STEROID-INDUCED ANAPHYLAXIS

  To report a severe adverse drug reaction (ADR) due to administration of injection hydrocortisone sodium succinate and to explore the possibility of an association between injection hydrocortisone and the severe ADR. After getting ethics approval from the institution, ADR form and patient's clinical record from the Department of Cardiology, in a Private Medical College was received. In that, it was recorded as a 75-year-old male patient, a case of unstable angina with troponin T - positive, was posted for coronary angiogram developed a severe reaction to intravenous (IV) hydrocortisone 100 mg stat, given to prevent allergy to contrast dye used in the procedure. 5 minutes after drug administration, he developed sudden itching all over the body, hypotension blood pressure: 60 mmHg and swelling of lips. No other drugs had been given at that time. The patient was already on aspirin 150 mg, clopidogrel 75 mg, and atorvastatin 80 mg, and enoxaparin 40 mg. The procedure was abandoned, and the patient was given injection pheniramine maleate 45.5 mg IV, injection dopamine 10 mcg/kg/min IV. He symptomatically improved within 6 hrs. Causality analysis using the WHO scale categorizes it as probable, as anaphylaxis occurred immediately after administration of hydrocortisone, no other drugs were given at that time, and rechallenge was not done. Very few cases of various steroid-induced anaphylaxis have been reported worldwide. This one among the rare ADR report may be due to the steroid or the excipients in the preparation. Skin prick test or in vitro (radioallergosorbent test assay) test can be done immediately to confirm the causative allergen in this case and would also help in identifying specific agents that will be tolerated in the future treatment

Global health concern of cyanotoxins in surface water and its various detection methods

Water is an absolutely required resource for life nourishment especially for the purpose of drinking, domestic and farming. People in various part of the world are under prodigious threat due to unenviable changes in the physical-chemical and biological properties of an ecosystem. Due to anthropogenic causes like industrialization, the use of fertilizers and urbanization leads to highly polluted water bodies that include fresh and brackish water. These changes influence the harmful growth of cyanobacteria that is blue green algae. cyanoHABs (Cyanobacterial Harmful Algal Blooms)  became a worldwide threat to drinking and recreational purpose due to its adopting nature according to the temperature fluctuations. In this study, a basic introduction to cyanotoxins as well as the entanglement of public health that includes route of exposure health effects and the pervasive impact of cyanotoxins and alleviation efforts in the waterbodies along with that the toxicosis. Cyanobacterial toxins such as hepatotoxicosis, neurotoxicosis, gastrointestinal disturbances respiratory and allergic reactions were reviewed. Their detection process and the treatment techniques with various physicochemical methods and bioassay methods were also reviewed

Knowledge, awareness and attitude towards rational use of medicines by community pharmacists in and around Coimbatore, India

Background: Achievement of goals of rational use of medicine (RUM) in the community is not possible without participation of community pharmacists. Pharmacists must know that they are the main tool to educate and spread information on rational use of medicine in the community. This background enabled this study to observe the knowledge, awareness and attitude of the community pharmacists towards the rational use of medicine. Aim and Objectives were to assess the knowledge and awareness among community pharmacists about rational drug use in and around Coimbatore.Methods: It was a cross sectional observational study using a preformed questionnaire. Study participants were 215 Community Pharmacists (those are registered pharmacist running standalone pharmacy stores not affiliating to any institutions /hospitals/not a part of a large chain of stores) inside (115 Pharmacist) and around (100 Pharmacist) Coimbatore city. Questionnaire was given to them and results were analyzed and expressed in percentage at the end of the study.Results: Comparing the awareness about RUM in the community pharmacists in and around Coimbatore was found with the results which was almost equal or less in terms of dispensing medicines without prescription, issuing medicines to outdated prescription, educating the public about ADR etc.Conclusions: This study ensure the need of the community pharmacist participation for the development of a clear educational policy on promoting rational use of medicine involving all segments of health care system to ensure the community benefit and safety

Formulation and Evaluation of Controlled Porosity Osmotic Tablets of Lornoxicam

The Present study Lornoxicam (LOX) is a mainstay Non Steroidal Anti Inflammatory Drug (NSAID) for the treatment of inflammatory diseases like Rheumatoid Arthritis (RA) and Osteoarthritis (OA). But this drug has shorter half life (3-4 hours) and induces side effects when used for long term. The aim of the present study is To formulate controlled porosity osmotic tablets of LOX using mannitol as osmogen. To increase the solubility of LOX using tromethamine as solubility modifier and SLS as wicking agent. To release LOX in a controlled manner osmotically with cellulose acetate coating along with sorbitol as a pore former. The main objective of the study is to produce controlled release of LOX for the pain management of RA and OA and to improve the efficacy and patient compliance

To compare the anti-inflammatory effect of oral hypoglycemic drugs in type 2 diabetes mellitus.

