Effect of fenofibrate on acute and subacute inflammation in male Wistar rats

Background: The objective of the study was to investigate the effect of fenofibrate on acute and subacute models of inflammation in adult male Wistar rats.Methods: After obtaining clearance from Institutional Animal Ethics Committee, six adult male Wistar rats were allocated to each of the three groups i.e. control, aspirin and fenofibrate. Acute inflammation was studied using carrageenan induced rat paw oedema and the volume displacement due to paw oedema was measured using the plethysmograph. Subacute inflammation was studied using foreign body insertion (cotton pellet and grass pith) models. Dry granuloma weight and histopathological examination of the granuloma were the outcome measures for measuring subacute inflammation. The percentage inhibition of inflammation with aspirin and fenofibrate was calculated in both acute and subacute models. The experiments were conducted according to the guidelines of the Committee for the Purpose of Control and Supervision on Experiments on Animals (CPCSEA). The mean volume displacement obtained with a plethysmograph, the mean dry weight of granuloma and the percentage inhibition with aspirin and fenofibrate were analyzed by one way analysis of variance (ANOVA) using Graph pad prism software.Results: Aspirin and fenofibrate significantly reduced both acute and subacute inflammation (p<0.001). Dunnet’s test showed a significant difference in the study groups when compared to the control. The reduction of inflammation with fenofibrate was comparable to aspirin.Conclusions: Oral fenofibrate showed significant anti-inflammatory activity, which was comparable to aspirin, in both acute as well as sub-acute models of inflammation. This anti-inflammatory effect may benefit atherosclerosis in patients receiving fenofibrate for hyperlipidemia

Patterns and Outcomes of Polypharmacy and Effect of Potentially Inappropriate Medications in Elderly Patients undergoing Orthopaedic Surgeries: A Retrospective Observational Study

Introduction: Prescription of Potentially Inappropriate Medication (PIM) among elderly patients is becoming a global concern. There has been an increase in the number of elderly patients coming for operative procedures, especially in orthopaedic surgery, due to the association of advanced age with chronic musculoskeletal conditions, such as osteoarthritis, and an increased incidence of fragility fractures. Aim: To determine the prevalence of polypharmacy and PIMs among elderly patients undergoing orthopaedic surgery. Materials and Methods: A retrospective observational study was conducted from February 2022 to April 2022 in the Orthopaedic Department of Anaesthesiology, MOSC Medical College, Kolenchery, Ernakulam, Kerala, India. Hospital records of 130 patients aged 65 years and above, who underwent orthopaedic surgeries from January 2016 to December 2021, were included. The prescriptions during the perioperative period were analysed for polypharmacy, defined as the use of five or more drugs. The American Geriatric Society (AGS) 2019 Beers criteria were used to identify PIMs, drug interactions, and drugsyndrome interactions. Chi-square tests were performed on clinically significant variables to assess their effect on hospital stay, with a p-value of <0.05 considered significant. Results: Polypharmacy was highest on postoperative day 1, with 119 patients (91.5%) experiencing it. The study observed a high prevalence of PIMs, with 106 patients (81.53%) affected. The most commonly used PIMs were Pantoprazole, followed by Piroxicam, Regular human Insulin, and Glimepride. A significant association was observed between hospital stay ≥10 days, postoperative Intensive Care Unit (ICU) stay, and preoperative polypharmacy (p-value=0.002). Conclusion: Polypharmacy and PIMs in patients above 65 years of age admitted for surgeries remain major concerns. Further exploration of current pharmacologic practices in the perioperative period and interventions, such as physician education programs regarding PIMs, are needed