International Journal of Basic & Clinical Pharmacology
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Pre COVID-19 usage of smartphones and medical applications among medical students
Get PDFBackground: To determine awareness of medical students that utilize smartphone and their familiarity of medical applications.Methods: The questionnaire-based descriptive study was conducted in December 2019 and comprised medical students of first year and second year of the CMH Kharian Medical College, Kharian, and Nawaz Sharif Medical College, Gujrat, Gujranwala Medical College, Gujranwala and Mohi-ud-Din Islamic Medical College, Mirpur. Questionnaires were distributed in the classrooms and were filled by the students anonymously. SPSS 20 was used for statistical analysis.Results: Among the 770 medical students in the study, 747 (97%) had smartphones and 23 (3%) were using simple cell phones. Overall, 362 (47%) of the smart phone users were using some medical apps. Besides, 223 (29%) were aware of the medical apps but were not using them. Also, 655 (85%) students were not using any type of medical text eBooks through their phone, and only 115 (15%) had relevant text eBooks in their phones.Conclusions: A very low awareness among medical college students exists regarding smartphones as a gadget for improving medical knowledge
Efficacy and safety of different terbinafine regimens in patients of recurrent tinea corporis and cruris
Get PDFBackground: Tinea corporis and cruris is said to be recurrent when there is relapse of sign and symptoms after 6 weeks of cure. Recently, there has been increase in cases of recurrent tinea corporis and cruris, with atypical lesions. This study was done to establish efficacy and safety of different terbinafine regimens against recurrent tinea corporis and cruris.Methods: Sixty patients with clinically and mycologically diagnosed recurrent tinea corporis and cruris were enrolled and divided into three groups. Group A was administered oral terbinafine 500 mg once daily for 2 weeks, group B was given terbinafine 250 mg once daily for double duration i.e., 4 weeks, and group C was given standard treatment which is 250 mg once daily for 2 weeks. Physician assessment four-point scale (PA4PS) and KOH wet mount were assessed for clinical and mycological efficacy. Biochemical laboratory parameters (liver function tests and kidney function tests) and adverse drug reactions were assessed for safety.Results: At the end of 6 weeks, reduction in PA4PS from baseline was 46.5%, 95.8%, and 20.4% in groups with double dose, double duration and standard therapy respectively with statistically significant (p<0.05) improvement in group with double duration. Mycological cure at the end of 4 weeks was 80%, 100% and 50%. There was no safety concern in any of the groups.Conclusions: Double duration of terbinafine was found to be more efficacious and safer
Impact of the coronavirus disease on the mental health and physical activity of pharmacy students at the University of Zambia: a cross-sectional study
Get PDFBackground: The novel coronavirus disease (COVID-19) is a serious global health problem that has negatively impacted the mental health of students.Methods: We conducted an online descriptive cross-sectional study among 273 undergraduate pharmacy students at the University of Zambia from August to September 2020. A partial proportional odds regression model was used to determine the predictors of anxiety. All statistical tests were set at 95% confidence level (p<0.05).Results: A response rate of 70% was obtained with the majority of the students being female 51.6%. Of the 273 respondents, 23.8% did not experience anxiety, 34.4% experienced mild anxiety, 24.9% experienced moderate anxiety while 16.9% experienced severe anxiety about COVID-19. It was also found that 61.2% of students reported that their attention to mental health increased during the COVID-19 pandemic whereas 44.3% reported an increased resting time with a significant reduction in relaxation 51.3% and physical activity 45.4% time. Factors that affected mental health included; reduced family care (OR: 2.27; 95% CI: 1.09-4.74), not changing attention to mental health (OR: 0.33; 95% CI: 0.18-0.62), being in the final year of study (OR: 0.33; 95% CI: 0.13-0.84), reduced time of resting (OR: 2.10; 95% CI: 1.26-3.50) and feeling helpless (OR: 0.42; 95% CI:0.23-0.75).Conclusions: COVID-19 negatively impacted the mental health and physical activity of pharmacy students at the University of Zambia. This can have negative health and academic outcomes for students going forward. Higher learning institutions and key stakeholders should implement measures to aid students to recover from the impact of COVID-19 on their mental health and physical activity
A comparative study of efficacy of oral pregabalin and clonidine for attenuation of pressor response to intubation
Get PDFBackground: Endotracheal intubation is associated with hemodynamic stress responses. Various drugs have been used in the past to attenuate the pressor response; however, none has been proved to be ideal. Present study was planned to evaluate the oral pregabalin 150 mg and clonidine 200 µg for attenuation of pressor response to intubation.Methods: The study was conducted on 100 adult patients of either gender scheduled to undergo elective surgeries under general anaesthesia (GA). The patients were randomly allocated into 2 groups. In group A patients received pregabalin 150mg and in group B patients received clonidine 200µg orally. The hemodynamic parameters were recorded until 10 minutes after intubation. The sedation, anxiety and side effects were also assessed.Results: In clonidine group, the mean HR remained below the baseline value at all the time intervals. In pregabalin group, the mean HR remained below the baseline value at most of the time intervals but increased above baseline just after intubation (T0i) and 1 minute after intubation (T1i) where increase was only 1.488±1.20% and 0.45±1.16% respectively from baseline. In both pregabalin and clonidine groups, the mean SBP and MAP remained below the baseline value (Tb) at all the time intervals from T0.5 to T10i. Both clonidine and pregabalin provided adequate anxiolysis and sedation with pregabalin providing more pronounced sedation and anxiolysis than clonidine.Conclusions: Both clonidine and pregabalin are effective oral premedication drugs for attenuation of the pressor response to laryngoscopy and endotracheal intubation.
