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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]
  • Oncogenic challenge of bromocriptine and L-arginine versus conventional
           antidiabetics on diethyl nitrosamine-induced liver tumorigenesis in
           diabetic rats: focus on AMPK activation

    • Authors: Wafaa A. Hewedy, Eman I. Anwar, Gehan M. Sharara, Mona A. Hadi, Suzan A. Darwish, Cherine A. Ismail
      Pages: 1 - 9
      Abstract: Background: Diabetes mellitus (DM) is associated with a spectrum of cancers where the metabolic antecedents, consequences, and therapy might affect cancer risk. The association between hepatocellular carcinoma (HCC) and DM had been confirmed. Approaches to HCC prevention focus on the molecular regulators of the disease process defined as the inflammation-fibrosis-cancer axis. The AMP-activated protein kinase (AMPK) is an interesting metabolic tumor suppressor and a promising target for cancer prevention and therapy. This study aimed to investigate the effects of bromocriptine mesylate and L-arginine on hepatic carcinogenesis on a rat model of hepatic neoplasia induced by diethyl nitrosamine (DENA) and promoted by type-2 DM in contrast to the conventional antidiabetics.Methods: One hundred male Wistar rats were randomly assigned into two sets; control set (normal, HCC, DM, and combined HCC/DM) and treated set where rats received one of the following drugs for another 5 weeks: insulin glargine, glimepiride, metformin, pioglitazone, bromocriptine mesylate, or L-arginine. Bodyweight changes, blood glucose level, liver functions tests, serum C-peptide and alpha-fetoprotein (AFP), and hepatic activated AMPK were assessed beside the hepatic histopathological changes.Results: Equivalent to metformin, bromocriptine and L-arginine treatment significantly reduced AFP, despite their minor glycemic control. L-arginine induced AMPK activation, yet less than metformin. Histopathologic examination revealed a reduction in hepatic intra-lobular chronic inflammatory cell infiltration, steatosis and necrosis by metformin, bromocriptine, and L-arginine. Hepatic necro-inflammatory changes were most prominent in insulin-treated rats.Conclusions: L-arginine and bromocriptine mesylate prevent early neoplastic changes almost equivalent to metformin at least partially via hepatic AMPK activation.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223348
      Issue No: Vol. 12, No. 1 (2022)
       
  • Evaluation of pharmacological prophylaxis for deep venous thrombosis in
           hospitalized patients with risk factors at the university teaching
           hospitals, Lusaka, Zambia

    • Authors: Martin Kampamba, Davison Kafulu, Christabel Nang’andu Hikaambo, Steward Mudenda, Audrey Hamachila, Jimmy M. Hangoma
      Pages: 10 - 17
      Abstract: Background: Deep venous thrombosis is a common clinical problem accounting for high rates of morbidity and mortality. The existence of risk factors, which include trauma, venous stasis, and hypercoagulability, is linked to the occurrence of the condition. Objective of current study was to evaluate DVT risk factors and prophylaxis pattern of use for patients who were admitted at the University Teaching Hospitals in Lusaka, Zambia.Methods: A cross-sectional study was conducted using medical files for patients who were hospitalized at the University Teaching Hospitals in Lusaka, Zambia from May 2020 to June 2021. Two hundred and ninety-six patient files were reviewed, and the Caprini risk assessment model was used to stratify patients into DVT risk categories. Multilinear regression analysis was used to identify factors associated with DVT prophylaxis.Results: Of the 296 patient files that were sampled from ICU, medical, and surgical wards, 198 (66.9%) (>2 caprini score) were eligible for DVT prophylaxis, but only 77 (38.9%) of these eligible patients received prophylaxis. The number of eligible patients for DVT prophylaxis per department was as follows; ICU 50 (100%), Medical 71 (57.7%) and Surgery 77 (62.6%) wards. However, DVT prophylaxis was given to 21 (42%), 33 (46.5%), and 23 (29.9%) patients from the ICU, medical, and surgery, respectively. Enoxaparin was the most commonly used anticoagulant for Venous thromboembolism (VTE) prophylaxis with a mean dose of 60mg (SD±5). Across all departments, the most common predisposing risk factors for DVT were bed confinement for >72 hours (167, 56.4%) and age of 41-60 years (118, 39.8%). In the adjusted model, swollen legs (AOR: 3.6, CI: 1.97, 6.57) and history of VTE (AOR: 21.3, CI: 9.87, 46.08) were significantly associated with a higher likelihood of DVT prophylaxis.Conclusions: Pharmacologic thromboprophylaxis is underutilized in patients in ICU, medical and surgical wards at the university teaching hospitals in Lusaka, Zambia. This study underscores the importance of implementing a DVT risk assessment technique for patients in ICU, medical and surgical wards and administering prophylaxis unless contraindicated.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223349
      Issue No: Vol. 12, No. 1 (2022)
       
  • Knowledge, attitude, and practices among clinically exposed medical
           students and interns towards COVID-19 vaccine in a tertiary care hospital,
           Kanyakumari district: a cross-sectional survey

