A CASE REPORT OF NADROPARIN INDUCED HYPERKALEMIA

ABSTRACTNadroparin, a low molecular weight heparin, has prophylactic and therapeutic use in thromboembolic disorder. In a patient with carcinoma ovarystage 3 B, nadroparin was given prophylactically for deep vein thrombosis (DVT) before and after interval cytoreduction surgery. Nadroparin 0.3 mlwas given subcutaneously once daily for 1 day preoperatively and 8 days postoperatively. Rise in serum potassium was observed on the third postoperativedaysuggestiveof hyperkalemia.Intravenousfluids weregiven,and thedrug wasstoppedon the 9 post-operative day and hyperkalemiaresolved after 2 days. Monitoring of serum potassium level is essential when Nadroparin is administered prophylactically for more than 7 days forDVT. As this case illustrates a causal relationship between nadroparin and hyperkalemia, caution must be exercised with nadroparin.Keywords: Nadroparin, Hyperkalemia, Thrombosis.t

ADVERSE REACTION DUE TO CLINDAMYCIN

ABSTRACTA 43-year-old patient was diagnosed of left sided empyema. He was started on injectable piperacillin-tazobactam combination and clindamycin.After 11 days, he developed itchy red lesions over different parts of the body. Both the drugs were immediately stopped in view of drug allergy.However, oral clindamycin with a lower dose was restarted, and patient tolerated the drug without any skin related episodes. Postdischarge he wasprescribed oral clindamycin for 2 more weeks. 2 days postdischarge he started developing rash. The patient continued the drug for next 10 daysand as a severity of rashes increased he reported to the hospital. He had itchy red lesions throughout the body. Clindamycin was stopped, and hewas prescribed clonate lotion and tablet cetirizine for 10 days. The lesions resolved. A patient was informed that he is allergic to beta-lactams andclindamycin.Keywords: Clindamycin, Skin rashes, Beta-lactams

EVALUATION OF EFFICACY AND TOXICITY OF DIFFERENT TREATMENT REGIMENS IN PLASMODIUM FALCIPARUM MALARIA

The efficacy and toxicity of four commonly used antimalarials was evaluated. Thecombinations evaluated were Artesunate and Doxycycline, Quinine and Doxycycline, Artesunateand Quinine, Artesunate and Mefloquine. The four combinations did not show any statisticallysignificant difference in terms of days of defervescence, parasite clearance and hospital stay. Allthe four combinations were well tolerated

Assessment of adverse drug reactions to antituberculosis regimen in a tertiary care hospital

Background: Adverse drug reactions are common with multidrug therapy in tuberculosis, if detected early can improve patient compliance and prevent emergence of resistance.Methods: A prospective observational study as a part of Pharmacovigilance Program under Central Drugs Standard Control Organisation was conducted in Kasturba hospital, Manipal to collect adverse drug reactions (ADR). Data of patients reported with antitubercular treatment (ATT) related ADRs from September 2012 to August 2013 was evaluated for patient demography, type of tuberculosis, ATT regimen, organ/ system affected and time of onset of ADR. ADRs were then subjected to causality assessment as per WHO scale.Results: A total of 65 ADRs were reported in 60 patients during the study period, of which 46.7% were in males and 53.3% in females. 85% of ADRs were reported in patients with pulmonary tuberculosis. 77% of ADRs were observed with daily regimen. Common ADRs were hepatitis (40%), gastritis (15%), skin reactions (15%), peripheral neuropathy (14%), gout (6%) and nephritis (3%). Median duration for the onset of ADR was 31 days each for hepatitis, gout, nephritis and 20, 11, 9 days for gastritis, peripheral neuropathy and skin reactions respectively. As per causality assessment, 80% of ADRs were assigned “possible”, 11% “probable” and 9% “certain”. As per severity scale 27.7% of ADR were severe, 36.9% were moderate.Conclusions: Early detection and management of ADRs is vital for the success of ATT and patient adherence

