Articles

  1. Evaluation of Hepatoprotective activity of Jasminum Sambac in rats Download Article

    Veeresh Babu D, Ramesh Kulkarni, Ramdas Bhatt
    • Type: Research Article
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    • Pages (104-116)
    • No of Downloads: 109

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    The present study was aimed to evaluate the hepatoprotective effect of Jasminum Sambac flower extract (JSFE) in acute experimental liver injury induced by Carbon tetrachloride (CCl4), alcohol, paracetamol (PCM) and thioacetamide (TAA) in rats. In Ccl4, alcohol, PCM and TAA models rats were treated with 10, 15, 5 and 7 days respectively. To induce the liver toxicity 24 hour after the last treatment  CCl4(2ml/kg. s.c), PCM (2g/kg, p.o.) and TAA (100mg/kg, s.c.) was administered where as for alcohol model alcohol (30% 1.5ml,p.o. twice a day) was given for 15 days. Rats were received different treatments such as silymarin (100 mg/kg), low and high doses of Jasminum Sambac flower extract (JSFE 100 and 500 mg/kg,) orally. The protective effect of prophylactic treatment was analysed by estimation of serum biomarkers like serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), alkaline phosphatase (ALP) and bilirubin (total and direct) and by histopathological observation. The activities of serum biomarkers were significantly decreased in all treated groups compared with toxic control. It was concluded that high and the low dose of Jasminum Sambac flower extract (JSFE) demonstrated reduced serum biomarkers activity significantly which was supported by histopathological study.

  2. A review on essentials of drug interactions Download Article

    Dr. G. RamyaBalaprabha, Sai Mahitha, Aparna, Vikas Patnaiak, Sikha Singh, Dr.Sharadha. R, Dr. K. Abbulu
    • Type: Review Article
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    • Pages (117-126)
    • No of Downloads: 84

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    Drug interactions are widely an important source of medication errors. Recently, potentially serious drug-drug interactions among medication errors has achieved significant clinical importance. An interaction is said to occur when the effect of one drug is changed by the presence of another drug, food or environmental chemical changes. Many of the drug interactions can be predictable; if the prescriber updates the knowledge with clinical pharmacology they can be avoided. Monitoring safety and effectiveness and evaluating the patient’s response to therapy. To identify and prevent drug related problems like adverse drug events by conducting a comprehensive medication review. Warfarin with Antimicrobials (Amoxycillin, Ampicillin, Ciprofloxacin, Nitrofurantoin) -  may have risk for upper Gastrointestinal bleeding and the interaction occurs prior to 14 days of administration.

    Drug interactions are considered as one of the major important factor for the occurrence of negative outcomes like adverse drug events. So, drug interactions cannot be neglected and should be considered seriously. Patient should be monitored closely for adverse drug reactions.

  3. A questionnaire based study to assess the knowledge of 2nd year medical students on self-medication / OTC Download Article

    Dr Swapna R Nayaka, Dr Sabari Anand J V
    • Type: Research Article
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    • Pages (127-133)
    • No of Downloads: 71

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    The  aim  of  our  study  was  to  assess the  knowledge  of  medical  students  about  OTC drugs.

    Materials & methods

    150  students  who  are  in  2nd  year  MBBS  studying  at  MVJ  Medical  College  and  Research  Hospital,  Hoskote  were  given  a  questionnaire  covering  about awareness & various  aspects  on  usage  of  OTC  drugs  &  responses  obtained  were  noted.

    Results

    120 (80%) students knew that OTC means Non-prescription drugs.  Among  150  students,  only  (54%)  used  OTC  &  majority  of  them  have  taken  treatment  from  physician in  the  past  6  months. The  frequently  reported  illness  that  prompted  self-medication  included  respiratory diseases  [cough, cold, sore throat,  pharyngitis,  tonsillitis  etc.]  & viral fever.  Majority of  them  obtained OTC  by  telling  the  drug  name  -  self  decision  (64%),  telling  symptom  (11.33%),  showing  old  prescription  (8.66%)   &  10 (6.66%) students  have  practiced  self-medication  by  advice  from  an  herbalist  /  Ayurveda.  Most  common  reasons  for  self-medication  was  its  less  time  consuming  (43.33%)  &  previous  experience of similar  illness  (26.66%)  which  lead  to  repeated  use  of  self-medication  for  same  problem  in  (82%)  students.  Commonly used self-medication was analgesic (97.33%).  Gastrointestinal  side  effects  (47.33%)  &  sedation (39.33%)  were  more  with  OTC  drugs  used.  We  have  found  that  (51.33%)  people  share OTC  among  relatives  and  friends.  About (81.33%) students  were  aware  about  precautions to be  taken as  per  instructions  &  label, whereas (57.33%)  students  knew  about  possible  drug  interactions  /  contraindications  of  OTC  drugs.