    • Authors: S. Anisha, G. Agnes Golda Priyadarshini, Supriya Selvakumar Suseela, V. Ganesh
      Pages: 18 - 21
      Abstract: Background: Several COVID-19 vaccines have been approved against coronavirus disease and its distribution to different countries. The study is mainly done to determine the knowledge, attitude, and practice among clinically exposed medical students and interns toward COVID-19 vaccine.Methods: A cross-sectional study was conducted from June 2022 to August 2022 in a tertiary care hospital. Using questionnaires, the knowledge, attitude, and practice among medical students and interns were assessed, and they were then analysed and categorised accordingly. Then the students were given awareness regarding COVID-19 vaccine.Results: The questionnaires were distributed among students and interns, and responses were collected. A total number of participants (n=300), out of which the majority of responders were second-year students 89 (29.6%). Overall, 39.75% had high-grade knowledge, 43.5% had a positive attitude and 37.5% had good practice regarding the COVID-19 vaccine. The results show that 81.2% of interns had high-grade knowledge, 76.6% possess a positive attitude and 71.9% of good practice and preventive measures towards COVID-19 vaccine.Conclusions: Our study concludes that there were certain gaps in knowledge, attitude, and practice among second and third-year medical students when compared with final-year medical students and interns.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223327
      Issue No: Vol. 12, No. 1 (2022)
       
  • Evaluation of the safety and efficacy of codeine phosphate and
           chlorpheniramine maleate in a fixed dose composition for the management of
           dry cough in adults: an open label phase IV clinical trial

    • Authors: Ashok Kumar, Jyoti Batra
      Pages: 22 - 28
      Abstract: Background: Dry cough is one of the most common symptoms for which patients seek medical attention. It not only causes discomfort in patients, but also hampers their daily work and routine. Since there is no specific underlying cause for dry cough, a definitive treatment is still not available. Several cough suppressants have been used for the treatment of dry cough including codeine which reduces discomfort. However, some reports suggest that use of codeine at high doses leads to sedation and drowsiness. To evaluate the safety and efficacy of codeine, a clinical trial for fixed dose composition of codeine phosphate and chlorpheniramine maleate was conducted.Methods: The trial was conducted on 219 adults with prior symptoms of dry cough. Safety was evaluated on the basis of the change in patient’s vital parameters, any adverse event or severe adverse event that occurred during the course of study. Efficacy was assessed on the basis of cough severity scores, number of night awakenings due to cough, and overall decline in cough.Results: According to the investigator's evaluation the product was safe to use as no significant changes in the patient’s vital parameters were observed during the course of study. Also, no severe adverse events were reported. Administration of the investigation product significantly decreased cough severity and frequency at the 7th day of the study.Conclusions: This study suggests, FDC of codeine phosphate 10 mg and chlorpheniramine maleate 4 mg per 5 ml oral syrup is safe and efficacious for the treatment of dry cough.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20222982
      Issue No: Vol. 12, No. 1 (2022)
       
  • Taxanes induced hypersensitivity reactions in cancer chemotherapy patients
           reported at adverse drug reaction monitoring centre at a tertiary care
           hospital

    • Authors: Shaik Haseena Begum, Venugopal Reddy M., Christina Sahayaraj, Sharon Sonia S., Vijayabhaskara Reddy Y.
      Pages: 29 - 33
      Abstract: Background: Cancer chemotherapy involves highly complex regimens using antineoplastic agents like taxanes (paclitaxel, docetaxel) etc. Taxanes cause hypersensitivity reactions (HSRs) like redness, rashes, dyspnoea, severe anaphylaxis and death. In this study, adverse drug reactions (ADRs) associated with taxanes are described & analysed on their severity and preventability. The present study aims to analyse and determine the prevalence of ADRs, especially HSRs in patients treated with taxanes.Methods: After getting IEC approval, the present study is done retrospectively by assessing the HSRs in suspected ADR reporting forms from December 2019 to February 2022 in ADR monitoring centre (AMC) in the Department of Pharmacology at Kurnool Medical College, Kurnool. Descriptive statistics used to analyse patient demography, frequency, various carcinomas under treatment & organ involved, causality assessment using WHO-UMC Scale and Naranjo's Algorithm, severity assessment using modified Hartwig & Siegel’s scale and preventability by modified Schumock & Thornton scale.Results: A total of 258 ADRs were recorded, of which 30 cases reported HSRs with taxanes-paclitaxel (22) and docetaxel (8). The most commonly occurred HSR is shortness of breath. Naranjo’s algorithm showed 52.5% possible (score 1-4) HSRs. WHO-UMC causality assessment scale showed 56.4% as probable HSRs. Modified Hartwig & Siegel severity scale showed 46.6% moderate (level 3). Modified Schumock and Thornton scale showed 76.9% as not preventable.Conclusions: Chemotherapy-related ADRs among cancer patients urges the oncologists to be actively involved in ADR reporting, in the need of the hour in order to mitigate, avoid their occurrence and reducing morbidity and mortality, when practiced with diligence.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223350
      Issue No: Vol. 12, No. 1 (2022)
       