Aim: To compare the anti-inflammatory effects of Metformin sulfonylurea and Sitagliptin combination with Metformin Sulfonylurea and Acarbose combination in Type2DM patients by using Anti-inflammatory markers (IL6, hs CRP) and also To compare the clinical outcome between these two groups by using the following parameters FBS, PPBs, HbA1C, Plasma Insulin. Materials and Method : In this study 30 type 2 diabetes patients on Metformin and Sulfonylurea combination ,HbA1c value >7.5 were recruited and randomized into two groups in which one group was added on Acarbose and the other group was added with Sitagliptin along with Metformin, Sulfonylurea combinations and followed for 3 months. Result : In this study Sitagliptin combination reduced the mean value of FBS, PPBS, HbA1c, Plasma Insulin , Insulin Resistance ,hsCRP and IL-6 , which were similar to the results of previous studies. In Acarbose combination, there was a reduction in the mean values of FBS,PPBS, HbA1c, Plasma Insulin, Insulin Resistance, hsCRP but not IL-6. Hence long term follow up and large sample size may be required to see the progression in the reduction of inflammatory markers and the role of these drugs in the insulin resistant states. Conclusion : This study explained the synergism when Sitagliptin given along with Metformin Sulfonylurea combination and has proved a definite role in reducing chronic inflammation

Detection of erm Gene among Inducible Clindamycin Resistant Staphylococcal Isolates in Clinical Samples

BACKGROUUND: Staphylococcus aureus infection is associated with hospital and infections which arise from the community. The emergence of resistance to most antimicrobial agents in Staphylococci indicates the need for new effective agents in the treatment of Staphylococcal infection. Among the alternatives available Clindamycin is considered to be safe, effective and less costly agent. In vitro routine tests for Clindamycin susceptibility may fail to detect inducible Clindamycin resistance due to erm genes, resulting in treatment failure, thus necessitating the need to detect such resistance by a simple D-test on routine basis. AIM OF THE STUDY: The present study is aimed to detect erm gene in inducible Clindamycin resistant Staphylococcal isolates and to study the relationship between Clindamycin and Methicillin resistance. MATERIALS AND METHODS: During the study period a total of 100 non duplicate clinical isolates of Staphylococci were collected from different clinical samples like aural swabs, wound swabs, pus and vaginal swabs from both in-patient and out-patient departments of Tirunelveli Medical College The Staphylococcal species were identified by standard biochemical techniques.and their antibiotic susceptibility tested by standard disk diffusion method on Muller Hinton agar [MHA] according to the standards of clinical and laboratory standards institute[CLSI]. Detection of inducible Clindamycin resistence was performed by D-test on a Mueller Hinton agar plate with a lawn culture of the isolate which was adjusted to 0.5 Mcfarland’s concentration . Discs of Clindamycin(2μg),Erythromycin(15μg) were kept at a distance of 15mm. The disc diffusion D test, showed 1. Inducible MLSB phenotype (iMLSB), 2. Constitutive MLSB phenotype (cMLSB), 3. MS phenotype. The Staphylococcal isolates from MLSBi were further tested by Real-Time PCR for ermA/ermB/ermC genes. RESULTS: In this study among the 100 Staphylococcal isolates 80% were Staphylococcus aureus and rest 20% were coagulase negative staphylococcus. Out of strains isolated 80% were from hospitalized patients . The study group contained 55% males and 45% females and Male to female sex ratio was 1.2 2:1. Majority of the study group were found among the age group 21-30 yrs. Majority of the Staphylococcal aureus 75% and CONS 100% were isolated from pus and majority of the MSSA 76.36% and 72% MRSA were also from pus. Inducible MLSB resistance was detected by Disc diffusion test (D-test). In D-test the phenotypic distribution of iMLSB, cMLSB and MS were 35%, 12.5% and 52.5% respectively. In the phenotypic distribution of iMLSB Staphylococcus .aureus was 37.5% and CONS 25%, MSSA 31.58% and MRSA 46.15%. Majority of the iMLSB was susceptible to Ciprofloxacin, Cotrimoxazole and Gentamycin. while cMLSB and MS phenotype were resistant to ciprofloxacin when compaired to iMLSB .There was high rate of resistance exhibited by cMLSB towards Cefoxitin when compaired to iMLSB. No resistance was observed to vancomycin. Genetic analysis by real time PCR performed on iMLSB showed 21.42% erm A,7.14% erm B,14.3% erm C,50% erm A and erm C and 7.14% erm B and erm C. CONCLUSION: In this present study D-test is easy to perform and found inexpensive for practical purpose than PCR which is the gold standard. This test is used to detect an inducible Clindamycin resistance in staphylococci as a routine work in clinical microbiology laboratories. This test help us to provide confident laboratory reports and Clindamycin can be omitted in patients with infections caused by inducible Clindamycin resistance staphylococci, and therapeutic failures may be thus avoided