    Conclusion

    Even  though  self-medication  was  not  common  among  our  students  because  most  of  them  were  aware  about  OTC  drugs  their  advantages  &  disadvantages,  it’s  inevitable  to  stop  its  usage  among  the  public.  The  intervention  will  require  better  education  of  public  and  health  professionals  to  avoid  the  irrational  use  of  drugs.

  4. Formulation and in vitro, in vivo evaluation of Cefixime controlled Gastroretentive floating drug delivery system Download Article

    E. Sathish Reddy, Meesala. Srinivasa Rao, Mohammed Ibrahim
    • Type: Research Article
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    • Pages (134-146)
    • No of Downloads: 87

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    The aim of the present work was to develop and optimize gastroretentive floating system of cefixime (CF) for the effective treatment. The present study was carried out with an objective of preparation and in vivo evaluation of floating tablets of using cefixime as a model drug using Eudragit polymers (Eudragit-S100, Eudragit-RLPO & Eudragit-RSPO) to improve oral bioavailability of cefixime floating tablets by increasing gastric residence time. The tablets were prepared by direct compression method. The effect of polymers concentration and viscosity grades of Eudragit on drug release profile was evaluated. The result of in vitro dissolution study showed that the drug release profile could be controlled by increasing the concentration of Eudragit-RLPO. The optimized formulation (F18) containing Eudragit-RLPO showed 99.24% drug release at the end of 24h. Changing the viscosity grade of Eudragit-RLPO had no significant effect on drug release profile. The optimized formulations (F18) containing sodium bicarbonate 40mg per tablet showed desired buoyancy (floating lag time of about 20 min and total floating time of >24hr). Optimized formulation (F18) followed diffusion controlled zero order kinetics and fickian transport of the drug. FTIR and DSC studies revealed the absence of any chemical interaction between drug and polymers used. The best formulation (F18) was selected based on in vitro characteristics and was used in vivo radiographic studies by incorporating BaSO4. These studies revealed that the tablets remained in the stomach for 24hrs in fasting human volunteers and indicated that gastric retention time was increased by the floating principle, which was considered desirable for the absorption window drugs. Studies to evaluate the pharmacokinetics in vivo showed better bioavailability, area under the concentration time curve, elimination rate constant and half-life than marketed product.

  5. Hypolipidemic changes in Kanakalinga karpoorati mezhugu therapy in Experimental hypothyroid disorder Download Article

    Elango.V, JeyaVenkatesh J
    • Type: Research Article
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    • Pages (147-150)
    • No of Downloads: 54

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    Kanaka linga karpoorathi mezhugu is a herbomineral drug preparation used in Siddha system of medicine used to treat thyroid disorders and allied ailments. Known risk factors for thyroid disease include autoimmunity, external irradiation of the head and neck, a biosynthetic defect in iodine organification, replacement of the thyroid gland by tumour, and use of certain drugs. There are several forms of herbomineral drugs like Mezhugu, Parpam, Chendooram, Chunnam, Pathangam, Kattu, Kalangu etc have their in own pharmacological system, but needs to meet the global standards. Male albino rats of were used for this present thyro-toxicity study. Animals were provided with normal rats feed and normal water ad libitum. Hypothyoidi condition was induced using methimazole. They were provided with KLK mezhugu in water suspension in test groups. Aanimals were sacrificed, blood was drawn and the serum was separated for biochemical analysis. The result of this study shows the significant thyrotoxicity induced by methimazole was evidenced by increase in serum T3 Triiodothyronine, T4 Thyroxine, TSH secretion due to thyroid cellular necrosis. The administration of KLK mezhugu for 30 days was found able to treat and protect thyroid necrosis against methimazole induced thyroid-toxicity. 

