International Journal of Basic & Clinical Pharmacology
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Lichenoid eruption due to antitubercular drugs: a case report
Get PDFAdverse drug reactions can be predictable or unpredictable. Regardless, they must be communicated to patients to improve the quality of healthcare. According to the World Health Organization (WHO), in the year 2020, tuberculosis was the thirteenth leading cause of death worldwide. For the clinician who commonly encounters tuberculosis, the effectiveness of antitubercular drugs such as rifampicin, isoniazid, pyrazinamide and ethambutol are complicated by the severity of adverse reactions. This requires the physicians to weigh both the benefits and the risks of using these medications and to choose appropriate management strategies. Here, we report a case of lichenoid drug eruption related to antitubercular drugs in an elderly gentleman diagnosed to have extrapulmonary tuberculosis. The skin disorder presented with thickness and hyperpigmentation of the skin. The exact offending drug could not be conclusively identified but therapy was continued under the cover of a topical steroid and an antihistamine agent. The medical reporting of such cases is essential to identify one of several cutaneous adverse reactions seen with antitubercular drugs. Furthermore, it aids in alerting health care professionals and the public of the potential undesirable effects of these drugs
Comparison of the effect of kalsitrapine and metformin as adjunctive therapy in the treatment of infertility in women with polycystic ovary syndrome
Get PDFBackground: Chronic anovulation is one of the most common causes of infertility. In women with polycystic ovary syndrome (PCOS), other factors related to oocyte quality or endometrial and nesting disorders may also play a role. Infertile and non-ovulatory women who tend to become pregnant are candidates for ovulation induction. The aim of this study was to evaluate the effect of Kalsitrapine and metformin on the treatment of patients with PCOS.Methods: The clinical trial study was performed on 80 female patients with PCOS who had referred to Ardabil city hospital for infertility treatment were randomly divided in two groups with personal consent. One group received Kalsitrapine and another group received metformin.Results: The mean age of all patients was 26.08±5.21. There was no significant difference between 2 groups in term of age and BMI. There was no statistically significant difference between the two groups in terms of primary and secondary infertility. The mean duration of infertility was 3.68±3.49 years. There was no statistically significant difference between the 2 groups in terms of infertility duration. There was no statistically significant difference between the 2 groups in terms of the type of menstrual cycle. The response rate to treatment was 17.5% in the metformin group and 10% in the Kalsitrapine group. There was no statistically significant difference between the 2 groups in terms of response to treatment. In comparison, none of the studied factors in the 2 groups was significantly associated with the response to treatment.Conclusions: It is true that the recovery rate of the herbal medicine Kalcitropine in this study was slightly lower than metformin, but due to the side effects of metformin, including lethargy, abdominal pain, diarrhea, headache, constipation, bloating, weight loss, heartburn, nausea and Vomiting, unpleasant taste of metal in the mouth In some people, such people may be prescribed kalcitrapine for a longer period of time to evaluate its effect
Hemichorea-hemiballismus as a rare presentation of non-ketotic hyperglycemia: a case report
Get PDFHemichorea-hemiballismus is a hyperkinetic movement disorder on one side of the body resulting from involvement of the contralateral basal ganglia and striatum mainly. A 50-year-old female presented with a 5-days history of choreiform movements affecting the left upper and lower limb along with hemiface. Her plasma glucose was 576 mgl/dl and her urinary ketones were negative suggesting non-ketotic hyperglycemia. Computed tomography revealed hyper-density in right caudate and putamen consistent with diabetic striatopathy. Non-ketotic hyperglycemia is a rare cause of hemichorea-hemiballismus syndrome. Hemichorea-hemiballismus can be an unusual and rare presentation of diabetic elderly population especially females. Early diagnosis and treatment of hyperglycemia yields an excellent prognosis
Assessment of knowledge and awareness among the pregnant women about their medication use in a tertiary care hospital
Get PDFBackground: Pregnancy is a physiological state where drug therapy is of particular concern. The pertinent use of drugs during pregnancy is beneficial as it affects not only the health of the pregnant woman but also the developing fetus. The study was carried out to access the knowledge and awareness regarding the drug use among pregnant women.Methods: Cross sectional descriptive study was conducted among 150 pregnant women for six-month duration. All the information was acquired through direct interview with the subjects and from treatment chart of subjects which were then recorded in a data collection form.Results: Majority of the subjects were under the age group of 18-28 years (50%). Most of the subjects predominantly has tertiary level of education (69%). Furthermore, 57% of the subjects were at the third trimester of their pregnancy. Knowledge regarding use of their own medications were significantly high (95%), which suggest that the subjects were well aware of their medications. Besides, 82% of the subjects had knowledge about the medications that were not to be consumed during pregnancy. In addition, 89% of the pregnant women did not take any over the counter medications and about 92% of the subjects did not treat themselves with any ayurvedic or homeopathic medications.Conclusions: Significant number of subjects were aware about their medication use. They ensured themselves and their developing fetus a better health.
