Introduction:Diabetes mellitus is on alarming rise in India. Drug utilization studies help to identify the adherence to standard treatment guidelines and to evaluate the rational drug usage.Objective:To study prescription pattern, calculate the cost of antidiabetic drugs and to evaluate the adherence to treatment guidelines in diabetic patients attending the medicine outpatient department in a tertiary care teaching hospital.Materials and Methods:A prospective observational study was carried out for a period of 5 months. The diabetic patients who visited the medicine outdoor department were included. Demographic data and complete prescription details were recorded in the structured case record form. Cost of the drug therapy was calculated from the patient's bills. Indian Council for Medical research guidelines-2005 for diabetes management was used to evaluate the adherence.Results:A total of 250 patients were enrolled in the study with mean age 57.91 ± 9.37. Out of 250 patients 126 (50.4%) were male and rest were female. A total of 1,391 drugs were prescribed, with mean of 5.56 ± 2.52 drugs and out of which 539 drugs were antidiabetics with mean of 2.18 ± 0.96. In monotherapy, metformin was frequently 218 (40.45%) prescribed. Glimepiride and metformin was the most frequently prescribed in 119 (76.28%) out of 156 antidiabetic drug combinations. Most commonly used drugs other than antidiabetics were aspirin 146 (18.9%) and atorvastatin 119 (15.41%). Mean cost of therapy for a month for a diabetic patient was 354.60 ± 305.72 INR. Majority 209 (83.6%) of prescriptions was in accordance to guidelines.Conclusion:Metformin was the most frequently prescribed drug in the diabetes patient. Metformin and glimeperide being the most frequent combination used. Majority of the prescriptions followed standard guidelines.

AIM:The aim of the present investigation is to study the incidence medication error (ME) in hospitalized patients in a tertiary care hospital. Further, the study was aimed to categorize medication error in the hospitalized patients of surgery and general medicine wards of tertiary care hospital. Method: A prospective observational study of seven months was conducted in the department of surgery ward and general medicine ward at Jivraj Mehta Smarak and Health Foundation. Data were collected using structured data collection form. Major Findings are recorded for the demographic details, drug details and criteria for identifying errors and their categorization, details of drugs involved in errors and rationality of prescription. Result: The study was conducted in 427 patients, where 231 were males (54%) and 196 were females (46%). Out of 427 cases, MEs has detected in 196 cases (45.90%). Most of the medication errors were observed in the age group of 41-60 years (34.69%). Reported incidences of MEs, 99 (51%) and 97(49%) were observed in surgery and general medicine department, respectively. The most frequent error was prescription errors (138; 70.40%) followed by administration errors (58; 29.59%). A potential drug interactions were observed in 95 cases (48%) and serious drug interactions in 28 cases (14%). Majority prescriptions were semi-rational (178; 41.68%) followed by irrational (96; 22.48%) and rational (135; 31.61%). On the evaluation of severity, majority of MEs were category C (118; 60%) followed by category B (44; 22%) and category A (34; 17%). Majority of MEs were belonging to cardiovascular drugs (23; 23%) in medicine ward and gastrointestinal drugs (29; 29%) in surgery ward. Conclusion: The study helps to assess the incidence of medication error and to categorize medication error. In the general medicine department, the majority of patients were geriatrics who are more prone to errors, thus guidelines for safe use of medications in geriatrics should be strictly implemented to prevent medication errors. Antimicrobials are the major class of drugs involved in medication errors, thus this study recommends strict implementations of antibiotic policy in the hospital.

Background: Studying the prescribing audit is that part of the medical audit which seeks to monitor, evaluate and if necessary, suggest modifications in the prescribing practices of medical practitioners. Our objective was to study the Prescription Audit in Out Patient Department of in Multispecialty Hospital in western India. Methods: An Observational study was carried out during the period of 2012-2013. Total 150 prescriptions of Outpatient department were collected, scrutinized and statistically analyzed with Reporting procedures to pharmacy and quality department. We have also considered Statistical Process control (SPC) to provide the guidance on how the process may be improved by reducing variation & to assess the performance of a process. Results: Total 150 patients were evaluated for Prescription Audit, out of which 60% were Male & 40% were Female cases. In the same mainly 13 parameter were assessed according to the checklist provided by the Hospital with total 1950 (150*13) counts; from this 1126 Counts were under compliance, 74 Counts were non-compliance & 750 Counts were not applicable. 50 cases were analyzed for 3 months, showed better compliance rate of prescription audit parameters in February 2013 compared to December 2012, while non-compliance rate in prescription audit was reduced as time progresses. Conclusions: A definite role of clinical pharmacist, in the process control by utilizing SPC during prescription audit. The members of the hospital and Quality committee need to focus on findings of it, which help them during accreditation by regulatory authority.

We have studied the effect of 8-week treatment with spironolactone (20 mg*kg(-1)*day(-1)) on cardiovascular complications associated with streptozotocin (STZ)-diabetic rats. Wistar rats were made diabetic with STZ (45 mg/kg, intravenously). Various biochemical and cardiac parameters were measured at the end of 8 weeks. STZ produced hyperglycemia; hypoinsulinemia; hyperlipidemia; increased blood pressure; increased creatinine, cardiac enzyme, and C-reactive protein levels; reduction in heart rate; and cardiac hypertrophy. Chronic treatment with spironolactone significantly prevented STZ-induced bradycardia, hypertension, and elevated fasting glucose level with simultaneous increase in serum insulin levels. It significantly reduced the elevated cholesterol, very-low-density lipoprotein, and triglyceride levels and increased the lower high-density lipoprotein-cholesterol levels in diabetic rats. Furthermore, spironolactone also produced a significant reduction in the elevated creatinine levels, C-reactive protein, and levels of lactate dehydrogenase and creatinine kinase. It also produced beneficial effect in diabetic rats by preventing cardiac hypertrophy as evident from decrease in left ventricular collagen levels, cardiac hypertrophy index, and left ventricular hypertrophy index. Our data suggest that spironolactone prevents not only the STZ-induced metabolic abnormalities but also cardiovascular complications.