  6. Analysis of hospital deaths as per the patients time of arrival to the hospital and evaluation of the net and gross deaths Download Article

    Dr.Bheemathati Rangarao, Dr.V.Kalarani
    • Type: Research Article
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    • Pages (151-154)
    • No of Downloads: 73

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    Aim

    Analysis of hospital deaths as per the patients’ time of arrival to the hospital in DSR GGH a teaching hospital under ACSRGMC, Nellore and to evaluate the so called non-hospital, net and gross deaths occurred

    Method

    Patient demographic details over a period of two months are considered for the study and number of the deaths that have been occurred in the within 48hrs or < 48 hrs were considered and taken as so called non-hospital deaths. The death of the subject may be occur due to any reasons like poisoning, severe sepsis, CKD,CVA or some other criteria were excluded like the financial problems, lack of information and few else. Variation between gross and net death was noted for the patients admitted to the hospital in emergency ward, intensive care unit and some other care units to denote the so called non-hospital deaths. In this study only deaths are taken in to consideration

    Results

    The overall percentage of the gross, net death and so called non-hospital deaths were found in the hospital.

    Conclusion

    Gross and net deaths are differentiated Gross deaths are all the deaths that occurred in the hospital during a certain period, whereas Net deaths are those that occurred after the 48 hrs of the admission to the hospital. Those deaths that occur within 48hrs of admission or the difference between gross and net deaths shall be considered for the so called non hospital deaths i.e where the causes that lead to these deaths need not be due the hospital   performance or personnel.   

  7. A randomized double blinded placebo controlled trail on efficacy of resveratrol in controlling hypertension Download Article

    Mrs.K.Anitha, B. Anusha, M.Archana, B. Anjali, B. Aruna Kumari, C. Anitha
    • Type: Research Article
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    • Pages (155-162)
    • No of Downloads: 57

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    High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure. The target of this study is to assess the efficiency of resveratrol in managing blood pressure in members diagnosed with prehypertension and stage 1 hypertension. The main objectives of this trial are to regulate the BP-lowering actions of resveratrol on systolic, diastolic, and mean arterial BP in members diagnosed with prehypertension and stage 1 hypertension. The outcomes from this study will help to decide the effectiveness of short-term resveratrol treatment in hypertensive patients and connect the gap with regards to the recent preclinical and clinical evidence. The primary results in this study will be BP. Systolic and diastolic BPs will be measured by using a mercury sphygmomanometer twice on patient in a sitting position after a 10-minute rest and with a 15-minute interval. The measurement will be done every week during the intervention period. The mean systolic and diastolic BP will be computed. Mean arterial pressure will be calculated as systolic blood BP plus two times the diastolic BP divided by three [(SBP + 2 × DBP) ÷ 3]. This study will also help in gathering further data with regard to recognizing a therapeutically effectual dose of resveratrol in reducing cardiovascular disease risk factors. Importantly, if a positive outcome is identified, it will provide us with an effectual therapeutic strategy to fight against hypertension and would pave the way for reaching enormous population well-being sake. Pharmacokinetics may have assisted to draw a relation between the plasma bioavailability and the actual physiological effect. In this trial, stage 1-hypertensive patients will be on quality therapy for hypertension as well; therefore, it may not be feasible to understand the standalone effictiveness of resveratrol in lowering BP in these patients.

  8. Assessment of factors influencing self reported drug adherence to anti-epileptic drugs at a tertiary care hospital Download Article

    Dr. Mohammed Yaqub Pasha, Dr. Debdipta Bose, Dr. Sushma M., Dr. Jagadish B. Agadi
    • Type: Research Article
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    • Pages (163-169)
    • No of Downloads: 67

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    Background

    Epilepsy is one of the most common neurological disorders worldwide which requires incorporation of complex therapeutic regimens in daily routines. Success of the antiepileptic drugs (AEDs) regimen depends on the medication adherence. Non-adherence leads to recurrence, higher incidence of hospital admissions and imposes economic burden.

    Objectives

    To assess the factors contributing to self reported drug adherence of AEDs.

    Materials and Methods

    The study was conducted at the Neurology OPD, BMCRI for 6 months. 200 patients diagnosed with seizure disorder and prescribed AEDs were enrolled. Medication adherence was measured by patient self report using a single item question. The demographic and clinical variables of adherent and non-adherent patients were compared.

