International Journal of Basic & Clinical Pharmacology
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Video assisted thoracoscopy surgery a viable alternative for duplication cyst excision: a case report on foregut duplication cyst
Get PDFAlimentary tract duplication is a relatively uncommon congenital abnormality. It can be found anywhere from the mouth to the anus and can be symptomatic or undetectable. Although congenital duplication can happen anywhere in the gastrointestinal tract, the ileum, oesophagus, and colon are the most common locations. The foregut, which includes the stomach, and first and second segments of the duodenum, is the source of one-third of all duplications. When foregut duplication involves the bronchial tree, respiratory symptoms are often present. Furthermore, excision through surgery is required for pathological examination of the resected specimen for definitive diagnosis. The most promising surgical approach for cyst excision has been thought to be open surgical resection through a posterolateral thoracotomy incision. However, video assisted thoracoscopy surgery has recently emerged as a viable surgical option for duplication cyst removal In paediatric surgery, video assisted thoracoscopy surgery has been established to facilitate the removal of mediastinal masses. However there is a limitation of research in the literature regarding the best surgical technique for oesophageal duplication cyst excision. In girls, foregut duplication is more common, especially in cases when bronchopulmonary involvement is present. While many duplications result in issues in early development, some are discovered by accident. When foregut duplication involves the bronchial tree, respiratory symptoms are often present. Haemoptysis and respiratory distress may be present in specific cases of the patient. Here, we described a 5-year-old male infant's case of foregut duplication with bronchial involvement and its management
Antibacterial activity of Kemloko fruit ethanol extract (Phyllanthus emblica L.) against Staphylococcus aureus and MRSA bacteria
Get PDFBackground: Indonesia is a tropical country, so the prevalence of infectious diseases caused by bacteria remains high. On the other hand, the high use of antibacterial ingredients in Indonesia causes bacterial resistance to existing antibacterial drugs. One of the herbal plants that some people widely use is Kemloko fruit. This study aimed to determine the activity of Kemloko fruit (Phyllanthus emblica L.) ethanol extract against the growth of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) bacteria.
Methods: Simplicia of Kemloko fruit were tested for secondary metabolites and characterization test of the simplicia. The antibacterial activity test was carried out using the diffusion method, where the disc paper was immersed in the test solution with the ratio of the test concentration.
Results: The results of phytochemical screening showed that the secondary metabolite compounds of Kemloko fruit are alkaloids, flavonoids, steroids, tannins, saponins, and glycosides. Antibacterial activity of ethanol extract of Kemloko fruit with agar diffusion method effectively inhibits S. aureus bacteria, namely at a concentration of 80 mg/ml, the inhibition zone is 14.1 mm, and at a concentration of 100 mg/ml, MRSA bacteria obtained an inhibition zone of 14.3 mm.
Conclusions: The ethanol extract inhibits the growth of S. aureus and MRSA
Aframomum subsericeum and Aframomum alboviolaceum leaf essential oils exhibit testosterone antagonistic and oestrogen synergic effects in male Wistar rats: potential candidates for prostate cancer treatment
Get PDFBackground: Aframomum species are routinely used as spices in many traditional Cameroonian meals due to their sweet fragrance. Many species of the Aframomum species are also used to treat cancer, pain, arthritis, and stomach disorders. This work was performed to determine the chemical composition, antiandrogenic, and estrogenic properties of Aframomum subsericeum and Aframomum alboviolaceum leaf essential oils.
Methods: The chemical components of A. subsericeum and A. alboviolaceum essential oils were identified by gas chromatography-mass spectroscopy. The anti-androgenic and estrogenic properties were investigated in vivo in physically and chemically castrated Wistar rats, respectively.
