Effect of Lagenaria siceraria fruit extract (Bottle gourd) on hepatotoxicity induced by antitubercular drugs in albino rats

Background: Anti TB drug induced hepatotoxicity has higher incidence in Indian population [11.5%] than western population [4.5%]. Antitubercular drug induced hepatotoxicity is mediated through oxidative and free radical damage to hepatocytes. Lagenaria siceraria [Bottle Gourd] is reported to have antioxidant and hepatoprotective activity. Hence in the present study we tested hepatoprotective and antioxidant activity of fruit extract of L. Siceraria in anti tubercular drug induced hepatotoxicity.Methods: We administered antitubercular drugs alone and in combination with fruit extract of Lagenaria siceraria (EELS 100mg/kg and EELS 200mg/kg) in healthy albino rats by oral route for 15 days. On 16th day blood collection for biochemical analysis is done by cardiac puncture. Biochemical markers used are serum transaminases (SGPT/SGOT), serum alkaline phosphatase [ALP], total bilirubin, total protein, superoxide dismutase [SOD] and malondialdehyde [MDA]. Liver is dissected for histopathological examinations.Results: Groups that received EELS [100 mg/kg & 200 mg/kg], in combination with anti tubercular drugs, showed significant reduction [p value <0.001] in biochemical parameters for hepatotoxicity [SGOT, SGPT, ALP, Total bilirubin, Total protein] in comparison with group that received anti tubercular drugs alone. Combined treatment of EELS [100 mg/kg & 200 mg/kg] & Anti tubercular drugs showed significant reduction in oxidative stress [SOD & MDA, p<0.001] as compared to anti tubercular drug alone. Histopathological examination of liver showed grade I & grade 0 changes in combination group while grade IV changes in group receiving anti tubercular drugs alone.Conclusion: Ethanolic extract of Lagenaria siceraria fruit possesses significant hepatoprotective and antioxidant activity in antitubercular drugs induced hepatotoxicity

Study of drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of tertiary care hospital

Background: Mental disorders are now widely recognized as a major contributor to the global burden of disease. The drug use in psychiatric illness is a complex process and because of this the optimal benefits of drug therapy in patient care is not achieved. This often leads to increased cost of medical care, drug resistance, adverse effects and patient mortality. Hence, this study is undertaken to study the drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of a tertiary care hospital.Methods: A prospective, observational study was undertaken from 1st February 2015 to 31st July 2016. A total of 250 prescriptions were analysed. Defined daily dose of the drugs were calculated. ADR’s were recorded in the format of the National Pharmacovigilance Programme of India (PvPI).Results: In 250 prescriptions most, common drug prescribed was antipsychotics (48.5%). Total drug utilization in terms of DDD/100 bed days was 669. The total number of adverse drug reactions observed was 8%. Antipsychotics were the most common class of psychotropic drugs causing ADR’s.Conclusions: In conclusion, it has been found that the psychotropic drugs used in our psychiatry department was rational and was based on clinical knowledge, expertise and the guidelines available in the field of psychiatric practice

Study to assess knowledge, attitude and practice regarding swine flu vaccine amongst medical students

Background: Due to recurrent outbreak and associated high mortality of swine flu there is panic amongst medical students also because of higher risk of getting infected. Vaccination for swine flu is the best preventive measure. So this study was undertaken. The aim of the present study was to assess the knowledge, attitude and practice regarding swine flu vaccine amongst medical students of government medical college and provide data to improve awareness about swine flu vaccineMethods: This was a cross sectional observational study carried out amongst 250 medical students during period of April-June 2015. A pre designed and pre tested, multiple choice questionnaires was used to assess KAP regarding swine flu vaccine and descriptive analysis was done.Results: Knowledge of participants regarding Swine flu vaccine was high as the mean score of correct answers marked was 152.5. But Only 21.8% participants had knowledge about cost of vaccine and 33.2% about the adverse drug reactions to the vaccine. Internet was the most common source of information amongst participants. Attitude of participants toward vaccination was favourable (mean score -128.4) but attitude for vaccination during pregnancy (30.8%) and with other vaccines (32.8%) was unfavourable. Only 30(12%) candidates have taken the vaccine which shows very poor practice.Conclusions: This study shows high knowledge, favourable attitude but poor practice towards Swine flu vaccination amongst medical students. So there is need to increase awareness for vaccination of swine flu amongst medical students by continuous health education and also need to increase the availability of vaccine in government hospitals

