scholarly journals Drug Utilization Study in Medical Emergency Unit of a Tertiary Care Hospital in North India

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sharonjeet Kaur ◽  
Sujit Rajagopalan ◽  
Navjot Kaur ◽  
Nusrat Shafiq ◽  
Ashish Bhalla ◽  
...  

Objective. To generate data on the drug utilization pattern and cost of drug treatment and to determine the rationality of prescriptions.Methods. A retrospective cross-sectional drug utilization study was conducted in the medical emergency unit of our hospital. Patient case records were reviewed to extract data on the pattern of drug use. Cost of drug treatment for the emergency visit was calculated by referring to the cost mentioned in Monthly Index of Medical Specialties and the rationality of prescriptions was evaluated using WHO core indicators of drug utilization.Results. 1100 case records were reviewed. Majority of patients received proton pump inhibitors followed by multivitamins. The median cost per prescription was 119.23$ (7.32$–7663.46$). Majority (49.9%) of drug cost was driven by antibiotics alone. An average of 4.9 drugs was prescribed per prescription. There were 14.89% encounters with antibiotics. 75.17% of the drugs were given as injectables and only 29.27% of the drugs were prescribed as generics.Conclusion. There is need to rationalize the drug therapy in terms of increasing prescribing of drugs by generic name and to avoid overuse of PPIs and multivitamins in emergency unit. Also the hospital pharmacy should be encouraged to procure more cost effective alternative antibiotics in future.

Author(s):  
Dr. Sreya Todi

Acute poisoning is common everywhere in medical emergency.  Acute poisoning may be due to deliberate exposure to drugs, chemicals and natural toxins or accidental which is emergency for common medical health.  The main aim of this study was to investigate the pattern of drug utilization, poisoning agents, and outcome in patients with treated acute poisoning. Material and Methods:  This prospective cross sectional study was carried out in the emergency department of a tertiary care centre over a one year period. Result: During the period of 1 year total 310 Acute poisoning cases were recorded by us. Out of 310 acute poisoning cases 170(54.8%) were male where as females were 140(45.2%). The majority of cases were from age group of 20 -50 years in males whereas mean age of female patients was 37.3 years and majority of the cases were from 25-50 age group. The most common route of exposure to poisons (69.6%) was ingestion and followed by dermal exposure (in cases of venomous animal exposures) (25.8%) and inhalation (4.6%).The most common symptomatic treatments given to the patients were antimicrobials (88.7% of cases),  antiemetics (82.6%% of cases), H2 blockers (72.9% of cases) and Atropine (51% of cases), pralidoxime (41.6% of cases)  Proton pump inhibitors and  Vasopressor agents  etc respectively. The most commonly prescribed specific antidotes were Anti-snake venom (ASV) (12.9% of cases).Conclusion: In the present study, the main causes of poisoning were identified as household products in urban areas of India. Awareness about the dangers of such poisons should be the added responsibility of  health and hospital authorities. Poison control center establishment in the region will also help in preventing and controlling such poisoning events.


Author(s):  
Ujwala P. Gawali ◽  
Salman H. Rizvi ◽  
Prashant S. Mishra

Background: Drug utilization study is of utmost importance in the elderly. The consumption of drug amongst elderly segment of society is maximum and many of them use at least three prescribed drugs, concurrently. One of the plausible explanation of usage of large number of medicines is prevalence of multi-morbidities as well as suffer from chronic and degenerative pathology amongst them along with the alteration of pharmacokinetics and pharmacodynamics of many drugs are altered with advanced age. Thus, the aim of this study was to assess current prescribing practices among physicians for geriatric patients in tertiary care hospital.Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with Department of Medicine in a tertiary healthcare hospital. As per inclusion criteria, patients visiting Medicine outpatient department (OPD) from 01 October 2018 to 31 December 2018 were enrolled in the study.Results: The average number of drugs per encounter was 4.1. 100% of the drugs were prescribed by their generic name and those prescribed from World Health Organization (WHO) list of essential medicines were 70.2%. Analysis of polypharmacy showed maximum 11 and minimum 1 drug was prescribed. Overall analysis of the drugs showed, the most common route of administration was orally. Drugs acting on cardiovascular system (CVS), gastrointestinal system (GI) system, analgesics and anti-inflammatory drugs and vitamins and mineral supplements constitute the major bulk of drug prescribed.Conclusions: In our study, though polypharmacy was found but it was necessary unavoidable, but was within the WHO standards of 1.6 to 4.8. Drugs acting on CVS and GI system were the most common drugs prescribed. Prescriptions with injections and steroids were less in the study population. All the drugs were prescribed by their generic name and most were present in the essential list of medicines.


Author(s):  
Ujwala P. Gawali ◽  
Prashant S. Mishra ◽  
Salman H. Rizvi ◽  
Sukhmeen Kaur

Background: The illness due to psychiatric diseases and behavioral disorders is enormous, but it remains under represented by conventional public health statistics; which mainly targets mortality more than morbidity or dysfunction. The drug utilization study was conducted to find out problems and provide feedback to prescribers so as to create awareness about irrational use of drugs. This study was conducted in psychiatry outpatient department (OPD) of a tertiary care hospital.Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with department of psychiatry in a tertiary care hospital. Patients fulfilling the inclusion criteria visiting psychiatric OPD from 01 October 2018 to 31 December 2018 period of 3 months were enrolled in the study. Assessment of the prescriptions was done as per the ICD-10 criteria and World Health Organization-indicators for rational use of drugs (WHO-INRUD).Results: Among total 390 prescriptions; 71.54% was males and 28.46% were females. All the drugs were oral formulations. The burden of diseases are depression 35.89%, anxiety 20.51%, schizophrenia 18.97% and bipolar disorder 11.28% and other psychiatric diseases were 13.33%. Olanzapine was the most common drug which was prescribed followed by alprazolam. Total 1,140 drugs were prescribed out of which 86.32% was psychotropic drug and 13.68% were other like vitamin B-complex, analgesics, anta-acids, antibiotics and NSAIDS. The Most common prescribed class was atypical antipsychotics 26.31% followed by benzodiazepines 20.26%, antipsychotics 19.74%, tricyclic antidepressants 8.16%, anticonvulsants 9.21%, antiepileptics 2.37% and lastly selective serotonin reuptake inhibitors.Conclusions: Atypical antipsychotics was most commonly prescribed drug followed by benzodiazepines. All the drugs were prescribed by their generic names which suggests awareness among prescribers regarding WHO policies for generic prescribing.


