Objective structured clinical examination (OSCE) in pharmacy education - a trend / Examen clínico estructurado y objetivo (OSCE) en la educación de farmacia - una tendencia

Pharmacy education has undergone a radical change as it evolves towards becoming a more patient oriented profession. With a greater emphasis on problem based teaching and competency, the Objective Structured Clinical Examination (OSCE), supported by its reliability and validity became the gold standard for the evaluation of clinical skills of undergraduate students of medicine and pharmacy worldwide. Core competency evaluation has become a mandatory and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. Interpersonal and communication skills, professional judgment, skills of resolution etc., may be best assessed through a well structured OSCE in comparison to oral examinations, multiple choice tests and other methods of assessment. Though OSCEs as an objective method of evaluation offer several advantages to both students and teachers, it also has disadvantages and pitfalls in implementation. This article reviews the OSCE as a trend in pharmacy education (AU)

La educación en farmacia ha sufrido un cambio radical a medida que evoluciona hacia convertirse en una profesión más orientada hacia el paciente. Con un mayor énfasis en la enseñanza basada en problemas y competencias, el examen clínico estructurado y objetivo (OSCE), soportado por su fiabilidad y validez, se ha convertido en el patrón-oro para la evaluación de las habilidades clínicas de los estudiantes de grado de medicina y farmacia en todo el mundo. La evaluación de las competencias centrales se ha convertido en una norma obligatoria y crucial para la responsabilidad de los objetivos educativos, ya que los exámenes tradicionales no pueden evaluar la competencia clínica. Las habilidades interpersonales y de comunicación, el juicio profesional, las habilidades de resolución, etc. Pueden evaluarse mejor mediante un OSCE bien estructurado en comparación con los exámenes orales, los exámenes de elección múltiple y otros métodos de evaluación. Aunque los OSCE son un método objetivo de evaluación que ofrece varias ventajas tanto a estudiantes como a profesores, también tiene inconvenientes y problemas de implantación. Este articulo revisa los OSCE como una tendencia en la educación de farmacia (AU)

Objective structured clinical examination (OSCE) in pharmacy education - a trend.

Pharmacy education has undergone a radical change as it evolves towards becoming a more patient oriented profession. With a greater emphasis on problem based teaching and competency, the Objective Structured Clinical Examination (OSCE), supported by its reliability and validity became the gold standard for the evaluation of clinical skills of undergraduate students of medicine and pharmacy worldwide. Core competency evaluation has become a mandatory and critical norm for accountability of educational objectives as the traditional testing tools cannot evaluate clinical competence. Interpersonal and communication skills, professional judgment, skills of resolution etc., may be best assessed through a well- structured OSCE in comparison to oral examinations, multiple choice tests and other methods of assessment. Though OSCEs as an objective method of evaluation offer several advantages to both students and teachers, it also has disadvantages and pitfalls in implementation. This article reviews the OSCE as a trend in pharmacy education.

Antidiabetic activity of Pseudarthria viscida aqueous root extract in neonatal streptozotocin-induced NIDDM rats

The antidiabetic activity of the aqueous root extract of Pseudarthria viscida (L.) Wight & Arn., Fabaceae, was investigated in normal and neonatal streptozotocin (n2-STZ)-induced non insulin-dependent diabetes mellitus (NIDDM) rats and compared with glibenclamide as a reference standard. Two different doses (250 and 500 mg/kg) of the extract were administered to normal and experimental diabetic rats for 21 days. Fasting blood glucose levels, serum lipid profiles and changes in body weight were evaluated in normal and diabetic rats while serum insulin, glycated hemoglobin, urea, creatinine, magnesium, protein, albumin and glycogen, glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), lactate dehydrogenase (LDH) levels in kidney and liver were evaluated additionally in diabetic rats. Treatment with extract at both dose levels was found to exhibit antidiabetic activity, with the higher dose showing more significant activity.

Methanol extract of dried exudate of Commiphora mukul prevents bone resorption in ovariectomized rats.