Results: Fifteen compounds versus nine compounds were identified in A. subsericeum and A. alboviolaceum essential oils, respectively. The main compounds of Aframomum subsericeum were cyclohexene, 1-methyl-4-(1-methylethylidene) (10.03%), γ-terpine (12.22%), and myrtenyl acetate (8.52%), while those of Aframomum alboviolaceum were γ-terpinene (20.07%), caryophyllene (11.58%), myrtenyl acetate (7.22%), and (1R)2, 6, 6 trimethylbicyclo [3.1.1] hept-2-ene (6.97%). The results of the anti-androgenic test reveal that both A. subsericeum and A. alboviolaceum induced a significant decrease in androgen-dependent organs, especially the prostate and seminal vesicle, at doses of 200 mg/kg and 100 mg/kg. Interestingly, A. alboviolaceum showed oestrogen synergic effects on the above organs.
Conclusions: So, this study reveals mainly the presence of diterpenoids in both A. subsericeum and A. alboviolaceum, which are potential candidates for prostate cancer treatment. The in vivo results show that Aframomum leaf essential has antiandrogenic and oestrogen synergic properties, suggesting that the oils could provide a safe natural drug for prostate cancer treatment
An expert consensus on managing cough in Indian pediatric practice: airway disease education and expertise 2.0 (2024)
Get PDFCough in children is one of the most frequent presenting symptoms in health care settings. Coughing can significantly affect a child's sleep and level of activity, which often causes parents’ distress. Promptly addressing chronic cough may enhance the quality of life in children and reduce the considerable stress on parents. In 2017, airway disease education and expertise (ADEX) NEXT recommendations for diagnosis, management, and follow-up of persistent (chronic) cough were published. For the present work 27 modified Delphi consensus statements were prepared, and a survey was undertaken involving 30 expert pediatricians from across India. The opinions of the expert panel on the updates related to pediatric chronic cough awareness, diagnosis, and management were collected. Consensus was predetermined to be obtained if more than 75% of the participants agreed or remained neutral for the statement. All the statements were supported by the latest data from the literature search. All the statements reached consensus after an agreement of more than 75%. Consequently, all the opinions from experts were consolidated and expert recommendations were framed. Children presenting with cough should be treated in accordance with child-specific guidelines. The present expert recommendations can be utilized by pediatricians to make well-informed decisions when treating pediatric patients with cough. The management of cough in children should be determined by the underlying cause, where a prompt and efficient therapy can result in early resolution
Utilization patterns of drugs used in the treatment of chronic obstructive pulmonary disease in a tertiary hospital
Get PDFBackground: Chronic obstructive pulmonary disease (COPD) is a disease where there is a limitation of airflow that comes in and out of the lungs due to some abnormalities of the lung`s airway. COPD affects 10% of the global population and is associated with significant morbidity and mortality. The treatment aims to control the symptoms and achieve a good quality of life. The aim of this study is to identify the utilization patterns of different drugs used in the treatment of COPD in Sultan Qaboos University Hospital (SQUH).
Methods: This was a retrospective study that included 170 patients who received treatment for COPD. Patients’ data and drugs’ data were collected through accessing the TrackCare system at SQUH.
Results: The results show that 139 (81.8%) of patients were prescribed with muscarinic receptor antagonists followed by 131 (77.1%) patients who were prescribed with beta 2 receptor agonists. Salbutamol and tiotropium were the most specific drugs prescribed for 103 (60.6%) and 102 (60.0%) patients respectively. 24.7% of the patients received only one drug. There is evidence of a significant association between muscarinic receptor antagonist usage and gender.
Conclusion: This study shows the utilization patterns of drugs that were used in the treatment of COPD in a tertiary hospital
A randomized, open-label and prospective study to compare the efficacy and safety of synbiotics and rosuvastatin along with concomitant ursodeoxycholic acid in non-alcoholic fatty liver disease in North India
Get PDFBackground: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disorder without significant alcohol consumption with a global prevalence of 32%. It is strongly associated with dyslipidemia, obesity, insulin resistance and gut dysbiosis with no current USFDA approved pharmacotherapy. Thus, this study aims to compare the efficacy and safety of Synbiotics and Rosuvastatin along with concomitant Ursodeoxycholic Acid (UDCA), in treatment of NAFLD.
