Wound healing property of paroxetine in immunosuppressed albino rats

Background: The objectives of this study were to evaluate the wound healing activity of Paroxetine in different wound models in wistar rats and to study its effects on dexamethasone suppressed wound healing.Methods: For assessment of wound healing activity, excision and incision wound models were used. Group I was assigned as control, orally, Group II received Paroxetine, i.p, Group III received Dexamethasone intramuscularly (i.m) and Group IV received Dexamethasone i.m and Paroxetine, i.p. Parameters observed were epithelization and wound contraction of excision model and breaking strength of incision wound model.Results: In incision model, it was noted that the breaking strength was not significantly increased in paroxetine treated group when compared to control group. Paroxetine hastened the period of epithelization and the effect of dexamethasone was reversed by paroxetine in incision and excision modelsConclusion: It is concluded that Paroxetine could be an effective agent for healing wounds in immunocompromised patients

Rationale use of drugs in pregnancy induced hypertension at a tertiary care hospital

Background: Pregnancy induced hypertension known as preeclampsia is considered to be the second cause of death next to anaemia. There are significant sources of maternal and foetal mortality and morbidity. Antihypertensive medication reduces the progression of the course of hypertensive disorders. However, its effect on the outcomes of pregnancy may include development of preeclampsia, preterm delivery, foetal /neonatal demise, IUGR, low birth weight. Whether such associations are casual or confounded is unknown. Hence, we intended to study the rationale use of drugs in pregnancy induced hypertensive patients. Methods: Patients diagnosed with hypertensive disorders in pregnancy were recruited. Pregnant women in the age group of 18-45 years who consented to participate were included. Non pregnant women and women with PCOD, depression and on any medications were excluded. Details on drug treatment, type of drugs, combination, dose, dosage and duration were noted. Results: 105 patients were enrolled. 51% belonged to 18-25 years. 98% mothers received monotherapy and 2% received dual therapy. Labetalol was the most commonly prescribed drug. 50% of the patients received a combination of Nifedipine and Methyldopa while another 50% received Nifedipine with Labetalol. The outcome of new born babies born in mothers receiving antihypertensive drugs had complications of low birth weight and malformations. The dose of the medications prescribed was well within the range. Conclusions: Proper counselling to the patients regarding life style management, regular follow ups and monitoring of blood pressure is important to understand, resolve the burden and complication

Influence of anti-epileptic drugs on hematological and biochemical parameters in patients with epilepsy

Background: Epilepsy is a chronic neurological condition which may require long-term treatment with antiepileptic drugs (AEDs). The challenge in AED management is to attain freedom from seizures, without side-effects and with good quality-of-life. However, AEDs are reported to induce potential adverse effects, which can remain unnoticed over long time. In this regard, earlier studies report inconsistent results in hematological and biochemical toxicity of AEDs. The objective of the present study was to evaluate the effects of AED monotherapy and polytherapy on hematological and biochemical parameters.Methods: This was a cross-sectional, observational study carried out among patients with epilepsy (PWE) receiving AEDs. The data on baseline demographic characteristics, treatment, adverse drug reactions, hematological, and biochemical investigations were collected. Statistical analysis was performed using the SPSS version 18 and descriptive statistics such as mean and median were used to summarize the data and inferential tests like Chi-square was used to compare categorical variables between groups.Results: There were 255 PWE in mean age range of 28.68±9.29 years, with 56.54% males. A total of 78.04% had focal, 18.04% had generalized seizures and remaining 3.92% were unclassified. Majority of (55.69%) PWE received polytherapy with AEDs. Females had significantly lower levels of hemoglobin (Hb) when compared with males (p=0.000), and patients on AED polytherapy showed significant difference in low Hb (p=0.006) and high alkaline phosphatase (ALP) levels (p=0.001).Conclusions: The results of this study showed significant alterations in the levels of Hb and ALP with the use of AED polytherapy in PWE. Routine hematological and biochemical investigations may be considered during AED treatment in those patients receiving AED polytherapy

