An observational study to evaluate the awareness of drug treatment, prescription pattern, adverse drug reactions, and adherence in patients of major depressive disorder.

Aims: Due to the paucity of studies in and out of India that dealt with treatment awareness of major depressive disorder (MDD), we decided to assess the awareness of MDD patients, and since adherence and awareness are linked to each other, we assessed adherence too. Prescription pattern studies identify changes in prescriptions due to poor initial response or adverse drug reactions (ADRs), which may result in dose reduction or switching medications and delay remission. Therefore, the study assessed the ADR pattern. Methodology: A cross-sectional questionnaire-based study was carried out on 200 MDD patients with treatment records for at least 3 months after getting approval from the Institutional Ethics Committee and consent from the patients. The data obtained were entered in Microsoft Excel and analyzed using descriptive statistics. Results: The mean age was 44.65 ± 12.02 years, and females were 70%. Maximum patients (98%) were aware of the consequence of stopping the drugs suddenly, and only 12.5% were aware of the onset of response to treatment. Escitalopram was the most common antidepressant prescribed (43.77%), and 67 ADRs out of 136 were attributable to it. Weakness and fatigue were the most common ADRs. The majority (97) of the ADRs were possibly related to antidepressants, and 65% of patients showed optimal adherence to medications. Conclusions: This study sheds light on the treatment awareness and adherence of MDD patients in India and highlights the need for educating patients about treatment response. It also emphasizes the importance of monitoring ADRs and adjusting prescription patterns accordingly to improve treatment outcomes.

Underutilization of Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitors in Diabetic Nephropathy Patients in Government-Run Hospitals in India.

The editorial discusses the beneficial effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors in patients with diabetic nephropathy and their underutilization in government hospitals in India for the treatment of diabetic nephropathy. The authors provide a comprehensive analysis of various factors contributing to the under-prescription of these medications, including lack of awareness and education among healthcare professionals, limited availability and accessibility of medications, high cost, and poor adherence to evidence-based guidelines. Addressing these factors through education, research, and affordable pricing and reimbursement policies may help improve the appropriate prescription of SGLT-2 inhibitors in government hospitals in India.

Evaluation of the Effects of Caesalpinia crista on Letrozole-Induced Models of Polycystic Ovarian Syndrome.

Background Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, affecting reproductive, endocrine, and metabolic functions. This study was designed to validate the claims in Ayurveda regarding the efficacy of Caesalpinia crista (Latakaranj) to treat PCOS. Its seeds are uterine stimulants and ovulation inducers and improve menstrual cycle irregularities. Objectives The present study aimed to evaluate the effects of Caesalpinia crista on reproductive abnormalities, reproductive hormones, and glycemic changes in a letrozole-induced model of PCOS. Material and methods The study was performed in rats with six groups having six rats in each group. The control group was given the vehicle carboxymethylcellulose (CMC) for 21 days orally, followed by normal saline (0.9% NaCl) orally for 15 days. The inducing agent, letrozole, was given to the disease control group and the four treatment groups for 21 days, followed by a treatment period of 15 days with either clomiphene citrate (1.8 mg/kg) orally in the clomiphene group, low-dose (100 mg/kg) Caesalpinia crista, medium-dose (300 mg/kg) Caesalpinia crista, or high-dose (500 mg/kg) Caesalpinia crista. The variables assessed were daily vaginal smears to check for estrous cyclicity, body weight, blood glucose, serum testosterone (T), serum luteinizing hormone (LH), serum follicle-stimulating hormone (FSH), and the number of oocytes from each oviduct. Histopathology of ovaries was also done. Result There was no significant difference between the different groups for body weight and blood glucose. There was a significant difference between the regularity of the estrous cycle of the disease control group and the high-dose Caesalpinia crista (500 mg/kg) group (p<0.01). Hormonal levels of luteinizing hormone (LH) (p<0.05) and follicle-stimulating hormone (FSH) (p<0.05) were significantly raised in the high-dose Caesalpinia crista group, and that of testosterone was significantly decreased (p<0.05) in the high-dose Caesalpinia crista group compared to the disease control group. The number of ova was significantly high in the high-dose Caesalpinia crista group compared to the disease control group (p<0.05). Decreased number of atretic follicles was seen in the high-dose and medium-dose Caesalpinia crista group on histopathology, with an increased number of corpus lutea (p<0.05). Conclusion Treatment with Caesalpinia crista in high dose, i.e., 500 mg/kg, significantly improved the reproductive abnormalities (ovulation and menstrual irregularities) and histopathological changes associated with PCOS. It also restored reproductive hormone levels (testosterone, FSH, and LH), which are elevated in PCOS, and normalized the LH/FSH ratio, which is deranged in PCOS.

Anxiolytic effect of minocycline in posttraumatic stress disorder model of Syrian hamsters.

OBJECTIVE: The objective was to study the anxiolytic effect of minocycline in resident-intruder social conflict in submissive hamsters post resident intrusion model using open field test (OFT) and elevated plus maze (EPM) and serum cortisol levels. MATERIALS AND METHODS: Fifty-two singly housed male Syrian hamsters were used, post standardization of an animal model. Resident intrusion was done (5 min), in which smaller hamsters were placed in the cage of larger hamster, and the behavior of smaller hamster was noted. Eight submissive hamsters per group (disease control, lorazepam group as a positive control, and the test drug was minocycline) were used, and the drug was administered immediately post resident intrusion, intraperitoneally. Behavioral tests, namely OFT and EPM, were done followed by retro-orbital blood collection for serum cortisol estimation. The level of significance was set at P < 0.05. RESULTS: The minocycline group showed a statistically significant decrease in serum cortisol levels compared to the disease control group. Among all the variables pertaining to both the behavioral tests, namely EPM and OFT, the results indicated an anxiolytic effect, which was statistically significant compared to the disease control group. CONCLUSION: As per the biochemical test using serum cortisol levels and behavioral tests in the form of EPM and OFT, the study concluded that the anxiolytic effect of minocycline is at least comparable to the positive control, lorazepam.

