Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214503
Mutharasan M., M. M., P. K, V. G, P. N.
Background: Cardiovascular drugs are the number one cause of death globally; more people die annually from CVDs then from any other cause CVD. The purpose of this study to identify the rationality of drug prescribed for cardiovascular diseases with its comorbidities. Along with medication adherence and cost analysis. To assess the drug use pattern and to observe the drug related complications in patients with cardiovascular diseases.Methods: A hospital based prospective observational study was conducted at department of medicine in RMMCH. A total of 79 patients were enrolled based on inclusion criteria and the data was collected using designed data collection form.Results: Data of 79 patients were collected over 6 months mean age of patients with 19.95-60.5. Male to female ratio was 1.43:1. In cardiovascular diseases, most common disease conditions are systemic hypertension and acute coronary syndrome seen in our study population. Average drugs prescribed per patient was 4-9. Most frequently prescribed drug classes were beta blocker, antiplatelet, hypolipidemic agent. In these few minor drug interactions have been found. Study has no adverse drug reaction. The average cost of drugs was prescribed for 2500-3200 IND. Before patient counseling medication adherence and outcomes were less after counseling, medication adherence and outcomes are increased from 5% to 65%.Conclusions: The study concludes that most of the drugs were prescribed rationally according to world health organization/ESC guidelines. As behalf of this study, we could provide the information about the risk factor, leading commodities. Importance of medication adherence and cost of medications to cardiovascular drugs.
{"title":"Study on drug use pattern in the management of the cardiovascular diseases and with comorbidities","authors":"Mutharasan M., M. M., P. K, V. G, P. N.","doi":"10.18203/2319-2003.ijbcp20214503","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214503","url":null,"abstract":"Background: Cardiovascular drugs are the number one cause of death globally; more people die annually from CVDs then from any other cause CVD. The purpose of this study to identify the rationality of drug prescribed for cardiovascular diseases with its comorbidities. Along with medication adherence and cost analysis. To assess the drug use pattern and to observe the drug related complications in patients with cardiovascular diseases.Methods: A hospital based prospective observational study was conducted at department of medicine in RMMCH. A total of 79 patients were enrolled based on inclusion criteria and the data was collected using designed data collection form.Results: Data of 79 patients were collected over 6 months mean age of patients with 19.95-60.5. Male to female ratio was 1.43:1. In cardiovascular diseases, most common disease conditions are systemic hypertension and acute coronary syndrome seen in our study population. Average drugs prescribed per patient was 4-9. Most frequently prescribed drug classes were beta blocker, antiplatelet, hypolipidemic agent. In these few minor drug interactions have been found. Study has no adverse drug reaction. The average cost of drugs was prescribed for 2500-3200 IND. Before patient counseling medication adherence and outcomes were less after counseling, medication adherence and outcomes are increased from 5% to 65%.Conclusions: The study concludes that most of the drugs were prescribed rationally according to world health organization/ESC guidelines. As behalf of this study, we could provide the information about the risk factor, leading commodities. Importance of medication adherence and cost of medications to cardiovascular drugs.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91314777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214499
S. Thanawala, R. Shah, P. Katnapally, U. Bhatnagar
Background: Objective of this study was to evaluate anti-inflammatory properties of a novel standardized Boswellia serrata extract–bsRx (developed using natural excipients and designed to have specific ratio of its major actives, viz. AKBA and BBA) in dextran sodium sulfate (DSS)-induced IBD model in BALB/c mice.Methods: Animals (BALB/c mice) in control (CL) group were administered vehicle; DSS-induced colitis group (DSS group), 2.5 % DSS; and Boswellia serrata group (BS group) received DSS, for inducing colitis, together with a novel standardized extract of Boswellia serrata (41 mg/kg, 4.1 mg/ml solution in distilled water) for 10 days. Reference group (SS group) received DSS with sulfasalazine (30 mg/kg, 3.0 mg/ml suspension in distilled water) for 10 days. Clinical assessment for disease activity index (DAI), histopathological examination and hematological assessments were performed.Results: Treatment with Boswellia serrata showed significant reduction in the DAI score on day 10 compared to the DSS group (2.49±0.93 versus 3.63±0.55, p≤0.05). Body weight (18.54±2.21 gm versus 17.05±3.53 gm) and colon length (6.8±0.9 cm versus 7.6±0.6 cm, p≤0.05) also improved in the BS group compared to DSS group, respectively. Histological scoring of colitis was lower in the BS group (10.1±1.37). There was no difference in leukotriene levels between groups (p>0.05).Conclusions: Treatment with novel Boswellia serrata extract improved colon length, DAI and histological scoring index in DSS-induced colitis in IBD mice models. Our results indicate the promising potential of novel Boswellia extract in IBD and gut health management.
