Παρασκευή, 2 Δεκεμβρίου 2016

The effect of fexofenadine, a newer second-generation antihistaminic, on phenobarbitone sleeping time and its comparison with terfenadine, astemizole and cetirizine in albino rats

Source: National Journal of Physiology, Pharmacy and Pharmacology
Suresha K R, Suryanarayana R Babushaw.
Background: The second-generation antihistaminic fexofenadine has been claimed to be superior to terfenadine and cetirizine, in possessing the negligible sedating property and can be safely given to pilots and drivers. Here, it is a study that compares the sedative property of fexofenadine to terfenadine, astemizole, and cetirizine by phenobarbitone induced sleeping time in albino rats. Aims and Objectives: To evaluate the nonsedative antihistaminic action of fexofenadine and comparing it with cetirizine, terfenadine, and astemizole. Materials and Methods: A total of 90 albino rats of either sex weighing 100-200 g were selected and randomly divided into nine equal groups. At 0 h phenobarbitone 40 mg/kg is injected intraperitoneal to the rats. The animals are placed on their backs, and duration of loss of righting reflex is measured. Each rat was pretreated at −1 h with the drugs orally using orogastric tube. The different groups are as follows: Group 1 was given distilled water; Groups 2-9 were given with fexofenadine 20 mg and 40 mg/kg. Terfenadine 20 mg and 40 mg/kg, cetirizine 2 mg and 4 mg/kg, and astemizole 2 mg and 4 mg/kg body weight, respectively, and data are statistically analyzed by unpaired t-test and ANOVA. Results: The mean phenobarbitone sleep time duration of fexofenadine (20 mg and 40 mg) is comparable to placebo and is less sedative. This study shows cetirizine produces longer duration of sleep (P


Analysis of commonly used pediatric systemic antibacterial liquid formulations for rational drug therapy

Source: National Journal of Physiology, Pharmacy and Pharmacology
Payal P Naik, Chaitali D Mehta, Sachendra K Srivastava.
Background: Antibiotics are frequently prescribed medication. When drugs are dispensed in form of syrups or suspensions, appropriate volume should be dispensed in a bottle otherwise, it may result into wastage of drug, inadequate treatment, and resistance and also increased cost of treatment. Aims and Objective: The aim of our study was to analyze systemic antibacterial liquid formulations to ascertain the availability of adequate strength, volume dispensed for adequate treatment. Materials and Methods: The commonly available (IDR triple, Issue 2, 2016) oral liquid antibacterial formulations were analyzed. According to the weight of child (for 12 and 18 kg), amount of drug and requirement of number of bottles for 5 days were calculated. Results: Majority of manufacturers have dispensed inadequate volume of antibacterial drugs which was not sufficient for one course of therapy. For example, most of the formulations of cephalexin, cefixime, cefpodoxime, and amoxicillin + clavulanic acid were available in dispensing volume of 30 ml. This results into inadequate dose, wastage of drug (residual volume), resistance, and unnecessary social and financial burden to the patient. Hence, more number of bottles shall be required to complete a course of antibiotic. Conclusion: The dispensing volume of oral liquid dosage forms of most of the formulations were inadequate and thus, minimum amount dispensed should be 60 ml or as applicable for an antibiotic.


Clinicopathological correlation of serum prostate specific antigen levels in patients of prostatomegaly in a tertiary care hospital

Source: International Journal of Medical Science and Public Health
Vitesh Popli, Amit Rajan, Sonali Bose, Amit Kamewad.
Background: In clinical practice, biopsies are generally performed only when the results of a prostate specific antigen (PSA) test or digital rectal examination (DRE) are abnormal. This leads to misdiagnosis of most small prostatic cancers present in many older men. Patients with lower urinary tract symptoms (LUTS) who have serum PSA levels higher than 4 ng/ml are primarily advised to undergo prostate biopsy to rule out cancer. However, PSA is organ specific but not cancer specific, so the presence of other prostate diseases such as benign prostatic hyperplasia (BPH), and prostatitis may influence its effectiveness for cancer detection. Hence, the PSA-based prostate cancer detection is fraught with high false-positive rate. Objectives: The use of Serum PSA levels for the early detection of prostate cancer and evaluate its role with other modalities for diagnosis of prostate cancer and to diagnose different diseases of prostate, i.e., prostatitis, BPH in prostatomegaly, and its correlation with serum PSA levels. Materials and Methods: This prospective descriptive study was conducted in Command Hospital (EC), Kolkata, West Bengal, India, in the period of June 2011 to June 2013. The patients were selected from the outdoor of Department of Urology and General Surgery. Institutional Ethical Committee Clearance and informed consent of all patients were obtained. 101 men at or >50 years of age presenting with LUTS specifically attributed to prostate problems were included in the study. Men with calcified or fibrotic prostate, with skeletal or distant metastasis or LUTS caused by any urological malignancy and who had previous prostatic surgery or pelvic radiotherapy or complications of urinary obstruction, were excluded from the study. Results: A total of 101 male patients presenting with LUTS were included. Their mean age was 68.66 years. The majority, i.e., 49 (48.5%) of the study group were in the age group of 61-70 years. 52 (51.5%) of patients had serum PSA


