Analysing adverse drug reaction patterns observed during district residency program: a prospective observational study

Background: Adverse drug reactions (ADRs) pose a substantial cost to global healthcare systems. The heterogeneous patient demographics and healthcare environments of district residency programmes (DRPs) provide special possibilities for detecting trends of ADRs. In order recognize recurring trends and related variables, this study will examine ADR incidents that occur during DRPs. Methods: A prospective observational research with forty-three patients was carried out. Standardized reporting forms were used to gather data on ADRs, and descriptive statistical techniques were used to analyse the results. We evaluated medication information, patient demographics, and ADR features to seek for patterns and potential causes. Results: Preliminary analysis revealed a diverse range of ADRs observed during DRPs, spanning various severity levels and therapeutic classes. Common ADRs included gastrointestinal disturbances, allergic reactions, and central nervous system effects. Factors such as patient age, polypharmacy, and comorbidities emerged as potential predictors of ADR occurrence. Conclusions: The panorama of ADRs seen during DRPs is clarified by this study, underscoring the significance of careful monitoring, and reporting mechanisms in these initiatives. Gaining insight into ADR trends and related variables can help in improving patient safety, simplifying drug management plans, and directing future educational initiatives for medical professionals

Questionnaire-based assessment on knowledge, attitude and practice of fixed-dose combination in medical undergraduates of a tertiary care teaching hospital, Kanpur

Background: Aim was to assess knowledge, attitude and practice of second-year medical undergraduates towards FDC. Methods: A cross-sectional questionnaire-based study was conducted among second-year medical undergraduates of GSVM, medical college, Kanpur in the form of a pre-test, and after sensitizing the students about FDC, the same questionnaire was given as a post-test. Results: A total of 251 students, 157 students participated in the pre-test and 140 participated in the post-test. The percentage of male students in pre and post-test were more (58% and 61.4%) compared to female students (42% and 38.6%). After conducting a post-test survey, there is a significant improvement in knowledge and attitude toward FDC. Conclusions: The inclusion of FDC in the undergraduate curriculum is a good initiative by NMC but there is a need to conduct more CME, symposiums, and workshops in medical colleges to update the knowledge regarding FDC among medical undergraduates.

Role of clinical pharmacist in drug utilization evaluation, medication adherence and pharmacovigilance

A series of systematic, criterion-based drug evaluation known as Drug utilization review are conducted on a regular basis to ensure that medication is utilized appropriately. It’s a mean of learning more about the issues brought on by drug usage, if done properly, may help to solve the issues. Medication adherence generally refers to a patient’s ability to take prescription drugs as directed and their continued use of those drugs. The increasing body of research linking medication non adherence to unfavorable outcomes and increased healthcare cost has raised concerns among clinicians, healthcare institutions, and other stakeholders. Pharmacovigilance, in which the procedures keeping an eye on the assessing adverse medication reactions, is essential to clinical practice, public health and efficient drug regulating system.  Aim of the study was wo study about the role of pharmacist in drug utilization review, medication adherence and pharmacovigilance

Natural treasures from Picrorhiza kurrooa: a computational exploration of drug-like properties and bioactivity of kutkin, cucurbitacin, apocynin and lupanine

Background: To analyse and predict the basic pharmacokinetic and toxicological properties of four compounds of interest found in Picrorhiza kurroa (Kutkin, cucurbitacin, apocynin and lupanine) using computational bioinformatics tools. Methods: The chemical structures and molecular properties of the compounds were obtained from authentic sources and processed for data profiling. 2D structures were converted to 3D structures using ChemSketch software and PHASE module. In silico screening of the 3D structures was performed using bioinformatics prediction software to assess drug-likeness, absorption, blood-brain barrier penetration, enzyme interaction potential, skin penetration, and acute oral toxicity. Results: Kutkin exhibited poor drug-likeness and low oral absorption, while the other three compounds showed promising drug-like properties and good oral absorption. Cucurbitacin and lupanine were predicted to cross the blood-brain barrier, while Kutkin and Apocynin were not. None of the compounds were substrates for P-glycoprotein, but Kutkin and cucurbitacin were substrates for CYP3A4. All four compounds had low skin penetration. Acute oral toxicity varied, with cucurbitacin classified as highly toxic and the others as slightly toxic. Conclusions: Cucurbitacin, apocynin, and lupanine have potential for further development as therapeutic agents due to their favorable drug-like properties and good absorption. Kutkin's poor drug-likeness and low absorption make it less suitable for oral drug development. This information provides valuable insights for further research on the medicinal properties of Picrorhiza kurroa and the development of new drugs based on its active compounds