COVID-19 vaccine induced Guillain-Barre syndrome: a case report
Get PDFGuillain-Barre syndrome (GBS) is a rare immune mediated clinical disorder of the peripheral nerves. A number of vaccines including COVID-19 vaccine have been shown to be associated with an increased risk of GBS. We reported a case of Corbevax® (COVID-19 vaccine) induced GBS. A 12 years old girl presented to the paediatric emergency with 2 days history of progressive weakness of all four limbs. The weakness started after one day of patient received her first dose of Corbevax®. Neurological examination findings were weakness, decreased muscles tone, decreased muscles power, diminished or absent deep tendon reflexes of all four limbs. The findings of cerebrospinal fluid showed increase in protein and normal cell count. The diagnosis of GBS was confirmed by nerve conduction studies. After confirmation of the diagnosis, she was given intravenous immunoglobulin (IVIG) with the dose of 2 g/kg body weight divided over 5 consecutive days. Then the patient was examined, clinical condition was improved dramatically. GBS rarely caused by COVID-19 vaccination. GBS may become life threatening due to respiratory muscles involvement. In about 30% of cases may require admission in Intensive Care Unit and need for mechanical ventilatory support. So careful monitoring is required after administration of COVID-19 vaccine. This case report never discourages the vaccine rollout, but monitoring of evolving data should be carried on by manufacturers and independent authorities coming to a definite conclusion
Learner’s perspectives on competency-based medical education in pharmacology at a tertiary care teaching hospital in South India
Get PDFBackground: Competency based medical education (CBME) was implemented recently in India. The study was conducted to evaluate the perspectives of undergraduate medical students towards CBME curriculum in pharmacology at a tertiary care medical college in South India.Methods: After the completion of the curriculum, feedback was taken in a semi-structured, validated questionnaire. It was based on Kirkpatrik’s level 1 model of evaluation. Majority of the questions were framed on a 5-point Likert's scale (1 being poor to 5 being excellent). Qualitative data was collected by open ended question on additional comments.Results: The response rate was 72.8%. Majority of the participants rated the theory classes, practical classes, small group discussions, self-directed learning, integration, and assessments as good and excellent. More than 80% participants rated role play as an innovative and worthwhile concept towards mastering prescription communication. They felt that role play ignites team work, and provides confidence. Close to 90% of the participants rated the overview on emergency use authorization, orientation on drug regulators, perspectives on hydroxychloroquine prophylaxis as effective and excellent. More than 85% participants felt that AETCOM provided them insight on ethical issues, patient communication, and perspective of doctors as caregivers. 9.8% (16) participants provided comments to open ended question for feedback.Conclusions: The study provided an insight of medical undergraduates towards CBME curriculum. Further studies can be designed to look into the effectiveness of teaching learning methods based on the performance of the students, perspective of faculties with focus faculty development, and role of various stakeholders
A questionnaire based study to assess knowledge, attitude and practice of pharmacovigilance among exam going second year undergraduate medical students in a South Indian teaching hospital
Get PDFBackground: Pharmacovigilance not only helps in the early detection of adverse drug reactions (ADRs) but also facilitates the identification of both, risk factors and the underlying mechanism. To increase the reporting rate, it is essential to improve the knowledge, attitude, and practices (KAP) of healthcare professionals regarding ADR reporting and pharmacovigilance, especially during undergraduate and postgraduate education. The objective of this study was to assess the KAP about pharmacovigilance among exam-going second-year undergraduate medical students.Methods: A cross-sectional questionnaire-based study was conducted among 150 exam-going second-year undergraduate students from Mysore Medical College and Research Institute, Mysore from April 2022 to June 2022. A validated questionnaire consisting of 22 questions divided into 3 sections; knowledge, attitude, and practice was used. Statistical analysis of data was done using an MS excel spreadsheet.Results: Out of the 150 participants 133 had good knowledge about ADR and pharmacovigilance. Majority of the students agreed that reporting of ADRs is necessary (95.3%), mandatory (95.3%), and should be included in pharmacology practicals (94.7%). Only 29.3% of the students had witnessed an ADR and none of the participants had ever reported an ADR indicating poor practice among the undergraduate students.Conclusions: Students had good knowledge and positive attitude towards ADR reporting and pharmacovigilance. Practice regarding pharmacovigilance was found to be poor, indicating the need for training the undergraduate students in ADR reporting by including ADR recognition and reporting as a part of clinical posting curriculum