{"title":"Efficacy of standardized novel Boswellia serrata extract in the dextran sodium sulfate-induced colitis model - potential use in gut health management","authors":"S. Thanawala, R. Shah, P. Katnapally, U. Bhatnagar","doi":"10.18203/2319-2003.ijbcp20214499","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214499","url":null,"abstract":"Background: Objective of this study was to evaluate anti-inflammatory properties of a novel standardized Boswellia serrata extract–bsRx (developed using natural excipients and designed to have specific ratio of its major actives, viz. AKBA and BBA) in dextran sodium sulfate (DSS)-induced IBD model in BALB/c mice.Methods: Animals (BALB/c mice) in control (CL) group were administered vehicle; DSS-induced colitis group (DSS group), 2.5 % DSS; and Boswellia serrata group (BS group) received DSS, for inducing colitis, together with a novel standardized extract of Boswellia serrata (41 mg/kg, 4.1 mg/ml solution in distilled water) for 10 days. Reference group (SS group) received DSS with sulfasalazine (30 mg/kg, 3.0 mg/ml suspension in distilled water) for 10 days. Clinical assessment for disease activity index (DAI), histopathological examination and hematological assessments were performed.Results: Treatment with Boswellia serrata showed significant reduction in the DAI score on day 10 compared to the DSS group (2.49±0.93 versus 3.63±0.55, p≤0.05). Body weight (18.54±2.21 gm versus 17.05±3.53 gm) and colon length (6.8±0.9 cm versus 7.6±0.6 cm, p≤0.05) also improved in the BS group compared to DSS group, respectively. Histological scoring of colitis was lower in the BS group (10.1±1.37). There was no difference in leukotriene levels between groups (p>0.05).Conclusions: Treatment with novel Boswellia serrata extract improved colon length, DAI and histological scoring index in DSS-induced colitis in IBD mice models. Our results indicate the promising potential of novel Boswellia extract in IBD and gut health management.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87941373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214504
Anbu D., Benimana Grace, M. K., B. K.
Background: Chronic obstructive pulmonary disease and bronchial asthma are common among elderly people and have become a major public health concern of today. The purpose of this study is to identify the prescription pattern and role of medication adherence in the COPD and bronchial asthma. Prescription pattern monitoring (PPMS) are mainly focus on prescribing, dispensing, administering of drugs they promote appropriate use of monitored drugs and reduction of abuse/misuse.Methods: A hospital based prospective observational study was conducted at department of medicine in Rajah Muthiah Medical College and Hospital. A total of 90 patients were enrolled based on inclusion and exclusion criteria and the data was collected using designed data collection form.Results: Out of 90 patients, male (81.10%) and female (18.90%) are reported with COPD and bronchial asthma. On prevalence 57 (63.34%) of patients with co-morbidities and without co-morbidities 33 (36.66%). Among co-morbidity patients, 38.90% of patients has type-2 diabetes mellitus. PPA indicate that cephalosporins (46.68%), macrolides (38.88%) class of antibiotic are used prominently along with corticosteroids of hydrocortisone 47 (62.66%) and prednisolone 28 (37.34%). 47 (62.66%) patients received expectorants and anti-tussive in that, Ipratropium bromide + levosalbutamol (50%) are commonly prescribed.Conclusions: This study concludes that COPD and bronchial asthma was most predominant in elderly patients and its treated with mainly antibiotics and corticosteroids with bronchodilators in the way of inhalers and nebulizers. The rational use of drugs and patient counselling reflects a better medication adherence.
