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   Table of Contents - Current issue
Coverpage
July-September 2018
Volume 9 | Issue 3
Page Nos. 111-151

Online since Thursday, July 12, 2018

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EDITORIAL  

Professional medical writing support: The need of the day p. 111
Suhasini Sharma
DOI:10.4103/picr.PICR_47_18  
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ANNUAL CONFERENCE KEY NOTE ADDRESS Top

My 40-year journey in diabetes research: The power of collaboration Highly accessed article p. 113
Viswanathan Mohan
DOI:10.4103/picr.PICR_86_18  
This article describes a 40 year journey in diabetes research of an Indian diabetologist, starting as an undergraduate medical student. The article describes how collaborations with multiple stake-holders is necessary if one is to advance one's research from the simple studies that one starts with and take it to higher and higher levels. It is also essential that the seeds for doing research are planted early in a medico's life even during undergraduate days, as only then will more doctors take up medical research as a career. Finally, the article demonstrates how it is possible to do good quality research in India if one has the passion and sustained interest in the field even if one is not in a university or academic setup.
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ORIGINAL ARTICLES Top

An analysis of completeness and quality of adverse drug reaction reports at an adverse drug reaction monitoring centre in Western India p. 123
Manali Mangesh Mahajan, Urmila Mukund Thatte, Nithya Jaideep Gogtay, Siddharth Deshpande
DOI:10.4103/picr.PICR_105_17  
Purpose/Aim: The Adverse Drug Reaction [ADR] form is the source document for the Pharmacovigilance Programme of India [PvPI] and captures information first hand from the patient. The raw data from it then gets converted into an individual case safety report [ICSR] after entry into Vigiflow. The National Coordinating Centre [NCC] uses an instrument to assess quality of these ICSRs. We carried out the present study to assess whether the same instrument with minor modifications could be used to check the quality of ADR forms at our centre. Materials and Methods: ADR reports of three months from three consecutive years were selected randomly. The ADR form [18 fields] was matched with the NCC instrument [14 fields] as the latter is made from the former. A perfect ICSR would score 1. Three fields in the NCC instrument - case narrative, compliance with standard operating procedures [SOPs] and free text [5 components] were modified, while the rest were retained. Zero was given to the first two fields. In the third field, we retained only 3/5 components and changed the last two components [sender and reporter comments] to dechallenge and rechallenge while keeping the total score the same. Results: A total of 1008 ADR reports were analyzed. We found an overall completeness score of approximately 80% with the lowest completeness score being for the year 2015. The mandatory fields had close to 100% scores. Conclusion: The NCC instrument was found well suited to evaluate quality and completeness of ADR forms.
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Knowledge and attitudes of Indian surgeons regarding professional medical writing support p. 127
Natasha Das, Saurendra Das
DOI:10.4103/picr.PICR_88_17  
Aim: The number of scientific papers published from India each year is low. We tried to determine how often Indian surgeons publish in biomedical journals, challenges preventing them from publishing more often, their awareness of the international guidelines that acknowledge professional medical writing as an ethical service, and their willingness to hire medical writers for their publications. Materials and Methods: A convenience sample of 100 of the surgeons attending a national conference were explained about the survey and asked to complete a survey questionnaire. All results were expressed as absolute frequencies and percentages. Results: Of the 81 who responded, 43 (53%) had never published. Only 31/81 (38%) had published in the last 5 years. The challenges preventing more frequent publication were reported to be the lack of support for carrying out statistical analyses (58%), lack of time (41%), lack of sufficient data (38%), and lack of support for literature search (37%). Twenty-two (27%) surgeons were aware that they could hire a professional medical writer (PMW), 26 (32%) knew that the International Committee of Medical Journal Editors allowed PMWs to contribute to articles published in the biomedical journals, 75 (93%) were interested in hiring medical writers or to consider it in the future. Only 6 (7.4%) showed no such interest. Conclusion: There was poor awareness and great interest in hiring PMWs. It might be beneficial to increase the awareness of clinicians about the scientific expertise and communication skills of PMWs and how they can add value to biomedical publications.
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Drug prescription pattern of outpatients in a tertiary care teaching hospital in Tamil Nadu p. 133
S Shanmugapriya, T Saravanan, S Saranya Rajee, R Venkatrajan, Pinky Mariam Thomas
DOI:10.4103/picr.PICR_86_17  
