Journal of Basic and Clinical Pharmacy最新文献

Cold agglutinin disease (CAgD) is a type of autoimmune hemolytic anemia which generally occurs in adults and is characterized by the presence of IgM antibodies directed against polysaccharide antigens on red blood cell surface. A 16-year-old male, having clinical picture of sepsis and anemia, presented to the Emergency Department of our Institute in an Hemodynamically unstable condition. Investigation profile revealed hemolysis due to CAgD, which responded to corticosteroids, antibiotics and supportive treatment. This case highlights the importance of recognizing this entity in such type of cases presenting with sepsis and anemia.

Canagliflozin (Invokana) is an innovative treatment for type 2 diabetes mellitus (DM) approved in a new class acknowledged as sodium-glucose co-transporter 2 inhibitors. Acute pancreatitis is a very rare side effect with an incidence <1%. a 50-year-old white male with DM type 2 presented to the emergency department with acute onset of abdominal pain after 4 days treatment with canagliflozin. He was successfully diagnosed with diabetic ketoacidosis induced by acute pancreatitis. Canagliflozin was discontinued. His diabetic ketoacidosis was improved after aggressive intravenous fluid along with intravenous insulin infusion. Our case demonstrates very rare but serious side effect, acute pancreatitis in the use of canagliflozin. As the utility of canagliflozin expands, physicians must be aware of this potentially fatal adverse effect. More specific details on potential candidates for this novel therapy are urgently needed.

Background: Adverse drug reaction (ADR) is considered to be the sixth leading cause of death. The incidence rate estimates approximately 2% of hospital admissions are due to ADRs.

Objective: To monitor ADRs in Pulmonology department of a tertiary care hospital patient with pulmonary diseases in an inpatient department of pulmonology.

Materials and methods: A prospective, single centered, observational and open labeled study was carried out in Princess Esra Hospital. The patient population was broadly divided into four categories based on diagnosis - chronic obstructive pulmonary disease, Infections, Asthma and Others. Suspected ADRs were reported, analyzed, and causality assessment was carried out using Naranjo's algorithm scale.

Results: A total of 302 patients were observed, of which 98 patients experienced ADRs, which accounted for 32.23% of the incidence and totally 160 ADEs were observed. Adult Patients were found to have higher incidence (32.09%) while the incidence rate was slightly greater in geriatric patients (32.39%). The highest incidence of ADEs were found in others group (78.57%). Majority of ADRs were suspected to be due to theophylline (19.39%). Gastrointestinal system (38.75%) was the most common organ system affected due to ADRs. Drug was withdrawn in 12 patients, and specific treatment was administered to 32 patients in view of clinical status. Specific treatment for the management of suspected reaction was administered in 32.65% of ADR reports.

Conclusion: A relatively high incidence of adverse drug events (32.2%) have been recorded which shows that not only Geriatric patients, but also adults are more susceptible to adverse drug effects. A number of drugs in combination were used, and ADEs often get multiplied. Careful therapeutic monitoring and dose individualization is necessary.

Background: The substances abuse has become one of the major public health problems of present society. Recently there has been an increase in the incidence of substance abuse including that of opioids throughout the world. The proper assessment of the current trends and pattern of opioid abuse can be helpful in more effective intervention of this menace.

Materials and methods: To find out various socio-demographic variables and pattern of opioid abuse, a predevised questionnaire was administered to 200 opioid patients who presented to de-addiction center for treatment.

Results: Majority of the participants (75%) were of young age group (20-30 years) and the mean age of subjects was 27.6 years. More than half of participants (55%) were abusing the opioid substances for < 3 years followed by 30% of the abusers who were using the opioids for 4-6 years. Oral route was the most common route(35%)of substance administration followed by chasing(13%) and intravenous(11%) routes. Diverted pharmaceuticals emerged as one of the common substances of abuse, and peer pressure was found to be the main reason to start substance abuse.

Conclusion: A comprehensive preventive program targeting young adults needs to be formulated and strict laws against sales of diverted pharmaceuticals to be implemented.

Background: Dental diseases negatively influence people's oral health-related quality of life (OHRQoL) and thus their perceived need for dental care. QoL is increasingly acknowledged as a valid, appropriate and significant indicator of service need and intervention outcomes in contemporary public health research and practice.

Objectives: (1) To assess the psychometric properties of oral health impact profile-14 (OHIP-14) scale among rural and urban OHIP of Udaipur population. (2) To assess and compare clinical dental status (dental caries, periodontal disease and prosthetic status) and its impacts on OHRQoL rural and urban population of Udaipur.

Materials and methods: A cross-sectional descriptive survey was conducted among rural (600) and urban (600) population of Udaipur that have age ranges between 20 and 79 years, chosen from outpatient department of Pacific Dental College and Hospital. The OHIP-14 was tested for validity and reliability. Chi-square, Student's t-test, analysis of variance and multiple logistic regression analysis were employed for statistical analysis.