2021 ◽  
pp. 192-194
Author(s):  
Shazia Bashir ◽  
Aamir Hussain ◽  
Irm Yasmeen

AIM: To evaluate and compare the cytograding of breast cancers using Robinson's and Moriquand's grading methods MATERIAL AND METHODS: This study was a cross-sectional retrospective study conducted over a period of three years w. e .f October 2014 to October 2017 and includes diagnosed or highly suspicious malignant cases of breast carcinoma. Slides were retrieved from the cytology section of Department of Pathology, GMC Jammu. A total of 84 cases of breast cancers were studied and grading was done using Robinson's and Mouriquand's methods and the two grading methods were then compared. RESULTS: Out of 84 cases of breast cancers , on using Robinson's grading method , 11 cases [13.10%] were graded as grade 1, 65 cases [77.38%] were graded as grade 2 and 8 cases [9.52%] cases as grade 3. 9 (10.71%) cases are graded as Grade I by Mouriquand's method with score less than 5. 68(80.95%) cases were graded as Grade II with score 5-9 and 7 (8.33%) were graded ad Grade III with score ≥10. On doing comparison between the two cytograding methods, we found a high degree of concordance between the two systems [ 96.42% ] . The relationship observed between the scores obtained by the two methods was also seen to be highly signicant. CONCLUSION: There is possibility of comprehensive cytograding of breast cancers by using the two different methods proposed by Robinson's and Moriquand's but out of the two methods inspite of a high degree of concordance between the two methods , the grading system of Robinson's because of its more objective set of criterias and easy reproducibility has been found to be easier and better.


2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Meenakshi Basnet ◽  
Bibek Ghimire ◽  
Akriti Shrestha ◽  
Gyan Raj Aryal

Introduction: Epistaxis is a common medical emergency with 5% to 15% of patients admitted for epistaxis will require surgical management as nasal packing has high failure rates. A modern endoscopic technique like Endoscopic Sphenopalatine Artery Ligation has increased in popularity for managing intractable posterior epistaxis. It has less complication and a high success rate. The study conducted to estimate the success rate of Endoscopic Sphenopalatine Artery Ligation of refractory posterior epistaxis among admitted patients in a tertiary care hospital. Methods: This is a descriptive cross-sectional study conducted from June 2019 to June 2020 at the Department of Otorhinolaryngology, Nobel Medical College and Teaching Hospital among the patient with refractory posterior epistaxis with the help of retrospective data. A convenient sampling method was used. These patients underwent endoscopic sphenopalatine artery cauterization for recurrent/intractable posterior epistaxis. Ethical clearance was taken from the Institutional Review Board. Data were analyzed in Statistical Package for the Social Sciences. Results: Out of the total patient with refractory posterior epistaxis who underwent Endoscopic Sphenopalatine Artery Ligation, the overall success rate was 39 (95.12%). Among them, 25 (60.97%) males and 16 (39.02%) females underwent endoscopic sphenopalatine artery ligation. Twenty (48.78%) of them were unilateral whilst 21 (51.21%) were bilateral disease. About 2 (4.8%) cases had re-bleeding within 48 hours which was managed conservatively. Hypertension was found to be the most common comorbid condition followed by diabetes, chronic kidney. Conclusions: From our study, we conclude that the success rate for Endoscopic Sphenopalatine Artery Ligation in a patient with refractory posterior epistaxis was high.


Author(s):  
Sonal M. Parekar ◽  
Girish K. Maindarkar ◽  
Vishal V. Maindarkar

Background: Drug utilization study is essential, as safe and effective therapeutic regimen in paediatric population is challenging. Pattern of use of drugs in pediatrics vary as compared to adults, also there is limited data available. The objective of this study was to study drug utilization pattern in pediatric patients attending pediatric outpatient department of Maindarkar pediatric hospital, Latur.Methods: A cross sectional study was carried out for a period of six months from September 2019 to February 2020, by analysing a total 1000 prescriptions of patients who had visited the OPD of Maindarkar pediatric hospital. Prescriptions were selected by simple random sampling method.Results: In our study, out of the total of 1000 prescriptions, 244 (24.4%) were of neonates, 556 (55.6%) were of infants (1 month to 1 year) and 200 (20%) were of children above 1 year. 547 (54.7%) prescriptions were of male patients and 453 (45.3%) were of female patients. The most frequent classes of drugs prescribed were nonsteroidal anti-inflammatory drugs 704 (70.4%), followed by drugs used for respiratory disorders 655 (65.5%) and supplements (60%). Antimicrobials were prescribed in 498 (49.8%) prescriptions. The average number of drugs per prescription was 2.45. About two third of all the prescribed drugs (74.41%) were from national essential medicine list. Most of the prescriptions had oral drug formulation 825 (82.5%) followed by inhalational 208 (20.8%) followed by injectables 150 (15%). All the drugs were prescribed by brand names.Conclusions: Our study helps health-care system to understand, interpret and improve prescribing, administration, to minimize adverse events and promote rational use of medicines.


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