An observational study to evaluate the prescription pattern of analgesics used in the perioperative period in a tertiary care hospital.

BACKGROUND AND AIMS: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. There are limited observational prescription pattern studies of analgesics in perioperative period in tertiary care hospitals for which this study was carried out in orthopedic, general surgery, and plastic surgery departments. The primary aim was to study the prescription pattern of analgesics in the perioperative period with the secondary aim to study the specific use of opioids and pain relief using the Visual Analog Scale (VAS). METHODS: A total of 250, 250, and 100 patients were taken from orthopedic, general surgery, and plastic surgery departments, respectively. The analgesics commonly used in preoperative, intraoperative, and postoperative period were observed. The use of opioids in the perioperative period, the number of fixed drug combinations used, the number of generic drug prescription, and pain relief postoperatively were also observed. The analysis was done using descriptive statistics. RESULTS: Total analgesics prescribed were 1168, 117, and 369 in orthopedic, general surgery, and plastic surgery departments, respectively, and were maximum in the intraoperative period. Most commonly used analgesic in the preoperative and postoperative period was paracetamol and that in intraoperative period was fentanyl. Nonsteroidal anti-inflammatory drugs (NSAIDs) were mainly prescribed by the general surgery department in postoperative period. The amount of pain in postoperative period after treatment with analgesics was mild to moderate as per the VAS. CONCLUSION: This study revealed that in preoperative and postoperative period, the most common analgesic used is paracetamol. In the intraoperative period, maximum patients received fentanyl. Diclofenac is an established NSAID used in the management of acute and chronic pain states. In our study, we found that the usage of paracetamol was more than NSAIDs and the usage of opioid was maximum during intraoperative period.

Perception of postgraduate students in pharmacology toward animal simulation model.

OBJECTIVE: The objective of the study is to evaluate the perception of postgraduate pharmacology students toward computer-simulated method (CSM) in comparison to the prevalent isolated live tissue-based bioassay method. MATERIALS AND METHODS: A questionnaire-based survey was conducted in 30 postgraduate pharmacology students who had used the animal simulation software and had completed at least five isolated tissue experiments. Students' opinions on the usage, logistics, advantages, disadvantages, and usefulness of CSM compared to live animal experiments (LAE) were analyzed. RESULTS: Four tissues were used for LAE, whereas with CSM, students could perform experiments using 11 different tissues. Of the total nine bioassay methods, students had performed six assay methods using both LAE and CSM. Majority of the students (23/30) agreed that CSM reduces anxiety, technical errors and is less time consuming when used before LAE. Most of the students agreed that CSM can be used for difficult, lengthy experiments (19/30), and for UG/PG teaching (19/30). However, opinions regarding replacing LAE with CSM in PG teaching were divided (agree: 7, neutral: 12, and disagree: 12). CONCLUSION: CSM should be integrated alongside LAE to complement, reinforce, and enhance learning from other techniques.

Evaluation of antiepileptic effect of S-adenosyl methionine and its role in memory impairment in pentylenetetrazole-induced kindling model in rats.

BACKGROUND: Epilepsy is the third most common cause of neurological disability worldwide. Despite the introduction of antiepileptic drugs (AEDs) in the past 20years, the seizures of around 30% of patients with epilepsy remain refractory to available treatment. Also, available AEDs and the disease itself have the potential to exert detrimental effects on cognitive function and therefore compromise patient wellbeing. S-adenosyl methionine has potential antiepileptic and memory-enhancing properties because of its involvement in the transmethylation reaction. OBJECTIVES: The present study was designed to evaluate the antiepileptic effect of S-adenosyl methionine and its role in memory impairment in the pentylenetetrazole (PTZ)-induced kindling model in rats. MATERIALS AND METHODS: The antiepileptic effect of 2 doses of SAM (50 and 100mg/kg) was tested by evaluating seizure severity score and seizure latency in the pentylenetetrazole-induced kindling model in rats. At the end of the study, spatial memory was evaluated in an elevated plus maze (EPM) test, and animals were sacrificed for estimation of oxidative stress markers in brain tissue homogenate. RESULTS: A higher dose of SAM (100mg/kg) exhibited an increase in seizure latency and a decrease in seizure severity score, suggesting its antiepileptic activity in the PTZ-induced kindling model. Also, the administration of SAM (50 and 100mg/kg) showed a decrease in transfer latency in the EPM test compared to the disease control group (p<0.0001). Biochemical analysis of rat brain tissue revealed significantly decreased malondialdehyde (p<0.0001) and increased glutathione (GSH) (p<0.0001) in the SAM 100-mg/kg group compared with that in the disease control group. CONCLUSION: The results demonstrated that S-adenosyl methionine exerts antiepileptic, memory-enhancing, and antioxidant properties in a pentylenetetrazole-induced kindling model of epilepsy.