Articles

  1. Hyperbilirubinemia during Atazanavir treatment in HIV/AIDS patients taking second line ART drugs Download Article

    Savithri Desai, Harish.G.Bagewadi, Harinika G
    • Type: Research Article
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    • Pages (01-06)
    • No of Downloads: 114

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    Background

    Hyperbilirubinemia is frequently observed in HIV (Human Immunodeficiency Virus) patients treated with Atazanavir containing antiretroviral regimen in the dose of 300 mg once daily. However, little is known about the incidence of Atazanavir-associated hyperbilirubinemia in Asian population. Hyperbilirubinemia is defined as an excess of bilirubin in blood either conjugated or unconjugated.

    Aim

    To estimate the incidence of Atazanavir associated hyperbilirubinemia in HIV patients receiving second line antiretroviral regimen advocated by National AIDS Control Organisation (NACO) by measuring serum bilirubin levels.

    Materials and Methods

    The study was done in 100 HIV-infected patients attending ART Plus centre at a tertiary care centre receiving Atazanavir regimen for a period of 12 months. The bilirubin levels in blood were estimated by MALOY & EVELYN METHOD.

    Results

    The incidence of grade I hyperbilirubinemia was 26%, grade II was 24%, grade III was 48% & grade IV 2%. The Study data suggested that Atazanavir-associated hyperbilirubinemia is common and self limiting.

    Conclusion

    It was observed that most of the HIV/AIDS patients receiving Atazanavir containing ART regimens developed hyperbilirubinemia, so these patients should be regularly monitored for Atazanavir induced hyperbilirubinemia.

  2. Study on the prevalence of gestational diabetes mellitus at a tertiary care hospital Download Article

    Chitra B, Shreedarshan M, Tharayil Nishi Nainan and Vishnu N
    • Type: Research Article
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    • Pages (07-11)
    • No of Downloads: 99

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    The prevalence of diabetes is increasing globally. Women with Gestational Diabetes Mellitus are an ideal group for the primary prevention of diabetes as they are at increased risk of future diabetes, predominantly type 2 diabetes, as are their children. A prospective observational study was carried out in gynaecology department over a period of 6 months enrolling 150 patients. The study was carried out to identify the prevalence of GDM, to assess the prescribing pattern of anti-diabetic drugs in GDM, to identify the risk factors involved, to assess the patient’s level of knowledge about diabetes and to provide patient counselling. 106 patients were diagnosed with GDM. Most commonly prescribed anti-diabetic drugs were metformin followed by insulin. The risk factors identified were age above 30 years, obesity, family history and prediabetes. The occurrence of maternal and neonatal complications in the GDM patients were observed and most frequent complication found was caesarean in 49 cases.  The assessment of distribution of patients based on gestation period revealed that patients at gestational age of 24-26 weeks of pregnancy were more frequently diagnosed with GDM. A standard questionnaire was used to assess the level of knowledge about diabetes in GDM patients. Based on the level of knowledge, the patients were educated regarding the disease and lifestyle modification with the help of patient information leaflet. . The severity of drug interactions were evaluated and found that 13 prescriptions had major interactions, followed by 36 moderate interactions and 12 minor interactions. The present study points out the role of a clinical pharmacist in improving the patient care and overall quality of life in GDM patients.

  3. The study of prescription pattern in respiratory tract infection diseases in a tertiary care hospital Download Article

    R Ragini, Shivkumar Shete, K Anoosha, P Anees , Afshan Shadab baig
    • Type: Research Article
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    • Pages (12-19)
    • No of Downloads: 82

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    Introduction

    A respiratory tract infection is an infection anywhere in the respiratory tract (i.e nose, throat, lungs). The infection can be caused by bacteria, viruses or fungi. Respiratory infections are very common. They are believed to be one of the main reasons why people visit their General Physician (GP) or Pharmacist. Respiratory tract infection is of two types Upper Respiratory Tract infection and Lower Respiratory Tract infection.

    Aim

    To study the prescription monitoring in respiratory tract infections in a tertiary care hospital.

