International Journal of Basic & Clinical Pharmacology
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Renal biomarkers of Rosemarinus officinalis L. on gentamicine induced acute kidney injury in adult male albino rats (Rattus norvegicus)
Get PDFBackground: Gentamicin (GN) drug is a common choice for treating severe gram-negative bacteria infections especially in resource-limited settings where cost effective options are considered. However, its potential effect of causing acute kidney injury (AKI) has limited its wide use in clinical applications. R. officinalis (rosemary) is a traditional herb rich in antioxidants and anti-inflammatory properties. Conversely, renal biomarkers effect of Rosmarinus Officinalis (RO) on GN has not yet been elucidated. The main objective was to investigate the renal biomarkers and protective effect of R. officinalis against Gentamicin induced acute Kidney injury in adult Albino rats.
Methods: 25 adult male Albino rats were equally divided into five groups (5 Albino rats per group). Control group received rat pellets plus water ad libitum, GN (100 mg/kg/bwt/i.p), low dose RO (RO 100 mg/kg/bwt/po+GN), Medium RO(150 mg/kg/bwt/po+GN), and high dose RO (200 mg/kg/bwt/po+GN) groups. GN was administered intraperitoneal, and RO orally for seven consecutive days. After completion of 24hours of the last drug administration, they were humanely sacrificed, serum biochemical analysis of renal biomarkers (creatinine and urea) was determined.
Results: Gentamicin was able to induced acute kidney injury by increasing levels of creatinine and urea. However, with concurrent administration of high dose of RO, Serum creatinine and urea remained within the normal ranges.
Conclusions: These findings showed that, Concurrent administration of a high dose of RO 200 mg/kg/bwt with Gentamicin protects kidneys against Gentamicin induced injuries
Antimicrobial sensitivity pattern of bacterial pathogens for uncomplicated urinary tract infection in female patients at a tertiary level hospital
Get PDFBackground: Urinary tract infections (UTIs) remain the common infections in outpatients as well as hospitalized patients. Antimicrobials are frequently used drugs for the treatment of UTIs. Periodic evaluation of antimicrobial activity of different antimicrobial agents is essential as the pattern of antimicrobial sensitivity may vary over period. The aim of this study was to identify the antimicrobial sensitivity pattern of the isolated uropathogens in female patients in urinary tract infection at a tertiary care hospital in Bangladesh.
Methods: This observational cross-sectional type of study was conducted in the department of pharmacology and therapeutics in collaboration with department of microbiology SBMC, outpatient department of medicine, and gynaecology and obstetrics, SBMCH, Barishal, from January 2017 to December 2017.
Results: In this study, age of the subjects ranging from 18 to 65 years, majority subjects (57.0%) belonged to age group of 31-44 years. The mean age was found 44.5±9.1 years. Out of 200 cases, 83% cases hailing from rural area and 17% from urban site. In this study microbial culture result of uncomplicated UTI revealed that 103 (51.5%) of urine samples had significant bacteriuria. E. coli was found to be the most prevalent 47 (45.6%), followed by Klebsiella pneumoniae 18 (17.4%), Proteus spp. 11 (10.6%) and Enterobacter spp. 9 (8.7%).
Conclusions: The pattern of resistance to commonly used antimicrobials for treating UTI alerts us against indiscriminate usage of antimicrobials
Septic shock diagnosis and its treatment
Get PDFIn critical care, sepsis continues to be a major cause of mortality. The pathogenic, diagnostic, and therapeutic panorama of sepsis is no longer restricted to the critical care unit: many patients who enter treatment through other doors, both inside and outside the hospital, develop severe illness. Next, administer fluids and broad-spectrum antibiotics after taking the proper cultures. Step up the treatment to include monitoring urine output, blood gases for base excess, lactate, haemoglobin, and glucose if the situation does not get better within the following six hours. These will dictate how bicarbonate, insulin, fluids, transfusions, and vasopressors are managed. The patient should be sent to intensive care if the hypotension doesn't improve (septic shock). Sepsis can now be treated with methods that have produced better results with other illnesses. New medicines have been created as a result of a better understanding of the biology of severe sepsis and septic shock, placing a strong emphasis on early detection and aggressive treatment. The major priorities continue to be prevention through screening, preventing cross infection, and prudent antibiotic usage
A rare presentation of adult Bartter syndrome: a case report
Get PDFBartter syndrome (BS) is an inherited renal tubular disease. It is caused by a defective salt reabsorption in the thick ascending limb of loop of Henle. The term BS signify a group of renal disease which is the common divisor of hypokalemia and metabolic alkalosis. BS is categorized into 5 types based on the specific channel; type 1 is linked to gene SLC12A1, type 2 is linked to a gene KCNJ1, type 3 is linked to a gene called CICNKb while type 4 is linked to a gene BSND and type 5 is linked to CASR gene. This disorder is correlated with an increased antenatal and neonatal mortality. Here, a 61 years old female patient was presented with complaints of fever, myalgia, nausea, and cough for one day, decreased appetite and unable to do daily routine. Patient had conscious, oriented and afebrile. She had history of OAD, type 2 diabetes mellitus and hypertension. On hospital stay, she was started on IV calcium gluconate, potassium chloride, magnesium sulphate, antipyretics and other supportive measures. This case concludes the rarity of the BS. Correct diagnosis of BS is more expensive and not routinely available genetic testing. Therefore, the significance of diagnosing the case is more relevant
Assessment of efficacy and safety of clindamycin with nicotinamide in mild to moderate acne vulgaris: a prospective study
Get PDFBackground: Acne vulgaris is a very common skin disease that is usually treated with topical products, systemic medications, or a combination of both. Acne vulgaris affects approximately 9% of the population worldwide causing permanent physical scarring, negatively affects the quality of life and self-image, and has been associated with increased rates of anxiety, depression, and suicidal ideation.