  • A clinical pharmacological evidence-based analytical research study on the
           clinical pharmacokinetic dose-dependent correlation of oral haematinics
           with the obstetric and gynaecological global anaemic patients’ recovery
           rate

    • Authors: Moumita Hazra
      Pages: 34 - 38
      Abstract: Background: The goal of iron therapy is to repair the haemoglobin deficit and replenish storage iron. Oral haematinics are the treatment of choice, due to their higher effectiveness, higher safety, higher ease of administration, higher patient compliance, better accessibility, no occurrence of nosocomial infections and lower cost. This analytical evidence-based clinical research was conducted for the molecular pharmacokinetic study of the pharmacological response and adherence of the patients to oral haematinics, in global tertiary medical care centres.Methods: 100 anaemic patients, who were treated for moderate iron-deficiency anaemia, were prescribed oral haematinics, such as, ferrous ascorbate, ferrous sulphate, ferrous fumarate and ferric ammonium citrate, containing 60 mg of elemental iron, once to thrice daily, with or after meals, according to the progress of the disease, treatment regimen scheduling, occurrence or non-occurrence of adverse drug reactions and prognosis of the patient. The pharmacokinetic dose-dependent percentage recovery rate of the patients on 1st (30th day), 2nd (60th day) and 3rd (90th day) months and follow-up (105th day) visits, was finally deduced from the patients’ recovery features of symptoms and signs, and the confirmatory laboratory investigations recordings, with the efficacy and safety evaluation findings.Results: During the oral haematinics treatment, the pharmacokinetic dose-dependent percentage recovery rate of the patients was 29% on 30th day, 62% on 60th day, 93% on 90th day and 100% on 105th day of treatment.Conclusions: All the oral haematinics treated global anaemic patients had shown 100% recovery rate in tertiary medical care centres.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223351
      Issue No: Vol. 12, No. 1 (2022)
       
  • An audit of prescriptions in general medicine outpatient department in a
           tertiary care government hospital in Eastern India: a quality improvement
           project

    • Authors: Luv ., Ravikirti ., Ratnadeep Biswas, Vishnu S. Ojha
      Pages: 39 - 42
      Abstract: Background: Prescriptions are an important link between physicians and patients. Any medication therapy can become ineffective if not communicated properly to the pharmacist and patient. Therefore, it’s important to maintain the quality of prescription-writing. Thus, we conducted a prescription audit in a tertiary-care hospital.Methods: 413 prescriptions having 1683 drugs were selected by convenience sampling. Adherence to 4 quality parameters, namely mention of date, allergy status, date of next visit, and whether or not the prescription was signed legibly, were observed for each prescription. 5 parameters viz. whether or not the drug was written in capital letters, whether the generic name of the drug was mentioned, and prescription of drug schedule, dose, and duration were evaluated for each drug separately. Frequency tables and appropriate bar plots were created.Results: Dates were mentioned in all prescriptions. There were 4.07±0.44 (mean±SD) drugs per prescription. Using capital letters and generic names was observed for 12% and 21% of the drugs. Dose, duration, and schedule were written for 51.4%, 98.6% & 98.7% drugs respectively. The next visit was mentioned in 61.7% cases. 21.8% prescriptions were signed legibly and only 0.5% prescriptions had allergy status.Conclusions: A significant scope of improvement was observed in signing the prescription legibly, mentioning next visit, using generic names, writing the drug names in capital letters, drug doses, and mentioning allergy status. Conducting regular audit-feedback-audit loops will improve the quality of health care delivery in a practical manner. 
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223352
      Issue No: Vol. 12, No. 1 (2022)
       
  • Post-valuation quality check of multiple-choice questions

    • Authors: Kavita M. Jaiswal, Sujata Dudhgaonkar, Piyush Gharade, Nikita Sharma
      Pages: 43 - 48
      Abstract: Background: Multiple choice questions find important place in assessment in medical curriculum. Each MCQ is called item. Item analysis is quality check of MCQs after valuation of response sheets. This serves to recognize flaws in MCQs so that the given questions can be preserved in question bank, modified or deleted. Methods: 140 medical students of second MBBS were assessed pharmacology through 20 single best response type MCQ. Post exam validation of MCQs was done by item analysis. Each item was analyzed for level of difficulty, ability of the question to discriminate between poor and good performing students and distracter effectiveness.Results: Score ‘1’ was given for correct and ‘0’ for incorrect or no response. The mean score of the test was found to be 10.58±2.48, with a range 5-18. The whole test had an acceptable difficulty level with 43.25±17.81 mean difficulty index. The discrimination index of the whole test was found to be 0.123±0.184 mean PBI correlation coefficient, which is not satisfactory. Out of 60 distractors, 51 were found to be functional, hence distractor efficiency of the given test was 85%±19.96% which is acceptable.Conclusions: 60% questions were found to be ideal and 25% were acceptable with revision of stem or options. One question was easy with poor discrimination which needs major modification in construct or subject to be placed in question bank while another one question was difficult but had negative biserial index which needs to be deleted from the question bank.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223353
      Issue No: Vol. 12, No. 1 (2022)
       
