Saajid Hameed

Abstract

Background: Inapt medical use is a major problem to ensure effective and safe treatment. Most common health diseases are treated by the people themselves without medical supervision, commonly referred to as self-medication (SM). However, it is also known that responsible SM must be accompanied by relevant health information. It has become a serious problem that raises concerns about misdiagnosis and drug reactions as well. Aim: To determine the pattern of SM procedures, to identify common diseases and common drugs used, SM causes and to examine the relationship between the level of medical education and SM practices among undergraduate medical students. Materials and Methods: A structured and validated questionnaire was used for the study to collect information regarding age, gender, awareness of SM practice, type of drugs self-medicated and source of information. Students were also interviewed to check their knowledge and attitude towards self-medication. Results obtained from this study were presented in tabular form and data were interpreted by using Microsoft Excel 365 software. Results: Out of 387, 365 students (94.32%) students accepted self-medication practice. Most of the self-medicators used the medicines for fever (24.11%) followed by common cold (17.26%) and headache (16.71%). Paracetamol was used by 51.78% of students. Most of the students took self-medications for quick relief and for minor ailments. Conclusion: our study shows that SM is most prevalent in medical students of North India. Schedule H drugs have also been used without a prescription. This highlights the need for improved drug control.   Keywords: Self­Medication, Students, Questionnaire, Drugs, Prescription.

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Abstract

Objective: Survival of post renal transplant patients has been improved by the suppression of the recipient’s immune system by immunosuppressive agents. However, various adverse drug reactions are also associated with immunosuppressive agents. Keeping this in mind, present study was planned to study the prescriptions pattern of immunosuppressant drugs and to study adverse drug reactions associated with immunosuppressant drugs. Materials and Methods: It was an observational and cross-sectional study. We have collected reported ADRs, prescriptions, IPD files and laboratory reports of 40 patients who had already undergone renal transplant prior to start of this study and 10 patients who undergone renal transplant after start of this study. Result: Most patients were prescribed prednisolone + tacrolimus + MMF as immunosuppressive regimen (70%) followed by prednisolone + cyclosporine + MMF (22%). Prednisolone was prescribed to all patients. Tacrolimus was prescribed to 72% of patients. Total 78 ADRs were reported from 50 patients in our study (incidence rate 68%). Drug MMF was mostly associated with ADRs (35.90%) followed by tacrolimus (29.49%), prednisolone (19.23%) and cyclosporine (15.38%). Most of the ADRs was mild (65.38%) while only one ADR was severe. Conclusion: Corticosteroid continues to be mainstay of therapy in post renal transplant patients. Calcineurin inhibitors were exclusively associated with nephrotoxicity. MMF was associated with most ADRs followed by tacrolimus. Most of the ADRs were mild and treated symptomatically. Keywords: Renal transplant, Immunosuppressant, ADR.

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Abstract

Objective: Due to limited availability of newer antibiotics to treat emerging multidrug-resistant species of pathogen, there is an urgent need for highlighting the misuse of antibiotics and taking appropriate measures to promote rational antibiotic prescription. This study was designed to know the antibiotic prescription patterns in MICU, the prevalence of antibiotic resistance, the effectiveness of empirical antibiotic therapy and safety and tolerability of the antibiotics prescribed. Materials and Methods: This study was an observational and prospective study. 100 consecutive prescriptions were collected from MICU, IGIMS, Patna from January 2019 to June 2019. All antibiotics listed on first prescription slip was noted and their dosage schedule, route of administration, date of discontinuation, generic name and related laboratory investigations were also recorded. Result: 723 drugs were prescribed out of which 244 were antibiotics. 3rd generation cephalosporins (118 prescription/48.36 %) were most frequently prescribed followed by Amoxicillin + Clavulanate (40 prescriptions/16.39%). Prevalence of resistance was most in cephalosporins (6%) followed by Amoxicillin + Clavulanate (5%). Approx. 27.5% failure of treatment was found in patients receiving empirical antibiotic therapy. Percentage of suspected ADRs was mostly found in linezolid (33.33%) followed by Ceftriaxone (16.66%). Conclusion: Antibiotics are overprescribed in our ICUs and this is increasing the burden of unnecessary adverse effect, resistance and treatment costs. At the time of admission, patients with poor prognosis and older age are prescribed more antibiotics. Antibiotics stewardship programs should be promoted and regulation of antibiotic utilization, proper use of guidelines and proper surveillance should be ensured by responsible authorities. Keywords: Antibiotics, ICU, Prescriptions, Resistance, Safety & tolerability.

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