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   2018| July-September  | Volume 9 | Issue 3  
    Online since December 18, 2018

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Evolving role of clinical pharmacologists in Indian accredited hospitals
Subhrojyoti Bhowmick, Ashok K Shenoy
July-September 2018, 9(3):121-125
Over the past decade, the health-care sector in India has made significant progress. It is presently one of India's largest sectors, in terms of revenue and employment, and is continuing to expand rapidly. The huge pool of trained medical professionals in the country and the availability of high-quality medical services at affordable costs have given India the advantage over its peers in the rest of the world. Presence of world-class hospitals and skilled medical professionals has strengthened India's position as a preferred destination for medical tourism. Improving patient safety, medication management, infection prevention and control, quality performance and improvement, and environment of care are the primary objectives of hospitals. The hospitals involved in medical tourism are voluntarily seeking accreditation of their patient safety and service quality standards from accrediting bodies nationally and internationally. In India, the National Accreditation Board for Hospitals and Healthcare Providers (NABH) is the constituent board of Quality Council of India, which has been set up to establish and operate accreditation program for health-care organizations. The accreditation program requires complete compliance to safe medication practices as a part of the management of medications in the hospital. This review discusses the evolving role expected to be performed by clinical pharmacologists as the primary custodian of medication management and medication safety process. As more hospitals in India aspire to become NABH accredited, it is expected that the role of clinical pharmacologists will be understood better and would be required to ensure proper and safe medication management system.
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An opioid-benzodiazepine interaction: Benzodiazepines as opioids?
Neville F Ford
July-September 2018, 9(3):165-166
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Development and implementation of pharmacology museum as a teaching-learning tool: A prospective, interventional study
Urwashi I Parmar, Raakhi K Tripathi, Snehalata V Gajbhiye, Nirmala N Rege
July-September 2018, 9(3):147-152
Objective: To evaluate the perception of 2nd-year medical undergraduates on pharmacology museum as teaching–learning (TL) tool. Materials and Methods: The Institutional Ethics Committee permission was taken before initiation of the study. After voluntary written consent, II MBBS students were enrolled in this study. An additional museum was created for easy visibility and access. The display cards with drugs about two finalized biological systems were displayed in the museum. The TL activity was planned for 2 phases; in Phase 1, students were mandatorily instructed to visit the museum and see the various dosage forms of drugs for a given period. A pretest and posttest, consisting of 21 validated multiple-choice questions on dosage forms, were conducted in Phase 1. Phase 2 comprised voluntary visits to the museum. Students were given the opportunity to clear their doubts with regard to dosage forms of drugs displayed. At the end of Phase 2, the perception of the student for the museum as a TL tool was recorded on a twenty-item perception questionnaire. Results: The performance of students was increased from pretest score of 7.59 ± 2.9 to 10.25 ± 3.03 (P < 0.001). Of 173 students, 85 felt that display information was adequate and 77 opined that this information brought clarity. Students (n = 97) felt that visualizing the drugs helped them to remember the various dosage forms better, museum-inspired them to read about the dosage forms (n = 90), and encouraged self-learning (n = 107). They expressed that they can score better in examinations (n = 88). Conclusion: Students perceived that the museum improved their knowledge regarding dosage forms. In spite of this, they did not appreciate museum as a teaching tool, which has posed a bigger challenge to the teaching faculty to make the museum interesting and resourceful.
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Comorbid physical and mental health illness of prescription opioid abusers attending de-addiction centers of Sikkim: A Northeastern State of India
Debranjan Datta, Sunil Kumar Pandey, Sanjiba Datta, Yogesh Verma
July-September 2018, 9(3):160-164
Objective: To recognize comorbid medical and psychiatric illness of treatment-seeking prescription opioid abusers in Sikkim. Setting and Design: A cross-sectional descriptive study was conducted among 223 individuals who were seeking the treatment for prescription opioid and other substance abuse-related problems at different de-addiction centers of Sikkim. Subjects and Methods: Participants were interviewed by a single interviewer by administering pretested questionnaires. Those who gave informed consent were included in this study. Statistical Analysis Used: Database development and analysis were carried out using SPSS software version 20. Results: The mean age of prescription opioid abusers was 27 years. Prescription opioid abuse was found prevalent among unmarried, school dropout (40%) and those living in a nuclear family. A majority reported having serious employment problems in lifetimes. Dextropropoxyphene was reported as most used prescription opioid. About 52% reported getting hospitalized several times for chronic medical problems in lifetimes. Incidences of psychological distress, such as anxiety/tension (96.9% vs. 68.3%), were reported more than psychiatric problems such as severe depression in lifetimes. Conclusion: Increased incidences of prescription opioid abuse and need of treatment for substance abuse disorder and associated comorbid chronic health issues and psychiatric as well as the psychological illness was observed in Sikkim.
