Antinociceptive effects of purified Curcuma longa in mice

Background: Since ancient times Curcuma longa is said to have antinociceptive effects in literature.Methods: It was a quantitative experimental study done in the laboratory setting of the department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Medical Sciences, Dharan, Nepal (BPKIHS). Hot plate test, Tail flick test and Writhing test were used for evaluating the antinociceptive effects. Animals were divided into five groups of six each, group I as control, group II as standard control whereas groups III, IV and V as test groups (three doses). Control and the three test drug doses were given for 21 days. Data were presented as mean ±Standard Error of Mean. Statistical differences between the test drug and control groups as well as within the test drug groups were calculated using Mann-Whitney U test. A probability level less than 0.05 (p < 0.05) was considered significant.Results: Significant effects in comparison to vehicle were observed in all the three anti nociceptive test models at 200mg /kg test dose of aqueous extract of purified Curcuma longa (CL). No significant effect as compared to vehicle was observed at 50mg/kg and 100 mg/kg test doses of CL.Conclusions: This study showed that CL possesses antinociceptive effect. The mechanism(s) and active principle(s) behind the effects of CL could not be established

Comparative bioavailability study of phenytoin in healthy Nepalese volunteers

Our study aimed to assess and compare the bioavailability of Eptoin 100 mg and Epileptin 100mg tablets in Nepalese healthy volunteers. A randomized, two-treatment cross-over study with two weeks’ wash-out period was conducted in 12 healthy non-smoker and non-alcoholic Nepalese male volunteers over a period of 6 months in the department of Clinical Pharmacology and Therapeutic at B. P. Koirala Institute of Health Sciences, Dharan, Nepal after approval from the Institutional Review Committee. The participants were randomized using sealed envelope system and received a single 100 mg oral tablet of either of the formulations with a two week washout period. Blood samples were collected predose and at regular intervals postdose upto 72 hours. Plasma phenytoin levels were estimated by reverse phase high performance liquid chromatography. The analytical method was validated prior to the start of study. Cmax (Peak Plasma Concentration), Tmax (Time to achieve maximum Plasma Concentration), AUC0-72 (Area under plasma concentration time curve 0 to 72 hours), AUC0-∞ (Area under plasma concentration time curve 0 to ∞) and T½ (Elimination half-life) and Kel (Elimination rate constant) were calculated and 80-120% margin (90% confidence interval) was used to assess bioequivalence. ANOVA test was used to analyze the data at P-value of 0.05. All volunteers completed the study. The log-transformed values of Cmax, Tmax, AUC0-t, and AUC0-∞ of the both formulations were within the specified limits and were bioequivalent according to the regulatory definition of bioequivalence based on the rate and extent of absorption. Both products can be considered equally effective in medical practice. Keywords: Bioavailability, Bioequivalence, healthy volunteer, Nepal, phenytoin sodium

KNOWLEDGE, ATTITUDE AND PRACTICES ON ANTIBIOTIC USE AND RESISTANCE AMONG DOCTORS IN B.P. KOIRALA INSTITUTE OF HEALTH SCIENCES

Background: Assessment of knowledge, attitudes and practices (KAP) of antibiotic prescription among doctors may help in developing guidelines to improve antibiotics use and decrease resistance. Aims and objectives: Our aim was to evaluate KAP regarding antibiotic use and its resistance among doctors. Materials and Methods: A cross sectional, questionnaire based study was conducted among the doctors of B.P. Koirala Institute of Health Sciences, Dharan, Nepal between January-March 2016 and their KAP regarding antibiotic use and resistance was assessed by using a five point Likert scale. The data were analyzed by calculating percentage and frequency. Results: Almost half of the doctors (50.2%) used to prescribe antibiotics more than once daily. Nearly two thirds of the doctors (65.3%) received antibiotic education at a formal lecture on ward rounds. Most of the doctors (87.4%) agreed that antimicrobials are overused. One hundred thirty four doctors (42.3%) agreed that patients’ demands for antibiotics contribute to its overuse. Nearly two third doctors (70.7%) believed that locally developed antimicrobial guidelines would be more useful. Most of the respondents (89.9%) wanted more ongoing education on antibiotic use and its resistance. Conclusions: Our study reveals that antibiotics are overused and patients’ demand contribute to this. Locally developed antimicrobial guidelines would be more useful. More CME on antibiotic use and its resistance should be conducted to enhance the awareness among doctors. Keywords: Antibiotics; Attitude; Antimicrobial drug resistance; Knowledge

