A Comprehensive Study on Anthemintic Activity of Some Herbal Plants and Its Essential Oil

It is an interesting opportunity to repurpose the medication by using it in conjunction with other treatments that function in a variety of different ways in order to combat helminthic infections and the diseases they cause. In this article, we emphasised how the usage of antioxidants, either alone or in conjunction with anthelmintic drugs, might reduce the chance of developing infection-related malignancies as well as tissue damage and infection-related issues. As a result, antioxidants have the potential to be utilised as a supportive strategy throughout the treatment process in order to reduce the possibility of undesirable effects. This results in a more complex immune interplay that has not yet been investigated. Deworming and supplementing the diet with iron-rich nutrients have been suggested as treatments for patients with podoconiosis who live in resource-poor conditions. Additionally, it is believed that hookworm infection may aid to decrease inflammatory reactions. However, due to the unmistakable connection that exists between a non-infectious and an infectious disease, it is possible for a situation to arise in which the treatment of one disease condition during a co-infection either makes the other disease condition worse or is mitigated by the impairment brought on by the other disease condition. We provide more detail on the immunopathogenesis of podoconiosis and investigate the potential immunological dynamics of hookworm co-infection in the immunopathology of podoconiosis with the goal of better managing the disease and eventually eliminating it. This work is being done in the context of the immunopathology of podoconiosis

Pancytopenia in Indian Children: A Clinicohematological Analysis

Objective: To determine the etiological profile of pancytopenia in pediatric patients in India. Material and methods: Medical records review of a 5-year period between 1st September 1997 and 31st August 2002. Clinical and hematological data of all patients with pancytopenia (hemoglobin [Hb] ≤10 g/dL, TLC ≤4 × 109/L, platelet count ≤150 × 109/L) at presentation were analyzed. Patients on cytotoxic chemotherapy, those developing pancytopenia during hospital stay, patients referred from other centers with hematological malignancies and neonates were excluded. Results: Forty-two children (mean age 8.26 years, range 8.5 months to 13 years, M:F : 1:0.8) were included. Megaloblastic anemia, aplastic anemia and infections were commonest causes, being responsible for 25%, 19.6% and 32.1% of the cases, respectively. Bone-marrow aspiration (BMA) was helpful in reaching a definitive diagnosis in 92.8% of those in whom sufficient marrow tissue was retrieved for analysis. Aplastic anemia was the commonest reason for failure of BMA in providing a diagnosis. Conclusions: Majority (almost 60%) of the causes of pancytopenia among pediatric patients in this region are easily treatable. There is a need to be aware of such conditions and appropriate investigative modalities should be undertaken for the same

Comparative study of amlodipine versus ramipril and their effects on markers of renal disease in type 2 diabetes mellitus

Background: Diabetes mellitus is a chronic metabolic condition and patients require long treatment for it. The aim of the study was to evaluate the effects of amlodipine and ramipril on the blood pressure and markers of renal disease (viz. serum creatinine, albuminuria and eGFR) in type 2 diabetes mellitus.Methods: This was a randomized, open labelled, parallel study conducted to assess the effect of Amlodipine (2.5-10 mg) and Ramipril (2.5-10 mg) daily for 24 weeks in T2DM patients (n=103). Patients were recruited from department of Medicine OPD/Ward in the GGS Hospital and Medical College, Faridkot. Subjects in the age group of 30- 80 years who had T2DM with or without hypertension were enrolled and randomly divided into two groups viz. Group A (n=51, amlodipine 2.5 to 10 mg/day) and Group B (n=52, ramipril 2.5 to 10mg/day). Patients were evaluated at day 0 and then at 12 and 24 weeks for Blood pressure, S. Creatinine, albuminuria, eGFR and other routine investigations.Results: At 24 weeks SBP, DBP and MAP values were decreased significantly in both the groups (p 0.05) in Ramipril group. eGFR was decreased (9.73%, p <0.01) in Amlodipine group while increased in Ramipril group (10.29%, p<0.01 %).Conclusions: Both amlodipine and ramipril are equally efficacious in improving SBP, DBP and MAP in T2DM patients. Whereas, ramipril is also improves the markers/predictors of renal disease (viz. serum creatinine, albumin level in urine and eGFR) in T2DM patients, furthermore, it is having renoprotective action in an addition to lowering raised blood pressure which is useful to treat diabetic nephropathy cases

A STUDY OF DRUG PRESCRIBING PATTERN AND COST ANALYSIS AMONG DIABETIC PATIENTS IN A TERTIARY CARE TEACHING INSTITUTE IN NORTH INDIA’

