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Ayesha Vaseem, Mazher Ali, Khuteja Afshan
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174659

Abstract:
Background: Metformin, a biguanide is the most preferred choice of drug in the treatment of type 2 diabetes mellitus. It has many advantages - it does not cause hypoglycaemia and weight gain, prevents insulin resistance besides being cheap and relatively safe. It has other pleiotropic benefits beyond its glucose-lowering effect with preclinical evidence for many indications. This prospective observational study was conducted to assess the prescribing pattern of metformin for various indications by physicians.Methods: Prescriptions containing metformin were collected from the inpatient and Outpatient Departments of different specialities. The data collected were analysed and grouped on the bases of age, gender, disease condition and analysed for significance.Results: A total of 218 patients were included in this study. All the prescriptions containing metformin were collected and analysed. Metformin was most extensively prescribed for Type 2 diabetes (51.83%) followed by Polycystic ovarian disease (PCOD) (26.14) and least number of prescriptions were collected for prediabetes (1.37%). Most common age group receiving metformin was 31-40 years (35.77%).Conclusions: Metformin is the oldest and most widely prescribed as a first choice antihyperglycemic drug for treatment of type 2 diabetes mellitus. There are many experimental and clinical studies which have shown an array of potential benefits of metformin other than in the treatment of diabetes. But its clinical application is limited despite convincing basic evidence. The possible reasons could be absence of recommendations in the guidelines and insufficient evidence for use.
Shamiya Sadiq, Kanika Khajuria
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174656

Abstract:
Background: Complementary and alternative medicine (CAM) use is prevalent among chronic diseases like Diabetes mellitus (DM). Therefore, the aim was to study the pattern of CAM use among Type2DM in our set up.Methods: The study was done in diabetic patients attending OPD of Government medical college hospital over a period of 2 months. Patients who gave consent were subjected to a pre-structured questionnaire which consisted of two parts pertaining to socio-demographic profile and CAM usage details.Results: Out of 280 patients enrolled in the study, 110 admitted being CAM users along with conventional Anti-Diabetic treatment. The CAM users were mostly females (56.36%) and were from rural background (70.90%). CAM was prevalent in educated patients (90.90%) more than illiterates (9.09%). Ayurveda (44.54%) was the most common type of CAM used and relatives (58.18%) provided main source of CAM information. 32.72% patients thought that CAM is safe, effective (20.90%) and less costly (19.09%). Only 16.36% patients disclosed regarding their CAM usage to the attending physician while majority (83.63%) were non-revealers. The results suggest that patients should be encouraged to reveal to their physician regarding CAM as it can avoid possibility of interactions.Conclusions: CAM is prevalent in T2DM and more so in females from rural areas. Ayurveda was the most widely type of CAM used and majority of patients did not disclose to the treating physician regarding CAM usage.
Asha P. Dass, Prashanth Chary Ramoji
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174657

Abstract:
Background: This study was aimed at investigating the effects of aluminium chloride (AlCl3) in altering the serum lipid profiles and ways to reduce its effect using two different doses of ginger extract 500mg/kg and 1000mg/kg body weight in male wister rats.Methods: The rats were randomly divided into 4 groups consisting of 5 animals in each group. Groups II, III and IV received AlCl3 100mg/kg bodyweight single dose, Groups III and IV receiving an additional daily oral single dose of ginger plant extract through a stomach tube. All animals were fasted before the treatment. All rats were weighed before the start of the experiment and at the end of the experiment. The blood was collected firstly at the beginning of the experiment, then on the 45th day. The collected blood was left to clot then centrifuged at 3500 rpm for 5 min. The serum was separated and stored at - 80°C for later analyses.Results: This study shows that a single dose of 100mg/kg aluminium chloride causes a rise in total body weight, TC (total cholesterol), LDL (low density lipoproteins) and TG (triglycerides) levels in the rat, and aqueous Zingiber officinal (ginger) extract reduces this rise in TC, LDL and TG levels in the rats.Conclusions: Ginger was effective in lowering serum cholesterol levels levels in the ginger treated rats to almost normal value. These results indicate that treatment with aqueous extract of ginger may be effective in lowering lipid levels in AlCl3 induced hyperlipidemia in rats.
Pooja Shukla, Anisha Porwal, Suman Roy, Shivam Chaturvedi, Smriti Tripathi, Nalini Arya
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174655

Abstract:
Background: Agomelatine is a synthetic analogue of melatonin and a potent agonist of melatonin receptors. Agomelatine has Hepatoprotective as well as antioxidant activity. The aim of study was to evaluate the antiulcer activity of Agomelatine and its potentiation through the pyridoxine on ethanol induced gastric ulcer in rats.Methods: Thirty number of rats were divided in to five groups contro, standard, Agomelatine low dose, Agomelatine high dose and Agomelatine with Pyridoxine groups. Ethanol was used to induced gastric ulcer in rats. ulcer index and also the other biochemical parameters like free Acidity, total Acidity, gastric pH, volume of gastric juice was determined. Statistically analysis was done by ANOVA P value less than 0.05 was considered Statistically significant.Results: In the present study, an attempt has been made to investigate the gastric antisecretory, antiulcer and cytoprotective properties of agomelatine. The results are statistically significant by ANOVA test. Ranitidine showed a statistically significant decrease in the volume of gastric juice by free acidity and total acidity. when compared to control. Agomelatine shows a showed similar response to the volume of gastric juice. A significant difference in pH was observed between the agomelatine-treated, agomelatine with pyridoxine treated group and the control groups.Conclusions: Pretreated rats with Agomelatine (40mg/kg) showed protective effect against ethanol induce gastric ulcer. Agomelatine (40mg/kg) showed the ameliorative effect with Pyridoxine (0.3mg/kg), on gastric ulcer.
Muralidhar C., Vijay Prasad S., Sridhar I.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174634

Abstract:
Background: In many patients, the presently available antiepileptic drugs such as phenobarbital, phenytoin, benzodiazepines, sodium valproate, etc., are unable to control seizures efficiently and the problem of adverse effects has also not been circumvented completely and approximately 30% of the patients continue to have seizures with current antiepileptic drugs therapy. Hence, search should continue to develop newer, more effective, and safer neuro-protective agents for treatment of epilepsy. Aim of the study was to investigate the activity of nifedipine, the dihydropyridine calcium channel blocker, diazepam, the benzodiazepine anti- convulsant of established efficacy and their combinations against rat models of pentylenetetrazol (PTZ) induced convulsions. Method: Wister albino rats of either sex, weighing between 150-220gm were used. Rats were divided into 10 groups, in each group n=6 total N=60.Methods: PTZ was administration 30 min after test drug administration. Intraperitoneal injection of PTZ at the dose of 80mg/Kg body weight were administered to the rats to produce chemically-induced seizure. The effect of nifedipine and diazepam were assessed on such seizure model. The onset and duration of clonic convulsion were recorded.Results: The onset time of PTZ-induced clonic convulsion was significantly prolonged with the Nifedipine in the doses of 4mg and 8mg per Kg. in comparison to nifedipine in dose of 2mg per Kg. The interesting observation was that while Diazepam in 1mg/Kg. dose significantly (P
Avula Naveen, M. R. Sravani
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174635

Abstract:
Background: Drug utilization studies play crucial role in the health sector and ultimately it provides insight into the efficiency of drug use and results of such research can be used to help to set priorities for the rational use of medicines and allocation of health care budgets. Respiratory tract infections (RTIs) contributing to significant mortality and morbidity of populations especially in developing countries like India. Polypharmacy and irrational prescription are significant negative fallouts in treatment of RTIs. Keeping in view of this, our study was undertaken to analyze the drug utilization pattern of RTIs.Methods: The study was conducted at Gandhi Hospital, after obtaining permission from the Institutional Ethics Committee. We have collected data of 600 case records of the patients diagnosed with respiratory tract infection and evaluated for prescribing patterns in consonance with WHO indicators.Results: Out of the total case records 348 (58%) were of male patients and 252 (42%) of female patients. Age wise distribution was done; 79 (13.16%) 0-15 years, 46 (7.67%) 16-30 years, 123 (20.50%) 31-45 years, 194 (32.33%) 46-60 years and 158 (26.33%) patients belongs to >60 years of age group respectively. A total of 4682 drugs were prescribed, 2468 (52.71%) antibiotics, 768 (16.4%) bronchodilators, 581 (12.4%) corticosteroids, 323 (6.89%) antacids, 542 (11.57%) in miscellaneous category respectively. With regard to formulations 2463 (52.60%) oral, 1463 (31.24%) injectable and 756 (16.14%) inhalational drugs were prescribed. Numbers of Fixed dose combinations were 712 (15.20%). 7.8 drugs were prescribed per prescription. 2493 (53.24%) drugs were prescribed from National Essential Medicine List. 4168 (89.02%) drugs were prescribed by their brand names.Conclusions: Prescription of drugs with branded names, Irrational prescribing, poly pharmacy were observed in our study. So there is an urgent need for creating awareness among the health care professionals regarding rational prescription by using data from from drug utilization studies.
Shajil Anand Justin, Senthil Gobalakrishnan, Sylvia Santhakumari Asirvatham
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174369

