Background: Upper respiratory tract infections are the most frequently occurring illness of childhood. The common types of upper respiratory tract infections are common cold, rhinitis, laryngitis, pharyngitis, otitis media and sinusitis. Common misuse of antimicrobial agents is seen in infections caused by viruses, which are self-limited and they do not respond to the currently available anti-infective agents. Methods: A prospective observational study was conducted at pediatric out-patient department of Basaveshwara Medical College Hospital and Research Centre, Chitradurga for a period of six months. The data was collected from outpatient record in a suitably designed individual case record form of the patients diagnosed with upper respiratory tract infection. Results: A total of 120 patients aged less than 13 years were collected from the paediatric outpatient department of a tertiary care teaching hospital. The most common diagnosis was nonspecific upper respiratory tract infections (49.1%). Only 10 drugs were prescribed from the essential drug list. Amongst all drug class, respiratory drugs were prescribed in more (29%), antihistamines (24.6%), antimicrobials (24.3%), Non-steroidal anti-inflammatory drugs (18%) and nasal drops (4.1%). In antimicrobials, amoxicillin + clavulanic acid (45.8%) was the highly prescribed combination. The main drug interactions were between chlorpheneramine and terbutaline. Conclusions: Antibiotic prescriptions were inappropriate in acute self-limiting upper respiratory tract infection. Antibiotics are over prescribed for paediatric upper respiratory tract infections. Amoxicillin with clavulanic acid combination were preferentially prescribed. Doctors should be educated on more appropriate and cost effective prescribing.

Objective: The objective of this study was to study the prescribing pattern in geriatric patients. Methods: A prospective study was carried out for a period of 4 years with one of the objectives to study the prescribing pattern in geriatric patients (≥65 years). The information was collected, from patients admitted to various departments of tertiary care hospital and old-age home at Chitradurga. Sociodemographic, economic, and clinical diagnosis and medication details were collected from medical records in a pre-structured case record form. The medications were classified based on Anatomical Therapeutic Chemical classification system. Results: A total number of 526 geriatric patients were enrolled during the study period. Young older patients (75.29%) and male subjects (55.89%) were predominant. Multiple morbidity conditions were more in the present study. Among the diseases diagnosed, circulatory system (I00-I99) affecting was more 41.83%. Prescriptions found with a sum total of 3228 formulations with 357 active drugs. About 56.27% of patients received ≥6 medications (polymedication) and an average of 6.14 drugs per prescription. Usage of parenterals (53.06%) was more among dosage forms. Prescriptions with alimentary tract, metabolism (A) (26.96%), and general anti-infective (J) (19.08%) class of drugs were common. Among individual drugs, pantoprazole (A02BC02), paracetamol (N02BE01), and ceftriaxone (J01DD04) were found more frequent in prescriptions. Conclusion: The study concludes the need of intellect prescribing practice, to install more rational therapy among geriatric patients.

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Toxic epidermal necrolysis (TEN) is severe adverse cutaneous drug reaction that predominantly involves the skin and mucous membranes. It is usually induced by medications. Anti-convulsants such as phenytoin, carbamazepine and phenobarbital have been enlisted as high risk drugs for causing TEN. Objectives: The main objective of this case report is to evaluate the importance of detection, assessment and reporting of an adverse drug reaction and to improve the medication adherence. Methods: This is an observational type of case report which we observed in our hospital on regular ward rounds. Results: This is a case report of Toxic epidermal necrolysis due to a Phenytoin which was used in the treatment of epilepsy in a 25 year old female patient. Causality assessment of the event with Naranjo' scale suggest "Probable". Conclusion: Proper counselling to the patient regarding the use of medications is of utmost importance, in such life threatening conditions where treatment guidelines remain hazy.

Diuretics are drugs that increase the rate of urine flow; clinically useful diuretics also increase the rate of excretion of Na+ (natriuresis) and an accompanying anion, usually Cl. Diuretics are a mainstay of therapy for a wide variety of diseases ranging from hypertension to the nephrotic syndrome. Objective: To study the prescribing patterns of diuretics in General Medicine and ICU. To assess the drug-drug interaction of diuretics. To study the route of administration of diureics. Materials and methods: A prospective observational study was conducted over a period of six months at general medicine and ICU department of Basaveshwara Medical College and Hospital and Research Centre, Chitradurga.a otal of 100 in-patients are included as study subject. Results: Mostly prescribed diuretic in this study were furosemide (52.9%), followed by mannitol (28.1%), spironolactone (11.57%), torsemide (5.79%), amiloride (0.82%) and hydrochlorothiazide (0.82%). Out of 100 prescriptions 84.4% of diuretics prescribed in intravenous route, 15.6% of diuretics prescribed in oral route. Out of 100 prescriptions total 89 drug interactions with diuretics are found. In that 2.3% major interactions and 67.4% moderate interactions and 30.3% minor interactions are found. Conclusion: Prescription monitoring helped to reduce the diuretic usage errors with respect to dose and drug-drug interaction with other prescribed drugs to provide better patient care. Keywords:  prescribing pattern, drug-drug intraction, diuretics

Ayurvedic medicines are being used increasingly to fight or prevent common diseases. Sitopaladi churna is a polyherbal formulation containing Piper longum (Piperceae), Elettaria cardamom (Zingiberaceae), Cinnamomum zeylanicum (Lauraceae). Methanolic and Aqueous extracts of Sitopaladi Churna was screened for their antimicrobial activity against Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Aspergillus niger and Candida albicans. The results of antimicrobial activity of Aqueous and Methanolic extracts of the Sitopaladi churna indicated that methanolic extract inhibited the growth of one or more test pathogens than aqueous extract. Sitopaladi churna formulation extracts showed a broad spectrum of antimicrobial activity. Phytochemical investigation revealed the presence of tannins, saponins, alkaloids, glycosides, flavonoids and triterpinoids. This may be due to the multifunctional effect of all the three plant ingredients of Sitopaladi churna.

Background: The treatment options for Diabetes mellitus and their prescribing has increased over years. This needs appropriate selection of drugs. The main objective of this study was to highlight the current prescribing trends in Diabetes mellitus patients with other co-morbid conditions. Methods: A prospective observational study was conducted on inpatients admitted to various wards in a tertiary care hospital for period of 6 months between October 2016-March 2017. Prescriptions of the patients are collected in a designed questionnaire form and the relevant information is recorded and analysed. Results: 235 patient prescription patterns were studied, out of which 62.97% were males and 37.02% were females. Most of the patients were in the age group of 41-60. Hypertension was the most commonly found co-morbid condition. Rapid acting insulin was mostly prescribed during hospital stay. Metformin was the commonly prescribed oral hypoglycemic agent followed by glimeperide. Conclusion: The adverse drug reactions can be minimized by replacing the drugs with novel therapeutic agents like Glucagon-like peptide agonist, Dipeptidyl peptidase inhibitors and Sodium-glucose transport inhibitors. The management of drug interactions should be done by clinical significance and correlation.