Results: The Cronbach's alpha of the scale was found to be 0.85 among the rural population and 0.89 among the urban population. Prevalence of periodontal disease (community periodontal index and loss of attachment) was found greater among the rural population than the urban population. Urban population showed significantly greater proportion of subjects with prosthesis (including partial, fixed and total) as compared to the rural population. Among study population, OHIP-14 was significantly (P ≤ 0.05) associated with age, gender, presence of decayed teeth (DT), missing teeth (MT), and location. Significantly greater odds ratio (OR) (OHIP-14) were revealed among males (OR = 1.35, P = 0.02), urban residents (OR = 1.13, P = 0.002), those < 45 years of age (OR = 1.23, P = 0.01), those without DT (OR = 1.48, P = 0.002) and without MT (OR = 1.08, P = 0.03).

Conclusion: The rural and urban study subjects had a fair clinical status. The presence of dental caries had greatest impacts on OHRQoL. In addition, rural subjects faced greater impact than urban subjects.

Drugs raise blood glucose concentrations via two broad mechanisms: By reducing insulin biosynthesis or secretion, or by reducing tissue sensitivity to insulin. Until date, there have been very few reported cases of isoniazid induced diabetes. We are presenting a case report of 6-year-old child with isoniazid induced diabetes who was misdiagnosed initially as a case of type 1 diabetes mellitus. We hereby stress that before diagnosing a patient with diabetes-type 1 or 2, a detailed history of drug intake for any such drugs, which can cause hyperglycemia has to be taken. Clear cut knowledge/cognizance of all such culprit drugs is therefore required.

Aim: Periodontitis is one of the major problems slowly progressing and could affect 70% of the global population. The prevalence of periodontitis differs from mild to moderate forms of race and geographic region. The aim of this study is to determine the acid phosphatase (ACP) activity in the gingival tissues of periodontitis subjects. In this study, the activity of ACP in the gingival tissue of subjects with periodontitis was examined.

Materials and methods: A total of 30 subjects were selected for the study and are divided into group I (n = 15, healthy subjects in control) and in group II (n = 15, periodontitis subjects). The gingival tissue from group I and group II subjects were collected after the surgery and the ACP enzyme level was analyzed using ultraviolet spectrophotometer. Assessment of periodontitis was done based on periodontal probing depth (PPD) and clinical attachment level (CAL). The statistical analysis applied was independent sample t-test, P < 0.05 was considered as significant.

Results: The results of group II periodontitis subjects showed statistically significant increased gingival tissues ACP level when compared with the control group I subject. The mean levels of CAL and PPD were significantly >4 mm in periodontitis subjects when compared to control.

Conclusions: The elevated level of ACP in the gingival tissue and Gram-negative microorganisms found in sub-gingival plaque was greater in periodontitis. Based on these results, gingival tissue ACP level can be considered as an independent risk factor for evaluating the microbial status and periodontal tissue damage.

Objectives: The aim was to evaluate the effect of high molecular weight protein fraction of Calotropis procera latex on edema formation and oxidative stress in carrageenan-induced paw inflammation.

Methods: A sub-plantar injection of carrageenan was given to induce edema in the hind paw of the rat. The inhibitory effect of high molecular weight protein fraction of C. procera latex was evaluated following intravenous administration (5 and 25 mg/kg body weight) and was compared with that of diclofenac given orally (5 mg/kg). The levels of reduced glutathione (GSH), thiobarbituric acid reactive substances (TBARS) and myeloperoxidase (MPO) were measured in the inflamed paw tissue at the end of the study.

Results: The high molecular weight protein fraction obtained from the latex of C. procera produced a dose-dependent inhibition of edema formation that was accompanied by normalization of levels of oxidative stress markers (GSH and TBARS) and MPO, a marker for neutrophils in the paw tissue.

Conclusions: The high molecular weight protein fraction of C. procera latex ameliorates acute inflammation in the paw through its antioxidant effect.

Objectives: To retrospectively determine the extent and types of adverse drug events (ADEs) from the patient cases sheets and identify the contributing factors of medication errors. To assess causality and severity using the World Health Organization (WHO) probability scale and Hartwig's scale, respectively.

Methods: Hundred patient case sheets were randomly selected, modified version of the Institute for Healthcare Improvement (IHI) Global Trigger Tool was utilized to identify the ADEs; causality and severity were calculated utilizing the WHO probability scale and Hartwig's severity assessment scale, respectively.

Results: In total, 153 adverse events (AEs) were identified using the IHI Global Trigger Tool. Majority of the AEs are due to medication errors (46.41%) followed by 60 adverse drug reactions (ADRs), 15 therapeutic failure incidents, and 7 over-dose cases. Out of the 153 AEs, 60 are due to ADRs such as rashes, nausea, and vomiting. Therapeutic failure contributes 9.80% of the AEs, while overdose contributes to 4.58% of the total 153 AEs. Using the trigger tools, we were able to detect 45 positive triggers in 36 patient records. Among it, 19 AEs were identified in 15 patient records. The percentage of AE/100 patients is 17%. The average ADEs/1000 doses is 2.03% (calculated).

Conclusion: The IHI Global Trigger Tool is an effective method to aid provisionally-registered pharmacists to identify ADEs quicker.