Neethu J

OTC medicines are medicines sold directly to a consumer without a prescription from a healthcare professional. Which are legally allowed to be sold by pharmacists which is also known as non-prescription medicine. OTC medicines have Advantages and Disadvantages Healthy adults who utilize OTC prescriptions periodically and appropriately have an okay of unfavorable effects. However, certain individuals are at more serious risk, utilization of OTC drug might cause unsafe effects. In this condition we should know about OTC medication. Here examined about OTC meds in specific unhealthy circumstances and their viewpoints, for example, Asthma, Diabetes, Hypertension, Hyperlipidaemia, and Hear failure. Use of non prescription drugs in this situation may leads to harmful effects there for every patient and pharmacist should be aware about it. Patient counselling plays important role in effective treatment. The safe and effective use of drugs depends on patients’ information about their medication .During counselling the pharmacist should assess the patient’s understanding about their illness and treatment and supply individualized advice and data which can assist the patients to require their medication. Patient counselling is an essential component of clinical pharmacy practice in hospital and in community pharmacy settings. Counseling enhances the patients understanding of their illness and its treatment and may improve adherence and therapeutic out come. It allows pharmacists to gain first hand knowledge of medication use from the patients perspectives.

Psychopharmacology is the study of substances that influences behavior or mental state. It is the combination of psychology and pharmacology. There are various psychological reasons that can influence a person’s mind and can lead them to suicidal ideation. Suicide is a fatal, self- injurious act with few evidence of motive to die. It is the deliberate killing of oneself. Youth and adolescence are the time of development in which children hatch out from their protective shell and begin to fly in the world of reality and dreams. They are the future of the world. But there are various factors which affect these individuals which are known as the risk factors. It can be due to their high expectations towards life or other factors. Such situations inevitably lead to some level of helplessness, insecurity, stress and a sense of loss of control. These can have a negative impact in their lives and can lead to suicidal ideation. So, initiatives should be taken to identify these youngsters and provide the support they need for defeating all these negative factors and rise them high in their lives. It can be done only with the help of their parents, teachers, friends and the society along with suicide preventing resources.

Chronic kidney disease (CKD) is defined as any abnormality in kidney structure or function present for three months or longer, with implication for health. Anemia, which affects most patients with CKD, is caused by a decreased production of erythropoietin (EPO), a glycoprotein that stimulates red blood cell production in the bone marrow and is released in response to hypoxia. A 68 years old female came with complaints of generalized tiredness, left side chest pain during inspiration, pedal oedema and breathing difficulty .Her past medication history include CKD, diabetes mellitus, hypertension, recurrent UTI, gastritis. A diagnosis of CKD-end stage renal disease associated with anemia was made following the review of her clinical examination and laboratory findings. She was subsequently managed for anemia with recombinant human erythropoietin and intravenous iron , monitored, and expected result was not found. In this study we conclude that the patient is resistant to erythropoietin so packed RBC is given for the management.

Prostatitis is the inflammation of the prostate gland can be due to an infection as well as other various causes. Prostatitis is a common condition, with 35- 50 % of men affected with symptoms associated with Prostitis during their lifetime. Prostatitis can be caused by bacteria that leak into the prostate gland from the urinary tract. It can also caused by sexually transmitted organism such as Neisseriagonorrhoeae Chlamydiatrachomatis, HIV, Escherichia coli. According to National Institute Of Health Chronic Prostatitis Symptoms (NIH-CPSI) Prostatitis is of three types, Acute bacterial prostatitis, Chronic bacterial prostatitis, Chronic prostatitis /chronic pelvic pain syndrome, A symptomatic inflammation prostatitis .Chronic prostatitis /chronic pelvic pain syndrome is the common condition and most cases of prostatitis fall into this category. Traditionally, Chronic prostatitis /chronic pelvis pain syndrome in men was believed to be related to inflammation (usually secondary to infection) localized to the prostate [1]. Management of chronic prostatitis/chronic pelvic pain syndrome consisted of antibiotics and anti inflammatory and, later ?-blockers and 5 -reductase inhibitors.?-Blockers, antibiotics and combination of these therapies provide greatest improvement in treatment of chronic prostatitis/chronic pelvis pain syndrome. Chronic prostatitis is not a single condition, but a term that is loosely used to describe a group of conditions causing genito –pelvic pain and urinary dysfunction in adult men [10].Both chronic prostatitis and the chronic pelvis pain syndrome is associated with abnormalities in semen and infertility and also result in the reduction in the quality of the life. Prostatitis tissues are best penetrated by drugs with a high pKa and high lipid solubility, such as quinolones ,macrolides ,tetracyclines and sulfa drugs [3]. Antibiotic therapy is recommended for acute exacerbation of chronic prostatitis, chronic bacterial prostatitis and chronic inflammatory prostatitis, if there is clinical, bacteriological or supporting immunological evidence of prostate infection[9]. Antibiotics treatment should be stopped if there is no improvement in symptoms. Many patients  with category III prostatitis will improve with antibiotic therapy.

