An Exploratory Study on the Drug Utilization Pattern in Glaucoma Patients at A Tertiary Care Hospital.

Glaucoma is a chronic, progressive optic neuropathy caused by group of ocular conditions which lead to damage of optic nerve with loss of visual function. The objective of the study is to assess the average number of drugs per prescription, formulations being prescribed, various categories of drugs being prescribed and the category most often used in glaucoma patients in ophthalmology. This is a retrospective hospital based study carried out in the department of ophthalmology at A.J institute of medical sciences, Mangalore. The study period was from July 2012 to July 2013. Total number of prescriptions analyzed were 344 , in which total of 1,064 drugs were prescribed. Analysis of the prescriptions showed that average number of drugs per prescription was 3.09. The maximum number of drugs prescribed were in the form of eye drops (76.56%), followed by ointments (12.06%), tablet (4.2%), capsules (3.94%), syrup (2.16%) and injection (1.08%). The dosage form was indicated for 94%, frequency of drug administration for 96% drugs and duration of treatment for only 78% of the drugs prescribed. Around 48.44% of diagnosis accounted for primary open angle glaucoma. Rest 32.96% and 18.6% acconting for angle closure glaucoma and absolute glaucoma respectively. The number of antibiotics prescribed was 600 (56.43%), out of these 413 (68.79%) antibiotics were prescribed in the form of drops, 174 (29.06%) as ointment and 13 (2.15%) orally. Number of encounters with anti-inflammatory and antiallergic drugs was 118 (11.12%), mydriatics and cycloplegics 105 (9.84%), miotics 28 (2.6%), lubricant and miscellaneous eye drops 209 (19.63%) and multivitamins 4 (0.38%). Prescription writing errors were at its minimum thereby avoiding irrational prescriptions. Duration of treatment and prescribing by generic name were very low.

Anxiolytic effect of chronic administration of ursolic acid in rats.

Anxiety is a cardinal symptom of many psychiatric disorders and an almost inevitable component of many medical and surgical conditions. Indeed it is a universal human emotion, closely allied with appropriate fear presumably serving pyschobiologically adaptive purposes. Anxiety is a normal emotional behaviour. When it is severe and/or chronic, however, it becomes pathological and can precipitate or aggravate cardiovascular and psychiatric disorders. Although many drugs are available in allopathic medicine to treat anxiety disorders, they produce various systemic side effects. Ursolic acid has been identified as the active principle of Ocimum sanctum. From our laboratory we have established the antianxiety, anticateleptic and antidepressant activity of ethanolic extract of leaves of Ocimum sanctum. In the present study, we have attempted to evaluate the anxiolytic- activity of ursolic acid in rats by employing, elevated plus maze and bright and dark arena. The rats were divided into five groups, each group containing six animals. The effects of the test drug ursolic acid (at 0.05, 0.1 and 0.2 mg/kg doses), the standard anxiolytic, diazepam (1.0 mg/kg) and control group 14% dimethyl sulfoxide (10ml/kg) were assessed after repeated doses administration for ten days. The results suggest that, ursolic acid exhibited anxiolytic like activity comparable to diazepam.

Effect of acorus calamus on electrical and chemical induced seizures in mice.

Acorus calamus Linn. (Family: Araceae) is an aromatic semi-aquatic perennial marshy herb. Experimental studies have indicated the efficacy of this plant against various types of epileptic seizures, but the results vary with the models and the type of extract used. These conflicting reports and the unavailability of the data regarding the effects of aqueous extract of Acorus calamus (AEAC) prompted us to evaluate the efficacy of AEAC on electrical and chemical induced seizures in albino mice. Either normal saline or sodium valproate or AEAC was given sixty minutes prior to the experiment in acute study, whereas in chronic study, they were given twice daily for ten days and the last dose was given one hour prior to the exposure of the animal either to maximal electrical shock (MES) or pentylenetetrazole (PTZ) administration. On acute administration, AEAC dose dependently reduced the duration of tonic hind limb extension in MES induced seizure which was comparable to that produced by sodium valproate. Whereas, in PTZ induced seizures, the test drug decreased the latency and increased the duration of seizures as well as mortality. On repeated administration (chronic study) the test drug significantly reduced the duration of tonic hind limb extension and also the clonus phase of MES induced seizures. However, in PTZ induced seizures, results were similar to that obtained in acute study. Results indicates that AEAC has protective effect against MES, but not against PTZ induced seizures.

Antidepressant activity of aqueous extract of fruits of emblica officinalis in mice.

