Prospective observational study of drug utilization in neonatal seizure at a tertiary care hospital with Pharmacoeconomics

Background: Seizures are the most common indicator of significant neurologic dysfunction in neonatal period with incidence of 11.7/1000 live births. Phenobarbitone is used as first line of treatment since 1900s. Newer anti-epileptic drugs (AED) available are Levetiracetam, Topiramate etc. Present study focused on utilization pattern of AED, treatment outcomes and to study economic burden of disease.Methods: An observational study was done on 100 neonates admitted to Neonatal Intensive Care Unit in Basaveshwara hospital, Kalaburagi (June 2016-May 2017). Prescription data was entered into specially designed proforma, WHO core indicators were determined. The data was analyzed using descriptive statistics and presented as means and percentages.Results: Majority of neonates were male (58%) and 63% were diagnosed with subtle seizure. Out of 458 drugs prescribed, 201 were antiepileptics. 41% cases were successfully managed by monotherapy. Most commonly used drug was phenobarbitone (82%) and phenytoin (31%). Leviteracetam, newer AED was used in 3 refractory cases. The major combination of drugs used was Phenobarbitone-Phenytoin (24%). AED were rationally prescribed, but antibiotic was over-utilized(68%). 31% cases had adverse drug reaction. On average per prescription, number of drugs used were 4.6 and drug cost was Rs.3803/-. The total cost of illness per patient was Rs.16363/-.Conclusions: AED utilization in neonatal seizures was in accordance to guidelines, with phenobarbitone being extensively used despite its potential neurotoxicity. The utilization of newer AED would increase if clinicians are supported with the safety and efficacy data. Although monotherapy was preferred with respect to AED, antibiotics were highly prescribed; hence awareness is needed to curb this practice

MEDICINAL SIGNIFICANCE OF NOVEL COUMARINS: A REVIEW

Coumarone is a chemical compound found in many plants. Coumarone having diverse pharmacological properties popularly known as an antimicrobial, Analgesic anti-inflammatory, Anticancer, Antiviral, anticoagulant, antihypertensive, anticonvulsant, antihyperglycemic, antioxidant, activities. Coumarone was also observed in all green color veggies, and also in fruits and their seeds, dark coffee, tea leafs, further it is used for herbal remedies due to having less toxicity, very cheaper. The most useful method for the synthesis of Coumarone is from phenol and ethyl acetate and also by using catalyst. In this paper we tried to update the observations of authors towards the biological and medicinal significance of novel the natural and synthetic coumarone derivatives

Spermatogenic Inhibition Properties of a Phenolic Phytoestrogen Isolated from Momordica charantia (Bitter Guard) Seeds

Mechanisms and potencies of phytoestrogens are not completely clarified and they may be considered potential endocrine disruptors, and therefore caution should be exercised while taking them. Eating very high levels of some phytoestrogens may pose some health risks. Reproductive problems have been documented in laboratory animals, farm animals and wildlife that ate very high (up to 100% of their diet) amounts of phytoestrogen-rich plants. Sheep consuming large amounts of clover showed infertility and reproductive disorders. Cheetahs in captivity also had reduced fertility rates when consuming a feline diet composed of a soybean product, which was reversed when it was removed from the diet. Toxicities associated with herbal medicines that include phytoestrogens have also been reported in the literature. Phenolphthalein a phenolic phytoestrogen has been isolated from the crude ethanol extract of Momordica charantia Linn. seeds. After preparative HPLC whitish amorphous compound was obtained. Its structural elucidation using IR, NMR and Mass spectral data revealed that the molecule isolated from the ethanol extract of M. charantia seeds was surprisingly, phenolphthalein. In order to clarify testicular influence of ethanol extract, fractions and isolated phenolphthalein were treated for sixty days to adult male albino rats. All the treated groups showed statistically significant reduction in testis weight. On histological examinations of testis showed spermatogenic inhibition effect, as the number of spermatogonia, spermatocytes, spermatids and spermatozoa were significantly decreased