Abstract:
Background: Parkinson disease (PD) is a major neurological disorder known since ancient times. Though drugs are available for therapy, still effective drug targeting the etiopathogenesis is always going on.Methods: After obtaining permission from animal ethics committee, the mice were divided into four groups of eight each (normal control, experimental control with normal diet only, silybin 300mg/kg, silybin 600mg/kg). At the end of 55 days the mice were subjected to overnight fasting followed by plasma and liver biochemical analysis.Results: The mice treated with 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) developed motor dysfunction and behavioural changes similar to PD, which was tested with rotarod test, photoactometer test and hang test which revealed the impaired performance, hypo-locomotion and impaired neuromuscular strength respectively. Treatment with silybin reversed the motor dysfunction significantly (p≤0.001) in a dose dependent manner. Biochemical analysis measured the oxidant (TBARS, SOD, CAT) and antioxidants (GPx and GSH) which revealed the oxidant activity of MPTP and antioxidant activity of silybin. Histopathological evaluation showed the cytoprotective effect of silybin.Conclusions: Silybin by its antioxidant property has a neuroprotective activity both in motor activity and behaviourally in the MPTP induced Parkinson disease in mice. Hence present study offers a conclusive evidence that silybin is a neuroprotective. Diet supplemented with silybin can protect against neurodegenerative disorders and prevent the progression of neurodegeneration.
Yadhuraj M. K., Somasekharam P., Vinay D. M., Akhil Rao U. K.
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2441-2445; https://doi.org/10.18203/2319-2003.ijbcp20174373

Abstract:
Background: To evaluate and compare the efficacy of epidurally administered Tramadol. Hydrochloride and Pentazocine Lactate in providing post operative pain relief for lower abdominal and lower limb surgeries. To compare the side effects between epidural tramadol and pentazocine. Design of the study was a prospective randomized study. Methods: The study population consisted of 100 patients aged between 18-65 years posted for various elective lower abdominal and lower limb surgeries requiring neuraxial anaesthesia at M.V.J. Medical College and Research Hospital, Hoskote, Bangalore. The study population was randomly divided into 2 groups with 50 patients in each sub group. Group T: Administered 50mg Tramadol, diluted to 10ml with Normal saline, epidurally (n = 50) Group P: Administered 0.3mg/kg Pentazocine, diluted to 10ml with Normal saline, epidurally (n = 50). Patient was monitored on various parameters including duration of action, hemodynamic variables, and side effects. Results: In group administered 50mg Tramadol epidurally, the mean time to onset of analgesia was 4.36±2.23 mins and the mean time to onset of analgesia in the group administered pentazocine was 4.84±2.24 mins, with a p value of 0.286, which is not considered significant. In tramadol group, the analgesic period averaged 7 hours 20 minutes, while the duration of analgesia in group P averaged 6 hours 43 minutes, with a p value of 0.475, which is not considered significant. It was also observed that 0.3mg/kg of pentazocine produced marginally higher incidence of bradycardia, dizziness, drowsiness. Conclusions: With these results, we conclude that epidural tramadol 50mg gives longer lasting and more profound analgesia with lesser side effects when compared to 0.3mg/kg of pentazocine.
Anil Kumar Mehta, D. D. Gupta, Ramesh Kumar, Atal Sood
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2358-2365; https://doi.org/10.18203/2319-2003.ijbcp20174359

Abstract:
Background: Depression, a major common affective disorder which carries excess mortality through suicide. Among various drug classes available SSRI’s are usually a choice, but many patients show inadequate response, residual symptoms or discontinue medication due to intolerable side effects. Disturbances of circadian rhythm function are an etiopathogenic hallmark of depression. The degree of circadian misalignment correlates with the severity of depression and circadian abnormalities may partially be a consequence of alterations in behavior and sleep patterns that accompany depression. Agomelatine an agonist acts on MT1 and MT2 receptors and antagonist of 5HT2c receptors contributes to its resynchronization of circadian rhythms, enhancement of dopaminergic and adrenergic input to the frontal cortex, induction of hippocampal neurogenesis, and ultimately, to its antidepressant effect.Methods: The study was randomized, prospective, comparative and interventional regarding the efficacy of therapy. Hundred consenting patients of MDD attending psychiatry OPD were screened for possible enrollment into group A(Agomelatine) and group B(Sertraline). Patients were assessed by semi-structured case recording form, DSM-IV- TR Criteria for major depressive episode, Hamilton Rating Scale for Depression (HAM-D) and Clinical Global Impressions for severity (CGI-S) at baseline and CGI for improvement (CGI-I), every two weeks interval and final assessment at 8 weeks.Results: Socio-demographic parameters like age and sex distribution, marital status, locality, family type, educational status, occupation and socio-economic class were comparable between two groups. Similarly baseline HAM-D and CGI-S values between the two groups were statistically non-significant. HAM-D, CGI-S and CGI-I values at eight weeks among the two groups were also statistically non-significant but in all three sertraline had decreased the values to a greater extent and showed a trend towards improvement.Conclusions: Both groups had shown significant decrease in scores of all scales i.e. HAM-D, CGI-S, and CGI-I at the end of 8th week as compared to baseline scores, indicating that the uses of agomelatine and sertraline have resulted in significant improvement in symptoms of patients of MDD and reinforcing there efficacy in treatment of MDD. No statistical difference was observed between two groups.
Chandrakala Sharma, Arkojit Endow, Sudip Dutta
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174358

Abstract:
Background: Prescription audit is an important tool to analyse rational use of drug at different health sectors. The aim of the study was to evaluate the prescribing pattern using World Health Organization prescribing indicators for lower respiratory tract infection in children below five years of age.Methods: A cross-sectional study was conducted in the outpatient department of Paediatrics at Central Referral Hospital, Gangtok, Sikkim, India for a period of 18 months. Study involved children between 1-5 years of age with fever/cough with or without respiratory distress. The data were collected from the out patient department prescription slips as well as interviewing the parents/guardians after finishing the physician consultation. The data were processed using statistical software SPSS 20.Results: The study was conducted with 57 prescriptions comprising 210 drugs from both male (54.38%) and female (45.61%) patients. The average number of drugs per prescription was found to be 3.68. negligible (0.013%) prescription containing generic name of drug was found, 96.66% of medicines were prescribed from National Essential List of Medicine (NELM). No prescriptions were found to have injectables, 8.57% of the prescriptions were found to contain fixed dose combination. Amongst the drug categories, salbutamol accounted for 23.33% in total prescription followed by paracetamol (22.85%) and amoxicillin (7.14%). While accounting for the formulations used, the maximum prescriptions were containing syrup followed by nebulization.Conclusions: The use of generic names was minimal, only few of the prescriptions had vitamins and tonics with no use of injectable preparations. Maximum numbers of drugs were prescribed from NELM.
Yadhuraj M. K., Somasekharam P., Vinay D. M., Akhil Rao U. K.
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2528-2533; https://doi.org/10.18203/2319-2003.ijbcp20174389

Abstract:
Background: Administration of Suxamethonium, laryngoscopy and intubation is associated with rise in intraocular pressure (IOP). The need to attenuate rise in IOP is of utmost importance, especially in patients with perforating injury of the eyeball. The present study was undertaken to compare the effectiveness of intravenous Dexmedetomidine 0.4μg/kg and oral Clonidine 3μg/kg in attenuating the rise in IOP following administration of suxamethonium, laryngoscopy and intubation.Methods: 150 patients of ASA I or II, aged between 18-60 years, who were posted for elective non-ophthalmic surgery requiring general anaesthesia were included in this study. Patients were randomly divided into 3 groups with 50 patients in each group. Group-D: Received 0.4μg/kg IV dexmed in 10ml sterile water, over 10 min before induction. Group-C: Received 3μg/kg oral clonidine two hours prior to surgery. Group-S: Control group.Results: IOP, MAP, and HR were recorded at baseline, before induction, after induction, 1 min, 3 min and 5 min after administration of suxamethonium. Although Suxamethonium laryngoscopy and intubation increased IOP in all the 3 groups there was significant reduced rise in IOP noted in dexmed group and clonidine group compared to study group (p=
Tushar R. Bagle, Vijay A. Vare, Alankar Nimgade, Rohankumar C. Hire, Yogesh Sharma, Prasita Kshirsagar
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2334-2342; https://doi.org/10.18203/2319-2003.ijbcp20174355

Abstract:
Background: India is expected to bear the burden of world’s greatest increase of diabetes population. This burden needs to be considered in terms of costs.Methods: Cross-sectional study was done in type 2 diabetes mellitus 100 patients that attended Medicine OPD. Prior to enrollment Institutional Ethics Committee permission was taken. Written Informed consent was taken. Demographic information related to Education, Occupation and Income was taken down. Also Information related to diagnostic tests and medications were documented. Inclusion criterion were 18-70 years of either gender diagnosed by Physicians in OPD as type 2 diabetes, willing to participate and have followed in OPD for at least one year. The Exclusion criterion was Critically ill or unconscious patients and Pregnant women. Direct and indirect costs were calculated.Results: The average age was 56.31±10.50 years. The average fasting blood glucose was 120.65±22.70mg/dl. The average cost per month for investigations was 159.74±128.06. Annual visit to OPD was 13.06±7.35. Time loss per visit was 5.62±1.29 hours and of accompanying person was 6.55±3.87 hours. There were 2 from Lower and 63 from Upper Lower socioeconomic class. There were 41 patients having diabetic complications. The indirect cost was around 5838.51 and direct cost was around 19925. Total cost per annum per patient was around 32361.27 INR.Conclusions: There is need for strategies to reduce the cost burden. There is also needed to design financial systems for diabetes related nationwide health programs.
Rama Mohan Pathapati, Manchi Rajesh Kumar, B. L. Kudagi, Madhavulu Buchineni
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174357