Steroidal and gonadotropin hormone profile studies of a classical ayurvedic preparation of “Saraguna Balijarita Makardhwaja” after chronic administration to male Sprague-Dawley rats

Background: Saraguna Balijarita Makardhwaja (SGM) is an Ayurvedic preparation used as a traditional antipyretic in the rural population. This research work was designed to get an overview of steroidal and gonadotropin hormone profiles after chronic administration of this drug. Methods: The acute pharmacological test of SGM recorded no death or any signs of effectivity even at the highest dose of 4000 mg/kg body weight. For chronic pharmacological evaluation, sixteen healthy Sprague-Dawley male rats were randomly divided into two groups, one group was a control group and the other was an experimental group. The experimental group was assigned to receive the drug at a dose of 400 mg/kg of body weight orally. After 28 days of treatment, blood samples were collected for biochemical tests. Results: The research showed the following effects on the steroidal and gonadotropin hormone profile. In this study, serum circulating level of dehydroepiandrosterone sulfate (DHEA-S), testosterone level, progesterone, 17-beta-estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured to determine safety profile study of SGM after chronic administration. There were no significant differences in any parameters which is suggesting that SGM has no effect of the steroidal and hormone profile. Conclusions: According to studies, SGM has no harmful effect on the steroid and hormone profiles after chronic treatment. Further studies are needed to establish the safety aspects of SGM

Antibacterial drug utilization study in patient of sepsis due to Staphylococcus aureus

Background: Sepsis is the most common and highly fatal clinical syndrome due to infection. Gram-positive organisms as a cause of sepsis have increased in frequency over time more common than gram-negative infections. S. aureus bacteremia (SAB) is one of the most prevalent and difficult to treat infections associated with significant morbidity and mortality. Aim was to study antibacterial drug utility, sensitivity and resistance pattern of antibacterial drugs in S. aureus infective septic patient in medicine department. Methods: A prospective observational study was done in medicine department of SSG hospital, Vadodara over a period of 9 months. Results: Total 50 S. aureus were tested for their sensitivity and resistance pattern towards ten antibacterial agents in microbiology department by disc diffusion method. The antibiogram of S. aureus indicated widespread resistance antibacterial agent ranging from a minimum resistant to vancomycin (4%) to a maximum of 90% against penicillin G. Total 142 antibacterial agents were prescribed in 50 patients. Metronidazole, ceftriaxone and piptaz were the most frequently prescribed antibacterial agents with DDD/1000 patient days 2.44, 3.55 and 2.62 respectively. 30 out of 50 patients needed a change in antibacterial agents during their course of treatment either due to antibacterial agent failure or after culture sensitivity report. 60% of the patients were prescribed ≥3 antibacterial agents at any point of time during treatment. Mean DOT/LOT was 2.22±0.84. Conclusions: There is a need of antibacterial agent usage guidelines and restriction policies for the rational prescribing of antibacterial agent in critically ill patients

Evaluation of invitro antidiabetic activity using silver nanoparticles of Galinsoga parviflora leaf extract

Background: Diabetes mellitus, characterized by chronic hyperglycemia, can lead to severe complications if untreated. G. parviflora, a plant from the Astereaceae family, is traditionally recognized for its medicinal properties, including hypoglycemic effects. This study investigates the antidiabetic potential of silver nanoparticles synthesized from G. parviflora leaf extract. To evaluate the in-vitro antidiabetic activity of silver nanoparticles from G. parviflora by assessing their α-amylase and α-glucosidase inhibitory activities, and glucose uptake using the everted gut sac method. Methods: Silver nanoparticles were synthesized from G. parviflora and tested for α-amylase and α-glucosidase inhibitory effects using colorimetric methods. Glucose uptake activity was assessed with an everted gut sac model from chicken ileum. Statistical analysis employed one-way ANOVA and Tukey’s post-hoc test, with significance set at p<0.05. Results: The nanoparticles exhibited significant α-amylase inhibitory activity, with 90.2% inhibition at 200 µl and 91.9% at 400 µl, surpassing the standard drug Acarbose. They also showed dose-dependent α-glucosidase inhibitory activity, achieving 34.5% inhibition at 200 µl and 32.6% at 400 µl. Glucose uptake analysis revealed significant reductions at 150 minutes for both the standard drug and nanoparticles compared to the control (p<0.05). However, at 300 minutes, only the standard treatment maintained significant differences. Conclusions: Silver nanoparticles of G. parviflora exhibit significant in vitro antidiabetic activity by inhibiting key digestive enzymes and reducing glucose uptake. These findings suggest their potential for developing novel antidiabetic therapies

