This paper reports a study of the prescribing and dispensing of drugs in India. The drugs supplied to 2400 patients by the public and private medical sectors and by private pharmacies (over the counter dispensing) were recorded, and were analysed with respect to the patient's presenting complaint and diagnosis. The main findings discussed in this paper are: 1. Large numbers of drugs are prescribed by doctors in the private sector. Combination preparations containing 'hidden' classes of drug are often given. Anti-infectives are widely and often inappropriately used. 2. Potentially dangerous drugs are sold over the counter and prescribed for trivial or bizzare indications. Drugs which have been withdrawn as dangerous in the West remain popular first line drugs in India. 3. Food supplements and tonics of dubious nutritional and pharmacological value make up a high proportion of the total drugs bill. It is concluded that a rational drugs policy and/or an essential drugs list will be useless unless accompanied by intensive efforts to improve the education and updating of doctors and pharmacists and to reduce the commercial pressures on doctors to prescribe unnecessary drugs.

Analgesics↗

PubMed1986

Drug marketing in the Third World: beneath the cosmetic reforms.

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Advertising↗

PubMed1978

On the nature of the neural abnormality in human amblyopia; neural aberrations and neural sensitivity loss.

In this investigation contrast threshold measurements are compared with supra-threshold perception for a group of human amblyopes. The results indicate that human amblyopia involves, in some cases, not only loss of sensitivity but spatial distortion. Thus a new group of amblyopes can now be identified in which only distortion occurs. These results have important physiological implications for both the normal and abnormal visual systems. Neurophysiologists investigating visual loss from deprivation should assess whether similar distortions occur in animals. This question may hold the answer to whether the present animal models are relevant to the human condition.

Amblyopia↗

PubMedDate not supplied

Towards a broader agenda for training in critical appraisal.

Much progress has been made in recent years towards an evidence-based approach to health care, i.e. the routine framing of an explicit decision sequence in the clinical encounter, the systematic search for published evidence, and the appraisal of relevant research articles. We argue that this is a commendable but limited milestone, and that training in evidence-based health care, particularly the use of critical appraisal techniques, is in need of a broader agenda. We outline a proposal through which the skills and attitudes needed for the critical appraisal of published articles may be applied to all other aspects of clinical practice, from planning research projects to presenting results and guidelines and peer review of articles submitted for publication.

Evidence-Based Medicine↗