Abstract:
Background: The Hot Plate test is a thermal hyperalgesia model to assess the analgesic activity of many compounds. Traditional analysis compares reaction times with controls, reports only analgesic activity without considering escape reflex. Escape reflex to pain sensation also provides an indirect measure of analgesic activity. However, it requires repeated exposure of rats to hot plate. We explored the learning activities and escape behaviour of rats by calculating the change from baseline of reaction times.Methods: Male Wister strain albino rats, weighing between 150-200mg were used for assessment of hot-plate induced hyperalgesia. Author analysed the analgesic activity of aspirin (100mg/Kg) and compared with animals receiving saline. Aspirin and saline were administered 1hr orally before the commencement of the experiment. The reaction time was recorded at every 30 min up to 6hrs.Results: With traditional analysis, we can observe that the onset of action, peak action and duration of analgesic activity of aspirin was at 0.5, 2.0 and 5.0 hours respectively. Peak inhibition of reaction time was seen at 2 hours with a magnitude of 474%. When we applied a statistical procedure, absolute change from baseline statistics, we found that animals treated with aspirin also exhibited escape reflex after fading of drug response and animals treated with saline demonstrated early (0.5hr) escape behaviour from the hot plate and continued throughout the rest of the experiment.Conclusions: Change from baseline as an outcome illustrates escape behaviour of rats in hot plate method and it should be employed along with percentage inhibition during assessment of analgesic activity.
Ayesha Vaseem, Mazher Ali, Khuteja Afshan
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174356

Abstract:
Background: Tulsi (Ocimum sanctum L.) common household plant, a potent adaptogen has been used for its medicinal property for many years. It is known in Ayurveda as Incomparable one, Mother of medicine of Nature and The Queen of Herbs. The present study evaluated the stress induced anti-ulcer effect of tulsi leaves in albino rats.Methods: Albino rats were randomly, allocated to different experimental groups and aqueous leaf extract of Tulsi (Ocimum sanctum) is given for 7 days. Gastric ulcers were induced by cold restrain methods and results were compared with control using distilled water and standard drug Ranitidine.Results: The Anti-ulcer effect of aqueous extract of Tulsi was significant in a dose dependent manner with cold restraint model. The percentage of ulcer protection of Tulsi leaf extract at dose 100mg/kg is 68.85% and at dose of 200mg/kg showed 65.66% and the standard drug Ranitidine showed 78.23% ulcer protection which is significant (p <0.05).Conclusions: The study showed that when Tulsi (Ocimum sanctum) is given at dose 100-200mg/kg for 7 days i.e., pre-treatment in rats for anti-ulcer effect, it caused a significant reduction in the ulcer scores and ulcer index when compared with control group, as evidenced by the gross appearance and histological findings of gastric mucosa in rats. There were few signs of mucosal injury and the percentage of damage was less compared to control group. Serosal surface revealed very few dilated blood vessels and petechial hemorrhages and mucosal surface had few ulcers of varying sizes.
Rajiv Kumar Gupta, Parveen Singh, Renu Rani, Rashmi Kumari, Bhavna Langer
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174387

Abstract:
Background: The growing concern about antibiotic resistance, of late, led World Health Organization to declare it as World Health Day theme in 2011. Knowledge spreads awareness and understanding by melting the barriers of ignorance while attitudes and practices have a bearing on the health related behaviour. The present study aims at evaluating the knowledge, attitudes and practices of medical students towards antibiotic usage.Methods: The present cross-sectional study was conducted among the Pre-final medical students (6th / 7th semester) who participated in the questionnaire survey on knowledge, attitude and practice towards antibiotics usage. The data was analysed and Chi-square was used as test of significance.Results: Overall, 132 students were interviewed. Majority (96.2%) had heard of antibiotic resistance. About 22% of the sample stated that antibiotics can cure viral infections, among them female being in the higher proportion (p90%) agreed that antibiotic resistance is a serious problem and had positive attitude about population awareness campaign regarding antibiotic resistance. Among practices, higher proportion of male respondents preferred antibiotics in case of cough and sore throat. (p<0.05).Conclusions: Despite being Pre-final MBBS students, the results have revealed that knowledge and attitude of the respondents were not up to the desired levels. The practices regarding use of antibiotics were more or less adequate. For effective curriculum, thorough knowledge and rational prescription of antibiotics needs to be reinforced among medical students both before and during internship.
Ritu Bala, Harminder Singh, Rupali, Kuhu Verma
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174388

Abstract:
Background: Hypertension is the most prevalent cardiovascular disease and the relevant data suggest that the burden, risk factors and co-morbidities associated with the essential hypertension is increasing with every passing day. It is one of the major chronic diseases resulting in high mortality and morbidity in today’s world. Aim: The aim of the study was to compare effects of cilnidipine and amlodipine on the blood pressure (BP), heart rate and proteinuria among patients of hypertension with chronic kidney disease.Methods: 100 patients were included in this study. Patients were randomly assigned into two groups Group A and Group B (50 each). Group A: Patients received Cilnidipine (5-10mg/day). Group B: Patients received amlodipine (5-10mg/day).Results: No significant difference in SBP, DBP, MBP and proteinuria while comparing both the groups of patients taking cilnidipine and amlodipine at baseline i.e. 0 to 12 week, 12 to 24 weeks and 0 to 24 weeks. Cilnidipine caused decrease in HR 0 to 12 week (p value 0.001), 12 to 24 weeks (p value 0.001) and 0 to 24 weeks (p value 0.0001). Amlodipine had increased heart rate from baseline to 12 weeks (p value 0.0001), 12 to 24 weeks (p value 0.051) and 0 to 24 weeks (p value 0.001). No significant difference was seen in any biochemical readings.Conclusions: There was a significant change in all the parameters including BP, heart rate, proteinuria and other biochemical tests when they compared within the group but no significant difference while comparing both the groups.
Jayeshkumar P. Vaghela, Anupama Sukhlecha
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174386

Abstract:
Background: Sick and pre-term neonates are admitted in neonatal intensive care units (NICU) and treated. A great care needs to be taken to use drugs in neonates due to the immaturity of their body functions. There is a lack of standard drug prescribing guideline in children, especially neonates because; safety and efficacy for a majority of drugs have not been established in them. The objectives of the study were to evaluate the drug utilization pattern in NICU of a teaching hospital and to identify problems in drug utilization and suggest measures, if needed.Methods: A prospective, observational study was carried out in NICU for duration of one year. Demographic details like age, sex, birth weight, duration of hospitalization was recorded from the case files of neonates. The morbid condition, treatment with drugs and other supportive modalities were recorded. The outcome of treatment was also noted. WHO drug utilization core indicators were also evaluated.Results: Out of 623 admissions in NICU, 56% were males. There were 56% of neonates who were born pre-term. The maximum used drugs were Vitamin K (73%) and antibiotics (64%). The antibiotics were mainly from penicillin and aminoglycoside groups. Respiratory distress syndrome (19%) and neonatal sepsis (16%) were the most common causes for admission. Out of total admissions, 64% were discharged following recovery, while, 12% had expired.Conclusions: Drugs usage in neonates should be minimal and should be prescribed from essential drug list. Antibiotic policy needs to be formulated for hospitals to minimize antibiotic usage and prevent development of resistance.
, , Steven Aibor Dkhar, Vikneswaran Gunaseelan
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174353

Abstract:
Mitochondrion, “the power house” of the cell plays a vital role in generating energy for the intricate functions of the cells. Mitochondria also play important roles in various apoptotic pathways. Around 80-90% of the ATP generated in cells is contributed by these organelles through the process of oxidative phosphorylation. Though this process is essential for the functioning of cells it also generates various Reactive Oxygen Species (ROS), which are toxic to cells. Hence mitochondrial dysfunction is hypothesized to be an important factor in the occurrence of disorders related to aging such as neurodegeneration and malignancies. Several commonly used drugs in clinical practice exert their action by interacting with mitochondrial pathways. This review attempts to focus on the various groups of drugs which act on mitochondria and are utilized for therapy of conditions like cancer, diabetes mellitus, neurodegeneration and so on.
Vinay M., Seethalakshmi S., Vijay Kumar
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174385

Abstract:
Background: Ormeloxifene (Centchroman) is a Selective Estrogen Receptor Modulator (SERM) which acts as estrogen antagonist and having anti progestogenic activity also. It is being used in the management of dysfunctional uterine bleeding and as nonhormonal oral contraceptive. It is also being investigated for the indications such as osteoporosis, breast and endometrial carcinoma. In this study, we have evaluated the Antioxidant potential of drug by using DPPH and NO synthase Assay. It was found that ormeloxifene has significant antioxidant activity which could be cause for its use in various gynaecological and other conditions.Methods: In this study, we have demonstrated in vitro antioxidant activity of ormeloxifene. DPPH and NO synthase assay tests were done for different concentrations of ormeloxifene.Results: In our study, it showed that the free radical scavenging activity of ormeloxifene was less in lower concentration and increased in the higher concentration in DPPH assay. The free radical scavenging activity of drug ormeloxifene was 22% at 100µg/ml and 27% for the concentrations of 1000µg/ml in DPPH assay. No scavenging activity was 3% at 100µg/ml and 11% at 1000µg/ml.Conclusions: The invitro antioxidant analysis of ormeloxifene, was proved to be a potent antioxidant.
, Suresha R. N., Jayanthi M. K., Satish A. M., Kalabharathi H. L., Pushpa V. H.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174378