{"title":"A study on prescribing pattern and medication adherence in elderly COPD and bronchial asthma patients in a tertiary care teaching hospital","authors":"Anbu D., Benimana Grace, M. K., B. K.","doi":"10.18203/2319-2003.ijbcp20214504","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214504","url":null,"abstract":"Background: Chronic obstructive pulmonary disease and bronchial asthma are common among elderly people and have become a major public health concern of today. The purpose of this study is to identify the prescription pattern and role of medication adherence in the COPD and bronchial asthma. Prescription pattern monitoring (PPMS) are mainly focus on prescribing, dispensing, administering of drugs they promote appropriate use of monitored drugs and reduction of abuse/misuse.Methods: A hospital based prospective observational study was conducted at department of medicine in Rajah Muthiah Medical College and Hospital. A total of 90 patients were enrolled based on inclusion and exclusion criteria and the data was collected using designed data collection form.Results: Out of 90 patients, male (81.10%) and female (18.90%) are reported with COPD and bronchial asthma. On prevalence 57 (63.34%) of patients with co-morbidities and without co-morbidities 33 (36.66%). Among co-morbidity patients, 38.90% of patients has type-2 diabetes mellitus. PPA indicate that cephalosporins (46.68%), macrolides (38.88%) class of antibiotic are used prominently along with corticosteroids of hydrocortisone 47 (62.66%) and prednisolone 28 (37.34%). 47 (62.66%) patients received expectorants and anti-tussive in that, Ipratropium bromide + levosalbutamol (50%) are commonly prescribed.Conclusions: This study concludes that COPD and bronchial asthma was most predominant in elderly patients and its treated with mainly antibiotics and corticosteroids with bronchodilators in the way of inhalers and nebulizers. The rational use of drugs and patient counselling reflects a better medication adherence.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"213 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77462072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214500
Sana Habib, A. Anwar, F. Hoda, R. Verma, M. Akhtar, A. Najmi
Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous gynaecological endocrine disorder characterized by clinical features including oligo-amenorrhea/ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. PCOS increases the risk of depression and anxiety which leads to poor quality of life. Aim of the study were to determine the prevalence of anxiety and depression among women suffering from PCOS and to determine the quality of life (QOL) in PCOS women.Methods: The study was prospective, observational, non-interventional and questionnaire-based. 192 women with PCOS voluntarily helped in filling the questionnaires consisting of questions using PHQ-9 for depression, GAD-7 for anxiety, SF-12 for general health and PCOSQ-50 for disease-specific domains. All data were recorded in pre-designed case record forms and analysis of data was done using different statistical methods.Results: Majority of PCOS women were either overweight or obese. Based on PHQ-9 20% of women was suffering with major depression and based on GAD-7, 25% with major anxiety. It is found that psychosocial and emotional domain and coping domain of PCOSQ-50 is significant in patients with major depression and major anxiety. Significant effects were seen on their general health as per SF-12 domain. Lack of physical exercise was found in 83% of women.Conclusions: PCOS is a complex disease which decreases the overall quality of life. Therefore, treatment of PCOS women should include psychological counselling along-with with medication, especially in obese PCOS women. Women should be educated with the benefits of lifestyle modification in PCOS.
{"title":"Prevalence of depression, anxiety and Quality of life among North Indian Polycystic ovary syndrome Women: Evidence from a prospective observational study","authors":"Sana Habib, A. Anwar, F. Hoda, R. Verma, M. Akhtar, A. Najmi","doi":"10.18203/2319-2003.ijbcp20214500","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214500","url":null,"abstract":"Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous gynaecological endocrine disorder characterized by clinical features including oligo-amenorrhea/ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. PCOS increases the risk of depression and anxiety which leads to poor quality of life. Aim of the study were to determine the prevalence of anxiety and depression among women suffering from PCOS and to determine the quality of life (QOL) in PCOS women.Methods: The study was prospective, observational, non-interventional and questionnaire-based. 192 women with PCOS voluntarily helped in filling the questionnaires consisting of questions using PHQ-9 for depression, GAD-7 for anxiety, SF-12 for general health and PCOSQ-50 for disease-specific domains. All data were recorded in pre-designed case record forms and analysis of data was done using different statistical methods.Results: Majority of PCOS women were either overweight or obese. Based on PHQ-9 20% of women was suffering with major depression and based on GAD-7, 25% with major anxiety. It is found that psychosocial and emotional domain and coping domain of PCOSQ-50 is significant in patients with major depression and major anxiety. Significant effects were seen on their general health as per SF-12 domain. Lack of physical exercise was found in 83% of women.Conclusions: PCOS is a complex disease which decreases the overall quality of life. Therefore, treatment of PCOS women should include psychological counselling along-with with medication, especially in obese PCOS women. Women should be educated with the benefits of lifestyle modification in PCOS.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"651 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91463836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214511
M. Dey, B. Mishra, A. Sahoo
Lidocaine is a commonly used local anesthetic in the field of dentistry. It has been known to cause allergic reactions, mainly immunoglobulin (IgE)-mediated and T-cell –mediated type IV reactions, which require the use of alternative drugs without adverse effects. Here we present the case of a 29 year old female patient who developed Type IV hypersensitivity reaction in the vicinity of the injection site after the administration of lidocaine local anesthetic for performing exodontia. Levocetrizine tablet was prescribed in order to relieve the symptoms of the reaction. Levocetrizine is a selective, potent, oral histamine H(1) receptor antagonist that is used for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria. It has been reported to be effective and generally well tolerated by the patients. In our case also it was able to cure Type IV hypersensitivity reaction to lidocaine without producing any adverse events. Apart from curing allergic rhinitis and urticaria, levocetrizine is a wonderful option for treating Type IV hypersensitivity reaction to a local anesthetic, and it hardly produces any adverse effect. More cases are required to be reported in the future in order to support this article.
