Bhallatakadi Ghrita: Development and evaluation with reference to Murcchana and Shata-Dhauta process

Background: Ayurveda is primarily based upon use of herbs either singly or in combination (polyherbal).The cow ghee (clarified butterfat) is considered as a precious base for preparing medicines in Ayurveda.Processing of ghee with plant ingredients is renowned for enhancing their therapeutic efficacy.Objective: In present research work, the attempt was made to develop cow ghee based PolyherbalBhallatakadi Ghrita formulations and evaluate them with reference to ‘Murcchana’ and ‘Shata-Dhauta’process.Materials and methods: The research plants were identified, procured, authenticated and processed. Theextracts of plant materials were prepared and used for development of Polyherbal Bhallatakadi Ghrita(PHBG), Polyherbal Bhallatakadi Murcchita Ghrita and Polyherbal Bhallatakadi Shata-Dhauta Ghrita formulations as per Ayurvedic procedures. The prepared ghrita formulations were subjected to organoleptic(colour, odour, taste, appearance and touch), physicochemical (pH, viscosity, moisture content, specificgravity, refractive index, acid value, saponification value, iodine value, peroxide value, Rechert Meisslvalue and Polenske value) evaluation, in-vitro antioxidant and GC-MS analysis. The accelerated and realtime stability studies were carried out to determine shelf life of ghrita formulations.Results: The results of evaluations indicate that, developed PHBG formulations retained the organolepticand physicochemical characteristics of ghee. The shelf life of formulations was found to be in the range of1.6 to 3.3 years at accelerated and 2.2 to 3.8 years at real time stability conditions. All ghrita formulationsexhibited antioxidant activity in dose dependent manner.Conclusion: The standardization or evaluation of Polyherbal Bhallatakadi Ghrita formulations was foundto be crucial for the establishment of a steady biological, chemical or simply a quality assurance profile ofthe drugs

Studies on Ashwagandha Ghrita with reference to murcchana process and storage conditions

Background: Withania somnifera (L.) (family-Solanaceae), known as ‘Indian ginseng’ or ‘Ashwagandha’ isacclaimed as an effective adaptogen, immunomodulator, aphrodisiac and sedative. Ashwagandha ghrita isa recognized ghee based Ayurvedic formulation. Few ancient texts suggest murcchana process forpreparation of Ashwagandha ghrita.Objective: The study was undertaken to evaluate probable effects of murcchana process on ghritapreparation with reference to time and storage conditions.Materials and Methods: Ashwagandha ghrita samples were prepared separately using plain ghee (Indiancow's ghee) and murcchana ghee. These formulations were stored separately in different glass bottles atroom temperature and 400C/75%RH. Organoleptic characters (colour, odour, taste, texture and touch)and physicochemical parameters (acid value, peroxide value, iodine value, saponification value, unsaponifiable matter, refractive index and specific gravity) were determined after 3, 6, 9 and 12 months.Plain ghee and prepared ghrita were subjected for antioxidant evaluation by various in vitro methods.Results: Changes were observed in organoleptic characters and physicochemical parameters of plainghee and Ashwagandha ghrita formulations. Alterations in these parameters were more pronounced athigh temperature and on long storage. Ashwagandha ghrita prepared with murcchana process exhibitedbetter antioxidant potential in all in vitro methods.Conclusion: The murcchana process was found to be beneficial towards quality of ghrita. Hence, Ashwagandha ghrita may be prepared along with murcchana herbs and stored in a good quality glass bottleto ensure improved shelf life of ghrita.