CONTEXT: Gum guggul, a resinous exudate of the plant Commiphora mukul Engl. (Burseraceae), has been found efficacious in the treatment of bone fractures, arthritis, and hyperlipidemic disorders. OBJECTIVE: The present study is an effort to explore the anti-bone-resorptive potential of the dried methanol extract of the gummy exudate of C. mukul (MECM) in ovariectomized rat model. MATERIALS AND METHODS: The animals were randomly divided into five groups of equal size (n = 6). Animals in all the groups were ovariectomized except group 1, which was sham operated. Groups 3, 4 and 5 were treated with Raloxifene, MECM 250 mg/kg and MECM 500 mg/kg, respectively. The 2nd group was fed with vehicle. ASSESSMENT: biochemical estimations, viz., alkaline phosphatase (ALP), tartarate resistant acid phosphatase (TRAP), serum calcium (Ca); biomechanical evaluations, and histopathological examinations. RESULTS: The LD(50) of MECM was found to be > 2500 mg/kg orally. A significant elevation was observed in the ALP, TRAP, Ca and cholesterol levels in the 2nd group with a significant reduction in biomechnical strength. Groups 3, 4 and 5, showed a significant reduction in TRAP and ALP levels (p < 0.001). The Ca levels were normalized in the groups 4 and 5, while cholesterol levels dropped in group 5. The bone strength, however, was normalized in all the groups (p < 0.001) along with the histopathology. DISCUSSION AND CONCLUSION: Findings suggested a significant gain in bone strength and nearly complete restoration of bone microarchitecture along with lowered levels of TRAP indicating the anti-bone resorptive potential of the extract.

Formulation, characterization and optimization of hepatitis B surface antigen (HBsAg)-loaded chitosan microspheres for oral delivery.

CONTEXT: Approximately 400 million persons worldwide have chronic hepatitis B. This is due to problems associated with vaccine delivery, stability and cost. Hence the present challenge in vaccinology is to develop safer, cheaper and easy-to-deliver forms of vaccines. A novel needle-free oral vaccine will be an ideal tool to fight this silent killer disease. OBJECTIVE: The aim of this work was to prepare and evaluate chitosan-loaded HBsAg microspheres for oral delivery. MATERIALS AND METHODS: Chitosan microspheres were prepared by emulsion solvent evaporation technique. To overcome the enzymatic and permeation barrier, protease inhibitors and permeation enhancers were also added. Studies were conducted to find the effect of stabilizer concentration, stirring speed, cross-linking agent and polymer concentration on microsphere size and entrapment efficiency. Formulations were characterized for their particle size, entrapment efficiency. They were also evaluated for the in vitro drug release, in vivo performances and the effect of different storage conditions. RESULTS: HBsAg-loaded chitosan microspheres with bacitracin as protease inhibitor showed better protective levels of immunity after oral administration comparing with aprotinin as protease inhibitor. Stability at room temperature up to a period of four months reduces incomplete vaccine coverage and logistic requirements. CONCLUSION: The study signifies the potential of the formulated chitosan microspheres for effective oral administration of HBsAg.

A HPTLC densitometric method for the determination of aloeverose in Aloe vera gel.

Aloe vera gel is a familiar ingredient in a range of widely available and advertisement healthcare and cosmetic products. As to date there are no documented reports on the standardization of A. vera gel and the following study is an attempt in this direction. A. vera gel was evaluated for its aloeverose content for the first time. Aloeverose, was separated on a thin-layer of silica gel by isocratic gradient elution technique was determined by using HPTLC-photodensitometry. The proposed method is simple and sensitive and can be used for the routine assay of aloeverose in phytomedicines containing A. vera gel.

Curcuma zedoaria Rosc. (white turmeric): a review of its chemical, pharmacological and ethnomedicinal properties.

