PSYCHOSOCIAL FACTORS AS RISK FACTOR IN SUICIDAL POISONING: A CROSS-SECTIONAL STUDY

  Objective: Suicide is known to be a phenomenon in low-, middle-, and high-income countries and occurs in all sociodemographic groups. It ranges from acute to fatal lethal attempts which occur in the context of a social crisis. Deliberate self-poisoning for suicide is a growing public health concern with frequent emergency department admissions. An epidemiological surveillance is essential for every region to understand the pattern, underlying psychological factors, and the scope of preventive measures.Methods: The 2-year retrospective study describes the epidemiology and influencing factors of suicides by self-poisoning in patients admitted to a Government Hospital and a Teaching Hospital in Pune, Maharashtra, from January 1, 2014 to December 31, 2015.Result: Out of 1010 poisoning cases reported, 539 were suicidal self-poisoning. Significantly males more than females were brought to the hospitals due to deliberate self-poisoning (1:0.86, χ2=38.05; p<0.001). The age group most recorded was 20-35 years (67.7%). Psychosocial factors were associated with increased risk of suicidal self-poisoning attempts (risk ratio 4.76, 95% confidence interval 4.07-5.57; p<0.001). Psychosocial factors were interpersonal conflict (52.4%), stress (30.4), dissatisfaction in life (6%), and alcoholism or mental disorders (11.1%). Household and agricultural products (71.8%) were the popular choices of the toxic agent in self-poisoning with phenols (20%) being the most common. 19 cases (3.5%) were severe, out of which 15 cases lead to death (2.8% mortality).Conclusion: There is an urgent need to develop and implement preventative and treatment strategies for high-risk groups attempting suicide by self-poisoning

ASSESSING THE RATIONALE OF FDC CONTAINING OFLOXACIN AND AZOLES: DISSOLUTION, PERMEATION AND ANTIMICROBIAL STUDIES

Objective: To study fixed-dose combinations (FDC) of antibacterial and antiprotozoal products (ofloxacin and azoles), prescribed for the treatment of diarrhea. Methods: Rationality of these FDC products was verified by assessing parameters such as drug content and release by assay and dissolution tests, respectively mentioned in the Indian Pharmacopoeia (IP). Amount of drug solubilized and permeated as per the Biopharmaceutics Classification System (BCS) was determined. Ex vivo permeation study was performed on the gut of goat using the everted gut sac technique. Antimicrobial efficacy in terms of minimum inhibitory concentration (MIC) was assessed using agar well diffusion method against Shigella boydii, the causative agent for diarrhea. Comparative studies were performed on an individual as well as combination doses of antibacterial and antiprotozoal products for the synergistic effects to assess the rationale of these FDC. Results: The BCS solubility of ciprofloxacin (CPX), norfloxacin (NFX) and tinidazole (TNZ) was high in acidic medium (pH 1-5) and decreased at pH above 5. The assay studies showed that the individual drug contents of FDC were within the IP limits. In vitro dissolution results for both, individual drugs and their combination illustrated 99 % drug release within 30 min in 0.01N HCl. Ex vivo permeation of TNZ was higher than CPX and NFX in individual drugs. No significant change in the permeation rate was observed for individual drugs and their FDC. CPX and NFX exhibited more antimicrobial activity in terms of inhibitory zones than their FDC with antiprotozoal TNZ, above 2.5 µg/ml MIC. The pharmaceutical, biopharmaceutical and antimicrobial evaluation study showed the similarity of FDC with the individual drugs. Conclusion: The study showed no significant data to justify the therapeutic advantage of FDC over individual drugs

Misdiagnosed schizophrenia be Megaloblastic

Abstract Medical disorders may be mistaken for a primary psychiatric disturbance because of commonly associated psychiatric or behavioural normal blood synthesis and neurological function; its deficiency association with many psychiatric disorders like mood disorders. treatment for Schizophrenia since 7

HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY FOR THE SIMULTANEOUS ESTIMATION OF CEFOPERAZONE AND SULBACTAM IN RAT PLASMA AND ITS IMPORTANCE IN THERAPEUTIC DRUG MONITORING

Objective: To study the Therapeutic drug monitoring and pharmacokinetics of marketed antibiotics formulation by developing a sensitive and specific Bioanalytical Chromatographic method. Methods: In the present study, we developed a rapid, sensitive and selective chromatographic method for simultaneous estimation of Cefoperazone (CEF) And Sulbactam (SAL) in male Wistar rat plasma. A novel liquid phase extraction method has adopted the preparation of plasma sample preparation. The CEF and SAL were eluted on a peerless Basic C18 (25 cm; 4.6 mm x 5 µm) column maintained at controlled environmental conditions. The gradient mobile phase comprised of 10 mmol ammonium acetate and acetonitrile. A UV detector was set at 250 nm and retention times for CEF and SAL were approximately 5.6 and 14.2 min, respectively. The proposed HPLC method was validated according to the US FDA guidelines with respect to the linearity, accuracy, precision, detection and quantitation limits, robustness and specificity. Results: Calibration curves of CEF and SAL were linear across the concentration range of 600-1000 and 6-10 µg/ml, with correlation coefficients (r2)>0.9977 and (r2)>0.9987, respectively. The limits of detection for CEF and SAL were 70.48 and 0.35 µg/ml, respectively. Additionally, CEF and SAL were stable in plasma for at least 24 h when stored at room temperature and 2-8 °C.  Conclusion: The developed chromatographic method was effectively utilized to measure the plasma CEF and SAL concentrations in a pharmacokinetics study after intravenous injection to the healthy male Wistar rats

ANTIBIOTIC UTILIZATION PATTERN AT THE SURGERY DEPARTMENT OF A TERTIARY CARE HOSPITAL

Objective: The present study aims to determine the pattern of antibiotic utilization at the surgery department of a tertiary care hospital.Method: A prospective observational study was conducted over a period of 6 months period in surgical ward at Bharti Hospital and Research Centre, Pune, a 1000 bedded teaching hospital. Patients above 18 years and receiving antibiotic therapy pre and post-surgery were included in the study.Results:160 patients with surgical operations were included in the study.The disease spectrum was classified into respective system-wise surgical procedures of which 49.37% cases are skin & soft tissue infections, 25.62% cases of general surgical procedure, 12.5% cases of gastrointestinal surgical procedure, 11.25% cases of urinary system and 1.25% case of head neck system. 20.62% of the study patients had hernia, 18.12% patients had cellulitis, 16.87% patients had diabetic foot ulcer, 16.25% patients had abscess, and 10.62% patients had appendicitis and cholelithiasis. In this study, it was found that 471 antibiotics were used in total of 160 patients, among which highest group of antibiotics prescribed were third generation Cephalosporin (28.23%) followed by Penicillins (23.56%). The most frequently prescribed antibiotics were Metronidazole − 19.74% among the Nitroimidazoles followed by Ceftriaxone − 19.53% of the class Cephalosporins.Conclusion: The rate of prescribing of broad-spectrum antibiotics has increased demonstrably which may result in development of bacterial resistance; however development of guidelines for antibiotic prescription and use of appropriate drugs for the diseases can minimize the unfavourable use of antibiotics and cost of healthcare.Â

