A RANDOMIZED CONTROLLED TRIAL OF CURCUMIN AND DICLOFENAC COMBINATION IN KNEE OSTEOARTHRITIS

Objective: The objective of the study was to evaluate pain relief and safety of the combination of curcumin and diclofenac versus diclofenac alone in the treatment of knee osteoarthritis (OA). Methods: 140 patients of knee OA meeting inclusion criteria were randomized to receive either curcumin 500 mg with diclofenac 50 mg twice daily or diclofenac 50 mg tablet alone twice daily for 28 d. Patients were assessed at baseline, Day 14 and Day 28. Primary efficacy measure was severity of pain (Visual Analogue Scale) at day 14 and day 28. Safety after treatment was evaluated by recording side effects and laboratory investigations. Results: Patients receiving curcumin plus diclofenac showed significantly superior improvement in severity of pain at each study visit (p<0.001) when compared to diclofenac. Adverse effects were significantly less in curcumin plus diclofenac group (p<0.001). Conclusion: Combination of curcumin and diclofenac showed a significant improvement in pain on the basis of VAS when compared to diclofenac which may be due to synergistic effect between curcumin and diclofena

PHYTOCHEMICAL ANALYSIS OF PORTULACA OLERACEA AND PORTULACA QUADRIFIDA EXTRACTS USING GAS CHROMATOGRAPHY–MASS SPECTROMETRY

Objective: The two plant species Portulaca oleracea and Portulaca quadrifida are commonly known as purslane and chickweed, respectively. They are typically consumed as salad or pickle. Traditional systems of medicine from Africa and China have described these plants belonging to family Portulacaceae as remedies against a host of diseases. Recent pharmacological investigations have revealed the importance of these plants as sources of antioxidants, essential fatty acids, and even antimicrobial agents. The objective of this study was phytochemical analysis and comparison of ethanolic extracts of these two species of Portulaca.Methods: The ethanolic extracts of both the species were prepared using Soxhlet extraction and were analyzed using gas chromatography coupled with mass spectrometry (GC–MS). Furthermore, the ethanolic extracts of fresh and dried whole plant of P. oleracea and seed of P. oleracea were studied.Results: The phytochemical constituents of ethanolic extracts of P. oleracea and P. quarifida were found to be quite different from one another and contained beneficial polyunsaturated fatty acids, alkaloids among other beneficial chemical species.Conclusion: The results of the study could be further used by researchers to assess the beneficial properties of both these species for in vitro and in vivo experiments

EFFECT OF MURRAYA KOENIGII LEAVES EXTRACT ON GLUCONEOGENESIS AND GLYCOGENOLYSIS IN ISOLATED RAT HEPATOCYTES CULTURE

Objectives: The present study was aimed to investigate the in vitro activity of Murraya koenigii extracts through various carbohydrate metabolic pathways in the isolated rat hepatocyte models.Methods: Different doses of metformin, aqueous and methanol extracts of M. koenigii leaves were evaluated in the MTT, glucose, and glycogen content assays in the cultured in vitro rat hepatocytes.Results: The study showed that there was a significant increase in activity with respect to the increased concentration of extracts. Slight effect was observed in the isolated rat hepatocytes culture, M. koenigii leaves extract may exert cytoprotective and hypoglycemic action.Conclusion: It may be needed to determine the effect of ex vivo rat hepatocytes isolated from diabetic rats. Effects of the plant or isolated compounds on the genes expression of signaling pathways should be investigated in further studies

ANTIUROLITHIC ACTIVITY OF AQUEOUS EXTRACT OF ROOTS OF CISSAMPELOS PAREIRA IN ALBINO RATS

                                                        ABSTRACT Objective:      To evaluate the antiurolithic activity of aqueous extract of roots of Cissampelos pareira (AQERCP) in 2% Ammonium chloride (AC) and 0.75% Ethylene glycol (EG) induced urolithiasis in albino rats. Methods :  Urolithiasis was induced in rats by supplying drinking water mixed with 2 % (AC) and 0.75 % (EG) for 10 days. Calculi were confirmed by the high urinary levels of calcium, uric acid and low levels of magnesium and high levels of serum creatinine and calcium. The animals were treated with 03 doses of AQERCP i.e., 100 mg/kg, 200 mg/kg, 400 mg/kg respectively orally in different groups of rats once daily for 10 days along with 2 % (AC) and 0.75% (EG) mixed drinking water. On 11th day 3 rats from each group were kept in one metabolic cage and urine (pooled) collected for 24 h was subjected for estimation of various biochemical parameters. Blood was collected on the same day and analysed for various parameters. Kidneys were observed for the histopathological changes.Results: Rats treated with 03 doses of AQERCP significantly (P≤ 0.05) reduced urinary calcium, uric acid and increased urinary magnesium levels, reduced serum calcium, creatinine and increased serum magnesium. Histopathology of kidneys in groups treated with AQERCP at 200 mg/kg and 400 mg/kg doses revealed less tissue damage and the cytology of nephrotic tissue was almost similar to the control Group I rats.Conclusion :              Results showed AQERCP has shown significant antiurolithic effect against chemical induced urolithiasis in rats.Keywords :  C.pareira,  Roots extracts, Antiurolithic activity, Ammonium chloride, Ethylene glycol .                                                     Â

