Treatment of Anaphylaxis in Adults: A Questionnaire Survey

Objective: To identify the medications that medical students, interns and casualty medical officers are likely to prescribe when treating an adult patient with anaphylaxis, and to ascertain the dose and route of administration of adrenaline they would use. Design: A questionnaire study survey. Setting: Kasturba medical college hospital, Manipal (Udupi District) and public health centers of Udupi district, Karnataka. Subjects: Data collected from 39 second year medical students, 35 interns and 35 casualty medical officers. Main outcome measure: To determine the percentage of use of adrenaline for the treatment of anaphylaxis in the correct dose, strength and route. Results: Majority (73 .3%) of participants correctly opted to use adrenaline. Only 9 participants have written the correct dose, route and concentration of adrenaline. 41.28% and 66.05% participants preferred to use antihistamines and corticosteroids respectively. Conclusion: This study has shown that confusion exists regarding the correct route of administration and dose of adrenaline to be used when treating anaphylaxis. This confusion applied to medical students, interns and medical officers. Therefore doctors must be made aware of the guidelines to treat anaphylaxis effectively

EVALUATION OF ANTIUROLITHIATIC PROPERTY OF ETHANOLIC EXTRACT OF FENNEL SEEDS IN MALE WISTAR ALBINO RATS

Objective: Few studies have explored the diuretic property of fennel (Foeniculum vulgare). Hence, the aim of this study was to evaluate the antiurolithiatic property of ethanolic extract of fennel seeds in male Wistar albino rats.Methods: Prophylactic and curative urolithiasis models were used with 5 groups of 6 rats in each model. Ethanolic extract of fennel seeds in three doses 100, 200, and 300 mg/kg was used. Cystone 750 mg/kg was used as a standard drug. All drugs were administered orally. Zinc discs were surgically implanted in the bladder in all rats. After recovery, rats in the prophylactic model received three different doses of ethanolic extract of fennel seeds along with 1% ethylene glycol for 2 weeks whereas the rats in the other model received 1% ethylene glycol for 2 weeks followed by an ethanolic extract of fennel seeds in three doses for the next 2 weeks. Both models had a control group receiving 1% ethylene glycol. At the end of study period, rats were sacrificed and vesical calculi collected, weighed, and statistically evaluated using one-way ANOVA.Results: In both the models, all three doses of an extract of fennel seeds were effective in reducing stone formation as compared to control group with p<0.05. In both the models, all three test doses were comparable with cystone, but 300 mg/kg extract in prophylactic showed significance (p <0.05) when compared to standard.Conclusion: Fennel seeds can be used prophylactically as well as curatively in the treatment of urolithiasis. However, further studies and clinical trials are warranted to explore this property

Evaluation of the antipeptic ulcer activity of the seed extract of sesame (Sesamum indicum) in stress induced peptic ulcers in rats

Background: The peptic ulcers can be developed inside the inner lining of the stomach (gastric ulcer) or the small intestine (duodenal ulcer). Around 10% population of the world is suffering from the peptic ulcer disease. From the ancient times there is a reference about herbal extracts like Sesame indicum for the treatment of various diseases. The aim of the study is Evaluation of the anti-peptic ulcer activity of the seed extract of sesame (Sesamum indicum) in stress induced peptic ulcers in rats.Methods: The study was carried out by stress-induced ulcer model in wistar rats. The antiulcer activity of S. indicum (0.5, 1mg/kg p.o. for 7 days) was compared with standard drugs (pantoprazole). The studied parameters were mucin content, gastric volume, pH, total acidity, free acidity, ulcer index, size and number.Results: The low and high dose of S. indicum extract significantly reduced gastric mucosal lesion, mucin content, volume of gastric juice, gastric pH, free and total acidity when compared to positive control group. The high dose of S. indicum extract showed comparable results in parameters like effect on mucin content, gastric volume, pH, free acidity and total acidity with standard group. The statistical significant changes noted only in ulcer size, number and index.Conclusions: Although the high dose S. indicum (1mg/kg) group showed significant gastric protection against ulcer induced by cold restraint method. However, no clear inference can be drawn at this stage and hence there is a need for further extensive research