The study of blood pressure profile among school going adolescents in urban Agra

Background: Hypertension once considered a problem of adults only in the high income countries, now dramatically is on the rise in low and middle income countries. An established predictor of adult hypertension and organ damage is childhood hypertension. Thus for the control, effective treatment and prevention of its complications, early diagnosis of hypertension in adolescents in an important strategy. The objective was to study the blood pressure profile and its socio-demographic determinants among school going adolescents in urban Agra.Methods: A cross-sectional survey was done among 534 adolescent in age group of 13-18 years studying in various government and private schools in urban Agra. Socio demographic details, anthropometric measurements and family history of hypertension were obtained. Also the dietary habits, physical activity, mode of transport to school were included in the present study. Blood pressure was measured at 0 and 30 minutes and average of two readings was taken as the final reading of that individual.Results: It was found that 49.82% of the study subjects had above normal blood pressure and among them 21.16% were hypertensive and 28.66% had pre-hypertension. Higher blood pressure showed a statistically significant (p<0.05) association with gender, age, dietary habits, physical activity, body mass index, and parental history of hypertension.Conclusions: Hypertension among the adolescent age group was very high. Prevalence of high blood pressure significantly associated with age, gender, family history of hypertension, physical activity, type of school and dietary habits.

Are we pharmacovigilant enough in ophthalmic practice.

No drug is absolutely safe. Pharmacovigilance is the science related to detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problems. The ocular medications and devices can cause localized and systemic adverse effects. Not all adverse effects are known when a drug or device is launched in market because of limitations of clinical trials. Many adverse effects are recognized due to the spontaneous reporting of the vigilant doctors who observe and report such events encountered in their practice. Despite a large ophthalmic patient population base, India does not have robust adverse drug reaction (ADR) database because of lack of reporting culture. Government of India recently launched the Pharmacovigilance Programme of India (PvPI) to monitor ADRs and create awareness among the healthcare professionals about the importance of ADRs. Suspecting and reporting a possible drug reaction is very important in developing a safe and rational ophthalmic practice.

How endemic countries can accelerate lymphatic filariasis elimination? An analytical review identify strategic and programmatic interventions.

Lymphatic filariasis (LF) is endemic in 81 countries in the world, and a number of these countries have targeted for LF elimination. This review of literature and analysis was conducted to identify additional and sustainable strategies to accelerate LF elimination from endemic countries. This review noted that adverse events due to mass drug administration (MDA) of diethyl carbamazine (DEC) tablets, poor knowledge and information about LF amongst health workers & community members, and limited focus on information, education & communication (IEC) activities and interpersonal communication are the major barriers in LF elimination. The new approaches to increase compliance with DEC tablets (including exploring the possibility for DEC fortification of salt), targeted education programmes for physicians and health workers, and IEC material and inter personal communication to improve the knowledge of community are immediately required. There is a renewed and pressing need to conduct operational research, evolve sustainable and institutional mechanisms for education of physicians and health workers, ensure quality of trainings on MDA, strengthen IEC delivery mechanisms, implement internal and external monitoring of MDA activities, sufficient funding in timely manner, and to improve political and programmatic leadership. It is also time that lessons from other elimination programmes are utilized to accelerate targeted LF elimination from the endemic countries.

Causes of Child Deaths in India, 1985-2008: A Systematic Review of Literature.