Study of clinico-epidemiological profile, drug utilization pattern, and outcome of swine flu cases: A recent epidemic in Latur

Source: International Journal of Medical Science and Public Health
Aruna Gurung, Jugalkishor Bhavarlal Jaju, Shrikant Chandrakant Dharmadhikari, Ganesh Ramkrishna Pawar, Rajvardhan Rameshrao Solunke.
Background: Swine flu, an acute respiratory tract disease, is caused by swine flu virus. The World Health Organization (WHO) declared the H1N1 pandemic in June 2009 after more than 70 countries reported cases of H1N1 infection. Since 2009-2014, 59,677 cases and 4141 deaths have been reported in India. Objective: To study the clinico-epidemiological profile, drug utilization pattern, and outcome of H1N1 positive cases admitted to swine flu ward from January 2015 to September 2015 at a tertiary care hospital in Latur. Materials and Methods: The study was conducted from January 2015 to September 2015 at Government Medical College (GMC), Latur. Clinicoepidemiological profile, treatment details, and outcome of the patients were recorded. Prescription pattern was analyzed using the WHO International Network for Rational Use of Drug use indicators. Results: A total of 52 swine flu positive cases were admitted to GMC, Latur, out of which 38 (73.07%) were female patients and 14 (26.92%) were male patients. Total numbers of drugs prescribed were 267. The most common antimicrobial prescribed was oseltamivir. Total drugs prescribed from the National List of Essential Medicine 2015 were 98 (36.70%). Conclusion: This study is an attempt to know the clinico-epidemiological profile, drug utilization pattern, and outcome in swine flu positive patients. A good adherence to the WHO guideline for clinical management of swine flu cases, the Joint Indian Chest Society and the National College of Chest Physician guidelines, and the WHO Essential Drug List was seen in our study. However, prescription with the brand name, polypharmacy, and excessive use of fixed dose combinations are a matter of concern.


Cutaneous metastasis: An unusual presenting feature of silent renal cell carcinoma

Source: International Journal of Medical Science and Public Health
Pradosh Kumar Sarangi, Pragnyamaya Debadatta Mangaraj, Pratisruti Hui, Sasmita Parida, Jayashree Mohanty.
Renal cell carcinoma (RCC) is a potentially lethal cancer with aggressive behavior and propensity for metastatic spread. However, it is very rare for RCC to present as metastasis to skin and it is virtually a sign of poor prognosis. Skin metastases have been reported to occur in around 3% of RCC. The most common site for cutaneous metastasis from RCC is the scalp and face, followed by the chest and the abdomen. Herein, we are reporting a case of RCC in a 60-year-old man who presented to us with multiple skin nodules in thorax and abdomen as the sole complaint. Fine needle aspiration cytology from these nodules revealed metastatic deposits of RCC though the patient had no urologic symptoms. Computed tomography and ultrasonography of abdomen revealed right RCC with multiple secondaries in liver, spleen, lungs, chest wall, abdominal wall with retroperitoneal lymphadenopathy, and inferior vena cava thrombus. This case highlights the ubiquity of RCC metastasis and emphasizes the importance of keeping RCC as differential in patients who present with cutaneous metastases.


Socioeconomic impact on prevalence of chronic suppurative otitis media in school going children in a tribal district of India

Source: International Journal of Medical Science and Public Health
Sachin Garud, Aniket Buche, Prashant Keche, Gaurav Chamania.
Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in the South East Asia having a prevalence of approximately 5.2% in the general population. The socioeconomic cost of CSOM can hamper the auditory development of the child, thus putting a burden on the society. Objective: To find the prevalence of CSOM in school going children and its relation with socioeconomic status. Materials and Methods: Descriptive cross-sectional study involving 990 schools going children in Nanded District of Maharashtra. Result: The prevalence of CSOM was found to be 6.4%, with tubotympanic type constituting majority 87.50% trailed by atticoantral type 12.50%. With respect to socioeconomic groups, upper and lower groups had 37.5%, and lower group had 34.37% prevalence. The most patients presented with moderate hearing impairment 43.75% and mild hearing impairment 31.25%. Conclusion: The socioeconomic cost of CSOM puts an immense burden on the growth of a child. Improvement of health care facilities and awareness among health-care providers would definitely be helpful in reducing the prevalence of ear diseases in the developing countries like ours.


