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  Citation statistics : Table of Contents
   2013| April-June  | Volume 4 | Issue 2  
    Online since April 20, 2013

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Adverse drug reactions in the elderly
Dhriti K Brahma, Julie B Wahlang, Maxilline D Marak, Marlina Ch. Sangma
April-June 2013, 4(2):91-94
DOI:10.4103/0976-500X.110872  PMID:23761706
Medications probably are the single most important health care technology in preventing illness, disability, and death in the geriatric population. Age-related changes in drug disposition and pharmacodynamic responses have significant clinical implications; increased use of a number of medications raises the risk that medicine-related problems may occur. The relationship between increased use of drugs including the prescription medication and elderly is well established. Majority of ADRs (80%) causing admission or occurring in hospital are type A reactions. Although less common occurring in elderly, type B ADRs may sometimes cause serious toxicity. Studies have correlated the integral association between old age and increased rate of adverse drug reactions arising out of confounding association between age and polypharmacy contributed by age-related changes in pharmacodynamics and pharmacokinetics at least for some medical conditions. A drug combination may sometimes cause synergistic toxicity which is greater than the sum of the risks of toxicity of either agent used alone. But, strategies to increase opportunities for identifying ADRs and related problems have not been emphasised in current international policy responses especially in India to the increase in elderly population and chronic conditions. Careful epidemiological studies that encompass large numbers of elderly drug users are required to obtain this information as increased knowledge of the frequency and cost of adverse drug reactions is important in enabling both more rational therapeutic decisions by individual clinicians and more optimal social policy.
  15 5,143 1,008
Diclofenac induced acute renal failure in a decompensated elderly patient
Pallavi Dhanvijay, Arup K Misra, Sushil K Varma
April-June 2013, 4(2):155-157
DOI:10.4103/0976-500X.110916  PMID:23761717
Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed drugs in post-operative period worldwide. Their nephrotoxic effects are documented and accounts for around 15.5% of all cases of drug induced renal failure. Acute renal failure following NSAIDs usage are reported in volume depleted patients which is further precipitated by co-morbid conditions like hypertension and various drug interactions that increase plasma level of NSAIDs and worsens the condition. This highlights the importance of hydration in post-operative period as well as assessment of co-morbid conditions before administration of NSAIDs to prevent acute renal failure.
  8 2,547 526
Scientific evaluation of the scholarly publications
Alok Saxena, Vijay Thawani, Mrinmoy Chakrabarty, Kunda Gharpure
April-June 2013, 4(2):125-129
DOI:10.4103/0976-500X.110894  PMID:23760040
Worthiness of any scientific journal is measured by the quality of the articles published in it. The Impact factor (IF) is one popular tool which analyses the quality of journal in terms of citations received by its published articles. It is usually assumed that journals with high IF carry meaningful, prominent, and quality research. Since IF does not assess a single contribution but the whole journal, the evaluation of research authors should not be influenced by the IF of the journal. The h index, g index, m quotient, c index are some other alternatives to judge the quality of an author. These address the shortcomings of IF viz. number of citations received by an author, active years of publication, length of academic career and citations received for recent articles. Quality being the most desirable aspect for evaluating an author's work over the active research phase, various indices has attempted to accommodate different possible variables. However, each index has its own merits and demerits. We review the available indices, find the fallacies and to correct these, hereby propose the Original Research Performance Index (ORPI) for evaluation of an author's original work which can also take care of the bias arising because of self-citations, gift authorship, inactive phase of research, and length of non-productive period in research.
  6 2,475 493
Insufficient stocking of cyanide antidotes in US hospitals that provide emergency care
Lucas Gasco, Margaret B Rosbolt, Vikhyat S Bebarta
April-June 2013, 4(2):95-102
DOI:10.4103/0976-500X.110875  PMID:23761707
Objective: To identify the influence of catchment area, trauma center designation, hospital size, subspecialist employment, funding source, and other hospital characteristics on cyanide antidote stocking choice in US hospitals that provides emergency care. Materials and Methods: A web-based survey was sent out to pharmacy managers through two listservs; the American Society of Health-Systems Pharmacists and the American College of Clinical Pharmacy. A medical marketing company also broadcasted the survey to 2,659 individuals. We collected data on hospital characteristics (size, state, serving population, etc.,) to determine what influenced the hospital's stocking choice. Results: The survey response rate was approximately 10% ( n = 286). Thirty-eight hospitals (16%) stocked at least 4 antidote kits. Safety profile, recommendations from a poison control center, and ease of use had the strongest influence on stocking decisions. Conclusions: Survey of 286 US hospital pharmacy managers, 38/234 (16%) hospitals had sufficient stocking of cyanide antidotes. Antidote preference was based on safety, ease of use, and recommendations by the local poison center, over cost.