Abstract:
Background: Oringaoleifera is a widely used plant with high medicinal value, well known for its pharmacological actions and is used in various conditions. It has been reported to have many biological properties like anti-inflammatory, antimicrobial, antispasmodic, antitumour including antidiabetic activity.Methods: The study was carried out in Wistar albino rats with body weight 150-250gms. Diabetes was induced by injecting Streptozotocin intraperitoneally- dose 55 mg/kg BW. Animals were divided into 5 groups with 6 animals in each group. First group (Control) was given 2% gum acacia. Other 4 groups were induced diabetes by giving Streptozotocin. Diabetic control group received gum acacia (0.5 ml), Standard group received Glibenclamide (0.5mg/kg BW), Test group received Moringaoleifera extract (300mg/kg) and Test+ Standard group receiving combination of Moringaoleifera and glibenclamide at half the above doses. All drugs were given orally for 28 days and blood glucose levels analyzed using Glucometer on Day 0 before drug and on D1, D3, D7, D14, D21, and D28. Data were statistically analyzed by ANOVA and Tukey‘s Post Hoc test.Results: Hypoglycemia produced by Moringaoleifera extract was significant (p<0.001) when compared to diabetic control group from day 7 to day 28. The percent reduction of blood glucose level was 52.9% as compared to Glibenclamide group 61.3%. The combination group also showed significant hypoglycemic activity the percentage reduction being 56.44%.Conclusions: Thus, Moringaoleifera decreased blood glucose level efficaciously as compared to diabetic control group and similar to standard group at p<0.001.
Sushma V. Naidu, Harsha R., Jyothsnya S.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174382

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Background: To evaluate the anti-convulsant activity of ethanolic extract of Moringa oleifera (Drum stick leaves) in seizure induced albino mice and to compare it with standard drug Sodium valproate.Methods: Swiss albino mice of either sex weighing around 25-30g were randomly selected and divided into four groups of six mice each. Group 1: control- treated with gum acacia. Group 2: Standard - Valproic acid 40mg/kg body weight. Group 3: T1- ethanolic extract of Moringa oleifera (150mg/kg). Group 4: T2 - ethanolic extract of Moringa oleifera (300mg/kg). All drugs were administered orally one hour prior to induction of seizure. The anticonvulsant activity was screened using maximal electroshock seizure (MES) model and pentylenetetrazole (PTZ) model.Results: Results were analysed by ANOVA followed by Bonferroni’s post hoc test. Abolition of Tonic hind limb extension was taken as the protective end point against MES induced seizures and prolongation of seizure latency in PTZ model.At both the doses the ethanolic extract of Moringa oleifera significantly (p value <0.05) reduced the duration of hind limb extension in MES test and also significantly (p value <0.05) delayed the onset of clonic seizures in PTZ induced convulsion when compared with control group.Conclusions: On comparing the percentage protection offered by Moringa oleifera leaves against both MES and PTZ model, it possesses significant anticonvulsant activity at both doses, with more efficacy at 300mg/kg BW indicating that the test drug can prove a very promising drug for treatment of epilepsy. Further studies are required for isolation and identification of the active constituent.
A. M. Praharsheta, Vanitha Samuel, P. Nirmala
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2487-2490; https://doi.org/10.18203/2319-2003.ijbcp20174381

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Background: Renal dysfunction arises as a result of exposure to medicines, industrial or environmental chemicals. Cisplatin is a major antineoplastic drug used for the treatment of solid tumors. Its chief dose limiting side effect is nephrotoxicity; 20% of patients receiving high-dose cisplatin have severe renal dysfunction. Ebselen a promising antioxidant, was used to explore the nephroprotective effect.Methods: The rats were divided into five groups; each group consisting of 6 animals. The experimental design included one control group and four experimental groups. The study was carried out for a period of 7 wks. The test drug Ebselen in group 4 and 5 and the reference standard drug Amifostine in group 3 was administered once a week intraperitoneally for 5 weeks. Nephrotoxicity was induced by cisplatin (5mg/kg IP) in the 6th week, following this the drug Amifostine in group 3 and Ebselen in group 4 and 5 will be continued twice a day for 5 consecutive days post induction. Urine samples were collected and sent for determination of urine creatinine and albumin.Results: The Urine creatinine level and albumin level estimation in group II show significant renal damage as compared to control group. The statistical reduction in urine creatinine and urine albumin level in Ebselen treated group I (10mg/kg), Ebselen group V (20mg/kg) as compared to Cisplatin group II show a potential reduction in renal damage. Ebselen treated group V showed a reduction in urine creatinine and urine albumin as same as in group III.Conclusions: This study brings to a close that Ebselen lessens Cisplatin induced renal damage.
Majid F. Bhat, , Manoj Goyal
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174377

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Background: Preventive treatment has an important role in the management of migraine. Propranolol and flunarizine have been used for more than two decades while, open-label, controlled studies suggest divalproex sodium may also be efficacious for migraine prevention. The objective of the study to compare efficacy and safety of propranolol, flunarizine and divalproex sodium in patients for migraine prophylaxis.Methods: Following approval from IEC a 12-week randomized, open, comparative study was carried out at the outpatient department of Medicine. Patients between 18 to 65 years, with history of 3 to 12 migraines a month (IHS) for six months were included. Patients were divided into three groups of 30 patients to receive - propranolol 20 to 160mg/day; flunarizine 5 to 10mg/day or divalproex sodium 250 to 750mg/day, for three months.Results: Total 90/116 patients completed the study. No significant differences were found between the groups with regards to mean age or other baseline migraine features. All the drugs significantly decreased the frequency, duration and severity of migraine (P<0.001). There is no statistically significant difference between propranolol, flunarizine and divalproex sodium for any of the efficacy parameters. All the three treatments were well-tolerated and safe.Conclusions: All the three study drugs were equally effective with an acceptable tolerability profile, Divalproex sodium group showed more side effects, none of which were serious. However, further studies with larger number of patients and longer duration of treatment are recommended.
Vikrant Panwar, B. L. Pandey, U. S. Dwivedi, Alok Singh
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2452-2458; https://doi.org/10.18203/2319-2003.ijbcp20174375

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Background: Benign Prostatic Hyperplasia (BPH) is one of common disorder in men of old age group. The pathogenesis of BPH is multi-factorial and still not been fully elucidated. There are numerous reports which suggest possible link between several metabolic alterations known as Metabolic Syndrome. In the present study, the aim was to establish relation between Benign Prostatic Hyperplasia and Metabolic Syndrome and to find out effects of therapeutic intervention of Metabolic Syndrome on prostatic parameters.Methods: 93 patients of Benign Prostatic Hyperplasia enrolled who met qualifying criteria for inclusion in study and divided into three groups on the basis of Metabolic Syndrome and its treatment administered. Administration of alpha adrenergic blocker was common to all patients of all groups. Metabolic parameters including Fasting blood glucose, High-density lipoprotein (HDL), Triglycerides (TGs), waist circumference and prostatic parameters that is prostate volume, prostate specific antigen (PSA), uroflometry, International prostate symptom score (IPSS) were assessed at baseline, after 3 and 6 months follow-up. Further appropriate statistical tests were applied for comparison of parameters among groups.Results: Patients receiving no treatment for Metabolic Syndrome were having most deranged prostatic parameters as compared to patients without Metabolic Syndrome or patients with Metabolic Syndrome receiving treatment for same. Further patients receiving treatment for Metabolic Syndrome and alpha adrenergic blocker were having better clinical profile than patients of alpha adrenergic blocker alone.Conclusions: These findings show probable link between Metabolic Syndrome and worse prostatic profile. Metabolic Syndrome must be looked for and treated in patients of Benign Prostatic Hyperplasia. Metabolic derangements must not be overlooked and must be treated accordingly.
S. K. Narendra, N. C. Sahani, Upendra Das, S. Tripathy
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174374

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Background: Oral viral lesions associated with HIV infection are important since they affect the quality of life of the patient and are useful markers of disease progression and immunosuppression. The purpose of this study was to correlate the persistence of herpetic gingivostomatitis lesions with the current CD4+ T cell count for adherence of HIV-infected individuals to anti retroviral therapy (ART) and antiviral therapy.Methods: 302 HIV +ve patients developing oral ulcers were included in this study. The herpes simplex viral infections associated with the oral manifestations were detected through Immuno histochemical staining. The quantitative analysis of oral ulceration was done by using mucositis index.CD4T cell count was correlated with clinical manifestations of extensiveness of oral ulcers, acute febrile condition and other constitutional symptoms during follow up of cases for the treatment with anti viral therapies.Results: Association of herpes simplex viral infections was found in 72 out of 302 HIV+ ve cases. All the HSV +ve patients developed extensive oral mucsal lesions during the 1st week. Extensive lesions developed within 7 days in patients with CD4 count 500, manifestation of mucosal ulcers due to acute herpetic gingivostomatitis was limited to a period of 1 to 2 weeks. Patients with CD4 count >200 <500 did not follow a definite pattern.Conclusions: Persistent oropharyngeal mucosal ulcers along with acute febrile condition due to herpes simplex virus infection are associated with low CD4 T cell count in HIV + patients under antiretroviral therapy.
Ujwala P. Gawali, Harshad V. Kesari, Komal S. Gawand
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174371

