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Papers by Dr.Shaktibala Dutta

Journal of Medical Science And clinical Research, 2019

Santosh University Journal of Health Sciences

International journal of health sciences

Background: Evaluation of drug utilization patterns need to be done consistently to facilitate ob... more Background: Evaluation of drug utilization patterns need to be done consistently to facilitate obligatory modifications in prescription pattern of drug to hike the therapeutic benefit and to lessen the adverse effects. Osteoarthritis (OA) is becoming growingly acknowledged as a leading reason of chronic pain and lower limb disability amid the elderly people . There are a very few studies which assess the pattern of drug utilization in newly diagnosed osteoarthritis. So the aim & objective of this research is to study & analyze the recent trends in pattern of drug prescription in newly diagnosed osteoarthritis patients . Methods : It was Prospective, Observational study , newly diagnosed patients with osteoarthritis were enrolled in the study considering the inclusion and exclusion criteria. Data was recorded in a specially designed proforma . Results: NSAIDs were most common prescribed class of drugs which were used in all prescriptions. Paracetamol was used in 73% prescr...

Oncology, 1973

DNA from seven experimentally induced morphological mutants and the wild type strain 74A of Neuro... more DNA from seven experimentally induced morphological mutants and the wild type strain 74A of Neurospora crassa showed typical bimodal denaturation profiles in a Gilford 2400 spectrophotometer. The ‘slime’ and ‘ropy’ mutants showed comparatively high proportion of A + T rich DNA sequences. The DNA sequences of the slime mutant were distinctly different from those of parental DNA as well as

Journal of Pharmaceutical Negative Results

Objectives: Study was conducted to compare the evaluation of efficacy and safety of Nebivolol plu... more Objectives: Study was conducted to compare the evaluation of efficacy and safety of Nebivolol plus Amlodipine combination with Atenolol plus Amlodipine combination in hypertensive patients.Materials and Methods: A Prospective Observational study was conducted at tertiary care teaching hospital which included a total 334 patients with essential hypertension. The demographic and baseline data, Blood pressure and Heart rate of the patients were recorded. After baseline investigation patients were randomly divide into 2 groups. All patients were subsequently monitored and reassessed at 4th-week, 8th week and 12th weeks of interval during each follow-up.Results: Nebivolol plus Amlodipine group include a total 169 patients in which 129 patients were males and 40 patients were females with mean age 46.89 ±12.48 years, Atenolol plus Amlodipine group include a total 165 patients in which 111patients were males and 54 patients were females with mean age 48.19±12.14 years. Patients were receiv...

Current Medicine Research and Practice, 2022

Background: Cancer chemotherapeutic drugs are commonly associated with serious adverse effect whi... more Background: Cancer chemotherapeutic drugs are commonly associated with serious adverse effect which contributes to increase in the duration of hospitalisation and economic burden. Aim: The aim of this study was to characterise the seriousness and outcome of adverse drug reactions (ADRs) produced by chemotherapy drugs in cancer patients. Materials and Methods: Patient''s demographic characteristics and ADRs due to chemotherapeutic drugs were documented inpatient case report form. Frequencies of the seriousness of the ADRs, its outcome and preventability were studied using descriptive statistics. Proportion of life-threatening ADRs and ADRs linked to increase in duration of hospitalisation were studied. Factors associated with serious ADRs and patient characteristics were studied using calculation of odds ratio (OR) at 95% confidence interval (P < 0.5). Results: A total of 412 ADRs were noted in selected 120 patients received chemotherapy drugs. Majority of ADRs (61%) were linked to increase in duration of hospital admission. Some ADRs (12%) were noted as life-threatening to the patients. OR 1.58 was found on the association between patient age group and serious ADRs (P = 0.02). Association of preventability of ADRs and serious ADRs shows OR of 3.65 (P = 0.0001). Common serious ADRs were noted as anaemia, neutropenia, fever, thrombocytopenia, diarrhoea, mucositis and nausea and vomiting. Conclusion: The incidence of serious ADRs due to chemotherapy drugs amongst cancer patients is high. Studies on the nature of seriousness of ADRs, outcome and its triggering factors may help to prevent them. Early identification of serious ADRs may support to reduce hospital stay and economic burden.

