A PROSPECTIVE COMPARATIVE STUDY TO EVALUATE EFFICACY, SAFETY AND COST EFFECTIVENESS OF DICLOFENAC AND THEIR COMBINATION WITH VARIOUS PROTEOLYTIC ENZYMES IN ORTHOPAEDIC DEPARTMENT OF TERTIARY CARE TEACHING HOSPITAL
Hetal V. Kacha, Dr. Amita R. Kubavat*, Shailesh G. Mundhava and Shahenaz M. Malek
ABSTRACT
Objectives: To evaluate efficacy, safety and cost effectiveness of diclofenac, serratiopeptidase and chymotrypsin/trypsin as add on in reducing swelling and pain following upper and lower limb fracture. Methodology: This is a prospective, observational study Including 150 patients with upper and lower limb fractures admitted in orthopaedic department of tertiary care teaching hospital. Patients were randomly divided into 3 groups (50 of each), Group-1 tablet diclofenac prescribed, and group-2 tablet serratiopeptidase with diclofenac prescribed and group-3 tablet chymotrypsin/trypsin with diclofenac prescribed. Evaluation of swelling reduction was made by using tape measurement. Pain was assessed by using visual analogue scale at day 0, then daily up to 5 days. Adverse drug reactions were also recorded. Result: Reduction of swelling within group was significant (P=<0.0001). Comparison of reduction of swelling in all three groups was statistically not significant (p > 0.05). Reduction in pain score in three groups was significant, but decrease was more in group 1. Cost of therapy was more in group 2 and group 3 as compared to group 1. Conclusion: Patients in Group 2 and 3 showed more anti-inflammatory effect than of group1. However it is not statistically significant. Diclofenac showed more analgesic effect as compared to proteolytic enzymes. Cost of therapy in group 2 and 3 is more. Mild to moderate adverse effects were reported in group 1 and 2. Most common side effect reported was gastritis, in group1.
Keywords: inflammation in post-op fractures, anti-inflammatory, analgesics drugs, proteolytic enzymes.
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