Isolation and Characterization of Different Aggregates of Lipid from Bovine Milk

Bovine milk fat globules naturally vary from less than 0.2 µm to 15 µm in diameter. Milk has at least two distinct distributions of fat globules. While the majority (~90%) of globules in milk are of the smaller distribution (average diameter of 0.4 µm), virtually all the fat is carried in the larger globules (average diameter 3.5 µm). This distribution suggests some compositional and/or functional significance might exist between the two populations of fat globules, which may be related to origin of these globules in the lactating cell. Milk fat globules have a unique structure, composed of a core droplet of non polar lipids (triacylglycerol) surrounded by a lipid bilayer membrane known as milk fat globule membrane (MFGM). Other than MFGM, there is another source of membrane that has been identified in skim milk. It has been hypothesized that this skim milk membrane (SMM) is derived from MFGM, but little data are available to support this idea, and the membrane may also have alternate origins. In this study, different aggregates of lipids (small and large fat globules, SMM, skim milk) from milk were isolated and characterized for their lipid contents. Isolation of small and large fat globules fractions was verified by laser diffraction particle size analysis. The lipids were extracted from isolated different lipid aggregates and individual classes were separated using thin layer chromatography. Lipids were transesterified to fatty acid methyl esters and analyzed by gas chromatography-mass spectrometry. The results indicate that there are some compositional differences between native milk fat globule membranes of different sizes. For example, the total phospholipid fraction of small fat globules (SFG) contained significantly more unsaturated C18:1n9 and C18:2n6 than large fat globules (LFG). Conversely, sphingomyelin composition of SFG contained less C18:1n9 and C18:2n6cc, but more long chain fatty acids C22:0, C23:0, and C24:0. Phosphatidylethanolamine composition of SMM contained more C17:1 than SFG and LFG. The composition of C18:1n9 in triacylglycerol increased with fat globule size. Clear differences were also found in lipid profile of SMM and small and large fat globules from milk. Composition differences between SMM and native milk fat globules of different sizes suggest that origin of this membrane material in skim milk might have some different source than that of MFGM

PHARMACOECONOMIC ANALYSIS OF VARIOUS BRANDS OF COMMONLY PRESCRIBED ORAL ANTIHYPERTENSIVE MEDICINES IN INDIAN MARKET

Objectives: The objective of the study was to analyze the percentage cost variations among various brands of the commonly prescribed antihypertensive medicines in India. Methods: Cost of a particular medicine (cost per 10 tablets) in the same strength and dosage forms being produced by various pharmaceutical companies was taken from Current Index of Medical specialties and Drug Today. Difference between the highest and lowest cost of the same drug manufactured by various pharmaceutical industries was obtained and percentage cost variation was calculated. Results: The percentage variation in the price was above 100% with almost all of the commonly prescribed antihypertensive medicines. The cost of a total of 23 drugs (14 single and nine combination preparations), available in forty nine different formulations were studied. Overall, Amlodipine (5 mg) shows highest price difference of 982.3%, while Nifedipine (5 mg) shows lowest price difference of 39%. Telmisartan + Hydrochlorthiazide (80+12.5 mg) combinations shows highest price variation of 318.9%, while Amlodipine + Losartan (5+50 mg) shows lowest price difference of 50%. Conclusion: The average percentage price difference of the same antihypertensive medicine manufactured by various pharmaceuticals company in India is very huge. Hence, Government, Pharmaceutical companies, prescribing health care workers should educate themselves about huge variation in price of brand drugs in comparison with their cheap generic counterpart to provide maximum benefits with minimum financial burden to the patients receiving antihypertensive drugs

Analysis of package inserts of commonly used drugs in obstetrics and gynecology in Jhalawar district: an observational study in Rajasthan, India

