PRESCRIPTION AUDIT USING THE WORLD HEALTH ORGANIZATION PRESCRIBING INDICATORS FOR INDOOR PATIENTS TREATED UNDER CMAAY/PMJAY INSURANCE SCHEMES IN A TERTIARY CARE TEACHING HOSPITAL

Objective: This study focused on the prescriptions audit of indoor patients treated under Pradhan Mantri Jan Arogya Yojana (PMJAY) and Chief Minister Arogya Arunachal Yojana (CMAAY) insurance schemes as per the World Health Organization (WHO) prescribing indicators. Materials and Methods: Retrospective cross-sectional study was conducted and the prescriptions of around 960 patients were analyzed who were treated from June 2020 to December 2020 under CMAAY/PMJAY insurance schemes at Tomo Riba institute of Health and Medical Sciences in Arunachal Pradesh. Study was conducted in five departments and Information was collected through the review of case sheets. The post-operative day prescription was analyzed for the patients who have undergone surgery and the patients who were managed conservatively; admission day prescription was analyzed using the WHO core drug prescribing indicators. Following data were analyzed. (1) Average no of drugs prescribed per encounter; (2) percentage of encounter having antibiotic; (3) percentage of drugs prescribed by generic name; (4) percentage of encounters with an injection; and (5) percentage of drugs prescribed from the essential drug list. Results: A total of 960 indoor patients treated under five departments, out of which 359 (37.4%) treated under general surgery, 383 (39.9%) under Obstetrics and Gynecology department, 65 (6.8%) under ENT department, 68 (7.1%) under orthopedics department, and 85 (8.9%) under General medicine department. All departments taken together, the average number of drugs used per patient was 4.91. Antibiotics were prescribed in 92.18% of the total patients when all departments were included, single antibiotic was used in 72.18%, two antibiotics in 17.29%, and three in 2.7% of the total patients. Overall, the generic names were written in 67.3% of the total drugs and the most commonly used route was parenteral route, in about 98.19% of the total prescribed drugs. From the essential drugs list, 89.33% of the total drugs were prescribed. Fixed drug combination was used in 13.59% of the total drugs prescribed. Conclusion: In our study, the percentage of prescriptions with average no of drugs per prescription, antibiotic used, injections used were much higher when compared to the WHO core prescribing indicators. The reason might be because we have analyzed the prescription of indoor patients and most of them were post-operative patients, so it is justified. While prescribing, the physicians and surgeons followed WHO essential drug list but use of generic names was in few prescriptions. The generic name use to be more emphasized, encouraged, and promoted

EVALUATION OF ANTINOCICEPTIVE AND ANTI-INFLAMMATORY EFFECT OF THE HYDROALCOHOLIC EXTRACTS OF LEAVES AND FRUIT PEEL OF P. GRANATUM IN EXPERIMENTAL ANIMALS.

Background: We investigated antinociceptive, acute and chronic anti-inflammatory activity of hydroalcoholic extracts of leaves and fruit peel of P. granatum and compared it with standard drug Ibuprofen.Materials and Methods: Hydroalcoholic extracts of leaves and fruit peel of P. granatum was prepared using Soxhlet apparatus. Swiss albino mice weighing 25 ± 5 g and Wistar albino rats weighing 120 ± 10 g of either sex were used in this study. The antinociceptive property of both the extracts was screened by acetic acid-induced writhing in mice while acute and chronic anti-inflammatory property was studied using the carrageenan-induced paw edema and cotton pellet induced granuloma model respectively in rats. The percent inhibition of the writhing response, paw edema and dry weight of cotton pellet induced granuloma was noted.Results: Leaves and fruit peel extracts of P. granatum exhibited a significant reduction in writhing, carrageenan induced paw edema and weight of cotton pellet induced granuloma when compared to control. Fruit Peel extract of P. granatum at higher dose was found better than leaves extract of P. granatum at higher dose. Antinociceptive and acute and chronic anti-inflammatory activity of the standard drug Ibuprofen treatment was better than all the extracts, but there was no significant difference between the activities at higher doses of both plant extracts and standard drug. No toxicity was observed even when both extracts were administered at 10 times of highest dose used in this study.Conclusion: The results obtained indicate that fruit peel and leaves of P. granatum has favorable analgesic and anti-inflammatory activities and thus support the traditional use of fruit peel and leaves of  P. granatum as analgesic and anti-inflammatory agent.Key words: Antinociceptive, Anti-inflammatory, Acetic acid, Carrageenan, Cotton pellet, Punica granatum

A study of variations in branching pattern of axillary artery in cadavers

The knowledge of variable branching pattern of Axillary artery is needed for vascular surgeons, onco surgeons, anaesthesiologists, orthopedic surgeons and radiologists due to increased use of invasive diagnostic, interventional procedures. The aim was to study the variable branching pattern of Axillary artey in cadavers. 15 cadavers (30 upper limbs) - 12 male and 3 female embalmed with 10% formalin were dissected for this study. Variable branching pattern was observed in 6.6% of the cases on right side and 6.6% of the cases on left side in first part of axillary artery, 40% of the cases on right side and 53.3% of the cases on left side in second part and 53.3% of the cases on right side and 26.6% of the cases on left side in third part. The anatomical knowledge of the normal and variant anatomy of the Axillary artery is of importance for anatomists, surgeons, radiologists and clinicians during various interventional, diagnostic, therapeutic and surgical procedures on pectoral and axillary regions.</jats:p