Methods: This was a prospective study conducted at BMCRI including thirty-five subjects who were diagnosed with mild to moderate acne vulgaris. Patients were treated with topical clindamycin 1% with nicotinamide 4%. Efficacy was assessed by mean change in acne severity index (ASI) and total lesion count (TLC) from baseline and at the end of 4, 8 and 12 weeks. Safety was assessed by adverse events reported.
Results: There was statistically significant improvement noted at the end of each visit. Baseline ASI was 88.05±4.02 and end of 12 weeks was 14.17±2.7. Baseline TLC was 30.17±1.33 and at the end of 12 weeks was 4.25±0.99. Both the ASI and TLC results were statistically significant at the end of fourth, eighth and twelfth-week p value <0.0001.
Conclusions: Combination topical formulations are the most broadly used treatment regimen for Acne vulgaris to target one or more steps in the pathogenesis of acne. From the results of the present study the participants on combination of clindamycin with nicotinamide had a significant improvement in acne lesions at end of 12th week of topical application and were satisfied with the therapy with no major adverse effects
Enhancing patient safety: leveraging artificial intelligence-powered electronic medical records for effective drug-drug interaction nudge in real-world prescribing practices
Get PDFBackground: Concurrent prescriptions of various medications may lead to unfavorable and unanticipated potential drug-drug interactions. Hence, the elimination of drug-drug interactions is a key aspect of delivering a coherent treatment regime. In response to this concern, HealthPlix, one of India's largest AI-powered electronic medical record providers, introduced a drug-drug interaction nudge feature in June 2022, providing a proactive solution for physicians to address potential interactions between incompatible drugs. This study aimed to elucidate the role of electronic medical records in identifying and managing drug interactions and the advantages of interaction nudges for doctors in prescribing appropriate medications.
Methods: An observational retrospective study was conducted using data obtained from HealthPlix, containing two or more drugs, written for patients older than 18 years.
Results: In an average of 1.9 million patient visits analyzed, the interaction visits were observed to be 1.2 million. An average of 185,745 interactions were observed during the study period. For all observed interactions, an average of 72,383 molecules were removed. These results provide insights into the efficiency of HealthPlix in abrogating interactions and illustrate the tangible benefits of nudges in modifying prescription practices.
Conclusions: The above results illustrate the effectiveness of drug-drug interaction nudges as a clinical decision support tool integrated into HealthPlix, marking a significant advancement in Indian healthcare. This unique feature contributes to reducing the frequency of potent drug interactions, showcasing its potential to enhance patient safety and improve the quality of healthcare delivery
Alzheimer’s disease: newer modalities in treatment
Get PDFAlzheimer’s disease (AD) remains insurmountable despite a long history of research and clinical development. It is projected to rise in the coming decades of public health due to the aging population worldwide. Understanding the basic tenets of the disease and targeting key steps remains a time-tested approach even for AD. Apart from the currently available treatment options namely NMDA blockers, and acetylcholinesterase inhibitors, recently monoclonal antibodies that target Aβ amyloid protein are approved. This review highlights the key features of currently approved drugs along with promising drugs in clinical development
Drug utilization study of antidepressant drugs in psychiatric outdoor patients at a tertiary care hospital in Southern Rajasthan
Get PDFBackground: The World Health Organization (WHO) defines “Drug Utilization” as the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences. Antidepressants are used to treat depressive illnesses and anxiety disorders. However, these are also employed in the pharmacotherapy of several psychiatric disorders. Very few studies were found regarding the pattern of prescription of antidepressants in outdoor patients in southern Rajasthan. So, this study has been planned to learn about the prescription pattern of antidepressant drugs as per WHO Core Drugs Prescribing indicators at a tertiary care hospital in southern Rajasthan.
