Comparative study of oxytetracycline and doxycycline on calcium chelation: in-vitro assay

Background: Tetracycline class of antibiotics differ in their pharmacokinetic profile and chelating property. Objective of present study is to assess the effect of oxytetracycline and doxycycline on calcium chelationMethods: For estimation of calcium chelation of Oxytetracycline and Doxycycline, EDTA method (P. Trinder) and calcium binding assay was followed. Different doses of Oxytetracycline (25 mg, 50 mg and 100 mg) and Doxycycline (25 mg, 50 mg and 100 mg) were used in EDTA method and different concentrations of calcium were used in calcium binding assay. The procedure was done according to the standard methodology.Results: The intensity of colour appear to be increased with increase in dose of the Oxytetracycline (25 mg, 50 mg, 100 mg) as the concentration of calcium binding increases. But in Doxycycline intensity of colour is more with 100 mg as compared with 25 mg and 50 mg The UV absorption spectrum of solution of Oxytetracycline (1mM) was changed after the addition of CaCl2 to provide different concentration of Ca2+ (0.1, 0.5 and 1.0 mM).  With minor shift in the absorption coefficient and no shift in wavelength were observed for Doxycycline.Conclusions: The study concludes that oxytetracycline has more calcium chelating property than doxycycline

Assessment of medication adherence among hypertensive patients: a cross-sectional study

Background: Hypertension affects around one billion individuals worldwide and is expected to increase by 29% to reach 1.56 billion by 2025. It is usually asymptomatic, chronic disorder needing lifelong treatment. The objective of this study was to study the medication adherence among hypertensive patients using hill-bone compliance to high blood pressure therapy scale (HILL-BONE CHBPTS) and to compare medication adherence in hypertensive patients with controlled and uncontrolled blood pressure.Methods: A cross-sectional, observational study was conducted for a period of one year in the Outpatient department of Medicine in a tertiary care hospital, Navi Mumbai. A total of 129 hypertensive patients who were on at least six months on antihypertensive medications were enrolled. Blood pressure was measured and details of drug therapy were noted. Medication adherence was assessed using HILL-BONE CHBPTS and respective scores were calculated.Results: HILL-BONE CHBPTS scores were on the higher side signifying poor medication adherence among hypertensive patients. HILL-BONE CHBPTS score correlated significantly in a positive direction with diastolic blood pressure, duration of treatment and the number of medications, As per JNC 8 recommendations, 58.9% (76) hypertensive patients were having blood pressure under control, whereas 41.1% (53) were having uncontrolled blood pressure. HILL-BONE CHBPTS scores were significantly higher (reflecting lower adherence) in hypertensive patients with uncontrolled blood pressure than those having optimally controlled blood pressure.Conclusions: Overall the medication adherence was poor in hypertensive patients. Adherence to therapeutic regimens is an important factor in blood pressure control among hypertensive patients and needs priority. Health education related to medication adherence needs be improved in hypertensive patients

Effectiveness of crossword puzzle as an adjunct tool for active learning and critical thinking in Pharmacology

Background: Modern pedagogic methodologies are being introduced in Medical education and there is a growing evidence of crossword puzzle as an educational tool for active learning, problem solving and critical thinking. The aim of the study was to study the effectiveness of crossword puzzle as an adjunct to the conventional lecture for active learning and critical thinking in Pharmacology. This was a parallel group; pre and post assessment, educational intervention study conducted among second year undergraduate medical students.Methods: Second year medical students were randomly selected and assigned to two groups A (Cross word puzzle) and B (control), after an hour conventional lecture on “Drugs for Hypertension” In both the groups, pre- and post-intervention knowledge was assessed using the MCQ test. A self-designed crossword puzzle on the lecture topic was used as an intervention and students were allowed to read textbooks with a crossword puzzle in intervention group A, whereas control group B were allowed to read textbook only. After 45 minutes, the post-intervention assessment was done in both groups with the same set of MCQ and students’ feedback on crossword usefulness was obtained.Results: The average MCQ test score in Group A improved significantly from 6.65±3.4 pre-intervention to 11.26±2.5 post-intervention (p <0.05) with absolute learning gain 30.73 % and relative learning gain 69.32 %. The average test score in Group B also improved significantly from 5.7±2.9 pre-intervention to 9.59±2.5 post-intervention (p <0.05) with absolute learning gain 25.93 % and relative learning gain 68.23%. There was a significant improvement in the MCQ scores in both the groups after intervention. But the post-intervention MCQ scores in group A (crossword puzzle) was higher and statistically significant (P <0.05) in comparison to group B.Conclusions: Cross-word puzzle promotes active self-learning and develops critical thinking among medical students. It could be used as supplementary educational tool in pharmacology to enhance problem-solving skills along with the information provided through traditional teaching lectures or could be used as a micro task

Expanding horizons of anticoagulant therapy: Dabigatran etexilate a novel oral anticoagulant

Thrombo-embolic disease is a major challenging clinical problem associated with significant mortality and morbidity. Anticoagulation with the existing heparin products and vitamin K antagonist (VKA) anticoagulants are still the mainstay of management. However, due to the risk of bleeding and well-documented drawbacks, the quest for a novel oral anticoagulant has led to the clinical development of dabigatran etexilate. Dabigatran etexilate is a direct thrombin (IIa) inhibitor which has recently been approved in India for prevention of venous thromboembolic events (VTE) in patients who have undergone major orthopaedic (total knee or hip replacement) surgery and for prevention of stroke, systemic embolism and reduction of vascular mortality in adult patients with atrial fibrillation. Thus dabigatran etexilate is a promising alternative to the current heparin products and VKAs in patients who require long-term oral anticoagulation