    Results

    Out of the 200 patients, 105 (52.5%) were males, mean age of the patients was 37.87±16.41 years and mean duration of epilepsy was 8.05+7.39 years. Most commonly prescribed AED was Carbamazepine (42%). About 11% of the patients reported adverse drug reactions (ADRs). 64.5% (129) of them were found to be adherent to AEDs and 35.5% (71) were non-adherent. Univariate Analysis showed that Age, education status, marital status, seizure burden, polytherapy and ADRs had a statistically significant association (p=<0.05) with self reported drug adherence. Regression analysis depicted that Marital status and ADRs best predicted non-adherence to AEDs. Conclusion

    35.5% of the patients were found to be non-adherent to AEDs. Non adherence was significantly higher among married patients and those who developed ADRs.

  9. In-Vivo studies of anti-parkinson activity of Ropinirole Hydrochloride loaded in microsphere for brain targeting by intranasal delivery Download Article

    Shubhrajit Mantry, Anna Balaji
    • Type: Research Article
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    • Pages (170-174)
    • No of Downloads: 95

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    Objective

    In the present study, we evaluated anti-Parkinson’s activity of Ropinirole hydrochloride loaded in microsphere by intranasal delivery for brain targeting. 

    Material & Method

    All animal experiments were approved and performed in Malla Reddy College of Pharmacy accordance with the guidelines of Institutional Animal Ethics Committee (CPCSEA Registration No: 1217/PO/RE/S/2008).

    Result

    For In-Vivo evaluation of nasal microspheres of Ropinirole Hydrochloride, rabbit was chosen as a model for study because the blood volume of the rabbit is sufficiently large (approximately 300 ml) to permit frequent blood sampling and allow a full characterization of the absorption and determination of the pharmacokinetic profile of the drug. The Cmax after oral dosing was found to be 107.833±1.567 ng/ml and the corresponding Tmax was at 1.86±0.066 hrs.

    Conclusion

    From all the parameters studied, it can be concluded that combination of Carbopol 974P and guar gum is better mucoadhesive polymer for the formulation of mucoadhesive microspheres of Ropinirole Hydrochloride for intranasal administration. Thus, the formulated microspheres seem to be a potential candidate as intranasal controlled drug delivery system for treatment of Parkinson’s disease.

  10. An anti-diabetic activity of stevia rebaudiana with vitamin E Download Article

    P. K. Pawar,I. Ansari, Dr. S.K. Pawar
    • Type: Research Article
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    • Pages (175-181)
    • No of Downloads: 56

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    The present research work was carried out to find out the alternative medication for treating the diabetes mellitus and its further complications such as atherosclerosis, pre-eclampsia and male and female infertility, end-stage renal disease, IHD, gangrene of the lower extremities, and blindness in the adults with poor glycemic control. Therefore, rationally selected the combination of leaf extract of Stevia rebaudiana and vitamin E supplement. The phytochemical tests of plant extract of Stevia rebaudiana revealed the presence of Alkaloids, Carbohydrates, Flavonoids, Phenolic compounds, proteins. This study is an attempt to find out an adjuvant medication with hypoglycemic action in combination therapy which has shown beneficial effect in animal models maybe useful in supplementary dosage.

  11. Evaluation of pattern, predictability, severity and preventability of adverse drug reactions in the department of psychiatry at a tertiary care hospital in bengaluru – a five years experience Download Article

    Dr. C R. Jayanthi, Dr. Debdipta Bose, Dr. Sushma M
    • Type: Research Article
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    • Pages (182-190)
    • No of Downloads: 54

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    Objective

    Psychotropics are known to cause number of adverse drug reactions (ADRs) which often results in either nonadherence or discontinuation of therapy. Present study aimed to analyze the pattern as well as causality, preventability, severity and predictability of occurrence of ADRs in psychiatry.

    Materials and Methods

    This retrospective cohort study was conducted to analyze the ADRs reported spontaneously from the Department of Psychiatry at a tertiary care hospital, Bengaluru to the ADR monitoring centre, Bangalore Medical College & Research Institute. Causality of ADR was assessed by WHO-ADR probability scale, preventability was assessed using Modified Schumock & Thornton scale and severity was assessed using Hartwig and Siegel criteria. Beer’s criterion was used to identify the potentially inappropriate drugs among elderly that caused ADRs. Descriptive statistics was used for analysis.

