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Background: Anemia is a disease that is more prevalent among pregnant women in India. Objective: To Study the Drug Utilization Pattern, compare and evaluate better drug selection in Anaemic Pregnant Women. Methodology: A total of 300 pregnant women ranging in the age group of 17 to 38 years and having 1 month to 9 months of pregnancy was included in a study. The medical records of patients were checked and information was recorded. The prescriptions were analyzed for drug utilization patterns. Statistical analysis was done. Result: Out of all 300 pregnant women 176 patients having iron deficiency Anemia, 99 patients having sickle cell Anemia, 20 patients having folate deficiency Anemia, and the rest of the patients having Vitamin B12 deficiency or hemolytic or beta-thalassemia. The average number of drugs prescribed per patient was 3-4 and the average monthly cost per patient was 920.68 Rs. The most commonly prescribed drug was Vitamin C it is of Category C drug which could be harmful to the fetus followed by MVBC (Multivitamin B complex). Conclusion: Anemia was commonly seen in 2nd trimester. Sickle cell Anemia was seen in 1/3rd of the patients. Study data highlights that Vitamin C, Calcium & Multivitamin B complex were the most prescribed drugs in anemic patients. Drugs prescribed were produced risk to the fetus according to USFDA criteria.

Background: Obstructive airway diseases such as asthma and COPD are defined as a decreased capacity to get air through the conducting airways and out of the lungs. Objective: To study the drug utilization pattern in asthma and chronic obstructive pulmonary disease, determine irrationally (does not comply with prescription) drug usage, and whether they were prescribed following the standard treatment guidelines. Methodology: A total of 150 patients of either sex aged 18 years and above having asthma and/or COPD were included in the study. The medical records of patients were checked and information was recorded. The prescriptions were analyzed for drug utilization patterns. The newly diagnosed patients were followed up and medication adherence was determined after 1 month. Results: Out of all 150 patients there were 103 male and 47 female patients. 54 patients were having asthma, 89 patients COPD, and 7 patients asthma COPD overlap. The majority of the patient were prescribed 1 to 3 drugs per prescription. Inhaled corticosteroids were the highest prescribed drug class. The most commonly prescribed drug combination was budesonide + formoterol. The majority of the patients have poorly adhered to the treatment. Conclusion: Study data highlights that very few drug interactions were identified between prescribed medications. The drugs and their combinations were prescribed according to the standard guidelines GOLD (Global Initiative for Chronic Obstructive Lung Disease) and GINA (Global Initiative for Asthma).

Background: The pattern of prescribing Antidepressants to patients has been varying worldwide. Objective: We aim to observe the prescribing pattern of antidepressants as well as assess its various outcomes in patients, the rationality of the prescriptions, and the prevalence of antidepressant usage. Methodology: A prospective observational study of a total of 56 subjects receiving antidepressants was performed at the Psychiatry. They were screened for their various outcomes on using antidepressants. The written form of the medical record sheet was used to preserve the patient's Data. Prescription pattern, treatment chart, abnormal vitals were noted. Morisky's adherence scale was used to assess the adherence of patients to prescribed drugs. Hamilton depression rating scale was used to measure the patient's depressive stage. They were screened for possible ADRs. The causality and severity assessment of the observed ADRs was done by the WHO-UMC scale and Hartwig-Seigel scale respectively. Statistical analysis was done for all relevant data. Results: In our study, the age of patients varies from 18 years to 85 years. The maximum number of patients were from the age group of 31-40 years [28.57% (N=16)]. The 50% (N=28) of patients were diagnosed with Depressive mood disorder. A total of 169 drugs were prescribed out of which 52.07% (N=88) were Antidepressant drugs. Out of 88 Antidepressant drugs, 20% (N=18) patients received Venlafaxine, followed by 17% (N=15) Escitalopram. Out of 56, 26.78% (N=15) showed low adherence, 41.07% (N=23) showed medium adherence and 32.14% (N=18) showed High adherence.41.07% (N=23) patients were identified with drug use problems. Adverse drug reactions were suspected in 25% (N=14) patients. The most common type of Adverse reaction due to the drug was Weight gain (N=6 patients). Paroxetine drug was found with the highest number of ADRs 28.57% (N=4). Conclusion: Most common antidepressant prescribed was Venlafaxine. Most Patients in the community included suffered from Depressive mood disorder with a maximum number of patients appeared from the age group of the thirties to forties. Patients due to their unstable mental status were adhering to therapy at medium levels. Drug use problem was identified commonly with patients on sedatives resulting them to either forget taking the pills or missing the dose. Patients generally had a common Adverse drug reaction of weight gain. Proper lifestyle modifications and patient counselling is required to benefit patient from treatment.

