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Dry eye syndrome (DES) is a common disorder with rising incidence due to increased use of digital devices. While multiple treatment options are available, some are not efficacious or sometimes even safe for use in DES. This is particularly true for Fixed Dose Combinations (FDCs) that may contain ingredients having no rational for their use or may actually be harmful. Various committees appointed by the Government have reviewed several FDCs marketed in India and found some of them to be irrational and recommended for their removal. This paper discusses the contents of some of these FDCs marketed for DES with an aim to ensure that prescribers are mindful of their ingredients and whether there is adequate data about their efficacy and safety and prescribe them only if they consider them necessary for managing the patient.
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Background : India launched COVID-19 mass Vaccination campaign after regulatory approval of Covishield & Covaxin vaccines. However, inspite of Vaccination, cases of COVID-19 infection are being reported. Hence, this study is aimed to assess the COVID-19 infection and/or re-infection rate, including breakthrough infections, following vaccination among Health Care Workers at a Tertiary Care Dedicated COVID Hospital. This questionnaire-based survey was initiated following Institutional Ethics Committee approval. We also looked at reasons for Vaccine hesitancy and occurrence of adverse reactions following vaccination, their management and duration amongst the Healthcare Workers. Results : Of 564 Healthcare Workers (HCWs) who consented to participate, only 503 filled in the questionnaire completely. Majority of the HCWs received Covishield vaccine (78.56%). The infection rate postvaccination was 8.28% (with a median of 22 days and IQR of 8-43 days). This infection rate was significantly higher in those who were not vaccinated as compared to the Vaccinated HCWs (OR = 0.10, 95 CI% = 0.05�22, p <0.0001). Breakthrough infection rate was 2.42. Although 58.39% of the participants suffered adverse reactions after vaccination, like myalgia, Fever, Headache, these were mild in nature lasting for an average of 3-4 days. The vaccine hesitancy rate at our hospital HCWs was 6.36%, the main issue being the concerns regarding safety and effectiveness of the vaccines against the COVID-19 infection. Discussion/Conclusion : The infection and Breakthrough infection rates in our study were low and severity of COVID infection post vaccination was mild, not requiring hospitalisation
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Background: Gentamicin is widely used as an antibiotic for the treatment of gram negative infections.Evidences indicates that oxidative stress is involved in gentamicin-induced nephrotoxicity. In Ayurvedicmedicine, Punica granatum Linn. is considered as 'a pharmacy unto itself”. It has been claimed intraditional literature, to treat various kidney ailments due to its antioxidant potential.Objective: To explore the possible mechanism of action of methanolic extract of P. granatum leaves(MPGL) in exerting a protective effect on gentamicin-induced nephropathy.Material and methods: Animals were administered with gentamicin (80 mg/kg/day i.m.) and simultaneously with MPGL (100, 200 and 400 mg/kg p.o.) or metformin (100 mg/kg p.o.) for 8 days. A satellitegroup was employed in order to check for reversibility of nephrotoxic effects post discontinuation ofgentamicin administration. At the end of the study, all the rats were sacrificed and serumeurine parameters were investigated. Antioxidant enzymes and tumor necrosis factor alpha (TNF-a) levels weredetermined in the kidney tissues along with histopathological examination of kidneys.Results: Increase in serum creatinine, urea, TNF-a, lipid peroxidation along with fall in the antioxidantenzymes activity and degeneration of tubules, arterioles as revealed by histopathological examinationconfirmed the manifestation of nephrotoxicity caused due to gentamicin. Simultaneous administration ofMPGL and gentamicin protected kidneys against nephrotoxic effects of gentamicin as evidenced fromnormalization of renal function parameters and amelioration of histopathological changes.Conclusion: Data suggests that MPGL attenuated oxidative stress associated renal injury by preservingantioxidant enzymes, reducing lipid peroxidation and inhibiting inflammatory mediators such as TNF-a.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Background: With thousands of drugs currently in the market, the potential for medication errors due to confusing drug names amongst practising physicians, pharmacists and patients is significant. The existence of confusing drug names is one of the most common causes of medication error. There are many look-alikes, sound-alike (LASA) combinations that could potentially result in medication errors. There is insufficient data about medication errors due to LASA. Hence, we conducted the present study to determine the degree of awareness regarding LASA drugs among post graduate medical physicians and Pharmacists.Methods: This study was a cross-sectional, questionnaire-based survey, conducted among 137 year post graduate medical residents of a tertiary care teaching hospital and 121 local pharmacists in an urban metropolitan Indian city.Results: There were 34% resident doctors and 17% pharmacists were aware of concept of LASA drugs. Only 46% resident doctors and 22% pharmacists had knowledge about the full form of LASA. Among resident doctors, 39% came across prescription errors due to LASA drugs. Only 69% of the pharmacists agreed that they consulted their doctors when they faced problems due to prescription errors due to similar looking and similar sounding drugs.Conclusions: Look-Alike, Sound-Alike (LASA) drugs are common source of medication errors. Our study suggests that there is lack of awareness about LASA drugs amongst resident doctors and pharmacists, which may contribute to occurrence of medication errors. Therefore, combined efforts by prescribers, pharmacists, organizations, manufacturers and patients is required to overcome medication errors due to LASA drugs.