Use of iodine tincture in the management of wound dehiscence in operated mandibular fracture along with hardware salvage: a case report
Get PDFMandibular fractures are one of the most common facial fractures. Depending on the severity, they are treated either by closed reduction or open reduction and internal fixation. Hardware exposure is one of the postoperative complications associated with the latter. Data involving decision regarding removal or salvage of hardware in such cases is lacking. We present a case of wound dehiscence with hardware exposure in an operated mandibular fracture, which was managed by placing tincture iodine dressing, thus obviating the need for hardware removal
COVID-19 encephalopathy, presenting with Broca’s aphasia mimicking stroke
Get PDFNeurological manifestations are emerging as relatively frequent complications of coronavirus disease 2019 (COVID-19), including stroke and encephalopathy. Here we reporting a case of a young male presented with acute aphasia at the emergency department. The patient has a positive history of upper respiratory tract symptoms, subjective fever, and myalgias, a week before for which he was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse transcription polymerase chain reaction (PCR) on a nasopharyngeal swab. An electroencephalogram (EEG) demonstrated interictal epileptiform abnormalities over the left posterior frontal lobe. Magnetic resonance imaging (MRI) axial T2- weighted image shows focal area of altered intensity appearing hyperintense involving the left frontotemporal lobes pre-dominantly the pre-central gyrus. A subtle restriction on diffusion-weighted imaging (DWI), with a minimal drop on apparent diffusion coefficient images. In contrast, it shows gyriform enhancement with suspicious adjacent meningeal thickening and enhancement. Cerebrospinal fluid was negative for antibody. Intravenous immunoglobulin (IVIG) 400 mg/kg was given for 5 days. The patient responded well to the therapy without any major clinical side effects and revealed complete resolution after 2 months.
The effect of using Laban leaf (Vitex pinnata) methanol extract toothpaste on saliva pH in Students of SD Negeri I Pagar AIR
Get PDFBackground: Maintaining the pH balance of saliva is one way to prevent dental caries. The pH balance of saliva is influenced by the rate of salivary secretion. The rate of salivary secretion can be stimulated chemically and mechanically. Mechanical stimulation by brushing teeth and chemically by gargling. Indonesia is currently developing natural ingredients as medicinal ingredients that have been scientifically tested for their benefits and safety. Laban leaf (Vitex pinnata) is one of the many medicinal plants found in Indonesia. Laban leaves contain alkaloids, flavonoids, saponins, and tannins that can inhibit the growth of Streptococcus mutans so that it can remove dental plaque naturally. Some researchers state that laban leaf extract can affect the pH of saliva. This study aims to see the effect of the use of laban leaf methanol extract toothpaste on salivary pH.Methods: Experimental research method with pre and post-tests design with proposing sampling technique where 26 people were taken as samples. The sample was divided into 2 groups which received different treatment. Group 1 was instructed to brush their teeth with laban leaf extract toothpaste and group 2 with toothpaste circulating in the market tied their teeth for 3 minutes.Results: Results based on the comparison of salivary pH before and after brushing teeth, it was found that brushing teeth with methanol extract toothpaste of laban leaves was more effective in increasing salivary pH. Based on the use of toothpaste with laban leaf methanol extract, the significant value is 0.000<(0.05), so it can be concluded that reject H0. This means that there is an average difference before and after using laban leaf methanol extract toothpaste. In conclusion, the use of laban leaf methanol extract toothpaste has more effect on increasing the pH of saliva.Conclusions: brushing teeth with laban leaf methanol extract toothpaste is more effective in increasing the pH of saliva. We recommend recommending further research to determine the potential of laban leaves to be used as raw material for toothpaste.