Background: Acne vulgaris remains one of the commonest diseases to afflict humanity, with over 90% of males and 80% of females affected by the age of 21 years. Objectives: The aim of this study was to assessing the specific risk factors, determine the epidemiology and etiology of Acne Vulgaris. Methodology: It is a cross-sectional observational study conducted for a period of six month in the department of dermatology, Dhiraj General Hospital, Vadodara. Patients who were diagnosed with acne vulgaris and fulfilled the inclusion criteria were enrolled in the study. Data was collected by filling the patient medical record sheet. Result: Total 300 patients were included in the study. Out of which 38.67% males and 61.33% females were found affected by Acne Vulgaris. The mean age group affected were found to be 21.77±4.06 years. When compared their social habits, patients consumed more caffeine (49.67%) than alcohol (24.67%), smoking (15.33%) and tobacco (5.67%). 32.33% patients also had history of seborrheic dermatitis. Using GAGS scale, we found 94% patients suffered from moderate Acne condition while 6% suffered from severe Acne condition. Conclusion: Acne Vulgaris was predominantly found in females in adolescence and in males in adulthood. The severity was found more in males than females. The common site for Acne Vulgaris was found to be face while comedones and papules were the common types of lesions. Stress was found to be one of the major aggravating factors for severity of Acne Vulgaris.

Globally cancer is one of the most prevalent life-threatening diseases that have a significant impact on humans. The uncontrolled division of cells is a sign of the disease. Modern cancer therapies have several side effects on healthy cells. The problem of increasing tumour resistance to existing drug treatments is a serious concern. As a result, there is a critical need for more effective medicine to combat this condition. New ways to avoid this illness are in high need. Humans' pursuit of health is a never-ending drive for a healthier, longer life. Despite this, sickness and pain are still a part of his battle for survival. Natural products have a significant role in the battle against cancer and can be used to test novel therapeutic agents. Plants are natural remedies for a variety of illnesses. It is important to identify a variety of therapeutic plants which are useful for human being. Herbal therapies are a viable alternative to conventional cancer treatments. This article looks at plants from the Asteraceae family that have anticancer properties. Plants of the Asteraceae family play an important role in combating malignancies of the stomach, breast, colon, and lung, according to a thorough examination of research papers. The results of the study indicated a spectacular outcome in the prevention of cancer.

The precise incidence of drug-induced myopathy is still not known, only few reports with the use of Telmisartan. There are likely around 150 agents that are associated to cause myotoxicity like statins, corticosteroids, anti-retroviral, and immunosuppressants. Therefore, as recommended by the guidelines, therapeutic drug monitoring of Telmisartan is required after the initiation of the therapy. However, the rise in serum creatinine up to 20-30% is accepted. But if serum creatinine level increases >30% then withdrawal of the therapy is recommended. Suspicious with the previous therapy of Tab. Telmisartan as no other pathology could be detected. A causality analysis was done using the Naranjo’s algorithm and WHO-UMC Scale and the present ADR was found to be ‘Probable’ with Telmisartan. Tab. Telmisartan was withdrawn completely and was switched by another Antihypertensive -Tab. Enalapril (5mg). Gradually, the condition of the patient showed improvement in terms of both- the clinical symptoms and laboratory abnormalities. However, re-challenge of the drug was not performed in order to avoid further toxicity. After 15 days, the patient had visited Medicine Outpatient Department (OPD) again the creatinine and uric acid levels where checked which were normal and further advised to follow up every month. To be conclude, adverse drug reaction of myotoxicity associated with telmisartan is rare but quite significant. So, close monitoring is necessary to ensure safety of drug therapy especially in long term use.

