Drug utilization study of anti-diabetic drugs in patients attending medicine outpatient department at a tertiary care hospital in Western Maharashtra

Background: Studies on antidiabetic drug utilization are important for the optimization of drug therapy and rational prescription of drugs. The aim of the present study was to understand the trends in prescription pattern of oral anti-diabetic drugs among type 2 diabetes mellitus (T2DM) patients attending medicine outpatient department of tertiary care hospital of Western Maharashtra. Methods: A prospective observational study was conducted at Medicine OPD of Government Medical College and Hospital, Miraj. All adult patients (≥18 years) diagnosed with T2DM and willing to give informed consent to participate in the study, were enrolled. The study was approved by Institutional Ethics Committee. The data was computed using MS excel and results were expressed as counts and percentages. Results: Out of 72 T2DM patients enrolled, male population (58.33%) had higher prevalence than females (41.67%). Biguanides (63.16%) were the most commonly prescribed class of oral antidiabetic drugs followed by sulfonylureas (35.09%). Metformin (63.16%) was the most commonly prescribed oral antidiabetic drug followed by glimepiride (30.70%). Combination of oral antidiabetic drugs (OADs) were prescribed in 52.78% and 47.22% patients were prescribed single drug. ‘Metformin and glimepiride’ was the most commonly prescribed combination. Conclusions: In a chronic disease like diabetes mellitus, constant follow up for successful management is a must. It also demands active participation by the patients. Continuing education for the clinicians to keep themselves abreast of the latest development will also contribute in the effective management of diabetes mellitus and rational prescription of antidiabetic drugs

A SYNERGISTIC DECLINE IN HUMORAL AND CELLULAR IMMUNITY OF DIABETIC MICE ON EXPOSURE TO POLLUTED AIR

Abstract: It is clinically known that diabetic patients are more prone to infectious diseases, due to low immune status. Since, some of the common air pollutants are reported to suppress immune system, how exposure to artificially polluted air influences the immune responses in experimental diabetic mice was studied. A diabetic state was induced by alloxan and mice were exposed to artificially polluted air for 30 days. During the period of exposure, the humoral (antibody titer) and cellular (foot and swelling) immune responses to antigenic challenges with sheep RBC were investigated. The exposure to polluted air produced a significant decline in the immune responses in non-diabetic mice whereas a synergistic decline was observed in diabetic group. Since, daily oral treatment with vitamin E 050mg/kg) significantly prevented the pollution induced immunosuppression, the involveme:1t of free radicals is suggested

Research Paper - Pyrogallol: A novel tool for screening immunomodulators

OBJECTIVE:To induce immunosuppression in rats by pyrogallol and to develop a novel model to screen the immunomodulatory activity of a known agent. MATERIAL AND METHODS: In order to induce immunosuppression, pyrogallol was daily administered to rats for 7 days in different doses (10, 25, 50 and 100 mg/kg, i.p.). On Day 7 and 13, the rats were sensitized with sheep red blood cells (SRBC) to assess the humoral immune response. On Day 20, SRBC were injected in the subplantar region of the hind paw, and an increase in the paw volume was recorded on Day 22 to assess the cell-mediated immune responses. The phagocytosis in the peritoneal macrophages was assessed on the last day. The parameters of oxidative stress such as lipid peroxidation (LPO), reduced glutathione (GSH) content, superoxide dismutase (SOD) and catalase (CAT) activities were assessed on the last day. In another set of experiment, the immunomodulatory activity of Rubia cordifolia (RC) (50, 100, and 200 mg/kg, p.o., daily from Day 1 to Day 22) was screened in rats in whom immunosuppression was induced by a minimum effective dose of pyrogallol (50 mg/kg). RESULTS: The dose of 25 mg/kg of pyrogallol suppressed only the humoral immunity (P<0.05), while 50 and 100 mg/kg dose significantly (P<0.01) impaired all the parameters i.e. humoral immunity, cell-mediated immunity and phagocytosis (P<0.01). It also caused a dose-dependent increase in the LPO levels, depletion of GSH, and decrease in activities of SOD and CAT. The treatment with the alcoholic extract of Rubia cordifolia significantly prevented the influence of the minimum effective dose of pyrogallol (50 mg/kg) on all immunological parameters and concurrently prevented the changes in the marker parameters of oxidative stress. The dose of 100 mg/kg was found to be optimum for this purpose. CONCLUSION: Fifty mg/kg (i.p., daily for 7 days) appears to be the minimum dose of pyrogallol, which can induce significant immunosuppression in rats. The correlation analysis indicated that pyrogallol-induced immunosuppression is related to oxidative stress. In addition, it was found that the immunomodulatory activity of a known agent could be successfully screened by this method. Thus, pyrogallol can be used as an experimental tool to induce immunosuppression while screening the immunomodulatory activity of any agent