Prescription pattern in ischemic heart disease inpatients at B. P. Koirala Institute of Health Sciences: a cross sectional study

Background: Drug utilization pattern studies seek to screen, evaluate and suggest appropriate modifications in prescription practices. It would help to make patient care rational and cost effective. Objective was to analyze the drug prescribing pattern for treatment of ischemic heart disease (IHD). Methods: A prospective cross-sectional observational study was conducted in patients of IHD admitted in intensive coronary care unit and medicine ward for the period of six months. Data were collected in preformed case record form. The data were analyzed for drug use indicators, demographic parameters, morbidities, pattern of drug use using Microsoft excel 2010. Results: A total of 145 patients were enrolled out of that 89 (61.38%) were males. The mean age was 60.01±12.71 years and majority (26.89%) belonged to age group of 61-70 years. A total of 1208 drugs were prescribed in 145 patients. Most frequently prescribed drugs were antiplatelet group of drugs 100% encounters, followed by hypo-lipidemics (98.62%). Average number of drugs per encounter was 8.33 and percentage of drugs prescribed by generic name was 5.04%.  Conclusions: IHD was more common in males than females. The most commonly prescribed drug classes were anti-platelet drugs followed by hypolipidemic agents

Antinociceptive effects of purified Curcuma longa in mice

Background: Since ancient times Curcuma longa is said to have antinociceptive effects in literature.Methods: It was a quantitative experimental study done in the laboratory setting of the department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Medical Sciences, Dharan, Nepal (BPKIHS). Hot plate test, Tail flick test and Writhing test were used for evaluating the antinociceptive effects. Animals were divided into five groups of six each, group I as control, group II as standard control whereas groups III, IV and V as test groups (three doses). Control and the three test drug doses were given for 21 days. Data were presented as mean ±Standard Error of Mean. Statistical differences between the test drug and control groups as well as within the test drug groups were calculated using Mann-Whitney U test. A probability level less than 0.05 (p &lt; 0.05) was considered significant.Results: Significant effects in comparison to vehicle were observed in all the three anti nociceptive test models at 200mg /kg test dose of aqueous extract of purified Curcuma longa (CL). No significant effect as compared to vehicle was observed at 50mg/kg and 100 mg/kg test doses of CL.Conclusions: This study showed that CL possesses antinociceptive effect. The mechanism(s) and active principle(s) behind the effects of CL could not be established

Effect of root-extracts of Ficus benghalensis (Banyan) in pain in animal models

Introduction: According to the WHO, 70–80% population in developing countries still relies on nonconventional medicine mainly of herbal origin. Even in developed countries, use of herbal medicine is growing each year. Pain is an unpleasant feeling often caused by intense or damaging stimuli. Traditionally, different plant parts of Ficus benghalensis are claimed to have several analgesic properties. Few scientific evidences support these uses. Interestingly, still others contradict these uses. It was shocking to find very scarce scientific studies trying to solve the mystery. Materials and Methods: It was a quantitative experimental study in Swiss albino mice of either sex. Sample size was calculated using free sample size calculating software G*Power version 3.1.9.2. Hot-plate test and tail-flick test were central antinociceptive paradigms. Writhing test was peripheral model for pain. Test drugs were aqueous root extracts of F. benghalensis at 100 mg/kg and 200 mg/kg mouse weight prepared by Soxhlet method. Suitable negative and positive controls were used. The experimental results were represented as mean ±standard deviation statistical level of significance was set at P < 0.05. For calculation, parametric test - one-way analysis of variance (ANOVA) or nonparametric test - Mann–Whitney U-test was appropriately used. Results: Hot-plate reaction time at 100 mg/kg (13.64 ±1.30 s) and 200 mg/kg (10.32 ±2.23 s) were nonsignificant (P = 0.425 and P = 0.498, respectively) compared to negative control (11.87 ±1.92 s). One-way ANOVA revealed nonsignificant (P = 0.178) between-group comparison in mean tail-flick reaction time. Test drug at 200 mg/kg produced statistically significant more writhing (36.00 ±14.85 in 10 min) than negative control, normal saline (11.83 ±12.43 in 10 min) or the positive control, Indomethacin (3.50 ±5.21 in 10 min), P value being 0.031 and 0.003, respectively. Conclusion: Aqueous root extracts of F. benghalensis at 200 mg/kg produces statistically significant writhing