Indian Journal of Pharmacy and Pharmacology

48-59

Authors: Sheshaprasad R., Anuradha Pai

Introduction: Recurrent aphthous ulcer (RAU) is a common oral disease characterized by ulcers with an erythematous halo, affecting 5–25% of the general population. The underlying etiology is not clear, but several factors are believed to be responsible for the pathogenesis of the disease including stress, hormones, genetic factors etc. Behcet'ssyndrome is a multisystem disorder involving vasculitis of small and medium-sized vessels and inflammation of the epithelium, characterized by recurring oral and genital ulcers with eye lesions. Aim:The objectives of this paper were to compare different treatment options available for the patients suffering from RAU and major refractory oral aphthae without any systemic disease or any syndromes except Bechet’s, associated with RAU published in the review of RAU, point out drugs and therapies along with their dosages that may be used in the first line of treatment (topical) and second line of treatment (systemic). Materials and Methods: Pub Med search (full text and abstracts) with drugs belonging to several categories like anesthetics; antibiotics and antiseptics, corticosteroids, anti-inflammatory and antiallergic drugs hemorrheologic agents, zinc substitutes, immunomodulatory agents and chemical cauterizing agents was done. Pub Med search term “Behcet's trial oral” was used and only those publications that described clinical trial with drugs on patients with Behcet’s disease involving oral lesions were selected. Result:Total 62 articles were analyzed to extract the data regarding different therapeutic agents used in the treatment of Recurrent aphthous ulcer and oral ulcers in Bechet’s syndrome. The drugs most commonly used were lidocaine, benzocaine, tetracycline, chlorehexidine amlexenox and dexamethasone topically and prednisolone, levamisole and thalidomide systemically as a single therapy or in combination. The impact of immunomodulators and LASER in comparison with topical drugs also was assessed. Conclusion:Novel research strategies should be designed to clinically test combination therapies in the treatment of aphthous ulcers.

62-65

Authors: Sonia Dhiman, Rekha Bansal, Dinesh Kansal, Parveen K. Sharma

Objectives: Assessment of Health Related Quality of Life (HRQoL) of drug resistant tuberculosis patients at the start of treatment under PMDT regime. Materials and Methods: This observational study was conducted on a cohort of 172 drug resistant tuberculosis (DR-TB) patients at the time of registration under PMDT regime. Patients who started their treatment between January 2016 and December 2016 were included in the study after approval from IEC. A validated WHOQOL-BREF questionnaire was used for interviewing the patients. This questionnaire assesses HRQoL on 0-100 transforming scale in four domains – Physical, Psychological, Social relationship and Environmental. Results: Out of 172 participants, 50 (29.1%) were females and 122(70.9%) were males. Their mean age±SD was 40.23±15.77 years. 77.9% participants were married. 97.7% of them were residing in rural areas. Most of the participants were from district Mandi (33.1%) and Kangra (20.9%). Scores of Physical domain were 39.76±13.88; Psychological domain were 37.23±14.89; Social relationship domain were 43.28±13.48 and Environment domain were 50.66±9.13. Overall HRQoL scores were 42.73±10.11. Conclusion: Chronic diseases like tuberculosis affect all domains of HRQoL and there is need to consider HRQoL domains of patients of DR-TB along with smear positivity and mortality to evaluate the success of any national heath programme.

71-74

Authors: Tamilisetti Vidya Sagar, Sanjay Kumar, Pramila Nayak

Introduction: To know adverse drug reactions when Aspirin is prescribed with Antihypertensive medications. Materials and Methods:Prospective observational study conducted in a tertiary care hospital, total 60 patients of age Casuality assessment of all ADRs was done by Naranjo ADR scalegroup 18 to 65 years were included in the study, It is a 12 week study, clinical examination done at enrollment and with subsequent follow up at 4,8 and 12 weeks,Base line investigations done at enrollment and at 12 weeks ,ADR monitoring done at each follow up Results:Out of 45 patients who experienced adverse effects, causality assessment shows that Aspirin is responsible for producing ADRs in 15 patients and in Betablocker therapy and 26% in Aspirin with thiazide diuretics and 16% in aspirin with ACE inhibitors or Calcium channel blockersremaining 30 patients, Aspirin interaction is likely cause for ADRs, Incidence of adverse effects is 40% in Aspirin with concomitant Conclusion: This study shows Betablockers and Thiazide diuretics in treatment of hypertension,Incidence of ADRs is high in elderly patients,increased incidence of Adverse drug reactions (though these are mild ADRs) when Aspirin is added to Betablockers and Thiazide diuretics in treatment of hypertension,Incidence of ADRs is high in elderly patients.

82-85

Authors: Arvind Kumar Yadav, Meenu Pichholiya, Jitendra Jeenger

Introduction: Drug utilization studies can identify the problems and provide feedback to prescribers so as to create awareness about irrational use of drugs. This study was conducted to find out the prescribing pattern in out-patient department (OPD) of Psychiatry. Materials and Methods:This prospective observational study was carried out in a tertiary care teaching hospital of southern Rajasthan. The data was collected in a case record form from patients of all age irrespective of gender who attended the psychiatry OPD. Assessment of prescription patterns was done as per the selected WHO-INRUD (World Health Organization-Indicators for rational use of drugs) drug use indicators. Results:Depression (34%) was the most common diagnosis followed by schizophrenia (13.5%) and bipolar affective disorder (12%). Overall predominance of psychiatric disorders was found between 36-40 years age group with 20 male and 16 female patients. Mean age of depression patients was found 41.35 years and 37.07 for schizophrenia patients. Escitalopram (18.27%) was the maximally prescribed drug followed by Clonazepam (10.44%), Olanzapine (9.13%), Amitryptaline (7.83%). The average drug per prescription was 1.915 out of the total 383 drugs. 7.30% drugs were included in WHO Model list/National list of Essential Medicine. 0.78% drugs were prescribed by generic name. Not a single drug was given by injectable form and no antibiotic was prescribed to any patient. Conclusion:Escitalopram was the most commonly prescribed drug as depression was found most common disorder. Drugs were less prescribed by generic names and less percentage of essential drugs in prescriptions but there was no polypharmacy in our study.

93-96

Authors: Siddharth Athawale, M. D. Kulkarni, S. M. Doifode

Introduction: Acute poisoning is a very common & life threatening crisis and leads to serious conditions and even death of patients. Poisoning may be due to self consumption or accidental of various chemical compounds, medications and poisonous animals. The various drugs used in poisoning and there clinical outcome with different poisoning substances was investigated in this study Material and Methods: The patients which have been diagnosed with acute poisoning in Medical intensive care unit from January 2017 to July 2017 are included in this study. Results: During 7 months of study total 154 patients of acute poisoning were included in this study. Male patients were 111 (72%) while female patients were 43 (28%). Mean age of patients was 34.97 +14.46 years. The commonest cause of poisoning was by use of pesticides followed by venomous snake bite. Drugs prescribed to patients were mainly symptomatic like H2 blockers (99.3%), antiemetics (97.4%), and antimicrobials (90.2%). Specific antidotes prescribed were Atropine (92.8%), pralidoxime (79.8%) and anti-snake venom (17.5%) Conclusions:Organophosphorus compounds were the most common among poisons, followed by Snake bite. Gastroprotective and antiemetic drugs are most commonly prescribed drugs.