Abstract

The aim of present study was to develop and validate specific and accurate UV spectrophotometric method of Mycophenolate mofetil by using two different hydrotropic solubilizing agents. Objective was to perform solubility studies of Mycophenolate mofetil in the solutions containing urea (0.2 M) and sodium carbonate (0.2 M) as hydrotropic agents and find out the minimum hydrotropic concentration of urea and sodium carbonate for drug Mycophenolate mofetil. The linearity was observed in the concentration range of 10-30 μg/ml. The method was validated and found to be precise. Accuracy (percent recovery) for Mycophenolate mofetil was found to be 98.97-102.72. From the results it was concluded that urea as hydrotropic agent showed best aqueous solubility of Mycophenolate mofetil and all the validation parameters were found within the limits according to ICH guidelines. So that hydrotropic agent urea suitable solvent for increasing the solubility of Mycophenolate mofetil. The proposed method is new, simple, safe, eco-friendly, economic, accurate, cost-effective and can be successfully employed in routine analysis.

Abstract

BACKGROUND: Surgical site infections are a real problem to the surgeons and are considered as major infection control concern across the world. The present study gives the information on in-appropriate use of antibiotics and also helps to know the use of Antibiotic-prophylaxis in Surgical-site infections in-order to reduce the prevalence of infections. STUDY: A 6 months non-invasive prospective, observational study. METHODS: The study design was Non-invasive Prospective Observational study conducted during November 2016- April 2017. The study included all the patients admitted in Surgery wards for various surgeries and patients who were newly diagnosed and already underwent various surgical procedures. A detailed patient history was taken which includes age, sex, type of surgical procedure, and medical history to observe the clinical features of patients with Surgical site infections. Reports of antibiotic sensitivity and culture sensitivity tests conducted were collected and microorganisms presented at the infected surgical site according to the culture sensitivity test reports were noted. RESULTS: The results of the study has shown that inappropriate surgical prophylaxis leads to prolonged duration of hospital stay, resistant to micro-organisms due to use of broad spectrum antibiotics and inappropriate timings ultimately leading to high cost and affecting the efficacy of treatment. Improving public awareness, provider communication, diagnostic support, and strict regulatory implementation were the strategies to be suggested.

Abstract

Natural products from medicinal plants, either as pure compounds or as standardized extracts, help to overcome unmet medical needs. Phytoconstituents of many medicinal plants are unknown. One of such plant is Merremia emarginata (Burm.f.) Hallier.f. this plant has been reported for many biological activities but phytoconstituents are still unknown. Due to increasing demand for herbal drugs thereby seeking of therapeutic drugs from medicinal plants is necessary but these plants vary in content from regions and seasons hence demand for screening of herbal formulation and standardization of process is required. Process standardization will develop a quality product and hence safety and efficacy of herbal drugs can be improved. Herbal preparations for medicinal usage contain various types of bioactive compounds. Merremia emarginata (Burm.f) Hallier f.commonly known as Akhuparni is a medicinal Plant belonging to the family Convolvulacea. The plant has been used in many herbal formulations, but phytoconstituents of the plants are unknown except the broad categories. The present study reports the isolation of phytoconstituents by means of Supercritical fluid extraction and separation of isolates by means of HPLC and characterisation of purified isolates by FTIR, HRMS & NMR. JASCO SFE system of 2000series was used for extraction of compounds from plants, ethanol was used as modifier for the extraction and back pressure of system was maintained at 15MPa for 30mins. The extract was further isolated and purification was detected with help of JASCO HPLC-PDA detector. The Purified compounds were identified as Quercitin, Kaempferol & Naringin using characterisation techniques mentioned above.

