Cost variation analysis of various brands of anti-epileptic drugs currently available in Indian pharmaceutical market

Background: Epilepsy is a common neurological disorder affecting about 10 million persons in India. The compliance to a particular antiepileptic drug is highly dependent on the cost of the drug which directly translates into success or failure of therapy. Hence there is a need for all clinicians to keep themselves updated with the latest prices and price variation of the commonly prescribed drugs. This study aims to analyze cost variation of various brands of anti-epileptic drugs currently available in Indian pharmaceutical market.Methods: Current Index of Medical Specialities July-October 2016 edition was referred to know the maximum and minimum price in INR of various brands of anti- epileptic drugs in India. Further analysis was done by using Percentage Cost Variation.Results: There is wide variation in the prices of different brands of same antiepileptic agents in Indian market. The highest % cost variation was found for diazepam 5mg tablet (374.42), followed by lorazepam 2mg tablet (213.63), carbamazepine 100mg syrup/5ml-100ml (172.58), levetiracetam 1000mg FC-tablet (168.57), lamotrigine 25mg DIS- tablet (150), clobazam 10mg tablet (147.37), clonazepam 0.5mg tablet (145.90), oxcarbazepine 150mg tablet (89.46), gabapentin 300mg capsule (71.67), valproic acid 200mg FC-tablet (58.62), divalproex sodium 500mg ER-tablet (47.82), topiramate 50mg tablet (41.66) and lowest % cost variation was of phenytoin sodium 300mg tablet (0.23).Conclusions: The average percentage price variation of different brands of same oral anti-epileptic drug in Indian market is very wide. To counter act such cost variation, physicians should be encouraged to prescribe a medication brand with low cost. This in turn reduces the unnecessary economic burden to the patients

Complementary and alternative medicine: practice and perspective of allopathic doctors at a tertiary care hospital

Background: Complementary and alternative medicine (CAM) has been defined as a group of diverse healthcare systems, not considered to be a part of conventional (allopathic) medicine. Approximately 80% of general population use traditional medicines (WHO). Thus, patients using CAM and its associated adverse effects may be encountered in practice of modern medicine. Hence it is necessary to assess the knowledge, attitude and practices of CAM among health care professionals (HCPs).Methods: After obtaining IEC approval, the cross-sectional study was conducted in doctors at Bangalore Medical College and its attached hospitals. 200 doctors who gave informed consent were included in the study.Results: 61.5% of the HCPs were aware that CAM includes AYUSH. 53% of the HCPs used CAM for self, especially for respiratory disorders (28.3%) and chronic painful conditions (21.6%). The common adverse effects attributed to use of CAM among patients which required consultation of the HCPs were hepatic (42.5%) and renal impairment (32.5%), allergy (10%), relapse (10%), and metal intoxication (5%). 71% didn’t prefer suggesting CAM for patients. 70% opined that CAM therapies be subjected to clinical trials.Conclusions: HCPs had used CAM therapy for self at least once especially for respiratory disorders and chronic painful conditions. However majority of the HCPs didn’t prefer suggesting CAM to patients and as many as 70% of the HCPs  insisted that CAM therapies be subjected to scientific evaluation including clinical trials in view of patient safety before integrating them with conventional medicine

Efficacy of hydroxychloroquine as a potential antidiabetic drug

Background: India is the world’s diabetic capital. Oral antidiabetic therapy is still incomplete. Prior studies have shown that hydroxychloroquine (HCQ), a commonly used antimalarial, anti-rheumatic drug reduces the risk of developing diabetes mellitus. It probably acts by decreasing insulin metabolism- a novel mechanism of action.Methods: A systematic search was done in MEDLINE database with key words ‘Type 2 Diabetes Mellitus’, ‘Hydroxychloroquine’. Articles assessing the antidiabetic efficacy of hydroxychloroquine were reviewed and their results summarized.Results: With extensive literature search, we found out three RCTs and four Cohort studies assessing the efficacy of HCQ on glycaemic markers in patients with type 2 diabetes mellitus. Two randomized controlled trials done by Gerstein H C et al, Pareek A et al, comparing hydroxychloroquine with established antidiabetic drugs showed that there is significant reduction in glycaemic parameters with comparable similarity in both the groups (HbA1c: -0.91%±0.4%). Solomon et al in their study on patients with RA concluded that HCQ improved insulin sensitivity. Two cohort studies by Chen Y M et al and Wasko MCM et al respectively showed reduced incidence of diabetes mellitus in Systemic lupus erythematosus (Hazard ratio=0.26) and rheumatologic disease (relative risk=0.23) patients who received hydroxychloroquine. In a cohort study by Rekedal LR et al, HCQ reduced HbA1c by 0.66% compared to baseline in patients with RA. These studies also showed that hydroxychloroquine has favourable effect on lipid profile and good tolerabilityConclusions: Hydroxychloroquine has a potential to enter antidiabetic armamentarium due to its efficacy and low toxicity profile. More studies are required to confirm this