Journal of Pharmaceutical Research International, 2021

Aim and Objective: Cancer chemotherapy drugs causes substantial toxicity and produces number of a... more Aim and Objective: Cancer chemotherapy drugs causes substantial toxicity and produces number of adverse effects which can significantly reduce patient's health related quality of life. The aim of this study was to perform the assessment and explore the management practice of chemotherapy induced side effects among cancer patients. Material and Methods: Demographic characteristics of patient undergone cancer chemotherapy and adverse drug reactions (ADRs) of chemotherapeutic drugs were noted in patient's case report form. Assessments of ADRs were performed for Severity, Causality and Preventability of each ADR. Association between occurrence of severe ADRs and patient' characteristics were studied using chi square statistics. Frequencies of ameliorative therapy were studied in each patient. Results: 120 patients were selected and included in the study and a total of 412 ADRs were detected after cancer chemotherapy. Majority (60%) of the participant were female. Most common...

INDIAN JOURNAL OF APPLIED RESEARCH, 2021

BACKGROUND: Antibiotics are at times indiscriminately used in clinical management may cause adver... more BACKGROUND: Antibiotics are at times indiscriminately used in clinical management may cause adverse effects, drug resistance etc. Thus to optimize use, there is a need to regulate the prescription strategies with antimicrobial stewardship. MATERIAL & METHODS: To evaluate prophylaxis and post surgery uses of antibiotics with dose, route of administration, duration of antibiotic treatment, duration of stay in wards, no of antibiotics per prescription . This is a prospective observational type of study conducted as a collaboration of Santosh medical college Ghaziabad and All india institute of medical sciences Bhopal. Out of 169, 58(34.3%) were RESULTS: in orthopaedics (M/F = 37/21), and 111 in surgery (M/F = 57/75). In surgery, Beta lactam (amoxicillin/clavulanic acid, 84(49.7%) and ceftriaxone (79(46.7%) were given at dose of (mean dose1040 gram) for duration of 1.29 hours mean time. Post surgery the dose was 1052.97 g for 4.42 days . In orthopaedics Cefazolin of class cephalosporin ...

Research and Reviews: Journal of Pharmacology and Toxicological Studies, 2014

Pharmaco-epidemiological studies in allergic skin conditions are very few. To analyze and assess,... more Pharmaco-epidemiological studies in allergic skin conditions are very few. To analyze and assess, common allergic skin conditions and drug prescribing patterns to increase the rational prescribing. Prescriptions of 450 patients attending dermatology OPD of SGRRIM&HS, Dehradun were evaluated, for common skin conditions and drug utilization pattern for 6 months from January 2013 to June 2013 using WHO drug use indicators. A total of 450 prescriptions were analyzed, male: female ratio was 1:1.09, mean age of the patients 30.29±1.24yrs, 380 (84.45%) belongs to middle socio-economic group and 103 (22.89%) patients had h/o allergic diseases. Disease pattern observed in this study were contact dermatitis 203 (45.11%), urticaria 147 (32.67%), atopic dermatitis 100 (22.22%) respectively. Total 1255 drugs were used, oral formulations 680 (54.18%), topical 575 (45.82%), FDCs (fixed dose combination) 466 (37.13%), 2.79 drugs/prescription were prescribed. Antihistaminic 234 (34.41%) were most co...

Research and Reviews: Journal of Pharmacology and Toxicological Studies, 2014

To impart clinical pharmacology knowledge to the MBBS 2nd professional students and to improve th... more To impart clinical pharmacology knowledge to the MBBS 2nd professional students and to improve the quality of students by giving adequate knowledge in rational prescribing. A total no of 150 cases were followed up by the undergraduate students during 2nd professional MBBS in the department of pharmacology at SGRRIM &HS, Dehradun from June 2012 to November 2012. Patients were analyzed on various parameters using WHO drug used indicators and National List of Essential Medicines. A total of 150 cases were evaluated .115(76.66%) were males and 35(23.34%) were females, majority patients 124(82.66%) were 16-45 years of age. Morbidity pattern was observed as infectious diseases 100 (66.66%) and non- infectious 50 (33.34%) respectively. Amongst infectious diseases, fever 40 (40%), acute gastroenteritis 27 (27%), tuberculosis 11(11%) and urinary tract infection 9 (9%) were most frequently observed, and non-infectious diseases were epilepsy 11(22%), hypertension 7(14%) and gastro-esophageal r...