Abstract

The availability of several brands of spironolactone tablets in Bangladeshi pharmacies today places health practitioners in a problem of generic substitution. The purpose of this research work was to evaluate the pharmaceutical equivalent of six different brands of spironolactone 25 mg tablets using various pharmacopoeia and non-pharmacopoeia tests with special landmarks on in vitro dissolution study and with different price ranges purchased from retail pharmacies of Bangladesh. Assay of spironolactone tablets revealed that all samples contained 95.11-102.88% of labeled potency. In vitro drug release pattern was more than 85% in case of all brands in the medium within an hour of the test. The dissolution profiles were compared with the use of model independent approaches of difference factor and similarity factor; showing that only brand SPL2 is recommended to be used as alternative to reference brand SPL1. Results from the study have shown that switching or substituting brands of spironolactone in patients should be guided by a critical assessment of the dissolution data using appropriate evaluation techniques.

Abstract

Hypertension exerts a substantial public health burden on cardiovascular health status and healthcare systems in India. Successful control of hypertension can be achieved by improvement in medication knowledge and adherence. This also positively affects the health related quality of life. We conducted a study with the objective ‘to assess the change in the extent of medication knowledge, adherence and health related quality of life in community based hypertensive patients due to pharmacists’ intervention’. The study was carried out on 204 hypertensive patients residing in various clusters of Bangalore. Relevant data of the patients were collected using a Case Report Form and data was thoroughly analysed. Medication reminder cards and patient information leaflet were given to all the study participants to help them improve medication adherence. Majority of the participants were females (59%) compared to males (41%). Assessment of the extent of Medication Knowledge, Adherence and Health-Related Quality Of Life showed significant improvement on the final follow up when compared to the day of enrollment. The medication knowledge and adherence has shown to have a strong association in the control of blood pressure. Adherence to pharmacotherapy has also shown positive impact on the health-related quality of life. Pharmacists’ intervention in the form of patient education and counseling has had a remarkable outcome with a rise in the hypertensive patients’ level of medication knowledge, adherence and health-related quality of life. This in turn helped to achieve effective control of blood pressure.

The fruits of Physalis minima, an underexploited food plant, are known to be antioxidant in nature and suitable for consumption in both unripe and ripe stages. Hence it is important to find out the antioxidant activity of the fruit in both ripe and unripe stage to determine which stage of fruit could be exploited for nutraceutical and pharmaceutical research. Free radicals initiate many diseases including atherosclerosis, cancer etc. It was found that the unripe fruit methanol extract had higher free radical scavenging activity compared to that of ripe fruits as measured by DPPH, nitric oxide scavenging assay, phosphomolybdate assay and LDL oxidation inhibition assay. Further the unripe fruits were shown to have higher foam cell preventing activity than ripe fruits as seen by their abilities to prevent ox-LDL uptake by RAW 264.7 macrophages which indicates their potential to counteract atherosclerotic plaque formation. Nitrite radicals initiate and accelerate the process of atherosclerotic plaque formation by creating an inflammatory environment. The efficiency of unripe fruits to scavenge nitrite radicals in lipopolysaccharide stimulated RAW 264.7 macrophages was very high compared to that of ripe fruits indicating their anti-inflammatory potential. The methanol extract of unripe fruits had higher total phenolic content (6?g gallic acid equivalent/mg dry weight) which reduced to 3.92?g gallic acid equivalent/mg dry weight upon ripening. HPLC profiling indicated an excess of cinnamic and chlorogenic acid in unripe fruits compared to ripe fruits and disappearance of sinapic acid and ferulic acid from ripe fruits.

Uricosuric medications increase the excretion of uric acid in urine, thus reducing the concentration of uric acid in blood plasma. Prolonged and untreated hyperuricemia results into gout, a severe inflammatory condition. Crystals of monosodium urate may then form, particularly in the joints and connective tissues. These crystals initiate attacks of acute gout, and tophaceous deposits may occur if the hyperuricaemia is allowed to persist. The naturally available uricosuric agents are Tinospora cardifolia, Allium sepa, Cajanus cajan, Piper nigrum etc., Uricosuric agents increase the urinary excretion of uric acid hence the natural uricosuric agent is preferred to prevent many diseases like gout, arthritis, kidney stones etc., without side effect. The various screening methods for the uricosuric activity are uricosuric activity in mice, Potassium oxonate induced activity, Phenol red excretion method.