{"title":"Use of levocetrizine in the management of type IV hypersensitivity to lidocaine: a case report","authors":"M. Dey, B. Mishra, A. Sahoo","doi":"10.18203/2319-2003.ijbcp20214511","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214511","url":null,"abstract":"Lidocaine is a commonly used local anesthetic in the field of dentistry. It has been known to cause allergic reactions, mainly immunoglobulin (IgE)-mediated and T-cell –mediated type IV reactions, which require the use of alternative drugs without adverse effects. Here we present the case of a 29 year old female patient who developed Type IV hypersensitivity reaction in the vicinity of the injection site after the administration of lidocaine local anesthetic for performing exodontia. Levocetrizine tablet was prescribed in order to relieve the symptoms of the reaction. Levocetrizine is a selective, potent, oral histamine H(1) receptor antagonist that is used for the symptomatic treatment of allergic rhinitis and chronic idiopathic urticaria. It has been reported to be effective and generally well tolerated by the patients. In our case also it was able to cure Type IV hypersensitivity reaction to lidocaine without producing any adverse events. Apart from curing allergic rhinitis and urticaria, levocetrizine is a wonderful option for treating Type IV hypersensitivity reaction to a local anesthetic, and it hardly produces any adverse effect. More cases are required to be reported in the future in order to support this article.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82968960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214505
Moumita Hazra
Background: The inhibition of dipeptidyl peptidase-4 by anti-diabetic drugs dipeptidyl peptidase-4 inhibitors enhances hormonal activity of incretins (GLP-1, GIP, GRP), stimulates insulin release and reduces glucagon secretion, producing anti-hyperglycaemic activity among type II diabetics. The objective of this study was a global analytical molecular pharmacological study of the endocrinological rationale of anti-diabetic prescriptions appraisal attributes for metformin and sitagliptin, along with anti-diabetic tertiary medical healthcare patient satisfaction evaluation.Methods: 100 new early moderate grade type II diabetics were prescribed oral metformin 500 mg or sitagliptin 25 mg once daily for 3 months, in monotherapy, or in combination therapy, or in a mixed regimen of monotherapy and combination therapy. The patients’ endocrinological pharmacotherapeutic compliance was analysed. The number of prescriptions for metformin and sitagliptin was recorded; and prescription percentages were calculated. The completeness and molecular basis of prescription content attributes were analysed. The molecular basis of anti-diabetic pharmacotherapeutics, was analysed. The anti-diabetic tertiary medical healthcare patient satisfaction was evaluated by patient response to different attributes of anti-diabetic treatment.Results: All the patients had completed the study, with no adverse effects related drop-out, lost to follow-up or voluntarily withdrawn patients. The prescription rates of metformin was 75% (75 prescriptions), followed by sitagliptin: 25% (25 prescriptions).100% prescriptions were complete for each prescription content attribute. The molecular pharmacotherapeutic response mechanisms were significantly efficacious. All the patients were satisfied with each anti-diabetic medical healthcare attribute. Conclusions: The patient endocrinological pharmacotherapeutic compliance was significantly high. Metformin was most commonly prescribed, followed by sitagliptin. The prescription content analyses showed 100% completeness, with significant pharmacotherapeutic molecular efficacy. There was ample anti-diabetic medical healthcare satisfaction.