Background: osteoarthritis is a severe clinical condition in elderly patients. Almost any bone can fracture as a result of the increased bone fragility of osteoarthritis. Aim and Objective of study: The principle aim of drug utilization research is to facilitate the rational use of drugs in an individualized patient. To Study current prescription pattern and its efficacy to manage osteoarthritis. Methodology: This study was a prospective observational study and conducted over a period of six month from October 2015 to March 2016. Patients diagnosed with arthritis with or without co-morbidities were enrolled in the Study considering the inclusion and exclusion criteria. The main sources of data collection were OPD file and case sheets of patients. Results: In this study 148 patients were enrolled, 105 (70.9%) female patients and 43 (29.1%) male patients were participated. Out of 148 study participants 60 (40.54%) patients from age group 51-65 years, followed by 54 (36.48%) patients from age group 36-50 years. In the study population 94 (63.51%) patient were suffering osteoarthritis of both knee, 29 (19.59%) patients were suffering osteoarthritis of right knee and 25 (16.89%) patients were having osteoarthritis of left knee. X-ray report were representing in study population, in 44 patient reports were shows degenerative change seen in both knee, 08 patient report were shows degenerative change seen in right knee. In our study out of 148 patients, 92 (62.16%) patients prescribed NSAIDs, 25 (16.89%) patients prescribed Analgesic, 05 (03.37%) patients were prescribed Opioid analgesic, 11 (07.43%) patients were prescribed supplements and 15 (10.13%) patients received other class of drugs. Among the study population 112 (75.67%) patients were received oral route of drugs and 36 (24.32%) Patients were prescribed topical preparation. The visual analogue scale has been categorized as follows 0-3 Mild pain, 4-7 Moderate pain and 8-10 severe pain. In visual analogue scale initially 16 patients were suffering mild pain, but after treatment it was 93 patients suffering mild pain. The facial pain scale has been categorized as follow 0 = very happy, no hurt, 2 = hurts just a little bit, 4 = hurts a little more 6 = hurts even more, 8 = hurts a whole lot, 10 = hurts as much as you can imagine. Among 148 study participants 14 patients were having final Facial pain score 0, 67 patients were having a final Facial pain score 2 and 3 patients having Initial Facial Pain score 2, 42 patients were having a final Facial pain score 4 and 42 patients having Initial Facial pain score 4, 19 patients were having a final Facial pain score 6 and 63 patients having Initial Facial pain score 6, 06 patients were having final Facial pain score 8 and 33 patients having Initial Facial pain score 8, 07 patients having Initial Facial score 10. Conclusion: The principal aim of drug utilization research is to facilitate the rational use of drugs in an individualized patient. For the individual’s patients, the rational use of a drug implies the prescription of the well documented drug at optimal dose, together with the correct information, at an affordable price.

