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|Year : 2014 | Volume
| Issue : 7 | Page : 7-9
UK Sheth Prize
|Date of Web Publication||26-Dec-2014|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. UK Sheth Prize. Indian J Pharmacol 2014;46, Suppl S1:7-9
Effect of TinosporaCordifoliaon Physical and Cardiovascular Performance Induced By Physical Stress in Healthy Human Volunteers: A Pilot study
Petare AU, Salve BA, Tripathi RK, Kapse SV, Raut A, Rege NN
Department of pharmacology and Therapeutics, Seth GSMC and KEM Hospital, Parel, Mumbai, Maharashtra, India
Objective: Primary objective of the study was to evaluate the effect of TC on physical performance and secondary objectives were to evaluate muscle power, maximal oxygen consumption and sympathetic activity in comparison with placebo when subjected to physical stress. Settings and Design : Neuropharmacology Section, Department of Pharmacology and Therapeutics, Seth GS Medical college and KEM Hospital. Methods and Material: After Ethics committee approval and consenting, 30 participants were randomly assigned into three groups of 10 each namely placebo, TC 150mg and TC 300mg after screening visit. They were assessed baseline visit, day 14 and 28. Physical stressors were cycle ergometer exercise, Jammer's hand held dynamometer test and cold pressor test. Physical performance evaluated was maximum distance and speed, oxygen consumption (VO 2 max), hand grip strength. Cardiovascular response was assessed by multiple heart rate and blood pressure measurements during each test. Statistical analysis used: Repeated measure of ANOVA was used for the within group analysis, Post hoc Tukey test and unpaired t-test was used. Results: On day 28, TC 150mg group showed significant increase in mean maximum speed compared to placebo . On day 14 and 28, TC 300mg group showed significant decrease in mean systolic BP and HRmax on fixed workload exercise compared to placebo. There was significant increasing dose effect of both TC groups on systolic BP on day 14 and 28 and on HRmax on day 28 only. On day 14 and 28, TC 300 mg showed significant decrease in mean HR on cold pressor test, compared to placebo. TC down regulated over activity of sympathetic nervous system, useful to improve the physical performance in stressful life style.
Assessment of Knowledge Attitude Practice on PharmacovigilanceAmongst the Nursing Students and ExperiencedNurses inSilchar Medical College and Hospital
PinakiChakravarty, Babul Dewan 1
Associate Professor/In-Charge, Department of Pharmacology, Co-ordinator, Adverse Monitoring Centre underPvPI, Silchar Medical College and Hospital, Silchar, Assam, 1 Technical Associate, ADR Monitoring Centre, Department of Pharmacology, Silchar Medical College and Hospital, Silchar, Assam, India
Objective: To assess the awareness, knowledge and the methods of application of pharmacovigilance among the nursing students of Regional College of Nursing and experienced nurses (preclinical and clinical exposure subjects) workingin Silchar Medical Collegeand Hospital. Materials and Methods: A questionnaire was designed based on the preference which was set by previous studies and administered to 100 nursing students and experienced nurses of Silchar Medical College and Hospital, Silchar. The questionnaire comprised of 20 different questions (awareness-6, knowledge-6 and methods of application-8) and each question had only one correct answer. The respondents were graded into 3 categories-poor, unsatisfactory and satisfactory, based on their individual scores. The data was then analyzed by using the descriptive statistics and one way ANOVA. Results: A total of 100 questionnaires were statistically analyzed. It was found that the awareness, knowledge and the methods of application of pharmacovigilance was less in the students, as compared to the experienced working nurses. The methods of application in the experienced nurses were considerably higher, probably due to their continuous clinical exposure. It was also observed that the awareness and knowledge were highly significant which is related to better methods of application in experienced working nurses due to clinical exposure. Conclusion: In overall, nursing students have poor and unsatisfactory knowledge and methods of application attitude as compared to working nurses towards ADRs reporting and pharmacovigilance. Pharmacovigilance is being taught to some extent in theory, but the knowledge on the practical approach is lacking. This suggests the need of suitable changes in the nursing teaching curriculum and additional training amongst the students regarding ADRs.
Comparison of Effects of Amlodipine and Cilnidipine on Blood Pressure and Urinary Albumin in Hypertensive Patients: A Retrospective Study
Patil H P, Dange S V.
