Cross-sectional study exploring barriers to adverse drug reactions reporting in community pharmacy settings in Dhaka, Bangladesh.

OBJECTIVES: To assess community pharmacists'/pharmacy technicians' knowledge and perceptions about adverse drug reactions (ADRs) and barriers towards the reporting of such reactions in Dhaka, Bangladesh. METHOD: A cross-sectional study was planned to approach potential respondents for the study. A self-administered questionnaire was delivered to community pharmacists/pharmacy technicians (N=292) practising in Dhaka, Bangladesh. RESULTS: The overall response to the survey was 69.5% (n=203). The majority of the sample was comprised of pharmacy technicians (152, 74.9%) who possessed a diploma in pharmacy, followed by pharmacists (37, 18.2%) and others (12, 5.9%). Overall, 72 (35.5%) of the respondents disclosed that they had experienced an ADR at their pharmacy, yet more than half (105, 51.7%) were not familiar with the existence of an ADR reporting body in Bangladesh. Exploring the barriers to the reporting of ADRs, it was revealed that the top four barriers to ADR reporting were 'I do not know how to report (Relative Importance Index (RII)=0.998)', 'reporting forms are not available (0.996)', 'I am not motivated to report (0.997)' and 'Unavailability of professional environment to discuss about ADR (RII=0.939)'. In addition to these, a majority (141, 69.46%) were not confident about the classification of ADRs (RII=0.889) and were afraid of legal liabilities associated with reporting ADRs (RII=0.806). Moreover, a lack of knowledge about pharmacotherapy and the detection of ADRs was another major factor hindering their reporting (RII=0.731). CONCLUSIONS: The Directorate of Drug Administration in Bangladesh needs to consider the results of this study to help it improve and simplify ADR reporting in Bangladeshi community pharmacy settings.

In vitro thrombolytic potential of root extracts of four medicinal plants available in Bangladesh.

CONTEXT: Thrombus formation inside the blood vessels obstructs blood flow through the circulatory system leading hypertension, stroke to the heart, anoxia, and so on. Thrombolytic drugs are widely used for the management of cerebral venous sinus thrombosis patients, but they have certain limitations. Medicinal plants and their components possessing antithrombotic activity have been reported before. However, plants that could be used for thrombolysis has not been reported so far. AIMS: This study's aim was to evaluate the thrombolytic potential of selected plants' root extracts. SETTINGS AND DESIGN: Plants were collected, dried, powdered and extracted by methanol and then fractionated by n-hexane for getting the sample root extracts. Venous blood samples were drawn from 10 healthy volunteers for the purposes of investigation. SUBJECTS AND METHODS: An in vitro thrombolytic model was used to check the clot lysis potential of four n-hexane soluble roots extracts viz., Acacia nilotica, Justicia adhatoda, Azadirachta indica, and Lagerstroemia speciosa along with streptokinase as a positive control and saline water as a negative control. STATISTICAL ANALYSIS USED: Dunnett t-test analysis was performed using SPSS is a statistical analysis program developed by IBM Corporation, USA. on Windows. RESULTS: Using an in vitro thrombolytic model, A. nilotica, L. speciosa, A. indica, and J. adhatoda at 5 mg extract/ml NaCl solution concentration showed 15.1%, 15.49%, 21.26%, and 19.63% clot lysis activity respectively. The reference streptokinase showed 47.21%, and 24.73% clot lysis for 30,000 IU and 15,000 IU concentrations, respectively whereas 0.9% normal saline showed 5.35% clot lysis. CONCLUSIONS: The selected extracts of the plant roots possess marked thrombolytic properties that could lyse blood clots in vitro; however, in vivo clot dissolving properties and active components responsible for clot lysis are yet to be discovered.

Characterization of phytoconstituents and evaluation of total phenolic content, anthelmintic, and antimicrobial activities of Solanum violaceum Ortega.

OBJECTIVE: The present study was conducted to detect possible chemicals (phytoconstituents), prove ethno-medicinal value of the plant, and investigate antimicrobial, anthelmintic, and total phenolic content of crude methanolic extract of the Solanum violaceum plant. MATERIALS AND METHODS: Phytochemical screening was carried out using different chemical group test methods. In anthelmintic activity test (using Pheretima posthuma model), five concentrations (10, 20, 30, 40, 50, and 80 mg/ml in distilled water) of extracts and albendazole as standard were used which involved the vermifuge and vermicidal activity on the worms. For the evaluation of in vitro antimicrobial activity, disc diffusion method, and to determine the total phenolic content, Folin-Ceocalteu method (gallic acid as standard) were used. RESULTS: The phytoconstituent analysis revealed presence of alkaloids, carbohydrate, glycoside, flavonoid, saponin, gum, diterpenes, phenol, protein, and tannin. The crude extract exhibited significant anthelmintic property comparing with the standard. The methanolic extract revealed broad-spectrum antimicrobial activity at the concentration of 400 µg/disc. The results were compared with that of the standard ciprofloxacin. The extract exhibited moderate amount of total phenolic compound (54.67±1.18 mg/gm of gallic acid equivalent). CONCLUSION: Since S. violaceum have shown antimicrobial, antioxidant, and anthelmintic activities, more studies such as anti-inflammatory, analgesic, antipyretic, and other pharmacological activities should be carried out to justify its traditional use, as the plant is available and used broadly in the rural areas for folkloric remedies.