  • An audit of drug utilization patterns, rationality, and cost analysis of
           antimicrobial medicines in a tertiary care teaching hospital in central
           suburban India

    • Authors: Suhrud Panchawagh, Ankita Pol, Uma Bhosale, Vasundhara Bhopale, Ayush Bhosale
      Pages: 49 - 57
      Abstract: Background: Antimicrobial medicine (AMM) utilization patterns and rational drug use are important topics in today’s world wrought with AMM resistance, irrational prescription of antibiotics, and lack of proper training such as stewardship programmes for medical graduates and general practitioners. Our objective was to perform an audit of the antimicrobial drug utilization pattern, evaluate the rationality of drug use, and perform a cost analysis of these drugs.Methods: An observational cross-sectional study design was implemented. The study location was a tertiary care teaching hospital in suburban central India. Patients were recruited from the general medicine and general surgery departments.Results: Out of 189 patients, the average age was 45.714 years and 67.725% were females. A total of 595 AMMs were prescribed to 189 patients with an average of 3.148±1.578 drugs per patient. 6.5% drugs prescribed were generic, 95% prescribed were included in the national essential medicine list, and 90% of patients’ prescriptions were rational. The total expenditure on AMMs was ₹726043.610, with a median expenditure of ₹987.320.Conclusions: Drug utilization patterns vary between medicine and surgery departments. They also vary between different institutions within the same country. Creating a structured standardized training program to uniformly train healthcare professionals in conservative antibiotic prescription practices is needed. This study hopefully paves the way for future studies to target critical areas in AMM prescription and to prospectively assess the impact of a structured antibiotic stewardship program on AMM utilization patterns.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223354
      Issue No: Vol. 12, No. 1 (2022)
       
  • A study of reporting pattern of adverse drug reactions in a tertiary care
           teaching hospital

    • Authors: Shailendra Kumar, Rohit Kumar Singh, Raj Narayan Seth, Rani Indira Sinha
      Pages: 58 - 63
      Abstract: Background: Adverse drug reactions (ADRs) are one of the prime causes of morbidity and mortality, increase in hospital stay and socioeconomic burden on the patients. Periodic monitoring aids in formulating methods for safe usage of medicines in hospitals. Identification of ADRs and their reporting pattern can provide useful information for their prevention. Hence this study was done to see the pattern of reported ADRs in Patna Medical College and Hospital, Patna in a 3 months of study.Methods: It was an observational and retrospective study carried out between July 2022 to September 2022. Both outpatients and inpatients were included in the study. The ADRs in the form of Individual Case Safety Reports (ICSRs) were sent to the nearby adverse drug reaction monitoring centre (AMC).Results: The occurrence of ADRs was more common in females (56.25%) as compared to males (43.75%). Patients of age-group 21-40 years (40.625%) were most commonly involved. Medicine department (34.375%) reported the maximum percentage of ADRs. Antimicrobials (37.50%) was the most common drug-group causing ADRs. Maximum reported ADRs (81.25%) were probable, 9.375% were possible, 6.25% were certain, while 3.125% were unlikely with the suspected drug as per Naranjo scale.Conclusions: The pattern of ADRs reported in our hospital is comparable with the results of studies conducted in hospital setup elsewhere, along with a few differences. The study results revealed opportunities for interventions in ADR management especially for the preventable ADRs to ensure safer drug use.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223355
      Issue No: Vol. 12, No. 1 (2022)
       
  • Learner’s perspectives on competency-based medical education in
           pharmacology at a tertiary care teaching hospital in South India

    • Authors: Ananya Chakraborty, Meharban A., Latha Kamath
      Pages: 64 - 69
      Abstract: Background: Competency based medical education (CBME) was implemented recently in India. The study was conducted to evaluate the perspectives of undergraduate medical students towards CBME curriculum in pharmacology at a tertiary care medical college in South India.Methods: After the completion of the curriculum, feedback was taken in a semi-structured, validated questionnaire. It was based on Kirkpatrik’s level 1 model of evaluation. Majority of the questions were framed on a 5-point Likert's scale (1 being poor to 5 being excellent). Qualitative data was collected by open ended question on additional comments.Results: The response rate was 72.8%. Majority of the participants rated the theory classes, practical classes, small group discussions, self-directed learning, integration, and assessments as good and excellent. More than 80% participants rated role play as an innovative and worthwhile concept towards mastering prescription communication. They felt that role play ignites team work, and provides confidence. Close to 90% of the participants rated the overview on emergency use authorization, orientation on drug regulators, perspectives on hydroxychloroquine prophylaxis as effective and excellent. More than 85% participants felt that AETCOM provided them insight on ethical issues, patient communication, and perspective of doctors as caregivers. 9.8% (16) participants provided comments to open ended question for feedback.Conclusions: The study provided an insight of medical undergraduates towards CBME curriculum. Further studies can be designed to look into the effectiveness of teaching learning methods based on the performance of the students, perspective of faculties with focus faculty development, and role of various stakeholders.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223356
      Issue No: Vol. 12, No. 1 (2022)
       
