International Journal of Basic & Clinical Pharmacology
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Drug-related problems among type 2 diabetes mellitus patients with hypertension: a prospective observational study
Get PDFBackground: Type 2 diabetes mellitus (T2DM) and hypertension (HTN) are common comorbid conditions that pose significant management challenges due to drug-related problems (DRPs), which can adversely affect clinical outcomes. This study aimed to evaluate the prevalence and types of DRPs in T2DM and HTN patients, analyse drug utilization patterns and identify factors influencing DRPs.
Methods: A prospective observational study was conducted over six months at a multi-specialty hospital in Bengaluru. Data from 110 adult patients with T2DM and HTN were collected, including demographics, clinical history and medication records. DRPs were identified using the Pharmaceutical Care Network Europe (PCNE) and Hepler-Strand classifications.
Results: The mean age of the participants was 63.45±13.66 years, with a nearly equal gender distribution. Monotherapy (37.27%) and dual therapy (33.63%) were the most common T2DM treatments, while calcium channel blockers (37.27%) and beta blockers (36.36%) were the predominant antihypertensives. DRPs were observed in 36.36% of patients, with untreated indications (14.54%) and drug-drug interactions (13.63%) being most common. Factors such as smoking and alcohol consumption were associated with higher DRP prevalence.
Conclusions: DRPs significantly impact the management of T2DM and HTN, highlighting the need for regular medication reviews and targeted interventions to optimize therapeutic outcomes in these patients
N-acetylcysteine in skin picking disorders
Get PDFWe have come across a selection of case studies referencing the effective use of N-Acetylcysteine (NAC) in the treatment of skin picking disorder and other impulsive behaviours. NAC’s pivotal roles in modulating oxidative stress, influencing inflammatory pathways and supporting skin barrier function are thought to be contributing factors in resolving skin picking disorders. Skin picking disorder (SPD) is a “repetitive skin manipulation, resulting in visible tissue damage and the impairment of social functioning”. Despite the huge impact of this condition on quality of life, there have been inconsistent results in successfully treating this condition using current therapeutic modalities
Cosmetovigilance: a review and practice in India
Get PDFCosmetovigilance is a rapidly expanding area of research under pharmacovigilance in India. This study analyses the cosmetic consumption practices and associated adverse drug reactions reported by particulars. According to the US Food and Drug Administration’s (FDA), cosmetics are defined as ‘article for beautification, cleansing or altering physical appearance’ (U.S. Food and Drug Administration, 2018). The consumption of personal care products (PCP) has been rising for quite a while in passing decades which something has to do with physical appearance in the community globally which directly gave rise to emergent of cosmetic industries. Their continuous exposure could lead to significant accumulation in the body and for several adverse health outcomes which can appear as redness, scales and blisters, marking to no visible changes whereas major manifestation can range up to loss of hair, fragile nails and contact dermatitis. Data suggest hair dye is one of the leading causes for contact dermatitis in India. Counterfeit cosmetics is fraudulent or imitation beauty products that are designed to mimic genuine and reputable brands. These counterfeit products are often produced and distributed without the authorization or approval of either original brand or regulatory bodies. Impurities such as high level of heavy metals (lead, cobalt cadmium, mercury and aluminium) are reported in many cosmetics products (lipstick, lip glosses, eye shadow and hair dye) while they pose peculiar health threats like hand dermatitis, asthma and infertility, which is common among hair and saloon technicians
Long-term use of proton pump inhibitors and its impact on glucose homeostasis: results of a prospective observational study
Get PDFBackground: Proton pump inhibitors (PPIs) being the commonly used medications in various gastrointestinal diseases, and were so far considered as most tolerated and safe medications with few, mild adverse effects associated with their use, but of late there have some concerns emerged on their long-term use and the one important observation is their impact on glucose homeostasis. Aim of the study was to measure the dysglycemic potential of proton pump inhibitors by estimating blood sugar and HbA1c at baseline, 6 months and 1 year follow up in patients put on long-term PPIs.
Methods: 150 patients of both the sexes, aged ≥18 years and diagnosed as gastroesophageal reflux disease (GERD), functional dyspepsia or ulcer dyspepsia were included in the study. Patients excluded from the study were those who didn’t consent for their inclusion, known cases of diabetes, any liver or renal disease, pregnant ladies and the ones who were on medications like NSAIDs, steroids or any other hormone.