Diabetes mellitus is a chronic metabolic disorder associated with significant morbidity and mortality due to diabetic complications and other co-morbid conditions. Therefore, other drugs are also used commonly with antidiabetic drugs for the treatment of diabetic patients. A prescription is a written advice, mentioning the drugs and other instructions to a pharmacist to dispense the drugs properly to treat the disease. It becomes necessary to write the drugs and other parameters in a candid, concrete and clear manner on the prescription slip. It has been observed that prescriptions are generally vague which lead to misinterpretations and thereby resulting in failure of drug therapy, drug-drug interactions, overuse or underuse of drug and adverse drug reactions. WHO has set quality and quantity indicators to evaluate the use of drugs to be used in the hospitals/dispensaries. Prescription slips were randomly collected from the diabetic patients visiting the OPDs of the Guru Gobind Singh Hospital attached to Medical College, Faridkot, for analysis and evaluation. Prescriptions slips were taken from the patients after taking written consent and analyzed for quality and quantity prescriber indicators recommended by WHO. A total of 366 prescriptions were collected and analyzed for drugs used in diabetic patients. Average number of drugs prescribed is 4.98. The most commonly prescribed drugs were Oral antidiabetic agents, CVS related (antihypertensive, nitrate, antiplatelet, etc.), vitamins and minerals, insulin, GIT related drugs, lipid lowering drugs, antimicrobial, CNS related and NSAIDs and their percentages were 20.55%, 26.97%, 22.20%, 7.8%, 6.57%, 5.86%, 5.75%, 2.63% and 1.48% respectively. All the drugs were prescribed by non-generic (Trade) names, which included 31.36% drugs from the Essential Drugs List. Oral forms prescribed were 85.85% and injectable were 14.15% (insulin 7.8% and other injectable 6.35%).The average cost of the oral antidiabetic agent per day per prescription was ₹7.95/- and this cost increased to ₹10.15/- with addition of CVS related drugs, ₹17.23/- with vitamins&amp; minerals and ₹10.57/- with lipid lowering agents and it was seen that if a patient was prescribed all these drugs then the average cost of the treatment got raised to ₹45/- (approx.) or $ 0.82 USD per day per prescription. There is a high tendency and frequency to prescribe more than two drugs but less used from the essential drugs list for the treatment of the diabetesand other co-morbid conditions. Most of the drugs prescribed were cardiovascular related drugs and multivitamins along with oral antidiabetic drugs. There is an urgent need to develop the prescription writing skills for budding doctors regarding the use of Essential Drugs List to reduce the cost of treatment. Key words: Prescription audit, prescribing indicators, Essential Medicine List (EML), Co-morbid condition

An in-depth study of drugs prescribing pattern in the Surgery Department of a Tertiary Care Teaching Institute in Northern India

Background: In surgical patients, a number of drugs are prescribed to prevent post-operative infections and to relieve pain. Therefore, prescription audit should be periodically performed in Department of Surgery to analyze the present scenario of drugs prescribed for the surgical/post-operative patients. This will help us to use the medicines rationally and decrease the adverse effects in surgical patients. The main aim of the study was to evaluate the drugs prescribing pattern in the Surgery Department in Tertiary Care Teaching Institute.Methods: Patients’prescriptions or case record forms were randomly collected over a period of 1 year from the Department of Surgery at GGS Medical College and Hospital, Faridkot, Punjab (India) for analysis and rationalization.Results: A total of 900 prescriptions was collected and analyzed for drugs used in surgical patients. Average number of drugs prescribed is 4.26. The most commonly prescribed drugs were anti-microbial agents (AMAs), gastrointestinal tract (GIT) related, non-steroidal anti-inflammatory drugs (NSAIDs) and multivitamins and trace elements, and their percentages were 37.90%, 23.36%, 14.14 %, and 9.11% respectively. About 95% drugs were prescribed by non-generic (Trade) names. Drugs prescribed from National Essential Medicines List (EML) and World Health Organization EML were 69.25% and 45.31% respectively. Average cost per prescription per day was Rs. 610/- (INR) or $10.34 USD in a surgical patient.Conclusions: There is a high tendency and frequency to prescribe four and more than four drugs to post-operative patients. Most drugs prescribed were AMAs, GIT related, NSAIDs and Multivitamins and trace elements. There is an urgent need to develop proper prescription writing skills in budding doctors regarding the use of EML/drugs list and generic medicines to reduce the cost of treatment

Study of Patients’ awareness and their perspective about diabetic disorder in T2DM patients: A descriptive study