{"title":"A global analytical molecular pharmacological study of the endocrinological pharmacotherapeutic rationale of anti-diabetic prescriptions appraisal attributes for metformin and sitagliptin, with evaluation of anti-diabetic tertiary medical healthcare patient satisfaction","authors":"Moumita Hazra","doi":"10.18203/2319-2003.ijbcp20214505","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214505","url":null,"abstract":"Background: The inhibition of dipeptidyl peptidase-4 by anti-diabetic drugs dipeptidyl peptidase-4 inhibitors enhances hormonal activity of incretins (GLP-1, GIP, GRP), stimulates insulin release and reduces glucagon secretion, producing anti-hyperglycaemic activity among type II diabetics. The objective of this study was a global analytical molecular pharmacological study of the endocrinological rationale of anti-diabetic prescriptions appraisal attributes for metformin and sitagliptin, along with anti-diabetic tertiary medical healthcare patient satisfaction evaluation.Methods: 100 new early moderate grade type II diabetics were prescribed oral metformin 500 mg or sitagliptin 25 mg once daily for 3 months, in monotherapy, or in combination therapy, or in a mixed regimen of monotherapy and combination therapy. The patients’ endocrinological pharmacotherapeutic compliance was analysed. The number of prescriptions for metformin and sitagliptin was recorded; and prescription percentages were calculated. The completeness and molecular basis of prescription content attributes were analysed. The molecular basis of anti-diabetic pharmacotherapeutics, was analysed. The anti-diabetic tertiary medical healthcare patient satisfaction was evaluated by patient response to different attributes of anti-diabetic treatment.Results: All the patients had completed the study, with no adverse effects related drop-out, lost to follow-up or voluntarily withdrawn patients. The prescription rates of metformin was 75% (75 prescriptions), followed by sitagliptin: 25% (25 prescriptions).100% prescriptions were complete for each prescription content attribute. The molecular pharmacotherapeutic response mechanisms were significantly efficacious. All the patients were satisfied with each anti-diabetic medical healthcare attribute. Conclusions: The patient endocrinological pharmacotherapeutic compliance was significantly high. Metformin was most commonly prescribed, followed by sitagliptin. The prescription content analyses showed 100% completeness, with significant pharmacotherapeutic molecular efficacy. There was ample anti-diabetic medical healthcare satisfaction.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81673361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214502
Vijay Kumar, Avinash A. Ganapule, S. Supriya, D. Bhushan, Pallavi Lohani, S. Pandey, B. Sahoo, Anjani Kumar, Shruti Singh, Ramesh Kumar
Background: Objective of the study was to determine the efficacy of montelukast in reducing the severity of COVID-19 symptoms using a double blinded randomized controlled trial.Methods: Parallel, double-blinded randomized controlled trial (RCT) with placebo as comparison to montelukast. All patients above the age of 14 years both males and females, admitted with a diagnosis of mild or moderate COVID-19 (on the basis of a positive reverse transcriptase polymerase chain reaction (RT-PCR) report) at our facility during the study period from 01 September 2020-31 January 2021) and excluding those having adverse reaction to montelukast or those not willing to participate, and pregnant and lactating females. Patients in the intervention arm were given tablet montelukast 10 mg OD HS from the day of admission for 10 days. The patients in the placebo group were given an identical appearing placebo at bedtime for 10 days from the day of admission. The rest of the treatment was given as per the standard operating procedure (SOP) of the institute with minor adjustments as per the treating team’s judgement. Primary outcome was progression of the disease to severe grade and secondary outcomes were discharge on or before day 10 from admission, admission to ICU, need for mechanical ventilation and in-hospital mortality.Results: A total of 94 patients were enrolled for the study. 90 patients, 45 in each arm were included in the final analysis. The baseline characteristics of the two arms including age, sex, comorbidities, severity at admission and treatment given apart from montelukast or placebo, were comparable with respect to these variables. This study did not find any improvement in primary outcome of progression to severe disease and secondary outcomes of intensive care unit (ICU) admission, mortality or need of mechanical ventilation, discharge on or by day 10 with the use of montelukast as compared to placebo in mild to moderate cases of COVID-19.Conclusions: There was no difference in primary or secondary outcomes with the use of Montelukast compared to placebo.
