A prospective study on the effect of topical lidocaine gel versus drops on ocular pain in manual small incision cataract surgery

Background: Cataract is globally acknowledged leading cause of blindness. This study was undertaken to compare the effects of Lidocaine 4% drops with 2% gel on intra operative and post-operative pain in patients who underwent manual small incision cataract surgery.Methods: It was a single Centre, one-surgeon, prospective, comparison study. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1 ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were ocular pain of patient during and after surgery.Results: A total of 60 patients underwent MSICS, out of which 30 each received drops and gel. Mean intraoperative pain VAS score was 2.26±0.69 for gel group and 5.13±1.13 for drops group (p*<0.001) Mean post-operative pain VAS score was 0.26±0.69 in gel group and 1.13±1.13 in drops group (p*=0.002).Conclusions: Compared to drops, Lidocaine gel has reduced intraoperative and post-operative pain

Study of anti-inflammatory activity of Ficus racemosa linn stem bark extract in albino rats

Background: Inflammation is part of the complex biological response of vascular tissues to harmful stimuli. Though there are standard anti-inflammatory drugs like aspirin, diclofenac, etc., these are not free of side effects. This has led to an increase in demand for natural products with anti-inflammatory activity having less side effects. Hence the study was conducted to evaluate the anti-inflammatory activity of ethanolic extract of Ficus racemose (EEFR) in albino rats.Methods: Healthy albino rats of either sex were divided into 4 groups of 6 animals each. Group1-control, group 2-diclofenac sodium 2 mg/kg and group 3 and 4 EEFR (200 and 400 mg/kg respectively), anti-inflammatory activity was evaluated by Carrageenan induced paw oedema: formalin induced-peritonitis and cotton pellet induced granuloma model for in vivo activity and protein denaturation test for in vitro activity.Results: EEFR exhibited significant in vitro (p<0.001) anti-inflammatory effect at the dose of 200 and 400 mg/kg. EEFR produced 61.37% inhibition at the dose of 400 mg/kg and diclofenac (standard drug) produced 62.95% of inhibition after 3 hours of drug treatment in carrageenan induced paw oedema. The exudate volume was decreased in formalin induced peritonitis by EEFR and diclofenac significantly (p<0.001). In cotton pellet induced granuloma EEFR (400 mg/kg) and diclofenac showed decreased formation of granuloma by 28.36% and 28.00% (p<0.001) respectively.Conclusions: EEFR has significant anti-inflammatory activity in both acute and chronic model in a dose dependant manner in comparison with standard drug

Assessment of adverse drug reactions to antituberculosis regimen in a tertiary care hospital

Background: Adverse drug reactions are common with multidrug therapy in tuberculosis, if detected early can improve patient compliance and prevent emergence of resistance.Methods: A prospective observational study as a part of Pharmacovigilance Program under Central Drugs Standard Control Organisation was conducted in Kasturba hospital, Manipal to collect adverse drug reactions (ADR). Data of patients reported with antitubercular treatment (ATT) related ADRs from September 2012 to August 2013 was evaluated for patient demography, type of tuberculosis, ATT regimen, organ/ system affected and time of onset of ADR. ADRs were then subjected to causality assessment as per WHO scale.Results: A total of 65 ADRs were reported in 60 patients during the study period, of which 46.7% were in males and 53.3% in females. 85% of ADRs were reported in patients with pulmonary tuberculosis. 77% of ADRs were observed with daily regimen. Common ADRs were hepatitis (40%), gastritis (15%), skin reactions (15%), peripheral neuropathy (14%), gout (6%) and nephritis (3%). Median duration for the onset of ADR was 31 days each for hepatitis, gout, nephritis and 20, 11, 9 days for gastritis, peripheral neuropathy and skin reactions respectively. As per causality assessment, 80% of ADRs were assigned “possible”, 11% “probable” and 9% “certain”. As per severity scale 27.7% of ADR were severe, 36.9% were moderate.Conclusions: Early detection and management of ADRs is vital for the success of ATT and patient adherence