Background: Package Insert is the primary source of drug information for the patient. It is a printed leaflet that contains information based on regulatory guidelines for the safe and effective use of a drug. Studies on package inserts in India had shown that crucial information was often missing, and they lacked uniformity.Methods: 100 oral drugs used in Obstertrics and Gynecology from different brands were collected from big pharmacies located at Jhalawar and available package inserts were analysed according to Sections 6.2 and 6.3 of Schedule D of Drugs and Cosmetics Rules, 1945.Results: Out of 100 oral drugs studied, package inserts were found in 72 drugs, most available information in therapeutic indicators was Posology and method of administration (100%) followed by contra-indications (94.4%), use in pregnancy and lactation (83%), interactions (77.8%) whereas less information about antidote and least about ability in driving and use of machine. In pharmaceutical indicators, it is instruction for use (86%), followed by special precautions for storage (76.4%), shelf life in the medical product as packaged for sale (52.8%).Conclusions: This study showed that many information relevant to the safe and effective use of medication was lacking in the analyzed package inserts. It is, therefore, recommended to update the existing package inserts based on criteria mentioned in the Schedule D of Drug and Cosmetic Act, 1945

Study of incidence, trends and determinants of caesarean section in tertiary care hospital of Rajasthan, India

Background: Lower Segment Caesarean section (LSCS) is recommended when vaginal delivery might pose a risk to the mother or baby. Worldwide rise in LSCS rate during the last three decades, has been the cause of alarm and needs an in-depth study.Methods: It was a retrospective, observational study conducted in Obstetrics and Gynecology department of Jhalawar medical college, Jhalawar. Data were obtained from medical record database of patients admitted for deliveries from October 2017 to March 2018 over period of six months. The total number of patients delivered and the number of LSCS done were counted to find the incidence of LSCS in our hospital. Age, parity and gestational age of the patients who underwent LSCS were tabulated.Results: In present study the incidence of LSCS was 31.1%. Of these cases 91% belonged to age group 20 -29 yrs. Emergency LSCS (72.1%) and primary LSCS (66.5%) were more common. The commonest indication of LSCS was previous LSCS in 35% followed by foetal distress, breech presentation, severe oligohydrominos and pre-eclampsia.Conclusions: In present study LSCS rate was high as compared to the WHO standard. The scheme like Janani Suraksha Yojana (JSY) may have a great impact on accepting institutional deliveries by poor women which may be a reason of the increase of LSCS in India. Utilization of antenatal care, better doctor patient communication, doctor’s commitment to reduce the rate of LSCS, may help to reduce the increasing rate of caesarean delivery

Cost analysis and price variation of commonly used drugs in obstetrics and gynecology in Jhalawar district of Rajasthan, India

Background: Drugs used in obstetrics and gynecology are strong selling drugs in pharmaceutical market but they are the least studied drugs in terms of cost analysis and price variation.Methods: Cost of most commonly used Obstetrics and Gynecology drugs in Jhalwar district manufactured by different pharmaceutical companies, in the same strength and dosage forms was obtained from Drug Today (January-March 2018). The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in cost per 10 tablets/10 capsule/1 injection/1 protein packet/1 sachet were analysed.Results: In Obstetrics drugs, the highest cost ratio (1:9.5) and percentage price variation (848) was found for Ferrous Salt + Folic acid combination followed by Cefixime (1:4.3, 330), Nifedipine (1:3.7, 270), Folic acid (1:3.67, 266), Paracetamol. Amoxicillin was having least cost ratio (1:1.4) and percentage price variation (37). Maximum number of brand available for Ferrous Salt + Folic acid combination (41) followed by Paracetamol, Calcium Salt + Vitamin D3 combination. In Gynecological drugs, the highest cost ratio (1:35) and percentage price variation (3433) was found for Ethinylestradiol + Levonorgetral combination followed by Doxycycline (1:8.9, 793), Fluconazole. Metronidazole was having least cost ratio (1:1.3) and percentage price variation (27). Maximum number of brand available for Omeperazole (27) followed by Ethamsylate (22).Conclusions: This study shows that the average percentage price variation of different brands of the same drugs were very wide. Improved adherence to the drug treatment can be ensured by decreasing the cost of therapy, which can be done by changes in the government policies and regulations, integrating pharmacoeconomics as part of medical education curriculum, and creating awareness among treating physicians for switching to cost effective therapy