A cross-sectional study to assess the knowledge and practices about breastfeeding among women in Sembakkam village, Kancheepuram District

Source: International Journal of Medical Science and Public Health
Sahaya Sona Thresa.
Background: Breastfeeding is one of the most effective ways to ensure child health and survival. A lack of exclusive breastfeeding (EBF) during the first 6 months of life contributes to over a million avoidable child deaths each year. Objectives: To estimate the prevalence of EBF and to assess the knowledge and practices about breastfeeding. Materials and Methods: This cross-sectional descriptive study was conducted for a period of 18-month in Sembakkam village. Universal sampling was employed based on the prevalence study, and the sample size was 334. All women with children between 6 and 24 months of age were included as study participants after obtaining written informed consent. Data entry was done in Microsoft Excel, and statistical analysis was performed using SPSS version 23. Chi-square test was used for testing the association at P = 0.05. Results: The prevalence of EBF among the mothers was observed to be 69.1% whereas 30.9% did not practice EBF for their children up to the recommended period. Further, parameters such as educational status, socioeconomic status, occupation, mode, and place of delivery had a significant impact on the prevalence of EBF, and they were statistically significant. Conclusion: The prevalence of EBF in this study was 69.1%. The study participants had good knowledge about breastfeeding though some gaps were observed with regard to their practices. The study clearly emphasized the importance of increasing awareness among pregnant women about breastfeeding and even gave impetus on the necessity of family supporting breastfeeding for the recommended duration.


Prescription pattern of antihypertensive drugs in a tertiary care teaching hospital

Source: International Journal of Medical Science and Public Health
Rajeev Mishra, Priyanka Kesarwani, Shyam Sunder Keshari.
Background: Hypertension is a major health problem all over the world. It is not a disease in itself, but it is an important risk factor for cardiovascular mortality and morbidity. Objective: To evaluate the prescribing pattern of antihypertensive drugs in a tertiary care teaching hospital in Lucknow region. Materials and Methods: A cross-sectional study was carried out at the Outpatient Department in a tertiary care teaching hospital in Lucknow to access the prescription pattern of antihypertensive drugs during October 2015 to July 2016. Results: In the present study, 65.2% patients received monotherapy while 34.8% received combination therapy. In monotherapy, calcium channel blockers (CCBs) were most commonly prescribed, while angiotensin receptor blockers (ARBs) + diuretics were the most commonly prescribed combination therapy. Conclusion: In the present study, it was found that CCBs were the most commonly prescribed antihypertensive drug, followed by ARBs in monotherapy. Combination therapy was given according to associated risk factors and comorbid conditions.


A survey study in diabetic subjects on the general information about diabetes mellitus, it’s social aspects, complications and treatment

Source: Medicine Science | International Medical Journal
Gokhan Colpan, Merve Colpan, Canan Ersoy.
Diabetes mellitus (DM) is a metabolic disorder affecting many people worldwide, and its complications have become a global public health burden. Most diabetic patients are not aware of their conditions and the importance of the disease until complications develop, despite education programmes. This study was conducted to evaluate the general information level of diabetic patients about DM, its social aspects, treatment and complications. Patients with type 1 and 2 diabetes were enrolled in the study. A face to face questionnaire was applied to obtain patients' general information and diabetes awareness. To evaluate the overall knowledge, 40 questions were asked. In the assessment of the total scale scores (TSS), each correct answer was scored as 1 and incorrect as 0 point. The mean age of 120 participants was 42.5±15.4 years, 60.8% were females, 75% were married. The information level about the complications were statistically significantly higher in female diabetics than males. Information level about treatment of diabetes was higher in single diabetics compared to married ones. Married group had significantly higher scores concerning complications compared to single group. The results for the general information level, social aspect of diabetes, treatment and TSS were found to be statistically significantly higher in high education level group compared to low. In conclusion, education level of a patient seems to be the most prominent contributor of level of knowledge of diabetes, its complications, treatment and social aspects.


