Assessment of prescription writing skills among undergraduate medical students

Background: The existing medical undergraduate curriculum includes training in prescription writing in second phase under pharmacology and Therapeutics. This study evaluates the prescription writing skills of undergraduate medical students and interns and need for emphasis on prescription writing during various phases of learning process in medical undergraduates.Methods: After obtaining institutional ethics committee approval, we recruited 4th to 8th semester medical undergraduate students and interns into the study, who gave written informed consent. They were given a pilot-tested, pre-evaluated questionnaire addressing the issues of prescription writing. They were asked to prescribe for a common clinical scenario. Their prescriptions were analysed for various parameters as indicated in WHO guidelines.Results: Of the 350 medical undergraduate students and interns invited, 281 of them participated in the study. 169 participants (60.1%) agree that they have not written a formal prescription to any patient when the questionnaire was administered. 134 participants (47.6 %) feel that undergraduate training has not prepared them for prescribing properly. 90% of participants said reinforcing classes during 3rd, 4th year and during Compulsory Routine Rotatory Internship will be beneficial. Though 220 participants have opined that generic name should be used while prescribing, only 124 have actually used generic names in their prescriptions. Fifteen participants have failed to write the symbol while prescribing. All 121 interns in the study have used brand names while prescribing.Conclusions: There are widespread lacunae in prescription writing by medical undergraduates. There is perceived need for reinforcement sessions at third and final phase of undergraduate education to address this gap. Most participants opine that clinicians do not discuss this issue during case discussion. There is knowledge and practice gap in using generic names while prescribing

Formulation, Evaluation and Optimization of Amlodipine IP 5mg Film Coated Tablets

INTRODUCTION:Pharmaceutical products designed for oral delivery and currently available on the prescription and over the counter markets are mostly the immediate release type, which are designed for IR of drug for rapid absorption. Disintegrating agents are substance routinely included in tablet formulation to promote moisture penetration and dispersion of matrix of dosage form in dissolution fluids1. The oral route of drug administration is the most popular and successfully used for conventional delivery of drugs. It offers the advantages of convenience, ease of administration, greater flexibility in the dosage form design, ease of production, and low cost. The dosage form available for administrations are solutions, suspensions, powders, tablet and capsules. The physical state of most of being solids, they are administered in solid dosage form. The solid dosage forms provide best protection to drugs against temperature, light, oxygen and stress during transportation AIM OF STUDY:Developing a new formula for the Amlodipine tablet IP 5mg immediate release film coated tablets, by evaluation of trial formulations and invitro dissolution profile.OBJECTIVE OF STUDY:Carrying out literature survey of the drug molecule. Formulation of the tablets using different trials. Analyzing the trial samples. Optimizing the final formula.SUMMARY AND CONCLUSION:Totally 9 (n=9) formulations were prepared with Amlodipine granules ,prepared separately in a MCG mixer. Pre compression parameters like Bulk density , Tapped density ,Angle of repose indicate all formulation show good flow properties. Tablets are compressed using CADMACH compression machine and tablets are evaluated for post compression parameters like Weight variation,Hardness,Friability,Disintegration and Dissolution parameters. Formulation F1-F6 does not meet the criteria for hardness and disintegration time due to the improper mixing of lubricant,disintegrant and binder with dry mixture. Formulations F7-F9 has shown post compression within specified limits of the innovator.The release profile of the formulations F7-F9 was compared with innovator and all the formulations has shown a release of 70-95% and formulation F9(Amlodipine=7mg ,Starch=55mg ,Sodium starch glycolate=3mg,Magnesium Stearate=3mg,Lactose=26.4mg ,Talc=5mg ,Methyl paraben=0.5mg ,Propylparaben= 0.1mg ,Coloring material(sunset yellow)= 0.005mg ) has matched the innovator release profile.F9 has 96.87% Drug release. The compressed tablets packed in blisters and subjected to stability studies at 400C and 75% RH samples were analyzed at regular intervals as mentioned in stability protocol,and found that no significant changes observed in any of the studied parameters during the study period,thus it could be concluded that formulation F9 said to be stable. From the study, it may concluded that the Amlodipine IP 5mg film coated tablets can be prepared as immediate release formulations compared to conventional dosage forms