Liposomal delivery enhances cutaneous availability of ciclopirox olamine

The present study involves development and investigation of liposomal system for improving skin residence of ciclopirox olamine in cutaneous mycosis. Spherical unilamellar liposomes of ciclopirox olamine were prepared by ethanol injection method. The vesicle size and % entrapment efficiency were in the range of 196 ± 1.73 to 1040.66 ± 7.02 nm and 34.28 ± 4.4 to 54.89 ± 1.9 respectively. The electrokinetic potential varied from -52.4 ± 2.0 to -71.7 ± 1.3 mV. A 32 factorial design was utilized to optimize the concentrations of cholesterol and Phospholipon® 90H. Cholesterol was found to be primarily responsible for the behaviour of the liposomes as compared to the phospholipid. FTIR study revealed that liposomal encapsulation preserved the principal characteristic group of ciclopirox olamine required for antifungal action. In-vitro artificial membrane and ex-vivo excised rat skin studies demonstrated reasonably higher cutaneous deposition of the drug. Liposomes proved interesting tool for maximizing the drug retention in skin, an important requisite in treatment of cutaneous fungal infections.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Effect of vesicular encapsulation on in-vitro cytotoxicity of ciclopirox olamine

Context: Ciclopirox olamine (CPO), an antifungal has recently been cited as a drug repurposed for cancer treatment.  Vesicular drug delivery systems like liposomes and niosomes have proven to increase the efficacy of anticancer drugs. Objective: The purpose of this paper was to evaluate the effect of two vesicular delivery systems liposome and niosome on the anticancer potential of CPO using in vitro cytotoxicity assays. Materials and methods: CPO was encapsulated in liposomes (prepared from Phospholipon®90H) and niosomes (prepared from Span 60) by ethanol injection method.  The cytotoxic effect of liposomal and niosomal CPO was evaluated on KB (oral cancer), PC3 (prostate cancer), Siha (cervical cancer) and Vero (kidney epithelial) cell lines using MTT assay. The IC50 values were compared with free drug CPO and with standard anticancer drug doxorubicin Results: CPO exhibited cytotoxicity to all the cell lines studied. The niosomal encapsulation of CPO favored its cytotoxicity on the cancer cell lines. Much lower IC50 values were obtained in comparison to the liposomal and free form of CPO. The enhancement in the cytotoxic effect on the non-cancer cell line Vero was not noted. Discussion: CPO demonstrated marginal difference in the concentration required to produce cytotoxic effect on cancer and normal cell lines. The difference was enhanced by niosomal CPO as much lower concentration was required to produce cytotoxic effect on cancer cells while rendering no effect on normal cells. Conclusion: Enhanced cytotoxicity selectively to cancer cells in the present study demonstrates the pharmacological significance of niosomal drug delivery system of CPO

Correlations of adherence to iron supplements and prevalence of anemia in antenatal women

Background: The prevalence of anemia in pregnant women has remained unacceptably high worldwide despite the fact that routine iron supplementation during pregnancy has been almost universally recommended to prevent maternal anemia. The major problem with iron supplementation during pregnancy is compliance. The objective of this study was to correlate iron supplements compliance among pregnant women and incidence of anemia during pregnancy.Methods: A Prospective observational study was conducted over a period of nine months from August 2015 to April 2016 in the department of obstetrics and gynecology, Bharati Hospital and Research Center, Pune. Pregnant women more than 14 weeks who attended antenatal care unit were enrolled in this study. Data for compliance was collected by two methods - first by personal interview as well as looking for the empty iron tablet strips. Pregnant women were followed till the date of delivery and maternal outcome were noted.Results: Our results show that 64% were strictly compliant, 33% with partially complaint and 3% with non-complaint with iron supplements. The mean Hemoglobin concentration of pregnant women who strictly complies with iron supplements were 11.6 g/dl where the non-compliant and partially complaint to iron supplements were 9.7 g/dl. The prevalence of anemia was found to be more in partial and non-compliant to iron supplements (13% p value <0.001).Conclusions: Anaemia, low haemoglobin levels were found more in non-complaint and partially complaint pregnant women. The findings from our study highlighted that antenatal health and a nutritional intervention program for pregnant women is needful

COST OF THERAPY INCURRED FOR TUBERCULOSIS PATIENTS RECEIVING DIRECTLY OBSERVED THERAPY (DOT)

