Aim:The aim of the study is to conduct a prospective study on prescribing pattern of antibiotics in the out-patient department of Pediatrics and to evaluate the rational use of antibiotics. Methods: The study was conducted with a sample size of 480 patients for a period of 6 months at a Tertiary Care Teaching and Non-teaching Hospital after taking consent from both the hospitals. Results: In our study, a total of 480 prescriptions, hospital 1:225/129 and hospital 2: 225/154 were screened. Out of which 129(57.3%) and 154(60.39%) contained antibiotics and the average number of drugs was 2.93 ± 0.96 and 2.94 ± 0.9 for hospital 1 and 2 respectively. Majority of the prescriptions contained only one antibiotic. Moderate drug interactions of 85% and minor interactions of 15% were found from both the hospitals. Most common diseases found were upper respiratory tract infections (URTI-25.58%), fever (25.58%), gastroenteritis (GE) 17.82%) in hospital 1 and fever (22.72%), URTI (20.12%), LRTI (14.93%), GE (19.48) and UTI (16.23%) in hospital-2.Commonly prescribed antibiotic class and drugs was penicillin-amoxicillin(18.18%)-hospital1,cephalosporins-cefixime(32.14%), ceftriaxone (21.42%) and cefodoxamine (40.17%)-hospital 2. The commonly used antibiotic combination was amoxicillin + clavulanic acid (hospital1:75%, hospital2-100%). The average total prescription cost and antibiotic cost was Rs. 96.96 and Rs. 45.30 (hospital 1), and Rs. 69.80&Rs. 39.60. (hospital 2) respectively. Conclusion: The total number of drugs and the number of antibiotics prescribed were found to be rational in both the hospitals. However more rationality was observed in non-teaching hospital with regard to prescribing pattern as well as economic criteria compared to teaching hospital.
Aim: The aim of this study was to evaluate the association between health-related quality of life (HRQL) and disease severity using both disease specific and generic specific questionnaires and lung function measures. Methods: A survey was performed in patients with COPD and Asthma in tertiary care teaching hospital. One hundred and twenty (120) subjects (92 men and 28 women, mean age 48.6 years) completed the generic HRQL questionnaire; the Short Form 36 (SF-36) and disease-specific HRQL questionnaire; the St George's Respiratory Questionnaire (SGRQ). The subjects were divided into four severity groups according to FEV 1 percent of predicted normal using two clinical guidelines: GOLD and BTS. Results: From our study it was observed that the mean scores of SF-36 PCS is 40.46, p<0.0001 and MCS is 40.22, p<0.0001which showed an average HRQL and was significantly associated with COPD and Asthma. The COPD severity grades affected the SGRQ Total scores, varying from 67.8 to 22.9 (GOLD p<0.0001) and from 64.1 to 22.9 (BTS p<0.0001). The four stages of FVC% predicted had an impact on HRQL similar to the stages of FEV 1 % predicted outlined from GOLD and BTS. Strong negative correlation (-0.645, p<0.0001) was observed between SF-36 and SGRQ total scores, strong negative correlation (-0.847, p<0.0001) between SGRQ total scores and FEV 1 %/FVC% predicted in contrast with positive correlation (0.583, p<0.0001) with SF-36 and FEV 1 %/FVC% predicted. Conclusion: The results showed that HRQL in COPD deteriorates with disease severity and age. The results also showed that the level of HRQL of COPD and Asthma subjects deteriorate considerably with increase in the severity of disease and such deterioration showed linear relation to the decrease in the FEV 1 % predicted normal values.
Aim:To conduct a prospective observational study on prescribing pattern of antihypertensive drugs and to evaluate the current practice of antihypertensive drug by comparing with JNC-8 guidelines in north Karnataka hospital. Methods: The study was conducted for a period of 6 months with a sample size of 100 of all the in-patient of age ≥ 18 years of hypertension with or without co-morbidities, including pregnant women and lactating mothers. Results: A total of 100 prescriptions were analysed during the six-month study period. 55% were male while 45% were female. 25% patients received monotherapy while majority of the patient's i.e. 75% were put on multidrug therapy of which, 35% patients on two drug therapy, 32% of patients on three drug therapy and 8% on four drug therapy. The most common drug classes involved in the study were ARBs (17%), BBs (09%) and ACEIs (03%). Our study reveals that without diabetes or CKD (greater than 60 years) 75.60% of patients were compliant with JNC-8 goal (less than 150/90 mmHg) and without diabetes or CKD (less than 60 years) 64.30% of patients were compliant with JNC-8 goal (less than140/90 mmHg). Patients with diabetes and without CKD (all ages) 50% achieved the JNC-8 goal (less than140/90 mmHg) and Patients with CKD or without DM (all ages and races) 60% achieved the JNC-8 goal (less than140/90 mmHg). Conclusion: Calcium channel blockers (Amlodipine) and diuretics (Furosemide) were the drug of choice for hypertensive patients as a single drug and combination drug therapy. As per the JNC 8 guidelines majority of the BP goals were achieved. Our result reveals that antihypertensive medication adherence to JNC 8 guidelines is optimal at the study site.
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