolidine were taken as self medication in rural areas. 50% of antibiotics used as self medication was associated with development of ADRs. The adverse effects reported with antibiotics self medication were: vomiting, hyperacidity, gastrointestinal discomfort. 21.13% of persons reported adverse effects with NSAIDs self medication. Adverse effects reported with analgesic use in this study were: hyperacidity, skin rashes, nausea. Conclusions: NSAIDs, antibiotics, vitamins and GIT ailment drugs are commonly self medicated in rural areas of Pune. The self medication of antibiotics is disturbing, as these are liable for drug resistance and severe ADRs and hence should be taken under supervision only. Pharmacists, key person in rural areas, can provide information about adverse effects of self medicated drugs and also can guide about proper precautions to be taken for self medication.