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International Journal of Basic & Clinical Pharmacology
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2319-2003 - ISSN (Online) 2279-0780
Published by Medip Academy Homepage  [12 journals]
  • Investigation on the effectiveness of mouth-washing using laban leaves
           (Vitex pinnata) steeping water in reducing plaque accumulation: a study in
           state elementary school 1 Pagar Air, Aceh Besar

    • Authors: Cut Aja Nuraskin, T. Iskandar Faisal, Reca ., Teuku Salfiyadi, Ainun Mardiah
      Pages: 545 - 549
      Abstract: Background: Dental and oral diseases that are commonly suffered by Indonesian people, are dental caries and periodontal disease. Dental plaque is the primary cause of the periodontal disease and dental caries. The diseases can be prevented by inhibiting the formation of dental plaque using a mouthwash. One of the ways in removing dental plaque is by mouth washing using laban leaves (Vitex pinnata Linn) steeping water. Laban leaves contain alkaloids, flavonoids, saponins, and tannins which can inhibit the growth of Streptococcus mutans so that it capable of removing dental plaque naturally. Bio-ingredients have been long used in health sector for preventive, curative, and rehabilitative treatments.Methods: Experimental research with pre- and post-tests design using proposing sampling technique, where 56 people were taken as samples. The samples were divided into 2 groups which receiving different treatments. Group 1 was instructed to do mouth washing with laban leaves steeping water, while Group 2 was with water. Each of students did the mouth washing for 30 s (20 ml).Results: based on the comparison of the dental plaque index (before and after the mouth washing using laban leaves steeping water) it is revealed that the steeping water of laban leaves was effective in reducing the plaque index with p value of 0.000 (<α=0.05).Conclusions: mouth washing using the laban leaves steeping water was effective in reducing the plaque accumulation. We then recommend a further study to investigate the potential of laban leave to be used in a mouthwash. 
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222736
      Issue No: Vol. 11, No. 6 (2022)
       
  • Evaluation of efficacy and safety of Bacillus coagulans SNZ 1969
           supplementation for irritable bowel syndrome: a randomized, double-blind,
           placebo-controlled study

    • Authors: Raunak J. Soman, Sarath Chandra Gorantla, Malisetty Venkat Swamy
      Pages: 550 - 558
      Abstract: Background: Probiotic potential (efficacy and safety) of Bacillus coagulans SNZ 1969 has been studied in patients with constipation-predominant irritable bowel syndrome (IBS-C) and-diarrhea predominant IBS (IBS-D).Methods: This randomized, double-blind, two-arm, placebo-controlled parallel study randomized 92 patients (1:1) to receive either 500 million CFU of Bacillus coagulans SNZ 1969 (treatment group) or placebo (placebo group) twice daily for 60 days under two subtypes of IBS, IBS-D (n=46) and IBS-C (n=46). Primary outcomes were changes in IBS symptom severity noted using the gastrointestinal symptom rating scale-IBS version (GSRS-IBS) on days 30, 60, and 75, and the number of treatment responders defined by subject’s global assessment (SGA) of relief ≤3 and ≤2 at days 30 and 60, respectively. We also assessed patient’s quality of life.Results: The GSRS-IBS scores reduced from day 30 through 75 in both IBS groups treated with Bacillus coagulans SNZ1969 compared to placebo (p<0.05). Higher GSRS-IBS score was noted in patients with IBS-C in the treatment group (22.45±2.7) than the placebo group (3.55±3.02; p<0.0001), and this trend was similar in IBS-D patients (p<0.0001). Most patients (90%) with IBS-C and all with IBS-D responded to Bacillus coagulans SNZ 1969 compared to no responders with placebo (p<0.0001). The SF-8 scores significantly reduced in patients receiving Bacillus coagulans SNZ 1969 than placebo for both IBS subtypes. One adverse event unrelated to the study treatments was reported in IBS-D group.Conclusions: Bacillus coagulans SNZ 1969 is safe, effective in alleviating IBS-associated clinical symptoms, and improves quality of life.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222353
      Issue No: Vol. 11, No. 6 (2022)
       
  • Comparative analysis of medical pharmacology books based on competency
           based undergraduate curriculum followed by MBBS student in Rani Durgavati
           Medical College, Banda

    • Authors: Veerendra Singh Yadav, Vijay Kumar Singh, Sunil Kumar
      Pages: 559 - 563
      Abstract: Background: National Medical Commission (NMC) has implemented competency based undergraduate curriculum for training of new M.B.B.S. students. As per these curriculum authors of Medical Pharmacology books also changed their book content to fulfill the subject requirement.Methods: A systematic comparison of books carried out in department of pharmacology Rani Durgawati Medical College, Banda, Uttar Pradesh. There was comparison of 5 books of medical pharmacology of Indian author belongs to edition after 2019. The books included were Essentials of Medical Pharmacology (Jaypee Publication, 8th Edition, 2021), Medical Pharmacology (CBS Publishers And Distributors Pvt Ltd, 7th Edition, 2021), Pharmacology and Pharmacotherepeutics (Elsvier Publication, 26th Edition, 2021), Pharmacology for MBBS (Avichal Publication Company, 2nd edition, 2021) and Pharmacology for Medical Graduates (Elsvier Publication, 4th Edition, 2020). All the books were examined for the competencies described in the pharmacology syllabus. The table was prepared for the availability of topics according to the competencies of different section of syllabus. The chapter/page numbers mentioned in competency table were looked upon for the respective competencies and presence or absence of the topic was noted down.Results: All the books mainly covered competency given in the knowledge section of the syllabus. Few competencies in skill and communication sections were also covered in the text books.Conclusions: When all the five books were evaluated according to pharmacology competency in syllabus, none of the books covered whole pharmacology syllabus. This may be because authors considered the competency topics in skill and communication section as a part of practical or because many practical books or manuals are available in the market which covered topics in these sections.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222650
      Issue No: Vol. 11, No. 6 (2022)
       