Depression is a widespread psychiatric disorder affecting around 5% of the population. Furthermore, it is difficult to predict which patient will respond to any given treatment. In the traditional systems of medicine, many plants and formulations have been used to treat depression for thousands of years. Emblica officinalis (EO) contains tannic acid as its main ingredient and this compound has been shown to have non-selective mono-amine oxidase activity. Therefore, the present study was undertaken to evaluate the antidepressant potential of acute and chronic administration of EO in forced swim test (FST) and tail suspension test (TST). Inbred adult male Swiss Albino mice weighing 25-30g were used in the study. Standard drug (imipramine) and test drug (EO) were suspended in 1% gum acacia. The vehicle (10ml/kg, p.o), imipramine (10mg/kg, p.o) and EO (0.8mg/kg, 2mg/kg, 4mg/kg, p.o. respectively) were administered 1hour prior to acute study. In chronic study, all drugs were given for 10 days and the last dose was given 1hour before the experiment. Duration of immobility was noted in both the models. In our study, both imipramine and EO significantly reduced the duration of immobility in both experimental models as compared to the animals in the control group. The antidepressant activity of EO was comparable to that of standard drug imipramine. The results of the present study indicate the potential for use of EO as an adjuvant in the treatment of depression.

Evaluation of the anti-ulcer activity of NR-ANX-C (a polyherbal formulation) in aspirin & pyloric ligature induced gastric ulcers in albino rats.

Background & objectives: The aetiology of gastric ulcers is not completely understood and continuous use of anti-ulcer agents leads to many side effects. In this study we evaluated the anti-ulcer efficacy of a polyherbal formulation with potent antioxidant activity in aspirin and pyloric ligature induced gastric ulcers in rats. Methods: The efficacy of the polyherbal formulation NR-ANX-C (composed of the extracts from Withania somnifera, Camellia sinensis, Ocimum sanctum, shilajith and triphala) was evaluated in terms of antioxidant potential as assessed in terms of protection from lipid peroxidation and the antiulcer activity as seen by the area of gastric lesions, gastric juice volume, gastric pH, total acidity and total adherent gastric mucus content. Results: In our study, NR-ANX-C (25 and 50 mg/kg) was more efficacious than ranitidine in reducing ulcer index in both the models. At the highest dose tested (50 mg/kg), NR-ANX-C was comparable to omeprazole in preventing ulcer formation in the pyloric ligature model. NR-ANX-C showed a dose- dependent decrease in gastric juice volume and total acidity in both the models. A dose-dependent increase in gastric pH and total adherent gastric mucus was also seen in NR-ANX-C treated groups. The extent of lipid peroxidation was also reduced in the test drug treated groups. Interpretation & conclusion: Based on our findings, we presume that the cytoprotective, anti-secretary and antioxidant properties of NR-ANX-C were responsible for its anti-ulcer activity. These findings suggest the potential for use of NR-ANX-C as an adjuvant in the treatment of gastric ulcer.

Effect of NR-ANX-C (a polyherbal formulation) on haloperidol induced catalepsy in albino mice.

BACKGROUND & OBJECTIVE: Use of typical antipsychotics like haloperidol in treatment of schizophrenia is associated with a high incidence of extrapyramidal side effects. In rodents, administration of haloperidol leads to the development of a behavioural state called catalepsy, in which the animal is not able to correct an externally imposed posture. In the present study we evaluated the anticataleptic efficacy of NR-ANX-C, a polyherbal formulation containing bioactives of Withania somnifera, Ocimum sanctum, Camellia sinensis, triphala and shilajit in haloperidol induced catalepsy in mice. METHODS: Five groups (n = 6) of male albino mice were used in the study. Catalepsy was induced by ip administration of haloperidol (1mg/kg). The degree of catalepsy (cataleptic score) was measured as the time the animal maintained an imposed posture. We compared the anticataleptic efficacy of NR-ANX-C (10, 25 and 50 mg/kg) with scopolamine (1 mg/kg). The superoxide dismutase (SOD) level in brain tissue was also estimated to correlate the levels of oxidative stress and degree of catalepsy in the animal. RESULTS: Significant (P<0.01) reduction in the cataleptic scores was observed in all NR-ANX-C treated groups and maximum reduction was observed in the NR-ANX-C (25 mg/kg) treated group. Significant (P<0.05) reduction in SOD activity was observed in NR-ANX-C (25 and 50 mg/kg) treated groups and maximum reduction was observed in NR-ANX-C (25mg/kg) treated group. INTERPRETATION & CONCLUSION: In our study, maximum reduction in cataleptic score was observed in NR-ANX-C (25 mg/kg) treated group. The maximum reduction in SOD activity was also observed in the same group. These findings suggest a possible involvement of the antioxidant potential of NRANX- C in alleviating haloperidol induced catalepsy.