Methods: An interventional, randomized, open-label, prospective and parallel study of 12 weeks with patients randomly divided into two groups- A and B of thirty each. Group A was prescribed Synbiotics (Velgut) 5 billion CFUs BD and Group B was prescribed Rosuvastatin 20 mg OD along with UDCA 300mg BD in both the groups. Patients were followed up every 15 days and mainly assessed on hepatic profile, ultrasound grading, FibroScan, fibrosis indices and lipid profile along with safety profile and compliance.
Results: On comparison, Group A showed significant improvement in hepatic parameters (p<0.001) whereas Group B showed better improvement in lipid profile (p<0.001). In case of ultrasonography for hepatic steatosis and assessment of liver stiffness by FibroScan, both Group A and B showed comparable improvement over 90 days (p=0.143 and p=0.722, respectively) with no worsening of any grades. Both groups performed similarly in terms of safety (p>0.05) and patients showed good compliance (p>0.05).
Conclusion: Combination of Synbiotics and UDCA (Group A) seems to be more efficacious than Rosuvastatin and UDCA (Group B) in North-Indian NAFLD patients over a period of 3 months. Further extensive research with more sample size and studies with longer duration are needed to validate the role of these combination therapies in NAFLD
A prospective observational study on iv compatibility, dose adjustment and ADR of chemotherapy drugs in oncology department at tertiary care hospital
Get PDFBackground: Cancer is the second leading cause of death worldwide. Chemotherapy is a standard modality of cancer treatment that uses chemical agents or drugs to destroy cancer cells in the cell cycles or use chemicals or drugs to inhibit cancerous cells growth and spread. The objective of this study was to assess the IV compatibility of chemotherapy drug in different solution, assess the frequency of ADR, classify ADR according to the class of drug and dose adjustment.
Methods: In this study, cancer patients of either gender (aged 21-90) admitted on the oncology department of Bangalore Baptist Hospital were included in the study. Assessment of IV compatibility was done based on the prescription pattern, dose adjustment was done on the basis of body weight, BSA and hepatic and renal parameters. Adverse reactions reported by the patients, assessed by the doctors and nurses and changes in the laboratory parameters were analysed for the assessment of ADR.
Results: A total of 43 patients met the inclusion criteria; among which 44% were male and 56% were female. The mean age of the study was 57.49. Breast cancer, stomach cancer and lung cancer were more prevalent. In the study 24 chemotherapy drugs were used among them 20 drugs were compatible in 0.9% normal saline and 4 drugs were compatible in 5% dextrose. Dose adjustment were done for 4 drugs which were Carboplatin, Paclitaxel, Trastuzumab and Ifosfamide. The average dose adjusted for Carboplatin, Paclitaxel, Trastuzumab and Ifosfamide were -0.46±3.3, 0.5±10.6, -10±0 and -50±0 respectively. Total of 25 adverse drug reaction were seen where vomiting, gastritis and anemia were more frequently seen. Alkylating agents showed more number of ADRs.
Conclusions: From the study, it can be concluded that most of the chemotherapy drugs were compatible either in 5% dextrose or 0.9% normal saline. Dose adjustments were done on the basis of body weight and BSA. Alkylating agents showed ADR most frequently and least frequent was topoisomerase inhibitor. Vomiting was the most reported ADR
Cost analysis of drugs used in management of heart failure with reduced ejection fraction and marketed in India
Get PDFBackground: Heart failure is characterised by significant morbidity, mortality, poor functional capacity, reduced quality of life, and high cost of lifelong medications. No studies have been performed yet on cost analysis of oral drugs used in management of HFrEF (Heart Failure with Reduced Ejection Fraction). So, we analysed cost variations of different brands of such drugs which are marketed in India.