Maternal serum zinc levels and urinary tract infections among pregnant women at a tertiary hospital in Lusaka, Zambia: a cross-sectional study
Get PDFBackground: Micronutrient deficiency is one of the leading public health problems, particularly in lower-middle-income countries. The link between serum zinc (Zn) levels and urinary tract infections (UTIs) among pregnant women is still poorly understood. We investigated the association between maternal serum Zn levels and UTIs among pregnant women at women and newborn hospital in Lusaka, Zambia.Methods: We conducted an analytical cross-sectional study among 228 pregnant women aged 18 to 45 years between 1 September and 30 November 2019. Serum Zn levels were measured using atomic absorption spectrophotometry (AAS), whereas UTIs were determined based on the local hospital guidelines. We used the logistic regression model to determine the association between Zn levels and UTIs. The analysis was done at a significance level of 5% and 95% confidence interval.Results: Of the total participants, 118/228 (51.75%) tested positive for UTIs from urine culture. The mean serum Zn levels in the group diagnosed with UTIs were 53.95 ug/dl (SD=35.10), while in those who had no UTIs, it was 50.05 ug/dl (SD=35.10). In a multivariable logistic regression analysis, we found no evidence of an association between serum Zn levels and UTIs (p=0.435).Conclusions: From the study findings, there was no association between serum Zn levels and UTIs. This result suggests that Zn may not have any role in urinary tract infection. Nevertheless, more extensive studies are needed to confirm our findings
Assessment of the effect of calcium on the anti-inflammatory activity of etoricoxib in albino rats
Get PDFBackground: It would be worthwhile to investigate if it is possible to obtain an anti-inflammatory effect with a lower dose of etoricoxib after it has been combined with calcium, the effect of which is equivalent to higher dose of etoricoxib. Hence the aim was to study effect of calcium and calcium gluconate on the anti-inflammatory activity of etoricoxib.Methods: Animals were distributed in five groups each group containing six rats. Experiments were conducted between 9:00 to 16:00 hours. All animal procedures were performed in accordance with the recommendations for proper care and use of laboratory animal .The doses of drugs employed in the study were based upon the human dose after conversion to that of rat.Results: The results of present study indicate that calcium gluconate (50 mg/kg) combined with etoricoxib (5 mg/kg) possesses significant anti-inflammatory property both in acute and subacute models of inflammation which was comparable to that of etoricoxib (8 mg/kg).Conclusions: From the present study it is concluded that calcium gluconate (50 mg/kg) possesses an anti-inflammatory activity. Lower dose of etoricoxib (5 mg/kg) if combined with calcium gluconate (50 mg/kg) can produce significant anti-inflammatory effect. The advantages of such combined preparations are obviously a reduction in the dose of etoricoxib that could still produce significant anti-inflammatory action and a possible protection against COX -2 inhibitor induced prothrombotic events. It is worthwhile to evaluate such preparations through clinical trials
A conceptual framework on health professionals' engagement towards pharmacovigilance: a qualitative exploration
Get PDFBackground: With the growing reliance on drug therapy in the recent era, the safety of medications is one of the vital parameters for the success of any medicine. Considering this, pharmacovigilance (PV) was developed to provide adequate identification, reporting, evaluation, and understanding of adverse drug reactions (ADR). The objective of this study was to understand the opinion of health care providers on PV, the current reporting mechanisms, identifying the causes for underreporting, and the existing process in clinical practice.Methods: A qualitative study using pretested interview guide was conducted among 20 different cadres of healthcare personnel (doctors, pharmacists, and staff nurses) from various hospitals such as government, private, corporate, and medical college of Odisha state. The data were analysed using a thematic analysis. The meaning units have been identified from the transcript and coded with MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin).Results: Participants showed a lack of awareness regarding the concept of PV. A cluster of challenges such as lack of ADR monitoring, non-conducive work atmosphere and lack of cooperation between staff, lack of knowledge among the health professionals, and fear of legal liability as major pitfalls causing poor ADR reporting. To enhance the pharmacovigilance practice, participants suggested context-specific strategies such as IEC activities, innovative ideas to improve ADR monitoring, regular monitoring.Conclusions: Capacity building through training, regular monitoring and supervision to strengthen the pharmacovigilance practices is the current need in India