背景:本研究的目的是通过双盲随机对照试验确定孟鲁司特降低COVID-19症状严重程度的疗效。方法:平行双盲随机对照试验(RCT)，安慰剂与孟鲁司特比较。在2020年9月1日至2021年1月31日的研究期间，所有年龄在14岁以上的患者，包括男性和女性，在我们的设施中被诊断为轻度或中度COVID-19(基于逆转录酶聚合酶链反应(RT-PCR)阳性报告)，不包括对孟鲁司特有不良反应或不愿意参加的患者，以及怀孕和哺乳期女性。干预组患者自入院之日起给予孟鲁司特片10mg OD HS，持续10天。安慰剂组的患者从入院之日起10天内在睡前服用一种看起来完全相同的安慰剂。其余的治疗按照研究所的标准操作程序(SOP)进行，并根据治疗小组的判断进行微调。主要结局是病情进展到严重程度，次要结局是入院第10天或之前出院、入住ICU、需要机械通气和住院死亡率。结果:共有94名患者入组研究。90例患者，每组45例纳入最终分析。两组的基线特征包括年龄、性别、合并症、入院时的严重程度以及除孟鲁司特或安慰剂外的治疗，在这些变量方面具有可比性。该研究未发现在轻至中度COVID-19病例中，与安慰剂相比，孟鲁司特的使用在进展为严重疾病的主要结局和重症监护病房(ICU)入院、死亡率或机械通气需求、第10天或第10天出院的次要结局方面有任何改善。结论:与安慰剂相比，孟鲁司特的主要或次要结局没有差异。
{"title":"Efficacy of montelukast in the management of COVID-19: double blind randomized placebo controlled trial","authors":"Vijay Kumar, Avinash A. Ganapule, S. Supriya, D. Bhushan, Pallavi Lohani, S. Pandey, B. Sahoo, Anjani Kumar, Shruti Singh, Ramesh Kumar","doi":"10.18203/2319-2003.ijbcp20214502","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214502","url":null,"abstract":"Background: Objective of the study was to determine the efficacy of montelukast in reducing the severity of COVID-19 symptoms using a double blinded randomized controlled trial.Methods: Parallel, double-blinded randomized controlled trial (RCT) with placebo as comparison to montelukast. All patients above the age of 14 years both males and females, admitted with a diagnosis of mild or moderate COVID-19 (on the basis of a positive reverse transcriptase polymerase chain reaction (RT-PCR) report) at our facility during the study period from 01 September 2020-31 January 2021) and excluding those having adverse reaction to montelukast or those not willing to participate, and pregnant and lactating females. Patients in the intervention arm were given tablet montelukast 10 mg OD HS from the day of admission for 10 days. The patients in the placebo group were given an identical appearing placebo at bedtime for 10 days from the day of admission. The rest of the treatment was given as per the standard operating procedure (SOP) of the institute with minor adjustments as per the treating team’s judgement. Primary outcome was progression of the disease to severe grade and secondary outcomes were discharge on or before day 10 from admission, admission to ICU, need for mechanical ventilation and in-hospital mortality.Results: A total of 94 patients were enrolled for the study. 90 patients, 45 in each arm were included in the final analysis. The baseline characteristics of the two arms including age, sex, comorbidities, severity at admission and treatment given apart from montelukast or placebo, were comparable with respect to these variables. This study did not find any improvement in primary outcome of progression to severe disease and secondary outcomes of intensive care unit (ICU) admission, mortality or need of mechanical ventilation, discharge on or by day 10 with the use of montelukast as compared to placebo in mild to moderate cases of COVID-19.Conclusions: There was no difference in primary or secondary outcomes with the use of Montelukast compared to placebo.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81678032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214508
A. Olaleye, B. Ejikeme, Eziaha E. Okeke, Nwabunike E. S. Ede, B. I. Olinya, C. N. Edene, J. C. Obasi, E. O. Onyekelu, A. V. Nwafor
Heterotopic pregnancy, coexistence of living or dead intrauterine pregnancy, single or multiple, with extra-uterine pregnancy located in the oviduct, ovary, uterine cornua, cervix or rarely peritoneal cavity. Heterotropic pregnancy is relatively uncommon in spontaneous conception with 1 in 30,000 cases reported, the incidence of heterotopic pregnancy increases to 1 in 3900 when conception is enhanced with various assisted reproduction techniques (ART). It is an ectopic pregnancy coexisting with intrauterine pregnancy. But is the incidence of heterotropic pregnancy rising? A case was reported from our centre in 2018 by Ejikeme et al, and we have recorded another two cases in the period of one year. Ectopic pregnancy has been described as a great masquerader, which makes diagnosis and management of heterotropic pregnancy a dilemma to attending physician. We present a case of an unbooked 26 years old G4P3+0 who has no family history of multiple gestation and presented at gestational age of 8 weeks and 5 days with 2 days history of abdominal pain and vaginal bleeding and 2 hours history of loss of consciousness. She later had exploratory laparotomy with left salpingectomy and manual vacuum aspiration of Retained Products of Conception with good outcome. In conclusion, spontaneous heterotropic pregnancy is a rare occurrence, however with advent of artificial reproductive technology and increase incidence of pelvic inflammatory disease, the incidence could be higher than earlier suspected.