  6 2,539 334
Allopurinol induced granuloma annulare in a patient of lepromatous leprosy
Satyendra Kumar Singh, Kajal Manchanda, Aakash Amar Bhayana, Anurag Verma
April-June 2013, 4(2):152-154
DOI:10.4103/0976-500X.110915  PMID:23761716
Granuloma annulare (GA) is a benign, inflammatory dermatosis involving dermis or subcutis with unknown etiology and poorly understood pathology. GA has characteristic histological features of necrobiosis, granuloma formation and abundant mucin deposition. Various predisposing factors, systemic diseases and drugs have been implicated in the etiology. We hereby describe a case of 70 year old male who was a known case of lepromatous leprosy, taking multidrug therapy for 6 months presented with multiple discrete, annular, firm, non tender, smooth surfaced skin colored papular lesions ranging in size from 0.5-1 cm over back for 1 month. There was past history of intake of allopurinol for hyperuricemia which was started 1 year back. There was history of similar lesions 6 months back which healed within 1 month of stopping allopurinol and he started taking the drug for the past 4 months on his own without any medical advice. Histopathological examination showed superficial and deep perivascular lymphocytic infiltrate with numerous histiocytes scattered in the intersititum of reticular dermis and abundant mucin in between the histiocytes. Allopurinol was implicated as an etiological agent and dramatic improvement was seen after stopping the drug for a period of 4 weeks. Naranjo's algorithm showed a probable association with a score of 6. Thus the final diagnosis of allopurinol induced generalised interstitial granuolma annulare was made. Patient was advised to continue antileprotic drugs, low purine diet and avoid allopurinol intake.
  5 3,525 322
Clozapine associated thrombocytopenia
Natasha Kate, Sandeep Grover, Munish Aggarwal, Pankaj Malhotra, Manupdesh S Sachdeva
April-June 2013, 4(2):149-151
DOI:10.4103/0976-500X.110913  PMID:23761715
Although agranulocytosis as a side effect of clozapine is well known, there is scarcity of data with regard to thrombocytopenia associated with clozapine. In this report we describe a case of clozapine induced thrombocytopenia and review the existing literature. A 22 year old female patient developed thrombocytopenia while on clozapine 187.5 mg/day for 17 weeks. Thrombocytopenia persisted for 24 weeks even after reduction in the dose of clozapine and ultimately clozapine had to be stopped, which led to resolution of thrombocytopenia. Clozapine-induced thrombocytopenia is a less well-known, but potentially serious, adverse effect that should be screened for in practice. The case highlights the fact that besides monitoring the leucocyte count, platelet count of patients receiving clozapine should also be monitored.
  4 2,517 390
Caspofungin-induced fatal complete heart block: Another manifestation of Kounis syndrome
Nicholas G Kounis
April-June 2013, 4(2):161-162
DOI:10.4103/0976-500X.110918  PMID:23761719
  3 1,556 377
Modulation of multidrug resistance 1 expression and function in retinoblastoma cells by curcumin
Seethalakshmi Sreenivasan, Sathyabaarathi Ravichandran, Umashankar Vetrivel, Subramanian Krishnakumar
April-June 2013, 4(2):103-109
DOI:10.4103/0976-500X.110882  PMID:23761708
Objective: To determine the possible interaction of curcumin with P-glycoprotein (P-gp) expression and function by in vitro and in silico studies. Materials and Methods: In this study, curcumin was compared for its potential to modulate the expression and function of P-gp in Y79 RB cells by western blot, RT-PCR (reverse transcription polymerase chain reaction) and functional assay. Further, in silico molecular modeling and docking simulations were performed to deduce the inhibitory binding mode of curcumin. Results: Western blot and RT-PCR analysis decreased the expression of P-gp in a dose-dependent manner. The effect of curcumin on P-gp function was demonstrated by Rhodamine 123 (Rh123) accumulation and efflux study. Curcumin increased the accumulation of Rh123 and decreased its efflux in retinoblastoma (RB) cells. In addition, curcumin inhibited verapamil stimulated ATPase activity and photoaffinity labeling study showed no effect on the binding of 8-azido-ATP-biotin, indicating its interaction at the substrate binding site. Moreover, molecular docking studies concurrently infer the binding of curcumin into the substrate binding site of P-gp with a binding energy of -7.66 kcal/mol. Conclusion: These findings indicate that curcumin suppresses the MDR1 expression and function, and therefore may be useful as modulators of multidrug resistance in RB tumor.
