Priprava i karakterizacija čvrstih disperzija etorikoksiba s polietilenglikolom 4000 i polivinilpirolidonom K30

The objective of the present investigation was to study the influence of polyethylene glycol 4000 (PEG) and polyvinylpyrrolidone K30 (PVP) on in vitro dissolution of etoricoxib from solid dispersions. The preliminary studies were carried out using physical mixture of drug and carriers. The solid dispersions were prepared using the solvent evaporation method. A 32 factorial design was adopted in the solvent evaporation method using the concentration of PEG and PVP as independent variables. Full and reduced models were evolved for dependant variables, such as the percentage of drug release in 10 min (Q10), percentage of drug release in 30 min (Q30), percentage of drug release in 45 min (Q45) and percent dissolution efficiency (DE). The reduced models were validated using two check points. Q10 > 65%, Q30 > 75%, Q45 > 85% and DE > 80% were used as constraints for the selection of an optimized batch. Contour plots are presented for the selected dependant variables. PEG was found to be more effective in increasing the drug dissolution compared to PVP. Wettability study was carried out for pure drug and optimized batch. FT-IR spectroscopy, microscopic study, differential scanning calorimetry and X-ray diffraction study were carried out in order to characterize drug in the solid dispersions. Improved dissolution was attributed to decreased crystallinity of the drug, improved wetting and solubilizing effects of carriers such as PEG and PVP from the solid dispersion of etoricoxib. In conclusion, dissolution of etoricoxib can be modulated using appropriate levels of hydrophilic carriers.U radu je proučavan utjecaj polietilenglikola 4000 (PEG) i polivinilpirolidona K30 (PVP) na in vitro oslobađanje etorikoksiba iz čvrstih disperzija. Preliminarni pokusi provedeni su sa smjesom ljekovite tvari i polimernih nosača. Čvrste disperzije pripravljene su metodom uparavanja otapala. Za ovu metodu razvijen je 32 faktorijalni dizajn koristeći koncentraciju PEG i PVP kao nezavisne varijable. Za zavisne varijable razvijeni su potpuni i reducirani modeli, kao što su postotak oslobođene ljekovite tvari u 10 (Q10), 30 (Q30) ili 45 minuta (Q45) i postotak učinkovitosti oslobađanja (DE). Reducirani modeli su validirani pomoću dviju kontrolnih točaka. Q10 > 65%, Q30 > 80%, Q45 > 85% i DE > 80% su upotrebljeni kao ograničenja za izbor optimirane serije. Prikazane su konturne linije za pojedine zavisne varijable. Oslobađanje lijeka bilo je učinkovitije iz pripravaka s PEG-om. Vlaženje je proučavano za čistu ljekovitu supstanciju i omptimiranu seriju. Za karakterizaciju ljekovite tvari u čvrstim disperzijama korištene su FT-IR spektroskopija, mikroskopske studije, diferencijalna pretražna kalorimetrija i difrakcija rentgenskim zrakama. Povećano oslobađanje posljedica je smanjene kristaliničnosti ljekovite tvari, pojačanog vlaženja i solubilizacijskog učinka polimernih nosača u disperzijama. Može se zaključiti da se oslobađanje etorikoksiba može modulirati promjenom količine hidrofilnih nosača

Prescription audit of outpatients in tertiary care government hospital

Background: Prescription audit is a tool as well as a technique by its application,all professionals will improve the quality of prescribing drugs. Standards of medical treatment can be assessed by prescription audit. It is based on documented evidences to support diagnosis, treatment and justified utilization of hospital facilities. Prescription audit is a quality improvement process that seeks to improve patient care. In this background the present study was conducted. The objectives of the study were to know the frequently prescribed drugs in OPD, number of the drugs used per prescription and to find out the rationality.Methods: Study was conducted at Sri Chamarajendra Hospital, HIMS, Hassan in OPD of General Medicine.1000 prescriptions were collected and noted down the frequently used medication, number of drugs prescribed and their type of formulations for the particular diagnosis.Results: From the study it is noted that 1910 drugs out of 1000 prescriptions were prescribed which is approximately 1.91 drugs per prescription about 55% of the prescriptions contained single drug. Very few received 4-5 drugs (7%). Almost all the drugs in prescriptions were in Generic names. Around 95% of prescriptions doses were mentioned in mg, ml etc. The most commonly prescribed drugs in order are Antibiotics, antidiabetics antihypertensives, bronchodilators, steroids antiemetics and ORS were prescribed.Conclusions: Polypharmacy was not found in our prescriptions which indicates our prescriptions improved the patient conditions. This type of study will ensure to know the ‘P’ drug development and select the essential medicine list for various levels of health care

