DRUG UTILIZATION BASED ADRs DETECTION OF ANTIBIOTICS PRESCRIBED FOR LRTI IN TERTIARY CARE TEACHING HOSPITAL, NEW DELHI

Objective: Aim of to present study was to assess drug utilization pattern of antibiotics use in Lower respiratory tract infection and their adverse drug reaction assessment.Methods: The present study was an observational and prospective study. 110 patients fulfill the inclusion criteria were included in study. Physician prescription records, patient's medication profile types of antibiotics prescribed were recorded and analyzed.Results: Out of 110 LRTI patients, 74 (67.27%) patients were male and 36(32.72%) patients were female. 72 patients were suffered from bronchitis while 38 patients were suffering from pneumonia. 30 patients were in the age range of 56-65 y, followed by 21 patients who were in the age range of 66-75 y. It has been observed that among all the prescribed antibiotic agent's frequency of β-lactam 199(45.53%), quinolones115 (26.27%), macrolides 53(12.12%) chloramphenicol44 (10.06%) sulphonamide 17 (3.89%) and aminoglycosides 9(2.05%) were prescribed to all the patients. Average 3.97 antibiotic agents were prescribed to all the patients. Majority of drugs were given by oral route (68.19%) and Prescriptions are mainly ordered in brand names. The most frequent co-morbid condition was found to be diabetes mellitus (25.45%) followed by hypertension (16.36%) and coronary artery disease (11.81%).45.45%. Only 23 ADRs were detected in 110 patients. The most common culprit was an amoxicillin with clavulanic acid.Conclusion: The present study provides an overall pattern of antibiotic usage in different patients. The area of concern in the present study is polypharmacy and use of antibiotics in LRTI without following any guideline. ADRs monitoring is also required to prevent noxious effects of drugs by the use of antibiotics

SOLUBILITY ENHANCEMENT METHODS WITH IMPORTANCE OF HYDROTROPY

The effectiveness of formulation depends particularly on how efficiently is drug available at the site of action. Therapeutic effectiveness of a drug basically depends upon bioavailability and the solubility of drug moiety.  Most of the chemical entities that are being discovered are lipophilic and have poor aqueous solubility. A more than 40% drug suffers from poor water solubility. Currently number of techniques addressed the enhancement of solubility and dissolution rate of poorly soluble drugs. Hydrotropic solubilization is one of them. Hydrotropy is a solubilization phenomenon whereby addition of large amounts of a second solute results in an increase in the aqueous solubility of another solute. A hydrotrope is a compound that solubilises hydrophobic compounds in aqueous solutions. To solubilize water insoluble drugs especially in case of oral formulation, solubility remains a critical factor so for in this review various solubility enhancement techniques are highlighted and a brief review of hydrotropy and its preparation are discussed. Keywords: - Solubility, Hydrotropy, Mixed hydrotrop

Topical nanoemulsion of turmeric oil for psoriasis: characterization, ex vivo and in vivo assessment

Psoriasis is a chronic; T lymphocyte mediated autoimmune inflammatory disorder characterized by well-defined erythematous (reddish) plaques with large adherent silvery scales that affects the skin and other parts of the body. The essential oil in turmeric is anti-inflammatory and effective in treating chronic disorders like psoriasis that have inflammation as a root symptom. Nanoemulsions are isotropic, thermodynamically stable transparent (or translucent) systems of oil, water, surfactant and co-surfactant with a droplet size usually in the range of 20–200 nm. Their long-term stability and ease of preparation (spontaneous emulsification) make it promising tool for drug delivery. The aim of this study was to obtain nanoemulsions of turmeric oil for psoriasis and to evaluate their physical stability, irritation potential and in vivo inflammatory activity. For the preparation of nanoemulsion titration method was used which was composed of 15% turmeric oil, 42 % Smix (1:1) and 43 % distilled water. The nanoemulsion was stable during the period of study and was found to be practically non-irritating in the organotypic HET-CAM model. The anti inflammatory activity of optimized nonoemulsion was carried out by carragennen induced paw edema and found to be 70.35 % inhibition

Preventive role of Withania somnifera on hyperlipidemia and cardiac oxidative stress in streptozotocin induced type 2 diabetic rats

Purpose: The present study was intended to investigate the preventive role of Withania somnifera (WS) on hyperlipidemia and oxidative stress in the heart of streptozotocin (STZ)-induced type 2 diabetic rats.Methods: Single intraperitoneal injection of STZ (100 mg/kg) was given to 2 days rat pups to induce type 2 diabetes mellitus. Diabetes was confirmed 90 days after the administration of STZ by measuring blood glucose level. WS (200 and 400 mg/kg) was administered orally once a day for 5 weeks after the confirmation of diabetes. Glucose, lactate dehydrogenase (LDH), creatinine kinase (CK), total cholesterol (TCh), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), verylow density lipoprotein cholesterol (VLDL-C) and markers of oxidative stress parameters like lipid peroxidation (LPO), reduced glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S-transferase (GST), superoxide dismutase (SOD) and catalase (CAT) were evaluated in the heart of type 2 diabetic rats.Results: Oral administration of WS for 5 weeks resulted in a significant (P<0.001) reduction in glucose, LDH, CK, TC, TG, LDL-C, VLDL-C levels with significant elevation of HDL-C levels. On the other hand, WS treated diabetic rats significantly (P<0.01-P<0.001) reduced the elevated levels of LPO, increased levels of antioxidant enzymes (i.e, GSH, GPx, GR, GST, SOD and CAT).Conclusion: These findings propose the role of hyperlipidemia and cardiac oxidative stress in type 2 diabetic rats and suggested protective effect of WS in this animal model.Keywords: Withania somnifera; Hyperlipidemia; Oxidative stress; Streptozotocin; Type 2 diabete

