ABSTRACT
Background: The pattern of drug use in people hospitalized with a primary diagnosis of psoriasis has never been studied previously in India. The aim of the study was to characterize the prescription pattern of people admitted to hospital with psoriasis so that rational prescribing could be promoted among dermatologists. Methods: Case files belonging to 32 patients, admitted in the Department of Dermatology with psoriasis, of a tertiary care teaching hospital in Kerala, over a period of 1-year were retrieved with the assistance of the medical records department. The data thus obtained was analyzed using descriptive statistics. Results: The average age of patients who were admitted with psoriasis was 49.9 years, and their average duration of hospital stay was 7.96 days. A total of 296 formulations were prescribed to 32 patients. Out of 296 formulations, only 10 (3.37%) were generic and rest 286 (96.62%) branded. Fixed dose combinations consisted of 32.43% (96/296) of the prescribed formulations. Psoriasis vulgaris (56.25%) was the most common cause for admission. Of all the prescribed medications, 4 (1.35%) did not contain clear instructions for the route of administration. Strength was clearly mentioned in only 89 (30%) of the preparations. In 98% of the prescriptions, the exact dose was missing. Conclusions: The study reveals various deficiencies which exist in the prescribing pattern of drugs for management of psoriasis. Educational interventions among the doctors as well as students should be carried out to promote rational drug use.
ABSTRACT
Background: Corticosteroids are a group of commonly used drugs in dermatology practice whose non judicious use frequently results in undesirable and unwanted effects. Prescribing them rationally with care allows us to derive the maximum benefit out of them with minimal side effects. Methods: Retrospective analysis of 112 case files belonging to patients admitted in the department of dermatology over a period of one year was undertaken to ascertain the usage pattern of corticosteroids in relation to their potency, strength, frequency, duration, route, quantity to be applied. The data thus collected was expressed in terms of averages, ratios and proportions. Results: The total number of formulations prescribed were 929 out of which 10.8% were corticosteroids. The average number of formulations prescribed per patient was 8.29. About 78(70%) patients admitted in dermatology received corticosteroids. Topical steroids were prescribed in 50 patients (44.7 %) out of whom 36 (72%) received only topical, the remaining 14(28%) were prescribed both systemic and topical corticosteroids. Brand names were used in all cases. Highly potent corticosteroids like clobetasol, halobetasol and mometasone were prescribed to 39(50%) of all cases who received topical corticosteroids. Conclusion: The study reveals the deficiencies which exist in the present prescribing pattern of corticosteroids. Educational interventions among the doctors as well as students should be carried out to in order to promote rational drug use.
ABSTRACT
Background & objectives: The aetiology of gastric ulcers is not completely understood and continuous use of anti-ulcer agents leads to many side effects. In this study we evaluated the anti-ulcer efficacy of a polyherbal formulation with potent antioxidant activity in aspirin and pyloric ligature induced gastric ulcers in rats. Methods: The efficacy of the polyherbal formulation NR-ANX-C (composed of the extracts from Withania somnifera, Camellia sinensis, Ocimum sanctum, shilajith and triphala) was evaluated in terms of antioxidant potential as assessed in terms of protection from lipid peroxidation and the antiulcer activity as seen by the area of gastric lesions, gastric juice volume, gastric pH, total acidity and total adherent gastric mucus content. Results: In our study, NR-ANX-C (25 and 50 mg/kg) was more efficacious than ranitidine in reducing ulcer index in both the models. At the highest dose tested (50 mg/kg), NR-ANX-C was comparable to omeprazole in preventing ulcer formation in the pyloric ligature model. NR-ANX-C showed a dose- dependent decrease in gastric juice volume and total acidity in both the models. A dose-dependent increase in gastric pH and total adherent gastric mucus was also seen in NR-ANX-C treated groups. The extent of lipid peroxidation was also reduced in the test drug treated groups. Interpretation & conclusion: Based on our findings, we presume that the cytoprotective, anti-secretary and antioxidant properties of NR-ANX-C were responsible for its anti-ulcer activity. These findings suggest the potential for use of NR-ANX-C as an adjuvant in the treatment of gastric ulcer.