Methods: It was an analytical study in which maximum and minimum costs in rupees per 10 tablets/capsules of each drug in same strength, manufactured by different pharmaceutical companies in India, were obtained from “Current Index of Medical Specialties” (CIMS) January to April 2023, Indian Drug Review (IDR 2023) and Drug Today (January– April 2023 Cost ratio and % cost variation were calculated for each drug. % Cost variation= Maximum cost- Minimum cost × 100/ Minimum cost. Cost ratio= Price of the costliest brand/ Price of the least costly brand.
Results: Totally 652 brands of HFrEF management drugs from different classes were evaluated. Telmisartan 80 mg had highest cost ratio of 44 and 4300% cost variation, while Spironolactone 25 mg had lowest cost ratio of 1.29 and 31.11% cost variation.
Conclusions: Our study showed significant cost variation in different brands of the same drugs that are used in the management of HFrEF. To lessen economic burden and to improve adherence to treatment, also considering the demographics, it is desirable for doctors to prescribe least costly brands/ generic drugs, to meet the health-care needs of such patients
Evaluation of antidiabetic activity of Ocimum sanctum (Tulsi) through inhibition of alpha-amylase and alpha-glucosidase: an in vitro study
Get PDFBackground: The antidiabetic potential of Ocimum sanctum (Tulsi) has been of increasing interest due to its traditional use in herbal medicine. The aim of this study was to evaluate the inhibitory effects of Ocimum sanctum extracts on alpha amylase and alpha glucosidase enzymes and compare these effects to those of the standard drug, acarbose.
Methods: Various concentrations of Ocimum sanctum extracts were prepared and tested for their inhibitory activity against alpha-amylase and alpha-glucosidase enzymes. The inhibitory effects were measured and compared to the effects of acarbose, a known antidiabetic drug.
Results The extracts of Ocimum sanctum demonstrated a significant inhibitory effect on the alpha-amylase enzyme, with inhibition percentages of 9%, 16.6%, 28.5%, 41.1%, and 47.3% at concentrations of 20, 40, 60, 80, and 100 µg/ml, respectively. However, no significant inhibitory effect was observed on the alpha-glucosidase enzyme when compared to acarbose.
Conclusions: Ocimum sanctum shows potential as an antidiabetic agent through its significant inhibitory effect on alpha-amylase. Further research is needed to explore its full potential and mechanism of action
Natural treasures from Picrorhiza kurrooa: a computational exploration of drug-like properties and bioactivity of kutkin, cucurbitacin, apocynin and lupanine
Get PDFBackground: To analyse and predict the basic pharmacokinetic and toxicological properties of four compounds of interest found in Picrorhiza kurroa (Kutkin, cucurbitacin, apocynin and lupanine) using computational bioinformatics tools.
Methods: The chemical structures and molecular properties of the compounds were obtained from authentic sources and processed for data profiling. 2D structures were converted to 3D structures using ChemSketch software and PHASE module. In silico screening of the 3D structures was performed using bioinformatics prediction software to assess drug-likeness, absorption, blood-brain barrier penetration, enzyme interaction potential, skin penetration, and acute oral toxicity.
Results: Kutkin exhibited poor drug-likeness and low oral absorption, while the other three compounds showed promising drug-like properties and good oral absorption. Cucurbitacin and lupanine were predicted to cross the blood-brain barrier, while Kutkin and Apocynin were not. None of the compounds were substrates for P-glycoprotein, but Kutkin and cucurbitacin were substrates for CYP3A4. All four compounds had low skin penetration. Acute oral toxicity varied, with cucurbitacin classified as highly toxic and the others as slightly toxic.
Conclusions: Cucurbitacin, apocynin, and lupanine have potential for further development as therapeutic agents due to their favorable drug-like properties and good absorption. Kutkin's poor drug-likeness and low absorption make it less suitable for oral drug development. This information provides valuable insights for further research on the medicinal properties of Picrorhiza kurroa and the development of new drugs based on its active compounds