Purpose: Drug use prescribing indicators advocated by the World Health Organization (WHO) are important tools for assessing the degree of polypharmacy, use of generic medicines, and to evaluate if there is inappropriate use of antibiotics or parenteral medications besides estimating the adherence to the essential drugs list. This study aimed to assess the WHO prescribing indicators in prescriptions given at the medical outpatient department (OPD) in a private medical college hospital in South India. Materials and Methods: The study was done prospectively from patients when they presented for consultation at the medical OPD at our tertiary care center. Prescriptions were randomly chosen to be analyzed for the WHO prescribing indicators from September 2016 to April 2017. Results: A total of 700 prescriptions were analyzed and the average number of drugs per prescription was 2.955 ± 1.32. 32.57% of prescriptions had fixed drug combinations and a similar value of 36% was obtained for prescriptions containing more than one drug for the same indication. Amongst the prescribing indicators, generic prescribing was appallingly low (6.42%). In contrast, antibiotic prescribing and prescription of injections showed an appreciably rational trend with 15.42% and 8.14%, respectively. Furthermore, the prescription of the drugs enlisted in the essential drugs list was determined to be 90.67%. Discussion: The need for increase in generic prescribing and augmenting the adherence of prescriptions to the essential drugs list has been identified. This can be accomplished by multimodal approach that includes regulatory changes, conducting educational programs directed at attitudinal change among current doctors and imparting modifications in medical curriculum so as to inculcate the culture of abiding by the best prescription practices among budding doctors. Conclusion: This study has delineated the requisite for pertinent changes in current prescribing trends in a tertiary care teaching private colleges.
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Polypharmacy and comorbidity status in the treatment of type 2 diabetic patients attending a tertiary care hospital: An observational and questionnaire-based study p. 139
Rania Indu, Anjan Adhikari, Indira Maisnam, Piyali Basak, Tapas Kumar Sur, Anup Kumar Das
DOI:10.4103/picr.PICR_81_17  
Purpose/Aim: Diabetes mellitus is associated with several comorbid conditions. Thus, often, diabetic patients are prescribed multiple drugs. Although multiple drugs help to combat various diseases, they also increase the propensity of drug interactions and adverse drug reactions. The present study thus tried to evaluate the comorbid conditions and concurrent medications associated with type 2 diabetic patients. It also aimed to address patient compliance for the medications provided to them. Materials and Methods: This was a cross-sectional observational study conducted for 2 months – January–February 2017. Data were collected from prescriptions of the patients and also by interviewing the willing patients, attending the Diabetic Clinic of R. G. Kar Medical College, Kolkata, India. Results: During the study period, 150 patients were interviewed and their prescriptions were studied. Out of 150 patients, 69 (46%) were males and 81 (54%) were females. The mean age of the study population was 51.5 (±0.78) years. The present study evaluated that 83.3% (125) of the study population suffered from at least one comorbid conditions, the most common being hyperlipidemia (70.7%) and hypertension (47.3%). The average number of drugs prescribed is 4.72 (±0.11) per prescription. Metformin was prescribed to 96% of the patients. The concurrent medications recommended included hypolipidemics (72%), antihypertensives (68%), drugs for peptic ulcer (34.7%), and antiplatelets (10.7%). Conclusion: The present study thus concluded that diabetic patients suffer from a number of comorbid conditions, most commonly, cardiovascular problems. The comorbidity increased with the age. The level of polypharmacy was also high, thereby increasing the pill burden for the patients.
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STATISTICS Top

Understanding diagnostic tests – Part 3: Receiver operating characteristic curves p. 145
Rakesh Aggarwal, Priya Ranganathan
DOI:10.4103/picr.PICR_87_18  
In the previous two articles in this series on biostatistics, we examined the properties of diagnostic tests and various measures of their performance in clinical practice. These performance measures vary according to the cutoff used to distinguish the diseased and the healthy. We conclude the series on diagnostic tests by looking at receiver operating characteristic curves, a technique to assess the performance of a test across several different cutoffs, and discuss how to determine an optimum cutoff.
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REGULATORY UPDATES Top

Indian regulatory update: January – March 2018 p. 149
Amita Bhave
DOI:10.4103/picr.PICR_50_18  
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LETTER TO EDITOR Top

Plagiarism: Either intentional or unintentional, it is still plagiarism! p. 151
Beuy Joob, Viroj Wiwanitkit
DOI:10.4103/picr.PICR_17_18  
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