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   2011| October-December  | Volume 2 | Issue 4  
    Online since October 12, 2011

 
 
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EDUCATIONAL FORUM
Sugar substitutes: Health controversy over perceived benefits
Kirtida R Tandel
October-December 2011, 2(4):236-243
DOI:10.4103/0976-500X.85936  PMID:22025850
Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teeth and waistline. There have been some controversial suggestions that excessive sugar may play an important role in certain degenerative diseases. So artificial sweeteners or artificially sweetened products continue to attract consumers. A sugar substitute (artificial sweetener) is a food additive that duplicates the effect of sugar in taste, but usually has less food energy. Besides its benefits, animal studies have convincingly proven that artificial sweeteners cause weight gain, brain tumors, bladder cancer and many other health hazards. Some kind of health related side effects including carcinogenicity are also noted in humans. A large number of studies have been carried out on these substances with conclusions ranging from "safe under all conditions" to "unsafe at any dose". Scientists are divided in their views on the issue of artificial sweetener safety. In scientific as well as in lay publications, supporting studies are often widely referenced while the opposing results are de-emphasized or dismissed. So this review aims to explore the health controversy over perceived benefits of sugar substitutes.
  20,935 3,533 39
COMMENTARIES
The curious case of zinc for diarrhea: Unavailable, unprescribed, and unused
B Gitanjali, K Weerasuriya
October-December 2011, 2(4):225-229
DOI:10.4103/0976-500X.85933  PMID:22025848
  9,357 1,845 8
EDITORIAL
The National Formulary of India 2010: Thorough and extensive revision of the preprint version needed
B Gitanjali
October-December 2011, 2(4):219-220
DOI:10.4103/0976-500X.85928  PMID:22025846
  2,650 5,706 -
RESEARCH PAPERS
A study of adverse drug reactions in pediatric patients
R Priyadharsini, A Surendiran, C Adithan, S Sreenivasan, Firoj Kumar Sahoo
October-December 2011, 2(4):277-280
DOI:10.4103/0976-500X.85957  PMID:22025857
Aim: To study the adverse drug reaction (ADR) pattern in a pediatric population in a tertiary care hospital. Materials and Methods: An observational study was done in the department of pediatrics in a tertiary care hospital. The ADRs occurring in the inpatient wards and outpatient department of pediatrics were actively monitored. The collected reports were analyzed for ADR pattern, drug groups, demographic profile, causality, severity, and preventability of the ADR. Results: A total of 30 ADRs were documented during the mid period of 2009 among pediatric patients. Most of the ADRs (60%) occurred below the age of 1 year. Antibiotics comprised the major group of drugs causing ADRs (67%). Rashes and urticaria were the most common type of ADR (37%) followed by fever, anaphylactic shock, vomiting, chills, and rigors. A single case of death had been reported in the study period. There were more occurrences of ADRs with multiple drugs compared to single drug therapy. About 80% of the ADRs were of probable causality and 87% were of probable preventability. There were no mild reactions, with 77% of reactions being moderate and 23% of reactions being severe in the severity scale. Conclusions: ADRs occur more among infants and antibiotics were more commonly implicated. Most of the reactions were of moderate severity. This indicates the need for a rigid ADR monitoring among pediatric patients to ensure safety of drug therapy.
  3,936 1,046 14
COMMENTARIES
Research publications: Should they be mandatory for promotions of medical teachers?