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Phosphodiesterase 7B1 as therapeutic target for treatment of cognitive dysfunctions in multiple sclerosis
Arthi Balsundaram, Darling Chellathai
July-September 2018, 9(3):126-130
Multiple sclerosis (MS) is an autoimmune, chronic degenerative neuroinflammatory disorder affecting younger age groups of the United States of America and Europe. MS prevalence studies in India have shown that India is no longer a low-risk zone. Many studies have shown the seriousness of cognitive impairments (CIs) and its types caused in MS. In this review, the pathological basis for CI in various stages of MS was reviewed and revealed to provide a basis for the treatment. Role of phosphodiesterase 7B1 (PDE7B1) inhibitors in treating CI related to MS were also stated in this review. The literature for this review was collected from PubMed and Embase.
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Contribution of Italian clinical research for contrast media-induced nonrenal adverse drug reactions over the last three decades: A systematic review
Maurizio Sessa, Claudia Rossi, Annamaria Mascolo, Antonella Scafuro, Rosanna Ruggiero, Gabriella di Mauro, Salvatore Cappabianca, Roberto Grassi, Liberata Sportiello, Concetta Rafaniello
July-September 2018, 9(3):131-146
The aim of this study was to investigate the scientific contribution of Italian clinical research for contrast media-induced nonrenal adverse drug reactions over the last three decades. Ovid Embase, Ovid MEDLINE, Web of Science, and Cochrane Methodology Register were used as data sources to identify Italian descriptive studies, observational studies, meta-analyses, and clinical trials assessing contrast media-induced nonrenal adverse drug reactions as a safety outcome. The population of interest was men and women exposed to a contrast medium. Between 1990 and 2017, 24 original articles investigating contrast-induced nonrenal adverse drug reactions were identified. The cohort study was the most representative study design (10/24; 41.7%). The 24 studies were conducted mainly as monocenter studies (14/24; 58.3%) and without receiving funding (17/24; 70.8%). Seventeen out of 24 studies provided a level of evidence ranging from III-2 (11/24; 45.8%) to IV (6/24; 25.0%) on a Merlin scale. In total, 14 of 24 (58.3%) studies were published in a scientific journal ranked in the first quartile of their subject area. The 24 original articles mainly focused on adverse drug reactions already observed during clinical trials (i.e., idiosyncratic systemic reactions). In conclusion, during the last three decades and a burst was not observed in the Italian clinical research investigating contrast-induced nonrenal adverse drug reactions. High-quality clinical research is needed especially for procedures to prevent the onset of the aforementioned events, to identify risk factors, to minimize the risk of their occurrence, and to optimize their related prognosis.
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Effect of antihypertensive pharmacotherapy on oscillometric pulse wave analysis parameters in treated Gujarati hypertensives: A cross-sectional study
Jayesh Dalpatbhai Solanki, Hemant B Mehta, Sunil J Panjwani, Hirava B Munshi, Chinmay J Shah
July-September 2018, 9(3):153-159
Objective: To study the effect of different classes and combinations of antihypertensive agents on arterial stiffness and central hemodynamic parameters. Materials and Methods: A cross-sectional study was conducted in 446 treated apparently healthy hypertensives. Oscillometric PWA was performed by Mobil-o-Graph (IEM, Germany) to derive cardiovascular parameters that were further analyzed in groups stratified by antihypertensive used. Study parameters were brachial hemodynamics (blood pressure (BP), heart rate, and rate pressure product); arterial stiffness (augmentation pressure, augmentation index, pulse wave velocity, total arterial stiffness, and pulse pressure amplification); and central hemodynamics (central BP, cardiac output, and stroke work). Statistical significance was kept at P < 0.05. Results: All groups were selected by matching of age, gender, and body mass index. They were comparable with major confounding factors. There was no difference between study parameters in hypertensives taking exclusive angiotensin-converting enzyme inhibitor (ACEI), calcium channel blocker (CCB), or angiotensin II receptor blocker. Multitherapy showed better hemodynamics and monotherapy showed better stiffness parameters. Addition of CCB to ACEI did not make a difference except with diastolic BP. For most comparisons, most of the results lacked statistical significance. Conclusion: Discrete PWA parameters showed no class difference in hypertensives, treated by conventional monotherapy or combination, ACEI appears to be the best drug. This also indicates that early diagnosis and blood pressure control are more important than antihypertensive used.
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