A study on the effect of topical lidocaine gel versus drops on surgeon’s comfort during manual small incision cataract surgery

Background: Cataract is a frequent surgical procedure performed worldwide. The study compared lidocaine 4% drops with 2% gel on surgeon’s comfort, need for supplemental anaesthesia and duration of surgery in patients who underwent manual small incision cataract surgery.Methods: This was a Prospective, Comparison study conducted at a Single centre by multiple surgeons. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were surgeon’s comfort, need for supplemental anesthesia and duration of surgery.Results: The mean duration of surgery for gel was 20±8 minutes as compared to 29±6 minutes with drops (p*- value<0.001). 26 (87%) patients in gel did not require any supplemental anesthesia as compared to 3 (10%) patients in drops. Peribulbar supplementation was required for 20 (67%) patients in drops as compared to 1 (3%) patient in gel (p*- value<0.001). 26 (87%) patients in gel were operated comfortably by the surgeon as compared to 2 (6%) patients in drops. Mild to Moderate discomfort was experienced by the surgeon in operating 27 (90%) patients in drops as compared to 3(10%) patients in gel (p*- value<0.001).Conclusions: The surgeons were more comfortable using gel with least requirement of supplemental anaesthesia and faster completion compared to drops

Evaluation of anti-inflammatory activity of ethanolic extract of Derris brevipes (benth.) Baker leaves

Background: Ethnopharmacological relevance: Derris brevipes (benth.) Baker is widely used as an anti-arthritic agent in traditional medicine. Aims and Objectives: This study evaluated the anti-inflammatory activity of ethanolic extract of D. brevipes (EEDB) leaves, a member of the Leguminosae family in vitro and ex vivo. Materials and Methods: The EEDB leaves of was screened for anti-inflammatory activities by protein denaturation analysis and proteinase inhibition analysis. Prednisolone was used as the standard. EEDB (at doses of 300 mg/kg and 600 mg/kg) was administered through the oral route. Ex vivo analysis was performed by estimating the expression of tumor necrosis factor-alpha (TNF-α) in collagen (chicken sternal collagen)-induced arthritis (CIA) in Sprague–Dawley rats using the reverse transcription polymerase chain reaction method. The data were analyzed using one-way analysis of variance, followed by Dunnet’s multiple comparison tests. Results: Prednisolone (100 mcg/mL) and EEDB (600 mcg/mL) showed percentage inhibition of 80.32% and 80.04%, respectively, in protein denaturation assay. Similarly, prednisolone (600 mcg/mL) and EEDB (600 mcg/mL) showed 66.03% and 56.69% inhibition in the proteinase activity. Synovial tissue TNF-α levels showed a significant decrease in EEDB-treated groups and prednisolone-treated group compared to CIA control rats. Conclusion: From this study, it was concluded that the D. brevipes leaf extract possesses anti-inflammatory activity, which explains its beneficial role in rheumatoid arthritis

A prospective study on the effect of topical lidocaine gel versus drops on ocular pain in manual small incision cataract surgery

Background: Cataract is globally acknowledged leading cause of blindness. This study was undertaken to compare the effects of Lidocaine 4% drops with 2% gel on intra operative and post-operative pain in patients who underwent manual small incision cataract surgery.Methods: It was a single Centre, one-surgeon, prospective, comparison study. Patients enrolled for surgeries were divided into Group A: Lidocaine 4% drops 1 ml was instilled in the conjunctival sac 5 minutes before surgery and Group B: Lidocaine 2% gel 2ml was applied. Endpoints evaluated were ocular pain of patient during and after surgery.Results: A total of 60 patients underwent MSICS, out of which 30 each received drops and gel. Mean intraoperative pain VAS score was 2.26±0.69 for gel group and 5.13±1.13 for drops group (p*&lt;0.001) Mean post-operative pain VAS score was 0.26±0.69 in gel group and 1.13±1.13 in drops group (p*=0.002).Conclusions: Compared to drops, Lidocaine gel has reduced intraoperative and post-operative pain