India has a strong history of traditional herbal system of treatment of various health ailments. In spite of substantial advances in medicinal plant research and rapid advances in modern medicine, there was an increasing problem of liver disorders. The aim of the current study was to perform preliminary phytochemical screening, HPTLC finger printing profile and quantitative analysis of macronutrients, minerals including protein pattern by SDS-PAGE analysis for the various extracts of Melia azedarach lin leaves and seeds of Piper longum respectively. The study reveals that preliminary phytochemical screening of Melia azedarach extract; Piper longum extract shows the presence of constituents like alkaloids, carbohydrates, phytosterols, tannins, phenol, flavonoids, glycosides, terpenes, lignin. HPTLC fingerprinting profile and quantitative analysis for both plants of various extracts showed the presence of active components will be responsible for therapeutic activities like antioxidant, anti-emetic, anti-oxidant activity and hepato-protective activity. In future, further studies are needed with these plants to assess, isolate and characterize their pharmacological potentials with their medicinal values.

Homeopathic drugs are the most side effect less drugs and many homeopathic practitioners claim about better curing effect of such drugs in children and mothers. Anganwadi workers (AWW) are community based workers, and work as one of the crucial media for the delivery of ICDS services to children and mothers. There is no scientific data available for identifying their knowledge, attitude and practice (KAP) of homeopathic drugs. Therefore, an instrument has been designed and tested to identify KAP of AWW on homoeopathic drugs. This can be used for motivating AWW to participate in homeopathic drug delivery programs. It would result in sensitizing AWW on usefulness of homeopathy, especially in children. All the AWW from the two specific areas, namely Niali and Kantapada of Cuttack district of Odisha were included in this study. The study was undertaken by a survey that was carried out on a sample of 339 AWW in Cuttack district of Odisha to identify their KAP towards homoeopathy drugs. A bilingual questionnaire was prepared and tested on the AWW subjects. In some instances, the questionnaire items were identified via telephonic interview with the subjects. The questionnaire was tested in terms of its internal consistency, test-retest reliability, and face and construct validity. Their KAP was recorded and analyzed. For the study, it was observed that most of the AWW were young graduates with sound background knowledge on homeopathic medicines. They opine that since these medicines are cheap, there should not be any apprehension for treatment of diseases with such remedies especially in children. Albeit, they lack with a complete idea about the usage of the homeopathic medicines especially about their administration. Since AWW act as the bridge between community and health services, government should emphasize to train all AWW of all the poor states such as Odisha about homeopathic remedies especially their administration. A special drive may be initiated by the government on availability of homeopathic remedies with less or no cost at all health centers for their effective distribution through AWW.

All Pharmaceutical Industry aims to make products with good quality products so this can be done by allowing In-Process Quality Control (IPQC) Approaches. The importance of IPQC to carry out complete testing before, after and during the manufacturing process is completed for the Products or to Monitor and improve effectively the whole applied process at the every stage of the finished pharmaceutical products by according to Standard Operating Procedures (SOPs). This article proposes to establish clearly written in-process methods for critical points at all stages of the product their documentation and review.

Postpartum psychiatric disorders are the common conditions that are frequently missed by health care team but have significant negative impact on parenting capacities which in turn results in negative outcome of child cognitive and emotional developmental progress. The main aim of the study is to identify and manage the postpartum women who are associated with psychiatric illness and to assess the effectiveness of the management. The patients were identified using different scales like HARS, EPDS, PHQ. The study revealed that the postpartum psychiatric illness like anxiety and depression was majorly in age group 20-25, with incidence rate 43.33% which is higher. The study showed positive outcomes for intervention. Hence this study is useful for clinicians and other healthcare providers to identify the patients at risk and treating them early. We also conclude that awareness of such diseases regarding symptoms and progression through educational programmes will help in better maternal and child postnatal care.

