Psychodermatology – a case for sensitization of pharmacists in Mumbai, India

Background: Though studies have looked at the attitudes of dermatologists towards psychodermatology, few have highlighted the attitudes of pharmacists towards these conditions. Objectives: To study the knowledge, attitudes and practices of pharmacists towards the prescription of psychotropic medications to dermatology patients. Methods: This cross-sectional analysis included 80 pharmacists from Mumbai, India. We used an interviewer-administered questionnaire to collect information from pharmacists on their demographics, psychotropic medications in dermatological patients, knowledge about psychocutaneous conditions and comfort about dispensing these medications. Results: In our study, 37 (46%) of pharmacists received prescriptions of psychotropic drugs from dermatologists; however, 24 (30%) were not comfortable dispensing them. Sixty (75%) pharmacists felt that only psychiatrists should prescribe psychotropic drugs and 37 (46%) felt that they had a right to refuse to dispense prescribed medication; of these, 15 (19%) had actually refused to give medications to patients. Pharmacists who disagreed with the statement that 'the state of mind is associated with medical conditions', were more likely to discourage psychotropic prescription from dermatologists (29% vs 11%, P = 0.04). Pharmacists with experience of more than five years were significantly more likely to refuse to dispense medications (odds ratio: 5.14, 95% confidence interval: 1.02, 25.83; P = 0.047). Limitations: We did not have a list of all pharmacists in Mumbai; thus, no sampling frame could be applied. Conclusion: Pharmacists do comment on doctors’ prescriptions, discourage certain medications and even refuse to dispense them based on their personal opinions. Since they are the last stop for patients between the doctor and the medication, their inclusion (in addition to dermatologists, psychiatrists and psychologists) in integrated awareness, training and care programs would improve the quality of care of patients with psychocutaneous disorders

Exploring issues in the development of Ayurvedic research methodology.

Research is the prime need of contemporary Ayurveda, but modern research on Ayurveda has not been very rewarding for Ayurveda itself. Much of it uses Ayurveda to extend modern bioscience. In contrast, Ayurveda needs research designed to test and validate its fundamental concepts as well as its treatments. In this context, if Ayurveda is to be truly explored and validated in all its aspects, scientific inputs should conform to Ayurveda's principles and philosophy. While its evidence base, established since antiquity, may need further verification, research should now focus on the Science of Ayurveda, rather than merely looking for new drugs based on Ayurveda herbals; in-depth research is needed on Ayurveda. Such research will require teamwork between scientists and vaidyas based on truth and trust. Ayurveda research methodology requires the 'whole system testing approach', global participation with protocols evolved through intense interface with modern science, regulatory reforms to eliminate barriers, and to be investigated 'as it is', using approaches adapted from its own basic principles.

Reversal of nail changes after liver transplantation in a child.

We report a 6-year-old girl who received a left-lobe live-related liver transplant for decompensated liver disease after a failed Kasai’s surgery for biliary atresia. Preoperatively, her nails were white, dystrophic, brittle with severe onycholysis, clubbing and watch-glass deformities. Nail scrapings were negative for fungus. Five months after transplantation, her nails had become near normal. There is only one such documented case in literature on reversal of nail changes in an adult.

Antioxidant and antiulcer activity of aqueous extract of a polyherbal formulation.

The aqueous extract of Hingwashtak churna was evaluated for gastroprotection in rats using the ibuprofen and ethanol induced ulcer models. Efficacy was assessed by determination of mean ulcer size, ulcer number and ulcer index. Oral administration of the aqueous extract (750 mg/kg) significantly protected against gastric lesions by 84.96% and 91.12% as compared to ranititidine (95.54 and 95.2%) in the ibuprofen and alcohol induced ulcer models respectively. The findings suggest that the significant gastroprotective activity could be mediated by its antioxidant activity which was evaluated by using different antioxidant models of screening.

Medical applications of nanotechnology.

In the true spirit of interdisciplinary expansion of scientific knowledge, results from the applicability of nanotechnology in the fields of physical sciences and chemistry have now matured enough to extend into biology and medicine. The advances in nanotechnology in the past decade have offered novel opportunities for sensing clinically relevant markers, molecular dsease imaging and tools for therapeutic intervention, which have a potential to transform the field of medicine. We describe the currently available components of the nano-toolbox, which are likely to be incorporated in clinical practice in the forseeable future. These include nanowires, cantilevers and nanopores for sensing, naoparticles and quantum dots for molecular imaging and nanoparticles for therapy. We also discuss the issue of toxicity of these nanomaterials and other limitations in the application of nanotechnology to medicine.

Biomarker profiling for cancer diagnosis, prognosis and therapeutic management.

The basis of cancer treatment has come a long way since the days of the the classical TNM staging. Identification of novel biomarkers for various cancers and their specific correlations with prognosis have increased our understanding of carcinogenesis and tumour progression on the molecular level. Recent advances in technologies for simultaneous detection of multiple biomarkers have opened up new avenues for multimarker profiling on a more individual scale. We summarize the key molecular determinants and their prognostic role in various cancers, and examine the available techniques for analysing biomarker panels that can have a major impact on cancer diagnostics and therapeutics.