Hygeia journal for drugs and medicines

1-2

Authors: Prof.M K. Unnikrishnan

The other day, I was invited to participate in the National convention on Medicine and Law at Mumbai to deliberate on violence against doctors. The brochure ominously asserted that “75% of doctors have faced violence at work” Why has this antipathy towards doctors become so commonplace? Is it from the seeds of suspicion planted by Google-driven health information systems retrieved from the internet? Or is it the mounting expectations of the‘informed’ patient with insurance cover and cash? Could it be the corporatization of healthcare that places profit before patient care? Or is it lack of personalized attention? Or a sense of being swindled by unnecessary diagnostic tests and avoidable hospital admissions? Must be a combination of all of the above, in addition to even more reasons peculiar to India. The healthcare system is particularly vulnerable to exploitation because of ‘knowledge asymmetry.’ When we want to buy a car, we decide what car we need, what additional fittings it should adorn, and when we should take delivery. No such freedom exists when it comes to our own health. We have no idea what vaccinations or diagnostic tests we need, what medicines we should buy or what surgeries we have to go through.The knowledge intensive nature of healthcare typically creates a conflict of interest between the ignorant patients and well-informed, profit-seeking health care providers. Trust alone can bridge this divide.

16-26

Authors: Manjula Devi A.S*, Senthilvel. N, Dhanu Josey, Divya Ann Jetto, Evelyn Harold, Mabel Elizabeth V.K.

Plan: To assess the incidence of inappropriate dosing of drugs having side effects like hepatotoxicity in hospitalized patients with hepatic impairment. Preface: Inappropriate dosing in patients with liver dysfunction can cause toxicity or ineffective therapy. Method: The degree of hepatic impairment was calculated using Child-Pugh classification which incorporates five variables to assess the severity of liver disease: total bilirubin, serum albumin, prothrombin time, the presence of encephalopathy and the presence of ascites. The dose of all drugs with potential hepatotoxicity was evaluated using the published drug dosing guidelines and the dosing interval was increased or the total dose was reduced when necessary. Outcome: Four hundred and twenty nine drugs in 50 patients were evaluated, of which, most of the drugs requiring dose adjustment were anti hypertensives followed by anti diabetics. Major type of error identified was under dosing followed by overdosing and contraindications.About 27.58% of the drugs were to be avoided in hepatic impairment as per the available evidences. Conclusion: Drug dosing evaluation and concurrent feedback mechanism by the pharmacist can improve drug safety in patients with hepatic impairment.

35-43

Authors: Honey Jose, Arya KR, Sindhu TJ, Syamjith P, Vinod KR*, Sandhya S

Nutmeg and mace are the two spices derived from several tree species in genus Myristica. They contain essential oil and is used therapeutically cosmetic and culinary preparations. Several value addition products widens the commercial value of this herb. Although fifty percent shade is recommended in the initial levels,as the tree grows it can be reduced. It is better to adopt budding or grafting as there are possibility of plants seedlings to grow into male and female plants, resulting in the production of 50% unproductive male plants. The female trees start fruiting from 6 years old even though peak period is 20 years. Overdose of essential oils of nutmeg is having hallucination effects