Zincovit syrup ameliorates oxidative stress induced by carbon tetrachloride in rats.

Background: Zincovit (ZVT) syrup is a combined formulation of vitamins, minerals and lysine. The present study was aimed to investigate the in vivo antioxidant potential of ZVT syrup in carbon tetrachloride (CCl4) intoxicated Wistar rats. Methods: A total of 36 Wistar rats were divided into six groups of six rats each. Antioxidant potential of ZVT syrup at the dose of 15 mg/kg/day, 30 mg/kg/day and 60 mg/kg/day was evaluated in CCl4 intoxicated rats. The extent of CCl4 induced oxidative stress was studied by estimating malondialdehyde (MDA), glutathione-Stransferase (GST) and catalase (CAT). Results: Oral treatment with ZVT syrup, especially at the dose of 30 mg/kg/day and 60 mg/kg/day reversed CCl4 - induced alterations in MDA (p<0.05), GST (p<0.01) and CAT (p<0.01) compared to CCl4 intoxicated control (untreated) animals. Conclusion: The present findings revealed that ZVT syrup may be useful in oxidative stress associated tissue damage as a nutritional food supplement.

Adverse drug reactions and cost effectiveness of non-steroidal antiinfl ammatory drugs, muscle relaxants, and neurotropic drugs in patients with low back pain.

Background: The objective was to evaluate the adverse drug reactions (ADRs) and cost effectiveness of different classes of drugs in therapy of low back pain. Methods: A prospective observational study was carried out over a period of 12 months (November 2012 to November 2013) in which a total of 300 patients with low back pain were enrolled and divided equally into three groups – Group 1 (nonsteroidal anti-infl ammatory drugs [NSAIDs]), Group 2 (NSAIDs ± muscle relaxant), and Group 3 (NSAIDs ± muscle relaxant ± neurotropic drugs). Any ADR developed after the initiation of treatment at 3 weeks and 6 weeks was noted. Prescription cost per day was also calculated. Results: There was a male predominance in the study population with a mean age of 39.76±9.40 years. A total of 262 ADRs were noted among which most were seen in Group 3 (119 ADRs). Gastritis was the most common ADR in Group 1. Drowsiness was the most common ADR in Group 2 (30%) and 3 (46%). Prescription cost per day was highest in Group 3 (30.28±11.24 Indian Rupee [INR]) followed by Group 2 (25.92±8.66 INR) and Group 1 (12.22±3.38 INR). Conclusion: Patient on combination of three drugs (NSAIDs, muscle relaxants, and neurotropic agents) had maximum ADRs and their prescription cost per day was highest among the three groups.

Students’ attitude toward didactic lecture versus problem-based learning in pharmacology: a questionnaire based study.

Background: The study was conducted to assess student attitude toward learning by didactic lectures versus problem-based learning (PBL). Methods: A questionnaire containing 11 statements was distributed to the students. Statements ranged from general information on lectures and PBL to benefits of lecture-based learning (LBL) over PBL and vice versa. The students were asked to score each individual statement. The median total scores and median with interquartile range of individual statements was calculated. A comparison between questions that support LBL or PBL was performed. Student t-test was employed to compare the mean scores of different groups. Results: Two hundred and seven students participated in this questionnaire study. The individual median total score was 42 when compared with possible total score of 55. There was a statistically significant (p<0.05) difference between the total score (mean±standard deviation) for the questions related to LBL (3.2391±0.05120) and those related to PBL (4.0640±0.05688). Conclusion: The score for PBL was significantly higher than LBL showing that students liked PBL more than LBL.

Nevirapine induced Stevens-Johnson syndrome: a case report.

Stevens-Johnson syndrome (SJS) is a severe mucocutaneous skin reaction with extensive necrosis and detachment of the epidermis. Nevirapine is one of the high risk agents implicated in development of SJS. Here, we present a case of 27 years old male with HIV infection who was diagnosed to have SJS following administration of nevirapine.

Effect of Clobetasol Propionate and Clobetasol Butyrate with Biopolymer on Skin Inflammatory Model in Wistar Rats.

The treatment of chronic inflammatory skin conditions are not satisfactory. There is a need for better antiflammatory drugs for these conditions. This study was done to compare the efficacy of biopolymer based formulations of clobetasol propionate and clobetasol butyrate with commercially available Preparations of clobetasol in animal models of superficial skin inflammation in rats. The croton oil ear edema in rats was the chronic inflammatory model used in this study. In this model, the animals treated with clobetasol propionate and clobetasol butyrate with biopolymer showed a significant decrease in inflammation as compared to commercially available preparations of clobetasol(Tenovate and Eumosone).