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Background: Monitoring adverse drug reactions (ADRs) helps in alerting physicians and developing strategies to prevent and minimize the risk of developing ADRs. Data regarding pattern of ADRs due to psychotropic medications is scanty. Hence, the study was planned to assess ADRs among psychiatry outpatients of a tertiary care hospital in Maharashtra.Methods: A prospective, observational study was conducted in psychiatry outpatient department of a tertiary care centre for 3 months. Cases were enrolled by active and passive surveillance after obtaining informed consent. Demographic details, adverse event details, history of medications were recorded. Pattern of ADRs was studied according to demographic parameters, drug class, organ system affected, causality (WHO - Uppsala Monitoring Centre Scale) and severity (modified Hartwig and Siegel Scale).Results: Out of total 1200 patients screened, 77 qualified the inclusion and exclusion criteria and 92 ADRs were reported; overall incidence rate of 6.41%. Maximum ADRs were reported in the age group of 31- 40 years. 63.63% subjects received more than 2 psychotropic drugs. Among 24 types of ADRs observed, tremor (13.04%) was the commonest, closely followed by somnolence. Antipsychotics (45.65%) were most frequently incriminated and central nervous system (46.73%) the most often affected. Trifluoperazine (11.96%) was the commonest drug, followed by olanzapine and haloperidol (10.53% each). Causality analysis yielded 66 ADRs as “probable” and on severity analysis 80.43% were mild.Conclusions: The study provides an insight into pattern of ADRs in psychiatry outpatients. It is prudent to communicate this to treating physicians as well as counsel patients (and caregivers). Initiatives and concerted efforts involving all stakeholders in healthcare can go a long way in decreasing drug-related morbidity and health costs.
Smita L. Gaidhankar, Jaiprakash B. Ramanand, Parashram G. Kadam, Ajitkumar M. Zende, Rama R. Bhosale, Nitin N. Puram
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2401-2407; https://doi.org/10.18203/2319-2003.ijbcp20174367

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Background: Hypertensive disorders of pregnancy are an important determinant of drug use during pregnancy. The aim of study was to assess the clinical outcome and evaluate drug utilization according to WHO core drug prescribing indicators in hypertensive disorders of pregnancy.Methods: This prospective, observational study in a tertiary care hospital was conducted in 150 pregnant women with hypertensive disorders of pregnancy from January 2014 and December 2014 who fulfilled the inclusion criteria. Antepartum and intrapartum care and the maternal and perinatal outcome were noted. The data was analyzed to evaluate clinical outcome and drug utilization according to WHO core drug use indicators.Results: Gestational hypertension was most common among hypertensive disorders of pregnancy seen in 62/150 (41.3%) women. The most common symptom was headache (48%) while sign noted was edema (69%). A total of 66% women had preterm delivery and 42% babies weighed less than 2.5 kg. Average number of drugs per encounter was 9.7. Percentage of drugs prescribed by generic name and from essential drug list was 64% and 79% respectively. The most commonly used drugs were vitamins and minerals prescribed in 100% patients followed by antihypertensive drugs (92%). The most common antihypertensive used were calcium channel blockers and anticonvulsant was magnesium sulphate.Conclusions: There was increased maternal and perinatal morbidity and operative intervention among pregnant women with hypertensive disorders of pregnancy. Most of the drugs were used appropriately and were in accordance with standard guidelines. The important problems identified were inappropriate use of antimicrobials, use of sublingual nifedipine and use of brand names in 1/4th of prescriptions.
Rohini Gupta, Pavan Malhotra
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174376

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Background: Pharmacoeconomics identifies, measures and compares the costs and consequences of drug therapy to health care systems and society. The per capita income of all middle class people is limited and the drug prices are growing extensively. Therefore, it is the responsibility of the health-care professionals to balance both cost and quality of treatment. Hence, this study was planned among the postgraduate students who form the major part of health care delivery system to assess their awareness about pharmacoeconomis.Methods: This was a questionnaire based cross-sectional study. Self-administered questionnaire was distributed among 72 residents, out of which 61 completely filled questionnaires were finally used for statistical analysis. The questionnaire contained questions relating to awareness, knowledge, method of application and students’ attitude about pharmacoeconomics.Results: The willingness to participate in the study among postgraduates was extremely poor. Those who have participated, almost 39% of participants were having awareness about the topic. Nearly 31 % of the participants were having knowledge regarding pharmacoeconomics and around 21 % of participants have learnt the method of application in various aspects.Conclusions: Study has revealed that that the knowledge and perception level of postgraduates in day to day use of pharmacoeconomic concepts are poor and limited. Therefore, it is very necessary to make them aware about the concept of pharmacoeconomics by incorporationg it in their medical curriculum and by conducting CMEs and Workshops on pharmacoeconomics.
Bhuvaneswari K., Jeyalakshmi D., Umamaheswari A.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174370

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Background: Achievement of goals of rational use of medicine (RUM) in the community is not possible without participation of community pharmacists. Pharmacists must know that they are the main tool to educate and spread information on rational use of medicine in the community. This background enabled this study to observe the knowledge, awareness and attitude of the community pharmacists towards the rational use of medicine. Aim and Objectives were to assess the knowledge and awareness among community pharmacists about rational drug use in and around Coimbatore.Methods: It was a cross sectional observational study using a preformed questionnaire. Study participants were 215 Community Pharmacists (those are registered pharmacist running standalone pharmacy stores not affiliating to any institutions /hospitals/not a part of a large chain of stores) inside (115 Pharmacist) and around (100 Pharmacist) Coimbatore city. Questionnaire was given to them and results were analyzed and expressed in percentage at the end of the study.Results: Comparing the awareness about RUM in the community pharmacists in and around Coimbatore was found with the results which was almost equal or less in terms of dispensing medicines without prescription, issuing medicines to outdated prescription, educating the public about ADR etc.Conclusions: This study ensure the need of the community pharmacist participation for the development of a clear educational policy on promoting rational use of medicine involving all segments of health care system to ensure the community benefit and safety.
Himanshu Sharma, Saurabh Chauhan, Punya Pratap Singh, Raj K. Goel
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2388-2394; https://doi.org/10.18203/2319-2003.ijbcp20174365

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Background: The aim to study and elucidate the healing effects of ethanolic extract of dried whole plant of Bacopa monniera against experimental colitis in rats.Methods: Bacopa monniera whole plant extract was administered orally, once daily for 14 days, to rats after induction of colitis with acetic acid. We studied its effects on: faecal output, food and water intake, and body weight changes and also examined colonic mucosal damage, inflammation and status of antioxidants: superoxide dismutase, reduced glutathione; free radicals: nitric oxide, lipid peroxidation on 15th day of the experiment. Antibacterial activity of the extract was also studied using in vitro procedures. Statistical comparison was performed using either unpaired ‘t’ test or one -way analysis of variance (ANOVA) and for multiple comparisons versus control group was done by Dunnett’s test.Results: Bacopa monniera whole plant extract decreased colonic mucosal damage, inflammation, faecal output and increased body weight in acetic acid induced colitis. It also showed antibacterial activity and enhanced the antioxidant but decreased free radicals. Acute toxicity study indicated no mortality or other ANS or CNS related adverse effects even with ten time effective dose indicating its safety.Conclusions: Bacopa monniera whole plant extract is safe, effective and could be beneficial as a complementary agent in treatment of ulcerative colitis.
Mahesh N. Belhekar, Tejal C. Patel, Prasad R. Pandit, Kiran A. Bhave
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174366

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Background: In the year 2016, Government of India had banned 350 fixed dose combinations (FDCs) for the safety and efficacy purpose. The present study was conducted to assess the knowledge, attitude and practices of the clinicians and residents about the use of FDCs at a tertiary care hospital.Methods: A questionnaire based study was conducted at a tertiary care hospital after getting approval from institutional ethics committee. A pre-validated questionnaire comprising of 30 items was distributed to 100 participants. The questionnaire focused on the prescribing behaviour, knowledge on therapeutic efficacy, advantages and limitations of FDC use, clinician perception regarding FDC use and the strategies to improve the awareness about the regulatory updates of the marketed drugs.Results: Total 52/100 clinicians responded. Out of these, 88% prescribed FDCs in their practice, 62% prescribed FDCs only after ensuring therapeutic efficacy and 50% prescribed WHO approved FDCs. 64% were aware of the recent ban on some FDCs by DCGI. Internet was the most common source of latest updates on the regulatory status of the drug, as stated by 55% clinicians. All clinicians agreed that efforts are needed to ensure that prescribers remain up to date about the post-marketing regulatory status of the drugs.Conclusions: Even though many clinicians prescribe FDCs regularly, they appreciated the step of banning some FDCs; however, the clinicians need to be trained to update themselves regularly. The source and relevance of these updates should be taught to the undergraduate students during their training period which can be reemphasized during post graduate training period.
, Abhishek Bhattacharjee, N. Meena Devi
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174364