Anupama Sukhlecha
October-December 2011, 2(4):221-224
DOI:10.4103/0976-500X.85929  PMID:22025847
  2,454 2,219 3
RESEARCH PAPERS
Effects of atorvastatin and rosuvastatin on high-sensitivity C-reactive protein and lipid profile in obese type 2 diabetes mellitus patients
Suyog Sindhu, Hemant Kumar Singh, Mohammad Tariq Salman, Jalees Fatima, Vinod Kumar Verma
October-December 2011, 2(4):261-265
DOI:10.4103/0976-500X.85954  PMID:22025854
Objective: To evaluate and compare the effects on high-sensitivity C-reactive protein (hs-CRP) levels and lipid profile of atorvastatin and rosuvastatin in obese type 2 diabetes mellitus (T2DM) patients. Materials and Methods: A total of 40 subjects with 20 in each group were randomly allocated to two groups. Group 1 patients received atorvastatin and that of Group 2 rosuvastatin treatment for 6 months. The patients were administered atorvastatin (40-80 mg) and rosuvastatin(10-40 mg) in accordance to their LDL-C status as per NCEP-ATP III guidelines. The parameters studied were, hs-CRP and lipid profile comprising LDL-C, HDL-C, TG and TC. Results: Results obtained from the study, clearly indicate that atorvastatin (A) as well as rosuvastatin(R) have significant effect on lowering of hs-CRP levels (for A P=0.001; for R P=0.002), reducing LDL-C levels (for A P=0.008; for R P=0.001), elevating HDL-C levels (for A P=0.02; for R P=0.001) along with reducing TC (for A P=0.003; for R P=0.002) and TG (for A P=0.000; for R P=0.000) levels in obese T2DM patients. It is also seen that there is no significant (P>0.05) difference in effect of atorvastatin and rosuvastatin in lowering of hs-CRP levels, elevating HDL-C levels and reducing TG levels in obese T2DM patients. However, percentage lowering of LDL-C (P=0.000) and TC (P=0.001) by rosuvastatin is to a greater extent than that caused by atorvastatin in these patients. Conclusions: Thus this study throws light on the fact that rosuvastatin should be preferred over atorvastatin in obese T2DM patients in whom LDL-C and TC levels are deviated from normal reference values. In rest of obese T2DM either of atorvastatin or rosuvastatin can be employed to lower hs-CRP levels, to elevate HDL-C levels or to reduce TG levels.
  3,684 908 5
EDUCATIONAL FORUM
Saxagliptin: A dipeptidyl peptidase-4 inhibitor in the treatment of type 2 diabetes mellitus
Darshan J Dave
October-December 2011, 2(4):230-235
DOI:10.4103/0976-500X.85934  PMID:22025849
Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by insulin deficiency or resistance. Management starts with single oral antidiabetic drug (OAD) but eventually switch over to combination therapy because of progressive b-cell dysfunction. Hypoglycemia, weight gain, and adverse cardiovascular events are major limitations of the available OADs (Sulfonylureas [SUs], thiazolidinediones [TZDs]). Saxagliptin, a reversible, competitive dipeptidyl peptidase-4 inhibitor, is recently approved agent in the treatment of T2DM. It acts by preventing the degradation of glucagon-like peptide - 1 and hence increases secretion of insulin and decreases secretion of glucagon. It is a well-tolerated agent with commonly reported adverse events which include upper respiratory tract infection, urinary tract infection, and headache. Hypoglycemia, weight gain, and adverse cardiovascular events are negligible as compared with other OADs. In clinical studies, saxagliptin was found to be effective and well tolerated when used as a monotherapy as well as in combination with metformin, SUs and TZDs. It is administered in the dose range of 2.5 to 5 mg once a day regardless of meal. Dosage reduction is required in patients having moderate to severe renal impairment as well as with concurrent administration of strong CYP3A4/5 inhibitors. To conclude, saxagliptin because of its novel mechanism of action (preserving beta cell function) and better tolerability profile seems to be a promising agent in the treatment of T2DM, especially in the early stage of the disease, but long-term clinical studies are required to prove its status in the management of T2DM.
  3,378 1,071 9
RESEARCH PAPERS
Olopatadine hydrochloride and rupatadine fumarate in seasonal allergic rhinitis: A comparative study of efficacy and safety
Rituparna Maiti, Jyothirmai Jaida, Jalelur Rahman, Rajasri Gaddam, Anuradha Palani
October-December 2011, 2(4):270-276
DOI:10.4103/0976-500X.85958  PMID:22025856
Objective: To compare the efficacy and safety of olopatadine and rupatadine in seasonal allergic rhinitis (SAR). Materials and Methods: A 2-week, single-centered, randomized, open, parallel group comparative clinical study was conducted on patients with SAR. Following inclusion and exclusion criteria, 70 patients were recruited and were randomized to two treatment groups and received the respective drugs for 2 weeks. At follow-up, clinical improvement was assessed in terms of change in total and differential count of leucocytes, serum Immunoglobulin E (IgE) level, Total Nasal Symptom Score (TNSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scoring. Results: Both the drugs significantly reduced the differential count (P<&0.001) and absolute eosinophil count (P<</i>0.001), but olopatadine was found to be superior. In olopatadine group, there was significantly higher reduction in serum IgE (P=0.01), TNSS (P< 0.001) and RQLQ score (P=0.015) than that of rupatadine. Incidence of adverse effects was found to be less in olopatadine group when compared with rupatadine group. Conclusions: Olopatadine is a better choice in SAR in comparison to rupatadine due to its better efficacy and safety profile.
