Dhanya Hariharan

Metabolic syndrome is a constellation of interrelated cardio-metabolic risk factors that include Central Obesity, Hyperglycemia, Hypertension and Dyslipidemia. It has been estimated that about 1 in 5 (20.4%) adults in the U.S. have high blood pressure, it is very crucial to evaluate the serious health problems, level of awareness and knowledge about conditions relevant to metabolic disorders. Metabolic syndrome is caused not by genetic defects alone; in most cases, genetic factors predispose a person to a disease, while lifestyle factors determine whether (and when) the disease will develop. Several studies have demonstrated clearly the importance of dietary factors and physical activity level in the development of the metabolic syndrome. Given the same dietary and lifestyle factors, some individuals may be more prone to type 2 diabetes than others because of different genetic backgrounds. At a public health level, more attention must be given to modification of lifestyles of the general public to reduce risk of obesity and T2DM and to increase physical activity. At a clinical level, individual patients with increased metabolic risk need to be identified so that their multiple risk factors can be reduced. Considering the long asymptomatic period often preceding the manifestation of T2DM and CVD, early diagnosis could enable earlier targeted interventions such as implementation of healthy lifestyle changes in nutritional behavior and exercise or pharmacotherapy, thus reducing disease development. A deeper understanding of the underlying gene- interactions  In terms of both public health  and for individuals and genetic subgroups is therefor needed.

In India. Fixed Dose Combinations(FDCs) have drawn the attention of health service providers and the service recipients. Therefore, the development of fixed dose combinations (FDCs) is becoming increasingly important from a public health  perspective. The objective was to study the prescribing pattern and to assess the rationality of fixed dose combinations using seven point criteria. During the study period a total of 100 patients were enrolled based on inclusion and exclusion criteria. The study population includes an overall 56% male with an average age of 46.15 ± 19.33 years. A total of 538 drugs were prescribed to the patient with a mean of 5.38±5.77.The major therapeutic category of drugs prescribed were antibiotics (30.03%), antihypertensives (12.63%) and others (13.01%).The study population had 130 FDCs in which again antibiotics topped the list, followed by Anti-diabetics. Among these 92 contributed to antibiotic FDCs belonging to 15 different groups. The average interaction per prescription was 1.96±3.72.The FDCs involved in drug interaction were aspirin+clopidogrel, amoxicillin+ clavulanic acid. The average length of stay for study population was found to be 5.73±2.19 days. The rationality was assessed using 7 point criteria with a maximum scoring of 14. The most commonly prescribed combination were Piperacillin + Tazobactam (25.38%) and Amoxicillin+ Clavulanic acid(16.92%).Among the combinations, 26.6% scored 13 while 66.66% scored 9-12 and 6.66%scored 7. The results indicated that majority of FDCs especially antibiotics were rational.