Pd. Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, India
Objective: Hypertension is the most common cardiovascular disease. Cilnidipine is a novel dihydropyridine calcium antagonist that blocks L-type as well as N-type voltage dependent calcium channels. It is thought to provide additional benefits in hypertensive patients. Hence, this study was undertaken to assess the antihypertensive effect and antiproteinuric effect of cilnidipine and compare it with that of amlodipine. Material and Methods: This was a retrospective study. We screened the case records of the patients attending the OPD of Dhanashree Hospital, New Sangvi, Pune, during the period January 2011 to December 2013. We included the patients receiving either amlodipine or cilnidipine. Results: A total of 85 patients were included for the analysis (41 Amlodipine and 44 Cilnidipine). Both amlodipine and cilnidipine reduced the systolic and diastolic BP significantly. The decrease in BP was significantly (P< 0.05) greater with cilnidipine. There was significant reduction in pulse rate with cilnidipine (74.6 ± 11.6 vs. 68 ± 8.1 bpm). In patients with hypertension and diabetes (14 in amlodipine and 16 in cilnidipine group), there was significant (P< 0.05) reduction in urinary albumin with cilnidipine (25.1 ± 5.8 vs. 20.3 ± 3.5mg/L) while increase in amlodipine group (23.5 ± 6.2 to 35.2 ± 7.3). No pedal edema observed with cilnidipine group. Conclusion: Cilnidipine provided better control of BP as compared to amlodipine with no risk of rebound tachycardia. In addition, there was reduction in microalbuminuria with cilnidipine. Hence, cilnidipine might be considered better alternative to amlodipine in hypertensive patients.
Effectiveness and Safety of Ilaprazole versus Rabeprazole in patients of Uninvestigated Dyspepsia: A double blind randomized controlled study
Sourav Das Choudhury
Department of Pharmacology, IPGMER, Kolkata, India
Objective: Ilaprazole is a newly introduced Proton Pump Inhibitor (PPI), which lays claim to be more effective than existing PPIs. We carried out a head-to-head comparison of the effectiveness of Ilaprazole versus Rabeprazole in uninvestigated dyspepsia. [CTRI/2014/02/004413]. Materials and Methods: A double blind, randomized, controlled trial was conducted in a tertiary care hospital. Ambulatory adult patients with dyspepsia, not yet subjected to endoscopy, were included if they had at least moderately severe symptoms, defined as a score of ≥4 on a 7-point Global Overall Symptom (GOS) Scale. Subjects received either once daily Ilaprazole 10 mg or Rabeprazole 20 mg, orally, for 6 weeks. Modified Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (mFSSGERD) was used to gauge reflux, dysmotility and pain scores; SF-8 scale was used to appraise quality of life (QoL). The latter had physical and mental component scores (PCS, MCS). Results : Of 122 patients enrolled, data of 57 on Ilaprazole and 57 on Rabeprazole were analyzed. At 3 weeks, proportion of subjects responding (i.e. GOS score £ 2) in the two arms (Ilaprazole 52.63% vs. Rabeprazole 43.86%, p =0.454) were comparable but Ilaprazole showed a higher symptom resolution (i.e. GOS score £ 1)(Ilaprazole 15.79% vs. Rabeprazole 1.75%; p=0.016). However, at 6 weeks, both responder (Ilaprazole 61.4% vs. Rabeprazole 49.12%; p =0.258) and symptom resolution proportions (Ilaprazole 36.84% vs. Rabeprazole 29.82%; p =0.552) were comparable. Total score on mFSSGERD scale showed higher improvement in the Ilaprazole arm at 3 weeks (Ilaprazole 8(6-10.5) vs. Rabeprazole 10(6-12); p=0.032). The Ilaprazole arm showed higher scores at 3 weeks for both PCS (Ilaprazole 45(44-48) vs. Rabeprazole 45 (44-46.5); p=0.015) and MCS (Ilaprazole 49(45-51) vs. Rabeprazole 47(44-50);p =0.026). Even at 6 weeks, this trend was maintained for both PCS (Ilaprazole 47(44-49) vs. Rabeprazole 45(42.5-48);p =0.007) and MCS (Ilaprazole 47(46-51) vs. Rabeprazole 47(45-51); p =0.034). Conclusions : Ilaprazole is well-tolerated and more effective compared to Rabeprazole in the symptomatic treatment of uninvestigated dyspepsia.