{"title":"Heterotropic pregnancy: a common masquerade than ever thought?","authors":"A. Olaleye, B. Ejikeme, Eziaha E. Okeke, Nwabunike E. S. Ede, B. I. Olinya, C. N. Edene, J. C. Obasi, E. O. Onyekelu, A. V. Nwafor","doi":"10.18203/2319-2003.ijbcp20214508","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214508","url":null,"abstract":"Heterotopic pregnancy, coexistence of living or dead intrauterine pregnancy, single or multiple, with extra-uterine pregnancy located in the oviduct, ovary, uterine cornua, cervix or rarely peritoneal cavity. Heterotropic pregnancy is relatively uncommon in spontaneous conception with 1 in 30,000 cases reported, the incidence of heterotopic pregnancy increases to 1 in 3900 when conception is enhanced with various assisted reproduction techniques (ART). It is an ectopic pregnancy coexisting with intrauterine pregnancy. But is the incidence of heterotropic pregnancy rising? A case was reported from our centre in 2018 by Ejikeme et al, and we have recorded another two cases in the period of one year. Ectopic pregnancy has been described as a great masquerader, which makes diagnosis and management of heterotropic pregnancy a dilemma to attending physician. We present a case of an unbooked 26 years old G4P3+0 who has no family history of multiple gestation and presented at gestational age of 8 weeks and 5 days with 2 days history of abdominal pain and vaginal bleeding and 2 hours history of loss of consciousness. She later had exploratory laparotomy with left salpingectomy and manual vacuum aspiration of Retained Products of Conception with good outcome. In conclusion, spontaneous heterotropic pregnancy is a rare occurrence, however with advent of artificial reproductive technology and increase incidence of pelvic inflammatory disease, the incidence could be higher than earlier suspected.","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73516530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214497
M. Kampamba, Steven Mulolo, M. Phiri, Martha Chulu, W. Mufwambi, Steward Mudenda, M. Banda, C. Hikaambo
Background: The first few days of in-patient care are possibly the most significant in a patient’s recovery and any omitted medications during this period may harm the patient or increase their hospital length of stay. Therefore, our study aimed at assessing the frequency of medication administration omission errors and their reasons for the omission in the paediatric wards after admission at University Teaching Children’s Hospital.Methods: This was a descriptive study in which 259 patient files and drug charts were reviewed. Admission prescription charts were studied in detail over a period of four weeks and all drugs prescribed but then not given in the first 48 hours were recorded as omitted medications, along with the reason given for their omission.Results: From the 259 drug charts, a total of 1598 doses of drugs were ordered within 48 hours of admission. However, from this, only a total of 1132 doses were administered with the remaining 466 doses omitted, which accounted for a frequency of 29.2%. When the frequency of medication omission errors was compared, parenteral drugs (70.8% vs. 25.3%, [p=0.0001]), afternoon shift (48.5% vs. 15.8%, [p=0.0001]), and anti-infective medications (69.1% vs. 39.4%, [p=0.0001]) were found to be the most frequently omitted medications. There were also considerably more medication omissions in patients prescribed with more medications (median number: 4, I QR [2, 6] vs. median number: 2, IQR [2, 4], [p=0. 0.001]). The most common reason for the omission was medication unavailability (89.3%), followed by work overload (71.4%), and the patient is off the ward (71.4%).Conclusions: This study revealed that medication omissions are a continuing problem and this may result in increased morbidity and mortality rates. There is a need to put in place specific strategies to reduce this problem.