Background: Asthma remains one of the most common chronic respiratory diseases. Even with significant advancement in the diagnosis and management of asthma, its control remains suboptimal. As the overall health expenditures are escalating, the healthcare community has become more sensitive to the concept of Pharmacoeconomic. Objective: We aimed to assess the healthcare cost; economic burden associated with the management of asthma. Methodology: A Prospective Observational Study was conducted in a Hospital of Vadodara, Gujarat, India with the sample of 120 patients. Patient’s data, financial data and the healthcare cost were collected while interviewing the patient. The healthcare costs included were direct medical cost, direct non-medical cost, and indirect cost. Result: The average costs per asthmatic patient per month with severe, moderate and mild asthma were found to be USD 65.27, USD 50.89, and USD 48.85, respectively. The average overall cost with or without co-morbidity were calculated as USD 56 and USD 38, respectively. Out of USD 53.6, the average direct medical cost was USD 29.6, the average direct non-medical cost was USD 17.4, and the average total indirect cost was USD 6.6. The mean total cost for inpatient was calculated to be USD 105.12 and for outpatient it was USD 56.09. The 43% of the population had burden of illness less than 30% and 40% of the population had burden of illness between 60-80%. Only 6.6% of population had more than 80% of Pharmacoeconomic burden of asthma. Conclusion: In our study, it was concluded that the patients with severe asthma and/or co-morbidity have higher treatment cost. Out of the overall cost, the maximum cost borne by the patient was the direct medical cost. The hospitalization increased the total health care cost by about 47%. The 43% of the population has less than 30% of burden of asthma while only 6.67% of population had more than 80% of burden of asthma.

We describe a case of Linezolid-induced severe toxic optic neuropathy in a patient with drug-resistant tuberculosis. Linezolid produced severe toxic optic neuropathy in some who used it for a long time. To the best of our knowledge, the optic neuropathy was completely reversed after omitting Linezolid which is one of the effective drug regimens in his prescription, with significant improvements in eye vision.

Background: Antiepileptic drugs (AEDs) are the mainstay of the therapy for epilepsy, despite the development in recent years of new therapeutic options, such as brain stimulation or Surgery. Objective: To understand the pattern of drug utilization and medication adherence of anti-epileptic drugs (AEDs) among epileptic patients at a tertiary care teaching hospital. Methodology: A cross-sectional observational study of a total of 120 subjects receiving anti-epileptics was done. All the patients with epilepsy were prescribed with anti-epileptic drug who visited, admitted, or referred to the Department of Neurology. All inpatients and outpatients of epilepsy were screened for the study. Results: A total of 120 patients were included in our study into which (38.33%) were inpatients and (61.67%) were outpatient. The male (56%) patients were more as compared to female (44%) patients. A maximum number of patients were from the age group of 21-40 (41%) year. The majority of the patient were suffered from focal epilepsy (63%), remaining were having a generalized seizure. The highest comorbidities were found to be HTN and diabetes mellitus. Monotherapy was highly prescribed as compare to polytherapy. Among single AED, the maximum prescribed drug was Carbamazepine [30% (N=17)] followed by 25% (N=14) of phenytoin and levetiracetam 21% (N=12). In two AED Combinations, the most prescribed drugs were clobazam + Levetiracetam and Midazolam + phenytoin 12% (N=5) followed by sodium valproate + clobazam 10% (N=4). Highest combination of three AEDs that were prescribed the highest were carbamazepine + Levetiracetam + clobazam and phenytoin + phenobarbitone + sodium Valproate 20% (N=2) The highest medication adherence was found in patients who were on single AEDs and the lowest adherence was found in the patients who were on more than two AEDs. Conclusion: Antiepileptic drug monotherapy was highly prescribed as compare to polytherapy. Phenytoin was the most commonly prescribed AEDs followed by carbamazepine and highly prescribed single AEDs were found to be carbamazepine. The patients who were on single epileptic drugs showed the highest adherence as compared to the patients with more than two AEDs.