Assessment of frequency and factors associated with low back pain among undergraduate medical students in Bangalore Medical College and Research Institute: a cross-sectional study

Background: A large percentage of young adults suffer from low back pain. Due to their demanding curriculum, medical students are most susceptible. This study aims to assess the frequency and factors associated with low back pain among undergraduate medical students at a college in Bangalore. Methods: An online cross-sectional study using a questionnaire was conducted among undergraduate medical students at Bangalore Medical College and Research Institute. SPSS 26.0 was used to analyze the data with a significance level of p <0.05. Results: Of the 250 students enrolled, 45.6% had low back pain. Long hours of sitting were the common factor aggravating the pain. The logistic regression analysis revealed that Phase 3 (part 2) MBBS (OR=2.53, 95% CI: 1.34 - 4.66), overweight (BMI>25) (OR=3.03, 95% CI: 1.42-6.50), coffee consumption regularly (OR=1.761, 95% CI: 1.007-3.009), Family history of LBP (OR=5.900, 95% CI: 3.182-10.939), duration of exercise/sports 1-2 hours per week (OR=1.691, 95% CI: 1.023-2.794), spending >8 hours for electronic gadgets daily (OR=2.02, 95% CI: 1.14-3.59) were found to be independently associated with low back pain. These results demonstrate an increased risk of low back pain among medical students with high BMI, lack of physical activity and increased electronic device usage. Conclusions: It highlights the necessity of focused treatments to control stress, minimize extended periods of sitting, enhance physical activity, and support proper posture among medical students. By preventing and managing low back pain, medical students can improve overall performance and quality of life

Video assisted thoracoscopy surgery a viable alternative for duplication cyst excision: a case report on foregut duplication cyst

Alimentary tract duplication is a relatively uncommon congenital abnormality. It can be found anywhere from the mouth to the anus and can be symptomatic or undetectable. Although congenital duplication can happen anywhere in the gastrointestinal tract, the ileum, oesophagus, and colon are the most common locations. The foregut, which includes the stomach, and first and second segments of the duodenum, is the source of one-third of all duplications. When foregut duplication involves the bronchial tree, respiratory symptoms are often present. Furthermore, excision through surgery is required for pathological examination of the resected specimen for definitive diagnosis. The most promising surgical approach for cyst excision has been thought to be open surgical resection through a posterolateral thoracotomy incision. However, video assisted thoracoscopy surgery has recently emerged as a viable surgical option for duplication cyst removal In paediatric surgery, video assisted thoracoscopy surgery has been established to facilitate the removal of mediastinal masses. However there is a limitation of research in the literature regarding the best surgical technique for oesophageal duplication cyst excision. In girls, foregut duplication is more common, especially in cases when bronchopulmonary involvement is present. While many duplications result in issues in early development, some are discovered by accident. When foregut duplication involves the bronchial tree, respiratory symptoms are often present. Haemoptysis and respiratory distress may be present in specific cases of the patient. Here, we described a 5-year-old male infant's case of foregut duplication with bronchial involvement and its management

Medication error in general medicine department of tertiary care Koshi Zonal hospital in Nepal

Background: Medication errors are the leading cause of patient harm, injuries and even death in hospitalized patients. It endangers patient safety and also increases the cost of treatment leading to enhanced financial burden to the individuals and the community as well. The study was aimed to determine the pattern of occurrence of medication errors. Methods: A cross-sectional study was conducted in 188 hospitalized patients in medical ward at a Zonal Hospital. Medication errors were identified and categorized by reviewing the cardex. The data were analyzed to determine the cause of medication errors including rates of harm to patients. The descriptive statistics frequency and percentage were calculated using Microsoft Excel 2007. The findings were presented as tables and graphs. Results: A total of 985 medication errors were found in 650 (38.3%) drugs prescribed in 177 (94.1%) patients. Approximately 72.9% of the errors reached the patients and 32.39% of the errors were harmful. The most common observed errors were administration errors (41.6%) followed by prescribing errors (36.5%), transcription errors (14.3%) and monitoring errors (7.5%). Omission of prescribing information (63.88%) and wrong dosing schedule (34%) were the most common type of prescribing and transcription errors respectively. Omission of dosages administration (57.32%) to patients was the most common types of administration error. All types of medication errors were highest in the alimentary tract and metabolism class of drugs (32.39%). Conclusions: Medication errors were associated with the majority of hospitalized patients signifying the requirement of immediate preventive strategies and policies to ensure patient safety