AIM :Febrile  seizure  is  the  one  of  the  most  common  convulsive  disorders, mainly  occur  following  high  fever  without  any  evidence  of  underlying  health  issues, typically   in  the  children  of  age  of  upto  6  years. The  aim  of  this  study  was  to  assess the  relationship  between  variable  causative  factor  involved  in  the  incidence  of  febrile  convulsions between the  children  referred  to  Cosmopolitan Hospital, Thiruvananthapuram, Kerala (India). This  was  a hospital  based  prospective  observational  study. The  main  purpose  of  this  study  was  to identify  the  relationship  between  variable  risk  factors  associated with febrile  convulsion  in  children. The  children  of  age  upto  6 years  were  studied  to  assess  the  relationship  between  the  types of seizure ,gender ,electrolytes  and  variable  disease  conditions  which  leads  to  the  development  of  convulsive  event  in  children. The age and febrile seizure has a correlation that the children below 3 years is more hospitalized with febrile seizure. Viral fever associated febrile seizure shows more prevalence. Type of seizure and gender do not have any positive correlation in this study. Lab data provide significant positive correlation with the incidence febrile seizure. Pregnancy related complications and antenatal and natel complications also shows a significant relationship to the febrile seizure. Decreased breast feeding in the children also leads to the events of febrile seizure. family history of febrile seizure also provide a major relationship with febrile convu. Risk factor such as age, body temperature, family history, breastfeeding, low birth weight, cesarean, lab data’s that are involved in the development of febrile seizure were identified.

Childhood vaccination is our primary method to promote public health. Concerns and controversies about vaccination and vaccine safety had led some parents to decline recommended vaccination of their children 4.This study systematically reviewed the literatures on controversies in childhood immunization 2. The objective of our study is to assess the controversies and risk benefit ratio of vaccination from the available data 4.  Data resources were collected from existing articles, electronic citations and existing reviews. Supportive to some personal beliefs of parents and their trust to other systems of medicine like homoeopathy there are reports of ill effects of vaccines(poliomyelitis by oral polio vaccine, encephalitis by measles vaccine) . Some other disorders had also been reported with or without evidence. But most of the studies concludes that the benefits of immunization far outweighs risk. The risk of many diseases and mortality rate had decreased in present era due to vaccination. A dramatic example of the benefits generated by vaccination is evident in the context of diphtheria. During the 1930s an average of 61,000 cases of the disease were experienced each year in England and Wales, resulting in the deaths of approximately 3,000 individuals 3 .Studies shows that after taking immunisation ,during the first three years and nine months of the 1980s there were 15 notified cases of diphtheria and only one death. Poliomyelitis routine immunisation for infants has been pursued in England and in the 1980s only 10 cases of acute poliomyelitis have been notified to the authorities from an average of 2827 notified cases in 1956.  Educating parents about vaccine preventable diseases as well as the vaccines may be one of the ways to impart the importance of vaccines to the health of their child 1.

Most of the patients in current scenario are treated with more than one anti-hypertensives and most often with fixed dose combinations. Hence the use and efficacy of fixed dose combination are controversial and is the most debated issue in Indian perspective  The aim of this randomized pilot study was to evaluate the rationality and side effect profile of fixed dose anti-hypertensive combinations used in our hospital. A total of 25 hypertensive patients prescribed with anti-hypertensive FDCs were randomly selected and their outpatient record were monitored and recorded for a period of 2 weeks. The data was then suitably analyzed. Out of the 13 FDCs, only one FDC (7.69%) have its APIs present in both EML of WHO and NLEM of India. There was no established evidence in terms of therapeutic efficacy and safety for the 3 combinations (23.07%).76.92% of FDCs were cost effective when compared with their individual components. 11 FDCs (84.61%) provide published literature on the reduction of either dose of individual drugs or their adverse effects. Only one FDC was found to be irrational in this study. Giddiness (33.33%) was the most frequently seen side effect among the prescribed FDCs. During this limited study period with only 13 anti-hypertensive FDCs, we were able to find an irrational FDC, which clearly show an urgent need to conduct further studies on evaluating the rationality of FDCs as a whole. As a clinical pharmacist, our immense role in evaluating the rationality of FDCs could enable the DCGI to withdraw irrational FDCs from the market.