Background: There is a strong relationship between Hypertension and chronic kidney disease. HTN is highly prevalent in CKD patients, contributing to high cardiovascular risk. Objectives: This study aims drug utilization pattern of Antihypertensive drugs in CKD. The objective of the study to determine the occurrence of co-morbidities, the prevalence of CKD stages in chronic kidney patients and to prepare a protocol of anti-hypertensive in CKD. Methodology: This was an observational/cross-sectional study that was carried out for six months at Dhiraj General Hospital, Vadodara. CKD patients who were prescribed antihypertensive agents were included as per study criteria. Data was collected by filling the patient medical record sheet. Results: A total of 60 CKD patients with HTN were included in the study according to inclusion and exclusion criteria. Out of 60 patients, we noticed that number of inpatients was 67% while the number of OPD patients was just 33%. Comparing gender proportionality, male represents 63% and female represents 37% were found between the age group of 18-65 years. The recorded systolic BP in mild case in the overall study population was found to be 140-159 mmHg and diastolic BP was found to be 90-99 mmHg. In moderate case systolic BP was 160-179 mmHg and diastolic BP was found to be 100-109 mmHg. In severe cases systolic BP was ≥180 mmHg and diastolic BP was found to be ≥110 mmHg. Among antihypertensive Calcium channel blockers was prescribed in 34.18% of patients and mostly recommended drug for hypertensive chronic kidney patients was furosemide which was 19.34%. Most participants were treated with multi-drug therapy. Conclusion: In Hypertensive CKD patients, calcium channel blockers and furosemide were highly recommended which do not diverge from National Kidney Foundation Kidney Disease, Outcome Quality Initiative guidelines.

Background: Low birth weight (LBW) is still a significant public health problem globally and is associated with a range of both short- and long-term consequences. Overall, it is estimated that 15% to 20% of all births worldwide are low birth weight, representing more than 20 million births a year. Objective: We aimed the study to assess the risk factors associated with low-birth-weight neonates in a rural tertiary care hospital. Methodology: A prospective observational Case-Control Study was conducted in the Department of Pediatrics (Neonatal Intensive Care Unit) and Department of Obstetrics and Gynecology, Dhiraj Hospital, Vadodara with the sample of 240 women who were admitted for the delivery. The patient interview was done based on the questionnaires (Proforma). Results: Area of residence, Parent's education, Anaemia among pregnant women, Mid upper arm circumference (MUAC) less than 23 cm, Maternal age, and antenatal visits

Background: Drug information centre (DIC) is a facility specially developed to provide relevant, accurate and unbiased drug information (DI) to consumer and health care professionals regarding the proper use of the drugs, drug safety and all the critical problems regarding the drug information of their usage and side effects. Objective: The present study was about to access the knowledge of the primary care physicians and community pharmacists about the DIC and its facilities and to spread awareness regarding the same. Methodology: A cross-sectional, questionnaire-based study was conducted among the 88 participants of Vadodara city, Halol-Kalol town for 6 months of period. 68 pharmacist and 20 physicians took part in the study from these cities. The data was further Analysed by comparing the available data and resource to find out the awareness regarding the DIC. Result: During the study duration, a total of 88 participants took part in the study from various out of them 68 (77%) were community Pharmacist, and 20 (23%) were primary care physicians. In the end of the study, 48 (70.2%) pharmacist and 10 (50%) physicians know about the following data of DI, DIC, DIQ (Drug Information Query), resources and the role of pharmacist in DIC and it was clearly evaluated that the knowledge about the DIC, DI, DIQ was not thoroughly available for the pharmacist and physicians. Conclusion: The present study concludes that the awareness about Drug Information Centre (DIC), Drug Information, and its value and importance is not as much as it should be in Vadodara city, Halol-Kalol. Several awareness programme should be carried to bring the importance and value of DIC in limelight and to make it accessible easily for all to decrease several drug related problems.