Results: Mean age of the studied subjects being 41.5±14.6 years with the male: female ratio of 1.1:1. The mean body mass index (BMI) of the patients was 24.5±2.7 kg/m2. Prevalence of hypertension and hypothyroidism and hypercholesterolemia among the participants was 36%, 34.7% and 36.7% respectively and 18% participants had family history of diabetes.
Conclusions: The conclusions that can be drawn from the presents study are that in patients undergoing long-term more than 12 weeks treatment with PPI, there is a significant increase in overall blood glucose parameters, as measured by fasting blood glucose, random blood glucose, and glycosylated haemoglobin
Improvement of schizoaffective disorder with endoxifen treatment: a case report
Get PDFSchizoaffective disorder shares symptomatology and pathophysiology with schizophrenia and bipolar disorder. Studies related to treatment option and their efficacy in schizoaffective disorder are limited; thus, no current consensus treatment guidelines exist. Patients with schizoaffective disorders are treated mainly with combination of antipsychotics and mood stabilizers or antidepressants. Here, the author presents a case of schizoaffective disorders that was successfully treated with endoxifen, which had efficacy issues with amisulpride, quetiapine, and risoperidone and safety issues with clozapine.
Carbapenem resistance crisis: a retrospective investigation of gram-negative bacterial isolates in a tertiary care hospital in Egypt
Get PDFBackground: The increasing prevalence of carbapenem-resistant gram-negative bacteria poses a significant threat to public health worldwide. This study aimed to investigate the patterns and determinants of carbapenem resistance among gram-negative bacterial isolates from patients admitted to Tanta University Chest Hospital, Egypt.
Methods: A retrospective, observational study was conducted, involving patients who received carbapenem antibiotics (ertapenem, imipenem, or meropenem) for at least 48 hours during their hospitalization between January 1, 2023, and December 31, 2023. Data on patient demographics, duration and indication of use and microbiological data were collected. Carbapenem resistance was assessed using antimicrobial susceptibility testing.
Results: A total of 80 patients with gram-negative bacterial cultures were included in the study. The overall prevalence of carbapenem resistance was 70%. No significant associations were found between carbapenem resistance and gender, age or indication. However, significant differences in resistance rates were observed among bacterial species. Acinetobacter (87%), Klebsiella (82%), and Pseudomonas (78%) exhibited high probabilities of carbapenem resistance, while E. coli had a lower resistance rate (31%). Logistic regression analysis confirmed that E. coli was significantly less likely to be resistant to carbapenems compared to Pseudomonas (p=0.039, OR=0.127, 95% CI: 0.018-0.905).
Conclusions: The study revealed an alarmingly high prevalence of carbapenem resistance among gram-negative bacterial isolates in a tertiary care hospital in Egypt. Effective antimicrobial stewardship programs, strict infection control measures, and continuous surveillance of antimicrobial resistance patterns are crucial to combat the growing threat of carbapenem-resistant organisms
Knowledge, attitudes, and practices toward antibiotic use and resistance among medical students: a cross-sectional study
Get PDFBackground: Antimicrobial resistance (AMR) is becoming a major global health problem, which is jeopardizing the effectiveness of current antibiotics and causing increasing difficulty in routine clinical care. As future prescribers, medical students must develop strong knowledge, attitudes, and practices (KAP) to ensure effective antimicrobial stewardship (AMS). It explored the knowledge, attitude and practice of Indian undergraduate medical students concerning antibiotics and antimicrobial resistance.
Methods: A cross-sectional survey was conducted among 500 undergraduate medical students at a tertiary care hospital attached to a medical college in India. A validated, structured 30-item questionnaire based on World Health Organization (WHO) guidelines was used to assess KAP. The responses were reported using a 5-point Likert scale. Statistical analyses included t-tests, Mann-Whitney U tests, and Welch’s ANOVA to evaluate the influence of AMR training and academic progression (p<0.05).
Results: Students demonstrated strong theoretical knowledge of AMR, but reported low confidence and limited engagement in AMS activities. Only 47.6% had formal AMR training, and 16.8% participated in AMS programs. Trained students scored significantly higher in knowledge (p=0.006) but not in attitudes or practices. KAP scores improved progressively across academic years, with final-year students and interns scoring the highest.