Methods: A cross-sectional observational study was conducted among 375 patients by convenient sampling over one year duration, in the outdoor Department of Psychiatry at RNT Medical College, Udaipur, Rajasthan. Patient’s prescriptions were analyzed for drug utilisation pattern in OPD after relevant consent. All data was compiled in MS Excel and analyzed using statistical methods.
Results: Out of 375 prescriptions analyzed, 48.8% were males and 51.2% were females. Most commonly, patients had a diagnosis of depressive disorder (42.93%), followed by bipolar affective disorder (14.4%). The most common drug class prescribed was SSRI (88.86%). Escitalopram (41.65%) was the most prescribed drug, followed by Sertraline (30.51%).
Conclusions: Among the prescribed antidepressants SSRIs were the most common class of drug followed by TCA. Escitalopram was the most common drug to be prescribed followed by sertraline. More than half of the patients receiving antidepressants suffered from non-depressive disorders. Monotherapy was preferred over combination therapy. All patients were prescribed generic drugs
Ketamine but not glycine potentiates antidepressant like action of citalopram in mice exposed to chronic mild stress
Get PDFBackground: The present study was designed to investigate the effect of citalopram, ketamine, glycine and their combinations on animal models of depression.
Methods: Swiss Albino male mice were subjected to chronic mild stress for 6 weeks for inducing depression, and randomly divided into different groups: citalopram (5 and 10 mg/kg), ketamine (17.5 and 35 mg/kg), glycine (50 and 100 mg/kg), ketamine (17.5 mg/kg) + citalopram (5 mg/kg) and ketamine (17.5 mg/kg) + glycine (50 mg/kg). Two behavioural tests were utilized for the assessment of depression, namely tail suspension test (TST) and forced swim test (FST). Immobility time was recorded for 6 min, before and after administration of drug.
Results: Citalopram (10 mg/kg) administration caused significant decrease in the immobility time in TST model only but not in FST. Citalopram (5 mg/kg) and ketamine (17.5 mg/kg) caused insignificant decrease in immobility time in both the models. Moreover, ketamine in combination with Citalopram significantly reduced the immobility time in both the models. Glycine at a dose of 100 mg/kg (but not 50 mg/kg) significantly increased the immobility time in both the models as compared to control group. Further, ketamine when administered with glycine caused increase in the immobility time on both the paradigms, though insignificant.
Conclusions: Ketamine demonstrated antidepressant like action in both TST and FST models. Moreover, it potentiated the antidepressant effect of citalopram that might be due to the role of NMDA receptors
Knowledge, attitudes, and practices regarding drug allergy among healthcare providers in Eastern India
Get PDFBackground: Drug allergy (DA) or hypersensitivity is an immunologically mediated reaction producing stereotype symptoms which is challenging for health care providers (HCP). Objective of current study was to assess the knowledge, attitudes and practices of drug allergy among healthcare providers in eastern India.
Methods: A 25-item self-administered DA questionnaire was developed and applied in our study. The questionnaire covered 3 domains: knowledge, attitudes, and practice patterns. From July 2020 to September 2020, HCPs participated in the cross-sectional study.
Results: A total of 237 HCPs participated in the study, and all questionnaires were analysed.
Among the respondents, 226 (95.4%) were nurses, 9 (3.8%) were doctors and 2 (0.8%) were pharmacists. The majority of HCPs agreed that drug-induced immediate allergic reactions were IgE mediated 225 (94.9%), occur within 6 hours of drug administration (89.9%), and epinephrine was the first choice for drug-induced anaphylaxis (76.8%). 97.9% HCPs agreed that penicillin skin test was valuable to predict the allergic reaction. More than 80% of the respondents would take patients’ allergic history before drug administration, while 75.5% agreed that they recognize and manage drug allergy timely when it occurs.
Conclusions: Drug allergy was often diagnosed and managed inadequately, regardless of practice location, employment status and speciality in eastern India. The HCPs demonstrated a low level of knowledge regarding DA. Advanced education is urgently needed for better understanding and filling the gaps that exist in the knowledge and clinical practice of DA