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Background: Paediatric antibiotic prescription is a major concern in terms of public health since infections are the most frequent cause of childhood disease. The aim of this hospital-based cross sectional study was to assess the pattern of antibiotic use in the paediatric ward of RIMS hospital, Manipur, India.Methods: A retrospective study of six months duration was carried out for the month of October 2016 to March 2017. A total number of 200 patients case sheets were utilized for our study from paediatric in-patients department of RIMS hospital, Manipur. The data collected was then analysed for various prescribing indicators as laid down by world health organisation (WHO) for analysis of drug use parameters.Results: The mean age of paediatric patient was 2.1 years. The average number of drugs per encounter was 5.14. The average number of antibiotic per patient was 2.11. In present study antibiotic were 41% of total drugs prescribed. Most common prevalence of disease among study patients sample was acute gastroenteritis. The most commonly prescribed antibiotic was Ceftriaxone followed by Amikacin. In present study 8.2% of antibiotics were prescribed in generic name. Polypharmacy was evident from the study.Conclusions: Antibiotic prescribing in children is relatively high in RIMS, Imphal, Manipur. Prescription of broad-spectrum antibiotics though has increased demonstrably which h may result in development of bacterial resistance; however, development of guidelines for antibiotic prescription and use of appropriate drugs for the disease can result in minimizing the unfavourable use of antibiotics in children.
Rajnish Raj, Nisha Bhagat
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174390

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Drug Induced Liver Injury (DILI) is one of the leading causes of liver damage worldwide and raises concerns about its prescription in lieu of the limited drug options available for the depression. Venlafaxine (VEN) is an antidepressant with dual neurotransmitter receptor modulations i.e., serotonin and norepinephrine reuptake inhibitor (SNRI) and having an additional benefit in management of vasomotor symptoms especially in menopausal patients where hormone replacement therapy (HRT) is contraindicated. VEN induced hepatotoxicity have been reported to occur in less than 1% of patients. Until now, less than 11 cases of VEN-related liver injuries have been reported in literature. We hereby, report a rare case of VEN induced liver injury in a 40-year-old breast cancer survivor with co-morbid depression.
Y. Nisha Maheswari, B. Meenakshi, V. Ramasubramanian D. M., J. Ezhil Ramya
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174380

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Background: Cilnidipine is a dual blocker of L type and N type calcium channel and dilates both afferent and efferent arterioles. Hence it increases renal blood flow and reduces glomerular pressure ultimately reducing proteinuria. Thus, it may exert renoprotective effects. The present study was designed to compare the antiproteinuric effects of cilnidipine and amlodipine in hypertensive patients with chronic kidney disease as add on therapy to patients on losartan.Methods: This is a randomized, open label, prospective, parallel group study conducted in the out patient Department of Nephrology. The trial enrolled Diabetic CKD patients with hypertension and with spot urine protein creatinine ratio (PCR) ≥0.2 who were being treated with T. Losartan 50mg/day for >2 months. The subjects were then randomly assigned to 2 groups to receive either cilnidipine 10-20mg/day (Group A-46) or amlodipine 5-10mg/day (Group B- 50). The drugs were given for a duration of 6 months for each patient. The dose of losartan (50mg/day) was not adjusted throughout the study.Results: After 6 months, a significant reduction in systolic and diastolic blood pressure was seen in both the groups. The decrease in urinary protein creatinine ratio was significantly higher in cilnidipine group rather than amlodipine group. Thus, cilnidipine exerted greater antiproteinuric effect than amlodipine.Conclusions: Cilnidipine has antihypertensive effect equivalent to amlodipine but addition of cilnidipine rather than amlodipine to losartan decreased urine protein excretion in diabetic chronic kidney disease patients.
Surendra Gupta, Salikram Poudel, Anil P. Gupta, Basanta Bashyal, Bishal Baskota, Anil K. Sah, Subash Pandaya, Dhiraj Shrestha
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2303-2310; https://doi.org/10.18203/2319-2003.ijbcp20174354

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Background: This survey was designed to assess and evaluate the prescribing pattern of antibiotics used in patients suffering from ENT (Eye, Nose, and Throat) infections in ENT outpatient departments (OPD) at Manipal Teaching Hospital (MTH), Phulbari, Pokhara, Nepal.Methods: A prospective cross-sectional study was conducted in out-patients of ENT department at MTH for 6 month in which a total of 216 prescriptions were observed randomly and data filled patient profile forms were collected and analyzed.Results: Out of 216 patients, 126(58.33%) were male and 90 (41.67%) were female. Patients of age group 21-30 were maximum (29.16%) followed by age group of 11-20 (22.22%). Only 6.7% of drugs were prescribed from their generic names. Data analysis revealed that about 72.24%, 24.53% and 3.23% of prescription contained one, two and three antibiotic drugs respectively. All together 970 drugs were prescribed in 216 prescriptions out of which 251 (25.87%) were antibiotics drugs. This suggested that the average no. of antibiotics per prescription was 1.16. Among prescribed antibiotics, Amoxicillin (7.56%) of penicillin group, Azithromycin (8.36%) of macrolides, Cefuroxime (9.56%) of 2nd generation cephalosporin followed by Cefpodoxime (32.27%) of 3rd generation cephalosporin and Ofloxacin (6.37%) of quinolones group were frequently prescribed. From analysis, we found that other concomitant medications were also prescribed such analgesics, antihistamines, PPI (Proton Pump Inhibitors) and vitamins, minerals and dietary enzymes. The prescribed antibiotics accounted for large percentage of oral dosage forms (89.90%) followed parental injection dosage forms 5.05%.Conclusions: Prescribing more than one antibiotics was commonly encountered indicating the occurrence of polypharmacy which were based on empirical therapy without any culture and sensitivity test report. Therefore, local hospital culture sensitivity database for ENT infections has to be developed and prescribing with generic name from existing essential drug list or formulary should be encouraged for rational drug therapy.
Nalini R.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174362

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Background: Adverse drug reactions are important in psychiatry practice like any other branch of medicine. Adverse drug reactions associated with psychotropic drugs causes either noncompliance or at times discontinuation of therapy. The objective of the study was to evaluate the incidence and nature of adverse drug reactions in psychiatry outpatient department and to assess the causality and severity of the documented adverse drug reactions.Methods: Prospective observational study was done in the psychiatry outpatient department. All the patients were interviewed for basic details, history of medications and relevant history for adverse drug reactions. The causality, severity and modes of management assessment of the documented adverse drug reactions were done.Results: 2,727 patients attended psychiatry outpatient department, of which 582 patients developed at least one adverse drug reaction. The incidence of adverse drug reaction observed to psychotropic drugs was 21.34%. Majority of adverse drug reactions were seen with antidepressants 298 (10.93%) followed by antipsychotics 187 (6.86%), sedative hypnotics, anticonvulsants and antimanics. The most common adverse drug reactions were sedation 3.44%, weight gain 3.04%, and extrapyramidal symptoms 2.79%. Reported adverse drug reactions were assessed for causality and maximum belonged to probable (15.6 9%). The severity assessment of the reported adverse drug reactions revealed that most of the adverse drug reactions were mild (16.83%) in nature and majority of patients were made to continue the same treatment.Conclusions: Active monitoring of adverse drug reactions in psychiatry outpatient department can help in early detection and management of adverse drug reactions.
Shephali Singh, Nilam Nigam, Shalini Gupta, Shravan Kumar
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174372

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Background: Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia. In majority of patients oral hypoglycemic drugs remain the primary agents in management of DM. Currently there are variety of new drugs are approved in management of DM of which safety is established in clinical trials but there surveillance is needed for reporting newer adverse effects which are not documented yet.Methods: 112 patients were screened with the help of a predefined inclusion and exclusion criteria for the study and followed up for three months. The drugs which are relatively new and have been in the market for around 5-7 years were taken as new drug. These include specifically the following drugs: DPP-IV Inhibitors, PPAR α/γ agonist, SGLT-2 inhibitors. They were screened and investigated suitably for any ADRs. The severity of the adverse drug reactions was graded according to the Hartwig’s Severity Assessment Scale and Naranjo Scale was used for causality assessment between the drug and suspected reaction.Results: Maximum ADRs reported belonged to gastro intestinal system (53%). DPP-IV inhibitors showed maximum number of ADRs i.e. 70.6%. Majority of ADRs reported were mild i.e. 52.9%. Overall 15.2% patients reported ADRs. Majority of ADRs reported (70.6%) belonged to category ‘possible’.Conclusions: All three class of newer oral hypoglycemics seems reasonably safe to be used in general practice. As the number of patients were small, we need larger study to substantiate the findings.
Nikhil Era, Shatavisa Mukherjee, Bibhuti Saha, Santanu Kumar Tripathi
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2500-2506; https://doi.org/10.18203/2319-2003.ijbcp20174384

Abstract:
Background: Recently, the National Aids Control Organisation (NACO) in India advocated and recommended the use of tenofovir, lamivudine and efavirenz as a fixed-dose combination in initiating ART in all future treatment-naïve patients. The present study was thus undertaken to assess the nature and extent of safety concerns with this regime.Methods: A prospective observational study was carried out in the outpatient setting of nodal ART centre of Eastern India. A total of 242 patients on various ART regimens were studied for suspected ADRs over one year. Adverse event history, medication history and other relevant details were captured. Causality and severity of each reported ADR were duly assessed.Results: Out of 242 PLHIV put on this regimen, 75 patients did not encounter any adverse reactions during the entire study period. Out of remaining 167 patients who presented with a total of 451 ADRs, maximum ADRs were attributed to various psychiatric disorders which included insomnia, dizziness, drowsiness etc, which were followed by gastrointestinal disorders including anorexia, flatulence, nausea, vomiting etc. Dermatological complications included rashes, itching, SJS, pigmentation of nails, skin hyper pigmentation respectively.Conclusions: The study enables to obtain information on the pattern of adverse drug reactions associated with treatment naïve PLHIV put on first line antiretroviral regimen comprising of once daily dosing of tenofovir, lamivudine, efavirenz. Need of intensive monitoring for ADRs in ARTs followed with proper patient counselling regarding its nature can lead to better compliance to the therapy.
Rajeev Mishra,
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2372-2374; https://doi.org/10.18203/2319-2003.ijbcp20174361