Priprava kompleksa etorikoksiba s β-ciklodekstrinom metodom gnječenja i njihova karakterizacija

The binary system of etoricoxib with β-cyclodextrin (β-CD) was prepared by the kneading method. Drug-cyclodextrin interactions in solution were investigated by the phase solubility analysis. Differential scanning calorimetry, infrared spectroscopy, powder X-ray diffractometry and microscopic study were used to characterize the solid state of all binary systems, whereas their dissolution properties were evaluated according to the USP XXIII paddle method. The results indicate partial interaction of the drug with β-CD in the physical mixture and complete interaction in the kneaded complex. The dissolution of etoricoxib was notably increased as compared to pure drug as well as its physical mixture. The complex showed more than 75% drug released in 30 min.Metodom gnječenja pripravljen je binarni sustav etorikoksiba s β-ciklodekstrinom (β-CD). Tijekom 30 minuta iz kompleksa se oslobodilo više od 75% ljekovite tvari, što je značajno više u odnosu na fizičku smjesu etorikoksiba i β-CD ili na čistu ljekovitu tvar. Interakcije lijeka i ciklodekstrina u otopini ispitivane su analizom fazne topljivosti. Za karakterizaciju čvrstog stanja svih binarnih sustava korišteni su diferencijalna pretražna kalorimetrija, infracrvena spektroskopija, difrakcija rentgenskih zraka na praškastom uzorku i mikroskopija. Oslobađanje je praćeno metodom lopatice prema USP XXIII. Rezultati ukazuju na djelomičnu interakciju ljekovite tvari s β-CD u fizičkoj smjesi i potpunu interakciju u kompleksu

Culturally Adapted Interventions in Mental Health: Global Position Statement

The preponderance of western psychological concepts are often relied upon to conceptualise health-related phenomena. It is hardly surprising therefore that despite the availability of a number of interventions, studies have concluded that outcomes for minority cultural groups are not as good as for Caucasian people (western Europe and North America) in many high and middle income countries (HMIC). The evidence base of most psychosocial interventions is yet to be established in Low and Middle Income Countries (LMICs). There has been a propensity in some quarters to view low and middle income countries as passive beneficiaries of mental health knowledge, rather than as contributors or partners in knowledge production and development. A move towards a more equal bilateral relationship is called for, which should lead to better service provision. This Position Statement aims to highlight the current position and need for culturally adapted interventions. It is a global call for action to achieve a standardised mechanism to achieve parity of access and outcomes across all cultural groups regardless of country of residence

Factors associated with polypharmacy in geriatrics

Background: In population with advancing age, the prevalence of medical co-morbid conditions is high and they are prone for complications. Hence the apprehension of using multiple drugs is more. Using more than 5 drugs per day is referred to as Polyphrmacy. Sometimes treatment causes more harm than the disease proper. So, optimizing drug therapy in these aging population is a challenging task for physician. Polypharmacy can also lead to increase in drug interactions, adverse drug reactions and medication errors. Hence the present study was taken up to study drug utilization pattern and factors leading to polypharmacy in geriatrics. The objectives of the study were to study the number and type of drug use and to know the different factors leading to polypharmacy.Methods: Cross sectional study was carried out among 60 geriatric persons ≥60 years of age present in old age home in Hassan. The study was done after taking the consent. All the prescriptions and medications being used along with history were collected and documented. The total number of drugs being used and names of all drugs were noted down and analysed. Results were analysed using descriptive statistics.Results: Among 60 geriatrics 38% males and 62% females age ranges from 60- 87 years. Average number of drugs used per day per person is 5.03 (Males 6.2 and Females 3.8) in 58.03% of individuals. Most common group of drug used is Gastro intestinal system (78.3%) and most common drug being used is Tab. Ranitidine 140mg (50%). Next group is NSAIDs (68.33%) and most common drug being used is Tab. Diclofenac (46.7%). Antihypertensive drugs were prescribed in 53.3% of geriatrics, most commonly prescribed drug is Tab. Amlodipine (5mg). Self medication was found in 100%. Most common group of drugs used as self medication are GIT drugs, supplements and NSAIDs. In supplements (used in 63.3%), Cap. B Complex is widely used (50%).Conclusions: Polypharmacy was found in 58.3% of individuals and highest in age group between 71-75 years and self medication was found to be the most important factor leading to polypharmacy. To counteract the problems associated with Polypharmacy, interventional studies are needed to improve the quality of life of geriatrics patients