EVALUATION OF DIURETIC AND ANTIUROLITHIATIC PROPERTIES OF ETHANOLIC EXTRACT OF SIDA ACUTA BURM. F. IN WISTAR ALBINO RATS

Objective: To evaluate the diuretic and antiurolithiatic properties of ethanolic extract of Sida acuta Burm. f. in albino rats.Methods: Three different doses of Sida acuta (100 mg/kg, 200 mg/kg, 400 mg/kg) were tested for diuretic activity and compared with furosemide (25 mg/kg) and control group. 24 hr urine output and urinary concentrations of sodium (Na+), potassium (K+) and chloride (Cl-) ions were the parameters measured. Prophylactic and curative antiurolithiatic activity was tested for three doses (100 mg/kg, 200 mg/kg & 400 mg/kg) of Sida acuta and compared with control group and animals treated with standard herbal preparation Cystone (750 mg/kg) using zinc disc implantation model.Results: Sida acuta (400 mg/kg) significantly increased the urine output (p<0.001), which was almost equivalent to furosemide. Sida acuta also caused a significant increase in the excretion of K+ and Cl-at higher doses (200 mg/kg, 400 mg/kg). Effects on Na+excretion were not significant for all three doses of the test drug. Sida acuta (200 mg/kg, 400 mg/kg) showed statistically significant (p<0.05) reduction in depositions around zinc discs as compared to control when tested in prophylactically treated rats, but not in rats treated post-urolithiasis induction.Conclusion: Sida acuta produced a dose-dependent increase in urine output, with no effect on sodium excretion. This probably indicates that the diuresis produced could be due to its aquarectic action. It also showed significant prophylactic antiurolithiatic activity, but further studies are necessary to evaluate fully its therapeutic potential.Keywords: Zinc disc implantation, Calculi, Diuretic index, Cyston

Nevirapine induced Stevens-Johnson syndrome: a case report

Stevens-Johnson syndrome (SJS) is a severe mucocutaneous skin reaction with extensive necrosis and detachment of the epidermis. Nevirapine is one of the high risk agents implicated in development of SJS. Here, we present a case of 27 years old male with HIV infection who was diagnosed to have SJS following administration of nevirapine

A RETROSPECTIVE STUDY OF CLINICAL PROFILE AND DRUG PRESCRIBING PATTERN IN OSTEOPOROSIS IN A TERTIARY CARE HOSPITAL

Objective: To study the clinical profile and prescription pattern of drugs in the treatment of osteoporosis in a tertiary care centre in Karnataka, India.Methods: This was a retrospective study carried out in a multi-speciality tertiary care hospital in Karnataka. Information was collected from case record forms of 100 patients of osteoporosis during a 12 mo tenure regarding various signs and symptoms they presented with and treatment provided.Results: Majority of the subjects were females (90%). Low back ache was the most common presenting symptom. There was an increase in mean calcium (8.84±8.32 mg/dL) and phosphorus levels (2.45±1.83 mg/dL) as compared to baseline at the follow up visit. Vitamin D and calcium supplementation were the most commonly prescribed medications followed by analgesics, calcitonin and bisphosphonates. A total of 77 adverse reactions were reported, gastritis being the commonest one.Conclusion: Vitamin D and Calcium supplements were more commonly prescribed than specific anti osteoporotic medications.Â

EFFECT OF FUCITHALMIC AND SOFINOX EYE DROPS ON EXPERIMENTAL ALLERGIC CONJUNCTIVITIS IN RATS

Objective: To investigate the therapeutic effect of Fucithalmic 1%, Sofinox 0.5% and 1% eye drops against an IgE-mediated allergic conjunctivitis model in Wistar rats. Methods: IgE-mediated allergic conjunctivitis was induced by ovalbumin antigen challenge. Allergic conjunctivitis induced control rats (Group I) received normal saline (0.9% NaCl; 10 µl/eye) whereas Fucithalmic 1% (Group II), Sofinox 0.5% (Group III) and 1% (Group IV) were administered as 10, 20 and 10 µl/eye respectively to the treatment group animals (n=6) for 15 days. Eye scratching behavior, hypothermia and edema was evaluated after topical antigen challenge. Results: Sofinox 1% eye drops (10 µl/eye) significantly attenuated eye scratching behavior, hyperemia and edema in comparison with allergic conjunctivitis induced control (p < 0.001) and Fucithalmic 1% treated rats (p < 0.05). Eye scratching behavior and edema was also significantly decreased in Sofinox 0.5% eye drops (20 µl/eye) treatment group as compared to allergic conjunctivitis induced control rats (p < 0.05). Conclusion: The present study revealed that the Sofinox eye drop is the potential agent that could offer a novel therapeutic opportunity against IgE-mediated allergic conjunctivitis in Wistar rats