Parents’ knowledge, attitude, and practice on childhood immunization

Background: The objective of present study was to determine the knowledge, attitude, and practices of parents regarding childhood immunization.Methods: A cross-sectional survey was conducted in immunization clinic at Vanivilas hospital, a government tertiary care center (G) attached to Bangalore Medical College and Research Institute and a private pediatric clinic (P) in Bengaluru. Data were collected from 200 parents/guardians (100 from each set up) using structured questionnaire administered by the investigators.Results: Out of 200 parents surveyed, 172 (86%) children were found to be fully immunized. The sickness of child was the most common cause (67%) for missing vaccination. A statistically significant proportion of boys (95%) were completely immunized as compared to girls (84%, p<0.01). Most of them knew that vaccination prevented some communicable diseases but were unaware as to which diseases they prevented and that the immunity is not life-long. Knowledge (p<0.004) and practice (p<0.001) of parents opting for optional vaccines were significantly higher in private setting compared to the government setting. All mothers opined that compliance to immunization schedule is important, had recommended vaccination to others and maintained a vaccination card. Gender of the child, birth order, mothers’ educational status, monthly income of parents and religion significantly affected the vaccination status while mother’s employment did not influence it.Conclusion: Although childhood immunization practices and attitudes are satisfactory, majority do not have specific knowledge on vaccines and the duration of protection they offer. Socio-demographic factors had a significant influence on the immunization status. Hence, efforts should be focused on improving them also besides educating them about vaccines to improve their knowledge

Dual-band Bisected Psi Antenna for 3G, Wi-Fi, WLAN and Wi-MAX Applications, Journal of Telecommunications and Information Technology, 2020, nr 1

This paper presents an inexpensive and simple dual-band bisected psi antenna for 3G, Wi-Fi, WLAN, and WiMAX applications is presented. The antenna comprises a bisected psi-shaped patch on a low-price FR4 substrate with a cropped ground plane on the other side, and is fed by a 50 Ω microstrip line. It operates at two distinct frequency bands of 1.87–2.76 GHz and 5.16–5.75 GHz with |S11|≤ -10 d

DEVELOPMENT OF OSMOTICALLY CONTROLLED ORAL DRUG DELIVERY SYSTEM FOR NATEGLINIDE AN ANTI-DIABETIC DRUG

Objective: The purpose of the present study was to develop an oral push-pull osmotic drug delivery system for the drug Nateglinide which is a bio pharmaceutics classification system (BCS) class II drug. Methods: The tablets were prepared by the wet granulation method using ingredients microcrystalline cellulose (Adsorbent), potassium chloride (Osmotic agent), poly ethylene glycol (4000 and 6000) (Hydrophilic polymer, Plasticizer), starch (Disintegrant), and aerosil. The granules were compacted by double compression method and were coated with eudragit by dipping method. Different batches were prepared to study the effect of the various ingredients and their effect on the release of the drug from the system by varying the concentrations of the ingredients in each batch. Dissolution was assessed using USP dissolution apparatus 2 in phosphate buffer pH 6.8 for 12 h. Results: Certain key findings observed includes a decrease in micro crystalline cellulose content reduced the release of the drug due to the reduction of the hydrophilic content in the tablet which complements the uptake of water from the surroundings, and increase in the ethylene glycol leads to decrease in the release which resulted due to excess swelling and increase in the osmotic agent concentration lead to satisfactory release of the drug and followed zero-order release. Conclusion: To conclude, the push-pull osmotic tablet of Nateglinide was able to deliver the drug in a controlled pattern for a prolonged period of time. This type of formulation can be used in conditions like hyperglycemia where the patient compliance can improve by reducing the dosing frequency and the plasma drug levels can be maintained, the total drug load is also reduced so that the dose related side-effects are also reduced. Keywords: Controlled release, Push-pull osmotic pump, Nateglinid

ASSESSMENT OF PHARMACEUTICAL CARE SERVICES ON HEALTH RELATED QOL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS – A PROSPECTIVE INTERVENTIONAL STUDY

Background: In the last three decades role of pharmacist has changed dramatically. Patient counselling by pharmacist deals with providing information to the patients regarding the disease, Medications and lifestyle modifications. Diabetes mellitus (DM) is a severe medical and social problem that affects patient's general wellbeing. Despite of the advances in understanding the disease and its management, the morbidity and mortality rate are in rise. Objective: To study the impact of pharmaceutical care services on quality of life in type 2 diabetes mellitus. To improve the knowledge, practice abd attitude, Quality of life of patients towards disease management. Methods: This is a prospective intervention study. It was carried out to determine the quality of life, based on which patients were counselled regarding disease, medication, nutrition, exercise, insulin, foot care, eye care, personal hygiene, self monitoring of glucose and self care. Out of 80 patients, who are having diabetes mellitus and given patient counseling again collected after 1st and 2nd month. The paired t-test in Graph Pad InStat was used for statistical calculation. Results: The overall KAP scores for diabetes patients between test of baseline and final follow up was statistically significant (P&lt; 0.001). The test group has shown increased medication adherence than control which shows the importance of patient counseling. Conclusion: The study concluded that pharmacist mediated patient counseling and the disease, medications and lifestyle modifications will improve the knowledge, attitude and practice, Quality of life and Glycemic control

A Technique to Screen for Resistance to Stem Rot caused by Sclerotium rolfsii in Groundnut under Greenhouse conditions

A technique was standardized to screen for resistance to stem rot (Sclerotium rolfsii Sacc.) in groundnut (Arachis hypogaea L.). The technique involved inoculation of 10 day old groundnut plants raised in pots by spreading mycelial propagules of 5. rolfsii grown on sorghum grain medium (SGM) on soil surface, and covering them with groundnut leaf debris collected form the field at the time of harvesting of the previous season's crop. Inoculated plants were placed in a greenhouse in which temperatures ranged between 16° C and 34°C. Pots were watered at 24 h intervals to ensure high soil moisture. Almost 100% stem rot was produced on a known susceptible cultivar Robut 33-1 within 10–12 days after inoculation. Stem rot developed at all plant growth stages (10 to 90 days), but disease development was slower in older (>40 day-old) plants than in younger plants. Time between inoculation and stem rot expression also increased with an increase in the age of plants. None of the 350 groundnut genotypes screened using the greenhouse technique showed resistance when the inoculated plants were incubated at 23–36° C but eleven of them showed less than 20% incidence at 16–31° C