Nasal Spray Use Technique Among Patients Attending the Out-Patient Department of a Tertiary Care Hospital, Gandaki Province, Nepal.

BACKGROUND: Nasal sprays are used to deliver the medications locally to the nasal cavity. The majority of patients have been observed to perform nasal spray use techniques inadequately. This study was conducted to evaluate the impact of the intervention on nasal spray use technique. METHODS: This was a prospective pre- and post-interventional study to evaluate the nasal spray use technique among the subjects with the help of nasal spray checklist. A standardized WHO nasal spray checklist was used on the study conducted in Manipal Teaching Hospital, Pokhara, Nepal from July to October 2019. Subjects were asked to demonstrate the technique and a scoring system was applied before and after the intervention by the researcher. The total score of the intervention technique ranges from 0 to 11. After evaluation of the technique at the first visit, subjects were provided with an informative leaflet having all the steps to be followed to use the spray and the technique was re-evaluated after 10 days. RESULTS: A total of 81 subjects (51.9% male and 48.1% female) participated in the study. The average duration of nasal drug use was 15 days. The overall mean±SD score was 4.31±1.625 before intervention and 9.84±1.699 after intervention. After the intervention, the percentage of subjects using the nasal spray correctly increased by 50.27%. Wilcoxon signedrank test showed intervention on nasal spray use technique was effective (p=0.0001). CONCLUSION: The nasal spray use technique was poor among the subjects before the intervention. The intervention was substantially effective in improving the technique to use the nasal spray. Regular assessment and reinforcement of correct technique by health professionals will improve the proper use technique of nasal spray, hence increasing the effectiveness of the therapy.

Dual stimuli-responsive ursolic acid-embedded nanophytoliposome for targeted antitumor therapy.

The hindrances in achieving clinically translatable anticancer platforms are being tackled through nanotechnology-based formulations. In this study, stimuli-responsive, phytoactive constituent-loaded nanophytoliposomes were fabricated for designing a specific antitumor platform. Ursolic acid (UA)-loaded nanophytoliposomes (UA-PLL-HA.P) enwrapped in a poly-L-lysine (PLL) coat and hyaluronic acid (HA) were nanosized; these nanophytoliposomes had spherical morphology, slightly negative charge, and an in-range polydispersity index (~0.25). Successful fabrication of the nanosystem was proven through several characterization methods and the pH- and enzyme-responsiveness of the nanosystem was assessed through a release study. The cellular internalization in CD44 receptor-expressing cell lines was amplified by enhanced permeation and retention as well as by active targeting. In vitro antitumor behavior was confirmed through in vitro cytotoxic and apoptotic activity of the nanosystem. Similarly, in vivo imaging showed exceptional biodistribution in the tumor in agreement with the in vitro findings. Moreover, the tumor inhibitory rate of UA-PLL-HA.P was significantly higher, and was ascribed to the targeting potential and stimuli-responsiveness. In summary, UA-PLL-HA.P exhibited pronounced anticancer effect and could open a number of possibilities for discovering novel phytoconstituent-incorporated nanoformulations.

Disease proportions and drug prescribing pattern observed in a free health camp organized at Dhorphirdi Village Development Committee of Western Nepal.

BACKGROUND: Health camp is generally organized to provide health care services to the people deprived of health care facilities. The aim of this project was to assess the proportions of disease among attendees of health camp and study the drug prescribing pattern in a free health camp. METHODS: A case study was performed from 1 day health camp to determine the proportions of disease and drug prescribing pattern. Data collection was performed using log book maintained in the health camp and patient's demographic details, disease diagnosed and drug prescribed was obtained from same log book. RESULTS: A total of 317 patients were included in the study. The majority of the patients were in the range of 41-50 years. On the basis of study on ethnicity, Brahmins and Chettris, were found to be predominant ethnic groups with gastrointestinal disorders as the major disease. The total number of medications prescribed was 510, with non-steroidal anti-inflammatory drugs (NSAIDs) and antipeptic ulcer drugs being commonly prescribed. The average number of drugs per prescription and the percentage of antibiotics prescribed were 1.6 and 21.4%, respectively. It was observed that 96.8% of prescription was by generic names. Likewise, 100% of prescription included drugs from essential drug list. CONCLUSION: Majority of the patients were of working age group. Headache and fever were found to be the most prevalent cases and NSAIDs were the most commonly prescribed medications. The drug prescribing pattern of the free health camp complied with WHO recommended prescribing indicators.

Evaluation of anti-secretory and anti-ulcerogenic activities of avipattikar churna on the peptic ulcers in experimental rats.

BACKGROUND: Avipattikar churna, a poly-herbal formulation, is one of the popular ayurvedic formulations which is used for peptic ulcer diseases but the scientific documentation with regards to its effect for the indication is lacking. AIMS: This study was carried out to evaluate the anti-secretory and the anti-ulcerogenic activities of the churna and to compare its activity with that of ranitidine in a pyloric ligated model of rats. MATERIAL AND METHODS: Four groups of rats with 6 animals in each served as the ulcer controls, churna low dose (500 mg/kg), churna high dose (750mg/kg) and ranitidine (25mg/kg). The control group rats received only vehicle (2% (v/v) gum acacia), while the rats of the other groups received the respective dose of the churna or ranitidine which was suspended in the vehicle. The treatments were given twice a day, orally, for two days. After 1 hour of the last dose, pyloric ligations were performed and the rats were sacrificed for evaluation after four hours of the ligations. The gastric contents were collected and its volume, pH and acidity were measured. The numbers of ulcers and their lengths were measured which were used to calculate the gastric irritancy index and the curative ratio. The histological examinations of the gastric tissues were also performed. RESULTS: The churna, in both doses, significantly decreased the volumes of the gastric contents, the ulcer score, the length of the ulcer, the gastric irritancy index and pH increased as compared to those in the control group. The effects of the churna were comparable to that of ranitidine. The histopathological evaluation of the gastric tissue also supported the results. CONCLUSION: Avipattikar churna has anti-secretory and anti-ulcerogenic effects which are comparable to those of ranitidine in peptic ulcer diseases.