International Journal of Basic and Clinical Pharmacology

Antibiotics are the most frequently prescribed drugs among hospitalized patients. 1 The prevalenc... more Antibiotics are the most frequently prescribed drugs among hospitalized patients. 1 The prevalence of antibiotic use is very high in India and ranges from 24 to 67%. 2 Recently, Schedule H1 was introduced in India under the existent Drug and Cosmetic Act 1945 by the regulatory agencies to control the irrational prescribing of antibiotics. 3 Irrational antibiotic usage can lead to increased healthcare utilization, morbidity, mortality, adverse drug events and antimicrobial resistance. 4 ABSTRACT Background: Due to increasing resistance to a majority of antimicrobials, it becomes very necessary to teach undergraduate students, the future prescribers, about the judicious and rational use of antimicrobial drugs. The objective of this study was to impart the basic clinical skills to undergraduate MBBS students which will form an integral component of practising rational therapeutics. Methods: A total no of 737 cases were followed up by the 5th semester 2nd Professional MBBS students in the Department of Pharmacology at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIM and HS), Dehradun from June 2013 to July 2015. Patients were analysed on various WHO drug use indicators like drug formulations, drugs prescribed per prescription, Fixed dose Combinations (FDCs), drugs prescribed from National List of Essential Medicines (NLEM) and drugs prescribed by generic names. Results: A total of 737 prescriptions were analysed. Male: Female ratio was 1.74:1 (63.50%:36.50%). Majority of the patients 218 (29.58%) were in 16-30 years age group. A total of 1205 antimicrobials were prescribed. 304 (25.23%) cephalosporins were most frequent followed by 184(15.27%) penicillins, 176(14.61%) antitubercular drugs, 163(13.53%) nitroimidazoles, 143 (11.87%) fluoroquinolones, 102 (8.46%) aminoglycosides, 29 (2.41%) macrolides, 19 (1.58%) tetracyclines, 12 (1%) carbapenems, 11 (0.91%) antimalarials, 11 (0.91%) antihelminthics, 6 (0.50%) glycopeptides, 4 (0.33%) lincosamides and 41 (3.41%) miscellaneous antimicrobials. Most frequently prescribed antimicrobial was Ceftriaxone which was given in 97 (8.05 %) patients. A total of 424 (35.19%) oral antimicrobials, 777 (64.48%) injectable antimicrobials and 04 (0.33%) local/topical antimicrobial drugs were prescribed. 5.13 drugs per prescription and 1.64 antimicrobials per prescription were prescribed. 2100 (55.56%) drugs were prescribed from National List of Essential Medicine 2015 (NLEM 2015). 1177 (97.68%) antimicrobials were prescribed from NLEM. 1110 (92.12%) antimicrobials were prescribed by brand names. A total of 342 (28.38%); fixed dose combinations of antimicrobials were prescribed. Conclusions: Majority of the prescriptions revealed poly-pharmacy and a very high percentage of drugs were prescribed by their respective brand names. It is only by observing drug utilization patterns, current trends and common errors in prescriptions can be highlighted and rational prescription of antimicrobials can be taught to MBBS students.

International Journal of Basic and Clinical Pharmacology

Psychiatrists are continuously exposed to newly introduced drugs that are claimed to be safe and ... more Psychiatrists are continuously exposed to newly introduced drugs that are claimed to be safe and more efficacious. Newer drugs are however known to be expensive and unaffordable to the majority of patients, especially in developing countries. Although ABSTRACT Background: Due to increasing burden of psychiatric illnesses, it is essential to study the psychotropic drug utilization pattern in actual clinical practice. The objective of the study was to study the psychotropic drug usage pattern among patients attending psychiatric OPD of a tertiary care teaching hospital in Nepal. Methods: This observational retrospective study was conducted in Nepal Gunj Medical College, Nepal for a period of 6 months from January 2016 to June 2016. A total of 282 prescriptions from Psychiatric OPD were analysed for drug usage pattern. Prescriptions containing at least one psychotropic drug were included. Data was measured for number and percentage of prescriptions or drugs, using selected World Health Organization (WHO) drug use indicators. Results: A total of 282 prescriptions from Psychiatric OPD were analysed. Patients had a mean age of 35.01±1.17 years. Male and Female %age was 41.49% and 58.51% respectively. Majority of the patients (47.52%) were in 31-45 years age group. 70.57% patients were literate. Depression was the leading psychiatric illness seen in 144 (51.06%) patients followed by Anxiety disorders which were seen in 60 (21.28%) patients. A total of 2463 drugs were prescribed which included 591 (23.99%) antipsychotic drugs followed by 462 (18.76%) antidepressants, 390 (15.83%) antiepileptics, 312 (12.67%) supplements, 276 (11.21%) antianxiety, 171 (6.94%) antacids, 165 (6.7%) anticholinergics, 96 (3.9%) drugs in miscellaneous category. Drugs prescribed per prescription were 8.73 and psychotropic drugs per prescription were 6.09. Number of oral and injectable drugs were 2313 (93.91%) and 150 (6.09%) respectively. 87 fixed dose combinations (FDCs) of psychotropic drugs were prescribed. 903 (36.66%) drugs were prescribed from WHO's 18th List of Essential Medicines. Conclusions: Depression was the most common psychiatric illness and antipsychotics were the most commonly prescribed medicines in psychiatry OPD. Majority of the prescriptions revealed polypharmacy.