Objective: To estimate the cost of therapy of tuberculosis patients registered under DOTS program in the treatment of tuberculosis.Methods: A prospective observational study was conducted over a period of nine months in the Pulmonary Department of Bharati hospital and Research centre, Pune. 97 patients registered under RNTCP between August 2014 and April 2015, were interviewed at two time points: one at the time of first hospital visit and second on the completion of treatment. During the interview, information relating to various costs such as direct (out of pocket) and indirect cost was collected.Results: The mean total cost for Pulmonary tuberculosis treatment was found to be/5474.7 ($85.4), Extra pulmonary was/10574.8 ($164.9) and Pulmonary and Extra pulmonary was/14638.5 ($228.3) respectively. Out of total cost the cost incurred by the patients for the hospital stay and diagnosis (i.e. tuberculosis detection) has the maximum expenditure cost which was 90.4 % for pulmonary tuberculosis, 77.2% extra pulmonary and 72.5% pulmonary and extra pulmonary. About 39.2 % of patients and their care takers lost work days. 52.0% pulmonary patients, 68.4% extra-pulmonary and 66.7 % pulmonary and extra-pulmonary patients had decreased earning ability due to illness. Conclusion: The maximum cost is incurred for diagnosis and hospital stay in tuberculosis patients. Though DOTS strategy can help to reduce cost, achieve effective cure and save life of TB patients, still patients need to spend for other investigations and other drugs.Â

Utjecaj sadržaja lijeka i veličine aglomerata na tabletiranje i oslobađanje bromheksin hidroklorida iz aglomerata s talkom pripremljenih kristalokoaglomeracijom

The objective of the investigation was to study the effect of bromhexine hydrochloride (BXH) content and agglomerate size on mechanical, compressional and drug release properties of agglomerates prepared by crystallo-co-agglomeration (CCA). Studies on optimized batches of agglomerates (BXT1 and BXT2) prepared by CCA have showed adequate sphericity and strength required for efficient tabletting. Trend of strength reduction with a decrease in the size of agglomerates was noted for both batches, irrespective of drug loading. However, an increase in mean yield pressure (14.189 to 19.481) with an increase in size was observed for BXT2 having BXH-talc (1:15.7). Surprisingly, improvement in tensile strength was demonstrated by compacts prepared from BXT2, due to high BXH load, whereas BXT1, having a low amount of BXH (BXH-talc, 1:24), showed low tensile strength. Consequently, increased tensile strength was reflected in extended drug release from BXT2 compacts (Higuchi model, R2 = 0.9506 to 0.9981). Thus, it can be concluded that interparticulate bridges formed by BXH and agglomerate size affect their mechanical, compressional and drug release properties.Cilj rada bio je praćenje utjecaja sadržaja bromheksidin hidroklorida (BXH) i veličine aglomerata na mehanička svojstva, kompresivnost i oslobađanje ljekovite tvari iz aglomerata pripravljenih kristalokoaglomeracijom (CCA). Optimizirani pripravci aglomerata (BXT1 i BXT2) pripravljeni CCA metodom pokazuju adekvatnu sferičnost i čvrstoću potrebnu za učinkovito tabletiranje. U oba pripravka se smanjenjem veličine aglomerata smanjivala i čvrstoća, neovisno o količini ljekovite tvari. Međutim, povećanje prosječnog tlaka s povećanjem veličine čestica primijećeno je u pripravku BXT2 s omjerom BXH-talk 1:15,7. Iznenađuje da su kompakti pripravljeni iz BXT2, s visokim sadržajem BXH, imali veću vlačnu čvrstoću, dok su BXT1 s niskim sadržajem BXH (BXH-talk, 1:24) imali manju čvrstoću. Veća vlačna čvrstoća imala je za posljedicu produljeno oslobađanje ljekovite tvari iz BXT2 (Higuchijev model, R2 = 0,9506 do 0,9981). Može se zaključiti da mostovi među česticama BXH i veličina aglomerata utječu na njihova mehanička i kompresivna svojstva te na oslobađanje ljekovite tvari