Assessment of medical students’ attitude towards didactic lectures taken in pharmacology in a private medical college

Background: To assess the attitude of second year medical students towards the teaching Principles in Pharmacology didactic lecture classes.Methods: It was a descriptive epidemiological and questionnaire based study. Second year students who were attending pharmacology lecture classes for a period of one month (nearly 8 lectures) were given questionnaire and ask to fill it by assessing the theory classes which was conducted throughout that month. Each question was graded with mark and finally total score was converted to 50 marks. Five-level Likert’s criteria were used to analyze few questions in the questionnaire. Data were analyzed by frequency distribution.Results: Out of 115 students who attended the questionnaire session, 61% students were having a very good and better attitude towards the faculty talking Pharmacology lecture classes and remaining students have a few lacking areas in the teaching mode which should be analyzed.Conclusions: Students have good attitude towards the faculty taking didactic lectures and the lacking areas can be future improved by efficient planning of interactive and interesting lecture methods for the usefulness of students as well as the teacher

Antibacterial properties of Passiflora foetida L. – a common exotic medicinal plant

Passiflora foetida L. (stinking passion flower) is an exotic medicinal vine. The antibacterial properties of leaf and fruit (ethanol and acetone) extracts were screened against four human pathogenic bacteria i.e. Pseudomonas putida, Vibrio cholerae, Shigella flexneri and Streptococcus pyogenes by well-in agar method. The results showed the leaf extract having remarkable activity against all bacterial pathogens compared to fruits. This study supports, the traditional medicines (herbal extracts) to cure manydiseases like diarrhea, intestinal tract, throat, ear infections, fever and skin diseases

COMPUTING PRECISION SIGNIFICANCE SCORE BETWEEN ENCRYPTED INDEX AND QUERY PATHS

Within the recent occasions, various techniques were suggested to aid insertion and deletion procedures on assortment of documents. They are important works because it is very entirely possible that data proprietors require upgrading their info on cloud server. However couple of active schemes manage efficient techniques of multi-keyword rated search. We introduce a method of tree-based search over encoded cloud information that supports multi-keyword rated search in addition to dynamic operation on assortment of documents. Forecasted search system attains sub-straight line search some time and manages deletion in addition to insertion of documents. While nearly all works regarding searchable file encryption, our bodies views challenge from cloud server

In vitro antioxidant activity of Vetiveria zizanioides root extract

Free radicals induce numerous diseases by lipid peroxidation and DNA damage. It has been reported that some of the extracts from plants possess antioxidant properties capable of scavenging free radicals in vivo. Vetiveria zizanioides belonging to the family Gramineae, is a densely tufted grass which is widely used as a traditional plant for aromatherapy, to relieve stress, anxiety, nervous tension and insomnia. In this regard, the roots of V. zizanioides was extracted with ethanol and used for the evaluation of various in vitro antioxidant activities such as reducing power ability, superoxide anion radical scavenging activity, deoxyribose degradation assay, total antioxidant capacity, total phenolics and total flavonoid composition. The various antioxidant activities were compared with suitable antioxidants such as butyl hydroxy toluene, ascorbic acid, quercetin, alpha tocopherol, pyrocatechol and curcumin respectively. The generation of free radicals O2-, H2O2, OH and NO were effectively scavenged by the ethanolic extract of V.zizanioides. In all these methods, the extract showed strong antioxidant activity in a dose dependent manner. The results obtained in the present study clearly indicates that V. zizanioides scavenges free radicals, ameliorating damage imposed by oxidative stress in different disease conditions and serve as a potential source of natural antioxidant. The study provides a proof for the ethnomedical claims and reported biological activities. The plant has, therefore, very good therapeutic and antioxidant potential