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Background:Nebivolol is a third-generation β-blocker, with highest β1 selectivity and nitric-oxide-derived vasodilatation. It also exhibits antiproliferative and antioxidant property that has beneficial metabolic profile compared to second-generation β blockers like atenolol. This study was planned to study the comparative effects of nebivolol and atenolol on metabolic parameters in patients with essential hypertension.Materials and Methods:A prospective, randomized, parallel, open-label clinical study was carried out on patients with essential hypertension. The patients were randomly assigned to receive tablet atenolol (Group A) and nebivolol (Group B) for a period of 24 weeks. Investigations were carried out at baseline and at the end of study period, that is, 24 weeks. Out of 69 patients, 60 completed the study and the data was analyzed using student's t-test. P < 0.05 was considered statistically significant.Results:Atenolol and nebivolol both showed significant (P < 0.001) antihypertensive action after 24 weeks. Mean blood sugar and lipid profile were found to be significantly (P < 0.001) elevated after 24 weeks of treatment with atenolol but not with nebivolol. Heart rate was significantly (P < 0.001) decreased in both groups at 24 weeks.Conclusion:In view of metabolic adverse effects of atenolol, nebivolol is the better choice whenever β-blockers have to be used in essential hypertension.

Background: Appropriate selection of antimicrobial drugs is critical to optimize treatment of infections ad limit the spread of antimicrobial resistance. Antimicrobial resistance is a serious global problem of antimicrobial abuse and there is a growing consensus to urgently develop new strategies for prevention of resistance of bacteria to antimicrobial agents. Relatively few studies of knowledge, attitude and practice are published regarding antimicrobial resistance.Methods: To explore the perceptions of knowledge, attitude and practice of antimicrobial agent use and its resistance in medical professionals in a tertiary teaching care hospital in India. This study was a cross-sectional, questionnaire based study conducted in tertiary care teaching hospital in India for a duration of three months and on a sample size of 300. All medical teachers, residents and interns were included in studies. Questionnaire included 8 questions of knowledge, 10 questions of attitude and 8 questions of practice. The parameters on which the data was analysed were, gender-wise distribution of data, Age-wise distribution of data, hierarchy-wise distribution- Residents, Lecturers, Assistant Professors, Associate Professors, Professors, according to years of experience, Departmental survey. Some questions were assessed by Likert scale, whose responses ranged from always to never. Some questions were of yes and no type, others were multiple choice questions.Results: The majority of respondents were males (65.66%). Most of the participants were from 21-30years (44%) followed by 31-40 years (32.66%). Almost 77.6% participants had upto 5 years of experience in their respective field. Participants had good knowledge, positive attitude and followed a rational and fair practice about antimicrobial stewardship.Conclusions: Adequate training should be given to UGs and PGs about antimicrobial chemotherapy and its usage. It should be part of their curriculum- proper prescribing, dispensing and usage of AMA so as to promote judicious use of AMA.

Objectives: The objectives of the study were as follows: (1) To study the prescription patterns in Respiratory tract infections (RTI) in indoor patients in pediatric wards. (2) To check the rationality of treatment according to Modified Kunin’s rationality criteria. (3)To analyze the data of RTI by Anatomical Therapeutic Chemical classification.Methods: It was a non-interventional, prospective, observational study which was conducted in indoor pediatric patients in a tertiary care teaching hospital in India. Data were analyzed and evaluated according to the WHO rational use of drugs guidelines.Study sample: The study sample was 174.Study duration: The study duration was August 15, 2016–September 15, 2016.Results: Males (63.79%) were more as compared to females (36.20%), and the highest number of cases was seen in infants (62.06%). Acute bronchiolitis (54.02%) was highest in the incidence followed by Wheeze Associated Lower Respiratory Tract Infection (WALRI) (30.45%). The average duration of patient stay in hospital was 4.71 days whereas 93.33% were polytherapy and mostly prescribed antibiotic was amoxicillin-clavulanic acid in acute bronchiolitis and WALRI. Salbutamol (40.84%) and Ipratropium Bromide (39.43%) were the commonly prescribed respiratory medicines. Oral route (42.27%) was the most common route of administration. 56.11% drugs were prescribed by generic name.Conclusion: Standard treatment guidelines for the treatment of RTI need to be urgently developed and strictly implemented.

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Treatment of metabolic patients with telmisartan or lisinopril for the management of hypertension reduced both Systolic blood pressure (SBP) as well as Diastolic blood pressure (DBP) statistically significantly during 12 weeks treatment. However, telmisartan and lisinopril treatment were found effective.

Background: Skin is one of the most common targets of adverse drug reactions (ADRs) The practice of pharmacovigilance all over the world is 5% whereas in India, it is below 1%. Hence, the purpose of our study is to monitor and analyze the suspected cutaneous adverse drug reactions (ACDRs) reported at our tertiary care teaching hospital, to characterize the nature and predictability, severity and preventability of ACDRs and identify most common drugs causing cutaneous ACDRs so that they can be given cautiously and with keen surveillance.Methods: An observational study was conducted in patients attending outpatient and inpatient department for a period of 3 years. All ACDRs of patients were referred by health care professionals and the diagnosis were made by concern doctors. The recorded data was filled in the ADR form obtained from pharmacovigilance program of India (2011) and Central Drug Standard Control Organization (CDSCO) website.Results: Out of 1399 ADR reports analyzed, 564 reports (40.31%) were of ACDRs, female to male ratio was 0.85. Redness (44.32%) was most common symptom, followed by itching (44.14%) and rash (19.14%). Antimicrobials (43.97%), NSAIDS (21.63%), Anti-retroviral therapy drugs (13.65%) were common groups. As per WHO-UMC causality classification, modified Hartwig and Siegel severity scale, Thornton and Schumock preventability scale, ACDRs were probable, mild and possibly preventable respectively.Conclusions: Effective ADR monitoring plays a role in safety of medicines. So, awareness regarding early diagnosis and prompt treatment should be created among the health care professionals and reporting of ACDRs should be regularly practiced by all the departments.

Objectives: The objectives of the study were to evaluate and compare the utilization pattern of analgesic use in pre-operative, intraoperative, and post-operative wards of different surgical specialties. Methods: It was a prospective, cross-sectional, and observational study done for a period of 1 year and the data were obtained from case sheets of 386 patients admitted in surgical wards of the. Data were analyzed according to demography, type of surgery, and the WHO prescribing indicators. The percentage of analgesic prescribed from an essential medicine list or National list of essential medicine (NLEM), common analgesics, and fixed dose combinations (FDC) used in surgery, gynecology, ENT, and orthopedic wards in preoperatively, intraoperatively, and postoperatively, was assessed and the amounts of drugs consumed were converted into the number of daily defined dose (DDD) as per the 2010 version of ATC/DDD index. Results and Discussion: The female to male ratio of 1.21 and most of patients were in the category of middle-aged adults (49%). On the evaluation of WHO prescribing parameters, it was seen the average number of analgesics prescribed per prescription was 1.26, percentage of injectable analgesics and analgesics prescribed from NLEM were 81.09% and 90.64%, respectively. Perioperatively, injection diclofenac sodium was the most commonly used analgesic and its DDD was 460. The most common FDC used perioperatively was aceclofenac 325mg+serratiopeptidase 15 mg (5.04%) and Drug Controller General of India and the WHO approved FDCs were 80.28% and 75.53%, respectively. Conclusion: It is necessary to determine the prevalence and severity of post-surgical pain and implementation of standardized pain evaluation and treatment protocols which improve the post-operative patient care in the hospital setting.