CYTOTOXICITY OF PUNARNAVA (BOERHAAVIA DIFFUSA L.) IN BREAST CELL LINE

The incidence of cancer especially breast cancer is increasing alarmingly worldwide with a high percentage of death especially in developing countries. The Ayurvedic system treasures a host of medicinal formulations that have been shown to possess cytotoxic effects on tumor cell lines. Recently herbal medicines are coming to play a more vital role in the reduction and prevention of cancer. Boerhaavia diffusa L. (Punarnava), an annual herb has been used for managing wide range of diseases including cancer. This herb was also screened for various pharmacological activities like anti-inflammatory, anti-oxidant, immunomodulatory, anti-angiogenic, anti-metastatic activities and others. The decoction of root of Boerhaavia diffusa L. (Punarnava) was not scientifically evaluated for cytotoxicity. So the current study investigates the In vitro Cytotoxicity of root of decoction of Punarnava (Boerhaavia diffusa L.) in breast cell line (MCF-7). The five different concentrations of decoction of Punarnava (Boerhaavia diffusa Linn.) were used for In vitro Cytotoxicity by MTT assay at 24 hours and 48 hours. The test sample exhibits cytotoxicity of about 65.1±1.2at 800 µg/ ml concentration (48 hours) of incubation in MCF-7 breast cell line. The results were also analyzed statistically. It showed that there is highly significant difference in the percentage of inhibition of test sample in concentration from 50µg/ml -800µg/ml. The findings of this investigation concluded that the study drug Boerhaavia diffusa L. (Punarnava) has anti-cancer activity in MCF-7 breast cell line

A Study to assess the effectiveness of Ragi Kanjii Versus Soya Milk in improving the nutritional status of malnourished pre-school children at Institute of Child Health and Hospital for Children, Chennai

A study to assess the effectiveness of ragi kanjii versus soya milk in improving the nutritional status of malnourished pre-school children at Institute of Child Health and Hospital for Children, Chennai. Worldwide, the most common cause of malnutrition is inadequate food intake. Severe acute malnutrition should be recognized as a medical emergency with one million children under five dying in India due to malnutrition related causes. Preschool aged children in developing countries are often at risk of malnutrition because of their dependence on others for food, increased protein and energy requirements, immature immune system causing a greater susceptibility to infection, and exposure to non-hygienic conditions. Need for the study: The effects of malnutrition are many, which make the child prone to other diseases. Thus proper supplementation and appropriate education to the mothers will definitely help in reducing the mortality and morbidity in children. Objectives : To evaluate the efficacy of ragi kanjii on the nutritional status of the pre-school malnourished children, to evaluate the efficacy of soya milk on the nutritional status of the pre-school malnourished children, to compare the efficacy of ragi kanjii over soya milk on the nutritional status of pre-school malnourished children and to associate efficacy of ragi kanjii and soya milk on nutritional status with the selected demographic variables. Methodology : Research Approach: Quantitative research approach. Research Design: Quasi experimental design

Drug package inserts: how accessible is the information?

Background: Information given in drug package inserts is often not easily accessible by patients and practitioners. Presentation of important information in an easily accessible manner fulfills the very purpose of inserts. In the present study, accessibility of important information in drug package inserts is evaluated.Methods: We evaluated 110 package inserts. Accessibility to important information was noted under following headings: use of box, use of special/bigger font or color, use of table of contents and information in front sheet. Each of these parameters was given a point. Cumulative accessibility score of more than three considered as accessible. Provision of toll free numbers and internet addresses of the companies noted.Results: Information in inserts regarding posology, method of administration, precautions under special conditions, contraindications, pharmacokinetics, interactions, pregnancy and lactation, driving, and machine use precautions were adequate and orderly in most. Only seven drug inserts mentioned important information with special font/different color. 18 drug inserts had used boxes. About 13 inserts used bigger font size for revealing important information. We observed a mean accessible score was 0.37 a insert. Only two inserts carried toll free numbers.Conclusion: Important information in drug package inserts is not easily accessible. Display of toll free numbers and internet addresses for queries and reporting adverse drug reactions is highly recommended

A study on malassezia micro flora in the skin of healthy individuals in North Kerala, India

Background: Malassezia spp are accounted for approximately 60-90% of the total cutaneous fungal micro biota. An enhanced understanding of the distribution of Malassezia spp in healthy individuals is necessary to gain insight to involvement of these species in human skin disorders particularly in pityriasis versicolor. The aim of this study was to assess the Malassezia micro flora of healthy individuals and to identify species variation with different body sites, gender and age groups.Methods: A total of 120 apparently healthy men and 120 women without any skin diseases or who were not treated for Malassezia associated skin diseases were selected for the study. The specimens consisted of scrapings collected from chest, back and neck from each control subject totaling 720 sites.Results: The recovery rate of Malassezia was positive in case of 452 (62.78%) of 720 sites sampled, while the remaining 268 (37.22%) were found to be negative. Recovery rate of Malassezia was highest in chest with 83.33% positive cases, followed by the back with 73.33% and the neck 31.67%. M. globosa was identified as the common species (46.46%) followed by M. furfur (25%) and M. restricta (22.56%). No significant difference was present (P > 0.05) in distribution of species with different body sites, gender and age groups.Conclusions: The overall colonization rate of Malassezia spp in normal healthy individuals found in this study was 62.78%. M. globosa was identified as the common species (46.46%)