Analgesic use and potential hearing loss: a pharmacovigilance study

Background: Hearing loss is the most common sensory deficit in humans today. In India, as per WHO there are approximately 63 million people, who are suffering from significant auditory impairment and estimated prevalence at 6.3% in Indian population. The objective of the study was to determine the potential hearing loss in patients on analgesics.Methods: Prospective, observational study examined the association between analgesic use and potential hearing loss in 30 patients receiving NSAIDS. Data was collected using specialized designed case record form. The clinical signs like onset of tinnitus, appearance of another sound that didn't exist before, sinus infection or a respiratory illness, development of vertigo or spinning sensation were looked for. Audiometry test was advised for all the patients receiving analgesics.Results: Total of 30 patients were included in the study. Male predominance was noted Maximum patients were in the age group between 35-45 years (33.33%). The socioeconomic status was analyzed using revised kuppuswamy scale. 30% (n=09) of patients were in lower class. Majority of the patients were reported with road traffic accidents (n=19; 63.33%) and received analgesics for more than 2 weeks. Patients received different combination of NSAIDs among which aceclofenac was most commonly prescribed. 11 (36.66%) patients had hearing loss received either diclofenac or aceclofenac for more than 25 days.Conclusions: Regular usage of NSAIDS may increase the risk of hearing loss and the impact could be larger on younger individuals. Hence, extra precaution to be taken while prescribing NSAIDS

The sociodemographic, clinical and pharmacotherapy characteristics influencing quality of life in patients with epilepsy: A cross-sectional study

Context: Quality of life (QOL) assessment in patients with epilepsy (PWE) is increasingly recognized as an important component in the management of epilepsy. Aims: The objective of the present study was to assess influence of sociodemographic, clinical and pharmacotherapy characteristics collectively on QOL in adult PWE. Settings and Design: This was a cross-sectional, observational study in patients with confirmed diagnosis of epilepsy. Materials and Methods: QOL was assessed using modified QOLIE-10 questionnaire for epilepsy. Univariate and multiple regression analysis were done to determine factors associated with poor QOL, respectively. Results: There were 451 PWE, with a mean age 27.3 ± 8.15 years, 251 (56%) males and 191 (42%) had monthly income < 5000 Indian national rupees (INR)/month. The QOLIE score was 64.1 ± 15.97 (Mean ± SD). The univariate analysis showed factors such as lower monthly income, focal epilepsy, seizure frequency, antiepileptic drug (AED) polytherapy, conventional AEDs and frequent adverse drug reactions (ADRs) had significant negative influence on various domains of QOLIE-10 questionnaire. Multiple regression analysis showed seizure frequency as a significant predictor of most QOL domains and overall score, while ADRs as a significant predictor of all the domains. Seizure type was a predictive factor for domains like emotional well-being and overall score. Conclusion: Present findings showed patients on monotherapy had better QOL while those having lower monthly income, having focal epilepsy and who received conventional AEDs had negative influence on QOL scores. Further, higher seizure frequency and occurrence of ADRs were significant predictors of all the domains of QOL in PWE

Prognosticators of bone health in pediatrics with epilepsy using anti-epileptic drugs: A prospective interventional study

Introduction: Epilepsy is a common and long-lasting neurological disorder in children who require long-term treatment with Antiepileptic drugs (AED). Such long-term AED use may have negative effects on bone causing bone loss and osteoporosis, necessitating frequent monitoring. Data on the effect of AED on bone health in children is scarce compared to adults and hence this study was undertaken. &nbsp;Aim: To compare and quantify the effects of sodium valproate (SV), carbamazepine (CBZ), and levetiracetam (LEV) on bone health in children using specific bone biomarkers such as vitamin D, calcium, phosphorus, ALP, osteocalcin (OCN), and beta serum cross laps (CTx). Materials and methods: A prospective interventional study was carried out in Rajarajeswari Medical College and Hospital, Bangalore, between October 2019 to March 2022. A total of 79 confirmed cases of epilepsy within the age group of 1-18 years, receiving treatment with sodium valproate (SV), carbamazepine (CBZ), and levetiracetam (LEV) monotherapy for a period of minimum one month were enrolled. Serum samples of calcium (Ca), phosphorus (PO4), alkaline phosphatase (ALP), Vitamin D were analyzed at the time of initiation of study and these levels were considered as baseline levels.&nbsp