  • Real-world utilization and acceptance of biosimilar bevacizumab in
           metastatic colorectal cancer in India

    • Authors: Deepak Bunger, Anil Rajani, Lav Patel, Shreekant Sharma
      Pages: 564 - 567
      Abstract: Background: To describe the patient characteristics and usage pattern of biosimilar bevacizumab for the treatment of metastatic colorectal cancer (mCRC) in India.Methods: This real-world, retrospective analysis included adult patients receiving biosimilar bevacizumab between April 2021 and March 2022.Results: A total of 1125 patients with mCRC who received biosimilar bevacizumab-based chemotherapy were included. The mean age at diagnosis was 57.8 years. Majority of the patients were males (71%) and belonged to the age groups of 41-76 years. The primary tumor site was right colon (52.6%) followed by left colon (29.2%) and rectum (17.3%), and tumor grade was reported as high in most (88.7%) of the patients. Majority of the patients received biosimilar bevacizumab-based chemotherapy as first-line therapy (61.3%), followed by second-line (31.9%) and third-line therapy (6.8%). In combination with biosimilar bevacizumab, FOLFOX (folinic acid, 5-fluorouracil, and oxaliplatin) was the most commonly administered chemotherapy regimen (42.9%), followed by CAPOX (capecitabine and oxaliplatin, 26.5%) and FOLFIRI (folinic acid, 5-fluorouracil, and irinotecan, 22.8%).Conclusions: Biosimilar bevacizumab-based chemotherapy is being widely used in real‑world clinical setting in India for the management of patients with mCRC.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222629
      Issue No: Vol. 11, No. 6 (2022)
       
  • Physical comorbidity and its impact on symptom profile of depression in
           Indian setting 2 (COSPO-DEP-2 study)

    • Authors: Pragna Patel, Meera Kacha, Amit B. Jain, Nilanj Dave
      Pages: 568 - 575
      Abstract: Background: The objective of the study was to determine the symptom profile and prevalence of comorbidities and to understand the prescription patterns of antidepressants among depression patients in India.Methods: The real-world, retrospective, observational COSPO-DEP-2 study was conducted at various centres across India between April 2021 and March 2022.Results: Data of 7288 patients with depression was analyzed. The mean (SD) age of the patients was 45.1 (11.9) years. Majority of the patients were males (54.2%) and literate (92.7%); 53.1% were unemployed; 14.5% were unmarried and other 8.8% patients were divorced or separated. Almost equal proportion of patients were from urban and rural areas. A family history of psychiatric disorder was present in 14.9% patients. More than half (57.3%) of the patients presented with first episode of depression. Mild depression was present in 38.87% patients, moderate depression in 38.06% patients and severe depression in 23.07% patients. Diabetes was the most common comorbid condition (31.5%) followed by hypertension (26.6%), migraine (24.6%), and chronic pain (16.6%). Majority (54%) of patients were prescribed combination of pharmacotherapy with psychotherapy. The most commonly prescribed drug for depression management was escitalopram (57.5%) followed by benzodiazepines (38.7%). Escitalopram was also the most commonly prescribed drug in patients with depression having comorbidities.Conclusions: Depression is common among both genders and more commonly seen among unemployed people and in those with family history of depression. The commonly reported comorbidities include diabetes, hypertension, migraine and chronic pain. Escitalopram is the most commonly used agent followed by benzodiazepines among patients of depression with or without comorbidities.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222647
      Issue No: Vol. 11, No. 6 (2022)
       
  • Effect of diuretics on sodium, potassium and chloride levels- a cross
           sectional study

    • Authors: Varsha J. Patel, Paresh C. Parikh, Chirag Vaghela
      Pages: 576 - 579
      Abstract: Background: Diuretics are one of the widely used class of drugs used in various cardiovascular and other disorders. However, they can cause various metabolic adverse effects, electrolyte imbalance being among important changes.Methods: A cross sectional study was conducted in which patients diagnosed with hypertension for at least one month were included. Over a period of 6 months patients were enrolled irrespective of whether they were taking diuretics or not. Demographic details, drug therapy and electrolyte levels were recorded in a proforma. Data was analyzed for difference in serum electrolyte levels between diuretic and nondiuretic groups as well as between different diuretic groups.Results: Out of total 177 participants, 71 were on diuretic therapy. There was significant difference in mean serum sodium (S. Na), potassium (S. K) and chlorine (S. Cl) levels between diuretic and nondiuretic groups (P<0.05). Hyponatremia, hypokalemia and hyperkalemia were observed. Thiazide diuretic group showed significantly greater hyponatremia compared to other diuretics (P=0.028). Hyperkalemia was observed in participants receiving K sparing diuretic or combination of loop and K sparing diuretics. Old age and number of comorbidities showed negative association with S. Na. Females had significantly more hyponatremia than male participants.Conclusions: The study confirms that diuretics cause various abnormalities in electrolytes namely Na and K levels. Old age, comorbidities and female sex are risk factors for hyponatremia.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222737
      Issue No: Vol. 11, No. 6 (2022)
       