    Methodology

    The data were collected in a prescribed performa from the medical case sheets, Drug charts, Laboratory investigations of 119 Inpatients. This was a prospective observational study carried out for Inpatients in Pulmonology department.

    Results

    119 patients in Pulmonology department are administered with different types of antibiotics. Majorly Macrolide antibiotics are administered. Corticosteroids are administered in patients of age group 79-88 years. 60(50.4%)  patients were administered with Macrolides, 52(43.6%) were administered with Cephalosporins, 37(31.09%) patients were administered with Pencillins, 11(9.24%) were administered with Flouroquinolones, 7(5.88%) patients were administered with Tetracyclins and the rest of patients were administered with other types of  antibiotics like Carbapenems, Glycopeptides, Sulphonamides, Oxazolidines, Antimicrobials.

    Conclusion

    It was observed that the patients were prescribed rationally with antibiotics, Corticosteroids(particularly in elderly patients). A prescription based survey is considered to be one of the scientific methods to access and evaluate the rationality of the prescription for observation of drug utilization study. This observational, prospective study on drug use reflects the actual clinical practice in the communication.

  4. Protective effect of ethanolic leaf extract of ipomoea sepiaria against sodium arsenite induced toxicity in rats Download Article

    Vedavijaya Thangappan , Premlal Kulandai Raj, Sengottuvelu Singaravel
    • Type: Research Article
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    • Pages (20-24)
    • No of Downloads: 85

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    The objective of the study is to find out the protective effect of Ipomoea sepiaria on Sodium Arsenite induced toxicity in Wistar rats. The liver and kidney toxicity was induced by Sodium Arsenite (8 mg/kg, p.o.) for 60 days. Ethanolic leaf extract of Ipomoea sepiaria (200 & 400mg/kg) was administered orally for 60 days. At the end of the entire treatment, under Pentobarbitone sodium (60mg/kg, i.p), anaesthesia, the blood was collected by retro orbital puncture and serum was separated for biochemical estimations especially for Liver (SGOT, SGPT, ALP, Bilirubin and Protein) and Kidney (Serum urea and Creatinine). The Data’s were analyzed by using ANOVA. The result shows that higher dose of Ipomoea sepiaria reversed the biochemical parameter of both Liver functional test and the Kidney functional test in a significant manner as compared to Sodium Arsenite control. From the result it was concluded that, ethanolic leaf extract shows protective effect against Sodium Arsenite induced toxicity in rats in a dose dependent manner.

  5. Effect of ethanolic leaf extract of ipomoea sepiaria on sexual behaviour in male wistar albino rats Download Article

    Asokan Balakrishnan Ramajayam, Jaikumar Sankarapillai, Somasundaram Ganesan
    • Type: Research Article
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    • Pages (25-28)
    • No of Downloads: 99

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    The objective of the present study is to evaluate the sexual performance (aphrodisiac activity) of ethanolic leaf extract of Ipomoea sepiaria on male Wistar albino rats and the effects was compared with reference control Sildenafil citrate. Male Wistar albino rats were divided in to 4 groups of 6 animals each. Ethanolic leaf extract of Ipomoea sepiaria (200 & 400mg/kg ) were administered orally and its sexual performance was compared to the normal and reference control animals (Sildenafil citrate 4.5mg/kg body weight). The effect of Ipomoea sepiaria on sexual performance in male rats were observed by mount frequency, mount latency, intromission frequency, intromission latency, genital grooming and ano – genital sniffing. The data’s were analyzed using ANOVA followed by dunnetts’t’ test. Ipomoea sepiaria showed dose dependent increase in mounting frequency, intromission frequency, ano-genital sniffing and genital grooming and decrease in mount latency and intromission frequency as compared to control. The ethanolic leaf extract of Ipomoea sepiaria showed comparable aphrodisiac effect with the reference control Sildenafil citrate. From the result it was concluded that, ethanolic leaf extract of Ipomoea sepiaria exhibits dose dependent increase in sexual desire in male Wistar albino rats.