  3,109 878 5
Effect of heparin and low-molecular weight heparin on serum potassium and sodium levels
Girish M Bengalorkar, N Sarala, PN Venkatrathnamma, TN Kumar
October-December 2011, 2(4):266-269
DOI:10.4103/0976-500X.85956  PMID:22025855
Introduction: To study the effects of heparin and low-molecular weight heparin (LMWH) on potassium and sodium levels in patients with cardiovascular diseases (CVDs) and stroke. Materials and Methods : Sixty patients were recruited with 30 patients each receiving heparin and enoxaparin. Patients with CVD and stroke receiving heparin and LMWH were compared for their demographic profile and laboratory data, and this was analyzed by descriptive statistics. Risk factors associated with the development of hyperkalemia were analyzed using multiple logistic regression model. Results : There was an increase in potassium levels and decrease in sodium levels compared with baseline in both the groups. The difference between the groups with respect to sodium and potassium levels was not statistically significant. On analysis, the risk factors for development of hyperkalemia were baseline potassium levels, serum creatinine, and creatinine clearance. The change in sodium and potassium levels on the fifth day of therapy was increased with LMWH compared with heparin, although not statistically significant. Conclusions : The clinician should anticipate hyperkalemia especially in patients with renal impairment receiving these drugs.
  3,165 817 13
POSTGRADUATE CORNER
Measures of dispersion
S Manikandan
October-December 2011, 2(4):315-316
DOI:10.4103/0976-500X.85931  PMID:22025871
  3,175 615 7
MOLECULES OF THE MILLENNIUM
Belimumab: First targeted biological treatment for systemic lupus erythematosus
Ashok K Dubey, Shailendra S Handu, Suparna Dubey, Prashant Sharma, KK Sharma, Qazi M Ahmed
October-December 2011, 2(4):317-319
DOI:10.4103/0976-500X.85930  PMID:22025872
  2,909 770 7
METHODS
Starting a pharmacovigilance center: Actions for implementation
Mrinmoy Chakrabarty, Vijay Thawani
October-December 2011, 2(4):295-299
DOI:10.4103/0976-500X.85945  PMID:22025864
With burgeoning reports of adverse drug reactions due to pharmacotherapy, pharmacovigilance (PV) is the buzz word in health care circles. While there are experts in this rapidly expanding field, there are many health care professionals who do not fully appreciate the import of PV in the context of modern therapeutics. In view of the national directive to institutionalize a PV center in every medical college of India, there is an urgent need to inform, educate, and enlighten the readers about the constitution and dynamics of a PV center, which this article attempts to fulfill.
  3,004 650 2
RESEARCH PAPERS
Antitubercular effect of 8-[(4-Chloro phenyl) sulfonyl]-7-Hydroxy-4-Methyl-2H-chromen-2-One in guinea pigs
Parvati B Patel, Tejas K Patel, Seema N Baxi, Hemangini R Acharya, Chandrabhanu Tripathi
October-December 2011, 2(4):253-260
DOI:10.4103/0976-500X.85951  PMID:22025853
Objective: To evaluate the antitubercular efficacy and safety of New Chemical Entity (NCE): 8-[(4-Chloro phenyl) sulfonyl]-7-Hydroxy-4-Methyl-2H-chromen-2-One (CSHMC) in guinea pigs. Materials and Methods: This pilot study was carried out in guinea pigs. They were infected with M. tuberculosis H 37 Rv (1.5 × 10 4 cfu/guinea pig) via intramuscular route. After 30 days, infections were confirmed in 6 guinea pigs by histopathology of spleen, lung, and liver. After that CSHMC (5 and 20 mg/kg) was administered for 1 month and its effect was compared with vehicle, rifampicin (60 mg/kg) and isoniazid (30 mg/kg). Efficacy of CSHMC was evaluated on the basis of histopathologic scoring of lesion in lung, spleen, liver, and safety on the basis of measuring hemogram, liver and renal function parameters. Results: Isoniazid, rifampicin, and CSHMC (20 mg/kg) significantly reduce the median lesion score in lung, spleen, and liver as compared to disease control group. Reduction in median lesion score for lung and spleen were not statistically significant for CSHMC 5 mg/kg. CSHMC (20 and 5 mg/kg) did not produce any changes in hemogram, liver and renal function parameters with respect to normal values. Conclusions: CSHMC had shown significant antitubercular efficacy comparable to isoniazid and rifampicin and did not show hematological, hepato- and nephrotoxicity.
