International Journal of Basic & Clinical Pharmacology
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Analysis of antidiabetic drug utilization patterns in type 2 diabetes patients: a perspective on real-time prescribing practices
Get PDFBackground: Type 2 diabetes is a most common health problem associated with significant morbidity and mortality worldwide, evaluation of drug utilization pattern is very crucial and significant in order to promote the rational use of drugs in treatment of diabetes, and offer insights in to the actual patterns of drug use. The objective is to evaluate drug utilization pattern of antidiabetic drugs among type 2 diabetic patients at Integral Institute of Medical Science & Research.
Methods: This is a prospective observational study involving 100 subjects conducted for a period of 6 months after approval by Institutional Ethics Committee (IEC) of Integral University at IIMS and R Hospital. Informed consent was obtained from all the participants. Data gathered was examined using descriptive statistics and compared to the standard guidelines. Drug utilization pattern was studied and evaluated to analyse the pattern of drug therapy among type 2 diabetics.
Results: Antidiabetic drugs were given 198 times among the 100 participants, averaging 2 antidiabetic drugs per prescription, Insulin therapy (58.58%) and Metformin (20.20%) were the most prescribed medications, combination therapy was common, with 66% of patients particularly with Glimepiride (DPP4 Inhibitor) at 10.61%. Most prescriptions were given by generic name (55%) and 90% of the drugs prescribed were from the WHO essential medicines. Most patients were aged 51-60 years, with a nearly equal gender distribution.
Conclusion: The study highlights the prescribing patterns and characteristic use of antidiabetic medications. These findings provide valuable insights into the current prescribing practices in type-2 DM treatment and can contribute to optimizing treatment strategies for better patient outcomes.
A panoramic view of the strategies for epithelial ovarian cancer: a review of current challenges
Get PDFEpithelial ovarian cancer (EOC) remains a formidable challenge in the field of gynecological oncology, accounting for a significant proportion of cancer-related deaths among women worldwide. Despite advances in surgical techniques and chemotherapeutic regimens, the prognosis for patients with advanced-stage disease continues to be dismal, underscoring the urgent need for novel and more effective treatment strategies. This editorial review examines intriguing therapeutic modalities that have the potential to improve treatment outcomes as well as overcome the current difficulties in managing EOC. It presents a brief but comprehensive examination of current research literature about epithelial ovarian cancer, challenges, disease recurrence, molecular complexity, and emerging therapeutic modalities. The importance of gene- and stem-cell therapy in pursuing effective ovarian cancer treatments still holds the platform. While traditional chemotherapy remains crucial for advanced cases, surgical interventions remain pivotal for early-stage patients. Treatment options include innovative DNA polymerase (alpha/delta/epsilon) inhibitors, personalized treatments, and immunotherapies toward advanced cases for quality survival. The challenges posed by epithelial ovarian cancer and late diagnosis necessitate a continuous quest for improved therapeutic options. Emerging approaches such as gene and stem cell therapies show promise in reshaping treatment paradigms. Further exploring localized treatment modalities presents avenues for enhancing improved patient payoff
Bibliometric analysis on the publications of the statins-associated autoimmune myopathy: a comprehensive review
Get PDFThis bibliometric analysis aimed to assess the landscape of research on statin-associated autoimmune myopathy (SAAM), focusing on publication trends, contributors, and implications for further investigation. Access to the Scopus and Web of Science databases was obtained through institutional login credentials. An advanced search using keywords "statin associated autoimmune myopathy" or "SAAM" was conducted. Data were collected from 2003 to 2022 and analysed using the Biblioshiny package in R-Studio. A total of 110 publications were identified, involving 418 authors. The analysis revealed a steady increase in publication activity on SAAM, particularly notable in 2017, 2020, 2021, and 2022, with a peak of 13 publications in certain years. However, no publications were recorded in 2014. The accumulated citations from 2003 to 2022 totalled approximately 3,000, indicating a sustained interest in the topic. Statins, being first-line drugs for conditions like hyperlipidemia, diabetes mellitus, cardiovascular diseases, obesity, and cancer, underscore the importance of vigilant monitoring for associated adverse events. The analysis highlights the need for further research on SAAM, a drug-related adverse reaction, due to the widespread use of statins and their association with comorbidities. Understanding and monitoring SAAM is crucial for patient safety, and further investigation is needed to understand its mechanisms and risk factors