{"title":"Medication omissions in the first 48 hours after admission: failure in prescribed medicines reaching in-patients in paediatrics wards at the University Teaching Hospitals, Children’s Hospital in Lusaka, Zambia","authors":"M. Kampamba, Steven Mulolo, M. Phiri, Martha Chulu, W. Mufwambi, Steward Mudenda, M. Banda, C. Hikaambo","doi":"10.18203/2319-2003.ijbcp20214497","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214497","url":null,"abstract":"Background: The first few days of in-patient care are possibly the most significant in a patient’s recovery and any omitted medications during this period may harm the patient or increase their hospital length of stay. Therefore, our study aimed at assessing the frequency of medication administration omission errors and their reasons for the omission in the paediatric wards after admission at University Teaching Children’s Hospital.Methods: This was a descriptive study in which 259 patient files and drug charts were reviewed. Admission prescription charts were studied in detail over a period of four weeks and all drugs prescribed but then not given in the first 48 hours were recorded as omitted medications, along with the reason given for their omission.Results: From the 259 drug charts, a total of 1598 doses of drugs were ordered within 48 hours of admission. However, from this, only a total of 1132 doses were administered with the remaining 466 doses omitted, which accounted for a frequency of 29.2%. When the frequency of medication omission errors was compared, parenteral drugs (70.8% vs. 25.3%, [p=0.0001]), afternoon shift (48.5% vs. 15.8%, [p=0.0001]), and anti-infective medications (69.1% vs. 39.4%, [p=0.0001]) were found to be the most frequently omitted medications. There were also considerably more medication omissions in patients prescribed with more medications (median number: 4, I QR [2, 6] vs. median number: 2, IQR [2, 4], [p=0. 0.001]). The most common reason for the omission was medication unavailability (89.3%), followed by work overload (71.4%), and the patient is off the ward (71.4%).Conclusions: This study revealed that medication omissions are a continuing problem and this may result in increased morbidity and mortality rates. There is a need to put in place specific strategies to reduce this problem. ","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90936542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22DOI: 10.18203/2319-2003.ijbcp20214510
Muhammad Yusuf Shaharudin, M. Zulkhairi
A 73-year-old male whom suffers from stage 4 adeno-squamous lung carcinoma with high programmed death-ligand 1 (PD-L1 immunohistochemistry-tumor proportion score (TPS)>50 began his treatment with a type of immune checkpoint inhibitors (ICI) therapy. After 8th cycle of treatment, patient experiences vague symptoms of fever, lethargy and drowsy. Initial working diagnosis was infection and empirical treatment was initiated. Subsequently as patient’s condition did not improve despite appropriate antibiotics, other diagnosis was considered which include adrenal insufficiency and this confirms after checking cortisol level. Hydrocortisone was started promptly and patient clinical condition improved. Decision was to stop ICI treatment interim. Consideration to re-challenge again with ICI may be considered once patient is more fit in the future. Adrenal insufficiency following ICI treatments are rare and misdiagnosed due to its non-specific symptoms. Nonetheless, it comes with high morbidity and mortality. Hence, we wanted to emphasize more on this condition as more elderly patients whom suffers from various type of cancers will be exposed towards ICI treatment.
{"title":"Adrenal insufficiency resulting from immunotherapy: a rare but life-threatening side effect","authors":"Muhammad Yusuf Shaharudin, M. Zulkhairi","doi":"10.18203/2319-2003.ijbcp20214510","DOIUrl":"https://doi.org/10.18203/2319-2003.ijbcp20214510","url":null,"abstract":"A 73-year-old male whom suffers from stage 4 adeno-squamous lung carcinoma with high programmed death-ligand 1 (PD-L1 immunohistochemistry-tumor proportion score (TPS)>50 began his treatment with a type of immune checkpoint inhibitors (ICI) therapy. After 8th cycle of treatment, patient experiences vague symptoms of fever, lethargy and drowsy. Initial working diagnosis was infection and empirical treatment was initiated. Subsequently as patient’s condition did not improve despite appropriate antibiotics, other diagnosis was considered which include adrenal insufficiency and this confirms after checking cortisol level. Hydrocortisone was started promptly and patient clinical condition improved. Decision was to stop ICI treatment interim. Consideration to re-challenge again with ICI may be considered once patient is more fit in the future. Adrenal insufficiency following ICI treatments are rare and misdiagnosed due to its non-specific symptoms. Nonetheless, it comes with high morbidity and mortality. Hence, we wanted to emphasize more on this condition as more elderly patients whom suffers from various type of cancers will be exposed towards ICI treatment. ","PeriodicalId":13901,"journal":{"name":"International Journal of Basic & Clinical Pharmacology","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85503584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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