Indian Journal of Pharmacy and Pharmacology

4-6

Authors: Himani Prajapati, Dinesh Kansal, Usha K.Chaudhary.

Introduction: Adverse events can lead to admission in hospital, prolongation of hospitalization, increase in investigations as well as treatment costs, deformities, danger to life and even death. Objective: The aim of this study was to conduct adverse drug reactions (ADRs) monitoring in various departments of a tertiary care teaching hospital. Methods: A retrospective observational study was conducted on ADRs reported in adverse drug monitoring center of our hospital from April, 2016 to December, 2016. Data such as age, gender, diagnosis, drug intake, types of ADRs, treatment and outcome of the reactions were collected. Each reported patient was assessed individually. Causality assessment was done on Naranjo’s probability scale. Modified Hartwig’s criteria were used to assess the severity of ADRs. Results: A total of 173reports were studied. 65(38%) patients were males and 108 (62%) were females. The majority of ADRs were due to cancer chemotherapy agents in 87(50%), followed by anti-tubercular drugs in 22(13%), antimicrobial agents in 22 (13%) and anti-retroviral drugs in 16(9%).Out of total 574 events 192(34%)complaints comprised of gastro-intestinal manifestations. On Naranjo’s probability scale, 111(64%) reactions were probable, 54 (31%) as possible and 8 (5%) as certain. According to Modified Hartwig’s criteria 130 (75%) reactions were mild, 29 (17%) were moderate and 14(8%) were severe. Conclusion: Health-care providers will have to do vigilant monitoring and reporting of ADR´s.

11-16

Authors: Anju Saxena, Sujata Singh, Rahul Kumar Goyal, Jaspreet Kaur, Sumit Saxena.

Objectives: Antibiotic resistance in microorganisms has become a critical health issue these days and has evolved to become a worldwide health threat. Carbapenem-resistant Enterbactriaceae (CRE) is one example which really is a nightmare bacteria, resistant to most, and in some cases all, antibiotics. The commonest cause is ellaboration of various types of carbapenemases amongst which the recent detection of New Delhi metallo beta-lactamase-1 (NDM-1), a superbug, further compounded the problem. So the present study was undertaken to study the pattern of carbapenem resistance and role of carbapenamase (blaNDM-1) gene towards it. Materials and Methods: The study was a cross sectional study conducted in the department of Pharmacology in collaboration with Microbiology and Biochemistry, SRMS IMS, Bareilly. All clinical isolates, their sensitivity pattern and MBL detection of carbapenem resistant ESBLS were obtained from Microbiology records. blaNDM-1 gene was detected by PCR. Results: A total of 312 ESBL producers were isolated. Out of which 42 were found to be carbapenem resistant. Amongst these 19.05% (8) were found to be MBL positive and 5 (62.5%) MBL positive isolates were NDM positive. ESBL producers were sensitive to very few antibiotics and NDM producers were sensitive only to polypeptide antibiotics. Conclusion: ESBL is a great problem for gram negative organisms and now the frequency of carbapenem resistance is high which has limited antibiotics available for the treatment. Furthermore carbapenemase (blaNDM-1) gene has also shown a substantial role. This high incidence of antibacterial resistance demands development of newer antibiotics.

21-28

Authors: Karunakar Hegde, Aparna Emani, Shrijani J K, A R Shabaraya.

The objective of the recent work was to evaluate the anti-arthritic activity of Piper betle leaves against CFA induced arthritis in rats. Anti-arthritic activity of hydro-alcoholic (1:4) extract of Piper betle leaves was investigated against complete Freund’s adjuvant induced arthritis in rats. Two doses 20A0mg/kg and 400mg/kg of Piper betle leaves extract (oral route) was subjected for the evaluation of anti-arthritic activity against complete Freund’s adjuvant (0.1ml sub plantar region) induced arthritis in rats. Diclofenac (50mg/kg oral) was used as standard in both the models (prophylactic & curative). Physical parameters such as paw volume, paw diameter and body weight were evaluated. Serum parameters such as SGPT, SGOT and ALP, rheumatoid factor were evaluated. In addition histopathological study was also carried out. It was observed in both the models that both the lower dose (200mg/kg) and higher dose (400mg/kg) of Piper betle extract showed dose dependent significant decrease in SGPT, SGOT, and ALP, paw volume, paw diameter and increase in body weight when compared to arthritic control group. All treated animals showed significant decrease in serum rheumatoid factor. In addition anti-arthritic effect was also confirmed by histopathology of synovial joint showed less space narrowing of inter tarsal joints in treated rats. The results obtained were comparable with that of standard. The present study concluded that hydro-alcoholic extract of Piper betle leaves has significant anti-arthritic potential. The exact mechanism for the anti-arthritic activity of hydro-alcoholic extract of Piper betle is still unknown. Hence further studies are needed to isolate, characterize the active principles and to find out the exact mechanism responsible for its anti-arthritic activity.

33-36

Authors: Niket Rai, Ratinder Jhaj, Balakrishnan S..

Objective: A cross sectional observational survey to assess the drug use pattern and habit of writing rational prescription followed by a feedback to the prescribers to ensure the best practice in writing prescriptions. Materials and Methods: Prescriptions were analyzed in the month of January 2016 at All India Institute of Medical Sciences, Bhopal, MP, India using the WHO core prescribing indicators. In addition, quality of prescription writing was also assessed in terms of legibility and completeness of information e.g. whether diagnosis, strength, frequency and duration of drug prescribed was written or not. The collected data was analyzed in Microsoft Excel 2007. Statistical analysis had been done to obtain frequency, average/mean, and percentage. Result: Total number of prescription analyzed were 503, contained a total of 1118 drugs i.e. on an average 2.2 drugs per prescription. Drugs prescribed by generic name and injectable route were 71(6.3%) and 9(1.0%) respectively. A total of 163 antimicrobials were prescribed in 117(23.2%) prescriptions out of which 108 were anti-bacterials. A large proportion (60.1%) drugs prescribed were not included in the NLEM. Incomplete and illegible prescription were 357(70.9%) and 219(43.5%) respectively. Conclusion: This prescription audit revealed that polypharmacy, overuse of injections and unnecessary use of antimicrobials were not a concern in the target prescribers. But there is a scope for improvement in generic prescribing, use of essential medicines, better quality of prescription writing in terms of completeness of information provided and legibility of prescriber details.

40-43

Authors: Rangeel Singh Raina, Sona Bharti Kaushal.

Introduction: Adverse drug reactions seems to be a major problem in women than men. Objective: This study as planned to assess the incidence rate, clinical manifestations, and causative agents for adverse drug reactions (ADRs) in female patients. Materials and Methods: This study was a retrospective study in which analysis of the clinical variables related to all suspected cases of ADRs reported in female patients of the tertiary centre hospital. Results: Out of 206 patients reported with ADR in between period of 2012 to 2015, 110 (53.4%) were female whereas only 46.6% were male patients. Although Mean age of female patients affected from ADRs was 31.53 years and most of ADRs were reported in the age group of 20-39 years (41.8%).Department of dermatology has reported maximum number of ADRs in females (51, 46.36%), followed by medicine (21, 23.6%) and Surgery (19, 17.02%). Amongst 85 ADRs cases reported due to antimicrobial, betalactams (31, 36.5%) and quinolones (17, 20%) were the mostly responsible, followed by aminoglycosides (11, 12.9%). Skin was affected more frequently (69.6%), followed by gastrointestinal (14.9%). Conclusion: Adverse drug reactions in female seems to be a significant problem and we need to evaluates the physiological and other cofactors to understand the high occurrence of adverse drug reaction in females.