A rare case of esophageal variceal bleeding from portal hypertension due to extrahepatic portal vein obstruction in a two-year-old
Get PDFExtrahepatic portal vein obstruction (EHPVO) is a type of liver vascular disease characterized by cavernomatous transformation and obstruction in the portal veins. Congenital defects, numerous transfusions, trauma, sepsis, dehydration, and hypercoagulable disorders are important risk factors. Since most patients have no symptoms, acute extrahepatic portal vein obstruction is frequently disregarded. Hematemesis and splenomegaly without hepatic decompensation are among the symptoms that might occur in subacute and chronic stages. Imaging studies aid in the diagnosis; Doppler imaging is added to ultrasonography to visualize portal vein blood flow. MRI and CT scans are used to visualize portal vein blockage. Prevention of acute bleeding is the cornerstone in the management. Studies have shown that transhepatic thrombolysis is the preferred choice to avoid systemic side effects. Treatment for extrahepatic portal venous thrombosis involves an intrahepatic portosystemic shunt, which is usually followed by conservative measures to stop variceal haemorrhage. When other forms of therapy are ineffective, liver transplantation is carried out. This case report describes a rare instance of EHPVO in a two-year-old boy who was hospitalized due to recurrent fever, increased belly circumference, and a persistent feeling of fullness in the abdomen. The patient had a surgically placed splenorenal shunt, which helped him respond well to treatment
Evaluation of protective potency of coconut oil-based probiotic against antibiotic-induced compromised gastrointestinal attributes and associated complications in Swiss albino mice
Get PDFBackground: Antibiotic-induced gastrointestinal toxicity is a major concern globally. The gut-organ axis has been explicitly studied, and hence, any damage to the gut ecosystem directly or indirectly manifests into compromised multi-organ functions. Therefore, the present study was designed to explore the protective potency of coconut oil-probiotic (C-PRO) against antibiotic-induced compromised gastrointestinal attributes and associated complications.
Methods: Animals were divided into 5 groups (n=6). Normal saline was given to the control group; the antibiotic cocktail was given to the antibiotic group. In the treatment group, low and high doses of C-PRO were given post-antibiotic treatment. In the per se group, only a high dose of C-PRO was given. After 28 days, animals were studied for neurobehavioral parameters and scarified. Blood and organs were collected and stored for histopathological, immune histochemical, and biochemical analysis.
Results: Antibiotic treatment reduced body weight, increased oxidative stress, and caused histopathological damage to the stomach, duodenum, colon, brain, heart, liver, lungs, kidney, spleen, and testis. It also altered biochemical parameters such as lactate dehydrogenase (LDH), creatine kinase-myocardial band (CK-MB), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), albumin, creatinine, urea, uric acid, and blood urea nitrogen (BUN). Additionally, Antibiotic exposure in mice exhibited depressive-like behaviour and declined cognitive function. The treatment with a low dose of C-PROs showed negligible protective effect, whereas a high dose of C-PRO effectively reversed the structural, biochemical, and neurobehavioral attributes toward normal.
Conclusions: We conclude that the synergistic effect of coconut oil and probiotics, which have potent antioxidant and anti-inflammatory effects, might be responsible for multidimensional protective effects against compromised gastrointestinal attributes and associated complications
A prospective observational comparative study of effectiveness and adverse effects of amitriptyline versus duloxetine in the treatment of somatoform pain disorders in a tertiary care hospital
Get PDFBackground: To compare the effectiveness and adverse effects as well as treatment compliance of amitriptyline and duloxetine in treating somatoform pain disorder.