Background: Antiplatelet agents reduce the occurrence of the cardiovascular issue in people with established cardiovascular disease. Objective: To understand the pattern of Antiplatelet drug utilization among cardiovascular disease patients. To evaluate the prevalence of polypharmacy and responsible factors like age, gender, co-morbid condition, and patient-related drug use problems. Methodology: A cross-sectional observational study. Patients with cardiovascular disease above 18 years of age were prescribed antiplatelet agents from the department of cardiology and ICCU were enrolled in the study. Result: A total of 150 patients were enrolled of which male 79% (N=119) and female 21% (N=31). Most patients belong to 51-60 years of age groups. The patients diagnosed with IWMI (inferior wall myocardial infarction) 43.3% (N=65) have highly prescribed antiplatelet agents. Smoking 54.7% (N=82) followed by Alcohol 26.7% (N=40) found to be the most dominant risk factors.60.7% (N=91) patients had no comorbidity followed by 31.3% (N=47) had a comorbid cardiac condition. Most prescribed antiplatelet agents were monotherapy of Aspirin 28.8% (N=43), Clopidogrel 16.7% (N=25), and combination therapy of both 51.2% (N=82). Conclusion: The study concluded that increases in the number of co-morbidities can significantly increase the Utilization of drugs which can further lead to drug use problems. The clinical pharmacist can help to alleviate the problems of polypharmacy and its consequence.

Background: Presently India, depicts 49% of the world’s diabetes burden, with an approximated 72 million cases in 2017. Comorbidities make type 2 Diabetes Mellitus (DM) management complicated for health care providers. Therefore, patients have been prescribed multiple drugs. As a result of polypharmacy, the chances of the occurrence of drug-related problems (DRPs) increase. Objective: The present study aimed to find out the prevalence of comorbidities, polypharmacy, and drug-related problems among type 2 DM patients. Methodology: A prospective observational study was conducted for six months among 110 patients having type 2 DM. Based on inclusion and exclusion criteria data were collected. All collected cases were analysed for the number of medications prescribed and comorbidities present. Prescriptions were further assessed to find out the drug-related problem. Results: Comparing the gender proportionality, male represents 59% (n=65) and female represents 41% (n=45) of the study population. The present study evaluated that 91% (n=100) of patients were having at least one comorbid condition or complication along with diabetes, the most common being cardiovascular disorders. The average number of drugs prescribed is 7.86±7.83 per patient. Polypharmacy was observed in 84.54% (n=93) of the patients. A total of 180 DRPs were found among 110 patients. Conclusion: The present study concluded that the increase in the number of co-morbidities significantly increases the burden of polypharmacy which can further lead to DRPs. Reducing the number of pills and the presence of a clinical pharmacist in prescription monitoring can help to alleviate the problems of polypharmacy and its consequences.

Background: All drug regulatory authorities have to ensure the safety, efficacy and quality of all the marketed products. Quality and efficacy can be determined by the data from preclinical and clinical trials. In clinical trials at the pre-marketing stage, it is challenging to identify rare Adverse reactions (ADR) and delayed side effects or effects due to long-term exposure because of lack of follow-up. In this case, pharmacovigilance comes into picture where it plays a significant role in marketed drugs safety profile establishment. Aim: This study helps in safety profile establishment for drugs. Methodology: It was conducted by the Department of pharmacy practice at drug information Centre in collaboration with Department of pharmacology at private multi-specialty Hospital. ADR reporting forms of the Central Drug Standard Control Organization has been used for collecting the data, and this form includes patient demographic details like clinical history, co-morbid conditions like Diabetes mellitus, Hypertension, Asthma, history of any drug allergies etc. were collected. The chance of preventability modified Schumock and Thornton criteria was found to be very less, and it was evident that most of them were not. By using Hartwig et al., scale, the severity of ADRs were of moderate severity. The reason behind this moderate severity was a history of allergy and multiple drug therapy. Result: It was observed that preventability 86% were not preventable whereas 14% were preventable as per Schumock and Thornton scale. In these cases of definitely preventable cases were due to history of reaction upon administration of the same drug. It is advised that in such cases usage of drug alert card is preferred. Conclusion: The major risk factor for the development of ACDR includes self-medication, patients’ lack of awareness regarding the dose and frequency of administration, polypharmacy. This can be avoided by prescribing the required drugs only and by educating the patients regarding the drugs.