  • A drug utilization study of topical corticosteroids in the department of
           dermatology in a tertiary care teaching hospital in upper Assam

    • Authors: Reuben P. Syiem, Meghali Chaliha, Krishna Talukdar
      Pages: 580 - 586
      Abstract: Background: Topical corticosteroids form an important group of drugs in dermatology and are among the most commonly prescribed medications. However, despite their efficacy, they are associated with various adverse effects and as majority of the skin conditions are chronic, there is a need to ensure that there is rationality in drug use. Thus, this study was conducted with an aim to analyze the drug utilization pattern of topical corticosteroids.Methods: The study was a hospital-based, prospective and observational study and conducted for a period of 12 months. The method of data collection was done based on one-on-one consultation with patients. Data collected were recorded prospectively in a specially designed proforma. Results were then entered and analyzed using Microsoft excel.Results: In the study, it was observed that 48% of the patients were males while 52% were females. Most patients belonged to the age group of 21-30 years (30%). Scabies (30%) was the most common dermatological condition. With regard to the prescribing frequency of different topical corticosteroids, mometasone furoate (31.4%) was the preferred choice in most patients. H1 antihistaminic drugs like levocetirizine (81.6%) were the most prescribed along with topical corticosteroids, followed by emollients (36.4%) and permethrin (29.2%). The average number of drugs per prescription was 3.6 and all drugs were prescribed by their generic names.Conclusions: Periodic monitoring of the drug utilization pattern in the form of prescription auditing is an effective tool to constitute guidelines for improving the utilization pattern.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222738
      Issue No: Vol. 11, No. 6 (2022)
       
  • Analysis of individual case safety reports of spontaneous reporting in
           adverse drug reaction monitoring centre at a tertiary care hospital

    • Authors: Gomathi S., Siddiraju Devipriya, Sudha K. M., Ramachandra Bhat C.
      Pages: 587 - 591
      Abstract: Background: In developing countries like India, the increased economic burden in healthcare system is due to adverse drug reactions (ADRs) related hospitalizations which in turn are related to polypharmacy associated with increased potential of ADRs. World Health Organization (WHO) started the program for international drug monitoring (WHO PIDM) in the year 1968. India is one of the member countries under WHO PIDM using the Vigibase for analysis of individual case safety reports (ICSRs). Aim of the study was to analyse the ICSRs by spontaneous reporting at ADR monitoring centre.Methods: The present study was focused on analyzing the ICSRs of spontaneous reporting using Vigiflow data from the ADR monitoring centre (AMC), Madras Medical College, Chennai.Results: A total of 541 ICSRs from the period between July 2017 and June 2018 were analysed. Among 541 ICSRs, 814 ADRs were analysed and found that the majority of the ADRs belonged to SOC of gastrointestinal disorders and the most of the ADRs were implicated by antimicrobial agents followed by non-steroidal anti-inflammatory drugs (NSAIDs). Among all the ICSRs, majority of the ADRs occurred in males (n=292) and the maximum number of ADRs were in the age group of 45-60 years (n=197). Of the 541 ICSRs, 313 were found to be of “serious” category and majority of the ICSRs outcome was found to be “recovered” (n=262). The causality assessment of the ICSRs were anlysed and found that the maximum number of ICSRs were under “probable” category as per WHO-UMC scale.Conclusions: Robust pharmacovigilance activities plays important role in minimizing the ADRs for better patient safety.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222739
      Issue No: Vol. 11, No. 6 (2022)
       
  • Effect of angiotensin receptor neprilysin inhibitor in patients of heart
           failure with reduced ejection fraction with reduced ejection fraction with
           cardiorenal syndrome type-1

    • Authors: M. A. Molla, Ashutosh Kumar, Bhawani Goru, Sumaiya Isharat
      Pages: 592 - 596
      Abstract: Background: Heart failure is recognized as one of the most common indications for hospitalization. The dysfunction of either the heart or the kidneys affect the functioning of each other and thus play an important role in the quality of life.Methods: This study is a Prospective interventional Cohort study over a period of 18 months in 125 patients. The patients were divided into two broad treatment groups. The primary end point of the study was to quantify the response of ARNI for renal recovery in patients of cardio-renal syndrome and improvement in cardiovascular parameters by measuring the change in urine output, estimated glomerular filtration rate, serum creatinine, change in weight of the patients, control of blood pressure and change in left ventricular ejection fraction. The secondary end-points were evaluated during the 60 days follow up period post admissions.Results: Cardio-renal syndrome was seen in 39% of the patients. On screening e-GFR was 91±14 and 49±8 for group 1and 2 respectively, the median age, UACR was 59 years ,1.0 mg/mmol respectively for both the groups and 19% had micro albuminuria. ACEIs had more reports of hyperkalemia (8/32, 25%), and greater deterioration of renal parameters (10/32, 34%) needing discontinuation of the drug in some patients. Patients also developed cough (6/32, 20%) needing replacement with ARBs. ARNI group developed more hypotension (6/31, 20%). In all cardiovascular and renal end points except UACR, ARNI showed better recovery profile in CRS-1patients including diabetics.Conclusions: This study showed beneficial effects of ARNI in heart failure patients with cardio-renal syndrome. 
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222740
      Issue No: Vol. 11, No. 6 (2022)
       
