RESUMO
Seizure is a very common manifestation of a variety of disorders in pediatric age groups. The choice of antiepileptic drugs varies in different age groups in various doses, routes and frequencies. The perception of the care giver regarding proper use of medications is also equally important for success of pharmacotherapy. This study aimed to explore the prescribing pattern of seizure medications in pediatrics inpatients of a tertiary care hospital and assess the parent’s knowledge on drug intake simultaneously. Methods: A prospective observational study carried out with the prescription data of 107 children aged less than 18 years admitted in the pediatric department with the diagnosis of seizure and analyzed with descriptive statistics to obtain drug utilization indices. A questionnaire survey was employed on the parents of the children to assess their knowledge. Results: Neonatal presentation with seizure was more common than older pediatric age group. Commonest causes of convulsions were birth asphyxia with its sequel (84.78 %), CNS infection (39.34%) and epilepsy (32.79%). Monotherapy was highly prevalent (73.80%) with phenobarbitone and phenytoin being commonest drugs in neonatal and post-neonatal populations respectively. No newer generation antiepileptics were used. Generic prescribing was 28.03% with all the drugs being enlisted in essential medicine list. Average no. of anticonvulsants per prescription was 1.28. Parent’s knowledge about frequency of drug administration and food interaction was largely deficient. Conclusion: Monotherapy with older antiepileptics are preferred in pediatric indoor patients presenting with seizures. Parent education on appropriate use of medication is needed to rationalize the therapy.
RESUMO
Background: Vitiligo is an idiopathic skin disease manifested by depigmented macules. It is characterised by melanocyte destruction, and redox imbalance is proposed to play a contributory role. Aim: The aim of this study was to analyze the effects of an ethanolic extract of Piper betle leaves on the generation of reactive oxygen species in erythrocytes sourced from vitiligo patients. Methods: The effect of Piper betle on the generation of reactive oxygen species in erythrocytes was measured by fl ow cytometry in patients with active and stable vitiligo versus healthy controls, using 5-(and-6)-chloromethyl-2’-7’-dichlorodihydrofl uorescein diacetate. Results: The generation of reactive oxygen species in erythrocytes was higher in patients with vitiligo (n = 23) compared to healthy controls (n = 18). The geometrical mean fl uorescence channel was 23.05 ± 2.11 in patients versus 17.77 ± 1.79 in controls, P = 0.039. The levels of reactive oxygen species were higher in patients with active vitiligo. Treatment of erythrocytes with Piper betle in concentrations of 0.5 and 1.0 μg/ml signifi cantly decreased the baseline levels of reactive oxygen species by 31.7% in healthy controls, and 47.6% and 44.3% in patients with active vitiligo, respectively. Piper betle effectively scavenged hydrogen peroxide, which was evident by a decrease in the geometrical mean fl uorescence channel by 52.4% and 62.9% in healthy controls, and 45.0% and 57.0% in patients with active vitiligo. Limitations: The study had a small sample size. Future studies should focus on evaluation of the antioxidant role of Piper betle at the lesional site. Conclusion: This pilot study indicates that patients with active vitiligo demonstrate enhanced generation of reactive oxygen species in erythrocytes, which was signifi cantly reduced following ex vivo treatment with Piper betle.