OBJECTIVES: Curcuma zedoaria Rosc is a perennial herb found in tropical countries, such as India, Japan and Thailand. Various parts of this plant are used in Ayurveda and other folk medicines for the treatment of different ailments such as diarrhoea, cancer, flatulence and dyspepsia. This study is an attempt to compile an up-to-date and comprehensive review of C. zedoaria that covers its traditional and folk medicinal uses, phytochemistry and pharmacology. KEY FINDINGS: Research carried out using different in-vitro and in-vivo techniques of biological evaluation supports most of the claims. SUMMARY: This review presents the botany, chemistry, traditional uses and pharmacological data of the plant.

Antidiabetic properties of the alcoholic extract of Sphaeranthus indicus in streptozotocin-nicotinamide diabetic rats.

We have investigated the possible antihyperglycaemic effects of Sphaeranthus indicus extract in rats rendered diabetic by nicotinamide (120 mgkg(-1) i.p.) and streptozotocin (STZ) (60 mgkg(-1) i.p). Fasting plasma glucose levels, serum insulin levels, serum lipid profiles, magnesium levels, glycosylated haemoglobin, changes in body weight and liver glycogen levels were evaluated in normal and diabetic rats. Oral administration of S. indicus for 15 days resulted in significant decrease in blood glucose levels and increases in hepatic glycogen and plasma insulin levels. Fasting normal rats treated with the alcoholic extract of S. indicus showed significant improvement in oral glucose tolerance test. Glibenclamide was used as a reference standard. The findings demonstrate that the alcoholic S. indicus extract may be useful in the treatment of diabetes.

Hepatoprotective potential of Fumaria indica Pugsley whole plant extracts, fractions and an isolated alkaloid protopine.

The present investigation demonstrates the hepatoprotective potential of 50% ethanolic water extract of whole plant of Fumaria indica and its three fractions viz., hexane, chloroform and butanol against d-galactosamine induced hepatotoxicity in rats. The hepatoprotection was assessed in terms reduction in histological damage, changes in serum enzymes (SGOT, SGPT, ALP) and metabolites bilirubin, reduced glutathione (GSH) and lipid peroxidation (MDA content). Among fractions more than 90% protection was found with butanol fraction in which alkaloid protopine was quantified as highest i.e. about 0.2mg/g by HPTLC. The isolated protopine in doses of 10-20mg p.o. also proved equally effective hepatoprotectants as standard drug silymarine (single dose 25mg p.o.). In general all treatments excluding hexane fraction proved hepatoprotective at par with silymarine (p

Simultaneous Estimation of Esomeprazole and Domperidone by UV Spectrophotometric Method.

A novel, simple, sensitive and rapid spectrophotometric method has been developed for simultaneous estimation of esomeprazole and domperidone. The method involved solving simultaneous equations based on measurement of absorbance at two wavelengths, 301 nm and 284 nm, lambda max of esomeprazole and domperidone respectively. Beer's law was obeyed in the concentration range of 5-20 mug/ml and 8-30 mug/ml for esomeprazole and domperidone respectively. The method was found to be precise, accurate, and specific. The proposed method was successfully applied to estimation of esomeprazole and domperidone in combined solid dosage form.

Simultaneous UV Spectrophotometric Estimation of Ambroxol Hydrochloride and Levocetirizine Dihydrochloride.

A novel, simple, sensitive and rapid spectrophotometric method has been developed for simultaneous estimation of ambroxol hydrochloride and levocetirizine dihydrochloride. The method involved solving simultaneous equations based on measurement of absorbance at two wavelengths 242 nm and 231 nm, the gamma max of ambroxol hydrochloride and levocetirizine dihydrochloride, respectively. Beer's law was obeyed in the concentration range 10-50 mug/ml and 8-24 mug/ml for ambroxol hydrochloride and levocetirizine dihydrochloride respectively. Results of the method were validated statistically and by recovery studies.

Determination of ebastine in pharmaceutical formulations by HPLC.

A simple, precise and rapid RP-HPLC method was developed for the determination of ebastine in pharmaceutical formulations. The method was carried out on a Phenomenex RP-C18 column using a mixture of methanol and water (90:10) and detection was done at 262 nm. The linearity range was 5-100 mug/ml. The intra-day and inter-day precision were in the range of 0.22% to 0.49% and 0.24% to 0.73%, respectively.

