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Background: A lack of availability of suitable pediatric formulation and high price are often the major hindrance to the better access of the essential treatment to the children. In the backdrop of paucity of literature addressing this problem in India and in particular West Bengal, the present work was planned. Aim and Objectives: This study has been a maiden approach to generate data regarding this issue in small scale and in an inexpensive way after conducting a survey in different government and private facilities in a district of West Bengal, India. Materials and Methods: This cross-sectional study used “WHO Children’s Medicines Survey Form” to make a rapid assessment of availability and pricing of 20 core children’s medicine formulations among ten government hospitals and nine private retail pharmacies in the district of Burdwan in West Bengal during September-October 2009. In retail pharmacies, the actual price to the patient of the cheapest brand was documented. In public health facilities, procurement prices for medicines were obtained from state government’s Central Medical Stores (CMS) listing. Results: Overall, the availability was sub-optimal in all levels of public health facilities-30% in medical college pharmacy, 33% in the district reserve stores, 33.75% in sub-divisional hospitals, 32.25% in primary health centers, and in retail pharmacies was only 45%. Out of the 20 formulations, only two (ORS, paracetamol) were available in all the public and private retail pharmacies. Availability of anti-infectives was better than other medicines in both types of facilities. The variation of prices among different brands was wide. The cost of even the cheapest brand was much higher than corresponding government procurement price. Conclusion: This maiden effort reveals sub-optimal availability of core essential medicines for children in both public facilities and private retail pharmacies. However, medicines available in private pharmacies were much costlier compared to CMS procurement price. This is a matter of concern. A larger nation-wide study is the need of the hour with a greater focus on affordability and prescribing behavior.
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Background: Gugulipid obtained from Commiphora mukul carries a long history of safe and efficacious use in hyperlipidemia as per Ayurvedic literature. Statins like atorvastatin are a highly prescribed hypolipidemic drug but not free from potentially serious adverse effects. Aims and Objectives: The present study was designed to establish antihyperlipidemic activity of gugulipid in triton-induced hyperlipidemic rats in comparison to atorvastatin and simultaneously to explore the combination of gugulipid and atorvastatin for any synergistic activity. Materials and Methods: Male Wistar albino rats (20) were divided equally into vehicle (2% gum acacia) (Group I), gugulipid only 6.75 mg/kgbw (Group II), atorvastatin 7.2 mg/kgbw only (Group III), and gugulipid 6.75 mg/kgbw and atorvastatin in 7.2 mg/kgbw combination (Group IV) in Phase 1 study. In Phase 2, additional three groups were created with five rats in each receiving gugulipid 6.75 mg/kgbw with atorvastatin at 5.4 mg/kgbw, 3.6 mg/kgbw, and 1.8 mg/kgbw dosage, respectively (Groups V–VII). Hyperlipidemia was induced by single intraperitoneal injection (400 mg/kgbw) of triton after 7 days of feeding with respective agents dissolved in vehicle through oral route. Results: Regarding total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL), Gr II was found superior to Gr I but inferior to others (P < 0.01). Gr IV prevented the rise of TC and TG significantly in comparison to Gr V, VI, and VII (P < 0.01) whereas Groups V and VI having non-significant difference in between, both differed significantly (P < 0.01) with Gr VII. Groups IV, V, and VI prevented the rise of serum LDL significantly (P < 0.01) from Group VII. Conclusion: Gugulipid showed significant antihyperlipidemic activity and was found to be optimally efficacious and safe in combination with even reduced dose of atorvastatin.