Journal of Nobel Medical College, 2016

Background Depression is an important global public health problem due to its relatively high lif... more Background Depression is an important global public health problem due to its relatively high lifetime prevalence and significant disability caused by it. The present study was conducted to compare improvement in disability outcome by Amisulpride and Escitalopram among depression patients using WHO-Disability Assessment Schedule (WHO-DAS). Materials and Methods The study was conducted in depression patients for 1 year in the Department of Neuropsychiatry, Nepalgunj Medical College & Teaching Hospital. A total of 117 depression patients were divided into 2 groups. Group I (58 patients) received Amisulpride tablet at a dose of 50 mg/day and Group II (59 patients) were given Escitalopram at a dose of 10 mg/day. The patients were required to follow up at 4 weeks, 8 weeks and at 15 weeks. The efficacy of the drugs was calculated by Hamilton depression rating scale (HAM-D). The improvement in functional outcome was compared between the two groups by using WHO-Disability Assessment Schedule (WHO-DAS). Appropriate statistical tools using GraphPadInstat 3.0 were used for analysis. p value < 0.05 was considered significant. Results HAM-D score in group receiving Amisulpride at 0 and 15 weeks was 16.92±0.35 and 7.87±0.29 (p<0.0001). HAM-D score in group receiving Escitalopram at 0 and 15 weeks was 17.09±0.39 and 6.63±0.39 (p<0.0001). WHO-DAS score in group receiving Amisulpride at 0 and 15 weeks was 112.54±0.82 and 43.08±1.41 (p<0.0001) respectively. WHO-DAS in group receiving Escitalopram at 0 and 15 weeks was 113.73±1.92 and 40.69±1.49 (p<0.0001) respectively. Intergroup comparison at 15 weeks was insignificant (p>0.05). Gastrointestinal disturbances, sexual disturbances, amenorrhea, lactation, agitation and insomnia were the commonly encountered adverse drug reactions. Conclusion Both Amisulpride and Escitalopram showed improvement in WHO Disability Assessment Score (WHO-DAS) at the end of study period. But intergroup comparison showed no significant difference in the two groups.

Journal of Drug Delivery and Therapeutics, 2015

Objective: This study was conducted with the objective of comparing safety and efficacy of hormon... more Objective: This study was conducted with the objective of comparing safety and efficacy of hormonal treatment and nonhormonal alternatives for the management of menopausal symptoms. Materials and Methods: A total of 40 patients suffering from menopausal symptoms were recruited to the study protocol and were divided into 4 groups according to the treatment they received, with 10 patients in each group. Group A received conjugated estrogen and medroxy progesterone acetate, Group B received Tibolone, Group C received Isoflavone and Group D received Vitamin E. Efficacy of the treatment was evaluated by improvement in symptomatic score and safety of the treatment was assessed on the basis of adverse effects reported and relevant laboratory investigations. Results: Most of the symptoms were significantly improved in groups A and B (p< 0.01) while in groups C and D significant improvement was observed in hot flushes, sweating and insomnia (p<0.05). On comparative analysis there was no significant difference in the efficacy between groups A and B and between groups C and D. On the other hand significant difference was observed in the efficacy when groups A and B were compared with groups C and D (p<0.01). Only mild tolerable side effects were reported by the patients in all the groups with slightly higher incidence in groups A and B. Conclusions: Hormonal treatment is very efficacious for the early relief of menopausal symptoms. Isoflavone and vitamin E can be considered as a satisfactory treatment alternative when for any reasons hormonal treatment cannot be used.