  2,861 417 -
Evaluation of the appropriateness of prescribing in geriatric patients using Beers criteria and Phadke's criteria and comparison thereof
Rima B Shah, Bharat M Gajjar, Sagun V Desai
October-December 2011, 2(4):248-252
DOI:10.4103/0976-500X.85948  PMID:22025852
Objectives: To evaluate appropriateness of prescribing medicines in geriatric patients using both Beers criteria and Phadke's criteria and compare them for validation of Phadke's criteria as a tool to evaluate rationality of prescribing in elderly. Materials and Methods: A cross-sectional prospective observational study was conducted and the baseline data were collected from different inpatient and outpatient departments in Shree Krishna Hospital (SKH), Karamsad. A total of 400 patients of geriatric age group (≥65 years) from various inpatient and outpatient departments of SKH were included in the study. Relevant information from patients included in the study was recorded in a structured proforma from their case files. Data were evaluated for appropriateness of prescribing by using both Beers criteria and Phadke's criteria and comparison between the two criteria was also carried out. Results: Out of total 400 patients, 291 (72.75%) patients were prescribed appropriately according to Beers criteria. Based on Phadke's criteria, 158 (39.5%) prescriptions were rational, 129 (32.3%) were semirational and 113 (28.3%) were irrational. Mean rationality score on a 30-point semiscientific scale was found to be 18.47 ± 9.66 (mean ± SD). The comparison of outcome by both the criteria showed no significant difference in appropriateness of prescribing (P>0.05). Conclusions: Inappropriate prescribing is common in elderly patients. Beers criteria is a well-established method for evaluating appropriateness of prescribing. This study has shown that Phadke's method of evaluating rationality of prescriptions compares equally well and hence can be a valuable objective tool for assessing appropriateness of prescribing in geriatric patients.
  2,520 700 5
RESEARCH LETTERS
Effect of silymarin in diabetes mellitus patients with liver diseases
Manonmani Alvin Jose, Anjana Abraham, MP Narmadha
October-December 2011, 2(4):287-289
DOI:10.4103/0976-500X.85952  PMID:22025861
  2,493 639 7
CORRESPONDENCE
Zotero: A bibliographic assistant to researcher
KK Mueen Ahmed, Bandar E Al Dhubaib
October-December 2011, 2(4):303-305
DOI:10.4103/0976-500X.85940  PMID:22025866
  2,320 542 6
RESEARCH LETTERS
Analysis of thyroid function tests in patients of multidrug resistance tuberculosis undergoing treatment
Naveen Chhabra, Neeraj Gupta, ML Aseri, Sunil K Mathur, Ramakant Dixit
October-December 2011, 2(4):282-285
DOI:10.4103/0976-500X.85949  PMID:22025859
  2,365 480 4
Evaluation of role of noradrenergic system in the antidepressant activity of tramadol using tail suspension test in Albino mice
Mukta N Chowta, M Manjunath, HN Gopalakrishna, P Gokul
October-December 2011, 2(4):281-282
DOI:10.4103/0976-500X.85947  PMID:22025858
  2,119 435 7
Timely detected medication error: Prescribing or dispensing?
Divya Goel, Sanjay Gupta
October-December 2011, 2(4):292-294
DOI:10.4103/0976-500X.85955  PMID:22025863
  1,975 550 1
RESEARCH PAPERS
Impact of chronic disease assistance program on the retail pharmacy sector: A retrospective study
Sandeep Maharaj, Kreshma Roopnarine, Vashish Maharaj, Sushain Maraj, Eenest Sankar, Meera Singh, Otelesante George Tayopa, Sureshwar Pandey, Prasanna R Deshpande
October-December 2011, 2(4):244-247
DOI:10.4103/0976-500X.85944  PMID:22025851
Objective: To assess the impacts of chronic disease assistance program (CDAP) on economic parameters, human resource and pharmacy structure and pharmaceutical care on the retail industry in Trinidad and Tobago. Materials and Methods: A partially perceptual retrospective investigation was carried out in 60 pharmacies from all regions (North East, North West, Central and South) in Trinidad. Questionnaires were distributed to all pharmacists of the each pharmacies indicated above. The validated questionnaires were distributed, over a period of approximately 2 weeks. Pharmacists employed at each pharmacy were asked to complete the questionnaire which consisted of 11 questions based on the three aspects of investigation. A five-point Likert scale (1 = strongly disagree, 5 = strongly agree) was used. Information from the completed questionnaires was tabulated in Microsoft Excel and the respective percentages and proportions were generated. Results: From the 60 pharmacies, 61% (n=37) believed that there was a decrease in sale of original brands while more than half of the respondents [53% (n=32)] believed there was an increase in sale of generics. The 60% (n=36) respondents viewed that there was compromised dispensary sale of original brands while 65% (n=39) felt there was increased orders for generic drugs. Of the CDAP prescriptions, it was disclosed that there was an overall increase in CDAP prescriptions from the year 2005-2008. A medium-scale pharmacy disclosed 1801 prescriptions in 2005, 2265 prescriptions in 2006, 3002 prescriptions 2007 and 3344 prescriptions in 2008 with overall increase in each year. Conclusions: The implementation of CDAP can explain the phenomenal increase in sale of generics drugs and the decrease in the sale of brands. There is a need for such a program in the developing countries.