RESUMO
Background: Studies comparing the efficacy and tolerability of the three fixed combinations of timolol with its monotherapy are not readily available. In this background, the current prospective observational study was planned. Aim and Objective: To evaluate and compare the intraocular pressure (IOP) reduction, change in visual field, and cup-disc ratio in glaucoma patients receiving timolol monotherapy vis-a-vis timolol based dual therapies among timolol sub-optimal responders. Materials and Methods: After obtaining written informed consent and fulfilling the inclusion-exclusion criteria, fifty consecutive newly diagnosed cases of glaucoma or ocular hypertension with risk factors were recruited in the study. They received timolol eye drop up to 4th week. Participants not responding to timolol monotherapy optimally received either timolol plus brimonidine or timolol plus dorzolamide or timolol plus latanoprost for another 12 weeks. Participants responding optimally (at least 30% reduction of baseline) were continued with timolol monotherapy. Besides IOP changes, effects on visual field, visual acuity, cup disc ratio, safety, tolerability, and rate of persistency to therapy were studied. Results: Fifteen participants (30%) achieved target IOP reduction at 4 weeks of timolol monotherapy. All four treatment groups achieved significant IOP reduction (P < 0.001) from baseline to 16th week. Participants receiving timolol followed by timolol plus latanoprost had shown the highest IOP reduction at 16th week both from baseline and 4th week value (ANOVA test, P = 0.027, P = 0.000 respectively). No change in visual field or visual acuity or cup disc ratio was noticed. Adverse drug reactions observed were mild and mostly self limiting. Conclusion: Timolol and latanoprost combination might be a better choice in sub-optimal responders to timolol whereas it is wise to continue timolol monotherapy in optimally responders.
RESUMO
Erectile dysfunction (ED) is the inability to achieve or maintain an erection that is required for satisfactory sexual performance, and affects a considerable proportion of men around the globe at least occasionally. Although roles for nonendocrine and endocrine pathways have been propose, presence of comorbidities, psychogenic factors may contribute to its development. Large number of published reports link many commonly prescribed drugs with sexual dysfunction. Many common drugs such asanti-hypertensive, anti-psychotic, and anti-histaminic are linked with iatrogenic ED. On the other hand, psychogenic ED may be wrongly perceived to be of iatrogenic origin. While dealing a subject with ED it is important for the clinicians to take a detailed medical, surgical, sexual and drug/substance abuse history. In this article, we have described two such cases which would reflect the importance of determining the cause of ED before initiating treatment.
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Aim: A study was conducted to develop a new approach of non-stress baseline and evaluate different approach of determining non stress baseline for Crop Water Stress Index (CWSI).Methodology: To observe maximum and minimum canopy temperature, two plots with three replications were maintained at fully stress (no irrigation) and no stress (fully irrigated) conditions, respectively. Portable weather station with data logger was installed at the middle of field to record continuous data at half an hour interval. Gypsum block soil moisture sensor were buried at 20 cm interval up to 100 cm and connected with data logger. Infrared radiometer was used to measure canopy temperature. Results: The evaluation was based on five statistical indicators; correlation coefficient (R2), root mean square error (RMSE), mean absolute error (MAE), mean bias error (MBE) and Wilmot index of agreement (d). It was found that new regression base line performed better than other existing approaches. The calculated value of RMSE, MAE, MBE, d and R2 were 0.65, 0.51, 0.02, 0.79 and 0.83, respectively, for new baseline approach. Interpretation: The newly developed multiple regression equation (incorporating three weather parameters (Rn, VPD and u) and two crop growth parameters (h and CC)) helped to reduce error in the calculation of non-stress baseline for wheat crop in humid subtropical climate
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Aim: The present study aimed to understand the periodical changes in fine root biomass, production, turnover and carbon and nitrogen return in forest fallows following shifting agriculture in Mizoram, Northeast India. Methodology: Root biomass was determined using sequential coring method in different fallow lands (FL-3, FL-5 and FL-10) following shifting agriculture. Annual fine root production was calculated as the sum of differences between annual maximum and minimum root biomass of different diameter classes. Concentrations of carbon and nitrogen in soil and roots were determined using CHN auto-analyzer, and their accumulations and returns were computed as the product of mass and element concentrations. Results: Total root biomass was maximum (561 g m-2) at FL-10, which decreased to 141 g m-2 at FL-3 with greater accumulation of fine roots in upper soil layer (0-10 cm) and coarse roots in lower depths. Root biomass was maximum (1499 g m-2) at the time of slashing which decreased to about one fourth just after burning. The amount of organic matter, carbon and nitrogen return to soil through fine root death was significantly regulated by soil moisture, microbial biomass carbon and total nitrogen in different fallow lands. Interpretation: Addition of organic matter, carbon and nitrogen to soil through death and decomposition of fine roots is an important mechanism responsible for sustaining soil fertility and crop productivity in different fallow lands. The output of the study has implications for the management of fallow lands following shifting cultivation and modeling global cycles of carbon and nitrogen.