Objective:To evaluate prevalence, types, and severity of potential adverse drug-drug interaction in medicine out-patient department.Materials and Methods:A single-point, prospective, and observational study was carried out in medicine OPD. Study began after obtaining approval Institutional Ethics Committee. Data were collected and potential drug-drug interactions (pDDIs) were identified using medscape drug interaction checker and were analyzed.Result:A total of 350 prescriptions with mean age 52.45 ± 14.49 years were collected over a period of 5 months. A total of 2066 pDDIs were recorded with mean of 5.90 ± 6.0. The prevalence of pDDI was 83.42%. Aspirin was most frequently prescribed drug in 185 (10.15%) out of total of 1821 drugs It was also the most frequent drug implicated in pDDI i.e. in 48.16%. The most common pDDI identified was metoprolol with aspirin in 126 (6.09%). Mechanism of interactions was pharmacokinetic in 553 (26.76%), pharmacodynamic in 1424 (68.92%) and 89 (4.30%) having an unknown mechanism. Out of all interactions, 76 (3.67%) were serious, 1516 (73.37%) significant, and 474 (22.94%) were minor interaction. Age of the patients (r = 0.327, P = 0.0001) and number of drugs prescribed (r = 0.714, P = 0.0001) are significantly correlated with drug interactions.Conclusion:Aspirin being the most common drug interacting. The use of electronic decision support tools, continuing education and vigilance on the part of prescribers toward drug selection may decrease the problem of pDDIs.

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Objective:Several tools have been introduced to evaluate the quality of prescribing. The aim of this study was to determine the quality of prescribing in hypertension and bronchial asthma in tertiary health care (THC) setting using the new Prescription Quality Index (PQI) tool and to assess the reliability of this tool.Methods:A prospective cross-sectional study was carried out for 2 months in order to assess the quality of prescribing of antihypertensive and antiasthmatic drugs using recently described PQI at THC facility. Patients with hypertension and bronchial asthma, attending out-patient departments of internal medicine and pulmonary medicine respectively for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor, medium and high quality based on total PQI scores.Results:A total of 222 patients were included. Mean age was 56 ± 15.1 years (range 4-87 years) with 67 (30.2%) patients above 65 years of age. Mean total PQI score was 32.1 ± 5.1. Of 222 prescriptions, 103 (46.4%) prescriptions were of high quality with PQI score ≥34. Quality of prescribing did not differ between hypertension and bronchial asthma (P > 0.05). The value of Cronbach's α for the entire 22 criteria of PQI was 0.71.Conclusion:As evaluated by PQI tool, the quality of prescribing for hypertension and bronchial asthma is good in about 47% of prescriptions at THC facility. PQI is valid for measuring prescribing quality in these chronic diseases in Indian setting.

Objective: The objective of this research was to evaluate prescribing pattern of fixed dose combinations (FDCs) of antihypertensives and antidiabetic agents among patients of private hospitals.Methods: An observational study was carried out in the outpatient department of two hospitals. Data of patients being diagnosed with the symptoms of hypertension and diabetes were enrolled which mainly included information related to prescribe FDCs, i.e., antihypertensives and antidiabetics, respectively. Descriptive analysis of collected information was done which involved representation of demographical data, number of comorbidities, number of FDCs prescribed, and type of FDCs consequently.Results: Combination drug therapy was prescribed in maximum patients, which was enumerated as 93% among hypertensive patients and about 91% in diabetics. Average age of patients suffering more from hypertension was 64.5±18 years and that in case of diabetes sufferers was 54.5±18 years. The most frequent combination prescribed in hypertensive patients was of angiotensin receptor blocker (ARB) and calcium channel blocker (CCB) which were about 53%, and in diabetic patients, it was of biguanides and sulfonylureas about 63%. Comorbidity too was notified, and its estimation was 61% in hypertensive patients and 72% in diabetic patients, respectively. Conclusion:The study here demonstrates that the most often prescribed antihypertensive combination is of ARB and CCB, and subsequently for diabetes, the oral hypoglycemic combination is of biguanides and sulfonylureas. Most of FDCs contained medications of these two classes. Positive results were also observed in levels of blood pressure and glucose within the normal range.