Evaluation of antidepressant activity of ondansetron alone and in combination with fluoxetine-an experimental study

Background: Direct antagonism at 5HT3 receptor site may be associated with antidepressant activity as conventional antidepressants also possess affinity for central 5HT3 binding site. So in this study, an effort is made to investigate the antidepressant effect of ondansetron (OND), a selective 5HT3 antagonist, alone and in combination with fluoxetine (FLX).Methods: Acute and chronic models of Forced swimming test (FST), tail suspension test (TST), open field test (OFT) and mice brain serotonin estimation  by UV spectrophotometry were applied for the evaluation of antidepressant activity.Results: In FST and TST (acute and chronic models), ondansetron showed statistically significant antidepressant activity (p<0.05) as compared to control. The combination groups (OND 0.25 mg/kg + FLX 5mg/kg & OND 0.5 mg/kg + FLX 5 mg/kg) showed statistically significant antidepressant activity (p<0.05) as compared to fluoxetine (5 mg/kg) and ondansetron (0.25 mg/kg and 0.5 mg/kg) in FST and TST (acute and chronic models). Open field test in chronic study showed ondansetron (0.25 mg/kg and 0.5 mg/kg) increases number of central squares crossed as compared to control which is statistically significant (p<0.05). The combination group (OND 0.25 mg/kg + FLX 5 mg/kg) showed significantly increased (p<0.05) number of central squares crossed as compared to fluoxetine (5 mg/kg). The combination group (OND 0.5 mg/kg + FLX 5 mg/kg) showed significantly increased (p<0.05) brain serotonin compared to control, ondansetron (0.25 mg/kg and 0.5 mg/kg) and fluoxetine (5 mg/kg).Conclusions: Our study concludes that ondansetron alone and in combination with fluoxetine possesses significant antidepressant activity in animal models of depression

Study of evaluation of anti-inflammatory activity of macrolide antibiotics in rats: an experimental study

Background: Inflammation is a complex and dynamic condition in which many changes take place at the site of inflammation, as well as systemically. In general, inflammatory response acts to protect the host, but many times it goes unchecked with tissue destruction leading to a spectrum of inflammatory disorders. Anti-inflammatory drugs have long been used to treat spectrum of inflammatory conditions. Anti-inflammatory agents, in use today, though have efficacy, cause a variety of side effects causing major problems during their clinical use. Amongst newer approaches to treat inflammation, macrolides, the anti-bacterial agents, seem to be beneficial in decreasing the inflammation. Still there is much speculation about the anti-inflammatory activity of macrolide antibiotics. So, we planned this study to assess anti-inflammatory activity of macrolide antibiotics (erythromycin, roxithromycin, azithromycin, and clarithromycin) and to compare their anti-inflammatory activity with control and indomethacin (standard non-steroidal anti-inflammatory drugs).Methods: To assess anti-inflammatory activity of macrolides, we used acute (carrageenin-induced paw edema and turpentine oil-induced arthritis), as well as chronic model of inflammation (cotton pellet induced granuloma).Results: All the macrolides, i.e., erythromycin, roxithromycin, azithromycin and clarithromycin showed significant (p<0.05) anti-inflammatory activity in acute models of inflammation as compared to control group. However, macrolides showed insignificant activity as compared to indomethacin (acute and chronic models of inflammation) and as compared to control (chronic model of inflammation).Conclusions: This study shows macrolide antibiotics have anti-inflammatory activity in animal models of acute inflammation

Carbamazepine induced toxic epidermal necrolysis in a patient of seizure disorder

Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a widespread life-threatening mucocutaneous disease where there is extensive detachment of the skin and mucous membrane. Many factors are involved in the aetiology of TEN, the most common being the adverse drug reactions. Here we report a case of TEN in a 12 year old female child who presented with fever and blisters all over her body after taking carbamazepine for uncontrolled generalised tonic-clonic seizure. This case has been reported to highlight the importance of using carbamazepine cautiously as this case shows the “probable” association between carbamazepine and TEN, which is a life threatening condition

A study on the clinico-epidemiological profile and the outcome of snake bite cases in the tertiary care hospital