Study of drug utilization pattern in gynecology department of tertiary care hospital of Rajasthan, India

Background: With increasing awareness the flow of patients visiting gynecology outpatient department has increased. Drugs used in gynecology are one of the most selling drugs in India, however they are least studied with respect to drug utilization. Thus, present study was undertaken to analyse drug utilization pattern of Gynecology OPD in a tertiary care hospital.Methods: A retrospective, cross sectional, observational study of prescriptions in Gynecology OPD of Jhalawar medical college, Jhalawar. Data was obtained from medical record database of patients that attended Gynecology OPD from October 2017 to March 2018 over period of six months. Prescription records of patients were screened as per inclusion and exclusion criteria and 300 prescriptions were randomly selected. Patient related, and drug related information was collected on a customized data collection sheet.Results: The mean age of patients was 20.5±8.65 years and common age of presentation was >18-30 years. In infective cases, PID (40.6%) was common, and in non-infective cases, menorrhagia (23.8%) was common. The average number of drugs per prescription was 5.2. In drug category, minerals (46.4%) were most commonly prescribed, followed by antimicrobials (27.6%), and NSAIDs (20.1%). Polypharmacy was observed in 100% of the prescriptions.Conclusions: In the present study all of the drugs prescribed were generic which were from the essential medical list of NLEM and WHO. This study revealed deviation from rational prescribing by the prescribers because average number of drugs per prescription was significantly higher than that recommended by WHO

Abnormal uterine bleeding: study among patients in a tertiary hospital in Southern Rajasthan

Background: Abnormal uterine bleeding is one of the commonest cases seen in gynecology OPD in the country. The incidence is more commonly seen in late adolescence and perimenopausal group of patients. A fair and objective procedural pattern needs to be adopted to ensure that these patients undergo rapid diagnosis and treatment. The Palm-Coein system is considered as the gold standard. The present study aims to ascertain the efficacy of this system in AUB patient diagnosis.Methods: The study involved as sample of 120 subjects who came to the OPD of the institute and consented to be a part of the study. The subjects were examined and relevant data pertaining to their diagnosis and management was recorded. The data was analyzed and reported.Results: The data revealed that menorrhagia was the commonest complaint. The predominant age group was above 40 years, and had a normal radiological profile in most cases. The use of Palm-Coein system proved effective in determining the diagnosis as well setting a procedural mechanism for adequate management.Conclusions: Palm-Coein is an effective modality for diagnosing and managing AUB cases in a tertiary care set up and can be adopted as a standard practice

CHEWING GUM: CONFECTIONARY TO A POPULAR TRANSBUCCAL DOSAGE FORM

Chewing gum is a highly convenient and controlled release transbuccal drug delivery system taken without water. It is gaining popularity as a selfadministrable carrier for the medication used for motion sickness, smoke cessation, hypertension, xerostomia, dental caries, pain, as nutritive and energy supplements. Functional chewing gum favors both local and systemic effects intended to be chewed about half an hour. It has emerged out with a fast onset of action either by direct absorption or swallowed with saliva into gastrointestinal tract.It has better bioavailability that lowers the doses and reduces the gastric side-effects. Gums adhere with ease and compliance of administration to children and dysphagia patients. Chewing gums are formulated using a water-insoluble gum base with water-soluble excipients with the active ingredient in the case of medicated gums. European Pharmacopeia standards used for release studies, there are no other particular official standards. It has attracted the researchers as successful potential drug delivery system in coming future. The present article reviews it as novel drug delivery system including its merits and limitations, material and methods of formulation and evaluation