Conclusions: While Indian medical students show a high awareness of AMR, confidence and practice-oriented engagement are limited. Curricular reforms incorporating experiential learning and early AMS integration are crucial to bridging the knowledge-practice gap
Potential concerns and challenges toward anti-SAR-CoV-2 vaccine among undergraduate students of North India
Get PDFBackground: SARS-CoV-2 has trampled the healthcare system during the pandemic and still frames distressed pictures of quarantine, isolation, and vaccine hesitancy. Hence, the present study was conducted at a tertiary care hospital in Uttarakhand to address the paucity of data regarding concerns and challenges in accepting the anti-SAR-CoV-2 vaccine among medical and nursing students.
Methods: An online survey was conducted via the Google platform using Google forms. A total of 248 undergraduate medical and nursing students who were selected via the non-probability.
Results: The mean age was 22.0±3.6 years. Of them, 58% were B.Sc. nursing students, and 42% were MBBS/DNB students. About 85% agreed that the COVID-19 vaccine was safe and were psychologically prepared for minor signs and symptoms after vaccination. About 23% were worried about the hormonal changes that may occur after getting vaccinated. Nearly one third (37%) had concerns about hospital admission and expenses in case of any adverse events. Overall, 56% had accepted the SARS-CoV-2 vaccine.
Conclusions: Although the acceptance rate was high among participants, a few concerns and challenges reported by participants cannot be overlooked. Hence, there is a need to continuously address the concerns to improve the rate of adherence and to further psychologically prepared for the minor signs and symptoms after vaccination SARS-CoV-2
Demographic and clinical profile of functional dyspepsia patients in a Northern Indian tertiary care setting
Get PDFBackground: Functional gastrointestinal disorders (FGIDs) are prevalent and diagnostically challenging conditions that lack structural abnormalities, but significantly contribute to patient morbidity. This study aimed to analyze the demographic and baseline clinical parameters of patients presenting with functional dyspepsia symptoms in a tertiary care hospital in Northern India.
Methods: This analysis was based on baseline data from a randomized controlled trial involving 71 patients (aged 18–75 years) with non-structural gastrointestinal complaints. Prior to randomization and treatment initiation, all patients underwent complete blood count, liver and renal function tests, fasting blood sugar measurement, electrocardiography (ECG), upper GI endoscopy (UGIE) and Helicobacter pylori biopsy. Demographic and baseline clinical data were analyzed using descriptive statistics and comparative tests.
Results: The mean age of patients was 46.37±15.2 years, with the highest representation in the 51–60 years age group. Females predominated slightly (56.34%). All patients had normal UGIE and ECG findings and tested negative for Helicobacter pylori. Laboratory parameters were within normal limits for both sexes. Most patients had moderate gastrointestinal symptom scores before treatment, as assessed by GDSS, SF-LDQ and VAS scores.
Conclusions: Functional Dyspepsia is more common in middle-aged individuals and slightly more prevalent in females. Despite the absence of structural findings, symptom severity is considerable, necessitating a comprehensive assessment and individualized management strategies. This study provides valuable insights into the demographic and clinical characteristics of patients with FGID in a tertiary care setting in Northern India
Comprehensive review of osteoarticular tuberculosis: from epidemiology to emerging therapies
Get PDFOsteoarticular tuberculosis (OATB) remains a significant global health challenge with high morbidity and potential for permanent disability. Recent advancements in diagnostics, pharmacotherapy, and adjunctive treatments have shown promise for improving the outcomes of patients with OATB. This review summarizes the latest developments in the field, focusing on epidemiology, pathogenesis, diagnostic innovations, novel anti-tuberculosis drugs, combination therapy approaches, surgical interventions, adjunctive therapies, and the importance of multidisciplinary approaches. Emerging diagnostic technologies such as advanced imaging modalities, molecular assays, and nanotechnology-based tests have enhanced the speed and accuracy of OATB detection. Newer anti-tuberculosis drugs, including bedaquiline, delamanid, and pretomanid, have demonstrated efficacy in multidrug-resistant (MDR) and extensively drug-resistant (XDR) cases, whereas DprE1 inhibitors and oxazolidinone alternatives show promise in early phase trials. Minimally invasive surgical techniques, joint-preserving procedures, and reconstructive methods using 3D-printed implants and antibiotic-loaded materials have improved functional outcomes. Immunomodulators, bone grafts, and regenerative medicine have been explored as adjunctive therapies. Effective management of OATB requires collaboration among various specialists, and integrated care models facilitate personalized treatment plans. Challenges remain, including drug resistance, and the need for further research to establish optimal regimens and durations specific to OATB. By highlighting key advancements and their potential impact on patient outcomes, this review underscores the importance of a multidisciplinary evolving paradigm for treating OATB in the era of precision medicine.