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Background: Pain is an unpleasant sensory and emotional experience which is associated with actual or potential tissue damage or described in such terms. NSAIDs are most commonly prescribed drugs for the treatment of pain and inflammation and is most commonly prescribed drug around the world. NSAIDs are also most commonly used drug over the counter. Present study was done to evaluate the prescription pattern of analgesics and to assess the rational use of conventional non-steroidal anti-inflammatory drugs (NSAIDs), selective cyclooxygenase-2 (COX-2) inhibitors, and opioid analgesics.Methods: Present study was Cross sectional study, done at outdoor department of Orthopaedics at T.S. Misra Medical College and Hospital, Lucknow during January 2017 to April 2017 in a pre-designed and pre-tested proforma. Both male and female patients, above the age of 18 years, who were willing to participate in this study were enrolled. Samples of 253 prescriptions were screened randomly and verbal informed consent was taken. Data were analysed using MS Excel 2007 and summarized as counts and percentages. Statistical analysis was not done as it was a descriptive study.Results: Most commonly prescribed analgesics were non-selective NSAIDs followed by selective COX-2 inhibitors. Most commonly prescribed FDCs combination was diclofenac with paracetamol.Conclusions: This study shows that diclofenac is the most frequently prescribed analgesic in orthopaedics OPD at this hospital. The extensive use of irrational FDCs must be curtailed. We observed in present study that most of the prescriptions were rational. But there are scopes for improvement by introducing appropriate educational intervention for rational prescribing.
Bhanuja Bhagwat, Anuradha H. V.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174360

Abstract:
Background: β lactam antibiotics are commonly prescribed groups of antibacterial drugs for various infections however the prevalence of its allergic effects is not clear in our country, hence the need for an effective diagnostic protocol to determine immediate hypersensitivity reactions. The objective was to formulate a diagnostic protocol for evaluating immediate drug hypersensitivity to β lactam antibiotics.Methods: A prospective study was conducted at a tertiary care hospital. Adults who were prescribed any class of β lactam antibiotic were included. Non irritating concentrations of the antibiotic as per The European Network on drug Allergy were used. A strict three step diagnostic algorithm with skin prick test followed by intradermal test and drug provocation test, with 20 minutes observation period between each step, to determine cutaneous allergic reactions was followed.Results: The most commonly prescribed drug was cefazolin, followed by ceftriaxone, and cefoperazone + sulbactam combination. The culprit drugs were ceftriaxone in 4 (4.7%) patients, followed by piperacillin + tazobactam combination in 3 (3.5%), amoxicillin + clavulanic acid in 2 (2.3%) and 1 (1.1%) each for cefotaxime and cefepime + tazobactam combination. No patients were positive for skin prick test; 2.4% were positive for intradermal test and 10.6% were positive for drug provocation test.Conclusions: This diagnostic protocol is apt to adequately diagnose immediate reactions to β lactam antibiotics and henceforth can be used effectively in India. However, the skin prick test may be excluded but the intradermal test and drug provocation test is crucial to identify these immediate reactions.
Meena K. N., Dwajani S., Nagaraj T. M.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174363

Abstract:
Background: Hearing loss is the most common sensory deficit in humans today. In India, as per WHO there are approximately 63 million people, who are suffering from significant auditory impairment and estimated prevalence at 6.3% in Indian population. The objective of the study was to determine the potential hearing loss in patients on analgesics.Methods: Prospective, observational study examined the association between analgesic use and potential hearing loss in 30 patients receiving NSAIDS. Data was collected using specialized designed case record form. The clinical signs like onset of tinnitus, appearance of another sound that didn't exist before, sinus infection or a respiratory illness, development of vertigo or spinning sensation were looked for. Audiometry test was advised for all the patients receiving analgesics.Results: Total of 30 patients were included in the study. Male predominance was noted Maximum patients were in the age group between 35-45 years (33.33%). The socioeconomic status was analyzed using revised kuppuswamy scale. 30% (n=09) of patients were in lower class. Majority of the patients were reported with road traffic accidents (n=19; 63.33%) and received analgesics for more than 2 weeks. Patients received different combination of NSAIDs among which aceclofenac was most commonly prescribed. 11 (36.66%) patients had hearing loss received either diclofenac or aceclofenac for more than 25 days.Conclusions: Regular usage of NSAIDS may increase the risk of hearing loss and the impact could be larger on younger individuals. Hence, extra precaution to be taken while prescribing NSAIDS.
Santosh Kumar, Chakrapani Cheekavolu, P. Leela, Simhadri V. S. D. N. A. Nagesh, N. Jagan
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2496-2499; https://doi.org/10.18203/2319-2003.ijbcp20174383

Abstract:
Background: The global scenario, human beings are using various forms of treatment for relief of pain; among them, medicinal plant products have gained popularity because of its wide range of use and less side effects.Methods: Adult Albino rats of either sex were selected and divided into 5 groups. The Eddy’s hot plate was used and maintained temperature (55±0.5ºC), the animals were placed on the hot plate and the time taken for paw licking or jumping was recorded and considered as nociceptive response. The reaction time was observed on 0, 30, 60, and 90 minute.Results: The hot plate reaction time in sec was collected in the intervals of 0, 30, 60 and 90 minutes in all groups. Reaction times as follows: group III (Cissus quadrangularis Linn.) were 2.18±0.04, 3.13±0.05**, 5.83±0.05**, 5.39±0.04**; Group IV (Zingiber officinale Rosc.) were 2.12±0.03, 4.13±0.04**, 7.43±0.07**, 7.16±0.06**; Group V Cissus quadrangularis Linn+ Zingiber officinale Rosc.) were 2.21±0.75, 4.67±0.98**, 8.15±0.89**, 9.02±0.75**; Group II (Dexamethasone) were 2.14±0.05, 5.53±0.05**, 8.14±0.06**, 10.08±0.10** respectively, Results are presented as mean±SEM, (n=6), *p
Dulcie Celia A., Mohamed Thajudeen S., Meenakshi B., Ezhil Ramya J.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174368

Abstract:
Background: India has 2.1 million of people living with HIV, and places in third-largest population of people infected with the HIV after South Africa and Nigeria. It is thus important for health care providers including medical, nursing and paramedical students to have adequate knowledge on PEP for HIV to protect themselves prior to starting their life long career.Methods: Cross-sectional study was conducted among 200 medical, nursing and paramedical students in Tirunelveli medical college from December 2016 to February 2017. A pre-designed questionnaire was used to collect data. Results were summarized in percentages and presented in tables.Results: A total of 96 (48%) males and 104 (52%) females responded in the study. Though many (87%) had heard about PEP, just 31 (15.5%) had received formal training on PEP for HIV. Only 81 (40.5%) knew the ideal PEP regimen and 88 (44%) knew the correct drug regimen. The majority 196 (98%) considered PEP was important and significant 178 (89%) considered themselves to be at risk of acquiring HIV at work, with 46 (23%) having experienced an exposure in the past. Of those exposed, only 21 (45.7%) received PEP.Conclusions: This study shows that knowledge, attitude and practice towards PEP for HIV is inadequate. A formal PEP training centre with proper guidelines is recommended for medical, nursing and paramedical students.
, Thresiamma K. Thomas, Savithri P., Rajalakshmi A. N.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174379

Abstract:
Background: All medicines with an ability to produce a desired therapeutic effect will also have the potential to cause unwanted adverse effects. It has been established that ~ 2.9%-5.6% of all hospital admissions are caused by Adverse drug reactions (ADRs) & as many as 35% of the hospitalized patients experience an ADR during their hospital stay. An incidence of fatal ADRs is 0.23%-0.41%. In some countries, ADRs rank among the top 10 leading causes of mortality. In order to increase awareness, observe the pattern of ADRs and communicate scientific data to prevent ADRs, this study was undertaken.Methods: It was a prospective observational study conducted at a tertiary hospital in Kochi. All the spontaneously reported ADRs were assessed and analyzed for type, severity and causality.Results: A total of 120 ADRs were reported during the study period. Most of the ADRs were seen in females in the age group of 61-70 years. Skin and appendage disorders were the most common manifestation of different type of ADRs (49.2%). Antineoplastic and immunomodulating agents (30.8%), followed by anti-infectives for systemic use (29.2%) were mostly implicated in the causation of ADRs. Majority of the ADRs were of mild to moderate in severity (89.2%).Conclusions: Although small, but significant number of patients had severe ADRs. Hence, we require a robust system for monitoring the medication use process. So that we can prevent and reduce the morbidity and mortality due to therapeutic agents.
C. Prabhakar Reddy, Uday Kumar Chiranjeevi, Chandrasekhar N., Kiran Kishore K., Kishan P. V.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174157