Recent medicinal approaches of novel pyrimidine analogs: A review

Pyrimidine derivatives attract researchers due to their versatile scaffold & their medicinal significance. Pyrimidine associated analogs are majorly contributed to the field of medicinal chemistry. In this review article, the recent new structural design and development of active agent studies and biological approaches are highlighted. In addition, the biological potency and the structure-activity relationship of pyrimidines such as antimicrobial, anticancer, anti-inflammatory, analgesic, anti-diabetic, anti-HIV, anthelmintic, CNS depressants, and cardiac agents are discussed. Finally, this review article may attract the researchers for new structural design and development of novel active pyrimidine scaffolds with more active and less harmful

Evaluation of Ovulation Inhibition Properties of a Phytoestrogen Isolated from Momordica charantia Linn. Seeds

Background and objectives: Momordica charantia Linn. has been used as a dietary / medicinal supplement for health care. The plant has a long history in worldwide people for the usage of vaginal discharge, to promote menstruation and to induce abortions. However, the mechanism of action for its ovulation inhibition effects is not clearly known. Therefore, the present study was carried out to evaluate the ovulation inhibition properties of phytoestrogenic molecule isolated from M. charantia seeds in albino rats as an experimental model. Methods: Ovulation inhibition properties of fractions of ethanol extract and phenolphthalein a phytoestrogenic molecule isolated from seeds of Momordica charantia Linn. were evaluated in fertile female albino rats. In the first batch of animals having groups I, II, III, IV were treated with 15 and 25mg/100g oral doses of Fraction I and Fraction II and group V served as control. In the second batch of animals having groups I, II, III was treated with 10, 15 & 20mg/100g isolated phenolphthalein and group IV served as control. Results: At autopsy on day 31st, decrease in ovarian weight and histological studies shows highly significant decrease in number of developing follicles, Graafian follicles, corpora lutea and significant increased in number of atreatic follicles is observed in Fraction I and phenolphthalein treatment. There are no appreciable changes are observed in the above parameters when both the doses of Fraction II administration. Interpretation and Conclusions: The study results suggested that M. charantia seed fractions and phenolphthalein possess ovulation inhibition properties in experimental animals. Interestingly, in recent years, the popularity of different kinds of pharmaceutical preparations containing phytoestrogens has constantly increasing. Therefore, studies of the influence of the above mentioned plant components on female reproduction have become more and more important. This leads to discovery of newer phytoconstituents with better activities and provide source of new biomolecules for biologists to work on. The studies explore the utilization of medicinal plants for effective management of contraception. It gives a larger platform for the medicinal plant growers by providing scientific support and data to the traditional invalidated herbal drugs. Taking account of all these facts, the present study was undertaken in albino rats

Aphrodisiac and phytochemical studies of Cocculus hirsutus extracts in albino rats

Objective: To investigate the in vivo aphrodisiac activity of various extracts obtained from aerial parts Cocculus hirsutus (C. hirsutus). Methods: We evaluated whether oral administration of C. hirsutus has spermatogenic activity in male rats. Petroleum ether, chloroform and alcohol extract of aerial parts (stem and leaf) of C. hirsutus were administered at the dose level of 25 mg/100 g body weight to adult male albino rats for 30 days. Results: The above said extracts have stimulated the spermatogenic activity and accessory reproductive organs performance in albino rats. Out of the three extracts administered, alcohol extract showed highly stimulant spermatogenic effects in mature male albino rats. Alcohol extract showed potent androgenic activity when treated in immature Albino rats. Males treated with the extract displayed more frequent and vigorous anogenital sniffing and mounting as compared to untreated animals. The increased spermatogenesis in extract treated groups was confirmed by change in histoarchitecture as evidenced by increase in number of spermatogonia, spermatocyte, spermatids and caudal spermatozoa. After subjecting to preliminary phytochemical screening, the alcohol extract showed positive tests for steroids, saponins, oils and fats, phenolic compounds and tannins. Conclusion: C. hirsutus exhibited remarkable increase in spermatogenic activity. These findings support the folk use of this plant as an aphrodisiac

Bimaxillary unilateral gingival fibromatosis with localized aggressive periodontitis (eating the tooth at the same table)

This case reports a unique presentation of two different clinical entities amidst few similarities and differences. Usually, aggressive periodontitis and gingival fibromatosis occur independently. Their simultaneous occurrence is rarely found. This report deals with the clinical features and management aspect of such a case