Research Reviews Journal of Pharmacology and Toxicological Studies, Jan 7, 2014

Journal of Medical Science And clinical Research, 2019

Santosh University Journal of Health Sciences

International journal of health sciences

Background: Evaluation of drug utilization patterns need to be done consistently to facilitate ob... more Background: Evaluation of drug utilization patterns need to be done consistently to facilitate obligatory modifications in prescription pattern of drug to hike the therapeutic benefit and to lessen the adverse effects. Osteoarthritis (OA) is becoming growingly acknowledged as a leading reason of chronic pain and lower limb disability amid the elderly people . There are a very few studies which assess the pattern of drug utilization in newly diagnosed osteoarthritis. So the aim & objective of this research is to study & analyze the recent trends in pattern of drug prescription in newly diagnosed osteoarthritis patients . Methods : It was Prospective, Observational study , newly diagnosed patients with osteoarthritis were enrolled in the study considering the inclusion and exclusion criteria. Data was recorded in a specially designed proforma . Results: NSAIDs were most common prescribed class of drugs which were used in all prescriptions. Paracetamol was used in 73% prescr...

Oncology, 1973

DNA from seven experimentally induced morphological mutants and the wild type strain 74A of Neuro... more DNA from seven experimentally induced morphological mutants and the wild type strain 74A of Neurospora crassa showed typical bimodal denaturation profiles in a Gilford 2400 spectrophotometer. The ‘slime’ and ‘ropy’ mutants showed comparatively high proportion of A + T rich DNA sequences. The DNA sequences of the slime mutant were distinctly different from those of parental DNA as well as

Journal of Pharmaceutical Negative Results

Objectives: Study was conducted to compare the evaluation of efficacy and safety of Nebivolol plu... more Objectives: Study was conducted to compare the evaluation of efficacy and safety of Nebivolol plus Amlodipine combination with Atenolol plus Amlodipine combination in hypertensive patients.Materials and Methods: A Prospective Observational study was conducted at tertiary care teaching hospital which included a total 334 patients with essential hypertension. The demographic and baseline data, Blood pressure and Heart rate of the patients were recorded. After baseline investigation patients were randomly divide into 2 groups. All patients were subsequently monitored and reassessed at 4th-week, 8th week and 12th weeks of interval during each follow-up.Results: Nebivolol plus Amlodipine group include a total 169 patients in which 129 patients were males and 40 patients were females with mean age 46.89 ±12.48 years, Atenolol plus Amlodipine group include a total 165 patients in which 111patients were males and 54 patients were females with mean age 48.19±12.14 years. Patients were receiv...

Current Medicine Research and Practice, 2022

Background: Cancer chemotherapeutic drugs are commonly associated with serious adverse effect whi... more Background: Cancer chemotherapeutic drugs are commonly associated with serious adverse effect which contributes to increase in the duration of hospitalisation and economic burden. Aim: The aim of this study was to characterise the seriousness and outcome of adverse drug reactions (ADRs) produced by chemotherapy drugs in cancer patients. Materials and Methods: Patient''s demographic characteristics and ADRs due to chemotherapeutic drugs were documented inpatient case report form. Frequencies of the seriousness of the ADRs, its outcome and preventability were studied using descriptive statistics. Proportion of life-threatening ADRs and ADRs linked to increase in duration of hospitalisation were studied. Factors associated with serious ADRs and patient characteristics were studied using calculation of odds ratio (OR) at 95% confidence interval (P < 0.5). Results: A total of 412 ADRs were noted in selected 120 patients received chemotherapy drugs. Majority of ADRs (61%) were linked to increase in duration of hospital admission. Some ADRs (12%) were noted as life-threatening to the patients. OR 1.58 was found on the association between patient age group and serious ADRs (P = 0.02). Association of preventability of ADRs and serious ADRs shows OR of 3.65 (P = 0.0001). Common serious ADRs were noted as anaemia, neutropenia, fever, thrombocytopenia, diarrhoea, mucositis and nausea and vomiting. Conclusion: The incidence of serious ADRs due to chemotherapy drugs amongst cancer patients is high. Studies on the nature of seriousness of ADRs, outcome and its triggering factors may help to prevent them. Early identification of serious ADRs may support to reduce hospital stay and economic burden.