Herbal excipients in novel drug delivery systems.

The use of natural excipients to deliver the bioactive agents has been hampered by the synthetic materials. However advantages offered by these natural excipients are their being non-toxic, less expensive and freely available. The performance of the excipients partly determines the quality of the medicines. The traditional concept of the excipients as any component other than the active substance has undergone a substantial evolution from an inert and cheap vehicle to an essential constituent of the formulation. Excipients are any component other than the active substance(s) intentionally added to formulation of a dosage form. This article gives an overview of herbal excipients which are used in conventional dosage forms as well as novel drug delivery systems.

Diseño y evaluación de matrices de difusión controlada en parches transdérmicos de clorhidrato de Diltiazem / Design and evaluation of matrix diffusion controlled transdermal patches of diltiazem hydrochloride

Se desarrolló un sistema matricial de tipo dispersivo para la administración transdérmica de clorhidrato de Diltiazemusando diferentes proporciones de colofonia con Eudragit RL PM y polivinil pirrolidona. El parche preparado concolofonia y polivinil pirrolidona no era transparente y muestra una distribución irregular de polivinil pirrolidona,lo que puede ser debido al carácter hidrófi lo de ésta. Se investigó el efecto de los polímeros sobre las propiedadestecnológicas; es decir, la liberación del fármaco, la velocidad de transmisión del vapor de agua, la pérdida porcentualde humedad y el grosor. El parche con colofonia: Eudragit RL PM (6:4) dio como resultado una liberaciónde 2651 mcg en 24 horas. Con el objeto de mejorar la liberación, se incluyeron distintas proporciones de alcanforen la formulación. El parche con colofonia: Eudragit RL PM (6:4) y un 5% p/v de alcanfor dio como resultadouna liberación constante del fármaco a lo largo de un período de 24 horas. La formulación F8 resultó ser la mássatisfactoria en lo que a las propiedades tecnológicas se refi ere. Se llevaron a cabo estudios posteriores de permeacióne irritación de la piel en ratas y conejos respectivamente. Por lo tanto, se puede concluir que con el parchede colofonia: Eudragit RL PM en proporción 6:4 con un 5% p/v de alcanfor, se alcanzan los objetivos deseablesen sistemas de administración transdérmica de fármacos tales como anular el efecto de primer paso, una amplialiberación y una frecuencia de administración reducida

A matrix dispersion type transdermal drug delivery system of Diltiazem Hydrochloride was developed using differentratios of rosin with Eudragit RL PM and polyvinyl pyrrolidone. The patch prepared by the combination of rosin andpolyvinyl pyrrolidone was not transparent one, and shows an uneven distribution of polyvinyl pyrrolidone, which maybe due to the hydrophilic nature of polyvinyl pyrrolidone. The effect of the polymers on the technological properties,i.e., drug release, water vapor transmission rate, percentage moisture loss and thickness were investigated. The patchcontaining rosin: Eudragit RL PM (6:4) showed a release of 2651 mcg in 24 h. In order to improve the release variousproportions of camphor was included in the formulation. The patch containing rosin: Eudragit RL PM (6:4) with5% w/v of camphor showed a sustained release of the drug extending over a period of 24 h. Formulation F8 emergedas the most satisfactory formulation as far as the technological properties were concerned. Further skin permeationand skin irritation studies were carried out on rat skin and rabbit respectively. Therefore it can be concluded that thepatch containing rosin: Eudragit RL PM in the ratio 6:4 with 5%w/v of camphor achieved the desired objectives oftransdermal drug delivery systems, such as overcoming of fi rst pass effect, extended release and reduced frequency ofadministration

In vitro antioxidant studies of Sphaeranthus indicus (Linn).