Background: Inhaler dosage forms are cornerstone therapy in respiratory disease. Inhalers are principle vehicles for effective administration of medication. The effectiveness of inhalation drugs can affect by factors including age, gender, education status, duration of disease, type of inhaler used and correct inhalation technique. Objectives: To assess Inhalation Technique in the patients of COPD and Asthma using MDI and Rota-haler. Study prescribing trend of patient of COPD and Asthma. Methods: A prospective, interventional study conducted in Medical Outpatient Department of Sheth HJ Mahagujarat Hospital, Nadiad. Patients were diagnosed with asthma and COPD using MDI and Rota-haler inhalers. Total 60 patients were included in the study; Patients' history was recorded and after explanation of procedure for inhalers; assessments of inhalation technique were evaluated in inhaler specific checklist described by Dutch Asthma Foundation. Results: Total 53.39% (Asthma) and 58.35% (COPD) users used inhaler incorrectly. In Asthma MDI; it shows clinical significance but statistically non-significant (p=0.10) and Rota-haler; shows both clinical and statistical significance (p=0.01). In COPD MDI (p=0.02) and Rota-haler (0.04); shows both clinical and statistical significance (p=0.02). It shows improvement in patients' performance after providing information on use of inhaler. The most commonly prescribed drugs with MDI and Rota-haler were Short acting β-agonist, Corticosteroids and Combination of Bronchodilator and Corticosteroids. Conclusion: Majority of patients in Asthma (53.39%) and COPD (58.35%) used inhaler incorrectly which leads to decrease in efficacy and drug delivery, increased side effects and economic burden with non-compliance. Post-Intervention use on inhalation technique showed improvement.

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Background. Dementia is one of the most frequent disorders among elderly patients, reaching to epidemic proportions with an estimated 4.6 million new cases globally annually. Partially effective treatments are available for dementia. Aims & Objectives. We aim to study drugs used in dementia and find out frequency of types of Dementia. Method. This was an observational study conducted at rurally based tertiary care hospital. Prospective data was collected from outpatient department, while retrospective data was collected from medical records. Descriptive statistics were used to analyze data. Result. Total 125 prescriptions of patients diagnosed with dementia were analyzed. Alzheimer's dementia was most common (65.6%), followed by vascular dementia (21.6%), and frontotemporal dementia (10.4%), with the rarest being Lewy body dementia in (2.4%) cases. 60.57% of patients were males. Mini Mental Score Examination mean score was 15.93 ± 1.37. Frontal Battery Assessment mean score was 4.75 ± 1.01. Prescribed drugs were Donepezil (68.49%), Rivastigmine (13.63%), Donepezil + Memantine (6.43%) and Galantamine (12.83%), Quetiapine (38.46%), Lorazepam (23.07%), Clozapine (11.53%), Escitalopram (10.25%), Haloperidol (3.84%), Zolpidem, Sertraline, Olanzepine (2.56%), Nitrazepine, Lamotrigine, Fluoxetine, Tianeptine (1.28%), Folic acid, and Vitamin B12, respectively. Conclusion. Alzheimer's is the most common type of dementia while Donepezil was the most frequent drug.

Background: About half a million women die every year of causes related to obstetrics complication. Complication can arise at any time during pregnancy; child birth and post natal period and in absence of intervention, there is a high feto-maternal morbidity and mortality. The aim of the study was to know the morbidity pattern and pregnancy outcome among the antenatal attending to the community health centre. Method: A prospective observational study was conducted on pregnant women during August 2013 to December 2013. Data regarding maternal socio-demographic profile and antenatal profile was collected. Results: A total 512 pregnant women attended the health centre of whom, 88.87% patients had at least one morbidity pattern or complain. In our study moderate anemia (65.26%), severe anemia (13.79%) and pregnancy induced hypertension (4.78%) were the most common morbidities. Further, morbidity pattern like, pregnancy associated common complains, mild anemia abnormal presentation, abortion, preterm labor, oligohydramnios, urinary tract infection and HIV were also reported. Conclusion: Maternal morbidity is notably high, although most of the common problems were not lifethreatening. They are more likely to have marked influence on their well-being and health status in the long run. Most conditions could be addressed through provision of health promotion and preventive interventions.