Introduction: Type 2 Diabetes mellitus, a metabolic disorder is mostly related to the sedentary life style of subjects. Awareness of diabetes disorder among diabetics plays a crucial role in its management. Aims &amp; Objectives: To study the awareness of diabetes disorder, its complications and management among T2DM patients. Materials and Methods: This was a cross-sectional and descriptive study done among T2DM patients who visited the OPD of department of Medicine at GGS Hospital, Faridkot (in a rural area of Punjab-India). A pretested proforma contained questionnaire related to the awareness/ knowledge to diabetic disorders, its complications and management was distributed among 300 subjects and their response was analyzed. Results: 235 patients responded (78.33%) to the pretested proforma. Males and females were 48.08% and 51.92% respectively. 25.53% subjects were illiterate. Lack of knowledge about diabetic disorders in 79.57%, duration of treatment in 73.61%, their complications in 74.89%, modification of diet in 40%, their body care/cleanliness in 62.55% and leaving of medication in 76.17% were seen. A habit of taking other indigenous / complimentary medicines was also seen in 40.43% of cases along with conventional antidiabetic therapy. Conclusion: Most of the diabetic patients had lack of knowledge about diabetic disorders, its complications and management. They also left the medicine in midway of treatment and had developed signs &amp; symptoms of hyperglycemia. A good number of patients also took indigenous products to treat their disease. They also didn’t follow the life style modification measures appropriately. Therefore, adequate awareness/knowledge should be provided to all the diabetic patients to manage diabetic disorder in a better way. Keywords: Knowledge, Perspectives, Complications, Life style modification, Complementary &amp; Alternative medicine (CAM), Medication compliance &amp; Adherence

Exploring factors affecting the timely transition of ventilator assisted individuals in Ontario from acute to long-term care: Perspectives of healthcare professionals

# Rationale Ventilator Assisted Individuals (VAIs) frequently remain in intensive care units (ICUs) for a prolonged period once clinically stable due to a lack of transition options. These VAIs occupy ICU beds and resources that patients with more acute needs could better utilize. Moreover, VAIs experience improved outcomes and quality of life in long-term and community-based environments. # Objective To better understand the perspectives of healthcare providers (HCPs) working in an Ontario ICU regarding barriers and facilitators to referral and transition of VAIs from the ICU to a long-term setting. # Methods We conducted semi-structured interviews with ten healthcare providers involved in VAI transitions. # Main Results Perceived barriers included long wait times for long-term care settings, insufficient bed availability at discharge locations, medical complexity of patients, long waitlists, and a lack of transparency of waitlists. Facilitators included strong partnerships and trusting relationships between referring and discharge locations, a centralized referral system, and utilization of community partnerships across care sectors. # Conclusions Insufficient resourcing of long-term care is a key barrier to transitioning VAIs from ICU to long-term settings; strong partnerships across care sectors are a facilitator. System-level approaches, such as a single-streamlined referral system, are needed to address key barriers to timely transition

PAR1-mediated NFΚB activation promotes survival of prostate cancer cells through a Bcl-xL-dependent mechanism

We have previously reported that protease-activated receptor 1 (PAR1 or thrombin receptor) is over-expressed in metastatic prostate cancer cell lines compared to prostate epithelial cells. In this study, we examined 1,074 prostate biopsies by tissue microarray analysis and demonstrated that PAR1 expression is significantly increased in prostate cancer compared to normal prostate epithelial cells and benign prostatic hyperplasia. We hypothesized that PAR1 activation contributed to prostate cancer cell progression. We demonstrated that stimulation of PAR1 by thrombin or thrombin receptor activating peptide (TRAP6), in androgen-independent DU145 and PC-3 cells resulted in increased DNA binding activity of the NFΚB p65 subunit. IL-6 and IL-8 levels were also elevated in conditioned media by at least two-fold within 4–6 h of PAR1 activation. This induction of cytokine production was abrogated by pretreatment of cells with the NFΚB inhibitor caffeic acid phorbol ester. The p38 and ERK1/2 MAPK signaling cascades were also activated by PAR1 stimulation, whereas the SAPK/JNK pathway was unaffected. Inhibition of p38 and ERK1/2 by SB-203589 and PD-098059, respectively, did not abrogate NFΚB activity, suggesting an independent induction of NFΚB by PAR1 stimulation. Furthermore, TUNEL assay showed that activation of PAR1 attenuated docetaxel induced apoptosis through the upregulation of the Bcl-2 family protein Bcl-xL. Akt activation was not observed, suggesting that drug resistance induced by PAR1 was independent of PI3K signaling pathway. Because thrombin and PAR1 are over-expressed in prostate cancer patients, targeting the inhibition of their interaction may attenuate NFΚB signaling transduction resulting in decreased drug resistance and subsequent survival of prostate cancer cells. © 2005 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48764/1/20533_ftp.pd