    Results

    40.7% of ADRs were observed among patients aged between 31-40 years. Higher frequencies of ADRs were noted among patients diagnosed with depression (34.5%), followed by schizophrenia (28.3%). Central Nervous System (58%) was affected predominantly. Headache (12.3) was the most commonly observed ADR followed by dystonia (11.1%) and drowsiness (9.9%). Patients receiving antidepressants (48%) and antipsychotics (37%) experienced more ADRs. Fluoxetine (17%) accounted for majority of ADRs followed by risperidone (12.3%).  85% of the ADRs were of ‘probable' causality and predominantly predictable (95.1%). 9% of the ADRs were definitely preventable. 44% of ADRs required additional medical treatment. 96.3% of patients recovered completely.

    Conclusions

    5% of ADRs were severe, no mortality was noted which highlights the appropriate management of ADRs at our centre. Regular intensive monitoring of ADRs in psychiatry outpatient department will help to improve to the quality of care.

  12. Evaluation of anti-hemolytic activity of green tea aqueous extracts by in vitro method Download Article

    Mr. K.P. Raghava Krishna, Asam. Harika, G. Sai Kiranmai, Y. Harshavardhan Reddy, Mr. Kartheek.Ch, Dr.A.M.S. Sudhakar Babu
    • Type: Research Article
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    • Pages (191-198)
    • No of Downloads: 69

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    Hemolysis is a disorder of destruction of RBC cells in our body; chloroquine is the drug that regularly preferred to anti-malarial activity. This current study observes the destruction of RBC cells by chloroquine when treated with malarial disease and control of RBC lysis with addition of green tea extract along with chloroquine. Green tea leaves consist of phenolic compounds like flavonoids and catechin. Due to the presence of flavonoids and catechin which reduce the hemolysis of RBC by oxidative stress. This current study deals with concentration of hemolysis when induced with chloroquine and compared with aqueous extract of green tea with induced chloroquine and RBC suspension. This was clearly done by using the separation of the serum from plasma and induced the chloroquine to RBC suspension then the Heme generated was assayed and also absorbance was seen in UV visible photometry by following concentrations [high (2mg/ml) and low (1mg/ml)] of chloroquine. This same was repeated with addition of aqueous extraction of green tea by same concentration [high (1mg/ml) and low (2mg/ml)]. And observed that hemolysis taken place was 38.27% to 15.3%. (at low concentrations of chloroquine and green tea extract (1 mg/ml)). And also 55.56% to 26.17% (at high concentrations of chloroquine and green tea extract (2mg/ml)).

  13. A comparative study of efficacy and safety of topical travoprost 0.004% versus latanoprost 0.005% in the treatment of primary open angle glaucoma at a tertiary care hospital Download Article

    C R Jayanthi, Divyashree R N, Sujatha R
    • Type: Research Article
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    • Pages (199-207)
    • No of Downloads: 57

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    Introduction

    Glaucoma, “silent thief of sight” is a chronic, progressive optic neuropathy leading to optic nerve damage and visual field loss. Lowering intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG) is beneficial in reducing the risk for visual field loss in the long term. Various prostaglandin analogues have demonstrated consistent superiority over other therapies in terms of IOP reduction, however superiority amongst them remains inconclusive.

    Objectives

    To compare efficacy and safety of topical travoprost 0.004% versus latanoprost 0.005% in reducing intraocular pressure in patients with POAG.

    Materials and methods

    60 newly diagnosed patients of POAG who fulfilled the inclusion /exclusion criteria were randomised into two groups of 30 each to receive either travoprost or latanoprost once daily in the evening. Efficacy was measured in terms of reduction in IOP monitored at 4, 8 and 12 weeks from baseline. Safety was assessed by monitoring treatment emergent adverse drug reactions.

    Results

    Both travoprost and latanoprost effectively reduced IOP when compared to baseline. Mean IOP reduction from baseline to week 12 was 9.08 ± 1.93 mmHg (p<0.001), 7.96 ± 1.11 mmHg, (p<0.001) in travoprost and latanoprost groups respectively. There was significant reduction in IOP with travoprost when compared to latanoprost (8.86 ± 2.07 vs 7.71 ± 0.92, p=0.0003) at the end of 8 weeks and the same trend continued even at 12 weeks (9.08 ± 1.93 mmHg vs 7.96 ± 1.11 mmHg, p< 0.0002). Adverse drug reactions (ADR) were comparable in both the groups with conjunctival hyperaemia (21.6%) being the most common ADR.

    conclusion

    Travoprost was found to be more efficacious in reducing IOP as early as 8 weeks as compared to latanoprost. There was an additional 1.12 mmHg reduction in IOP at the end of 12 weeks in comparison to latanoprost and it was well tolerated. Hence travoprost could be a favourable option for the treatment of primary open angle glaucoma.