A questionnaire based study on the knowledge, attitude, practice of staff nurses about pharmacovigilance in a tertiary care hospital

Background: Adverse drug reactions (ADR) - one of the global problems of major concern leading to morbidity and mortality. Spontaneous reporting of ADR is the cornerstone of Pharmacovigilance (PV) programme and it is important to reduce the risk of drug related harm to the patient. The active participation of healthcare professionals (Doctors, Nurses, Pharmacist) play a major role in the success of Pharmacovigilance. The objective of the study was to assess the knowledge, attitude, practice of Staff Nurses about Pharmacovigilance in a tertiary care hospital.Methods: A Cross sectional, Observational questionnaire based study was carried out using a pre designed KAP questionnaire. Study included 100 staff nurses who were working in Hassan institute of medical sciences (HIMS). The results were analyzed using descriptive statisticsResults: In our study 65% participants knows the correct definition and 48.8% knows the important purpose of Pharmacovigilance and 77.5% aware of existence of ADR reporting system in India. There was huge gap between ADR experienced (53.8%) and ADR reported (21.3%). The determinants of under reporting from our study include Lack of time / overburdened (33.7%) and lack of knowledge about ADR (31.25%).Conclusions: This study showed that majority of participants understand the need for reporting of ADR. In spite of that the reporting rate of ADRs by them is very low. Hence, there is a need to create awareness about the importance of reporting ADR by conducting many Pharmacovigilance programme

Experimental evaluation of analgesic activity of PPAR γ agonists: pioglitazone and rosiglitazone

Background: To evaluate analgesic activity of pioglitazone and rosiglitazone by tail flick method in rats and acetic acid induced writhing method in mice.Methods: Albino wistar rats of either sex weighing 180-200 g and Swiss mice weighing 25-30 g were used. Study was conducted after approval from the Institutional Animal Ethics Committee. The tail flick method in rats described by D’Amour and Smith (1941) and acetic acid induced writhing in mice were used. The dose of pioglitazone and rosiglitazone were 20 mg/kg and 10 mg/kg respectively.Results: In tail flick method of analgesia, both, pioglitazone and rosiglitazone have analgesic activity which was statistically comparable to aspirin. In acetic acid induced writhing model of analgesia, the action of pioglitazone and rosiglitazone was significantly greater than the control group but it was less when compared to aspirin.Conclusions: Analgesic activity of pioglitazone and rosiglitazone was comparable to aspirin in tail flick model of analgesia in rats while it was significantly less when compared to tramadol. Analgesic activity of pioglitazone and rosiglitazone was significantly less than aspirin in acetic acid induced writhing method

Suicidal ideation and behaviour among community and health care seeking populations in five low- and middle-income countries: a cross-sectional study.

: Aims Suicidal behaviour is an under-reported and hidden cause of death in most low- and middle-income countries (LMIC) due to lack of national systematic reporting for cause-specific mortality, high levels of stigma and religious or cultural sanctions. The lack of information on non-fatal suicidal behaviour (ideation, plans and attempts) in LMIC is a major barrier to design and implementation of prevention strategies. This study aims to determine the prevalence of non-fatal suicidal behaviour within community- and health facility-based populations in LMIC. : Twelve-month prevalence of suicidal ideation, plans and attempts were established through community samples (n = 6689) and primary care attendees (n = 6470) from districts in Ethiopia, Uganda, South Africa, India and Nepal using the Composite International Diagnostic Interview suicidality module. Participants were also screened for depression and alcohol use disorder. : We found that one out of ten persons (10.3%) presenting at primary care facilities reported suicidal ideation within the past year, and 1 out of 45 (2.2%) reported attempting suicide in the same period. The range of suicidal ideation was 3.5-11.1% in community samples and 5.0-14.8% in health facility samples. A higher proportion of facility attendees reported suicidal ideation than community residents (10.3 and 8.1%, respectively). Adults in the South African facilities were most likely to endorse suicidal ideation (14.8%), planning (9.5%) and attempts (7.4%). Risk profiles associated with suicidal behaviour (i.e. being female, younger age, current mental disorders and lower educational and economic status) were highly consistent across countries. : The high prevalence of suicidal ideation in primary care points towards important opportunities to implement suicide risk reduction initiatives. Evidence-supported strategies including screening and treatment of depression in primary care can be implemented through the World Health Organization's mental health Global Action Programme suicide prevention and depression treatment guidelines. Suicidal ideation and behaviours in the community sample will require detection strategies to identify at risks persons not presenting to health facilities.<br/