Promoting the proper use of medicines in rural school children of India

Background: The problem of irrational use of medicines is prevalent in rural India. For safe and proper use of medicines there is a need to understand the proper way of taking medicines. Teaching proper use of medicines is the most neglected domain of the school health curriculum. So this study targeted school going children in rural area of India as the earlier the intervention, the more firmly longer lasting health related behavior can be successfully inculcated. The objectives of the study were (1) To study base level knowledge about use of medicines and (2) To implement and see the effect of an intervention to increase medicine knowledge in the form of information, education and communication (IEC) in rural school children.Methods: This was an interventional, questionnaire based (quantitative) study in which an intervention in the form of lectures which was given to school children. Rural school going children in age group of13-15 years were selected from 3 different schools of rural areas of Nagpur district, India. 500 school children were included after obtaining permission from school authorities and informed consent from their parents. Pretesting done by administering a questionnaire containing 20 questions to assess children's base level knowledge about medicine use. The same questionnaire was repeated on 16th and 45th day of intervention i.e. daily lectures of 25-30 minutes for 15 days on proper use of medicines, to judge the improvement.Results: It was observed that the interventions brought about a positive change in the knowledge of the students as well as increased awareness about proper use of medicines.Conclusions: This study showed that properly timed and meticulously implemented intervention can bring about a positive change in the attitude and knowledge of school children

Anti-hyperalgesic effect of paracetamol in rat model of thermal hyperalgesia: implications for the treatment of neuropathic pain

Background: Neuropathic pain conditions are prevalent in general population and difficult to treat. Most currently available therapies do not provide adequate benefit in all treated patients. Though Paracetamol is available for more than 100 years and have huge safety data, it is still not included in any treatment guidelines for neuropathic pain, as very few studies have evaluated its effects in neuropathic pain conditions. The aim of this study was to evaluate antihyperalgesic activity of paracetamol and to compare it with antihyperalgesic effect of amitriptyline and gabapentin in rat model of thermal hyperalgesia.Methods: Male albino wistar rats weighing 200-250 g of body weight and 4-6 months old were used. After anaesthetizing rats with 2% halothane, mild thermal injury was induced using hot plate analgesiometer. Drugs were administered intraperitoneally 30 minutes after thermal injury. Paw withdrawal latencies were measured at 30, 60, 90 and 120 minutes after drug administration. Statistical analysis done using GraphPad Prism version 5.01 and one way ANOVA followed by post hoc Dunnett's test or Tukey's test were used.Results: Paracetamol showed both dose as well as time dependent antihyperalgesic activity. Gabapentin demonstrated significantly more antihyperalgesic activity compared to amitriptyline (p< 0.05) and paracetamol (p< 0.01).Conclusions: Paracetamol showed antihyperalgesic activity however, it was less as compared to drugs like gabapentin and amitriptyline. Considering the excellent safety profile of paracetamol, it might be useful adjuvant drug for treatment of neuropathic pain conditions

A 5 year retrospective analysis of adverse drug reactions associated with antimicrobials in a teaching hospital of Andaman and Nicobar islands

Antimicrobials are used widely especially in developing countries, due to the high prevalence of various infectious diseases. Inappropriate use of antimicrobials are associated with adverse drug reactions. The present study was done to analyze the patterns of Adverse Drug Reactions (ADR) due to antimicrobials reported to Adverse Drug Reaction Monitoring Centre (AMC) during the last five years.  This was a 5 year retrospective and cross-sectional study. After collecting demographic details of patients, ADR forms, and ADR associated with the antimicrobial class of drugs, data were analyzed for further details. A total of 877 ADRs, 360 ADRs belonged to the antimicrobial group. When data was analyzed data, it revealed that the majority of ADRs (73.05%) were reported in the adult group, 75.27% of reactions belonged to A category, Ceftriaxone (17.2%) was the most common drug-associated with ADRs, majority of ADRs were related to skin (56.66%), rash (27.5%) was the most common ADR encountered with antimicrobial use, 73.61% reactions were non-serious, 69.44% of ADRs recovered, and 77.77% of ADRs were probable category. Ceftriaxone was responsible for the maximum number of ADRs. The study results provide information regarding the pattern of ADRs associated with antimicrobials, and this might be helpful for improving the awareness of healthcare providers about PvPI and subsequently increase the spontaneous reporting of ADRs