Objective To understand the causes of child deaths in order to implement appropriate child survival interventions in the country. We present a systematic review of studies reporting causes of child, infant, and neonatal deaths from India for 1985 to 2008. Methods PubMed, EMBASE, Google Scholar, and WHO regional databases were searched along with a hand search and personal communication with researchers in child health to obtain studies and reports for the database. Study data was summarized and analyzed using appropriate statistical tools. Results We identified 28 published/unpublished studies and reports (6 multi-centric and 22 single sites). There was one nation wide study and rest were from 15 unique sites in 9 different states of India. There were differences in study design and cause of death assignment methods between the studies, which made comparisons and synthesis difficult. The median percentage of causes of deaths in neonatal period were sepsis/pneumonia: 24.9% (Q1: 19.6% and Q3: 33.4%); asphyxia: 18.5% (Q1: 14.2% and Q3: 21.9%); and pre-maturity/LBW: 16.8% (Q1: 12.5% and Q3: 26.5%). Amongst the infants, sepsis/pneumonia, asphyxia, and prematurity/low birth weight (LBW) remain substantial causes of deaths. The median proportional contribution of neonatal deaths to total infant deaths was 48.5% (Q1: 36.5– Q3: 57.5%). The proportion of deaths due to infectious diseases like diarrhoea, pneumonia, and measles seem to be greater in infancy, in comparison to that in neonatal period. There was no statistically significant difference in the proportional contribution of neonatal deaths to total deaths occurring during infancy (<1 year) between the two equal periods before and after 1996 (p=0.141). There also was no difference in the proportional contribution by cause of death assignment method (Verbal autopsy vs. other methods; p=0.715) or by study setting (urban vs. rural; p= 0.175). The median percentage of neonatal deaths by day 1 is 36.7% (Range: 20.0–58.0%). The median cumulative percentage of neonatal deaths by day 3 was 49.7% (Range 35.0–64.6%), and 70.9% (Range: 46.5–92.3%) by day 7. In addition, the timing of deaths during neonatal period seems to be static during the last 2 decades, with majority of deaths occurring during first week of life. Conclusions This review demonstrates the need for more studies with consistent methodological rigor investigating the causes of child death in India. We conclude that the structure of neonatal causes of death in India may be different from the rest of the world and that interventions to reduce neonatal deaths in first week of life may rapidly improve child survival in the country.

Evaluation of the knowledge, attitude and practice of self-medication among first-year medical students

This study was undertaken to determine the knowledge, attitude and practice of self-medication among first-year medical students of the Arabian Gulf University, Bahrain. This was an anonymous, questionnaire-based, descriptive study. A prevalidated questionnaire, containing open-ended and close-ended questions, was administered to the subjects. Data were analyzed using SPSS version 12 and the results expressed as counts and percentages. Out of the 134 respondents, 43 [32.1%] were males and 91 [67.9%] were females; their mean age in years +/- SD was 18.01 +/- 0.78. The respondents' knowledge about appropriate self-medication was poor, but knowledge of the benefits and risks of self-medication was adequate. The respondents found self-medication to be time-saving, economical, convenient and providing quick relief in common illnesses. Important disadvantages of self-medication mentioned were the risk of making a wrong diagnosis, inappropriate drug use and adverse effects. The majority [76.9%] of the respondents had a positive attitude favoring self-medication. Self-medication was practiced by 44.8% of the subjects. The most common indications for self-medication were to relieve the symptoms of headache [70.9%], cough, cold and sore throat [53.7%], stomachache [32.8%] and fever [29.9%]. Analgesics [81.3%] were the most common drugs used for self-medication. The practice of self-medication was appropriate in only 14.2% of cases. Knowledge about appropriate self-medication was poor, attitude towards self-medication was positive, and the practice of self-medication was common and often inappropriate

A comparative clinical study of sisomicin cream versus mupirocin ointment in pyodermas.

This study was designed to compare the efficacy and safety of sisomicin cream (0.1%) or mupirocin ointment (2%) in the treatment of primary or secondary pyodermas requiring topical antibiotic therapy alone. In the evaluable patients (n=290), impetigo was the commonest clinical condition reported. Staphylococcus aureus was the commonest pathogen isolated from the lesions. Both sisomicin and mupirocin treatments produced a steady improvement in the scores of erythema, oedema, vesiculation, pustulation, crusting and scaling but the improvement produced by sisomicin was quicker and more pronounced. The percentage of patients with complete clearing of all lesions was also higher with sisomicin than with mupirocin on days 4, 8 and 14. Patients subjectively rated the sisomicin formulation as excellent in 75% of cases as against 59% with mupirocin. Sisomicin and mupirocin are effective and safe in the management of pyodermas; however sisomicin therapy resulted in faster and greater relief of signs and symptoms.