How to investigate drug use in health facilities : selected drug use indicators

The book “ Teaching and Learning” is a valuable resource for distance educators and trainers who want to create relevant and intellectually challenging online courses. Nichols aims to share the best educational practices from traditional or face-to-face teaching and from the field of distance education. It is an ambitious goal that gives the book a distinctive purpose and helps the author strive for a comprehensive view of the educational process. The book provides practical guidelines for distance educators that are based solid research and classroom experiences. The book is divided into three major sections: the teaching and learning process, universal principles of teaching and learning and the final section describes how educational principles can impact vital instructional issues.

Teaching for Learning.

On the treatment of psoriasis

Selenium nanoparticles reduced cadmium uptake, regulated nutritional homeostasis and antioxidative system in Coriandrum sativum grown in cadmium toxic conditions

Background: Irrational prescription being a global problem leading to ineffective, unsafe treatment. Aiming to measure the performance of a health-care provider in key dimension related to appropriate use of drugs, the World Health Organization (WHO) has developed set of core prescribing indicators. 

Aims and Objectives: The aim of this study is to assess the drug use pattern using WHO core prescribing indicators. 

Materials and Methods: This was a prospective, cross-sectional study conducted at K.S. Hegde Charitable Hospital. Around 900 prescriptions from the outpatients attending the Department of Medicine from January to March 2016 were analyzed for WHO core prescribing indicators and was compared with the standard WHO values.

Results: Polypharmacy being the common finding, the concept of generic prescribing was negligible. There was reduced prescription of drugs from the National List of Essential Medicines, but the prescription of antibiotics and injections was within normal limits. 

Conclusions: There was moderate compliance with WHO prescribing indicators.

Assessment of drug use pattern using World Health Organization prescribing indicators in a tertiary care hospital in Mangalore: A cross-sectional study

Background: Arthritis is the diseases affecting all age groups with the worldwide prevalence of 3% and 20% in India. Drugs used for the management of arthritis have various adverse effects. Due to their low side effects, low costing, and ready availability the interest in producing herbal formulations for medicinal purposes is developed. Coriandrum sativum is a medicinal herb possessing many activities with anti-inflammatory action being one among them. 
Objectives: To evaluate antiarthritic effect of coriander seed essential oil (CSEO) using Complete Freunds adjuvant(CFA) induced arthritic model in wistar albino rats.
Methods: 24 rats were divided into 4 groups and the Experimental arthritis was induced by injecting 0.1 ml of CFA into the subplantar area of the left hind paw. Vehicle and drugs (Indomethacin & CSEO) were given for 20 days to animals of all the group, the Joint diameter was measured at day 0, 3, 7, 14 & 21 days and IL 6, TNF a levels were measured baseline & day21 by ELISA kit.
Results: Significant decrease in joint diameter and paw volume was seen within both the groups, but there was no statistical significance in joint diameter reduction among the groups. The TNF a levels were statistically reduced by CSEO group compared to Indomethacin group.
Conclusion: CSEO has antiarthritic effect due to its anti-inflammatory property which needs to be evaluated further with different doses and histopathological correlation.

Evaluation of antiarthritic activity of Coriander seed essential oil in Wistar albino rats

Background: Dental plaque is one of the predominant causes of major oral diseases. Although mechanical and chemical methods are extensively followed to control the development of plaque, plaque-related diseases still persist. Therefore, this necessitates for alternative measures of plaque control, one such alternative is photodynamic antimicrobial chemotherapy (PACT). Materials and Methods: Split mouth randomized clinical trial (CTRI/2017/03/008239) was conducted on 30 participants who reported to the hospital. Participants were asked to rinse their mouth for 1 min using 10 ml of 25 μM erythrosine solutions. Same tooth on both quadrants of the same jaw are selected as the test and control. Intervention used was halogen-based composite curing light with wavelength of 500–590 nm. Plaque sample from the control tooth and test tooth was collected before and after exposure, respectively, and sent to microbiological laboratory for colony count. Results: Logarithmic mean and standard deviation of control group with 102 dilutions of aerobic microbial count were found to be 5.34 ± 0.94, and for experimental group, it was 4.47 ± 1.37. The statistical difference between mean CFU values between aerobic bacterial counts was significant (P = 0.006). Conclusions: Erythrosine-mediated PACT reduces the extent of dental plaque microbial count and has a potential preventive and therapeutic use in day-to-day life and dental clinics.

Effectiveness of erythrosine-mediated photodynamic antimicrobial chemotherapy on dental plaque aerobic microorganisms: A randomized controlled trial

Background: Psoriasis is a chronic relapsing disease necessitates long-term therapy. The disease severity, comorbidities, and access to health care determine the choice of therapy for psoriasis. The main aim of the treatment of psoriasis is to induce prolonged remission and suppress the disease as there is no cure. It is only palliative and symptomatic treatment, and the choice of treatment modality is according to the type of presentation. The various modalities of treatment available include topical therapies, systemic therapies, phototherapy, and biologics. The difference includes among clinical varieties in their presenting features, severity, natural course, and response to the treatment are responsible for variation in choice of therapy.Methods: In this descriptive study, data collected from patients diagnosed with psoriasis who were admitted in a K.S. Hegde Charitable hospital from January 2017 to January 2019 were analysed for demographic features, disease pattern and drug use pattern in patients.Results: Psoriasis vulgaris/plaque type of psoriasis was commonly observed type of psoriasis in our patients with fourth and fifth decade patients getting more affected. Diabetes was the most commonly associated comorbid disorder. The patients were treated both with systemic and topical modalities of treatment, antihistaminic and methotrexate were most commonly most commonly used systemic drug and moisturizers and glucocorticoids were used topical drugs.Conclusions: Psoriasis needs a multimodality treatment with careful monitoring for the comorbid disorder. Treatment choice is individualised depending on the severity and body parts affected.

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A pharmaco-epidemiological study of psoriasis

Introduction Student assessment by multiple-choice questions (MCQs) is an integral part of student evaluation in medicine The medical teacher should be trained to construct an item with proper stem and valid options Periodic item analyses will make the process of assessment more meaningful Hence, we conducted the study to analyze MCQs (item analysis) tested on a batch of MBBS students in pharmacology in their three internal assessment examinations Methods The study was conducted in the Department of Pharmacology of a medical college in Mangaluru on 150 students The MCQs of the three internal assessment examinations (20 each) respectively were analyzed We analyzed each question for difficulty index (DI), discrimination index (DsI), and distracter efficacy or functionality and expressed the percentage results Results The DI was in an acceptable range of 60, 75, and 90%, respectively, in the three internal assessments The percentage of “too difficult” questions was 10, 20, and 10% and the average DsI was 032 ± 004, 028 ± 002, and 026 ± 002, respectively In the second and third internal assessments, 95% of questions had functional distracters, while in the first internal assessment, only 60% of questions had functional distracters Conclusion We conclude from our study that even though the items (MCQs) framed for the internal assessments were in the acceptable range of quality in terms of the parameters assessed, we must improve MCQ’s construction in selecting distracters in some topics

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Swathi Acharya

Papers

Assessment of drug use pattern using World Health Organization prescribing indicators in a tertiary care hospital in Mangalore: A cross-sectional study

Evaluation of antiarthritic activity of Coriander seed essential oil in Wistar albino rats

Effectiveness of erythrosine-mediated photodynamic antimicrobial chemotherapy on dental plaque aerobic microorganisms: A randomized controlled trial

A pharmaco-epidemiological study of psoriasis

Item Analysis of Multiple-Choice Questions in Pharmacology in an Indian Medical School