  3 2,174 410
Evaluation of acute physiological and molecular alterations in surgically developed hypothyroid Wistar rats
Maulik Patel, Vinay Mishra, Vaibhavi Pawar, Ramchandran Ranvir, Rajesh Sundar, Rajas Dabhi
April-June 2013, 4(2):110-115
DOI:10.4103/0976-500X.110891  PMID:23759902
Objectives: To explore the general physiological and molecular changes occurring as a result of acute hypothyroidism. Materials and Methods: Hypothyroidism was developed by thyroidectomy in wistar rats. After surgery, animals were observed for 14 days in order to determine changes in body weight, feed consumption, rectal temperature, heart rate, and blood pressure, clinical pathological and hormonal alteration. In addition, relative changes in weight, histopathology and MHC - α and β gene expression of heart was also evaluated. Results: Thyroidectomised rats showed lethargy, piloerection and decreased locomotors activity. Day dependent significantly decreased body weight and feed consumption were seen in hypothyroid rats. Rectal temperature was significantly reduced at day 7 and 14 after surgery. Heart rate and blood pressure were significantly decreased at day 14 in thyroidectomized rats in comparison with euthyroid rats. Haematological parameters shown high WBC count. Serum LDL and phosphorous levels were high where as triglycerides; total protein, creatinine kinase and globulin were low. Heart weight was significantly high. Histopathology of heart tissue showed myocardial segmental degeneration. Downregulation of MHC - α and upregulation of MHC - β were seen in hypothyroid rats in comparison with euthyroid rats. Conclusion: This finding suggests that deficiency of thyroid hormone (TH) in hypothyroidism is associated to a cardiac dysfunction and acute changes in body homoeostasis as result of sudden arrest of thyroid hormone.
  3 3,263 294
Dapsone hypersensitivity syndrome: A rare life threatening complication of dapsone therapy
Kolar Vishwanath Vinod, Karyampudi Arun, Tarun Kumar Dutta
April-June 2013, 4(2):158-160
DOI:10.4103/0976-500X.110917  PMID:23761718
Dapsone can cause several adverse effects, the most serious being dapsone hypersensitivity syndrome (DHS), which is potentially fatal. Here we report a case of severe, life threatening dapsone systemic hypersensitivity syndrome in a 17-year-old male who presented with high grade fever, eosinophilia, lymphadenopathy, skin rash, hepatitis and encephalopathy, which was managed successfully with oral steroids. The case is being reported to emphasize the need for timely diagnosis and prompt treatment of this rare complication for successful outcomes. DHS is also reviewed in brief.
  2 3,703 554
Bridging the gap between alternative medicine and evidence-based medicine
Mostafa Yakoot
April-June 2013, 4(2):83-85
DOI:10.4103/0976-500X.110868  PMID:23761704
  2 3,293 615
Policy of reviewing statistics in Indian medical and surgical journals
S Kannan, SP Deshpande, NJ Gogtay, UM Thatte
April-June 2013, 4(2):139-140
DOI:10.4103/0976-500X.110897  PMID:23761710
  2 1,585 268
A review of computer assisted learning in medical undergraduates
Lisha J John
April-June 2013, 4(2):86-90
DOI:10.4103/0976-500X.110870  PMID:23761705
Laboratory based practical classes, have been the corner stone of undergraduate pharmacology learning. Ethical issues with the use of animals and rapid development of information technology has led to newer trends in teaching and learning such as computer assisted learning. Computer assisted learning (CAL) software includes computer based packages, focusing on interactive instruction in a specific subject area, collection of animal experiments that encourage students to understand concepts in pharmacology. CAL offers a number of advantages to both students and teachers; most important being meeting the learning objectives. Few disadvantages and pitfalls to implementation in medical schools are also associated with CAL sessions. This article reviews the trend of CAL in pharmacology, advantages, disadvantages and pitfalls to the implementation of CAL.
  2 2,913 606
Continued medical education credit hours: Are they being awarded too liberally?