    Keywords: Latanoprost, Travoprost, Primary open angle glaucoma, Intraocular pressure

  14. Comparison of efficacy and safety of teneligliptin versus sitagliptin as add on to metformin in type 2 diabetes mellitus at a tertiary care hospital Download Article

    C. R. Jayanthi, Arjun Subash, Raveendra K R
    • Type: Research Article
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    • Pages (208-217)
    • No of Downloads: 128

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    Introduction
    Diabetes mellitus (DM) is a leading cause of mortality and an increasing health burden with a prevalence of 8.3% globally and 9.1% in India (IDF). Prevention of complications and improving quality of life are the principle goals in its management. DPP-4 inhibitors have a potential vasoprotective effect mediated by stromal cell derived factor-1a. Teneligliptin a novel, highly selective, more potent agent compared to Sitagliptin provides sustained glycaemic control, decreases cardiovascular complications, has additional beneficial pleiotropic metabolic effects and also safe in renal impairment.

    Objective

    To evaluate the glycaemic and non-glycaemic effects of Teneligliptin vs Sitagliptin as add on therapy to metformin.

    Materials and methods

    After obtaining Institutional Ethics Committee approval and written informed consent, 60 subjects with T2DM who failed to achieve glycaemic control with metformin (500mg TID) alone for 3 months were randomized in 1:1 ratio to receive Teneligliptin 20mg OD and Sitagliptin 100mg OD as add on therapy. Patients were followed up at 4, 8 and 12 weeks for glycaemic and non-glycaemic effects. Adverse drug reactions (ADRs), if any were recorded and graded according to severity.

    Results

    There was a statistically significant decrease in FBS (p<0.05, p<0.001) and PPBS (p<0.01, p<0.001) in patients treated with Teneligliptin on week 8 & week 12 from baseline compared to those treated with Sitagliptin. The reduction in HbA1c (p<0.0001), LDL-CH (p<0.0001) & TC (p<0.001) on week 12 from baseline was also significantly more in the Teneligliptin group.

    Conclusion

    Teneligliptin may be an effective and safe treatment option in reducing both glycaemic and non-glycaemic parameters as an add-on therapy in Type 2 DM with good patient tolerability.

  15. Assessment of level of knowledge and to explore association between knowledge and diabetic complications among type 2 diabetes mellitus patients Download Article

    Thushara. C, Sreeja. P A, Dr Radhakrishnan. A P
    • Type: Research Article
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    • Pages (218-223)
    • No of Downloads: 94

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    Aim

    To assess the level of knowledge and to explore the association between knowledge and diabetes complications among patient with type 2 Diabetes Mellitus.

    Methods

    A cross sectional study was conducted among 428 patients with type 2 diabetes mellitus attending a diabetic clinic at Palakkad district. Subjects of both sex and age group between 18to 80 years, who were capable of understanding and completing questionnaire, were included in the study. Subjects not willing to participate were excluded. DKQ adapted for south Asian population was used to assess the diabetes knowledge. DKQ score was a 24 point scale, participants showing more than 18 points were considered as good knowledge. Association between DKQ and diabetic complications were analyzed.

    Results

    Among 428 subjects, 4% of the participants had well, (52%) had moderate and (44%) had poor knowledge on diabetes. The mean DKQ score was 13.2± 2.2.  Most of the participants show Microvascular complications (55%), 45% had Macrovasular complications.

    Conclusion

    Patients with type 2 diabetes mellitus have limited knowledge, majority of patients have low educational level. Data also show that there is a relationship between knowledge and diabetes complications. Participants with poor knowledge and poor glycemic control are susceptible for developing long term complications.  Improving diabetes knowledge of people with diabetes might allow achieving better glycemic control. Involving a clinical pharmacist with endocrinologist might achieve this objective of improving patient knowledge of diabetes when followed longitudinally.