  6. Self medication practise among final year MBBS students of brims Bidar Download Article

    Dr Gajanan P Kulkarni, Jyothi D.B
    • Type: Research Article
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    • Pages (29-34)
    • No of Downloads: 86

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    Introduction

    In developing countries like India easy availability of a wide range of drugs coupled with inadequate health services has resulted in increased proportion of drugs used as self medication.

    Objective

    This study was undertaken to determine the knowledge, attitude & practice of self medication among final year MBBS students, BRIMS, Bidar

    Methods

    This study carried, questionnaire-based, descriptive study. A self-developed, pre-validated questionnaire consisting both open and close ended questions was filled final year MBBS students. Data was reviewed, organized and summarized as counts and percentages and evaluated using MS Excel .

    Results

    Out of a total of 100(10-no response) students, 70.5% were male & 29.4% were females. Their age ranged from 17-27 years. Out of these, 67.36%% students had taken self medication with 50.52% being females and 16.84% being males. The commonest indications for self-medication were fever seen in 47.50% of the students followed by, cough/common cold 35.36%. 55.55%% of the students didn’t feel the need to go to a doctor and this was the most frequent reasons for resorting to self-medication and the main source of self medication was books/internet 50% . Analgesics were the commonest drugs used (50.72%) followed by antimicrobials (14.03%) with 53.44% of the students completed the recommended course of antimicrobials.

    Conclusion

    The practice of self-medication in our study was common and often inappropriate and this high prevalence is a cause of concern. Education and proper information about the drugs may go a long way in promoting responsible self medication.

  7. First year medical student’s knowledge and practice on blood donation: a questionnaire based cross sectional study Download Article

    Dr. Vibha Rani, Dr. R. Shyamala
    • Type: Research Article
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    • Pages (35-39)
    • No of Downloads: 77

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    Aim of our study

    To assess the knowledge and practice about blood donation among medical students.

    Materials and methods

    A questionnaire based cross sectional study was conducted among first year MBBS students studying at Malla Reddy Medical College for Women, Hyderabad. A questionnaire with 19 questions on knowledge and practice on blood donation was given to the students. The data so obtained were entered into microsoft excel and statistical analysis was done.

    Results

    Knowledge regarding blood donation was average 94(71.2 %) among the students. 92.4% of the students agreed that blood donation is harmless procedure, 81.8% could tell about the screening tests done before donating blood and only 9% had knowledge regarding the age limit for blood donors. All 132 of our students who participated in the study had never donated blood, the reasons given were 56% of were never been asked to donate and 33.3% had fear of needles, sight of blood. 

    Conclusion

    This study highlights the importance of incorporating  effective awareness programmes as well as creating sufficient opportunities to these students in order to achieve 100% voluntary blood donation.

  8. Comparative evaluation of antidepressant activity of tramadol and tapentadol in swiss albino mice Download Article

    Dr. Narendranath S, Dr. Shruthi K.S, Dr. Pradeep
    • Type: Research Article
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    • Pages (40-48)
    • No of Downloads: 70

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    The study was done after obtaining approval from the institutional animal ethical committee of JJM Medical College, Davangere and CPCSEA. A total of 60 Swiss albino mice inbred in the Central Animal House of J.J.M.M.C of either sex and of weight between 20-40g and aged 3-4 months were taken for the study. They were divided into 10 groups of 6 animals each. The antidepressant activity of tramadol and tapentadol was evaluated in mice using forced swim test model and tail suspension test model.

    In both the experimental models, Group i  received normal saline- 10ml/kg(control group), group ii,iii,iv,v were given tramadol 20mg/kg, tramadol 40mg/kg, tapentadol 20mg/kg and tapentadol 40mg/kg respectively, once a day for 7 days. The drugs were given intraperitoneally.