  • A competency-based medical education on personal drug selection among
           medical students: a prospective, cross-sectional study

    • Authors: Pramod Kumar Manjhi, Akhilesh Kumar Rana, Rajesh Kumar, Chakrapani Kumar
      Pages: 597 - 601
      Abstract: Background: This study was conducted to know the students’ views regarding the personal drug (P-drug) concept in the rational prescription of drugs and also to give them training on creating and using personal drug concepts. Methods: The 60 medical students (5th semester) divided into four groups were involved voluntarily three-phase, questionnaire-based, and prospective study. In the first and second phases, students were taught and asked to derive P-drug using different standard textbooks and CIMS by analyzing the efficacy, safety, cost, and convenience of drugs used for stable angina pectoris. The third phase was designed to know the student’s perceptions regarding the exercise and difficulties faced in the process of P-drug selection. It contained demographic and 12 questions with the answer using the Likert scale.Results: Students selected tab. isosorbide dinitrate sublingual as a P-drug in terms of efficacy, safety, cost, and convenience. The 96.6% (58 out of 60) responded to the questionnaire. The overall median score was 2 and interquartile range was 2-5 (IQR 2-5). The majority (73% or 44) of students were in favour of introducing the process of selection of P-drug in the undergraduate pharmacology curriculum.Conclusions: The P-drug selection exercise helped students to understand the differences among various drugs used for the treatment of stable angina pectoris and gave them a strong foundation for developing rational use of the medicine in their future careers as a doctor.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222741
      Issue No: Vol. 11, No. 6 (2022)
       
  • Rational use and cost variation analysis of antifungal drugs available in
           the Indian market: a pharmacoeconomic study

    • Authors: Pramod Kumar Manjhi, Chakrapani Kumar, Akhilesh Kumar Rana
      Pages: 602 - 606
      Abstract: Background: Fungal infections are the 4th most common skin disease affecting 984 million people. Fungal infections are mostly associated with the use of broad-spectrum antibiotics, corticosteroids, anticancer/immunosuppressant drugs, indwelling catheters and implants, and the emergence of AIDS. The aim of this study was to analyze the rational use, cost ratio, and percentage cost variations in different brands of the commonly prescribed antifungal drugs available in the Indian market.Method: The maximum and minimum price of each brand of the drugs given in Indian rupees (INR) was noted by using ‘Drug Today’ (January to April 2021, volume II). The cost range, cost ratio, and the percentage cost variation for individual drug brands were calculated. The cost of tablets/capsule/injection was calculated and 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 antifungal agents, tab Itraconazole 100 mg had a maximum percentage cost variation of 733.33% and a cost ratio of 8.33 while tab Griseofulvin 250 mg had a minimum percentage cost variation of 16.98% and cost ratio of 1.16.Conclusions: The present study shows there was a wide variation in the cost of the different brands of antifungal drugs manufactured by pharmaceutical companies which increases the economic burden. The clinicians prescribing these drugs should be aware of rational use and cost variation to reduce cost of drug therapy and improve patient compliance. 
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222742
      Issue No: Vol. 11, No. 6 (2022)
       
  • Cross sectional observational study to assess the knowledge of drugs
           utilized in emergency medical conditions amongst medical interns and
           residents in tertiary care teaching hospital

    • Authors: Harsh J. Bhavsar, Devanshee R. Halvadia, Karan M. Suthar, Gurusharan H. Dumra, Mayank J. Patel
      Pages: 607 - 614
      Abstract: Background: Medical interns and residents are future medical professionals and as first-line responders, they may confront any type of emergency. Knowledge of pharmacotherapeutics (PTs) is the backbone of emergency care. Therefore, this study is designed to assess PTs’ knowledge and identify the lacunae in handling various medical emergencies among medical interns and residents.Methods: This was a cross-sectional, observational, questionnaire-based study. A self-structured questionnaire containing 30 close-ended questions, assessing the knowledge of drugs utilized in various medical emergency conditions was prepared and circulated in the form of a Google form. A credit score of “1” was given for each correct response. Grading of knowledge was done as “poor” (≤50%), “average” (>50-70%), and “adequate” (>70%-100%) The student’s unpaired t-test was used to analyse the data.Results: A total of 282 candidates responded, with 148 (52.48 %) interns and 134 (47.52%) residents. Participants had the least knowledge of PTs for anaphylactic shock. Participants’ knowledge of PTs was found to be adequate regarding the central nervous system and electrolyte disorders while average regarding toxicology, immunization, and endocrine system. Results suggested that residents (mean score: 21.42±5.06) were significantly (p=0.0165) more knowledgeable than interns (mean score: 19.96±5.08). Among respondents, 17.6% of interns and 13.4% of residents had poor performance while 45.9% of interns and 53.7% of residents had adequate performance.Conclusions: The current study provides valuable information regarding the state of PTs’ knowledge in medical emergencies among interns and residents, which can be used to improve undergraduate as well as postgraduate training.  
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222743
      Issue No: Vol. 11, No. 6 (2022)
       
  • Occurrence of depression, anxiety and stress among medical students
           working during COVID Pandemic