Comparative effect of calcium mupirocin and fluticasone on experimentally induced burn wound healing in rats.

Topical antibiotic like Calcium mupirocin and its combination with steroid Fluticasone are commonly used to treat burn wounds. But whether they influence healing of wounds is not known. Aim: To compare the effect of Calcium mupirocin and Fluticasone of Apex Laboratories Chennai, on experimentally induced burn wound healing in Wistar rats and compare with available market preparation Mupirocin and Fluticasone -mupirocin combination. Method: Partial thickness burn wound was inflicted, on Wistar rats under ketamine (50mg/kg/i.p) by pouring hot molten wax at 80◦ C into a metal cylinder of 300 mm2 circular opening placed on shaven back of the rat. Animals with partial thickness burn wounds were divided into 7 groups (n=10). Group I did not receive any drug and served as control group. Group II, III, IV, V, VI, and VII received Calcium mupirocin A, Calcium mupirocin B, Mupirocin, Fluticasone+Calcium mupirocin A combination. Fluticasone +Calcium mupirocin B combination and Fluticasone -mupirocin combination creams respectively, twice a day for 21 days or till complete healing whichever was earlier. Results: Calcium mupirocin significantly decreased the duration of epithelialization and increased % of wound contraction in comparison to the control group. This was confirmed by Histopathology studies. Conclusion: Calcium mupirocin of apex possess significant wound healing properties.

Evaluation of antiinflammatory and analgesic activities of alcoholic extract of kaempferia galanga in rats.

Alcoholic extract of Kaempferia galanga was tested for analgesic and antiinflammatory activities in animal models. Three doses, 300 mg/kg, 600 mg/kg and 1200 mg/kg of the plant extract prepared as a suspension in 2 ml of 2% gum acacia were used. Acute and sub acute inflammatory activities were studied in rats by carrageenan induced paw edema and cotton pellet induced granuloma models respectively. In both models, the standard drug used was aspirin 100 mg/kg. Two doses 600 mg/kg and 1200 mg/kg of plant extract exhibited significant (P<0.001) antiinflammatory activity in carrageenan model and cotton pellet granuloma model in comparison to control. Analgesic activity was studied in rats using hot plate and tail-flick models. Codeine 5 mg/kg and vehicle served as standard and control respectively. The two doses of plant extract exhibited significant analgesic activity in tail flick model (P<0.001) and hot plate model (P<0.001) in comparison to control. In conclusion K. galanga possesses antiinflammatory and analgesic activities.

Effect of topical phenytoin on burn wound healing in rats.

To evaluate the effect of phenytoin on burn wounds and to compare the effect of the combination of topical phenytoin preparation in dexamethasone treated burn wounds in rats, partial thickness thermal burn wounds were inflicted upon five groups of six rats each. Group I was assigned as control, Group II received the standard silver sulphadiazine, Group III was given topical phenytoin and Group IV received injection dexamethasone, Group V received the combination of the phenytoin and the dexamethasone. The parameters observed were epithelialization period, percentage of wound contraction and histopathological analysis as indicative of the process of healing. Phenytoin group showed significant improvement in burn wound contraction in comparison to standard silver sulphadiazine group, the combination group of topical phenytoin and dexamethasone also showed significant contraction compared to dexamethasone group. The period of epithelialization also decreased significantly in groups II, III and V. In conclusion, phenytoin promotes burn wound healing as evidenced by decrease in period of epithelialization and faster wound contraction.

A double blind randomized pilot clinical trial comparing the safety, tolerability and efficacy of combination of topical sodium fusidate and betamethasone valerate in biopolymer versus combination of fusidic acid and betamethasone valerate in the treatment of infected eczema.

Background: Eczema or dermatitis is a reaction pattern of the skin manifesting as itching, inflammation, redness, and swelling of the skin. There is currently no cure for eczema, but the condition can be controlled with a good treatment plan and newer strategies in formulation of existing drug can improve efficacy and acceptability. Aims: To evaluate the efficacy, tolerability and safety of topical Sodium Fusidate and Betamethasone Valerate in biopolymer Versus Combination of Fusidic acid and Betamethasone Valerate in the Treatment of Infected Eczema. Methods: This was a 6 week study in which patients had screening and randomization visit (day 0, visit 1), treatment assessments visits at week 2 (visit 2) and week 4 (visit 3) and a follow-up visit (visit4). The blinded medication was dispensed to patients. During visit 2 (after 2 weeks), a detailed skin examination and modified eczema scoring (12 points eczema score and 12 points of infection score with total of 24 points), Visual analogue scale for pruritus and global score index were carried out. Any adverse event was recorded. During visit 3 (week 4), clinical examination and laboratory examination (Hb%, TC, DC, ESR) was performed. Adverse events and patient compliance were also recorded during these visits. Results and Conclusions: Topical sodium fusidate and betamethasone valerate in biopolymer has shown to be more efficacious than topical sodium fusidate and betamethasone valerate. Both the combinations were well tolerable and safe.