  1,928 358 -
RESEARCH LETTERS
Clinical trials registered in clinical trial registry of India: A survey
Preeti Yadav, Jaykaran , Mayur Chaudhari, Deepak Saxena, ND Kantharia
October-December 2011, 2(4):289-292
DOI:10.4103/0976-500X.85953  PMID:22025862
  1,818 398 3
CASE REPORT
Sick sinus syndrome associated with topical timolol maleate instillation
Harpreet S Walia, Sandeep S Walia, Matthew E Emanuel
October-December 2011, 2(4):300-302
DOI:10.4103/0976-500X.85946  PMID:22025865
A 70-year-old black woman presented with intermittent palpitations and dyspnea was found to be bradycardic with a normal sinus rhythm. She had instilled her topical timolol maleate approximately 30 minutes prior to each of these episodes. Topical timolol was discontinued and the conduction abnormality resolved. She was diagnosed as having intermittent sinus bradycardia with intermittent atrioventricular block, likely induced by topical beta-blocker therapy. Topical timolol maleate is an effective treatment for ocular hypertension, acting by reducing aqueous fluid production. However, it can induce systemic side effects and should be used with caution in patients with, or predisposed to, cardiac or respiratory depression.
  1,766 364 1
RESEARCH LETTERS
Effect of Erythrina variegata on experimental atherosclerosis in guinea pigs
Mangathayaru Kalachaveedu, Sarah Kuruvilla, K Balakrishna
October-December 2011, 2(4):285-287
DOI:10.4103/0976-500X.85950  PMID:22025860
  1,636 403 -
WEB-WISE
Rat guide: A guide to health, medication use, breeding, and care of rats
S Parasuraman
October-December 2011, 2(4):313-314
DOI:10.4103/0976-500X.85932  PMID:22025870
  1,396 356 1
CORRESPONDENCE
Clinician and researcher - Can the twain ever meet? A young clinician's perspective
Vaishnavi Batmanabane Prakash, Prakash Muthusami
October-December 2011, 2(4):305-307
DOI:10.4103/0976-500X.85941  PMID:22025867
  1,314 282 2
Benfluorex withdrawal in France: Still be hiding somewhere in the world?
Irène Frachon, Grégoire Le Gal, Catherine Hill, Christophe Leroyer
October-December 2011, 2(4):307-308
DOI:10.4103/0976-500X.85942  PMID:22025868
  1,272 301 1
BOOK REVIEW
Biomedical Research - From Ideation to Publication
Vir Singh Negi
October-December 2011, 2(4):320-320
  1,112 261 -
CORRESPONDENCE
World Health Organization bids adieu to Hans Hogerzeil - The dynamic Director of Essential Medicines and Pharmaceutical Policies
B Gitanjali
October-December 2011, 2(4):308-309
DOI:10.4103/0976-500X.85943  PMID:22025869
  1,099 249 -
NEWS AND VIEWS
Peels to peel bad cholesterol
G Sivagnanam
October-December 2011, 2(4):311-311
  1,099 233 -
An oil to strike stroke
G Sivagnanam
October-December 2011, 2(4):310-311
DOI:10.4103/0976-500X.85935  
  1,009 260 -
ACE inhibitor and angiotensin-receptor blocker - A deadly combination
G Sivagnanam
October-December 2011, 2(4):311-312
  970 282 -
iPhone + iCard - A death preventing combination
G Sivagnanam
October-December 2011, 2(4):312-312
  833 217 -
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