Background: Snake bite is a common medical emergency and an occupational hazard in India. It is also a major public health issue in rural India where farming is a major source of employment. Very few studies describe epidemiology of snake bite from India. Hence, this study was planned to collect information on various aspects of snake bite in a tertiary care hospital.Methods: A prospective observational study of 167 patients of snake bite and unknown bite carried out from September 1, 2012 to August 31, 2013.Results: Among a total 167 cases, majority were males (54.49%), aged between 20 and 40 years (38.92%). Most of the cases were laborers (61.67%) and farmers (17.36%). Peak incidence was observed during monsoon (64.67%). Bite mark was seen in 46.70% cases, upper extremity being common site (52.09%). Most cases were of vasculotoxic bite (65.26%) and few were of neurotoxic bite (19.76%). Major complications were respiratory failure (4.79%) and acute renal failure (1.8%). Average bite to needle time was 365 min. Bleeding & clotting time was raised in 44.03% & 35.19% cases, respectively. Average dose of anti-snake venom (ASV) required was 17.1 vials. Allergic reactions to ASV observed in 8.38% cases. Mean duration of hospital stay was 4.3 days. Recovery rate was 94.01% with three cases referred to higher center. Mortality rate was 2.39%.Conclusions: Our study highlights various aspect of snake bite cases and tries to find out ways to improve quality of life of patients, decrease mortality and morbidity and decrease economic burden on society

Timely use of anti-snake venom improves maternal and fetal outcome: a case report

Snake bite is a common medical emergency and an occupational hazard in a rural population of India. Though it is uncommon in pregnancy, it is associated with poor maternal and fetal outcome. Early gestational age and delay in the treatment are the factors responsible for unfavorable prognosis. Here, we report a case of primigravida, aged 22 years, with 22 weeks of gestation presenting with a history of snake bite on the left frontal region of the face. While on anti-snake venom treatment, patient developed anaphylactic reaction. In spite of this, the maternal and the fetal outcome were good in this case

Evaluation of antidepressant activity of tramadol in mice: an experimental study

Background: In spite of availability of effective antidepressant drugs, depression continues to be a major problem. Hence, great interest is being taken in development of innovative antidepressants. Tramadol (TRM) is a centrally acting opioid agonist, which is clinically effective in the treatment of moderate to severe pain. By virtue of its action of inhibiting norepinephrine and serotonin uptake, it can function as an antidepressant like venlafaxine. Hence, this study was planned to evaluate antidepressant activity of TRM in comparison and in combination with fluoxetine (FLX) in albino mice.Methods: TRM (20 and 40 mg) and FLX (20 mg) were administered i.p., alone and in combination once daily for acute (7 days) and chronic (14 days) period to Swiss albino mice of either sex. The immobility period of control and treated mice was recorded in forced swimming test (FST) and tail suspension test (TST). The open field test was also done for same period to test the locomotor activity in animal. The antidepressant effect of TRM was compared with FLX and normal saline treated group for acute and chronic study period.Results: TRM (20 and 40 mg) treated group produced significant antidepressant effect alone and in combination with FLX (20 and 40 mg) as indicated by reduction in immobility period compared with control group in FST and TST. TRM and FLX treated groups did not show significant activity in open field test when compared with control group.Conclusions: This study shows TRM has antidepressant activity in standard models of depression

Study of drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of tertiary care hospital

Background: Mental disorders are now widely recognized as a major contributor to the global burden of disease. The drug use in psychiatric illness is a complex process and because of this the optimal benefits of drug therapy in patient care is not achieved. This often leads to increased cost of medical care, drug resistance, adverse effects and patient mortality. Hence, this study is undertaken to study the drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of a tertiary care hospital.Methods: A prospective, observational study was undertaken from 1st February 2015 to 31st July 2016. A total of 250 prescriptions were analysed. Defined daily dose of the drugs were calculated. ADR’s were recorded in the format of the National Pharmacovigilance Programme of India (PvPI).Results: In 250 prescriptions most, common drug prescribed was antipsychotics (48.5%). Total drug utilization in terms of DDD/100 bed days was 669. The total number of adverse drug reactions observed was 8%. Antipsychotics were the most common class of psychotropic drugs causing ADR’s.Conclusions: In conclusion, it has been found that the psychotropic drugs used in our psychiatry department was rational and was based on clinical knowledge, expertise and the guidelines available in the field of psychiatric practice