EVALUATION OF GASTROPROTECTIVE EFFECT OF COENZYME Q 10 AND L - GLUTAMINE IN STRESS AND ETHANOL-INDUCED PEPTIC ULCER IN WISTAR RATS: A NOVEL PRECLINICAL STUDY

Objective: Coenzyme Q 10 (CoQ10) and L-glutamine have antioxidant property their role in peptic ulcer diseases is not well known. Hence, the aim of present study is to evaluate the gastroprotective role of CoQ10 and L-glutamine in stress and ethanol-induced peptic ulcers in Wistar albino rats.Methods: A total of 90 rats were used for the conduct of study in two experimental models, the stress- and the ethanol-induced ulcer model. Each model consists of eight groups with six rats in each group. Sucralfate and pantoprazole were used as standard drugs along with CoQ10 and L- glutamine as test drugs. Drugs were administered for 10 days in stress model and 7 days in case of ethanol model. Statistically analyzed using analysis of variance and post-hoc test with significance as p>0.05Results: CoQ10 and L- glutamine when used alone as well in combination with pantoprazole and sucralfate showed no ulcer formation. Test drugs showed decrease in gastric acid secretion, decreased total and free acidity levels, higher gastric pH, increased mucous secreting ability, higher levels of reduced glutathione levels in both tissue as well as blood and lower malondialdehyde levels when compared with pantoprazole and sucralfate suggestive of their antioxidative benefit, in both the models.Conclusion: Well-designed clinical trials can be done to evaluate the use of CoQ10 and L- glutamine in the treatment of peptic ulcer disease due to various etiology

GASTROPROTECTIVE ACTIVITY OF SESAME (SESAMUM INDICUM) SEEDS EXTRACT IN ALENDRONATE-INDUCED GASTRIC ULCER IN RATS

Objectives: Bisphosphonates are known to cause gastritis and only few studies have evaluated the use of plant extracts in the treatment of bisphosphonate induced peptic ulcers. In the present study, we examined the effect of sesame seed extract in the alendronate-induced gastric ulcer in adult Wistar rats. Methods: Thirty adult Wistar rats (180–250 g) of both sexes, divided into five groups (n=6) were used: Group 1 (vehicle control) – 0.9% saline, Group 2 (ulcer control) – alendronate 60 mg/kg, Group 3 (standard) – alendronate 60 mg/kg + pantoprazole 30 mg/kg/day, Group 4 (test groups) – alendronate 60 mg/kg + sesame 0.5 mg/kg, and Group 5 (test groups) – alendronate 60 mg/kg + sesame 1 mg/kg. All drugs were given orally once daily for 7 days except for alendronate given only on day 1. On day 8, rats were sacrificed, and stomach tissues were analyzed macroscopically for ulcers. Estimation of gastric pH, acidity, and volume was done along with mucin content measurement. One-way ANOVA followed by Tukey’s post hoc test was used for statistical analysis with p<0.05 taken as significant. Results: Our study found that sesame extract given therapeutically at doses of 0.5 and 1 mg/kg showed comparable results with that of pantoprazole 30 mg/kg. Both the doses of sesame, 0.5 and 1 mg/kg showed similar gastroprotective activity against alendronate-induced gastric ulcers in Wistar rats. Conclusion: The findings of this study clearly demonstrated the protective effects of Sesame against alendronate-induced gastric ulceration

A comparison of two dissimilar monoclonal antibodies that are directed to a common epitope in the reduced and carboxymethylated chicken riboflavin carrier protein

Two monoclonal antibodies, D2A1 and D5G3 were elicited by immunization with a preparation of chicken egg riboflavin carrier protein which had been reduced and carboxymethylated. Epitopes recognised by the monoclonal antibodies were mapped using the Pepscan method. Epitopic determinants for D2A1 as well as D5G3 were identified within a region spanning 13 amino acids (residues 170-182) in the primary sequence of riboflavin carrier protein. Interestingly, these monoclonal antibodies, despite sharing a common epitope exhibited a marked difference in their binding to native (folded) riboflavin carrier protein versus reduced carboxymethylated (unfolded) riboflavin carrier protein. Both monoclonal antibodies bound reduced carboxymethylated riboflavin carrier protein to comparable extents in solid phase (ELISA and immunoblots) and liquid phase (radioimmunoassay) assays. However, while D5G3 could bind native riboflavin carrier protein in solid and liquid phase assays, D2A1 showed negligible binding to the native structure. Alanine substituted peptide analogs of the epitope in question defined the crucial amino acids of the epitope needed for binding to the two antibodies