A prospective comparative study of efficacy of lenalidomide plus dexamethasone combination therapy versus VAD (vincristine, doxorubicin and dexamethasone) regimen in the treatment of multiple myeloma

Background: Lenalidomide plus Dexamethasone (Len-Dex) and VAD (Vincristine, Doxorubicin and Dexamethasone) regimen are the two common drug therapies employed in the treatment of Multiple myeloma.Objectives: To compare the efficacy of Len-Dex versus VAD regimen based on complete remission achieved with treatment in newly diagnosed cases of multiple myeloma in a tertiary care hospital in Kerala.Methods: Eighty patients (forty in each group) of newly diagnosed cases of multiple myeloma, who were willing to give the informed consent, were included in the study. Patients were allocated by the treating physician to two groups; one group was given Len-Dex (lenalidomide + dexamethasone) regimen and the other VAD (Vincristine, Adriamycin, Dexamethasone) regimen. A total of six cycles were given for both groups. Their baseline investigations and follow up investigations were collected at regular intervals, based on these values, the outcome was classified as partial remission and complete remission and the results were compared and analyzed.Results: Among the forty patients in each group, 17 (38%) on VAD regimen and 28 (62%) on Len-Dex regimen achieved complete remission. The statistical analysis was done using chi square test (χ2= 6.13, df= 1, p= 0.01) which showed statistically significant difference.Conclusions: The study showed that the efficacy of Lenalidomide-Dexamethasone (Len-Dex) combination therapy is clearly higher than that of VAD regimen among the study population. The overall efficacy of Len-Dex combination is 70% and that of VAD regimen is only 42.5%

The incidence and risk factors for development of lower limb lymphedema after treatment for gynaecological cancers

Background: The development of postoperative lower limb lymphedema (LLL) is a disabling, yet usually overlooked sequele of most gynecological cancer treatment. It can lead to significant functional problems that negatively affect gynecological cancer survivors’ daily living, work, emotional state, and overall quality of life. The objective of this study is to calculate the incidence of lower limb lymphedema in patients undergoing surgery for gynecological cancer and to evaluate the risk factors for its development.Methods: Women with newly diagnosed carcinoma ovary, carcinoma endometrium and carcinoma cervix, who underwent surgery at a tertiary cancer centre from September 2016 were included in the study. The circumference of both lower limbs was measured at prefixed sites. The limb volume was calculated using the formula C2/pi. A baseline value was taken prior to surgery. The patients were followed up every 3 months and the limb volume were calculated at each visit. An increase in limb volume by >10% was defined as lymphedema.Results: The incidence of lymphedema after 1 year follow up was 43.5%. There was no significant association between known risk factors such as extent of lymphadenectomy (p value 0.633) number of pelvic or para aortic lymph nodes removed (p value 0.69 and 0.44 respectively) and type of adjuvant therapy (p value 0.455).Conclusions: The incidence of LLL according to the present study was 43.5%. There was no statistically significant association between development of LLL and risk factors like site and number of lymph nodes removed and type of adjuvant therapy

Tiger shark landed at Mookaiyur Fisheries Harbour, Tamil Nadu

A large sized male Tiger shark Galeocerdo cuvier measuring 288cm in total length (TL) and weighing 261 kg was landed at the Mookaiyur Fisheries Harbour on 22nd October 2020. The shark was caught in a tuna longliner of 22.7 m OAL fitted with 200 hp engine which had fished in the Arabian Sea, close to the Lakshadweep islands

First record of deformity in Chinese Pomfret, Pampus chinensis (Euphrasen, 1788) from Indian waters

The Chinese pomfret Pampus chinensis (Euphrasen, 1788) (Stromateidae) observed with deformity from fish landings at the Jegathapattinam fishing harbour along Palk Bay coast of Tamil Nadu. The abnormality owing to fractional dorsal fin may call as ‘saddleback syndrome’ and this may be due to any kind of physical injury during early stages or to a higher chance of predation and in due course, the wound healed and the individual survive even with extreme deformed condition. Such a deformity for this species of Pomfret has never been documented from Indian waters and this could be the first record in Pampus chinensis