Introduction: Hypertension is a multi-factorial and complex disease that has both environmental and genetic determinants. It is the single most significant risk factor for heart diseases and kidney diseases. Hypertension is a leading contributor to global burden of morbidity and mortality. It is considered as a silent killer because most of the time it is asymptomatic and goes undetected. Hence, hypertensive patients should be prescribed properly. Objectives: To evaluate the prescribing pattern of anti-hypertensive drugs in patients of hypertension. Material and Methods: This was an observational, cross sectional study conducted over a period of 1 year on hypertensive patients attending the Cardiology outpatient department of Government Medical College and Rajindra Hospital, Patiala and fulfilling the inclusion and exclusion criteria. The prescriptions were evaluated. Results: 22% of prescriptions had monotherapy, amongst which beta-blockers were most commonly prescribed. Majority of prescriptions had two drug therapy (47%), among which ARB+ beta blockers (17%) were most frequently prescribed. Beta blockers +CCB (9%) was the most common Fixed Drug Combination (FDC) prescribed. ARB+beta blockers+diuretics (14%) and ACEI+ARB+beta blockers+diuretics (1%) were most commonly prescribed three drug combinations. Among four drug combinations, only ACEI+ARB+beta blockers+diuretics was prescribed to 1% patients. Hypolipidemic drugs (66%) were maximally co-prescribed. Conclusions: A high trend of polypharmacy was observed in hypertensive patients. So, emphasis is needed to reevaluate the prescribing trends in these patients.

Objective: The objective of the study was to assess the pattern of adverse drug reactions (ADRs) along with the severity and causality assessment of the ADRs in the local population. Method: This was an observational and retrospective study. A total of 288 adverse drug reactions were reported from 175 patients of the outpatient and inpatient department of various clinical departments of Rajindra Hospital, Government Medical College, Patiala, Punjab. The ADRs were collected duringNovember 2015-August 2016. Results: The mean age of the patients was 43.14 (± 2.27) years. Gender distribution of the patients showed that there were 67 (38.28%) female and 108 (61.7%) male patients indicating male preponderance. Out of 288 ADRs, the majority of ADRs were related to the skin and appendages (26.04%) closely followed by gastrointestinal disorders (24.3%). Other ADRs were related to Central nervous system (12.15%), respiratory system (7.29%), cardiovascular system (6.94%) and others (23.2%). Using Naranjo's causality assessment scale, there were 9 definite, 131 probable, 136 possible and 12 doubtful/ unlikely causality of the ADRs with the suspected offending drug. Using Hartwig and Siegel scale of severity of ADR, it was found that there were 230 mild (79.86%), 52 moderate (18.05%) and 6 severe (2.08%) ADRs. Conclusion: The process of pharmacovigilance is a continuous one so as to detect even the rare ADRs.

Thimerosal, an organic-mercury (Hg) compound containing 49.55% Hg by weight, is added to vaccines as a preservative permitting formulation of multi-dose vaccine vials. Being a derivative of ethylmercury, it has been linked with autism as a possible risk factor based on the assumption that exposure to ethylmercury would have similar neurotoxic effects as another mercurial compound, methylmercury. In 1999, AAP issued a joint statement emphasising the removal of thimerosal from vaccines. Subsequently, several studies have been conducted; those showing positive association between thimerosal exposure and autism have been recognised to be fraught with methodological flaws. On the other hand, many well controlled studies have failed to find any such causal relation and there are others that have clearly demonstrated a much favourable kinetic profile of ethylmercury as compared to methylmercury. Owing to the lack of data, AAP retired its original statement in 2002. Recently, thimerosal has been exempted from regulation by Minamata Convention on Mercury resulting in the continued use of low cost thimerosal containing vaccines in low income countries which cannot afford to run their immunisation program using single dose thimerosal free vaccines, that comparatively cost much higher, as is the case in high income countries. Some bodies view this as a discrimination on the basis of wealth of a nation and have opposed this decision. This review presents various studies regarding the causal association between thimerosal containing vaccines and autism. The current evidence fails to support any such association. Hence this review supports the exemption of thimerosal from regulation and also justifies its use in LICs for uninterrupted vaccination of the most vulnerable population.

Background: Osteoarthritis is a chronic and debilitating disease. Management of disease is a big challenge. NSAIDS play an important role but have many adverse reactions. So, this study was designed to evaluate the efficacy and safety of natural compound rosehip versus glucosamine and chondroitin sulphate in patients of osteoarthritis.Methods: An open label, randomized, parallel group comparative study, conducted on patients of either sex with confirmed diagnosis of osteoarthritis on standard NSAIDs therapy, attending the outpatient department of orthopedics in a tertiary care centre.  150 patients were enrolled and divided into three groups (group A, group B and group C) of 50 each. Patients of group A were given Glucosamine plus chondroitin sulphate for 12 weeks. Group B was given rosehip for 12 weeks and group C placebo.  These supplements were given as add on therapy.  Patients were monitored and adverse drug reactions were noted. The data was analysed statistically using t- test for efficacy and descriptive stats for assessing the safety.Results: Efficacy was assessed by comparing mean reduction in the pain intensity between group A and B, group B gives highly significant results as compared to group A. While comparing joint tenderness, swelling around joint, mean functional capacity and improvement in the overall assessment, group B gives significant results as compared to group A. It was also observed that group A and group B were better than group C in all the efficacy parameters. All the drugs were well tolerated and systemically safe.Conclusions: There was significant difference in efficacy of rosehip compared with glaucosamine and chondroitin sulphate in patients of osteoarthritis. In comparison there was no significant difference in safety of two drugs and both were considered safe in patients.

Objective: This study was designed and conducted to establish the relationship of biomarker CA19-9 levels in pancreaticobiliary and gastrointestinal malignancies. Methods: 50 patients with confirmed diagnosis of pancreaticobiliary and gastrointestinal malignancies and 30 age and gender matched controls were included in the study. Serum values of CA19-9 were determined in patients before surgery and chemotherapy. Results: In our present study, maximum number of patients were in the age group of 51–60 years. Mean levels of serum CA19-9 in patients (n=50) are 146.28±156.87 U/mL. Total patients (n=50), in 19 patients CA19-9 levels were ≤37 U/mL and in 31 patients CA19-9 levels were >37 U/mL. CA19-9 levels were highest in pancreatic and cholangiocarcinoma. Conclusion: High sensitivity and specificity of CA19-9 in pancreatic and biliary tract tumors identified CA19-9 as a best validated biomarker.