    • Authors: Devanshee R. Halvadia, Harsh J. Bhavsar, Karan M. Suthar, Gurusharan H. Dumra, Mayank J. Patel
      Pages: 615 - 620
      Abstract: Background: Since the COVID-19 pandemic began, medical students have been allotted various duties like rapid antigen testing, Sanjivani corona ghar seva (service provided by the government for home quarantine people), RTPCR swab collection, and posting in wards and intensive care units (ICUs). While executing the COVID-19 duties, students had a significant degree of a significant degree of ambiguity and apprehension. The purpose of this study was to determine the psychological impact of COVID-19 on medical students performing COVID-19 duties.Methods: A questionnaire-based, cross-sectional observational study was conducted among undergraduate and postgraduate students of a tertiary care teaching hospital, who were deployed on COVID-19 duty during pandemic. A google form-based questionnaire was structured, encompassing demographic details, Depression, Anxiety and Stress Scale-21 (DASS-21) questionnaire and other (additional) COVID-19 duty related questions. The analysis of data was done by using unpaired t-test and chi-square test in Statistical package for social sciences (SPSS) version 20.0Results: In our research study, we found that occurrence of depression, anxiety, and stress was 40.46%, 48.37%, and 30.69% among the medical students during COVID -19 duty, respectively. Higher occurrence and more severity (p<0.01) of depression, anxiety and stress was seen in female medical students during COVID-19 duty in pandemic.Conclusions: We observed a higher occurrence of depression, anxiety, and stress among medical students while performing their COVID-19 duty in a pandemic. Medical students played a significant role in the COVID-19 pandemic. Therefore, measures should be taken to ensure the psychological wellbeing of medical students. 
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222744
      Issue No: Vol. 11, No. 6 (2022)
       
  • A retrospective study on the clinical picture of COVID-19 patients
           associated with type 2 diabetes mellitus in India

    • Authors: Mahalaxmi S. Petimani, Prabhakar Adake, Susheela Somappa Halemani, Greeshma B. Kotian
      Pages: 621 - 625
      Abstract: Background: The clinical characterization of COVID varies from mild to severe. In the initial phases of the disease, symptoms like fever, cough, and dyspnea can occur. The severity and outcome of COVID vary with preexisting conditions, particularly type 2 diabetes mellitus (T2DM). Objective of current study was to assess the clinical presentation and laboratory derangements of COVID-19 patients associated with T2DM.Methods: The present retrospective study was started after the approval of the Institutional Ethics Committee. Various clinical (Sp02, final diagnosis, co-morbidity, and outcome) and biochemical parameters (CBC, LFT, RFT, LDH, Trop I, CK-MB D-dimer, CRP, ferritin levels, RBS, HbA1c) of Covid-19 patients were collected from Central Laboratory and & Medical Record Department of our institution. Patient names were anonymized and data were analyzed. The results are expressed in percentages.Results: A total of 24 COVID-19 patients (with T2DM) details were collected from the medical record department and central laboratory. Out of 24 patients, 16 (66.6%) were male, and the remaining 08 (33.3%) were female. Out of 24, 05 patients had mild covid, 02 were moderate and the remaining 17 suffered from severe COVID. The mean values of oxygen saturation, LDH, D-dimer, Troponin-I, CRP, Ferritin, Procalcitonin, and CK-MB were 76%, 797.3 U/l, 1614.2 ng/ml, 6.93 ng/ml, 72.6 mg/dl, 521.2 µg/l, 2.33 µg/l and 40.59 ng/ml respectively. The average random blood sugar level and glycosylated hemoglobin were 308.8 mg/dl and HbA1c 10.22%. Mean values of 42.5 mg/dl and 1.54 mg/dl were recorded for blood urea and S. creatinine. Regarding liver function test, mean values of 0.87 mg/dl, 0.37 mg/dl, 0.49mg/dl, 344.8U/l, 115.6U/l,108U/l respectively noted for total bilirubin, direct, indirect, SGOT, SGPT and ALP. Regarding patient outcome, 09 (37.5%) patients recovered and 15 (62.5%) died due to COVID. The values of glycosylated Hb and random blood sugar among the 15 patients who died due to covid infection suggested uncontrolled diabetes Mellitus in 7 of them with associated hypertension and died due to septic shock. Conclusions: Though the laboratory mean values of the liver function test and renal function test shows moderate variations the mean values of CRP, LDH, Procalcitonin, and Ferritin which are the acute inflammatory markers are highly disrupted when compared to normal ranges.  
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222745
      Issue No: Vol. 11, No. 6 (2022)
       
  • Evaluate the prevalence of risk factors among patients of myocardial
           infarction in our population: review of one hundred forty-seven cases

    • Authors: Tirth Bhavsar, Devang Rana
      Pages: 626 - 629
      Abstract: Background: CAD is disease of persons older than 45 years of age. In India, CAD in males, it manifests earlier than west European and North American males. This study is designed to study prevalence of risk factors (and angiographic profiles) amongst patients of Myocardial infarction in our population. Methods: Total of 147 consecutive patients of AMI were studied for risk factors.Results: Out of 147 patients, 116 (79%) were males and 31 (21%) were females. 11 (9.5%) of males and 01 (3.2%) of females were below 40 years of age. Whereas 34 (29.3%) of males and 06 (19.4%) females were of below 50 years of age. Median age for males was 54 years while that for females was 63 years. Smoking remains most prevalent amongst males while high LDL and HT remain most prevalent amongst young and overall females respectively. 108 patients had STEMI while 39 had NSTEMI.Conclusions: AMI occurs much frequently in males. Median age for males is almost one decade earlier than West European males and nearly 5 years earlier than North American males. Smoking is most common and hypertension second most common risk factors amongst males. In females median age for AMI is almost one decade later than Indian males. It is similar to North American females while nearly 5 years earlier than Western Europe females. HT and DM remain first and second common risk factors amongst females. 
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222746
      Issue No: Vol. 11, No. 6 (2022)
       