  • A questionnaire based study to assess knowledge, attitude and practice of
           pharmacovigilance among exam going second year undergraduate medical
           students in a South Indian teaching hospital

    • Authors: Umashankar N., Hemanth Kumar K. H., Kishore M. S.
      Pages: 70 - 76
      Abstract: Background: Pharmacovigilance not only helps in the early detection of adverse drug reactions (ADRs) but also facilitates the identification of both, risk factors and the underlying mechanism. To increase the reporting rate, it is essential to improve the knowledge, attitude, and practices (KAP) of healthcare professionals regarding ADR reporting and pharmacovigilance, especially during undergraduate and postgraduate education. The objective of this study was to assess the KAP about pharmacovigilance among exam-going second-year undergraduate medical students.Methods: A cross-sectional questionnaire-based study was conducted among 150 exam-going second-year undergraduate students from Mysore Medical College and Research Institute, Mysore from April 2022 to June 2022. A validated questionnaire consisting of 22 questions divided into 3 sections; knowledge, attitude, and practice was used. Statistical analysis of data was done using an MS excel spreadsheet.Results: Out of the 150 participants 133 had good knowledge about ADR and pharmacovigilance. Majority of the students agreed that reporting of ADRs is necessary (95.3%), mandatory (95.3%), and should be included in pharmacology practicals (94.7%). Only 29.3% of the students had witnessed an ADR and none of the participants had ever reported an ADR indicating poor practice among the undergraduate students.Conclusions: Students had good knowledge and positive attitude towards ADR reporting and pharmacovigilance. Practice regarding pharmacovigilance was found to be poor, indicating the need for training the undergraduate students in ADR reporting by including ADR recognition and reporting as a part of clinical posting curriculum.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223357
      Issue No: Vol. 12, No. 1 (2022)
       
  • Knowledge, attitude and practicing behavior regarding antimicrobial use
           and awareness of antimicrobial resistance among interns and postgraduates
           in a tertiary care hospital

    • Authors: Samreen Nishat, Mohammed Abdul Muhaimin Ali, Maleha Butul, Samra Sameen, Syeda Ayesha Siddiqua
      Pages: 77 - 82
      Abstract: Background: Irrational use of antimicrobials and inaccurate practicing behavior leads to the issue of antibiotic resistance. This can be tackled by spreading awareness with the assistance of future medical practitioners. Hence, the present study was taken to determine the knowledge, attitude, and practicing behavior regarding antimicrobial use and awareness of antimicrobial resistance among interns and postgraduates.Methods: The study was conducted on interns and postgraduates in a tertiary care hospital. A standardized questionnaire was distributed to 120 participants and Ethical approval was taken before the study. Data was analyzed using SPSS software. For data comparisons, Chi-square tests were used, p≤0.05 is considered significant.Results: The study showed a majority in the 25 to 34 years of age group with female predominance. The subject of antibiotic resistance was moderately relevant to a majority, which highlighted a need for an increase in awareness workshops. The actual knowledge of respondents seems to be accurate in the study, a fair amount of attitude and practicing behavior was observed as well. A significant difference between the interns and postgraduates in knowledge (χ2=13.736, p=0.03), attitude (χ2=68.091, p=0.01), and practice (χ2=34.821, p=0.01) were noticed.Conclusions: Accurate knowledge and practicing behavior were observed in postgraduates and a fair attitude was observed in interns towards antimicrobial use and resistance. The awareness must be extended regarding this issue by conducting educational programs and by updating guidelines. Advancement in antibiotic prescribing pattern is required.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223358
      Issue No: Vol. 12, No. 1 (2022)
       
  • Chronopharmacology: an insight into its knowledge among medical students

    • Authors: Akshay Pankaj, Benz Tom, Manjunath G. Narasimhaiah, Riyaj A. Kalaburgi
      Pages: 83 - 87
      Abstract: Background: Chronopharmacology is the science which deals with the optimization of drug dose that promotes efficacy and minimizes the adverse effects by taking the medications in relation to the biological rhythm. Circadian rhythms can be manipulated to treat certain disorders through chronotherapy. The aim of the study was to explore this knowledge of chronopharmacology and to give an insight about it among medical students.Methods: This was a cross sectional study conducted across students of different medical colleges in India by giving semi structured questionnaire.Results: A total of 208 participants (74 males, 134 females) from different batches of MBBS were participated. Majority of them are aware about the term chronopharmacology but their lack of apprehension on chronotherapy   was evident throughout the study.Conclusions: There is an inadequate knowledge on chronopharmacology among medical students. Introducing this as a part of undergraduate curriculum can bring out a significant change in the practice of modern medicine. 
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223359
      Issue No: Vol. 12, No. 1 (2022)
       
  • An analysis of studies on non-small cell lung cancer registered on
           clinical trials registry of India