To develop and validate simple and rapid isocratic reversed-phase high-performance liquid chromatography method (RP-HPLC) for the simultaneous estimation of Amlodipine , Chlorthalidone and Olmesartan in synthetic mixture. The chromatographic separation was achieved by using mobile phase Methanol and Phosphate Buffer adjusted with Sodium Hydroxide (pH 5) (80:20 v/v), Hypersil BDS C18 column (250 mm x 4.6 mm, 5 ?m particle size). The mobile phase was pumped at a flow rate of 1.0ml/min and the eluents were monitored at 238nm. Retention times were 5.503 min, 3.107 min and 3.980 min for Amlodipine , Chlorthalidone and Olmesartan respectively. Linearity was observed in the concentration range of 2.5-7.5 ?g/ml, 6.25-18.75 ?g/ml and 10-30 ?g/ml for Amlodipine , Chlorthalidone and Olmesartan respectively. The percentage recoveries found to be as for Amlodipine 98.03-101.22 %, Chlorthalidone 98.97-101.38 % and Olmesartan 98.37-101.76 respectively. All the parameters are validated as per ICH guidelines for the method validation and found to be suitable for routine quantitative analysis in pharmaceutical dosage forms.

Chewable tablets which are required to be broken and chewed in between the teeth before ingestion. These tablets are given to the children who have difficulty in swallowing and to the adults who dislike swallowing. These tablets are intended to disintegrate smoothly in the mouth at a moderate rate either with or without actual chewing, characteristically chewable tablets have a smooth texture upon disintegration, are pleasant tasting and leave no bitter or unpleasant taste. Geriatric and pediatric patients and travelling patients who may not have ready access to water are most need of easy swallowing dosage forms like chewable tablets. The composition of chewable tablet consists of gum core, which may or may not be coated. The core is composed of an insoluble gum base like fillers, waxes, antioxidants, sweeteners, flavoring agents. The present review focuses on formulation, method of manufacture and evaluation of chewable tablets.

Endotracheal intubation is marked by sympathetic stimulation and increase in catecholamine concentration in susceptible individuals. Tracheal extubation can also be associated with detrimental airway and hemodynamic responses. Many drugs are used to attenuate the intubation response. Dexmedetomidine has been shown to be effective in maintaining hemodynamic stability during intubation and extubation without prolonging recovery. Fentanyl has been reported to reduce the prevalence of coughing during and after extubation. Magnesium sulphate decreases the hemodynamic response to airway management, with proven effectiveness. This study evaluated the efficacy and safety of dexmedetomidine, fentanyl and magnesium sulphate to find out safe anaesthetic technique so that pressor response changes and airway reflexes at the time of extubation are not harmful to the patient. Materials and Methods: This prospective, randomized study was conducted on 100 patients in the Government Medical College and Associated Hospitals, Jammu. The patients enrolled were those undergoing elective surgical procedures under endotracheal anaesthesia, of ASA Grade-I, within the age group of l8-65 years, of either sex. Pulse rate, blood pressure, electrocardiogram and oxygen saturation were recorded during preinduction, just before extubation, and l, 2, 3, 5 and 10 minutes after extubation. Mean arterial pressure at those intervals was calculated. Any laryngospasm, tracheal collapse, laryngeal edema, vocal cord paralysis, pulmonary edema and laryngeal incompetence bronchospasm, or desaturation was recorded. The time for requirement of first analgesic dose post-operatively was noted.The data so collected was analyzed, compared and subjected to statistical analysis. Results: There was statistically significant rise in mean heart-rate 1 and 2 minutes after extubation in all the groups (p<0.05) except in dexmedetomidine group. Mean heart rate decreased to non-significant levels in magnesium sulphate and fentanyl groups at 3 minutes, whereas it remained significant in the control group upto 5 minutes. Before extubation and after extubation, mean SBP, mean DBP and mean ABP shot up significantly in the control group. Conclusion: Dexmedetomidine is more effective as compared to magnesium sulphate and fentanyl in attenuating the rise in heart rate and blood pressure after extubation. There are no adverse effects seen in patients treated with dexmedetomidine.

