International Journal of Basic & Clinical Pharmacology
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Student selected components as an educational platform for teaching medical students about clinical pharmacology and quality improvement activities
Get PDFStudent selected components (SSCs) are increasingly described elements of medical undergraduate education, training and curricula. SSCs offer the potential for integration into both traditional (‘pre-clinical’ versus ‘clinical’) medical curricula, as well as into other innovative or evolving medical training curricula. This article employs a structured and descriptive approach to exemplify the process by which year 1 medical students were supported in a practical manner to undertake a distinct small group SSC project. In this illustration, the SSC was focused on a quality improvement (QI) topic of relevance to clinical pharmacology and therapeutics (CPT), and involved a review of the anticholinergic burden of inpatient prescriptions for a defined cohort. The SSC was completed in the context of a teaching hospital’s medicine of the elderly (MoE) clinical service. In a sequential manner, the paper describes experiential learning points from the perspective of a supervisor of an SSC project. The paper offers educational value with a potential for generalisable application to non-clinical and clinical educationalists. Furthermore, the paper offers guidance to supervisors, teachers, tutors and facilitators, with encouragement to consider how they may design similar projects for the training of undergraduate medical students in centres that they are affiliated with. The paper also highlights another key driver for productive SSCs i.e. the central principle of striving to promote projects and activities that support active student engagement, rather than merely passive inclusion
Antidiabetic effect of Nigella sativa compared with metformin on blood glucose levels in streptozotocin induced diabetic albino wistar rats
Get PDFBackground: Antidiabetic drugs are many but all of them have adverse effects ranging from simple side effects to serious side effects like hypoglycemic coma. We need alternative drugs which will not only lower blood sugar level but have fewer side effects. One such daily use ingredient in our food is Nigella sativa (kalonji) which has many properties.Methods: This was an objective study in an experimental animal. We divided albino wistar rats into six groups each group with six rats. Diabetes was induced using drug streptozotocin. Three doses of Nigella sativa 0.5 ml, 1 ml, 1.5 ml orally per rat were used. Metformin (100 mg/kg body weight) was used as standard drug. Blood sugar was estimated using glucometer on day 0 (starting day of treatment), day 5, day 10, day 20, day 40. The effect of Nigella sativa was compared with metformin group using the Anova test. Statistical analysis was done using SPSS software version 20.Results: Nigella sativa (NS) produced significant hypoglycemic effect. NS in the dose of 0.5 ml, 1 ml and 1.5 ml produced significant reduction in blood glucose in comparison to day 0. Metformin also (100 mg/kg body weight) produced significant reduction in blood glucose on day 20 and day 40. Comparison of hypoglycemic effect of Nigella sativa is not significantly different on day 10 (1 ml) and day 20 (1.5 ml) in comparison to Metformin (100 mg/kg body weight). Histopathological examination showed that there was partial regeneration of beta islet cells of pancreas by 1.5 ml of Nigella sativa which were damaged due to streptozotocin treatment.Conclusions: Alternative method of treatment for diabetes is very much needed and the study shows the use of the spice (Nigella sativa) daily can lower the blood sugar levels and can serve as an alternative treatment of diabetes mellitus
Study on the efficacy of ceftriaxone versus azithromycin for the treatment of uncomplicated enteric fever among the patients admitted in a tertiary level hospital
Get PDFBackground: Typhoid fever is a severe debilitating and potentially life threating illness. In Bangladesh, typhoid fever is a round the year problem which sometimes take epidemic proportions. The reasons behind such occurrences are unsafe water supply, defective sewage system and unhygienic food handling practice. This study aimed to compare the efficacy of ceftriaxone and azithromycin in the treatment of uncomplicated enteric fever.Methods: An observational study was conducted at the department of pharmacology in Dhaka medical college, Dhaka, Bangladesh. Data were collected from blood culture positive patients for Salmonella typhi and Salmonella paratyphi, who admitted in the Dhaka medical college and hospital, Dhaka during the period of July 2015 to June 2016. Data was collected by using a structured questioner, face to face interview, physical examination and investigation reports. Patients were hospitalized during the entire treatment period and at admission evaluation was made by history and physical examination in a structured format. Subjects ware asked regarding changes in symptoms and possible adverse effects of the study drugs. All patients were asked to return two weeks after completion of treatment for follow up. Blood culture of Salmonella typhi or Salmonella paratyphi were done in all cases. Total 91 patients were culture positive for either S. typhi or S. paratyphi which were finally studied.Results: During the study period out of 91 patients, 51 were receiving ceftriaxone and 40 