STUDY OF FIXED DOSE COMBINATIONS IN A TERTIARY CARE HOSPITAL

ABSTRACTObjective: To study and analyze the pattern of fixed dose combinations (FDCs) in medicine outpatient clinic.Methods: The study is prospective cross-sectional study was conducted for 2 months in medicine outpatient clinic in tertiary care hospital. Aftertaking approval from Institutional Ethics Committee, the data were collected on every working day of the hospital. Prescriptions from the patientscoming to medicine outpatient clinic outpatient department were taken and required information is filled in data record form.Results: A total of 83 prescriptions were included in the study. Out of 287 drugs, 111, i.e., 39.92% were fixed dose formulations. As per drug categoryanalysis, nutritional supplements were used (47.74%). While 27.02% and 9.03% of FDCs were given for cardiovascular complains and respiratorycomplains, respectively. FDCs used for other conditions were 16.21%. About 29.72% of total FDCs are included in approved list of FDCs by DrugsController General of India (DCGI), November 2014.Conclusion: 39.92% drugs are FDCs out of total prescribed drugs. Nutritional supplements are prescribed in higher concentrations. Out of total FDCsonly 29.72% were included in DCGI approved list of FDCs and only four FDCs are found in the WHO list of essential drugs.Keywords: Fixed dose combinations, Prescriptions, Approved, Drugs Controller General of India

Diuretic activity of aqueous extract of roots of Cissampelos pareira in albino rats

Background: Diuretic compounds that stimulate the excretion of water with small traceable ions are potentially useful in most of disorders including those exhibiting edema such as congestive heart failure, nephritis, toxemia of pregnancy, premenstrual tension, and hypertension. The aim was to evaluate the diuretic activity of aqueous extract of roots of Cissampelos pareira (AQERCP) by Lipschitz method in albino rats.Methods: Five groups of Albino rats were used to evaluate the diuretic activity of AQERCP by using metabolic cages. The Group I serves as normal control received vehicle (carboxymethyl cellulose 2% in normal saline), the Group II furosemide (10 mg/Kg, p.o) in vehicle; other Groups III, IV, and V were treated with low (100 mg/kg), medium (200 mg/kg), and high (400 mg/kg) doses of AQERCP in vehicle. Immediately, after the extract treatment all the rats were hydrated with saline (15 ml/kg, p.o) and placed in the metabolic cages (3/cage), specially designed to separate urine and faeces, kept at 21°C±0.5°C.The total volume of urine collected was measured at the end of 5th hr. During this period, no food and water was made available to animals. Various parameters such as total urine volume and concentration of sodium, potassium, chloride ions in the urine were measured and estimated respectively.Results: In this model, when compared to vehicle treated control group the AQERCP at different dose levels (100, 200 and 400 mg/kg) has significantly increased the urine volume and also enhanced the elimination of sodium, potassium and chloride ions in urine.Conclusion: The results showed that single dose administration of AQERCP as 100, 200 and 400 mg/Kg and standard frusemide (10 mg/kg b.wt) has significantly (p<0.05*, p<0.01**, p<0.001***) increased the urine output along with an increase in concentration of sodium, potassium, and chloride. AQERCP 400 mg/Kg produced a greater diuretic activity, which is comparable to the effect of standard furosemide (10 mg/kg).The present study has supported and justified the basis for folklore use of roots of C. pareira as a diuretic agent

Effects of angiotensin converting enzyme inhibitor: ramipril on different biochemical parameters in essential hypertensive patients

Background: Hypertension is a major risk factor for macrovascular diseases. The beneficial effects of lowering blood pressure on the vascular morbidity and mortality are well documented and demonstrated. The beneficial effects of antihypertensive agents on cardiovascular system can be counter-balanced by the induction of metabolic disorders. The modifications in various metabolic parameters (like lipids, serum electrolytes, uric acid, blood glucose levels, etc) are responsible for different adverse drug reactions of antihypertensive drugs. It might also have potential to produce secondary morbidities after long term use. The present study was designed to evaluate the effect of the commonly used first line antihypertensive drugs on these different biochemical parameters. Recent comparative studies suggest that, for the prevention of cardiovascular events, angiotensin converting enzyme inhibitor (ACEI) may be superior to alternative antihypertensive agents, independently of their antihypertensive effect and also claimed to have neutral or favourable effects on carbohydrate metabolism, lipid profile, uric acid. The metabolic abnormalities can be improved by ACEI. Therefore, this study was conducted to evaluate the effects of ramipril on different biochemical parameters in essential hypertensive patients. Objective was to study effects of six months monodrug therapy with ramipril on different biochemical parameters in essential hypertensive patients.Methods: 30 newly diagnosed patients of either gender with essential hypertension were included in the study. Patients having co-morbidities like diabetes mellitus, hyperlipidemia, gout, pregnant females were excluded from the study. Baseline readings of lipid profile, serum electrolytes, fasting blood sugar and uric acid were recorded before starting ramipril drug therapy. Same biochemical tests were repeated after six months ramipril monodrug treatment.Results: After comparing the means there is significant decrease in triglyceride levels, highly significant decrease in LDL, uric acid, sodium and fasting sugar level and highly significant increase in HDL levels.Conclusions: Ramipril has beneficial effects on RAS (Renin angiotensin system) and kinin system or both may contribute to the improvement in different biochemical parameters by ramipril