Methods: This study was done on 100 patients, with 50 in each group, at Mandya Institute of Medical Sciences (MIMS) over 6 months. Group A was treated with amitriptyline 75 mg per day, and Group B with duloxetine 40 mg per day. Patient Health Questionnaire (PHQ-15) as well as Social and Occupational Functional Assessment Score (SOFAS) were used to compare effectiveness of treatment. For medication adherence Medication Adherence Rating Scale (MARS) was used. Adverse effects were also monitored. The baseline measurements were taken, and evaluations were conducted at 4th, 8th, and 12th weeks of follow-up.
Results: There were 31% males and 69% females. At baseline and after 12 weeks, Group A had average PHQ-15 scores of 14.72±6.13 and 3.16±0.97, respectively, while group B had scores of 17.12±5.45 and 7.22±2.46. During the same period SOFAS scores were 48.70±6.27 and 85.9±5.06 for group A, and 50.86±5.99 and 82.62±6.10 for group B. The effectiveness of Amitriptyline group showed statistically significant difference (p<0.05) when compared with Duloxetine. Group A experienced more adverse effects like dry mouth, drowsiness when compared to Group B.
Conclusions: Amitriptyline and duloxetine are effective in treatment of somatoform pain disorder; the effectiveness of amitriptyline was higher when compared to duloxetine in our study
What do we know and how do we act: knowledge, attitude and practices around antimicrobial resistance
Get PDFBackground: The overuse and misuse of antibiotics has influenced a rise in antimicrobial resistance (AMR) thereby posing a significant threat to global health. Information on AMR has been available to the public; however, a gap exists in relay of information due to lack of effective interventions. This study focuses on exploring the knowledge, attitudes and practices (KAP) among rural, semi-urban and urban populations from Delhi NCR, India.
Methods: This study was a cross-sectional questionnaire based online survey conducted across rural, semi-urban and urban areas of Delhi NCR for one month (June-July 2024). The questionnaire comprising 28 close-ended questions was administered in English and Hindi languages to participants aged 15-80 years. The questionnaire focused on knowledge, awareness and practices of antibiotics and antimicrobial resistance.
Results: A total of 500 participants attempted the survey out of which 435 (87%) were aware about antibiotics. About 479 (95.8%) participants had earlier consumed antibiotics out of which 336/497 (70.1%) participants consumed antibiotics prescribed by doctors. Among 479 participants, 253 (52.8%) completed the course however 311 (69.1%) of the participants kept the antibiotics for reuse. Nearly 191/479 (39.9%) participants practiced antibiotics misuse by consumption of antibiotics when having similar symptoms as previously observed. The assessment of participants revealed that only 216/500 (43.2%) participants were knowledgeable about AMR. The participants aware of AMR agreed that the antibiotic practices of reuse (n=69/216, 31.9%), poor quality (n=87/216, 40.3%), lower dosage (n=81/216, 37.5%) and not completion of course (n=77/216, 35.6%) can result in AMR.
Conclusions: The study highlights that despite the participants being informed about antibiotics and followed medical advice their practice of reusing antibiotics raises the need for tailored interventions to promote awareness about AMR and appropriate use of antibiotics
Efficacy of panchakarma based ischemia reversal therapy along with diet modification in management of ischemic heart disease
Get PDFBackground: Aim was to evaluate the efficacy of panchakarma-based ischemia reversal therapy combined with diet modification in the management of ischemic heart disease.