    On day 7, the drugs were given 1 hour before conducting the experiment. The duration of immobility was noted and compared amongst the 5 groups in both the models. The observations were analyzed using ANOVA (one way) and post hoc Tukey’s test. The test drugs tramadol and tapentadol showed significant reduction in duration of immobility in both the models. In FST model, tapentadol showed significant reduction in duration of immobility at the dose of 20mg/kg (34.67sec) when compared to 40mg/kg (67.5sec); (P <0.003) and was comparable to tramadol at a dose of 20mg/kg (36sec). In TST model, tapentadol at 20mg/kg has shown a greater reduction in duration of immobility (54.8sec) as compared to tramadol at 20mg/kg (106.17sec). Tapentadol showed a greater antidepressant activity compared to tramadol in TST model (P<0.001) and showed similar activity but was statistically insignificant.

    Both tramadol and tapentadol have shown significant antidepressant activity in comparison with control group in both the test models. Tapentadol has shown better antidepressant activity than tramadol in TST model. Hence further animal studies with different model for depression and clinical studies should be conducted to confirm these findings and in choosing the better drug for treatment of chronic painful conditions like cancer which is often associated with depression.

  9. Potential observational study of exploitation of pharmacokinetic principles of antibiotics used for indoor patients Download Article

    Poulami Chatterjee, Mahuya Bhattacharya, Pintu Kr De and Tapan Kr. Chatterjee
    • Type: Research Article
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    • Pages (49-60)
    • No of Downloads: 63

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    The use of pharmacokinetic-pharmacodynamic (PK/PD) properties of certain antibiotics, if used judiciously, could be an effective way to improve drug concentration in body and hence, clinical outcomes. The aim and objective of this study was to observe the prescription pattern of selected antibiotics in indoor patients who were admitted in ICU and ward. In this study it was observed whether antibiotics were prescribed following PK/PD properties. This study focused on drug dosing pattern along with adjustment with creatinine clearance in renal impairment and duration of antibiotic infusion during individual dose of the antibiotics. This observational single center study was conducted for 256 patients. Among them, 16 patients were excluded and 240 patients were finally analyzed as they met the inclusion criteria. In the demographic parameter described it was found that the mean age was in elderly population. It was a male predominant cohort and mostly patients were included from intensive care area. It was observed that culture growth occurred in 53% cases and rest 47% showed negative culture. In majority of cases appropriate antibiotics were given. About 94.74 % were appropriate antimicrobials. The sources of sepsis were lung, and renal in majority however, other sources like GIT, skin and soft tissue, or hepato- bilary, were also there. The major sources of infections in this study were lung and renal (n=70), followed by unknown source (n= 42). The correlation of drug dose adjustment with renal clearance was also investigated in this study. Adjustment of drug following creatinine clearance was mostly found in intensive care area as compared to ward. From this study it could be commented that dose adjustment following creatinine clearance is not that prevalent in ward and should be emphasized to improve clinical outcome and to avoid drug toxicity.

  10. Drug utilization study in post cataract surgery patients in a tertiary care hospital Download Article

    Divya K, Jayanthi C R, Nagaraju G
    • Type: Research Article
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    • Pages (61-68)
    • No of Downloads: 69

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    Background

    Cataract is the major preventable cause of blindness. In India 50-80% of blindness is due to cataract. Recent data from World Health Organization (WHO) shows 25% decrease in blindness prevalence in India. Cataract surgery has been viewed as one of the most cost effective health interventions with a cost of disability adjusted life years saved each year being  20-40 $ (1200-1800 Indian Rs). There has been a substantial rise in cataract surgeries in recent years leading to increased utilization of drugs. Studies about pattern of drugs used in cataract patients are sparse in India. Hence the above study was taken up.

    Objective

    To analyze drug utilization in post cataract surgery patients based on WHO indicators.

    Materials and methods

    Across-sectional, observational study was conducted over a duration of 6 months at department of ophthalmology, Minto Eye Hospital, Bengaluru. A total of 110 prescriptions were analyzed who visited in-patient department. The data was analyzed by descriptive statistics.