Efficacy of topical phenytoin in healing diabetic foot ulcer

Background: India is fast becoming world diabetes capital. Complications are a cause of hospitalization in patients with diabetes mellitus especially foot complications. Gauze moistened with saline has been the standard method.Methods: The study was done from June 2015 to June 2016. The objective of this study was to assess the efficacy of topical phenytoin compared to standard and conventional methods of wound care in improving the healing process. In this randomised control trial, the data from 70 patients with diabetic ulcers was collected, 35 patients underwent topical phenytoin dressing while remaining 35 underwent conventional wound care. Histopathological and Clinical examination were done and the following parameters were calculated: Granulation tissue formation in 2 weeks and Mean duration of hospital stay.Results: In this study, Mean hospital stay in days was 33.4 in Phenytoin treated group and in other group with use conventional materials, the mean hospital stay in days was 39.7 days. Granulation tissue formation was faster as compared to conventional materials of Dressings.Conclusions: In this study we conclude Topical phenytoin helps in faster healing of Diabetic Foot Ulcers and it also reduces the mean hospital stay of the patients

Impact of long term Yoga practice on sleep quality and quality of life in the elderly

Background: Sleep disturbances and decline in the physical functionality are common conditions associated with aging. Pharmacological treatment of sleep disturbances can be associated with various adverse effects. Short term trials of Yoga on sleep have shown beneficial effects. Objectives: To evaluate the effect of long-term Yoga exercises on sleep quality and quality of life (QOL) in the elderly. Materials and Methods: This was a cross-sectional study in which data were collected from elderly people aged 60 years or more living in Nagpur city. We employed two types of survey questionnaires: Pittsburgh sleep quality index (PSQI) and QOL Leiden-Padua (LEIPAD) Questionnaire. A total of 65 elderly men and women who signed an informed consent and completed questionnaires were included in the study. Sleep quality score PSQI and QOL (LEIPAD Questionnaire) score of the study group were evaluated and compared with the control group using Mann-Whitney U test. Results: Total PSQI score in Yoga group was lower than that of the control group. Also various QOL scores of the Yoga groups were higher than the control group. Conclusion: Addition of regular Yoga exercises in the daily routine of elderly people can help to achieve good sleep quality as well as improve the QOL

A 5 year retrospective analysis of adverse drug reactions associated with antimicrobials in a teaching hospital of Andaman and Nicobar islands

Antimicrobials are used widely especially in developing countries, due to the high prevalence of various infectious diseases. Inappropriate use of antimicrobials are associated with adverse drug reactions. The present study was done to analyze the patterns of Adverse Drug Reactions (ADR) due to antimicrobials reported to Adverse Drug Reaction Monitoring Centre (AMC) during the last five years. This was a 5 year retrospective and cross-sectional study. After collecting demographic details of patients, ADR forms, and ADR associated with the antimicrobial class of drugs, data were analyzed for further details. A total of 877 ADRs, 360 ADRs belonged to the antimicrobial group. When data was analyzed data, it revealed that the majority of ADRs (73.05%) were reported in the adult group, 75.27% of reactions belonged to A category, Ceftriaxone (17.2%) was the most common drug-associated with ADRs, majority of ADRs were related to skin (56.66%), rash (27.5%) was the most common ADR encountered with antimicrobial use, 73.61% reactions were non-serious, 69.44% of ADRs recovered, and 77.77% of ADRs were probable category. Ceftriaxone was responsible for the maximum number of ADRs. The study results provide information regarding the pattern of ADRs associated with antimicrobials, and this might be helpful for improving the awareness of healthcare providers about PvPI and subsequently increase the spontaneous reporting of ADRs

Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students

Background: There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. Objectives: To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. Material and Methods: The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do′s and dont′s of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher′s Exact test. Results: It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. Discussion: The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. Conclusion: This study showed that a properly timed and meticulously implemented intervention brings about a positive change in the attitude and knowledge of pharmacy students

Acneform eruptions with use of minoxidil-a case report

A 32 year male patient resident of Andaman and Nicobar Islands presented to the dermatology OPD with the chief complaints of acneform eruptions since 1 month after the use of Minoxidil/Aminexil 5% solution for the treatment of Alopecia which he had since 6 months. Diagnosis of androgenic alopecia was made based on the clinical examination and hence treatment with tablet Finpecia (Finasteride) 1mg once daily and 5% Minoxidil/ Aminexil topical solution 1ml thrice daily local application was advised and patient was asked to come back for follow up after a period of 2 months, but the patient returned after 1 month of treatment with the complaints of comedonic eruptions on forehead