Methods: A retrospective, single centre study was conducted at a Madhavbaug clinic in Maharashtra from February 2022 to December 2023. Patients aged 20-75 years diagnosed with ischemic heart disease were included in the study. Follow-up was conducted weekly, for total duration of 90 days. Day 1 and day 90 data were compared
Results: A total of 22 patients with mean age of 58.64±9.81 years were included in this study. VO2max (day 1: 16.34±5.35 mL/kg/min and day 90: 28.11±7.39 mL/kg/min, p=0.00), duke treadmill score (day 1: -6.77±4.38 and day 90: 3.77±15.83, p=0.00), and MET value (day 1: 4.66±1.53 and day 90: 8.02±2.10, p=0.00) improved significantly at the 90-day follow-up.
Conclusions: Ischemia reversal therapy has proven to be effective in improving the cardiac capacity of heart, demonstrated by improvement in VO2max. Also improved Duke’s treadmill score
Experimental repurposing of metformin for Crohn’s disease in trinitrobenzene sulfonic acid induced colitis model in BALB/c mice
Get PDFBackground: Inflammatory bowel disease (IBD) is characterized by repetitive episodes of inflammation of the gastrointestinal tract caused by an abnormal immune response to gut microflora. It includes two types: Ulcerative colitis (UC), which causes widespread colon inflammation, and Crohn’s disease (CD). The current therapy focuses on symptom relief and provides inadequate maintenance of remission and quality of life improvement. Metformin has already been repurposed in few studies with dextran sulphate sodium (DSS) induced colitis. We aimed to evaluate the effect of metformin in TNBS induced acute on chronic colitis, to mimic the relapsing-remitting nature of CD in humans, which has not been done before.
Methods: Objectives were, phase I- evaluation of the effect of metformin in TNBS induced acute colitis in BALB/c mice. Phase II- evaluation of the effect of metformin in TNBS induced chronic colitis in BALB/c mice. Phase III- Evaluation of the effect of metformin in TNBS induced acute on chronic colitis in BALB/c mice. Materials And Methods: Trinitrobenzene sulfonic acid (TNBS) was used for inducing both acute, chronic and acute on chronic colitis in BALB/c mice. 36 BALB/c mice were divided into 4 groups i.e. normal control, disease control, positive control and test drug. Effect on DAI score, lower colon weight by length ratio, macroscopy and histopathology were assessed.
Results: Metformin showed significant improvement (p<0.05) in all the variables assessed i.e. reduction of (Disease Activity Index) DAI score, lower colon weight by length ratio, lower colon macroscopic score and lower histopathological score in comparison to the disease control group in all the phases i.e. acute (day 5), chronic (day 22) and acute on chronic (day 25). However, the effects were comparable to the positive control.
Conclusions: Metformin has potential to be repurposed for Crohn’s disease as it showed comparable efficacy in all three phases
Knowledge, attitude and practice towards sunscreen use among undergraduate medical students in a tertiary care teaching hospital in south India: a cross-sectional study
Get PDFBackground: This study was done to evaluate the knowledge, attitude and practice (KAP) of medical undergraduate students toward the usage of sunscreen as protective measures against ultraviolet (UV) radiation.
Methods: A cross-sectional survey was conducted among the undergraduate medical students in a tertiary care teaching hospital in South India. A pre-designed and validated questionnaire containing 13 questions was used to assess knowledge, attitude and practice. The filled KAP questionnaires were analyzed using descriptive statistics.
Results: A total of 100 medical students participated in our study. The mean age of respondents was 19.9±0.73 years. Half of the study participants (50%) were aware of the association between long term sun exposure and skin cancer. Only 17.5% of students were aware of the correct quantity of sunscreen to be used for effective sun protection.65% of respondents did not apply the sunscreen product 30 minutes prior to sun exposure. Only 40% of students could name at least 1 ingredient in sunscreen. Reapplication rates were 39.1% among respondents.
Conclusions: This study indicated that the awareness and level of knowledge of sunscreen use is not adequate among the medical personnel, thus requiring health education programs to emphasize the importance of regular and correct sunscreen use. It is imperative that the medical students are adequately informed regarding sunscreen benefits and skin cancer prevention as they form the future healthcare system