Journal of Pharmaceutical Research International, 2021

Aim and Objective: Cancer chemotherapy drugs causes substantial toxicity and produces number of a... more Aim and Objective: Cancer chemotherapy drugs causes substantial toxicity and produces number of adverse effects which can significantly reduce patient's health related quality of life. The aim of this study was to perform the assessment and explore the management practice of chemotherapy induced side effects among cancer patients. Material and Methods: Demographic characteristics of patient undergone cancer chemotherapy and adverse drug reactions (ADRs) of chemotherapeutic drugs were noted in patient's case report form. Assessments of ADRs were performed for Severity, Causality and Preventability of each ADR. Association between occurrence of severe ADRs and patient' characteristics were studied using chi square statistics. Frequencies of ameliorative therapy were studied in each patient. Results: 120 patients were selected and included in the study and a total of 412 ADRs were detected after cancer chemotherapy. Majority (60%) of the participant were female. Most common...

INDIAN JOURNAL OF APPLIED RESEARCH, 2021

BACKGROUND: Antibiotics are at times indiscriminately used in clinical management may cause adver... more BACKGROUND: Antibiotics are at times indiscriminately used in clinical management may cause adverse effects, drug resistance etc. Thus to optimize use, there is a need to regulate the prescription strategies with antimicrobial stewardship. MATERIAL & METHODS: To evaluate prophylaxis and post surgery uses of antibiotics with dose, route of administration, duration of antibiotic treatment, duration of stay in wards, no of antibiotics per prescription . This is a prospective observational type of study conducted as a collaboration of Santosh medical college Ghaziabad and All india institute of medical sciences Bhopal. Out of 169, 58(34.3%) were RESULTS: in orthopaedics (M/F = 37/21), and 111 in surgery (M/F = 57/75). In surgery, Beta lactam (amoxicillin/clavulanic acid, 84(49.7%) and ceftriaxone (79(46.7%) were given at dose of (mean dose1040 gram) for duration of 1.29 hours mean time. Post surgery the dose was 1052.97 g for 4.42 days . In orthopaedics Cefazolin of class cephalosporin ...

Research and Reviews: Journal of Pharmacology and Toxicological Studies, 2014

Pharmaco-epidemiological studies in allergic skin conditions are very few. To analyze and assess,... more Pharmaco-epidemiological studies in allergic skin conditions are very few. To analyze and assess, common allergic skin conditions and drug prescribing patterns to increase the rational prescribing. Prescriptions of 450 patients attending dermatology OPD of SGRRIM&HS, Dehradun were evaluated, for common skin conditions and drug utilization pattern for 6 months from January 2013 to June 2013 using WHO drug use indicators. A total of 450 prescriptions were analyzed, male: female ratio was 1:1.09, mean age of the patients 30.29±1.24yrs, 380 (84.45%) belongs to middle socio-economic group and 103 (22.89%) patients had h/o allergic diseases. Disease pattern observed in this study were contact dermatitis 203 (45.11%), urticaria 147 (32.67%), atopic dermatitis 100 (22.22%) respectively. Total 1255 drugs were used, oral formulations 680 (54.18%), topical 575 (45.82%), FDCs (fixed dose combination) 466 (37.13%), 2.79 drugs/prescription were prescribed. Antihistaminic 234 (34.41%) were most co...

Research and Reviews: Journal of Pharmacology and Toxicological Studies, 2014

To impart clinical pharmacology knowledge to the MBBS 2nd professional students and to improve th... more To impart clinical pharmacology knowledge to the MBBS 2nd professional students and to improve the quality of students by giving adequate knowledge in rational prescribing. A total no of 150 cases were followed up by the undergraduate students during 2nd professional MBBS in the department of pharmacology at SGRRIM &HS, Dehradun from June 2012 to November 2012. Patients were analyzed on various parameters using WHO drug used indicators and National List of Essential Medicines. A total of 150 cases were evaluated .115(76.66%) were males and 35(23.34%) were females, majority patients 124(82.66%) were 16-45 years of age. Morbidity pattern was observed as infectious diseases 100 (66.66%) and non- infectious 50 (33.34%) respectively. Amongst infectious diseases, fever 40 (40%), acute gastroenteritis 27 (27%), tuberculosis 11(11%) and urinary tract infection 9 (9%) were most frequently observed, and non-infectious diseases were epilepsy 11(22%), hypertension 7(14%) and gastro-esophageal r...