    • Authors: Krisha R. Marolia, Rajan P. Nerurkar, Arzan K. Vazifdar
      Pages: 88 - 92
      Abstract: Background: Lung cancer is the most common cancer in males, of which non-small cell type is more prevalent. It is an active area of research owing to the limited available treatment modalities with several studies registered on CTRI. Objectives of current study was to analyse randomized control trials for non-small cell lung cancer registered on clinical trial registry India.Methods: Studies registered on CTRI were reviewed in this registry-based audit using the keywords lung cancer and non-small cell lung cancer. Parameters such as type of study, nature of intervention, phase of study, primary and secondary endpoints used, etc, were analysed and summarised using descriptive statistics in Microsoft Excel 365.Results: Out of 230 trials for lung cancer, 121 studied non-small cell lung cancer, of which 103 studies (85.1%) were interventional studies. Most common intervention under study was drug 97 studies (94.2%) followed by radiation 4 studies (3.3%). Majority of trials were phase 3, 48 trials (39.7%) and only 4 (3.3%) studies were phase 1. Five most common primary and secondary endpoints observed were survival, response rate, safety, pharmacokinetic data & quality of life. Maximum patients were in the advanced stage of cancer(52.1%) and pemetrexed (9.9%) was the most common drug used.Conclusions: We observed an increasing trend in studies registered on CTRI, with maximum studies in phase 3 with patients in the advanced stage of cancer having overall survival as the endpoint.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223360
      Issue No: Vol. 12, No. 1 (2022)
       
  • Evaluation of knowledge, attitude and practice towards drug-drug
           interactions among postgraduates in tertiary care hospital, Kurnool

    • Authors: Christina Sahayaraj, Shaik Haseena Begum, Venugopal Reddy M., Sharon Sonia S., Vijaya Bhaskara Reddy Y.
      Pages: 93 - 98
      Abstract: Background: Drug-drug interactions (DDIs) are changes in a drug’s effects due to concurrent use of another drug. Clinically significant interactions lead to undesired adverse effects, therapeutic failure, toxicity or may even cause death of the patients. The Aim is to evaluate the Knowledge, Attitude and Practice of Postgraduates regarding DDIs and implementation of educational program may enhance patient’s safety.Methods: A cross-sectional study was conducted among postgraduates in all clinical departments of Government general hospital, Kurnool in the month of October 2021. Pre-validated questionnaire was used to assess the KAP. It contains demographic data, knowledge and practice questions related to DDIs and attitude towards the preferable sources of drug interaction information. Data analysis was done by using SPSS version 26.Results: Out of 220 questionnaires distributed, 126 postgraduates submitted with complete answers(n=126). Overall response rate is 57%. By using the Bloom’s cut-off points, most of the respondents (43.5%) had low level of knowledge towards DDIs. Even respondents with high knowledge level (19%) are not practicing the drug interaction screening during the admission of patients. Majority of PGs with low level knowledge agreed to ask doctors than pharmacist about DDIs and prefer to search for DDIs using reference book than online mode as the source of drug information.Conclusions: In my study, most of the respondents had insufficient knowledge to prevent life threatening DDI’s. So, there is a need to increase medical educational program regarding the importance of screening and assessing of DDI’s before prescribing medicines.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223361
      Issue No: Vol. 12, No. 1 (2022)
       
  • A clinical pharmacological experimental research analysis of the
           evidence-based rational pharmacotherapeutics of pefloxacin and newer
           quinolones

    • Authors: Moumita Hazra
      Pages: 99 - 107
      Abstract: Background: Pefloxacin is a newer broad-spectrum bactericidal fluoroquinolone antibiotic, with superior antibacterial activity in vivo against pathogenic ocular gram-negative and anaerobic microorganisms and better pharmacokinetic properties.Methods: 100 bacterial conjunctivitis patients were prescribed topical pefloxacin 0.3% ophthalmological drops monotherapy, 2 drops in each eye after every 3 hours for 2 days, and 2 drops in each eye after every 6 hours for next 5 days. The overall recovery of the patients was clinically examined and assessed. The patients who did not recover completely with 0.3% pefloxacin monotherapy ophthalmological drops, were administered topical pefloxacin 0.3% ophthalmological drops, 2 drops in each eye after every 6 hours for the next 3 days, as combination therapy, with other required ophthalmological eye drops, depending on the prognostic follow-up, on days 0, 3, 5, 7, 10, 15, 30, and on further follow-ups. The evidence-based rational pharmacotherapeutic patient percentage topical application requirements of 0.3% pefloxacin ophthalmological drops monotherapy and subsequent combination therapy for complete recovery from bacterial conjunctivitis was thoroughly analysed and assessed.Results: In this study, the patient percentage topical application requirements of pefloxacin 0.3% ophthalmological drops monotherapy and combination therapy in bacterial conjunctivitis patients showed that 93% patients had completely recovered with pefloxacin monotherapy, and 7% patients required pefloxacin combination therapy for complete recovery. The evidence-based rational pharmacotherapeutics of newer quinolones, in global multi-centre tertiary care hospitals, was also well characterized and analytically described.Conclusions: Therefore, 93% patients had completely recovered with the ocular antibiotic pefloxacin 0.3% ophthalmological drops monotherapy, and 7% patients required pefloxacin combination therapy for complete recovery. The evidence-based rational pharmacotherapeutics of newer quinolones was also distinctly delineated.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223362
      Issue No: Vol. 12, No. 1 (2022)
       
