Ranitidine: recent regulatory issues

Ranitidine is histamine 2 receptor blocker which became commercial in 1981 as an antacid by Glaxosmithkline Pharamceuticals by the brand name of Zantac in various formulations. The drug accelerated in the market as amongst most commonly used drug for peptic ulcer disease, acid reflux and sooner than later it became available as an over-the-counter drug in 1996 for adults and children. Ranitidine’s mechanism of action involves competitive block of histamine 2 receptor leading to decrease cAMP formation which reduces acid secretion from parietal cells of stomach thereby healing the peptic ulcer.

Major depressive disorder: association with vitamin C levels and role of vitamin C supplementation in pharmacotherapy

Background: Oxidative stress has a well-documented role in pathophysiology of depression. Decrease in levels of vitamin C, an antioxidant, has also been reported in major depressive patients. This study was conducted to assess the association of vitamin C deficiency with major depressive disorder and any change in clinical response to antidepressant therapy with vitamin C co-administration vis-a-vis baseline vitamin C level status.Methods: This study was a prospective, interventional, parallel, randomized and open label study. Sixty patients diagnosed as a case of major depressive disorder in accordance to ICD-10 criteria were enrolled after taking a written informed consent. Two clinical scales namely Hamilton depression rating scale (HDRS) and clinical global impression- illness severity (CGI-S) scale were used for assessment and monitoring.Results: Vitamin C deficient subjects had relatively severe disease as assessed by HDRS and CGI-S scales. A highly significant (p0.05) reduction was seen in HDRS and CGI-I scores in vitamin C sufficient group while also showing a comparatively milder disease.Conclusions: Vitamin C deficiency was found to have a direct relation with severity of illness, as those patients who had insufficient and sufficient vitamin C levels at recruitment were found to exhibit milder symptoms compared to those who were vitamin C deficient. With treatment, greater improvement was observed in those patients who were deficient at the outset

Human papilloma virus vaccines awareness among female medical and dental undergraduate students

Background: Human papilloma virus (HPV) infection is the major risk factor for cervical cancer. Pap smear is the commonest technique for early screening and diagnosis of cervical cancer.Methods: Cross sectional study was carried out at a medical and dental institution of Punjab, India, among 84 medical and dental female undergraduate students, falling in the age group of 18-25 years using a validated and guided questionnaire. Goal of the study was to raise the attention of the underrated and unaware agenda of prevention of cervical carcinoma by available vaccines.Results: 96.42%, 25%, population was aware of HPV vaccination in 3rd, 2nd, medical students respectively and 60.71% in 2nd year dental students. 8.33% of the whole population (n=84) was vaccinated against HPV. The main reasons of not taking the vaccination were that the students had not heard of such a vaccine followed by the cost of the vaccine.Conclusions: Medical and dental undergraduates are not adequately aware about the HPV vaccine and are not vaccinated in large number

Comparative study of efficacy and safety of omega 3 fatty acids and fenofibrate with background atorvastatin therapy in patients of atherogenic dyslipidaemia

Background: Trials of atorvastatin combined either with fenofibrate or with omega-3 fatty acids (O3FA) have shown promising results in atherogenic dyslipidemia but there are very few studies where both these TGs lowering agents have been compared with each other. This study was conducted to compare efficacy and safety of these two agents on lipid profile of patients of atherogenic dyslipidaemia on background statin therapy and also to monitor effects of these interventions on serum uric acid (SUA) levels.Methods: About 90 patients of dyslipidemia were randomised to 3 groups and received O3FA (2000 mg), fenofibrate (80 mg) or dietary restrictions, each with atorvastatin (20 mg) in background for a period of 90 days. Total cholesterol (TC), HDL-C,TGs, LDL-C, SGOT and SGPT levels were done at baseline, 6 weeks and 12 weeks. Other parameters (SUA and BMI) were done at baseline and 12 weeks.Results: Both group 1 (O3FA) and group 2 (fenofibrate) showed highly significant fall in TG levels (p <0.001) in comparison to group 3 (dietary restrictions) whereas comparative TG reduction between groups 1 and group 2 was not significant. Group 2 also showed significant fall in LDL-C levels (p <0.01) in comparison to group 3. LDL-C reduction, TG reduction and SUA reduction was more in group 2 compared to group 1 followed by group 3. No significant difference was observed in the incidence of adverse effects in three study groups.Conclusions: Combination of fenofibrate and atorvastatin was more effective than that of omega-3 fatty acid and atorvastatin, in lowering serum TG and LDL-C levels. There was a significant reduction in SUA levels in all three groups, but combination of fenofibrate and atorvastatin again showed better outcomes. With respect to the safety, all the 3 groups were comparable. O3FA, however, may be a good alternative to fibrates in patients not tolerating latter

Evaluation of indoor prescriptions of depression in psychiatry department of a tertiary care hospital in North India

Background: Depression is one of most common psychiatric illnesses affecting the human population and poses significant economic burden to society. Prescription for depression usually involves multiple medications sometime irrationally prescribed.Methods: Present study involved evaluation of 65 indoor prescriptions of patients diagnosed with depression from Psychiatry Department in a tertiary care hospital. The prescriptions were evaluated on basis of WHO Core Indicators for writing a good prescription. The demographic characteristics of the patient population were studied. Number of drugs prescribed per prescription and the average number per prescription were calculated to assess polypharmacy. The cost involved in treatment using latest market data from drug information source and the rationality of prescriptions were also evaluated.Results: 80% of the prescriptions were not in accordance with the WHO Core Indicators. An average of 2.415±1.102 medications were prescribed per prescription indicating polypharmacy. Insignificant difference was observed in cost per prescription per month of medicines when compared with lowest priced products available in market.Conclusions: Polypharmacy was found in most prescriptions and monotherapy was instituted in five prescriptions only, with clonazepam as the most prescribed antidepressant drug. Majority of prescriptions did not conform to WHO core indicators for prescription writing