  • Cost variation analysis of commonly prescribed oral antipsychotic drugs
           available in India-a pharmacoeconomic perspective

    • Authors: Nivetha Raj R., Geetha A.
      Pages: 630 - 634
      Abstract: Background: Antipsychotics are commonly prescribed for a variety of psychiatric disorders which require prolonged treatment. If a costly brand is prescribed, it reduces patient compliance, especially in the lower socio-economic groups. Awareness about the cost variation among different brands will guide an economically effective prescription by the treating physician.Methods: The cost of different brands of commonly used oral antipsychotic drugs available in the Indian market manufactured by different companies, in the same strength, number and dosage form was obtained from the latest CIMS, MIMS, and India drug Index. The cost ratio and percentage cost variation were calculated for each. The cost for the same drugs was also noted from the Jan Aushadhi generic medicines portal and a comparison was made. Results: The percentage variation in the cost was above 100% with most of the commonly used antipsychotic drugs like haloperidol (517%), trifluoperazine (504.12%), risperidone (485.27%), chlorpromazine (436.35%), aripiprazole (340.34%), flupenthixol (293.12%), olanzapine (245%), ziprasidone (176.02%), amisulpride (169.44%), quetiapine (163.16%). Percentage cost variation between branded and generic drugs ranged from 400-1050%.Conclusions: There is substantial cost variation among the various brands of antipsychotic drugs. Stigma surrounding generic prescription needs to be addressed. More psychiatric drugs need to be included under National list of essential medicines and DPCO (Drug price control order) so that there can be a ceiling on the maximum price. 
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222747
      Issue No: Vol. 11, No. 6 (2022)
       
  • A study of adverse drug reactions in tuberculosis patients in a tertiary
           care hospital

    • Authors: Shilpa L. Todkar, Smita Tiwari
      Pages: 635 - 640
      Abstract: Background: Tuberculosis is the most rambling communicable infectious disease on earth. It is the single most common cause of death in individuals aged 15-49 years. Adverse drug reactions to antitubercular drugs causing significant morbidity, mortality, incurring substantial additional costs because of added outpatient visits, tests, and hospitalizations. Study was carried out with objectives of assessing the rate and type of adverse drug reactions (ADRs) and detecting serious and preventable ADRs with collection of demographic details of patients taking antitubercular drugs and developing ADRS.Methods: A cross sectional, prospective, observational study conducted in department of chest and TB of a tertiary Health care and teaching hospital in both IPD and OPD patients for a period of 18 months. 480 patients monitored.Results: Among 480 patients 120 i.e., 25% developed ADR. frequency being significantly higher in males (58%) and adult age group (>18 years) amongst hospitalized comparing to outdoor patients the gastrointestinal tract [GIT] (39%) followed by, generalized body disorders (19%) hepatobiliary system (17%) were organ systems most affected Majority (56%) ADRs reported in 0-2 month of starting therapy (63%) of cases were in “probable according to Naranjo causality assessment (37%) being possible. 55% ADRs were moderate in severity followed by 36% mild and 9% severe. 30% of ADRs were definitely preventable followed by 20% of probably prevented according to schumock thronstone preventability scaleConclusions: Study highlights the importance of routine monitoring and robust pharmacovigilance system for success of national tuberculosis programmes in India as well as worldwide.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222748
      Issue No: Vol. 11, No. 6 (2022)
       
  • COVID-19 and tuberculosis reactivation: a systematic review assessing most
           common risk factors

    • Authors: Sachchidanand Tewari, Rahul Yadav
      Pages: 641 - 645
      Abstract: COVID-19 as a pandemic not only shifted the focus of the healthcare system from other diseases but also affected the disease progression of infections like tuberculosis which remained a leading killer in the past worldwide. COVID-19 itself is said to reactivate latent tuberculosis as shown in animal experiments. Immunomodulators such as corticosteroids and tocilizumab which are being used for covid treatment even further predisposes patients to tuberculosis reactivation and increased progression of the disease. Diabetes is already known to be a risk factor for tuberculosis reactivation and impact tuberculosis progression and worsen the situation. The exact mechanism of interaction of covid-19 and tuberculosis and their effect on each other remains unknown. Considering high prevalence of tuberculosis and the current scenario of covid-19 in world, there is need to study the impact of covid-19 infection on tuberculosis progression or reactivation and commonly associated risk factors. We conducted a systematic search of the online databases to collect data of patients who had tuberculosis reactivation or increased progression of disease after covid-19 infection. Data of a total of 18 patients was retrieved and used for the syntheses of the study. Diabetes was present in 50% of the patients. 55.5% patients were administered corticosteroids for covid-19 treatment later presenting with tuberculosis. Tocilizumab however was administered to 22.2% patients who also received corticosteroids. 27.7% patients suffered tuberculosis reactivation after covid-19 infection without history of diabetes and corticosteroid or tocilizumab administration. None of the patients were reported to have HIV infection. Major risk factors present in patients included corticosteroid administration and diabetes. However, tuberculosis reactivation was seen even in absence of these factors indicating that covid-19 infection may itself be responsible for tuberculosis reactivation. The exact mechanism however remains unknown and further clinical studies are needed to know the same.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222749
      Issue No: Vol. 11, No. 6 (2022)
       