Comparing the effect of statins on hepatic fibrosis induced by carbon tetrachloride in Wistar rats

Background: The clinical studies have shown contrary results regarding hepatoprotective effect of statins. However, antifibrotic properties of statins in in vitro and in vivo experimental models have been demonstrated. The purpose of this study was to assess and compare the effect of statins on serum liver enzymes and their antifibrotic effects.Methods: Forty two rats were divided into 7 groups (I to VII) (n=6). Liver toxicity was induced by injecting carbon tetrachloride (1 ml/kg). Control groups received corn oil (0.1 ml/100 gm) and carboxy methyl cellulose (0.50%) respectively. Group III to VII received carbon tetrachloride (CCl4) for 6 weeks and then groups IV, V, VI and VII received simvastatin (10 mg/kg), atorvastatin (15 mg/kg), rosuvastatin (2 mg/kg) and silymarin (50 mg/kg) for another 8 weeks respectively. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) levels were estimated in all the groups at baseline, 6 weeks and 14 weeks. At 14 weeks, histopathology of liver was done in all groups.Results: At 14 weeks, all the test groups (IV, V and VI) showed a significant decrease in serum ALT, AST and ALP levels as compared to control (p<0.05) and group III (p<0.05). On intergroup comparison, liver enzymes in rats in group VI (rosuvastatin) and group V (atorvastatin) were decreased more in comparison to group IV (simvastatin) but the difference was not statistically significant except for AST levels where the difference was significant between the statins. There was decrease in hepatic fibrosis by statins with rosuvastatin being superior followed by atorvastatin and simvastatin.Conclusions: In the present study statins decreased the serum AST, ALT and ALP levels and histopathological changes were reversed by statins in CCl4 induced hepatotoxic models

CLOZAPINE INDUCED PARALYTIC ILEUS

Clozapine is an atypical antipsychotic drug used for the treatment of schizophrenia in patient not responding to other antipsychotics. Dry mouth, constipation, loss of accommodation and urinary retention are the common side effects encountered with this drug. Here we are reporting a case of paralytic ileus secondary to clozapin

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 &lt; 0.001) and Fucithalmic 1% treated rats (p &lt; 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 &lt; 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

A bibliometric analysis of publication output in selected South American countries [version 1; peer review: 2 approved]

Research output provides an insight into the development of the scientific capability of a country. Budget allocation for research and development (R&D) is directly proportional to the research output of a country. Bibliometric analysis of South American countries has not been done in many studies. The purpose of this paper was to analyse research outputs from South American countries on various metrics. An analysis was done for a period of 11 years from 2010 to 2020. The analysis revealed that Brazil with highest percentage of research spend has lowest Field Weighted Citation Impact (FWCI). This contrasts with Uruguay, whose FWCI is high despite comparatively lower spend on R&D and lower publication output. Although Argentina has the highest percentage of researchers per million population (1202), it has the least papers per researchers (0.3 per year) among the countries studied. A huge disparity in terms of percentage of research spent, research output, papers per researcher, and output with national and international co-authorship was observed

Epigenetics: The New Frontier in the Landscape of Asthma

Over the years, on a global scale, asthma has continued to remain one of the leading causes of morbidity, irrespective of age, sex, or social bearings. This is despite the prevalence of varied therapeutic options to counter the pathogenesis of asthma. Asthma, as a disease per se, is a very complex one. Scientists all over the world have been trying to obtain a lucid understanding of the machinations behind asthma. This has led to many theories and conjectures. However, none of the scientific disciplines have been able to provide the missing links in the chain of asthma pathogenesis. This was until epigenetics stepped into the picture. Though epigenetic research in asthma is in its nascent stages, it has led to very exciting results, especially with regard to explaining the massive influence of environment on development of asthma and its varied phenotypes. However, there remains a lot of work to be done, especially with regard to understanding how the interactions between immune system, epigenome, and environment lead to asthma. But introduction of epigenetics has infused a fresh lease of life in research into asthma and the mood among the scientific community is that of cautious optimism