International Journal of Basic and Clinical Pharmacology

Antibiotics are the most frequently prescribed drugs among hospitalized patients. 1 The prevalenc... more Antibiotics are the most frequently prescribed drugs among hospitalized patients. 1 The prevalence of antibiotic use is very high in India and ranges from 24 to 67%. 2 Recently, Schedule H1 was introduced in India under the existent Drug and Cosmetic Act 1945 by the regulatory agencies to control the irrational prescribing of antibiotics. 3 Irrational antibiotic usage can lead to increased healthcare utilization, morbidity, mortality, adverse drug events and antimicrobial resistance. 4 ABSTRACT Background: Due to increasing resistance to a majority of antimicrobials, it becomes very necessary to teach undergraduate students, the future prescribers, about the judicious and rational use of antimicrobial drugs. The objective of this study was to impart the basic clinical skills to undergraduate MBBS students which will form an integral component of practising rational therapeutics. Methods: A total no of 737 cases were followed up by the 5th semester 2nd Professional MBBS students in the Department of Pharmacology at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIM and HS), Dehradun from June 2013 to July 2015. Patients were analysed on various WHO drug use indicators like drug formulations, drugs prescribed per prescription, Fixed dose Combinations (FDCs), drugs prescribed from National List of Essential Medicines (NLEM) and drugs prescribed by generic names. Results: A total of 737 prescriptions were analysed. Male: Female ratio was 1.74:1 (63.50%:36.50%). Majority of the patients 218 (29.58%) were in 16-30 years age group. A total of 1205 antimicrobials were prescribed. 304 (25.23%) cephalosporins were most frequent followed by 184(15.27%) penicillins, 176(14.61%) antitubercular drugs, 163(13.53%) nitroimidazoles, 143 (11.87%) fluoroquinolones, 102 (8.46%) aminoglycosides, 29 (2.41%) macrolides, 19 (1.58%) tetracyclines, 12 (1%) carbapenems, 11 (0.91%) antimalarials, 11 (0.91%) antihelminthics, 6 (0.50%) glycopeptides, 4 (0.33%) lincosamides and 41 (3.41%) miscellaneous antimicrobials. Most frequently prescribed antimicrobial was Ceftriaxone which was given in 97 (8.05 %) patients. A total of 424 (35.19%) oral antimicrobials, 777 (64.48%) injectable antimicrobials and 04 (0.33%) local/topical antimicrobial drugs were prescribed. 5.13 drugs per prescription and 1.64 antimicrobials per prescription were prescribed. 2100 (55.56%) drugs were prescribed from National List of Essential Medicine 2015 (NLEM 2015). 1177 (97.68%) antimicrobials were prescribed from NLEM. 1110 (92.12%) antimicrobials were prescribed by brand names. A total of 342 (28.38%); fixed dose combinations of antimicrobials were prescribed. Conclusions: Majority of the prescriptions revealed poly-pharmacy and a very high percentage of drugs were prescribed by their respective brand names. It is only by observing drug utilization patterns, current trends and common errors in prescriptions can be highlighted and rational prescription of antimicrobials can be taught to MBBS students.

International Journal of Basic and Clinical Pharmacology

Psychiatrists are continuously exposed to newly introduced drugs that are claimed to be safe and ... more Psychiatrists are continuously exposed to newly introduced drugs that are claimed to be safe and more efficacious. Newer drugs are however known to be expensive and unaffordable to the majority of patients, especially in developing countries. Although ABSTRACT Background: Due to increasing burden of psychiatric illnesses, it is essential to study the psychotropic drug utilization pattern in actual clinical practice. The objective of the study was to study the psychotropic drug usage pattern among patients attending psychiatric OPD of a tertiary care teaching hospital in Nepal. Methods: This observational retrospective study was conducted in Nepal Gunj Medical College, Nepal for a period of 6 months from January 2016 to June 2016. A total of 282 prescriptions from Psychiatric OPD were analysed for drug usage pattern. Prescriptions containing at least one psychotropic drug were included. Data was measured for number and percentage of prescriptions or drugs, using selected World Health Organization (WHO) drug use indicators. Results: A total of 282 prescriptions from Psychiatric OPD were analysed. Patients had a mean age of 35.01±1.17 years. Male and Female %age was 41.49% and 58.51% respectively. Majority of the patients (47.52%) were in 31-45 years age group. 70.57% patients were literate. Depression was the leading psychiatric illness seen in 144 (51.06%) patients followed by Anxiety disorders which were seen in 60 (21.28%) patients. A total of 2463 drugs were prescribed which included 591 (23.99%) antipsychotic drugs followed by 462 (18.76%) antidepressants, 390 (15.83%) antiepileptics, 312 (12.67%) supplements, 276 (11.21%) antianxiety, 171 (6.94%) antacids, 165 (6.7%) anticholinergics, 96 (3.9%) drugs in miscellaneous category. Drugs prescribed per prescription were 8.73 and psychotropic drugs per prescription were 6.09. Number of oral and injectable drugs were 2313 (93.91%) and 150 (6.09%) respectively. 87 fixed dose combinations (FDCs) of psychotropic drugs were prescribed. 903 (36.66%) drugs were prescribed from WHO's 18th List of Essential Medicines. Conclusions: Depression was the most common psychiatric illness and antipsychotics were the most commonly prescribed medicines in psychiatry OPD. Majority of the prescriptions revealed polypharmacy.