The free radical scavenging potential of the plant S. indicus was studied by using different antioxidant models of screening. The ethanolic extract at 1000 microg/ml showed maximum scavenging of the radical cation, 2,2-azinobis-(3-ethylbenzothiazoline-6-sulphonate) (ABTS) observed upto 41.99% followed by the scavenging of the stable radical 1,1-diphenyl, 2-picryl hydrazyl (DPPH) (33.27%), superoxide dismutase (25.14%) and nitric oxide radical (22.36%) at the same concentration. However, the extract showed only moderate scavenging activity of iron chelation (14.2%). Total antioxidant capacity of the extract was found to be 160.85 nmol/g ascorbic acid. The results justify the therapeutic applications of the plant in the indigenous system of medicine, augmenting its therapeutic value.

In vitro antioxidant studies on the benzyl tetra isoquinoline alkaloid berberine.

Berberine is a benzyl tetra isoquinoline alkaloid which is widely used as an antimicrobial and an antidiarrhoeal. As berberine containing plants are virtually used in all forms of traditional medicine, our study aimed to examine the antioxidant activity of berberine using 2,2-diphenyl 1-picrylhydrazyl (DPPH) radical scavenging, nitric oxide scavenging, lipid peroxidation, superoxide scavenging, iron chelating activity and 2,2-azino bis(3-ethylbenzothiazoline-6-sulfonate) (ABTS) radical scavenging methods. The IC(50) values for all the models were calculated by regression analysis. In all the models tested, berberine showed its ability to scavenge the free radicals in a concentration dependent manner. The present study thereby justifies the therapeutic potential of berberine.

Antioxidant and antiulcer activity of aqueous extract of a polyherbal formulation.

The aqueous extract of Hingwashtak churna was evaluated for gastroprotection in rats using the ibuprofen and ethanol induced ulcer models. Efficacy was assessed by determination of mean ulcer size, ulcer number and ulcer index. Oral administration of the aqueous extract (750 mg/kg) significantly protected against gastric lesions by 84.96% and 91.12% as compared to ranititidine (95.54 and 95.2%) in the ibuprofen and alcohol induced ulcer models respectively. The findings suggest that the significant gastroprotective activity could be mediated by its antioxidant activity which was evaluated by using different antioxidant models of screening.

Effect of aqueous bark extract of Garuga pinnata Roxb. in streptozotocin-nicotinamide induced type-II diabetes mellitus.

A study was undertaken to evaluate the antihyperglycemic activity of aqueous extract of bark of Garuga pinnata Roxb. (Burseraceae). The various parameters studied included fasting blood sugar levels, serum lipid levels, liver glycogen content, serum insulin level and glycated hemoglobin in diabetic and normal rats. Streptozotocin-nicotinamide was used to induce type-II diabetes mellitus. Treatment with the extract at two dose levels showed a significant increase in the liver glycogen and serum insulin level and a significant decrease in fasting blood glucose and glycated hemoglobin levels. The total cholesterol and serum triglycerides levels were also significantly reduced and the HDL cholesterol levels were significantly increased upon treatment with the extract thus proving the potent antidiabetic property of the plant.

Hepatoprotective effects of rubiadin, a major constituent of Rubia cordifolia Linn.

The hepatoprotective effects of rubiadin, a major constituent isolated from Rubia cordifolia Linn., were evaluated against carbon tetrachloride (CCl4)-induced hepatic damage in rats. Rubiadin at a dose of 50, 100 and 200 mg/kg was administered orally once daily for 14 days. The substantially elevated serum enzymatic activities of serum glutamic oxaloacetic transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), serum alkaline phosphatase (SALP) and gamma-glutamyltransferase (gamma-GT) due to carbon tetrachloride treatment were dose dependently restored towards normalization. Meanwhile, the decreased activities of glutathione S-transferase and glutathione reductase were also restored towards normalization. In addition, rubiadin also significantly prevented the elevation of hepatic malondialdehyde formation and depletion of reduced glutathione content in the liver of CCl4 intoxicated rats in a dose dependent manner. Silymarin used as standard reference also exhibited significant hepatoprotective activity on post treatment against carbon tetrachloride induced hepatotoxicity in rats. The biochemical observations were supplemented with histopathological examination of rat liver sections. The results of this study strongly indicate that rubiadin has a potent hepatoprotective action against carbon tetrachloride induced hepatic damage in rats.