Abstract:
Background: Diabetes Mellitus is a systemic metabolic disorder associated with Endothelial dysfunction and increased systemic inflammatory state with oxidative stress leading to increased Cardiovascular risk. This study planned to correlate the level of Endothelial dysfunction with oxidative stress and inflammatory status.Methods: Study was conducted in 60 Diabetes Mellitus subjects of both genders with duration of more than two years. Endothelial dysfunction assessed as Augmentation Pressure and Augmentation Index generated from Radial artery waveforms by tonometer using Spygmocor PWA system. Plasma Total Nitrite/ Nitrate, High sensitive C - Reactive Protein, Malondialdehyde and Glutathione were measured.Results: Out of total 60 Diabetes Mellitus subjects 16 subjects were with Coronary Artery Disease. There was no significant difference in High sensitive C - Reactive Protein, Glutathione, Malondialdehyde and Total Nitrite/ Nitrate between Diabetes Mellitus with Coronary Artery Disease and without Coronary Artery Disease, however significant difference (p=0.02) was observed Augmentation Pressure between Diabetic alone (12.8±5.19 mm of Mercury) and diabetics with Coronary Artery Disease (16.13±33.47 mm of Mercury) and Augmentation Index (p=0.04) between Diabetic alone (29.8±5.68 mm of Mercury) and diabetics with Coronary Artery Disease (40.01±5.74). As endothelial function is age dependent the subjects were divided into three age groups (20-40 years, 40-60 years and more than 60 years). High sensitive C - Reactive Protein, Glutathione, Malondialdehyde, Total Nitrite/ Nitrate and Augmentation Index did not differ in the three age groups while Augmentation Pressure (p=0.0096) showed significant difference between age group 20-40 years (10.59±3.24) and age group more than 60 years (15.83±3.92).Conclusions: There is significant endothelial dysfunction observed in Diabetes Mellitus subjects and Diabetes Mellitus with coronary artery disease showed greater endothelial dyfunction. Thereby concluding that Diabetes Mellitus subjects were at higher risk for development of coronary artery disease and as endothelial dysfunction is an early event, it may have some prognostic value.
Rama Mohan Pathapati, Bhakthavatsala Reddy Chirra, Parigala Madhavi, Tandayam Abhishek, B. L. Kudagi, Madhavulu Buchineni
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2328-2333; https://doi.org/10.18203/2319-2003.ijbcp20174137

Abstract:
Background: Normally the age of the arteries is same as that of the chronological age of the patient. In Hypertensive patients, complex interactions occur between prohypertensive factors, accelerating vascular age. Furthermore, prohypertensive factors to some extent are responsible for non-response to therapy at optimal doses. We assessed the correlation between response to therapy and vascular age in elderly hypertensives, in addition to vascular age and vascular response.Methods: In this study, we analysed the clinical records of both male and female hypertensive patients above 60 years old. We collected the details of age, gender, body mass index, systolic blood pressure (treated and untreated), diabetes and smoking. Vascular age was calculated using a composite score of these six prohypertensive risk factors. Accelerated vascular age was then derived using the formula vascular age minus chronological age. The optimal vascular response was considered if the patient's therapeutic blood pressures are less than 140/ 90mmHg.Results: In the present study, data from 517 elderly hypertensive patients were analysed, the mean chronological age, vascular age and accelerated vascular age was 66.74±6.6, 79.46±0.42 and 13.46±6.08 years. Only 32.7% were responders to anti-hypertensive treatment. The pattern of usage of anti-hypertensives in our patients is CCBs 39.10% followed by 30.90% ARB, 22.50% ACEI and 8.90% diuretics. The response in 20.50% of patients was achieved with a single drug, in 9.90% with two drugs and only in 2.30% of patients using three drugs. We found that 78.72% of our study population had vascular age more than ten years of chronological age, among them 66.6% between 60-69 years of chronological age were non-responders. We found a significant correlation (P
Apoorva R., K. Vasundara, Umadevi R. S.
International Journal of Basic & Clinical Pharmacology, Volume 6; https://doi.org/10.18203/2319-2003.ijbcp20174100

Abstract:
Background: Visual impairment poses a significant threat to proper medication practice leading to medication related challenges and some adopted self coping strategies with substantial impact on medication adherence. Visually impaired are potentially more likely to have unsafe medicine related practice which by itself is more rampant in general population. Studies related to them are largely unexplored and can provide data to improve disease management and health related quality of life. Objectives was to study the level of medication adherence, medication related challenges and self adopted coping strategies in visually impaired people.Methods: A cross sectional descriptive study enrolling 204 subjects with VI was done. Medication adherence was assessed using MMAS. Medication related challenges and self-adopted coping strategies was assessed by using pre-validated semi-structured questionnaire.Results: Majority of the subjects showed medium medication adherence with forgetfulness to take medicine as the main reason for non adherence. Difficulty in remembering the instructions, spilling of liquid medicine, taking wrong dose, difficulty in using topical medications were the most common challenges faced by them in daily drug administration. To overcome challenges locating the drugs at different places, finger felt volume for liquid medication, textural feeling of the drug or container, time tracking were the major self adopted coping strategies by the visually impaired subjects.Conclusions: Creating awareness of the medication related problem faced by visually impaired helps to provide adequate assistance to medication use and improve proper health care services in them.
Jyothsna Guduru, T. Rohit Singh, Somnath Motgi, Jamuna Rani
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2311-2316; https://doi.org/10.18203/2319-2003.ijbcp20174088

Abstract:
Background: Many studies have investigated the prevalence of self medication practices. World health organization promotes the practice of self medication for relief of symptoms without medical consultation to reduce the burden on health care services. Majority of the individuals in developing country like India have poor knowledge about appropriate use of self mediction, but still they practice taking it without knowing the benefits and risk factors.Methods: The present study was a cross sectional study aimed to gather information about prevalence of self medication in common illness among non health care professionals in a tertiary care hospital. The sample size comprised of 215 participants. Data was collected through an open ended semi structured questionnaire. All the descriptive data was coded, entered in micro soft excel and analysed with frequencies and proportions.Results: The prevelance of self medication was found to be 96%. Near about 30% of participants got information from pharmacist regarding self medication. 27% participants followed allopathy medicine.16% participants used becosules and mucaine gel for mouth and throat ulcers.26% participants used D-cold total for cough and cold.15% participants used dolo 650mg for fever and headache.41.7% participants used ciprofloxacin for ear and eye infections.26.6% participants used gelusil for GI infection .25.7% participants used calamine lotion for skin infections and 48% participants used turmeric for other minor ailments as self medication medicines.Conclusions: As the prevalence of self medication is high among educated participants. The present study suggest the growing trend of self medication has to be prevented by applying strong policies and prohibiting the supply of medicines without a valid prescription.
Indu Slathia, Pradeep R. Jadhav, Pooja Deb, Shashwat Verma
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2276-2281; https://doi.org/10.18203/2319-2003.ijbcp20173759

Abstract:
Background: Cardiovascular diseases are the most frequent cause of morbidity and mortality throughout the world particularly in South Asian population. With advent of newer, highly efficacious heterogeneous drugs and changing treatment guidelines, there’s a need to identify the cardiologist preference and prescribing patterns for rational utilization.Methods: It was an open label, prospective, cross-sectional, descriptive type of study conducted in Cardiology Outpatients at a Tertiary care hospital, Navi Mumbai. The study included 100 patients suffering from cardiovascular diseases attending cardiology outpatient department from October 2016 to March 2017. Informed consent was obtained and the currently prescribed drug details were recorded from prescription. The data was analysed for WHO core prescribing indicators and different types of drugs prescribed.Results: The average number of drug products prescribed was 3.4. Most commonly prescribed drugs were Antiplatelets (23%) followed by Statins (19.71%), β blockers (16%), Nitrates (11.70%), Angiotensin converting enzyme inhibitors (8.03%), Calcium channel blockers (5.50%), Angiotensin receptor blockers (4.70%), Diuretics (2.55%), Anticoagulant (1.83%), α+β blocker (1.46%), Cardiac glycosides ((1.09%), Potassium sparing diuretic and central sympatholytics. Majority of drugs were prescribed as single drugs (79.88%) while 20.11% as fixed dose combination (FDC). The combination of Telmisartan + Hydrochlorthiazide was the commonest prescribed FDC. Majority drugs were prescribed from NEDL 2015, but documented low generic prescribing.Conclusions: Antiplatelet and Statins dominated the prescribing pattern with high prescribing trend from national essential drug list, but showed scope for improvement in encouraging the cardiologist to prescribe by generic name.
, Bindu Gilbert, Santoshini Ravichandran, K. Bhuvaneswari
International Journal of Basic & Clinical Pharmacology, Volume 6, pp 2254-2258; https://doi.org/10.18203/2319-2003.ijbcp20173755

Abstract:
Background: Asafoetida is an herbal food supplement that has numerous peripheral pharmacological actions. Its central nervous system effects have not yet been completely elucidated in both animals and human participants. The study focuses on deciphering the effects of this Herbaceutical with that of Donepezil and vitamin C in mouse models of short term novelty object recognition memory and open field test.Methods: The study was conducted in two stages - a pilot stage which assessed the most effective dose of asafoetida on cognition, followed by a post-pilot study phase wherein its effects at that dose were compared with those of Donepezil and vitamin C. Novelty Preference Test (NPT) on y-maze and Open field test on Open field box were used to evaluate the effects of the formulation on memory and motor activity in mice.Results: A dose of 400mg/day of asafoetida orally was found to improve memory significantly in comparison to 200mg/day in mice. Asafoetida showed a greater potency in improving memory than Donepezil and vitamin C. After 11 days of daily treatment with Asafoetida commercial powder, more than fifty percent of the mice showed an increase in recognition index of 0.7-0.8 as compared to 0.55 at baseline.Conclusions: Asafoetida powder has nootropic efficacy in mouse model - this has to be explored mechanistically and pharmaceutically to enable the psychopharmacological characterization of the active principles and its pharmacological effects in the central nervous system.
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