A study on drug utilization and prescription habits of physicians in a government homeopathic hospital in West Bengal, India

Improper prescribing habits and inappropriate drug use lead to serious health and economic consequences. This study was undertaken to evaluate drug utilization services and prescription patterns of homeopathic doctors in a government homeopathic teaching hospital in India. METHODS： No standardized homeopathic drug use indicators are available. The researchers used indicators for health care setting （drug availability）-modified prescribing indicators and patient care indicators, based on World Health Organization＇s core drug use indicators. A cross- sectional, prospective, institutional, observational study of 2-month duration with record analysis was conducted on 600 patients visiting seven different outpatient departments （OPDs） for the first time at Mahesh Bhattacharyya Homeopathic Medical College ＆ Hospital, Howrah, West Bengal, India, using the developed indicators. RESULTS： Overall availability of prescribed drugs was quite satisfactory （92.28%）. Centesimal potencies accounted for the majority of prescriptions （74.76%）. There was a poor record of diagnosis （39.17%） except in the OPDs of Gynecology and Obstetrics （68.48%, P 〈 0.01） and Dermatology （64.58%, P 〈 0.01）. Records of investigational findings and ongoing therapies, if any, were also poor except OPDs of Gynecology and Obstetrics, and Pediatrics. Structure of prescriptions was maintained satisfactorily in all the OPDs. Though tendency of using ＇individualized homeopathy＇ predominated, there also existed the use of ＇polypharmacy＇. Mean consultation time was 5.9 min. Labeling was extremely poor and is an area needing improvement. The prescriptions were highly legible. CONCLUSION： This was a preliminary study, conducted for the first time in homeopathy using newly developed indicators that yield meaningful results. Further studies are necessary in order to evaluate the different factors involved and to plan future interventions to improve the quality of care in healthcare settings.

Stem cell therapy: A paradigm shift in breast cancer treatment

As per the latest Globocan statistics,the high prevalence rate of breast cancer in low-and middle-income countries has led to it becoming the most common cancer to be diagnosed,hence posing a major public health challenge.As per this data,more than 11.7%of the estimated new cancer cases in 2020 were due to breast cancer.A small but significant subpopulation of cells with self-renewing ability are present in the tumor stroma and have been given the nomenclature of cancer stem cells(CSCs).These cells display a high degree of plasticity owing to their ability to transition from the slowly cycling quiescent phase to the actively proliferating phenotype.This attribute of CSCs allows them to differentiate into various cell types having diverse functions.Breast CSCs have a pivotal role in development,metastasis,treatment resistance and relapse of breast cancers.This review focuses on the pathways regulating breast CSC maintenance and the current strategies that are being explored for directing the development of novel,targeted,therapeutic approaches for limiting and eradicating this aberrant stem cell population.

Developing the criteria for evaluating quality of individualization in homeopathic clinical trial reporting:a preliminary study

OBJECTIVE： This study describes the development of a preliminary version of an instrument that attempts to assess the quality of reports of individualized homeopathic prescriptions in clinical trials and observational studies. METHODS： A multidisciplinary panel of 15 judges produced an initial version of the instrument through iterative Delphi rounds and pilot-tested the instrument on five clinical trials. Later they assessed, under blind conditions, the individualization quality of 40 randomly-selected research reports. The final version of the instrument included six criteria. These items were scored consistently by all the raters regardless of background. RESULTS： The instrument appeared to have adequate face and content validity, acceptable internal consistency or reliability （Cronbach＇s a 0.606 - 0.725）, significant discriminant validity （F = 398.7; P 〈 0.000 1）, moderate interrater reliability （Fleiss K 0.533）, agreeable test-retest reliability （Cohen＇s K 0.765 - 0.934）, moderate sensitivity （0.4; 95% confidence interval 0.253- 0.566）, and high specificity （1.0; 95% confidence interval 0.891-1.000）. CONCLUSION： The initial data suggest that this instrument may be a promising systematic tool amendable for further development.

Medicine prescription practices of homeopathic undergraduate students in West Bengal,India

OBJECTIVE： To our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students. METHODS： A cross-sectional study was carried out involving all the students from four government homeopathic schools of West Bengal, India. Ethical requirements were ensured and data were collected using self-administered questionnaires. Chi-square tests and logistic univariate regression analyses were performed to identify associations and differences. RESULTS： A total of 328 forms were completed. Of these, 264 （80.5%） homeopathic undergraduate students admitted of prescribing medicines independently and most （40.5%） said that they did this 2-3 times a year. The most common reasons for this were ＇urgency of the problem＇ （35.2%）, ＇previous experience with same kind of illness＇ （31.8%）, and ＇the problem too trivial to go to a doctor＇ （25.8%）. About 63.4% of the students thought that it was alright to independently diagnose an illness while 51.2% thought that it was alright for them to prescribe medicines to others. Common conditions encountered were fever, indigestion, and injury. Students who prescribed medicines were more likely to belong to Calcutta Homeopathic Medical College and Hospital （odds ratio = 5.8; 95% confidence interval 2.247-14.972）. Prescription by students gradually increased with academic years of homeopathic schools. Many students thought it was alright for students to diagnose and treat illnesses. CONCLUSION： Prescription of medicines by homeopathic undergraduate students is quite rampant and corrective measures are warranted.