Aim:
World Health Organization (WHO) core prescribing indicators are highly standardized tools in reliably assessing the essential aspects of drug utilization pattern. It is critical that the rational use of drug prescribing is scrutinized for the utmost benefit of patient welfare. In this study, we aim to assess the prescription pattern and prescribing behavior of physicians using the WHO-recommended core prescribing indicators at a teaching hospital in South India.
Materials and Methods:
A prospective, descriptive cross-sectional study was conducted in the general medicine outpatient department of a tertiary care hospital for a period of 1 month in June 2019. A total of 600 prescriptions were sampled based on the WHO “How to investigate drug use in health facilities” document recommendation. The WHO guidelines and methods were observed to ensure data reliability. Descriptive statistical analyses such as frequencies, percentages, mean, and standard deviation were used to present the data.
Results:
The WHO core prescribing indicators analysis revealed that the average number of drugs per encounter was 2.38 ± 1.1 and only 796 (55.4%) of the drugs were prescribed by generic name. Whereas, the percentage of encounters prescribed with an antibiotic 44 (7.3%) and an injection 63 (10.5%) was less than the ideal recommendations as per WHO and 1265 (88%) of the drugs were prescribed from the National List of Essential Medicines.
Conclusion:
This study on prescription pattern audit done using the WHO core prescribing indicators highlights that prescriptions encountered with antibiotic and injection use were in accordance with the WHO recommendations.
Background: Acute myocardial infarction (AMI) management is one of the therapeutic challenges faced by the emergency physician. In the field of investigational cardiology advancements, the search of superior cardiac biomarkers has led to the discovery of sensitive biomarkers which help in the early confirmation of MI as timely intervention is the primary goal in acute coronary syndrome (ACS). Present study was aimed to evaluate the diagnostic performance of the novel biomarker H- FABP in patients with AMI especially in ST elevation MI (STEMI) and comparison of its diagnostic accuracy with the other biomarkers.Methods: We studied 66 patients with persistent STEMI presenting within 12 hours of symptom to the department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), Puducherry. Quantitative and qualitative estimation and analysis of serum biomarkers of acute myocardial infarction such as CK-MB, cardiac Troponin I (cTnI) and H-FABP were done.Results: The sensitivity and specificity of H-FABP were 80.7 and 88.9% respectively. The positive percentage of the serum biomarkers among these patients were 64%, 65%, 86% for CK-MB, cardiac troponin I, and H-FABP respectively. The area under the curve was observed to be 0.695, with 95% confidence interval (0.514-0.876) at the optimum cut-off value of 7.0ng/ml for H-FABP.Conclusions: H-FABP the novel biomarker, because of its early appearance in the blood stream and due to its superior sensitivity and specificity compared to Troponin I and CK-MB can be used in the early diagnosis of acute ST elevation Myocardial Infarction.
Background:
Coronary artery disease (CAD) is the leading cause of death in India. There was increased incidence and prevalence of CAD in males than in females. There have been several studies going on across the globe to find a similar equation in males between testosterone and CAD. This study aimed at correlating the serum free testosterone level in CAD patients with the severity of obstruction of the coronary arteries proven by coronary angiogram. This was the first study in South India to correlate the serum free testosterone levels with the severity of obstruction of coronaries.
Objective:
This study was designed to correlate the serum free testosterone level in male patients above 40 years with proven or newly diagnosed CAD with the severity of obstruction of coronary arteries as evidenced from coronary angiogram.
Materials and Methods:
This was a hospital-based cross-sectional study conducted from November 2015 to August 2017 in a rural-based teaching tertiary care hospital in Puducherry, India. The sample size was 40, calculated using the formula n = 4 × σ2/d2 from the previous study of serum free testosterone in men with coronary artery atherosclerosis done by Lucyna Siemińska et al.
Results:
Of 40 patients in the study group, 30% had CAD, 20% had hypertension (HTN), 45% had diabetes mellitus, 45% were smokers, 37.5% were alcoholic, and only 5% had family history of (H/o) CAD. In the study, ejection fraction was < 60 in 80% and ≥ 60 in 20%. In the study, 42.5% had single-vessel disease, 27.5% had double-vessel disease, and 30% had triple-vessel disease. The mean serum testosterone was 4.5 ± 3.1 and the median serum testosterone was 3.3, which showed that most of the patients with CAD had their testosterone levels in the lower range of normal.
Conclusion:
From the observations made in this study, it was clear that the skewing of serum free testosterone levels toward the lower side of normal can be taken as an indirect evidence that serum free testosterone is inversely related to CAD. There was no significant difference in median testosterone levels with respect to the type of disease. However, a statistically significant positive association between H/o systemic HTN and serum free testosterone level was observed in patients with CAD.
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