  16. Comparative analysis of first versus latest version of WHO essential medicine list Download Article

    Kavyashree AC, Laxminarayana Kamath
    • Type: Research Article
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    • Pages (224-231)
    • No of Downloads: 43

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    Background

    The concept of Essential medicines was pioneered by the WHO in 1977 to provide safe and effective treatment against the global burden of disease. Latest, 19thEML by WHO and 4th list of NLEM are published in 2015

    Aims and Objectives

    To study the factors affecting the change in profile of Essential medicine list.

    Materials and Methods

    The EML was accessed from the official website of WHO and the NLEM from Central Drugs Standard Control Organization website, downloaded and compared. A detailed analysis of 1st and latest EML was done in terms of System wise allocation, addition and deletion of medicines

    Results

    There is steady increase in number of Essential Medicines from 204 to 414 in latest EML of WHO when compared to first list. Maximum allocation of medicines  in WHO first list  is for Infectious disease (53/204,26%) followed by Cardiovascular diseases (25/204,12%),Central nervous system disorders (15/204,7%) whereas in latest version of EML by WHO maximum allocation of medicines is to Infectious diseases (135/414,33%) followed by antineoplastic medicines (47/414,11%), cardiovascular disorders (32/414,8%). Maximum increase in medicines is seen with following sub categories of diseases like Antineoplastic (47), Anti viral drugs (27), Anti tubercular drugs (17), Contraceptives (16), antidotes (15). Some of the medicines like Atorvastatin, Telmisartan, Glimepiride, Thiopentone, cetirizine etc are included in NLEM 2015 but not included in WHO-EML 2015

    Conclusion

    The study gives insight about the change in profile of medicines in essential medicine list over a period of time with respect to change in burden of disease, newer diseases , newer invention of safe and effective medicines

  17. A study on evaluation of hypothyroidism associated with pregnancy women Download Article

    Sweety George, Mrs.Thangamani.S, Dr .Mini.N.M
    • Type: Research Article
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    • Pages (232-235)
    • No of Downloads: 71

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    Maternal hypothyroidism may place the mother at an increased risk of adverse obstetrical outcomes. Untreated hypothyroidism is associated with increased risk for pre-eclampsia, low birth weight, placental abruption, miscarriage, and perinatal mortality.

    Aim & Objective

    Aim of the study to evaluate hypothyroidism associated with pregnancy person. Methodology: The study was a prospective observational study and was conducted over a period of six months in various hospitals.

    Results and Discussion

    Out of 109 patients, In age wise distribution, the highest number of patients (44.95%) fell in 22-25 of age range followed by 24.77% in 26-29 years range. 54.12% patients suffer from hypothyroid and 39.44% suffer from anemia most seen in second trimester and also followed by12.84% with hypertension. Prescription pattern among the obstetrics and gynecology patients observed was like Anti-anemic drug 67.88%, Calcium 56.88%, Vitamin supplement 17.43%,  Anti-emetics 15.59%, Anti-fungal 2.7%, Anti-ulcer 1.83%.

    Conclusion

    Hypothyroid, anemia, hypertension are associated disease in pregnant patients. Second trimester more suffer from hypothyroidism and anemia. Iron, calcium and vitamin supplement were the most frequently prescribed drugs.

  18. Curcumet capsules; an effective supplementation for various life style disorders & as a potent Antioxidant Download Article

    Govind Shukla, Nagalakshmi Yaparthy, NehaGiri, G.Santosh, C.J. Sampath Kumar
    • Type: Research Article
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    • Pages (236-241)
    • No of Downloads: 74

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    Curcumin Extract in curcumet capsules has antioxidant, anti-inflammatory, antiviral and antifungal actions.  Curcumin exerts anti-inflammatory activity by inhibition of a number of different molecules that play an important role in inflammation. curcumin is effective in reducing post-surgical inflammation. curcumin helps to prevent atherosclerosis by reducing the formation of bloods clumps. Curcumin inhibits the growth of Helicobacter pylori, which causes gastric ulcers and has been linked with gastric cancers. Curcumin can bind with heavy metals such as cadmium and lead, thereby reducing the toxicity of these heavy metals. This property of curcumin explains its protective action to the brain. Curcumin acts as an inhibitor for cyclooxygenase, 5-lipoxygenase and glutathione S-transferase. It is a common spice, known mostly for its use in Indian dishes as a common ingredient in curries and other ethnic meals. Turmeric has also been used for centuries in Ayurvedic medicine, which integrates the medicinal properties of herbs with food. This extraordinary herb has found its way into the spotlight in the west because of its wide range of medicinal benefits. This article reviews the current available scientific literature regarding the effect of Curcumet capsules as an effective supplementation for various life style disorders & as an effective potent Antioxidant.