A Comparative Evaluation of Intranasal Dexmedetomidine and Intranasal Midazolam for Pre Operative Sedation in Children
Arcojit Ghosh 1 , Asoke Kumar Das 2 , Maitreyee Mukherjee 3 , Sabnam Ara Begum 4
1 Post Graduate Trainee, Department of Pharmacology, R G Kar Medical College, Kolkata. 2 Professor, Department of Pharmacology, Calcutta National Medical College, Kolkata. 3 Assistant Professor, Department of Anesthesiology, R G Kar Medical College, Kolkata. 4 Assistant Professor, Department of Pharmacology, R G Kar Medical College, Kolkata, India
Objectives: The study aimed at comparing the efficacies of intranasal dexmedetomidine and intranasal midazolam regarding producing sedation at induction. The secondary end- points were preoperative heart rate and systolic bloos pressure changes after administration of either drugs. We also looked at sedation and analgesia status at the time of induction, recovery as well as 3 hours and 6 hours post operatively. Methods: Study subjects comprised of children aged 2-8 years posted for elective surgery under general anesthesia. It was a double blind randomized control trial comprising of 90 subjects divided into 2 groups. group A (n=42) received 0.2 μg/kg dexmedetomidine and group B (n=48) 0.5 mg/kg midazolam by intranasal route 45 minutes prior to induction. sedation and analgesia scores were assessed by Ramsay Sedation Scale and Observer Pain Scale respectively. heart rate and systolic blood pressures were recorded every 15 minutes pre- operatively after administration of drugs. sedation and analgesia scores were recorded at induction, recovery, after 3 hours and 6 hours post operatively. Results: 93% subjects in group A and 60% in group B achieved satisfactory sedation at the time of induction. Sedation status and analgesia obtained at the time of induction, recovery, 3 hours and 6 hours post operatively were significantly better in group A. Pre- operative changes in HR and SBP in both groups were comparable. Conclusion: Intranasal dexmedetomidine is safe andmore effective than intranasal midazolam for pre operative sedation in children. Also, intranasal dexmedetomidine is a superior agent than intranasal midazolam for post operative analgesia in pediatric population.
Immunotherapy in viral warts with intradermal BCG vaccine versus intradermal Tuberculin PPD: A double-blind, randomized controlled trial comparing the effectiveness and safety in a tertiary care centre in Eastern India
Amrita Sil 1 , Sabari Bhattacharya 2 , Vivek Mishra 2 , Indrasish Poddar 2 , Nilay Kanti Das 2
1 Department of Pharmacology, IPGMEandR, AJC Bose Road, Kolkata, India, 2 Department of Dermatology, Medical College and Hospital, 88 College Street, Kolkata, India
Objective: The present day therapeutic modalities for viral warts are ablative in nature and limited by high recurrence rate and unsuitable for numerous lesions. Immunotherapy has the potential to overcome these limitations. We aimed to compare the effectiveness and safety of intradermal BCG vaccine versus intradermal tuberculin PPD in the immunotherapy of warts. Materials and Methods: Patients with viral warts, recruited after obtaining informed consent were randomized into two groups and received 0.1 ml of BCG vaccine or tuberculin PPD intradermally over deltoid region at 4 weekly intervals till the resolution of all lesions or maximum of three doses. The patients were followed-up for another month for recurrence. Number of warts, complete cure and quality of life adjudged by DLQI were the effectiveness parameters. Result: Amongst 60 patients completing the modified intention-to-treat protocol; 33 patients received BCG (M: 20, F: 13) while 27 patients (M: 19, F: 8) received Tuberculin PPD. Complete remission was noted in 16 patients (48.5%) of BCG group and 5 patients (18.5%) of Tuberculin PPD group (p=0.121, Fischer's exact test). The baseline number of lesions were comparable in both groups (p=0.2619) and reduced significantly with treatment in both the groups (p<0.001, Friedman's ANOVA), seen from 1 st follow up onwards (p<0.05, Post hoc Dunn's test). Intergroup comparison showed significantly more reduction in BGG group than Tuberculin PPD (P < 0.05, Mann Whitney's test) from 2 nd follow up onwards. DLQI improved significantly with both treatments though there was no intergroup significant difference. Adverse events (pain during injection, abscess and scar at injection site) were more with BCG. No recurrence was seen. Conclusion : Both intradermal BCG and tuberculin PPD hold promise in the treatment of viral warts; though BCG is more effective it has more adverse events too.