Anupama Sukhlecha
April-June 2013, 4(2):164-165
  - 1,325 209
Author's reply
Sasmita Biswal
April-June 2013, 4(2):162-163
  - 1,094 165
The enema of your enemy is your friend
G Sivagnanam
April-June 2013, 4(2):166-166
  - 1,506 235
C-section, formula may disrupt 'good' gut bacteria in babies
G Sivagnanam
April-June 2013, 4(2):166-167
  - 1,178 276
First-born may be at greater risk for diabetes and hypertension
G Sivagnanam
April-June 2013, 4(2):167-167
  - 1,020 174
The critical steps for successful research: The research proposal and scientific writing
Pitchai Balakumar, Mohammed Naseeruddin Inamdar, Gowraganahalli Jagadeesh
April-June 2013, 4(2):130-138
DOI:10.4103/0976-500X.110895  PMID:23761709
An interactive workshop on 'The Critical Steps for Successful Research: The Research Proposal and Scientific Writing' was conducted in conjunction with the 64 th Annual Conference of the Indian Pharmaceutical Congress-2012 at Chennai, India. In essence, research is performed to enlighten our understanding of a contemporary issue relevant to the needs of society. To accomplish this, a researcher begins search for a novel topic based on purpose, creativity, critical thinking, and logic. This leads to the fundamental pieces of the research endeavor: Question, objective, hypothesis, experimental tools to test the hypothesis, methodology, and data analysis. When correctly performed, research should produce new knowledge. The four cornerstones of good research are the well-formulated protocol or proposal that is well executed, analyzed, discussed and concluded. This recent workshop educated researchers in the critical steps involved in the development of a scientific idea to its successful execution and eventual publication.
  - 7,905 1,014
Concomitant prescription of oral fluoroquinolones with an antacid preparation
Ratinder Jhaj, Gurusamy Sivagnanam
April-June 2013, 4(2):140-142
DOI:10.4103/0976-500X.110898  PMID:23761711
  - 1,813 327
Cross sectional surveillance of drug dispensing efficacy, availability and quality of labelling by patient care indicators in health care facilities
Lukshmy M Hettihewa, Kalana Jayarathna, Sewwandi Subasinghe
April-June 2013, 4(2):142-144
DOI:10.4103/0976-500X.110904  PMID:23761712
  - 1,421 290
Efficacy of aceclofenac and diclofenac sodium for relief of postoperative pain after third molar surgery: A randomised open label comparative study
Nagendra S Chunduri, Tanveer Kollu, Venkateswarulu R Goteki, Kiran K Mallela, Krishnaveni Madasu
April-June 2013, 4(2):144-145
DOI:10.4103/0976-500X.110910  PMID:23761713
  - 3,431 722
Comparison of the postoperative analgesia of intravenous infusion of adenosine and fentanyl
Yogendra Keche, Radha Yegnanarayan, Adnanali Sarkar, Shalini Thombre
April-June 2013, 4(2):145-148
DOI:10.4103/0976-500X.110912  PMID:23761714
  - 2,401 279
Assessment of proarrhythmic activity of chloroquine in in vivo and ex vivo rabbit models
Shailaja B Khobragade, Pankaj Gupta, Prashant Gurav, Girish Chaudhari, Madhumanjiri M Gatne, Vyas M Shingatgeri
April-June 2013, 4(2):116-124
DOI:10.4103/0976-500X.110892  PMID:23759957
Objectives: To evaluate the prolongation of ventricular repolarization and proarrhythmic activity of antimalarial drug chloroquine in two rabbit proarrhythmia models viz., in vivo α1 adrenoceptor-stimulated anesthetized rabbit and ex vivo isolated Langendorff rabbit heart using clofilium as standard proarrhythmic agent. Materials and Methods: In the in vivo model, three groups of rabbits, anesthetized by pentobarbitone sodium and α-chloralose, sensitized with α1 agonist methoxamine followed by either continuous infusion of saline (control) or clofilium (3 mg/kg) or chloroquine (21 mg/kg) for 30 min. In ex vivo model, rabbit hearts were perfused with clofilium (10 μM) or chloroquine (300 μM) continuously after priming along with methoxamine, acetylcholine chloride and propranolol hydrochloride. Results: In these models, prolongation of repolarization during α1 -adrenoceptor stimulation produced early after depolarization (EAD) and Torsade de pointes (TdP). Saline infusion did not induce any abnormality in the animals. Clofilium caused expected changes in the electrocardiogram in both the models including TdP (50.0% in in vivo and 66.67% in ex vivo). Chloroquine caused decrease in heart rate and increase in the corrected QT (QTc) interval in both the models. Further, apart from different stages of arrhythmia, TdP was evident in 33.33% in ex vivo model, whereas no TdP was observed in in vivo model. Conclusions: The results indicated that proarrhythmic potential of chloroquine and clofilium was well evaluated in both the models; moreover, both the models can be used to assess the proarrhythmic potential of the new drug candidates.
  - 2,735 387
The portal for rare diseases and orphan drugs
Jatinder Singh
April-June 2013, 4(2):168-169
  - 1,337 248