  • A case of severe bone-marrow suppression due to azathioprine in a patient
           of kidney transplant

    • Authors: Rohit Kumar Singh, Sandeep Guleria, Rani Indira Sinha
      Pages: 646 - 648
      Abstract: Azathioprine is one of the triple therapy immunosuppressive agents used in patients of renal transplant. Azathioprine is being used successfully in majority of patients of renal graft. But one of the dreaded complications caused by it is severe bone-marrow suppression. Here I am reporting a case of severe, life- threatening bone-marrow suppression in a 30 years old male patient of renal transplant. The case is very important and attention is needed to be given by health care professionals and by clinicians. The patient underwent renal transplant surgery in Indraprastha Apollo hospital, New Delhi. The patient was on immunosuppressive agents: prednisolone, cyclosporine and mycophenolate mofetil. After 10 months of renal transplant surgery, the patient was switched over azathioprine due to complains of GI upset due to mycophenolate mofetil. In initial 2 months there was moderate bone-marrow suppression, but afterwards there was severe bone-marrow suppression. Lastly TLC reached 300 /mm3 and Hb was 3.8 g/dL and that was life-threatening condition. The patient was managed in ICU with inj. Grafeel under strict hygienic conditions. The patient was recovered successfully with necessary conservative managements during admission. In my case, causality of azathioprine was “definite/ certain” as per Narenjo scale. Seriousness of the reaction was “life- threatening”.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222750
      Issue No: Vol. 11, No. 6 (2022)
       
  • Use of iodine tincture in the management of wound dehiscence in operated
           mandibular fracture along with hardware salvage: a case report

    • Authors: Mansi Dey, Bibhu P. Mishra, Vikram Sharma, Abhijeeta Sahoo
      Pages: 649 - 651
      Abstract: Mandibular 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.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222751
      Issue No: Vol. 11, No. 6 (2022)
       
  • Life threatening acute kidney injury in a patient of rheumatoid arthritis,
           is it drug or disease related'

    • Authors: Parth Kanani, Sapna D. Gupta, Supriya Malhotra
      Pages: 652 - 654
      Abstract: Even low-dose MTX therapy for treatment of rheumatic diseases is claimed to cause impairment in renal function. We report an insidious and progressive deterioration of renal function of patient with RA on low-dose MTX in a 41-year-old woman. We suggest that patients on low-dose MTX therapy should be periodically monitored for creatinine levels.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222752
      Issue No: Vol. 11, No. 6 (2022)
       
  • A case of phenobarbitone induced Stevens-Johnson syndrome-toxic epidermal
           necrolysis along with its causality assessment

    • Authors: Rohit K. Singh, Rakhi Rani, Vikas Shankar, Rani I. Sinha
      Pages: 655 - 657
      Abstract: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reaction, which are mainly caused by drugs; and these are usually associated with high degree of morbidity and mortality. They are characterized by mucocutaneous tenderness and typically haemorrhagic erosions, erythema and more or less severe epidermal detachment as blisters and areas of denuded skin.  High risk drugs for the development of SJS-TEN include phenobarbitone, phenytoin, carbamazepine, lamotrigine, nevirapine, NSAIDs, allopurinol, and cotrimoxazole. A 33 years old female patient came to skin and venereal diseases (VD) outpatient department (OPD) with complaints of painful skin lesions. She was apparently symptom free 15 days back. Then she took tablet phenobarbitone 60 mg, BD as her anti-epileptic treatment. After 12-13 days of taking the drug, she developed erythematous papules associated with itching over her both forearm, face, chest, abdomen, back and lower limbs bilaterally which rapidly progressed to fluid-filled blisters that ruptured to form painful erosions and desquamation of skin all over the body. The patient was managed by withdrawal of phenobarbitone and conservatively, and the patient recovered successfully. The causality of phenobarbitone in this reaction was “probable” as per Naranjo scale. Seriousness of the reaction was “prolonged hospitalization”. Phenobarbitone is one of the most common causative agents of SJS and TEN. The main stay of treatment is immediate withdrawal of causative agent along with supportive care.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222753
      Issue No: Vol. 11, No. 6 (2022)
       
  • The bromelain and rutoside advantage in systemic enzyme therapy:
           pharmacological basis of combination with trypsin

    • Authors: James John, Bhushan M. Khemnar, Ganesh H. Divekar, Nikita Patil
      Pages: 658 - 663
      Abstract: Inflammation involves various interlinked pathways and processes. In its uncontrolled form, inflammation results in variety of diseased sates. Current therapy for inflammatory diseases is limited to steroidal and non-steroidal anti-inflammatory drugs (NSAIDs). But these are associated with safety concerns and have a deleterious effect on wound healing. Proteolytic enzymes, also called proteases, which are naturally occurring substances derived from animal or plant sources, are believed to be effective and safer alternatives to the conventional medications. Combined with the bioflavonoid rutoside, the proteases trypsin and bromelain have been extensively investigated as alternatives to conventional therapies for pain and swelling associated with diverse conditions. Their individual mechanisms of action and the advantages of combining bromelain and rutoside with trypsin has been discussed. The combination not only covers a wider range of processes involved in inflammation, but they also complement each other’s actions and provide a more well-rounded control of the inflammatory processes.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222608
      Issue No: Vol. 11, No. 6 (2022)
       
  • Bisphosphonates-what’s new'