Unexplained recurrent hematuria and clot retention following transurethral resection of the prostate

Severe hemorrhage following a prostatectomy is a rare and serious complication. A 60-year-old male with recurrent hematuria and clot retention following transurethral resection of the prostate  (TURP) which led to anemia presented at our department and was treated with repeated clot evacuation and fulguration and lastly re-resection and fulguration succeed to stop bleeding. At 18 months follow-up, the patient had recovered well. We concluded that re-resection and fulguration on fresh tissue without opening the venous sinusoids should be considered as one of the effective treatment of choice in recurrent hemorrhage following TURP.   

Giant condyloma acuminatum of vulva

In this paper, A 23 year old married woman who was diagnosed as a case of giant condyloma acuminatum of vulva measuring about 15 x 8 x 3 cm, irregular surface with multiple projections, oval in shape, firm to hard in consistency, mildly tender, exophytic, cauliflower like growth involving the whole vulva (lower part of mons pubis, labia, vestibule, clitoris, around vaginal opening). Another multiple small lesions were present at perineal region but there was no inguinal lymphadenopathy. She underwent a combined electro cauterization and cryotherapy for small to moderate size multiple primary and recurrent warty lesions and wide surgical excision with fasciocutaneous advancement flaps procedure for a giant lesions in the vulva. Excisional biopsies were performed to detect potential malignancy but malignancy was not found histologically. The patient was advised to first follow-up 1 month after operation when multiple small warty lesions were developed and treated and the subsequent follow-ups for 3 months

Label-free electrochemical aptasensor for the detection of SARS-CoV-2 spike protein based on carbon cloth sputtered gold nanoparticles

The proliferation and transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or the (COVID-19) disease, has become a threat to worldwide biosecurity. Therefore, early diagnosis of COVID-19 is crucial to combat the ongoing infection spread. In this study we propose a flexible aptamer-based electrochemical sensor for the rapid, label-free detection of SARS-CoV-2 spike protein (SP). A platform made of a porous and flexible carbon cloth, coated with gold nanoparticles, to increase the conductivity and electrochemical performance of the material, was assembled with a thiol functionalized DNA aptamer via S–Au bonds, for the selective recognition of the SARS-CoV-2 SP. The various steps for the sensor preparation were followed by using scanning electron microscopy, cyclic voltammetry and differential pulse voltammetry (DPV). The proposed platform displayed good mechanical stability, revealing negligible changes on voltammetric responses to bending at various angles. Quantification of SARS-CoV-2 SP was performed by DPV and chronopotentiometry (CP), exploiting the changes of the electrical signals due the [Fe(CN)6]3-/4- redox probe, when SARS-CoV-2 SP binds to the aptamer immobilized on the electrode surface. Current density, in DPV, and square root of the transition time, in CP, varied linearly with the log[ SARS-CoV-2 SP], providing lower limits of detection (LOD) of 0.11 ng/mL and 37.8 ng/mL, respectively. The sensor displayed good selectivity, repeatability, and was tested in diluted human saliva, spiked with different SARS-CoV-2 SP concentrations, providing LODs of 0.167 ng/mL and 46.2 ng/mL for DPV and CP, respectively

Bromelain capped gold nanoparticles as the novel drug delivery carriers to aggrandize effect of the antibiotic levofloxacin

To develop bromelain capped gold nanoparticles (BRN capped Au-NPs) as the effective drug delivery carriers of the antibiotic levofloxacin (LvN) and evaluate antibacterial potential of its bioconjugated form compared to pure LvN. BRN capped Au-NPs were synthesized by in vitro method and bioconjugated to LvN using 1-ethyl-3-(3-dimethylamino-propyl)-carbodiimide as activator to form Au-BRN-LvN-NPs. These were characterized for mean particle size by dynamic light scattering analysis, zeta potential by Zetasizer nanosystem analysis and transmission electron microscopy (TEM) on carbon coated TEM copper grids by TEM respectively. Drug loading efficiency of LvN was calculated using UV-visible spectroscopy by standard curve of pure LvN. Antibacterial efficacy of Au-BRN-LvN-NPs and pure LvN was determined by evaluating minimum inhibitory concentration (MIC) against Staphylococcus aureus and Eschereschia coli.Two peaks were observed in Au-BRN-LvNNPs spectrum one at 307 nm and other at 526 nm while one peak in BRN capped Au-NPs at 522 nm during UV spectroscopy suggesting red shift. The drug loading efficiency of LvN was found to be 84.8 ± 2.41 %. The diameter of Au-BRN-LvN-NPs and BRN capped Au-NPs were found to be (58.65 ± 2 nm, 38.11 ± 2 nm), zeta potential (-9.01 mV, -13.8 mV) and surface morphology (~13.2 nm, 11.4 nm) respectively. The MICs against S. aureus and E. coli were found to be (0.128 μg/mL, 1.10 μg/mL) for Au-BRN-LvN-NPs and (0.547 μg/mL, 1.96μg/mL) for pure LvN. The results suggested that BRN capped Au-NPs can be used as effective drug delivery carriers of the antibiotic LvN. The Au-BRN-LvN-NPs exhibited enhanced antibacterial activity compared to pure LvN alone