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Introduction: Topical corticosteroids are currently the primary drugs to treat several dermatological disorders. But they are misused for various indications such as acne, pigmentation, fungal infection, and pruritus, and many times as a cosmetic or a skin cream for any type of rash. This study is performed to compare the magnitude of adverse events between practitioner-prescribed and self-prescribed groups of patients. In addition, this study also focuses on the demographic and educational status of patients where topical steroids are most widely misused. Materials and Methods: It is a cross-sectional, hospital-based observational study conducted in the Department of Dermatology in collaboration with the Department of Pharmacology, KIMS, Bhubaneswar. A total of 134 patients were enrolled after getting the informed consent for the study, and assessed based on their topical steroid misuse and their adverse effects. Results: The present study showed that steroid misuse was most common between 20 and 30 years of age group patients with low educational status. The most commonly applied steroid was clobetasol followed by mometasone and steroid abuse was more common in self-prescribed patients than physician-prescribed patients. The economic burden was more in the case of people using steroid cream only or steroid + anti-fungal creams because they have to be applied over a large body surface area. Incidence of adverse effects was observed more in self-prescribed patients and with low educational status. Conclusion: This study highlights the fact that self-medication increases the incidence of adverse reactions and economic burden on the patients. Continuous education of patients and strict regulations regarding over-the-counter sales of steroids may help decrease the incidence of steroid misuse. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes is more prevalent in middle- and higher-income groups and is spreading at an alarming rate. Drug therapy is compulsory because of the chronic and progressive nature of the disease. With such multifactorial background of high prevalence, progressive nature of the disease leading to various complications, increased healthcare cost, and availability of multiple therapeutic regimens prescribed, this study has been done to evaluate the cost-effective analysis of oral hypoglycemic agents. Materials and Methods: This is a prospective, parallel group, and comparative observational study conducted by the Department of Pharmacology in collaboration with the Department of Endocrinology at Kalinga Institute of Medical Sciences, Bhubaneswar. The duration of the study was of 2 years. A total number of 220 patients were selected and based on body mass index, patients were categorized into preobese (new and old diabetic patients) and obese (new and old diabetic patients) categories. In this study, cost-effectiveness analysis (CEA) was done to evaluate the cost differences between two or more medication groups, with a similar clinical effect. Results of CEA are expressed as an average cost-effectiveness ratio or as an incremental cost-effectiveness ratio. Results: From this study, it is observed that in terms of benefit, dual therapy of Metformin and Dapagliflozin was most efficacious followed by Metformin and Sitagliptin as well as Metformin and Glimepiride combinations. If cost is considered, Metformin montherapy and metformin and Glimepiride dual therapy was most cost-effective. In triple regimen, MET+VOG+GLIM combination was seen to be more cost effective than gliptin combination, both in terms of control of FBS as well as PPBS. The cost of treatment goes parallel with duration of disease, being higher in the old cases of long-standing duration. Conclusion: The present study shows that SGLT2 inhibitors are better class of oral hypoglycemics in terms of longterm benefits and this group is prescribed as dual therapy more frequently but cost of therapy is the greatest barrier. Metformin and Sulfonylureas remain the most beneficial combination, both in terms of efficacy and cost. The cost of treatment was varying, depending on the duration of disease, being higher in old cases and lower in new cases. [ABSTRACT FROM AUTHOR]

Background: Children are very much vulnerable to adverse drug reactions (ADRs) and also tend to have more severe form of adverse effects compared to adults. Though ADR is a significant problem in children, paediatricians seem to neglect this aspect. Knowledge, attitude and practice (KAP) studies related to pharmacovigilance among paediatricians are lacking in literature. Hence, this study was planned to know the gaps in KAP among paediatricians of Odisha and factors related to underreporting of ADR. Materials and Methods: Google Form containing the questions was shared to paediatricians of Odisha state working in both private and government organisations. The questionnaire was prepared based on previous studies and some new questions relevant to our scenario were added. The questionnaire contained six questions based on knowledge, four on attitude and three on practice of ADR. Apart from that, it contained questions to know their response regarding the factors that discourage paediatricians to report ADRs. There were 60 responses. Results: Among the paediatricians, 70%–80% were aware of the pharmacovigilance programme running in India. Also, 80%–90% agreed that ADR reporting is crucial in paediatric health care, while most of them were trained regarding ADR reporting. But only 50% of them had reported an ADR in their clinical practice, which clearly indicates towards underreporting. Conclusion: The motivation for voluntary reporting of ADRs among paediatricians for preventing the morbidity and mortality in this vulnerable population could be of immense importance, and hence, various workshops and CMEs should be conducted to improve the KAP of these doctors, so that the problem of underreporting could be minimised. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To identify the association of cutaneous adverse drug reactions (CADRs) with use of fixed-dose combinations (FDCs) and to compare the occurrence of preventable CADRs between self-medication and prescribed medication of FDCs. PATIENTS AND METHODS: All cases of suspected CADRs with the use of FDCs were collected, and causality assessment was carried out using the WHO UMC scale. The burden of CADRs on self-medication and prescribed medication was found out. Preventability status was analyzed by Schumock and Thornton Criteria and compared between self-medication and prescribed medication. RESULTS: A total of 74 CADRs were detected; 68.91% were detected with antimicrobial and 31.09% with nonsteroidal anti-inflammatory drug-based FDCs. Fluoroquinolones + nitroimidazole was the most commonly suspected medications. Majority of CADRs (44.59%) were fixed-drug eruptions, which was significantly higher than others (P = 0.002). Analysis of preventability showed that there was a significantly higher occurrence of definitely preventable CADRs in self-medication group (40%) in comparison to prescribed group (6.81%), P = 0.028. CONCLUSIONS: Self-medication with FDCs is quite common and associated with a higher rate of preventable CADRs in comparison to that in prescribed medication. [ABSTRACT FROM AUTHOR]