Study of adverse drug reactions associated with antiepileptic drugs: a pharmacovigilance study using spontaneous reporting system
Get PDFBackground: More than 25 antiepileptic drugs (AEDs) are available in the Indian market to treat epilepsy of which many have similar efficacy but differ in their tolerability and are associated with many adverse drug reactions (ADRs). ADRs are one of the most common causes of death and clinical trials are not sufficient to uncover all the ADRs, hence post-marketing surveillance or pharmacovigilance is necessary. The aim of the study was to analyze the ADRs of AEDs by spontaneous reporting system under Pharmacovigilance Program of India (PvPI).Methods: Suspected ADR reporting forms provided by PvPI were used to collect the data from healthcare professionals of Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai.Results: A total of 77 ADRs from 61 reports were analysed of which 34 were male and 27 were female patients and maximum were in the middle-aged adult group (N=44). Majority of the ADRs were related to skin and subcutaneous disorders (N=55) and most implicated ADR was found to be maculopapular rash (N=12) associated with phenytoin. Most of the ADRs were non-serious (N=42) and were probable category (N=45) as per WHO-UMC scale.Conclusions: Monitoring ADRs in patients using antiepileptic drugs is a matter of importance; hence a robust pharmacovigilance practice is essential
Anti-nociceptive, anti-inflammatory and antipyretic activities of the ethanol root bark extract of Salacia lehmbachii in rats and mice
Get PDFBackground: The decoction of the roots of Salacia lehmbachi is used in traditional medicine for the treatment of different diseases such as malaria pains diabetes and microbial infections.Methods: Phytochemical screening and oral acute toxicity tests were carried out on the ethanol root extract of the plant. Anti-nocicetive activity using acetic acid induced writhing and tail immersion method in mice, anti-inflammatory activity using carrageenan induced paw oedema in rats and xylene induced ear oedema test in mice and antipyretic activity using Brewer’s yeast and D-amphetamine induced pyrexia in rats were determined at 50 mg/kg, 100 mg/kg and 200 mg/kg doses of the root extract.Results: The ethanol root extract contain alkaloids, saponins, tannins, flavonoids, terpenoids, steroids and cardiac glycosides. The oral acute toxicity tests was found to be greater than 5000 mg/kg. The root extract and the standard drug (Aspirin) significantly (p<0.05 and p<0.01) decreased the number of writhes caused by acetic acid. The extract and morphine significantly (p<0.05 and p<0.01) prolonged reaction time in tail immersion model. The extract produced significant (p<0.05 and p<0.01) dose dependent inhibition of oedema which was comparable to aspirin in carrageenan induced paw oedema model. The root extract also demonstrated significant (p<0.05 and p<0.01) effect in xylene induced mouse ear oedema test compared to dexamethasone. The extract significantly decreased high temperature in both Brewer’s yeast and d-amphetamine induced pyrexia.Conclusions: Findings show that S. lehmbachii may provide a good source of plant compounds with analgesic, anti-inflammatory and antipyretic activities
An assessment of the prescribing skills among second year MBBS students in a tertiary care teaching hospital
Get PDFBackground: The medical undergraduate curriculum includes training in prescription writing from second year under Pharmacology. This study assesses the prescription writing skills of second year MBBS students in Sree Mookambika institute of medical sciences. The study can promote awareness among the medical students about the rational application of drug prescribing skills.Methods: After ethical clearance from the Institutional research committee, the cross-sectional study was conducted among 115, second year MBBS students who were above 18 years of age. Parameters like patient and doctor information, drug information and legibility of the prescription was assessed.Results: Of the 115 students who participated in the study, only 86 (74.7%) students got a score 4/4 for patient-related information and no student got 5/5 with respect to doctor related information. 98 students (85.2%) got 6/6 with regards to drug information. The most lacking information was the qualification of the doctor, followed by the total quantity of the drug prescribed. The legibility of the prescriptions was also not up to the mark with only 22 students (19.1%) who got a 4/4.Conclusions: The prescription writing skills among second year undergraduate students are suboptimal. Periodic assessment of the students must be done to evaluate their knowledge on prescription writing and the training clinicians must help to fill the knowledge-practice gap. WHO recommended six step prescription writing model must be followed and emphasized among students