were receiving azithromycin. Clinical cure was achieved in 46 patients (90%) of ceftriaxone group and in 31 patients (78%) in the azithromycin group. There were no significant differences of clinical cure between both treatment groups (p>0.05). Mean fever clearance time in ceftriaxone group was 3±1.4 days and was 4±1.6 days for azithromycin group. Difference in fever clearance time was statistically significant (p<0.05). No clinical relapses were detected in any study subject. No major side effects of both drugs occurred in any subject.Conclusions: These results indicated that both ceftriaxone and azithromycin were effective against enteric fever caused by sensitive organisms and multi drug resistant S. typhi and S. paratyphi. It is concluded that ceftriaxone is more effective and can be a convenient alternative for the treatment of enteric fever, especially in developing countries like us where medical resources are scarce
Association between vitamin B12 and non-alcoholic fatty liver disease: a case control study in Katra Jammu
Get PDFBackground: Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease in developed countries and obesity contributing maximum to the disease load. A reduction in the energy content of diet, alone, may not prevent NAFLD, nor could alleviate it. Recent studies are bringing to light the association, importance and role of dietary vitamins and liver fat accumulation. Vitamin B12 is involved in the metabolism of every cell of the human body. It is a cofactor in DNA synthesis and in both fatty acid and amino acid metabolism. Still, the influence of vitamin B12 deficiency on NAFLD has not been studied much.Methods: A case control observational study was conducted in the department of medicine, community health center, Katra during the period of August 2018 to July 2019. The study was conducted on 150 NAFLD patients and 50 aged and gender-matched healthy controls. Patients showing ethanol consumption, liver cirrhosis, DM, pancreatitis, renal failure or cancer were excluded.Results: Patients and controls almost matched in all clinical examinations like fever, jaundice, nausea, but vitamin B12 levels were significantly low among cases and stood at 377.60±181.43 pg/ml as against 548.28±285.70 for controls, but still remained within the reference range. Vitamin D levels were also found to be lower among cases. B12 deficiency is extremely common in India with an estimated prevalence of 47% and more males tend to have NAFLD than females.Conclusions: For better management of the disease, vitamin B12 levels should be assessed in all NAFLD patients
Microbiological profile and antibiotic resistance pattern of urinary tract infection in a tertiary care hospital
Get PDFUrinary tract infection (UTI), of varying severity is one of the most commonly encountered ailments in nephrology outpatient department (OPD). The commonest pathogens causing community acquired UTI (CAUTI) are E. Coli, Proteus mirabilis, Pseudomonas aeruginosa and Klebsiella pneumonia. There is a rapidly rising trend of antibiotic resistance among these uropathogens, may be due to indiscriminate antibiotic usage and poor patient compliance. We conducted a retrospective analysis of all culture proven UTI cases that attended the nephrology OPD of S. K. hospital, Trivandrum from August 2017 to July 2019 (24 months). 130 males and 121 females were included in the study. The mean age of the study group was 62.8 years with a male predominance in the age group above 50 years and a female predisposition in less than 50 years group. Commonest pathogen isolated in urine culture was E. coli (52.98%) followed by Klebsiella (39.09%), Citrobacter (8.76%), Pseudomonas (8.37%), Enterobacter (2.39%), Enterococci (1.99%), Candida (1.59%), Acinetobacter (1.2%), Proteus (1.2%), Streptococci (1.2%) and Serratia (0.4%)
A profile of poisoning in pediatric population in rural hospital in Jammu
Get PDFBackground: Acute poisoning is one of the commonest Pediatric emergencies and an important cause of morbidity and mortality. This study is aimed at understanding the incidence, aetiology and manner of poisoning, outcome among children less than 18 years reporting to Pediatric department at sub district Hospital level in Jammu region.Methods: All the children between one month and eighteen years of age reporting to the Pediatric Emergency of SDH Akhnoor, Jammu over a period of one year as a case of acute poisoning were included in the study. The information obtained from subjects/parents/guardians and examinations of subjects was recorded on a pretested proforma and analyzed.Results: A total of 150 patients were admitted as a case of poisoning over a study period of one year. Male: Female ratio was 1.41:1. Total incidence rate was 2.94/100 0 population over a period of one year. Majority of the cases were accidental (94.67%) while suicidal attempt cases were 5.33%. Most the cases (49.33%) were due to accidental ingestion of household products followed by drug ingestion (21.33%), food poisoning (14%) and then agricultural/industrial products (8%). Maximum patients (86.6%) recovered while 2% referred to higher centre and rest 11.3% either absconded or lost to follow up.Conclusions: Acute poisoning in children is usually accidental with favourable outcome. Death can happen depending upon nature of poison and the stage at which the patient is brought to the hospital. Poisoning can be prevented by increasing public awareness, counselling and right guidance to the parents.