  19. Longitudinal effects of in utero methadone exposure on development using revised norms on the Bayley Scales of Infant Development (BSID) Download Article

    Sherry Dingman, Maria E. Melilli Otte, William VanOrnum, and Rachel Trainque
    • Type: Research Article
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    • Pages (242-246)
    • No of Downloads: 78

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    Much of the scientific justification for using methadone to treat women with heroin use disorders relies on one heavily cited early review of five studies. The review concluded there were no long-term developmental effects directly associated with prenatal methadone exposure because scores for exposed infants on the Psychomotor Development Index (PDI) of the Bayley Scales of Infant Development fell “well within the normal range of development.”  However, three of the studies reviewed reported significant differences between exposed and control infants on the PDI.  The other two did not report scores on the PDI.  The PDI is a subscale of the Bayley Scales of Infant Development, which was released with a much more extensive normative sample in 1993. Extrapolating PDI scores from the earlier version to the better 1993 version reveals that methadone-exposed infants were not well within the normal range of development. Given the increasingly higher doses of methadone used to treat pregnant opioid-dependent women, we are concerned about the potential for greater adverse effects in the present era.  Beginning with the seminal review, this paper examines subsequent studies for longitudinal outcomes for prenatally exposed infants. We hypothesize that revised BSID-II PDI scores will reveal motor effects for infants born to women with heroin use disorders treated with methadone.

  20. Comparing the adverse drug reactions of conventional versus newer anti epileptic drugs: an observational study Download Article

    C. R. Jayanthi, Arjun Subash
    • Type: Research Article
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    • Pages (247-254)
    • No of Downloads: 47

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    Introduction

    Neurological disorders have been estimated to account for up to 20% of the nationwide cost of healthcare in developed countries. There is growing concern to assess the Adverse Drug Reactions (ADRs) of anti-epileptic drugs (AEDs), which have an impact on compliance, economic burden and quality of life. AEDs have broad spectrum of effects, need long term therapy leading to wide range of ADRs. Thus, the present study was undertaken.

    Aim

    To assess the incidence, severity, causality of ADRs due to AEDs and to compare the pattern of ADRs caused by conventional versus newer AEDs.

    Methodology

    This observational study was carried out from 2012 to 2016 to analyze the ADRs reported spontaneously from Department of Neurology at Bangalore Medical College and Research Institute to ADR monitoring centre. Patient demographics, clinical & drug data, details of ADR, onset time, causal drug details, outcome and severity were collected as per CDSCO ADR reporting form. Causality was assessed using WHO-ADR probability scale, preventability by Modified Schumock & Thornton scale and severity using Hartwig and Siegel Scale. Predictability was categorized as Type A and Type B ADRs.

    Results

    85 ADRs were reported in 5 years, with maximum in 21-40 yrs and equal male to female ratio. Conventional AEDs (75%), mainly Phenytoin (40%) and Carbamazepine (27%) contributed the most. Amongst newer AEDs, Levetiractam accounted for maximum ADRs (13%) followed by Gabapentin (10%). ADRs affecting Central Nervous System (CNS) (65%) were predominant in both groups. Newer AEDs caused Giddiness 10.7 times more frequently than conventional ones. Erythematous rash was 1.71 times more in the conventional drugs than newer ones. Frequency of drug withdrawal was higher among the patients on conventional AEDs (60% vs 30%). Causality assessment indicated that 90% had probable and 10% had possible causality. Majority of the ADRs in both the groups were of moderate severity (50%). The severe ADRs (7%) seen only with conventional AEDs were hepatotoxicity & pancreatitis due to Sodium Valproate and hyponatraemia due to Carbamazepine. Definitely preventable ADRs (12%) were noted among both the groups. No mortality was reported. 

    Conclusion

    85 ADRs due to AEDs were reported in 5 years period. Among conventional AEDs, Phenytoin and Carbamazepine contributed the maximum. Amongst newer AEDs, Levetiractam, followed by Gabapentin were implicated in majority of ADRs. ADRs affecting CNS were predominant in both groups. Severe ADRs were seen with only conventional AEDs.