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Background & objectives: Basti (medicated enema) is a popular Ayurvedic intervention recommended for obesity. However, there are no data to show whether any physiological or biochemical changes occur following this treatment. This study was conducted to identify the immunological and metabolic changes in obese individuals after a therapeutic course of basti. Methods: Thirty two obese individuals (18 and 60 yr) with a body mass index (BMI) ≥30 kg/m2 who received a therapeutic course of 16 enemas (basti) followed by a specific diet and lifestyle regimen for a period of 32 days as their treatment for obesity, were enrolled in the study. Clinical examination, measurement of immune and metabolic markers were done before (S1), immediately after (S2) and 90 days after the completion of therapy (S3). Results: A significant reduction (p<0.001) in weight, BMI, upper arm and abdominal circumference was seen at S3, along with a decrease in serum interferon (IFN)-γ (p<0.02), interleukin (IL)-6 (p<0.02) and ferritin (P<0.05) and increase in IgM levels (p<0.02). Peripheral blood lymphocytes (PBLs) stimulated with anti-CD3 monoclonal antibodies showed significant increase in reactive oxygen species (ROS) generation and calcium flux after Basti. All organ function tests revealed no changes. Interpretation & conclusions: Our study documents that a therapeutic course of basti modulates immune responses by regulating pro-inflammatory cytokines, immunoglobulins and functional properties of T-cells. These changes are associated with a reduction in the body weight which is maintained even after three months of treatment. the study also documents the safety of basti procedure.
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Tinospora cordifolia is used in Ayurveda as "Rasayanas" to improve the immune system and the body resistance against infections. Polysaccharides are the main constituents which are considered to be responsible for immune enhancement. In this study, immunomodulatory activity of three polysaccharide enriched fractions was evaluated using the polymorphonuclear leukocyte function test. Sugar composition was determined by GC-MS analysis of the derivatised fractions. The active polysaccharide fractions mainly constitute glucose, fructose and arabinose as monomer units.
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Functional constipation is one of the most common gastrointestinal symptoms across the globe. Its high prevalence rate, economic burden, and adverse implications on the quality of life make constipation a major public health issue. Though various treatment options are available for the management of constipation, evidence for their efficacy and safety are limited. An open-label, prospective, interventional, and exploratory clinical trial was carried out to evaluate the efficacy and safety of “TLPL/AY/01/2008” in 34 patients suffering from functional constipation. “TLPL/AY/01/2008” is an Ayurvedic proprietary polyherbal formulation in powder form, containing Isabgol husk, Senna extract, and Triphala extract. Administration of “TLPL/AY/01/2008” for 14 days showed a significant increase in mean weekly bowel movements from 10.19 ± 05.64 to 18.29 ± 05.72 (P<0.05). The mean average time spent on toilet for bowel evacuation reduced significantly from 11.02 ± 05.43 minutes (baseline value) to 08.70 ± 04.72 minutes on day 14 (P<0.05). Mean stool form score assessed on Bristol stool form scale was improved from 02.97 ± 00.48 (baseline value) to 04.61 ± 00.84 (P<0.05) on day 14. A significant improvement (P<0.05) was also noted in straining during defecation, sensation of incomplete evacuation, sensation of anorectal blockage, and other associated symptoms of functional constipation. The significant improvement in most of the above symptoms was endured for a post-treatment observatory period of one week. All the study patients showed an excellent tolerability to the study drug. These findings suggest that “TLPL/AY/01/2008” is an effective, safe, and nonhabit- forming herbal laxative formulation for the management of constipation. Comparative clinical studies with larger sample size would be able to confirm the above findings.