Pattern of antibiotic use in neonatal intensive care unit in tertiary care hospital in Southern India

Background: Repeated and prolonged courses of antibiotics exposure have resulted in an increase in the prevalence of hospital acquired infections and antibiotic resistant profile. The objective of this study was to quantify the use of antibiotics in a neonatal intensive care unit (NICU) from rural tertiary health care centre.Methods: A hospital based cross-sectional study was conducted in the NICU of tertiary care hospital located in western Maharashtra, India during the year 2011-12. A total of 237 neonates admitted to NICU from October 2011 to March 2012 were enrolled in the study according to inclusion criteria of the study. Demographic details, data on antibiotic prescriptions (name, dose, frequency, route of administration) were recorded by utilizing pre-tested structured proforma.Results: A total of 3822 prescriptions were received by the neonates and commonly prescribed antibiotics were amikacin (75.53%), cefotaxime (43.34%) and ampicillin (31.33%) respectively. It was also noted that 50% of the drugs prescribed were in compliance with the national list of essential medicines 2011. The max, 68.75% of antibiotics prescribed were in generics forms however, 12.5% were prescribed in the form of fixed dose combinations.Conclusions: The revealed that 3rd generation cephalosporins and amikacin are most commonly used antibiotics in NICU

A study of prescribing pattern of drugs in patients of cardiovascular emergencies at a tertiary care hospital of Western Maharashtra

Background: The main objective of drug utilization research is to assess the rationality of drug use. Recently it has been found that cardiovascular disease is the most frequent cause of morbidity and mortality throughout the world. The objective of present study was to focus on the trends in prescribing patterns of most frequently treated cardiovascular emergencies.Methods: A retrospective descriptive study was carried out in cardiovascular emergency patients. From the medical records the following data was collected:  Distribution of cardiovascular emergencies (age and sex wise), most common cardiovascular emergencies treated, outcome of each patient, average duration of stay in the hospital and drugs prescribed per patient,  correlation of clinical outcome with treatment if possible, drug utilization trend in cardiovascular emergencies. From the data, master chart was prepared for data analysis.Results: Total 82 patients case records were studied. Myocardial infarction (50%) was the most common cardiovascular emergency treated during study period followed by unstable angina (36.58%).  Male to female ratio was 1.83. Average hospital stay was found 5.75 days. The average number of drugs per patient was 8.4.  Hypertension (42.24%) and diabetes mellitus (19.51%) were the most common comorbidities found associated with cardiovascular emergencies. Aspirin clopidogrel combination (80.49%), enoxaparin (75.61%), atorvastatin (73.17%), glyceryl trinitrate (73.17%) were the most commonly prescribed drugs. The utilization rate of ACE inhibitors and ARBs (56.10%) was found higher than that of beta blockers (28.05%). Stool softeners (52.46%) and anxiolytics (28.58%) were the most commonly used non-cardiovascular drugs. Improvement was seen in 82.93% patients.Conclusions: Protocol of management strategy of cardiovascular emergencies in our tertiary care hospital was found near to standard recommended guidelines. Keywords:

ANTIMICROBIAL UTILIZATION PATTERN OF URINARY TRACT INFECTION IN TERTIARY CARE HOSPITAL

Objective: To study and analyze the pattern of antimicrobial utilization in urinary tract infection (UTI).Methods: A descriptive retrospective study was conducted in tertiary care hospital for 6 months including both male and female patients of all agegroups. Case sheets diagnosed with UTI based on ICD-10 disease coding were collected from medical records department. The demographic dataand prescription pattern of each case sheet were evaluated in detail. Drug utilization pattern was compared among different age groups of patients.Results: A total of 108 patients were included in the study, out of which 44.4% were males, and 55.6% were females. Most of the patients were in40-60 years age group (40.7%). UTI confirmed by culture in 59.26% patients; in which Escherichia coli was isolated in 35.9% patients followedby Klebsiella species (14.06%) and Pseudomonas aeruginosa (7.8%). Cephalosporins (70.37%) were most commonly used antibiotic followed byfluoroquinolones (38.89%), penicillins (29.63%), azithromycin (17.59%), and aminoglycosides (15.74%). Among the cephalosporins, third generationparenteral was most commonly used. In penicillins, amoxicillin + clavulanic acid combination was used in 9 patients. Amikacin was most commonlyused aminoglycoside followed by gentamicin. Mean duration of treatment was 6.28±3.02 days.Conclusion: Third generation cephalosporins (ceftriaxone and cefixime) were used as first line drug in most of the cases irrespective of the causativeorganism. This group should be reserved for complicated UTIs.Keywords: Urinary tract infections, Escherichia coli, Cephalosporins, Fluoroquinolones