    Results

    A total of 110 prescriptions were analyzed which included 431 drugs. Average number of drugs per prescription was 3.91, among which five drugs per prescription were maximum (41%). Majority of the drugs prescribed were in the form of eye drops (65.08%) and the commonest FDC eye drops prescribed being ciprofloxacin with dexamethasone (13.68%). Percentage of prescription with antibiotic is (52%) and injections were (0.89%). About (94.54%) of the drugs were prescribed by brand name and only (5.4%) by generic name. Percentage of drugs prescribed from essential drug list (72.92%). Commonly prescribed drugs were Antimicrobials (52%), Analgesic (23%), Steroid (7%), FDCs (10%), Mydriatics (4%) and others (4%).

    Conclusion

    Topical drugs were commonly prescribed to treat ocular infections. Evaluation of drugs using WHO core prescribing indicators showed that the number of drugs prescribed by generic names and from NLEM was low. 

  11. An prospective and observational study of comparison of efficacy and tolerability between metformin and combination of metformin and glibenclamide in the maintence therapy of type 2 diabetes mellitus in a tertiary care hospital Download Article

    Dr. Syed Wasif, Dr. Veeresh Salgar
    • Type: Research Article
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    • Pages (69-79)
    • No of Downloads: 75

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    Background

    Diabetes mellitus is one of the most common non-communicable disease world-wide. There are many groups of drugs available for the treatment of type 2 diabetes mellitus. we use these drugs as monotherapy or in combination to maintain normoglycemia. Because of paucity of published reports in the Indian literature regarding the pattern of use, efficacy, safety, tolerability of comparison of therapy of metformin and combination of metformin and glibenclamide, the present study was taken up.

    Objectives

    To study the comparison of efficacy, safety and tolerability of metformin and combination of metformin and glibenclamide in achieving normal blood glucose level in type 2 diabetes mellitus.

    Materials and methods

    100 properly selected subjects with type 2 diabetes mellitus were included for the present study. The medication were used empirically as monotherapy or fixed dose combination, OD or BID in a continuation manner after the meals. Blood glucose level was measured at the baseline and daily afterwards for one month using standard techniques. The data collected was analyzed statistically using descriptive statistics. Tolerability and patient compliance for the prescribed medications were also assessed during the follow up visits.

    Results

    Combination therapy reported to control the blood glucose level more efficiently as compared to metformin monotherapy at the end of the study, as 96% of subjects showed normoglycemia as compared to metformin (70%). Also, incidence of hyperglycemic episodes were less in combination therapy.  Subjects with combination therapy reported more side effects compared to metformin alone therapy. The patient compliance for the prescribed medications was excellent.

    Interpretation and Conclusion

    Blood glucose level can be effectively maintained under normal limits in Type 2 DM, with combination therapy as compared to monotherapy of metformin.

  12. Influence of Toddalia asiatica on cardio biomarkers and its protective role against Isoproterenol Induced Myocardial Infarction in Rats Download Article

    Jayakumar Paramasivam, KenyiEte, Nang AratiNamchoomEte and Jaikumar Sankarapillai
    • Type: Research Article
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    • Pages (80-84)
    • No of Downloads: 60

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    The objective of the study was to evaluate the influence of ethanolic leaf extract of Toddalia asiatica on cardio biomarkers against isoproterenol induced myocardial infarction in rats. The protective activity of Toddalia asiatica was assessed by estimating the cardiac marker enzymes (Creatinine Phosphokinase and Lactate Dehydrogenase) and antioxidants enzymes (superoxide dismutase and Catalase). Thirty male Sprague – Dawley rats were randomly allocated in 5 groups of 6 each. Group I served as control, II to V animals were Isoproterenol (85mg/kg) induced  myocardiaol infracted animals, pre treated with the reference control Lipistat (350mg/kg) and ethanolic leaf extract of Toddalia asiatica (200 & 400 mg/kg). All the test drugs were administered orally for 15 days. On 16th day the blood was collected and subjected to the estimation of cardiac marker enzymes. The animals were sacrificed; hearts were homogenized and used for the estimation of antioxidant enzymes. The result showed that, Toddalia asiatica significantly decreased the cardiac marker enzyme and increased the antioxidant enzymes. Toddalia asiatica produced a dose dependent cardioprotective effect against the acute cardiac damage induced by Isoproterenol in rats. From the result it was concluded that, Toddalia asiatica produced cardioprotective activity against isoproterenol induced cardiac damage in rats which was mediated by its antioxidant property.

