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Objectives Drug therapy (DT) is growing more complex, thus appropriate drug prescription becomes increasingly challenging. Drug interactions (DI) are one of the important factors that modify the response to a drug. The main objective of this study was to monitor the potentially serious and significant Drug-Drug Interactions (DDIs). Material and methods The number of drugs prescribed for each patient, drugs taken by the patient and the drug interactions were recorded. The interactions between the drugs were assessed using Micromedex software and Stockley's Drug Interaction. The type and severity of prescription with DDIs was also assessed. Results The number of potential DDIs for the study population was 390 and each prescription had at least one interaction. Of the total potential DDIs (n=390) identified, majority were of moderate severity (n = 257, 65.90%). Most frequent DDI was seen between Metformin + Ranitidine (moderate interaction) in 70 prescriptions (50%) and between Ranitidine + Acetaminophen (minor interaction) in 48 prescriptions (34.29%). The common major interactions were seen between Rabeprazole + Clopidogrel in 4 prescriptions (2.86%), Enalapril + Spironolactone and Ciprofloxacin + Tramadol in 3 prescriptions (2.14%). ConclusionThe drug related problems, primarily the drug interactions is a permanent patient related risk in hospitals and the utilization of computer software has become the best way to identify and prevent them.

The oral hypoglycaemic agents as well as injectable insulin does not significantly alter the oxidative stress in the diabetes mellitus patients. Being an antioxidant Vitamin C (ascorbic acid) might help in tackling the adversities of reactive oxygen species. A randomized placebo controlled study was carried out with parallel assignment of both the test group and control group of patients. The intervention model included metformin 500mg twice daily and a placebo once daily for control group. Alternatively, Vitamin C chewable tablets were given for the other group along with metformin 500mg twice daily. Our study postulates that there is a significant reduction in the fasting blood glucose, glycosylated haemoglobin levels, troponin T levels and Framingham risk score in participants who received ascorbic acid supplementation along with regular metformin. The supplementation of Vitamin C along with Metformin was well tolerated and did not cause any serious adverse drug reactions. The cheaper cost adjuvant approach with Vitamin C may be beneficial in patients in reducing the cardiovascular risk as well as to maintain an appropriate glycaemic control

Background Vitamin C is one of the most important micronutrient required for various physiological roles in the human system. Evidences suggest that there is an inadequate status of vitamin C in diabetes mellitus. The objectives of this study is to understand the prevalence of vitamin C deficiency in established type II diabetes mellitus patients and to study the correlation between various variables of diabetes mellitus with serum vitamin C levels. Methods A prospective cross-sectional study to assess the prevalence of vitamin C deficiency was carried out in diabetes patients. Fasting blood sugar levels, glycated hemoglobin, serum malondialdehyde levels, and lipid profile levels were correlated with serum vitamin C levels. Results The prevalence rate of hypovitaminosis C is found to be 55.13% among the enrolled patients. There is a significant increase in the systolic blood pressure levels in patients with inadequate as well as deficient vitamin C levels (p < 0.05). Inverse relationship exists between fasting blood sugar and vitamin C levels (p < 0.001). Similarly total cholesterol levels were also inversely related to the vitamin C levels (p = 0.0031). Body mass index, glycated hemoglobin, and fasting blood sugar levels are important predictors of vitamin C deficiencies. Conclusion Vitamin C deficiency is well established among diabetes mellitus patients. Deficiency of vitamin C levels has an impact on the serum malondialdehyde levels suggesting increased oxidative stress. The higher oxidative stress would have led to increase in glycated hemoglobin. Further research must be carried out to understand the beneficial effects of vitamin C supplementation in diabetes mellitus.

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