Journal of Nobel Medical College, 2016

Background Depression is an important global public health problem due to its relatively high lif... more Background Depression is an important global public health problem due to its relatively high lifetime prevalence and significant disability caused by it. The present study was conducted to compare improvement in disability outcome by Amisulpride and Escitalopram among depression patients using WHO-Disability Assessment Schedule (WHO-DAS). Materials and Methods The study was conducted in depression patients for 1 year in the Department of Neuropsychiatry, Nepalgunj Medical College & Teaching Hospital. A total of 117 depression patients were divided into 2 groups. Group I (58 patients) received Amisulpride tablet at a dose of 50 mg/day and Group II (59 patients) were given Escitalopram at a dose of 10 mg/day. The patients were required to follow up at 4 weeks, 8 weeks and at 15 weeks. The efficacy of the drugs was calculated by Hamilton depression rating scale (HAM-D). The improvement in functional outcome was compared between the two groups by using WHO-Disability Assessment Schedule (WHO-DAS). Appropriate statistical tools using GraphPadInstat 3.0 were used for analysis. p value < 0.05 was considered significant. Results HAM-D score in group receiving Amisulpride at 0 and 15 weeks was 16.92±0.35 and 7.87±0.29 (p<0.0001). HAM-D score in group receiving Escitalopram at 0 and 15 weeks was 17.09±0.39 and 6.63±0.39 (p<0.0001). WHO-DAS score in group receiving Amisulpride at 0 and 15 weeks was 112.54±0.82 and 43.08±1.41 (p<0.0001) respectively. WHO-DAS in group receiving Escitalopram at 0 and 15 weeks was 113.73±1.92 and 40.69±1.49 (p<0.0001) respectively. Intergroup comparison at 15 weeks was insignificant (p>0.05). Gastrointestinal disturbances, sexual disturbances, amenorrhea, lactation, agitation and insomnia were the commonly encountered adverse drug reactions. Conclusion Both Amisulpride and Escitalopram showed improvement in WHO Disability Assessment Score (WHO-DAS) at the end of study period. But intergroup comparison showed no significant difference in the two groups.

Journal of Drug Delivery and Therapeutics, 2015

Objective: This study was conducted with the objective of comparing safety and efficacy of hormon... more Objective: This study was conducted with the objective of comparing safety and efficacy of hormonal treatment and nonhormonal alternatives for the management of menopausal symptoms. Materials and Methods: A total of 40 patients suffering from menopausal symptoms were recruited to the study protocol and were divided into 4 groups according to the treatment they received, with 10 patients in each group. Group A received conjugated estrogen and medroxy progesterone acetate, Group B received Tibolone, Group C received Isoflavone and Group D received Vitamin E. Efficacy of the treatment was evaluated by improvement in symptomatic score and safety of the treatment was assessed on the basis of adverse effects reported and relevant laboratory investigations. Results: Most of the symptoms were significantly improved in groups A and B (p< 0.01) while in groups C and D significant improvement was observed in hot flushes, sweating and insomnia (p<0.05). On comparative analysis there was no significant difference in the efficacy between groups A and B and between groups C and D. On the other hand significant difference was observed in the efficacy when groups A and B were compared with groups C and D (p<0.01). Only mild tolerable side effects were reported by the patients in all the groups with slightly higher incidence in groups A and B. Conclusions: Hormonal treatment is very efficacious for the early relief of menopausal symptoms. Isoflavone and vitamin E can be considered as a satisfactory treatment alternative when for any reasons hormonal treatment cannot be used.

Research Reviews Journal of Pharmacology and Toxicological Studies, Jan 7, 2014