  • Adverse drug reactions due to gabapentin-nortriptyline in patients with
           neuropathic pain in a tertiary care teaching hospital

    • Authors: Rohit Kumar Singh, Ujjwal Kumar, Munish Kumar, Raj Narayan Seth, Rani Indira Sinha
      Pages: 108 - 110
      Abstract: Gabapentin and Nortriptyline are used to treat neuropathic pain. Gabapentin belongs to a group of drugs called anti-convulsant and Nortriptyline belongs to tricyclic antidepressant. Gabapentin acts by binding to the specific site on voltage- gated calcium channels. This helps in relieving nerve pain and lowers the risk of seizure. Nortriptyline works by preventing the released chemical messengers in brain (serotonin and norepinephrine) from being reabsorbed back into the nerve cells. As a result, it prolongs the effect of serotonin and norepinephrine in the brain and over time, this helps to relieve depression and lighten the mood. We are reporting a case series including 3 patients having neuropathic pain and taking tablet gabapentin-nortriptyline in department of neurology, Patna medical college and hospital, Patna developed some adverse drug reactions. Causality assessment was done in each case by Naranjo scale. Each case was filled properly in ADR (adverse drug reaction) reporting form and was sent to nearby adverse drug reaction monitoring centre (AMC). During the posting for pharmacovigilance in neurology department of Patna medical college and hospital, Patna from 01/07/2022 to 30/09/2022 we got three adverse drug reactions due to gabapentin-nortriptyline. Two of them were due to Gabapentin and one was due to nortriptyline. Gabapentin-nortriptyline is one of the most commonly used drugs in neurology department. It causes some frequent as well as some rare adverse drug reactions which are required to be assessed and finally reported to the nearby AMC.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223363
      Issue No: Vol. 12, No. 1 (2022)
       
  • Pharmacovigilance of cutaneous adverse drug reactions-a focused research
           in times of COVID pandemic

    • Authors: Ranit Bag, Debajyoti Saha
      Pages: 111 - 114
      Abstract: Severe cutaneous adverse drug reactions are limiting, ranging from 5 cases per million including acute generalized exanthematous pustulosis (AGEP) and drug reaction with eosinophilia systemic symptoms (DRESS) to 1 case per million of toxic epidermal necrolysis. Cutaneous adverse drug reactions following drug therapy of COVID-19 are not uncommon. Viral infection and drug interactions predisposes to the development of cutaneous adverse drug reactions, as already documented with Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, and HIV. The Adverse drug reaction monitoring center of CNMCH has actively participated in pharmacovigilance programme of India by reporting few adverse drug reactions including the following cases. It is iterated that pharmacovigilance programme extends beyond just mere detection and reporting of adverse drug reactions and also should involve in assessment and understanding the cases, thus facilitating control and prevention of these cases. Particularly in times of COVID pandemic there has been continuous amendment in the treatment guidelines both at the central and state level. Incorporation of various antibiotics, antiparasites and antiviral drugs for the treatment of COVID, has potentiated the risk of development of drug allergies. Admittedly, the detailed understanding of drug allergy cases has been in general constrained with a relative lack of access to standardized laboratory diagnostic tests. Focused research is the need of the hour in order to understand the drug allergies better. In this study we have included those cases reported by department of medicine and dermatology of Calcutta national medical college and hospital in the past six months. All the cases were COVID positive and were treated conservatively by de-challenging the culprit drug and administration of antihistamines, topical steroids, while a few was put on systemic steroid therapy. There were six such reported cases of cutaneous adverse drug reaction following COVID treatment. There were four cases of maculopapular drug eruptions, while the other cases were diagnosed with fixed drug eruptions and acute generalized exanthematous pustulosis respectively. All the cases were reported under pharmacovigilance programme of India.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223364
      Issue No: Vol. 12, No. 1 (2022)
       
  • Abciximab induced severe thrombocytopenia in an elderly patient

    • Authors: Aastha Sen, Neena Bhatti, Girish Joseph, Vinay Gautam
      Pages: 115 - 116
      Abstract: Abciximab is a humanized monoclonal antibody which acts against αIIbβ3 receptor. The use of abciximab with percutaneous coronary interventions (PCI) has proven good results in patients. The drug has been notorious to cause bleeding and also decrease in the number of platelets. In this case the patient had normal platelet count but the count decreased significantly after abciximab was given. A number of cases have been reported but very few have been reported from India. Hence, we found it important to report and it is a valuable asset for scientific research. 
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223252
      Issue No: Vol. 12, No. 1 (2022)
       