Effect of flunarizine on memory function by using step down passive avoidance test in albino rats

Source: International Journal of Basic & Clinical Pharmacology
Vinod Shinde, Radha Yegnanarayan, Khyati Doshi, Akhil Agarwal.
Background: Aim of the study was to evaluate effect of flunarizine on memory function by using step down passive avoidance test in albino rats. Methods: The study approved by IAEC was conducted using 24 albino rats (n= 6 in each group). Effect of normal saline (0.1 ml/100g), fluoxetine (10 mg/kg, intraperitoneally (ip)), and flunarizine (2 and 10 mg/kg, ip) on memory retrieval in rats was evaluated by using Step-down passive avoidance test. One day prior to conducting the test, each rat was trained to stay on central shock free zone platform (SFZ) for at least 90s. For the training, animals were applied shock of 15s every time when the rat stepped down placing all the paws on the grid floor. On the consecutive day retention of the memory was tested thirty minutes after administration of all test drugs. Step down latency (SDL) and number of mistakes was observed for a period of 5 min in all rats. Results: The data was analyzed by one-way analysis of variance (ANOVA) and Students t-test and P


Pharmacological evaluation of substituted 4, 5-diphenyl furan-3-carboxamide compound for antidepressant activity in mice

Source: International Journal of Basic & Clinical Pharmacology
Jayakumar J. K., Nityakarnam, Kishore Kumar P., Supriya.
Background: Depressive disorder is a prevalent psychiatric disorder, which affects 21% of the world population. Many drugs are available as effective antidepressants. But still there is necessity of developing novel compounds with minimized side effects. Hence this study was aimed to investigate the antidepressant activity of novel furan compound in albino mice. Methods: Antidepressant activity of novel furan compound was investigated by using forced swimming test (FST) and tail suspension test (TST) models. Fluoxetine was used as standard drug in this study. Results: It has been observed from our study that medium dose of test compound (10 mg/kg) reduced duration of immobility time to 35 seconds when compared to control group (147 seconds) in FST model. In TST model, the test compound of medium dose (10 mg/kg) had produced 83% protection against passive behaviour which is almost similar to standard drug fluoxetine (100%). Conclusions: The results of the specifies that compared to other two doses of test compound (5 mg/kg and 20 mg/kg), medium dose of test compound found as an effective dose for treating depression produced due to stress. However, further expansion of the study is needed for this compound to prove as a novel effective antidepressant compared to other drugs available for treating depression.


A prospective study on adverse drug reactions reported in a tertiary referral hospital

Source: International Journal of Basic & Clinical Pharmacology
Brahadeesh Mayathevar, Dhivya Thiyagarajan, Thamilarasi Soundararajan, Vallish B. N., Rizwan S. A..
Background: To determine the incidence of Adverse drug reactions in our hospital, to study the age wise distribution, the role of concurrent medication and the common drugs that are prone to cause adverse drug reactions and its seriousness. Methods: After getting prior approval from Institutional ethical committee a prospective study was done where in cases attending OPD, ward, ICU were studied over a year. A complete history was taken regarding drug exposure (dosage, date started, duration and interruptions in use), initiation of drug use and onset of reaction ,previous adverse drug reactions, improvement after decrease in dosage, disease states predisposing to eruptions, previous family and personal history of skin disease, environmental and occupational exposure to chemicals. Relevant laboratory test such as blood investigations, liver and renal function tests are carried out and results were analysed statistically by SPSS version 21 and interpretations done based on the results. Results: Incidence of ADR among OPD =0.18, IPD=1.98, OPD+IPD=0.39 /1000cases.The highest incidence of Adverse drug reactions were found among the age group of 30-39 years (27.45%), 40-49 years (23.53%), with the highest among antibiotic group of drugs (35.29%) involving a maximum duration of 2-7 days. Drug reactions mostly occurred with the oral route 66.67) and most of it requiring hospitalization (47.06%), 60.78% of reactions were manifested in skin, 58.82% of patients with ADR had concomitant medications and 19.61% had Diabetes mellitus, 90% of reactions abated after drug withdrawal with regard to its outcome 94.12% of reactions recovered. Conclusions: The study suggest the adverse drug reactions commonly occur in middle age, mostly manifesting in skin with oral route of administration ,associated with concomitant medications and it requires hospitalisation with a good recovery rate with diabetes being the common comorbid disorder.


Escobar syndrome: non-lethal multiple pterygium syndrome case report

Source: Medicine Science | International Medical Journal
Bayram Ali Dorum, Hilal Ozkan, Nilgun Koksal.
Escobar syndrome is a rare disorder that is a nonlethal variant of multiple pterygium syndromes. It is usually diagnosed in utero on fetal ultrasound and then confirmed in the neonatal period. Escobar syndrome is characterized by arthrogryposis multiplex congenita, excessive pterygia, congenital contractures, and abnormal facial appearance. It manifests as an autosomal recessive condition, and is caused by homozygous or compound heterozygous mutation of the CHRNG gene. Other variable features include growth retardation, congenital respiratory distress, ptosis, low set ears, cleft palate, and cryptorchidism. In this article, a newborn patient with Escobar syndrome was presented to share difficulties in the neonatal period, and the clinical features were discussed in the light of the literatüre.


Electrical stimulation (ES) of the upper airway (UAW) dilator muscles for patients with obstructive sleep apnoea (OSA)

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos

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