Bullying among trainee doctors in Southern India: a questionnaire study.

BACKGROUND: Workplace bullying is an important and serious issue in a healthcare setting because of its potential impact on the welfare of care-providers as well as the consumers. AIMS: To gauge the extent of bullying among the medical community in India; as a subsidiary objective, to assess the personality trait of the bullying victims. SETTINGS AND DESIGN: A cross-sectional, anonymous, self-reported questionnaire survey was undertaken among a convenient sample of all the trainee doctors at a Government Medical College in Tamil Nadu, India. MATERIALS AND METHODS: A questionnaire, in English with standard written explanation of bullying was used. Basic information like age, sex, job grade and the specialty in case of Postgraduates (PGs) were also collected. Statistical Analysis: The results were subjected to descriptive statistical analysis and Chi-square test for comparison of frequencies. RESULTS: A total of 174 doctors (115 PGs and 59 junior doctors), took part in the study with a cent percent response. Nearly half of the surveyed population reported being subjected to bullying. Nearly 54 (53%) of the men and 35 (48%) of women were subjected to bullying. Significant proportions (P < 0.0001) of medical personnel and paramedical staff bullied the PGs and junior doctors, respectively. More than 85 (90%) of bullying incidents went unreported. A significant (P < 0.0001) percentage of PGs and junior doctors revealed a personality trait towards bully. CONCLUSIONS: Workplace bullying is common among trainee doctors and usually goes unreported.

Aspirin resistance.

Aspirin reduces the odds of serious atherothrombotic vascular events and death in a broad category of high risk patients by about one quarter. The term 'aspirin resistance' has been used to describe not only an absence of the expected pharmacologic effects of aspirin on platelets but also poor clinical outcomes, such as recurrent vascular events, in patients treated with aspirin. Various factors such as genetic, nonadherence, variable response to different doses, co-morbid conditions and drug interactions are responsible for aspirin resistance. Many methods, with their limitations, are available to measure the effects on platelets. Despite treatment failures, aspirin remains the single most cost-effective drug for the secondary prevention of atherothrombotic disease. To optimize its clinical effectiveness, clinicians should be aware of the potential causes of aspirin treatment failure, prescribe aspirin in appropriate doses, and encourage patients to take aspirin, stop smoking, and avoid regular use of NSAIDs.

Enhanced wound contraction and epithelization period in steroid treated rats: role of pyramid environment.

Contribution and role of a pyramid/square box on the wound healing suppressant effect of dexamethasone was studied in rats of either sex using excision wound model to record the wound contraction rate and epithelization period. The results showed enhanced wound contraction rate and decreased epithelization period in the pyramid-exposed rats as compared to controls. Thus, it appears that pyramid environment facilitates the process of wound healing. Also, the wound healing suppressant effects of dexamethasone were significantly reduced.

Efficacy and tolerability of trandolapril in mild to moderate hypertension--a double blind comparative clinical trial with enalapril in Indian population.

Several large scale clinical trials have demonstrated that angiotensin converting enzyme inhibitors offer cardiovascular and renal protection independent of their effects on systolic BP. Trandolapril is a new angiotensin converting enzyme inhibitor approved for the treatment of hypertension. The potential advantages of this drug are long duration of action and better tolerability. The objective of the study was to compare the efficacy and tolerability of trandolapril with that of enalapril in mild to moderate hypertension in Indian population. In this double blind, multicentric, parallel comparative clinical study, 120 patients with mild to moderate hypertension were randomly assigned to receive trandolapril 2 mg or enalapril 5 mg once daily for 8 weeks. The attainment of sitting diastolic blood pressure <90 mmHg at the end of 8th week was considered as primary outcome measure and attainment of diastolic blood pressure <90 mmHg or reduction of at least 10 mmHg diastolic blood pressure compared to baseline at any visit was considered as secondary outcome measures. 98.4% patients treated with trandolapril and 92.6% patients treated with enalapril fulfilled the primary outcome measure. 54, 72 and 62% patients on trandolapril and 52, 61 & 64% patients on enalapril fulfilled secondary outcome measure at the end of 2nd, 4th and 8th week respectively. Also trandolapril was better tolerated than enalapril with no significant abnormality in lab parameters.

