{'fraction_non_alphanumeric': 0.0191914022517912, 'fraction_numerical': 0.018935516888433982, 'mean_word_length': 5.319320937752627, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Prescribing pattern of nutraceuticals in pediatric outpatient department at tertiary care teaching hospital

Background: Nutraceuticals use is increasing in a health-conscious society. Because of varying lifestyle diseases, people have changed their outlook towards nutraceuticals. The objective of the study was to study the prescription pattern of nutraceuticals by doctors in paediatric outpatient department of government medical college and hospital, Aurangabad, Maharashtra, India. Methods: This study was done between November 2018 to March 2019. Total of 156 patients were included in the study after obtaining written informed consent from parents of patients. The data was gathered, analysed and results were concluded. Results: Total 156 patients were prescribed nutraceuticals in paediatric outpatient department of which 51.92% female patients and 48.78% male patients received nutraceuticals. In this study, 62% patients received vitamins and 38% patients received vitamins and minerals. 67.31% patient receiving nutraceuticals were above the age of 6 years and 32.69% patients were under the age of 6 years. Among patients receiving nutraceuticals, B complex was received 55.77%. After that calcium lactate + vitamin D tablet were prescribed 21.80%. Ferrous sulfate + folic acid was received by 8.33% patients. Calcium carbonate + vitamin D3 were received by 7.69% patients. Folic acid tablet was received by 5.13% patients and poly-vitamin tablet by 1.28% patients. 100% prescriptions were prescribed in generic names. Conclusions: Nutraceuticals are being increasingly perceived as beneficial to health and are being continuously used in the treatment. The future of nutraceuticals is bright and can transform healthcare in a developing country like India.

medical or health benefits, encompassing, prevention and treatment of diseases. Presently over 470 nutraceutical and functional food products are available with documented health benefits. Nutraceuticals and functional foods have received considerable interest because of their presumed safety and potential nutritional and therapeutic effects. The global nutraceutical market size is estimated between 30 and 60 billion US$, with Japan, US, and Europe occupying the biggest share. 3 There is increasing market and use of nutraceuticals in United States, with estimated sales of over 21 billion dollars for the year 2006. 4 A nutraceutical is isolated from food stuff and it can be sold in the form of powders; pills and other forms. 5 Nutraceuticals are helpful to complement nutrition in healthy subjects as well as patients. 6 These products may range from isolated nutrients, dietary supplements and specific diets to genetically engineered designer foods and herbal products. 7 The Indians, Chinese and Sumerians are just a few civilizations that have provided evidence suggesting the food can be effectively used as a medicine. Indian nutraceutical market was estimated to be USD 1 billion in 2008. Global nutraceutical market is of USD 117 billion, of which India had less than 1% share in 2011. 8 With the passage of the dietary supplement health and education act of 1994, the definition of nutraceuticals has been expanded to include vitamins, minerals, herbs and other botanicals, amino acids and any dietary substance for use by humans to supplement the diet by increasing total dietary intake and subsequently increased the use of nutraceuticals dramatically. 9 There is a slight difference between the functional foods and nutraceuticals. When food is being cooked or prepared using "scientific intelligence" with or without knowledge of how or why it is being used, the food is called "functional food". Thus, functional food provides the body with the required number of vitamins, fats, proteins, carbohydrates, etc. needed for its healthy survival. When functional food aids in the prevention and/or treatment of disease(s) and/or disorder(s) other than anaemia, it is called a nutraceutical. 10,11 Nutraceuticals are the emerging class of natural products that makes the line between food and drugs to fade (Adelaja and Schilling 1999). Although the use of nutraceuticals by people has a long history, only recently scientifically supported nutritional and medical evidence has allowed nutraceuticals to emerge as being potentially effective (Dillard and German 2000). 12 Differences in demographic and behavioural characteristics between nutraceuticals users and nonusers would demonstrate the importance of including supplement assessment in both the planning and analysis of any epidemiologic study of diet or lifestyle characteristics and health. 13 Nutraceutical is regarded as the bio active substance and the constituents are either of known therapeutic activity or are chemically defined substance generally accepted to contribute substantially to the therapeutic activity of the drug. 14 There is little available data in India on prescribing trends of nutraceuticals. This study was therefore designed to evaluate the prescribing trend of nutraceuticals in government medical college and hospital in Aurangabad city of Maharashtra. This review gives highlights of some important facts regarding the use of nutraceuticals as the commercial and traditional remedies.

METHODS
This was an observational study conducted on patients of pediatrics outpatient department at government medical college and hospital Aurangabad over a period of 5 months from November 2018 to march 2019. The present study was taken up with the objectives of studying the prescription pattern of nutraceuticals among children under 12 years of age and to study whether the nutraceuticals are prescribed in generic or brand name by doctors in paediatric out patient department of government medical college and hospital Aurangabad, Maharashtra, India.
The study was conducted after obtaining clearance from institutional ethics committee in government medical college Aurangabad and is in accordance with the declaration of Helsinki.
Total 156 patients were enrolled in this study. The patients included in the study were patients of the Paediatric out patient department of government medical college and hospital Aurangabad, whose parents gave consent to participate in the study. Age group of patients included in this study was 1-12 years. This study was conducted after obtaining written, informed and understood consent from the parents of patients. Parents of patients also consented for the data to be published and reported. Pediatric patients more than 12 years old and patients who have not given consent were excluded from the study. The parents of patients were interviewed and the prescriptions were scrutinized to understand the usage of nutraceuticals. The data was entered into excel sheet and analysed based on percentages. (Figure 1), 75 male patients in paediatric department received of prescriptions contained nutraceuticals of one or the other types. However, 81 female patients in paediatric department received of prescriptions contained nutraceuticals.

As depicted in
As depicted in (Figure 2), 51 patients were below the age of 6 years who were prescribed nutraceuticals and 105 patients were above the age of 6 years who were given nutraceuticals. Patients below 6 years and who were not consuming tablets were given syrups.

CONCLUSION
Nutraceuticals are being increasingly perceived as beneficial to health and are being continuously used in the treatment. Majority of patients receiving treatment in the hospital expect to receive prescriptions for nutraceuticals. The future of nutraceuticals is bright and can transform healthcare in a developing country like India which utilizes a large number of natural compounds. More studies need to be taken up on prescription pattern of nutraceuticals in healthcare.