A Comparative Study of Efficacy and Safety of Three Atypical Antipsychotic Agents: Asenapine, Ziprasidone and Clozapine in Indian Schizophrenic Patients: A Randomized Controlled Trial
Trayambak Dutta 1 , Subhrojyoti Bhowmick 2 , Minakshi Mitra 3 , Sarmila Nath 4 , R.N. Chatterjee 5 , Sipra Bhattacharjee 6
1 Final Year Post Graduate Resident, 2 Assistant Professor, Department of Pharmacology, MGM Medical College and LSK Hospital, Kishanganj, 3 Clinical Associate, Department of Psychiatry, MGM Medical College and LSK Hospital, Kishanganj. 4 Final Year Post Graduate Resident, 5 Professor, 6 Professor and Head, Department of Pharmacology, MGM Medical College and LSK Hospital, Kishanganj
Objective: Second generation atypical antipsychotics are agents of choice for schizophrenic patients. However scarce data is available on efficacy and safety of newer antipsychotics like Asenapine and Ziprasidone in India. We present a comparative randomized controlled trial of efficacy and safety of Asenapine, Ziprasidone and Clozapine from a tertiary care teaching hospital in eastern India. Materials and Methods: A single blind controlled trial was conductedin 119outdoor schizophrenic patients diagnosed as per DSM V criteria at MGM Medical College and LSK Hospital, Kishanganj from March 2013 to February 2014. The trial was conducted for 6months with 3 visits at 0, 12, 24 weeks. Patients were randomized into three groups:Group A Asenapine (n=41), Group B Ziprasidone (n=40), Group C Clozapine (n=38). Patients attending at least 2 visits were included for analysis. Efficacywas evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale (CGI). Safety was evaluated by noting treatment emergent adverse events. Results : Final PANSS score was lower for Clozapine (70.5±16.1), followed by Ziprasidone (72.4±16.4) and Asenapine (76.7±16.9). This difference was statistically significant (P < 0.05). The CGIS improved gradually with treatment in all groups. 29% of Group A (Asenapine), 12.5% of group B (Ziprasidone), 10.5% of Group C patients (Clozapine) discontinued their study medication. Time to discontinuation of treatment was significantly longer in the clozapine group than in the Ziprasidone (P < 0.001) or Asenapine (P = 0.002) group. ADRs i.e., hyperglycemia and weight gainwas encountered in 67.5%, Asenapine Group, 57.5%. Ziprasidone and 63.5% of patients in Clozapine group, (P = 0.122) which was statistically not significant. Conclusion: Clozapine appears to be a good alternative in comparison to Ziprasidone or Asenapine in Indian Schizophrenic patients on basis of better tolerability and significant effectiveness.
Comparative Study of Cotrimoxazole versus Norfloxacin versus Levofloxacin in Uncomplicated Cases of Lower Urinary Tract Infection in Adult Patients at Tertiary Care Hospital: A Randomized Controlled Parallel Group Open Label Trial
Vachhani Arpit 1 , Patel Jeet 2 , Naik Viren 3 , Jha Pramod 4 , Tripathi Chandrabhanu 5
Third Year Resident, Department of Pharmacology, Government Medical College, Bhavnagar, India
Objective: Gram negative bacterial Urinary Tract Infection (UTI) is a most common nosocomial infection, occupying 35% of total infection. Approximately 90% of E. coli strains that cause UTI have adhesins such as P and S fimbria (motile organism). Material and Methods: Subjects with fever and dysuria with increasing frequency of urination were included in study. Cotrimoxazole, Norfloxacin and Levofloxacin were given to subjects according to randomization. Subjects were bound to give their blood and urine sample at first visit and at the end of 3 days. Results: The result of this study shows that Cotrimoxazole-DS (Trimethoprime 160 mg / Sulfomethoxazole 800 mg) 12 hourly for 3 days, Norfloxacin 400 mg 12 hourly for 3 days and Levofloxain 250 mg daily for three days are equally effective in treating subjects microbiologically and clinically in uncomplicated UTI including acute cystitis and concurrent bacteremia. Conclusion: The world wide empirical treatment of Community acquired Urinary tract infection (CA-UTI) should not be applied everywhere. In the Indian scenario routine urine culture should be necessary.