Browsing by Author "Shrivastava, Amit Kumar"
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Publication Cost Variation Analysis of Oral Hypoglycaemic Agents in Type 2 Diabetes Mellitus in Tertiary Care Hospital in Nepal(Rapti Academy of Health Sciences (RAHS), 2024) Shrestha, Laxmi; Basnet, Ambika; Palikhey, Anjan; Shrivastava, Amit Kumar; Joshi, BishalAbstract: Introduction: Diabetes Mellitus is a chronic metabolic condition affecting millions of individuals worldwide. The cost of drug therapy plays a significant role in the treatment of chronic disorders like type 2 diabetes mellitus, where lifelong medication is required. Understanding the cost variations of oral hypoglycemic agents is essential for optimizing treatment and improving patient compliance. This study was aimed at identifying the affordable treatment strategies for the management of type 2 diabetes mellitus. Methodology: A hospital-based cross-sectional study was conducted at the outpatient department of Medicine at UCMS-TH, Bhairahawa, Nepal, from December 2022 to May 2023. The cost of a drug manufactured by various companies, in the same strength and dosage form, was obtained. The difference in maximum and minimum price of the same drug manufactured by different companies and percentage price variation was calculated. Results: Among 250 prescriptions, the percentage price variation was highest in Voglibose (0.3 mg), 454.4%, followed by Metformin (500 mg) 260%, and least with Sitagliptin (50 mg) and Linagliptin (5 mg), i.e., 4.16% and 3.89%, respectively in monotherapy. In combination therapy, Metformin+Glimepiride (500 mg+1 mg) 285.71%, followed by Metformin+Linagliptin (500 mg+2.5 mg) 52.3%, showed maximum price variation. The least variation (3.84%.) was seen in the combination of Metformin+Linagliptin (850 mg+5 mg). Conclusion: A huge difference in the prices of different brands was observed. It is essential to educate prescribers regarding the significant price variation. Prescribing a cost-effective drug by the physician improves the patient’s adherence to the treatment regimen and minimizes the financial burden.Publication Dry Eye Disease among Patients with Glaucoma under Topical Antiglaucoma Agents in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Palikhey, Anjan; Koiree, Shahdev; Mehta, Roshan Kumar; Shrivastava, Amit KumarAbstract Introduction: Dry eye disease is a disorder of the tears and ocular surface that results in various symptoms, such as dryness, grittiness, burning and itching sensation in the eye, excessive tearing, and fluctuating vision. The prevalence of dry eye disease symptoms is increased with long-term topical anti-glaucoma medicine treatment. The objective of this study was to find out the prevalence of dry eye disease in glaucoma patients under topical anti-glaucoma agents in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 9 February 2022 to 5 June 2022 among glaucoma patients under topical anti-glaucoma agents at a tertiary care centre after receiving ethical approval from the Institutional Review Committee (Reference number: UCMS/IRC/028/22). Data were collected using a standard ocular surface disease index questionnaire. The dry eye disease was clinically diagnosed if the ocular surface disease index score was equal to or more than 13. Point estimate and 95% Confidence Interval were calculated. Results: Among 250 glaucoma patients, dry eye disease was found in 180 (72%) (66.43-77.57, 95% Confidence Interval). Mild, moderate, and severe symptoms were present in 50 (27.78%), 68 (37.78%), and 62 (34.44%) of the patients, respectively. The most frequently observed dry eye symptoms were itching and irritation seen in 56 (31.11%), followed by pain in the eye in 41 (22.77%) and redness in the eye in 32 (17.77%) patients. Conclusions: The prevalence of dry eye disease was higher than other clinical studies done in similar setting. It is extremely concerning and calls for increased focus on managing glaucoma and concurrent dry eye disease.