  13. A cross sectional study of hair dye use among doctors and nurses working at a tertiary care centre Download Article

    Jayanthi C R, Divyashree R N, Vijayalakshmi, Dharani S, Soumya R
    • Type: Research Article
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    • Pages (85-96)
    • No of Downloads: 65

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    Background

    Hair dye products are being extensively used worldwide to enhance an individual outlook. More than two thirds of hair dyes currently contain PPD (paraphenelenediamine) which is a potent allergen and also a carcinogen as demonstrated in experimental studies. With the paucity of existing scientific evidence among the Indian population on hair dye use and in the current scenario safety of hair-coloring agents being a matter of active debate impelled us to take up the present study.

    Objectives

    To assess the prevailing practices, perception and knowledge of hair dye use and also to know the profile of adverse drug reactions to hair dye use.

    Materials and methods

    A cross sectional study was conducted between October 2015- December 2016. A pre validated questionnaire containing 30 questions was administered to doctors and nurses working at Victoria, Vani Vilas, Bowring and Minto hospital attached to Bangalore medical college and research institute. The data tabulated was analyzed using descriptive statistics.

    Results

    A total of 130 doctors and 196 nurses participated in the study with an overall response rate of 79.5%. The age at which the participants started using hair dyes was 21-30 years among doctors and < 20 years among nurses with a frequency of  use being ≥5 times /year in both the groups. 63% of doctors and 80.6% of nurses used the hair dye to cover the gray hairs with the natural hair color being the most preferred option. Most of the participants i.e 64.6% of doctors and 73.97% of nurses used synthetic hair color with synthetic semi-permanent being the most commonly used hair dye although they opined that natural hair dyes are safe. An alarming issue observed in the study was that 69.2% of nurses and 52.30% of doctors never performed an allergy test prior to its use taking into consideration that PPD is a very potent allergen. Adverse drug reactions (ADR) was reported by 15.9% participants with itching (5.47%), rash (2.43%) and watering from eyes and nose (1.835) being the commonest ADR. 26.9% of the reactions were seen immediately and 19.2% sought medical treatment of whom 1.9% required hospitalization with duration of hospital stay being 1-2 days. There was uncertainty with regards to its safety, risk of cancer and safety during pregnancy and lactation in the medical fraternity.

    Conclusion

    Hair dye use was started at an early age and majority used synthetic hair dyes although they perceived that natural ones are safe. Adverse drug reactions noted were minor and provided the potential of PPD to cause life threatening reactions it is essential to increase the awareness regarding its adverse effect profile among the public and health care professionals. Further large scale studies need to be conducted to create a database regarding the hypersensitivity reactions and associated cancer risk which will help governing bodies in cosmetic industry to take sappropriate measures in India.

     

  14. Evaluation of wound healing activity of hydroalcoholic extract of vetiveria ziznoides roots in wistar albino rats Download Article

    Sarath Babu K, Chakradhar T
    • Type: Research Article
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    • Pages (97-99)
    • No of Downloads: 55

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    Background

    Wounds are the common skin disorders. It can occur by various methods. Agents having wound healing activity have wide therapeutic uses. The present study was planned to evaluate wound healing activity of hydroalcoholic extract of Vetiveria ziznoides roots in Wistar Albino rats

    Materials and Methods

    This study was done in the department of Pharmacology, SMIMS. Total 24 rats were divided in to four groups each of 6 rats. G-I: Control, G-II: HAEV.Zroot (75 mg/kg), G-III: HAEV.Zroot (150 mg/kg) and G-IV: HAEV.Zroot (300 mg/kg). 6 cm length of incision was made at para vertebral palace. Rats were given test drugs one week before incision made and one week after incision. Control group treated with distilled water. On 15th day tensile strength was measured.

    Results

    Significant difference was observed in the tensile strength with high dose of test drug compared to low dose and control group.

    Conclusion

    In conclusion, pre-administration of V.Z root increased wound healing compared to control group. Further studies required to find the mechanism of action.