    • Authors: Hemamalini Ramesh, Vivekraj Navabalan, Anusha Natarajan
      Pages: 664 - 667
      Abstract: Bisphosphonates are chemical-related to pyrophosphate. The oxygen atom in pyrophosphate is substituted by a carbon atom in these compounds, resulting in a P-C-P bond. They are potent antiresorptive medicines because they have a strong inhibitory effect on osteoclasts. It lowers fracture risk by reducing bone turnover, increasing bone mineral density, and decreasing fracture risk in the lumbar spine and hip. Bisphosphonates are strongly attracted to bone surfaces, where they accumulate, primarily at remodeling sites. They are rarely associated with systemic side effects due to their selectivity in action. Irritation of the upper gastrointestinal tract is the most common side effect. A strong third-generation bisphosphonate, zoledronate, is currently approved to treat postmenopausal-induced osteoporosis. This review mainly focuses on the mechanism of action, therapeutic uses, and its adverse effects.

      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222754
      Issue No: Vol. 11, No. 6 (2022)
       
  • A detailed overview of the patent system

    • Authors: Archana D. Kodilkar
      Pages: 668 - 675
      Abstract: The roots of today’s solid patent system are from the ancient trade system, the introduction, and the evolvement of different intellectual properties. Various international legislations, collaborations, and treaties, as well as the introduction of various acts, rules, and amendments, are responsible for the management and growth of the recent patent system. Novelty, utility, and non-obviousness are the basic patentability criteria. The Indian patent act also defines things that are not inventions under section 3 of the Indian patent act as “statutory subject matter”. The patent system working is described under patent prosecution (filing, publication, examination, opposition) sequentially. “Patent co-operation treaty” (PCT) introduced by the “World intellectual property organization” provides a most effective and economical way of patent application in multiple countries through a single filed application. A general overview of a patent application, drafting of claims, patent analysis, invalidation of patents, Infringement of patents, non-infringing activities, prosecution history estoppel, and remedies under the jurisdiction, are also described hereunder. At present, the number of patent applications filed in India is continuously increasing. Indian patent office is becoming one of the designated search authorities under the PCT. General awareness about patents and intellectual property in all sectors can be improved further. 
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222755
      Issue No: Vol. 11, No. 6 (2022)
       
  • Antimicrobial stewardship program activities in India: an appraisal

    • Authors: Janki Chauhan, Raja Chakraverty, Saman Pathan
      Pages: 676 - 679
      Abstract: Human antimicrobial misuse/overuse/irrational use is one of the main drivers of antimicrobial resistance (AMR) and in the presence of a rapidly drying up antibiotic pipeline, it becomes imperative that we learn to use antibiotics judiciously and responsibly. In 2010, India was adjudicated to be the world’s largest consumer of antibiotics and hence curbing injudicious use of antibiotics is a must. Antibiotic abuse happens due to common fallacies such as a belief that broad spectrum antibiotics are “safer” and failure to distinguish between bacterial infections and non-bacterial infections and non-infectious syndromes. In addition, antibiotics for durations longer than necessary, redundant cover (like double gram negative or double anaerobic cover) or treatment of colonizers or contaminants also constitute inappropriate antibiotic use. A stewardship program implementing rational antibiotic use is mandatory to curb irrational antibiotic use. Antimicrobial stewardship is defined as a set of coordinated interventions designed to measure and improve the appropriate use of antibiotics by promoting the selection of the optimal choice, dose, duration and route of the antibiotic which in turn lead to improved patient outcomes and decreased adverse effects.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222756
      Issue No: Vol. 11, No. 6 (2022)
       
  • Potential anticancer activity of some medicinal plants in vitro and in
           vivo study

    • Authors: Amit Kumar, Niranjan Sharan, Shilpa Gupta, Shikha Kumari
      Pages: 680 - 691
      Abstract: The public health burden caused by cancer is significant in both developing and developed nations. The ability of biological, chemical, or synthetic substances to prevent, inhibit, or stop the progression of carcinogenic is known as anticancer activity. To treat the condition, several synthetic drugs are utilized, however because of their toxicity, research is now being done to examine chemotherapeutic medicines produced from plants. A review of several in vivo and in vitro techniques for determining the anticancer activities of natural compounds from medicinal plants has thus been undertaken. In this study, 50 Indian anticancer medicinal plants from 35 families are presented, together with comprehensive data on the parts and extracts utilized, the model type employed, the cancer cell line types that were tested, etc. These plants are still utilized to treat numerous tumor forms, including lymphoma, sarcoma, leukemia, and carcinoma. All of plants are likely candidates for in vivo research since they have strong anticancer action in vitro.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222757
      Issue No: Vol. 11, No. 6 (2022)
       
  • Re-moulding publication criteria for the advancement of medical faculty: a
           wake-up call for medical fraternity

    • Authors: Subhiksha Subramanian, Indumathi Prabath, Sangeetha Raja
      Pages: 692 - 692
      Abstract: Sir,The National Medical Commission (NMC) is a dynamic organization constituted to revamp medical education all over the nation by imparting changes in the medical curriculum and criteria for teaching faculty. The core objective of recent regulations on teachers eligibility qualifications in Medical Institutions, 2022 is to promote a uniform teaching standard among medical institutions functioning under the scope of NMC.
      PubDate: 2022-10-27
      DOI: 10.18203/2319-2003.ijbcp20222758
      Issue No: Vol. 11, No. 6 (2022)
       
 
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