Several drugs are at high risk of causing Toxic Epidermal Necrolysis (TEN) including Anti-convulsants such as phenytoin, carbamazepine and phenobarbital. Other drugs include antimicrobials like sulfonamides followed by Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and anti-gout drugs. We are presenting a case of 60 year old female patient with Phenytoin induced TEN. Who had a history of cranial surgery 3 weeks prior to admission and prescribed with discharge medications of phenytoin, diclofenac and dexamethasone. After 3 weeks of treatment, patient has developed oral and genital erosions with itchy vesicles and bullae all over the body and admitted to tertiary care hospital with complaints of burning sensation on chest and pedal edema and hematuria for 3 days. Phenytoin induced TEN was suspected and was admitted from causality. The patient was managed aggressively with steroids, higher antibiotics and creams (over the lesion), nutritional supplement was taken care of and palliative care was given. The patient expired due to septic shock and multiple organ dysfunctions with metabolic acidosis after 8 day of admission. This case highlights the importance of Phenytoin possibly causing TEN. Government of India and Regulatory Authorities should create awareness among practitioners to report all the ADRs to concerned ADR Monitoring Centers.

Cosmetics are incredible in demand since historical time till day. Lipstick formulations are most widely used to enhance the beauty of lips and add glamour to touch to the makeup. With this aim and objectives, an attempt was made to formulate herbal lipstick using natural ingredients. The natural drug used in the formulation is a curcumin which is used for antifungal therapy and Pomegranate arils extract is used as coloring agent. Preformulation studies revealed that API and excipients were found compatible for the formulation of herbal lipstick. Preliminary trials were carried out for determination of concentration of ingredients and drug. Two ingredients such as carnauba wax and cocoa butter was varied and remaining all ingredients was kept constant on the basis of preliminary trials. Evaluation test like melting point, pH, breaking point, thixotropy structure, softening point, solubility, permeability study was performed, and select optimized batch on the basis of evaluation of lipstick. Determination of curcumin antifungal activity and stability study was performed on the finalized formulation. Skin has to bear various external traumas like irritation, cheilitis, braking of lips, blacking of lips etc. as well as topical fungal infection. Attempt was also made to access the antifungal activity of the formulation against Candida albicanse. Due to various adverse effects of available synthetic preparations and to improve patient compliance the present work was conceived by us to formulate herbal lipstick having antifungal activity to treat lips fungal infection and having minimal or no side effects which will extensively use by the women of our communities with great surety.

The phenolic contents of metabolic extracts of WarioniasaharaeL leaves, flowers and stems from Morocco were measured in this work. The antioxidant activities of these extracts were also evaluated. The leaves methanolextract afforded the highest yield (28.2 g/100 DW) while the lowest yield was obtained from the stems (5.6 g/100 DW). Total phenolic and flavonoid contentswere (73.0 ± 0.52 mg Gallic acid/ g extract) and (2.02 ± 0.22 mg quercetin equivalents (QE)/g extract). Moreover, flowers methanol extract has remarkable DPPH radical scavenging activity with IC50 = 31.45 ?g/mL.A result indicates that methanol flower extracts of W.saharaeL. have marked amount of total phenols which could be responsible for the antioxidant activityand could be further investigated by detailed phytochemical study.

The aim of present study highlights the evaluation of anthelmintic activity of Emblica officinalis leave extract in experimental adult Indian earthworm Pheretima posthuma. The shade dried leaves were extracted with ethyl alcohol and water. The different concentrations of water and ethyl alcohol extracts (100 mg/ml and 150mg/ml) were found to possess good vermicidal activity and the results were compared with standard drug Albendazole.