Effect of intracerebroventricular methotrexate on brain amines.

Intrathecal methotrexate in children with leukemia is known to cause seizures, dementia, leukoencephalopathy and cognitive dysfunction. To investigate the role of brain amines in cognitive dysfunction, male Wistar rats were given multiple intracerebroventricular injections of methotrexate. Our earlier studies in this regard revealed disruption of brain monoamines in hippocampus with severe cytotoxic effect on CA4 hippocampal neurons. Further extending this study, the levels of brain monoamines in frontal cortex, hypothalamus and brainstem were estimated by HPLC method and histopathological study of the frontal cortex. The concentration of all three-brain amine (norepinephrine, dopamine and serotonin) levels was reduced in 2 mg/kg dose of methotrexate in frontal cortex and brain stem. Hypothalamus did not show any significant change in brain monoamine levels. No structural changes in the frontal cortex neurons were observed. Disruption of brain monoamines has been proposed as a cause of brain dysfunction from this chemotherapy. The outcome of the study may have therapeutic implications in the management of childhood lymphoblastic leukemia.

L-ascorbic acid ameliorates postnatal endosulfan induced testicular damage in rats.

The aim of the present study is to investigate the effect of L-ascorbic acid on postnatal exposure of endosulfan induced testis damage in the rat. Four groups of seven day old male Wistar rats were treated with 3, 6, 9 and 12 mg/kg endosulfan orally (10 pups/group), from postnatal day 7 to 60 at intervals of 24 h. For 2 more groups (n = 10/group), endosulfan (9 mg/kg and 12 mg/kg) was administered along with L-ascorbic acid (20 mg/kg). The sperm morphology, sperm count and sperm motility was analyzed in all the groups on postnatal day 70. Endosulfan significantly affected the testicular function enhancing the incidence of abnormal spermatozoa, decreasing the sperm count and sperm motility in a dose dependent manner. Abnormalities were of both head and tail and increase in their frequency was more than two-fold of the control value. Sperm count abruptly decreased in 12 mg/kg group and sperm motility decreased up to 50% of the control value. L-ascorbic acid has nullified the toxic effects of the pesticide significantly, but not to the control level. Endosulfan induces the testicular damage following postnatal exposure and L-ascorbic acid prevents the adverse effects considerably in the rat.

Evaluation of intraperitoneal vincristine in malignant peritoneal effusion.

The efficacy and safety of intraperitoneal administration of vincristine sulphate was determined in mice bearing Ehrlich ascitic carcinoma. The tumor bearing animals were administered with 0.5 mg/kg body weight (b.wt) of freshly prepared vincristine sulphate intraperitoneally on day 6 after tumor transplantation followed by drug administration once daily 5 days a week consecutively. The observations regarding the survival, alteration in the volume of peritoneal fluid, increase in life span and pathological changes in the liver, kidney, gastrointestinal tract and bone tissues were made. The vincristine sulphate treatment reduced the malignant cell population significantly and there were no significant changes in the histological picture of liver, kidney, bone, except the intestine, where atropy of villi demonstrating nests and cords of uniform small round cells were observed. Our experimental data suggests that intraperitoneal administration of vincristine is beneficial in malignant peritoneal effusion.

Pyramid environment reduces the wound healing suppressant properties of dexamethasone in albino rats.

With a view to investigate the contribution and role of environment within a wooden pyramid model on the wound healing suppressant effect of dexamethasone in rats, wound breaking strength, dry weight, hydroxyproline content and histology of granulation tissue of the dead space wound were studied in rats. The results indicate that the environment within the wooden pyramid not only promotes significant wound healing but also reduces the wound healing suppressant effect of dexamethasone. Histological studies also confirmed the results.

Evaluation of hepatoprotective activity of Ginkgo biloba in rats.

The mechanism of hepatoprotective effects of Ginkgo biloba (GB), an herbal preparation with wide variety of therapeutic application, on paracetamol (Pcml) induced hepatic damage in rats has been investigated. GB treatment restored the marker enzyme levels indicating the in vivo protective effects against Pcml induced liver damage both in preventive and curative aspects. GB also reversed the increased TBARS levels, and elevated the GSH content of the liver. The results obtained from the study indicate hepatoprotective nature of GB, which might be due to its ability to prevent lipid peroxidation and replenishing the gllutathione level. The effects of GB were comparable to that of silymarin.