PRESCRIPTION AUDIT USING THE WORLD HEALTH ORGANIZATION PRESCRIBING INDICATORS FOR INDOOR PATIENTS TREATED UNDER CMAAY/PMJAY INSURANCE SCHEMES IN A TERTIARY CARE TEACHING HOSPITAL

Objective: This study focused on the prescriptions audit of indoor patients treated under Pradhan Mantri Jan Arogya Yojana (PMJAY) and Chief Minister Arogya Arunachal Yojana (CMAAY) insurance schemes as per the World Health Organization (WHO) prescribing indicators. Materials and Methods: Retrospective cross-sectional study was conducted and the prescriptions of around 960 patients were analyzed who were treated from June 2020 to December 2020 under CMAAY/PMJAY insurance schemes at Tomo Riba institute of Health and Medical Sciences in Arunachal Pradesh. Study was conducted in five departments and Information was collected through the review of case sheets. The post-operative day prescription was analyzed for the patients who have undergone surgery and the patients who were managed conservatively; admission day prescription was analyzed using the WHO core drug prescribing indicators. Following data were analyzed. (1) Average no of drugs prescribed per encounter; (2) percentage of encounter having antibiotic; (3) percentage of drugs prescribed by generic name; (4) percentage of encounters with an injection; and (5) percentage of drugs prescribed from the essential drug list. Results: A total of 960 indoor patients treated under five departments, out of which 359 (37.4%) treated under general surgery, 383 (39.9%) under Obstetrics and Gynecology department, 65 (6.8%) under ENT department, 68 (7.1%) under orthopedics department, and 85 (8.9%) under General medicine department. All departments taken together, the average number of drugs used per patient was 4.91. Antibiotics were prescribed in 92.18% of the total patients when all departments were included, single antibiotic was used in 72.18%, two antibiotics in 17.29%, and three in 2.7% of the total patients. Overall, the generic names were written in 67.3% of the total drugs and the most commonly used route was parenteral route, in about 98.19% of the total prescribed drugs. From the essential drugs list, 89.33% of the total drugs were prescribed. Fixed drug combination was used in 13.59% of the total drugs prescribed. Conclusion: In our study, the percentage of prescriptions with average no of drugs per prescription, antibiotic used, injections used were much higher when compared to the WHO core prescribing indicators. The reason might be because we have analyzed the prescription of indoor patients and most of them were post-operative patients, so it is justified. While prescribing, the physicians and surgeons followed WHO essential drug list but use of generic names was in few prescriptions. The generic name use to be more emphasized, encouraged, and promoted.</jats:p

Drug Utilization Pattern Among Indoor Patients Treated Under CMAAY/PMJAY Insurance Schemes at Tertiary Care Hospital in Arunachal Pradesh, North East India

Background: Drug utilization pattern helps to understand the current trend of the drug used in various conditions by healthcare providers. It also helps in rationalizing budget expenditure on the medication cost. The Chief Minister Arogya Arunachal Yojana/Pradhan Mantri Jan Arogya Yojana (CMAAY/PMJAY) is a cashless scheme run by Govt of Arunachal Pradesh and Govt of India where the surgeries, medicines/surgical items cost are borne by the government. Present study assessed the drug utilization pattern among indoor patients treated under these insurance schemes. Material and Method: Retrospective cross-sectional study was conducted at Tomo Riba institute of Health and Medical Sciences (TRIHMS) in Arunachal Pradesh, North East India. Prescriptions of around 960 patients were analyzed who were treated from June 2020 to December 2020 (for 7 months) under above mentioned insurance schemes. Data was collected through the review of case sheets. For patients who have undergone surgery, the prescription on the post-operative day and for the patients managed conservatively, the prescription on the day of admission was analyzed. Information regarding Name, Age, Gender, Antimicrobial agents, Analgesics, Antiulcer drugs and other drugs given to the patients were collected. Results: A total of 960 patients were treated. 359 patients got benefitted in the insurance scheme by department of General surgery, 383 patients by dept of Obstetrics and Gynecology, 68 patients by orthopedics department, 65 patients by ENT dept, 85 patients by medicine department. Most common antimicrobial agent used were ceftriaxone (54.1%) followed by cefuroxime (17.5%) ,metronidazole (10%) and cefoperazone(7.5%). Some other antimicrobial agents preferred were piperacillin, tinidazole and amikacin. Most common antiulcer drug used was proton pump inhibitor pantoprazole (76.25%). The analgesics commonly used were diclofenac sodium (53.3%) followed by tramadol (30.6%), pentazocine (23.3%) and paracetamol (20.2%). Other drugs commonly used were ondansetron, butrophase and tranexemic acid. Conclusion: From our study, a conclusion can be withdrawn that if few of the antibiotics, analgesic, antiulcer drugs can be made available in the Govt set up through Govt procurement then the institute can work in more cost-effective and economical way.</jats:p