  • COVID-19 vaccine induced Guillain-Barre syndrome: a case report

    • Authors: M. Shamim, Ghulam Nawaz, Rani Indira Sinha
      Pages: 117 - 119
      Abstract: Guillain-Barre syndrome (GBS) is a rare immune mediated clinical disorder of the peripheral nerves. A number of vaccines including COVID-19 vaccine have been shown to be associated with an increased risk of GBS. We reported a case of Corbevax® (COVID-19 vaccine) induced GBS. A 12 years old girl presented to the paediatric emergency with 2 days history of progressive weakness of all four limbs. The weakness started after one day of patient received her first dose of Corbevax®. Neurological examination findings were weakness, decreased muscles tone, decreased muscles power, diminished or absent deep tendon reflexes of all four limbs. The findings of cerebrospinal fluid showed increase in protein and normal cell count. The diagnosis of GBS was confirmed by nerve conduction studies. After confirmation of the diagnosis, she was given intravenous immunoglobulin (IVIG) with the dose of 2 g/kg body weight divided over 5 consecutive days. Then the patient was examined, clinical condition was improved dramatically. GBS rarely caused by COVID-19 vaccination. GBS may become life threatening due to respiratory muscles involvement. In about 30% of cases may require admission in Intensive Care Unit and need for mechanical ventilatory support. So careful monitoring is required after administration of COVID-19 vaccine. This case report never discourages the vaccine rollout, but monitoring of evolving data should be carried on by manufacturers and independent authorities coming to a definite conclusion.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223365
      Issue No: Vol. 12, No. 1 (2022)
       
  • The role of honey in the treatment of type 2 diabetes mellitus: a review
           of literature

    • Authors: Casimir C. Ofor, Omotayo O. Erejuwa, Godwin C. Akuodor, Daniel O. Aja, Anthony U. Mba, Elvis N. Shu
      Pages: 120 - 124
      Abstract: The use of honey in the control of hyperglycemia in patients with type 2 diabetes mellitus is a current option being explored globally. Honey bees which are named in Latin as Apis, use the collected nectar from plants to produce honey after regurgitation and digestion of nectar. Carbohydrate constitutes about 80% of the components of honey. It includes monosaccharides [fructose (37.5%) and glucose (30.6%), disaccharides (sucrose (1.6%) and maltose (2.7%)] and oligosaccharides. Natural honey also contains water (17.2%), proteins, vitamins, minerals, enzymes, acids such as flavonoids, phenolic acids and other components. Honey is rich in antioxidant content and these antioxidant compounds function as endogenous cellular antioxidant defences against free radicals in diabetes mellitus. Antioxidants have also been shown to exert a beneficial effects on blood glucose. Fructose and other bioactive constituents of honey have also been linked with amelioration of hyperglycemia. Besides the beneficial effects of honey on blood glucose, honey is widely used in the management of diabetic foot ulcers, an important complication of diabetes mellitus. The wound-healing benefits of honey are attributed to its antioxidant constituents and broad-spectrum antimicrobial activity. Though additional studies are needed, the use of honey in the management of diabetes mellitus holds much promise.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223366
      Issue No: Vol. 12, No. 1 (2022)
       
  • Recent advancement in drugs of Alzheimer's disease

    • Authors: Syed Rubina Zaidi, Ashutosh Badola
      Pages: 125 - 133
      Abstract: Alzheimer's disease (AD), a multifaceted neurological ailment that progresses over time, is the most common cause of dementia in older people. Intracellular neurofibrillary tangles and extracellular amyloidal protein deposits contribute to senile plaques on a pathological level. AD symptoms vary depending on the stage of the disease. Depending on the severity of cognitive impairment, AD is classified as preclinical or presymptomatic, mild, or dementia-stage. In addition, the condition is influenced by a number of risk factors, including advancing age, hereditary factors, head injuries, vascular diseases, infections, and environmental variables. There are currently only two types of licenced medications to treat AD: inhibitors of the cholinesterase enzyme such as donepezil, rivastigmine, galantamine and antagonists of N-methyl d-aspartate (NMDA) such as memantine, both of which are only effective in treating the symptoms of the disease and do not cure or prevent it.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223367
      Issue No: Vol. 12, No. 1 (2022)
       
  • Animal models of anxiety: a review

    • Authors: Ramyaa Desingu, Balakrishnan Sadasivam, Shamsher Singh Kalra, Bhawna Lakhawat
      Pages: 134 - 141
      Abstract: Anxiety is a disorder that affects the quality of life and also imposes a huge economic burden. Animal models of anxiety have widened our understanding of the pathophysiology behind anxiety and to identify newer pharmacological compounds. Every behavioral test has its own limitations, and there are ways to minimize these like environment and handling. This review lists various experimental models of anxiety based on unlearned ethological models, learned responses like the Vogel conflict test, and psychological and physical stress models.
      PubDate: 2022-12-26
      DOI: 10.18203/2319-2003.ijbcp20223368
      Issue No: Vol. 12, No. 1 (2022)
       
 
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