Chemical characterization, adverse effects and potential toxicological effects of medical devices applied in gastrointestinal disease: a review
Get PDFMedical devices have gained popularity as a therapeutic or diagnostic purpose in gastrointestinal obstructions caused by malignant tumour or benign stricture or any other pre-existing conditions. The problems of stents are like sense of foreign body, migration or incomplete expansion or re obstruction. In this scenarios, self-expandable metallic stents (SEMS), or biodegradable self-expanding stents, wall flex stents, drug eluted stents, etc prevents the obstruction related difficulties. SEMS associated with re-obstruction and migration along with difficulty in removal and chances of leaks due to corrosion. In case of biodegradable self-expanding stents, which are either made of magnesium-based materials or synthetic polymers, such as polylactide or polyglycolide, or co-polymers, such as polydioxanone. Magnesium-based materials are very biocompatible but due to the property of dissolving in the body by rapid corrosion, degradation can occur before the therapeutic objective is reached. Synthetic polymers associated severe mucosal hyperplastic reaction with overgrowth and/or ingrowth. Wall flex stents, drug eluted stents can be used to prevent complications associated with above variants but their clinical significance and toxicological effects were not evaluated completely. Under this given scenario toxicological evolution of various medical devices used in gastrointestinal disease and their potential toxicological effects are required to understand their tolerability and acceptability
Study of the cost variation analysis of anti-epileptic drugs available in different brands in Indian pharmaceutical market
Get PDFBackground: The aim of this study was to analyze the cost ratio and percentage cost variations in different brands of the commonly prescribed anti-epileptic drugs available in Indian pharmaceutical market.Methods: The maximum and minimum price of each brand of the drug given in Indian rupees (INR) was noted by using CIMS January to April 2020 edition and drug today April to June 2020 volume 1. The cost ratio and the percentage cost variation for individual drug brands was calculated. The cost of one bottle in case of 100 ml syrup and 10 tablets/capsules was calculated in case of oral drugs and the cost of one 1 vial or ampoule was noted in case of injectable drugs. At last the cost ratio and percentage cost variation of various brands was compared.Results: After calculation of cost ratio and percentage cost variation for each brand of anti-epileptic drug tablet clonazepam (2 mg) shows highest cost ratio and percentage cost variation as 10.41 and 941.66, carbamazepine (200 mg SR tablet) shows lowest cost ratio and percentage cost variation as 1.09 and 9.32.Conclusions: Epilepsy is the most common neurological disorder and epileptic drugs are to be prescribed for prolonged period. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. There is a wide difference in the cost of different brands of anti-epileptic drugs available in India. The clinicians prescribing these drugs should be aware of these variations in cost to reduce the cost of drug therapy
A prospective study of prevalence of anti-microbial susceptibility of bacterial isolates in lower respiratory tract infections
Get PDFBackground: Lower respiratory tract infections (LRTIs) is one of the most common causes of mortality and morbidity across all age groups. In recent years, antibiotic resistance is constantly increasing. Thus, there is a need to monitor the bacteriological profile of pathogenic organisms. The present study aims to identify bacterial pathogens and their antibiotic susceptibility pattern.Methods: A prospective, observational, single centered study was conducted at tertiary care hospital for a period of 1 year i.e. from March 2016 to March 2017. A total of 733 sputum samples were collected and analyzed in microbiology lab. The samples went subjected to microscopy testing, culture and antibiotic sensitivity using suitable bacteriological methods.Results: From 733 sputum samples, about 51.34% were males and 48.56% were females. Approximately 49.65% of total samples were growth positive. Klebsiella was found to be the predominant microorganism followed by Methicillin sensitive Staphylococcus aureus (MSSA) and streptococcus. The gram-negative bacteria showed highest sensitivity for piperacillin/tazobactam, imipenem and ciprofloxacin. The gram-positive bacteria were found to be more susceptible for vancomycin, teicoplanin and amikacin.Conclusions: LRTIs are contagious form of disease and can rapidly disseminate among community. The irrational use of antibiotics complicates the management due to the antibiotic resistance. Local trend of antibiotic susceptibility pattern should be known as it helps in increasing the appropriate use of the antibiotics, decreasing the mortality and morbidity and reduces the anti-microbial resistance
Berbamine application beyond cancer
Get PDFThe main purpose of this review was to ascertain the clinical application and future non oncological uses of Berbaminebamine (BERBAMINE). Berbaminebamine, as a STAT3 (signal transducer and activator of transcription) inhibitor, antioxidant, anti-inflammatory and modulator of many signalling pathways, should be investigated in autoimmune diseases. Berbaminebamine has been found to have pharmacological activity in the following cancers: breast cancer, lung cancer, prostate cancer, pancreatic cancer, ovarian cancer, glioblastoma, colon cancer, bladder cancer, chronic myeloid leukemia, hepatocellular carcinoma, triple negative breast cancer and osteosarcoma. Ischemic reperfusion injury, melanoma, COVID-19 and allergy diseases are among the conditions for which it is beneficial. It may aid in the treatment of obesity, metabolic syndrome, inflammatory syndrome, sepsis, COVID-19, dengue fever, Nipah virus infection, influenza, solid tumors, lymphoma, cancer, hematological malignancies, skin inflammatory disorder and atopic dermatitis. BERBAMINE can be used as versatile molecule in alcoholic liver disease, diabetic nephropathy and antiviral, anti-inflammatory