@article {368, title = {Advanced Practice of Total Parenteral Nutrition by Physicians in Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {12}, year = {2023}, month = {February 2024}, pages = {140-149}, type = {Research Article}, chapter = {140}, abstract = {

Objectives: To explore the physician{\textquoteright}s advanced practice of Total Parenteral Nutrition in Saudi Arabia. Methods: It analyzes a cross-sectional survey that discussed advanced physician practice of Total Parenteral Nutrition services (TPNs) in Saudi Arabia. The survey consisted of respondents{\textquoteright} demographic information about physicians and Advanced Practice Total Parenteral Nutrition services (TPNs) by Physicians, the types of prescribing, preparations, and administrations of the Total Parenteral Nutrition services (TPNs) system, The responsibility of Total Parenteral Nutrition services (TPNs). The 5-point Likert response scale system was used with closed-ended questions. The survey was validated through the revision of expert reviewers and pilot testing. Besides, various tests of the reliability of McDonald{\textquoteright}s ω, Cronbach alpha, Gutmann{\textquoteright}s λ2, and Gutmann{\textquoteright}s λ6 were done with the study. In addition, the data analysis of the Pharmacist practice of Cardiopulmonary Resuscitation (CPR) medications is done through the survey monkey system. Besides, the Statistical Package of Social Sciences (SPSS), Jeffery{\textquoteright}s Amazing Statistics Program (JASP), and Microsoft Excel sheet version 16. Results: A total number of 409 physicians responded to the questionnaire. Of them, almost one-half responded from the Northern region (186 (45.48\%)), and one Quarter responded from the central area (106 (25.92\%)), with statistically significant differences between the provinces (p=0.000). Females responded more than males (268 (65.53\%)) versus 141 (34.47\%)), with statistically significant differences between all levels (p=0.001). Most of the responders were in the age group of 36-45 years (198 (48.41\%)) and 46-55 years (109 (26.65\%)), with statistically significant differences between all age groups (p=0.000). Almost one-half of responders, 176 (43.03\%), worked at an organization that had Parenteral Nutrition services (TPNs) services, with only 86 (21.03\%) had been ever requested any Parenteral Nutrition services (TPNs) with statistically significant differences between all answers (p=0.000). The average score of items for advanced practicing Total Parenteral Nutrition services (TPNs) was (3.48). The {\textquotedblleft}Patient safety system for TPN{\textquotedblright} item scored the highest (3.74). Followed by The element {\textquotedblleft}Pediatrics TPN forms{\textquotedblright} (3.73) and The element {\textquotedblleft}Clean room for TPN preparation{\textquotedblright} (3.73). Most physicians had Customized Total Parenteral nutrition for geriatrics 228 (55.75\%) and Pediatric 225 (55.01\%). In using Standardized Total Parenteral nutrition, most physicians used for geriatrics, 283 (69.19\%) and 189 (46.21\%), do not know how to use it. In Pre-mixed Total Parenteral nutrition, most physicians used geriatrics 211 (51.59\%) and adolescents 209 (51.10\%). Conclusion: The advanced practice of parenteral nutrition by physicians was adequate. One-half of physicians practice the New model of parenteral nutrition. The physician had negative perceptions of the parenteral nutrition responsibilities of the pharmacist. The advanced practice of TPN should be considered for further evaluation and accountability in medical care.

}, keywords = {Nutrition, Parenteral, Physicians, Practice, Saudi Arabia}, doi = {10.5530/ijpcs.2023.12.18}, author = {Yousef Ahmed Alomi and Fatma Al Raisi and Riyadh M Alashban and Ban Abdullah Aldosary and Abdulmajeed Ali Alshehri} } @article {334, title = {Pharmacist{\textquoteright}s Knowledge of High-risk/Alert Medications in Saudi Arabia}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {11}, year = {2022}, month = {December 2022}, pages = {65-71}, type = {Research Article }, chapter = {65}, abstract = {

Objectives: To explore pharmacist{\textquoteright}s knowledge of High-risk/Alert medications in Saudi Arabia. Methods: It analyzes a cross-sectional survey discussing pharmacist knowledge of High-risk/Alert medications in Saudi Arabia. The survey consisted of respondents{\textquoteright} demographic information about pharmacists, the High-risk/Alert medications assessment of basic knowledge, and The Resources used about the High risk or high-alert medications. The 5-point Likert response scale system was used with closed-ended questions. The survey was validated through the revision of expert reviewers and pilot testing. Besides, various tests of the reliability of McDonald{\textquoteright}s ω, Cronbach alpha, Gutmann{\textquoteright}s λ2, and Gutmann{\textquoteright}s λ6 been done with the study. Furthermore, the data analysis of the pharmacist{\textquoteright}s knowledge of High-risk/ Alert medications is done through the survey monkey system. Besides, the statistical package of social sciences (SPSS), Jeffery{\textquoteright}s Amazing Statistics Program (JASP), and Microsoft Excel sheet version 16. Results: A total number of 442 pharmacists responded to the questionnaire. Of them, more than one-third responded from the Central region (183 (40.40\%)), and one Quarter responded from the Western part (119 (26.92\%)), with statistically significant differences between the provinces (p=0.000). Males responded more than females (264 (59.59\%)) versus 179 (40.41\%)), with statistically significant differences between all levels (p=0.000). Most of the responders were in the age group of 24-30 years (266 (59.91\%)) and 31-35 years (78 (17.57\%)), with statistically significant differences between all age groups (p=0.000). Most of the pharmacists were staff pharmacists (323 (72.75\%)) and pharmacy supervisors (56 (12.61\%)), with statistically significant differences between all levels (p=0.000). The average score of knowledge of pharmacists about High-risk/ Alert medications was (3.71). The pharmacists familiar with prohibited abbreviations during High-risk/Alert prescribing medications obtained the highest score (4.42). The element {\textquotedblleft}heard about the concept of High-risk/Alert medications{\textquotedblright} got the second highest score (4.39), with a statistically significant difference between the responses (p\<0.000). Followed by the pharmacists familiar with look-alike sound-alike of Highrisk/ Alert medications (4.30) and know the narcotics and controlled medications (4.27) ), with a statistically significant difference between the responses (p\<0.000). The most used resources for High-risk/Alert or high-alert medication information were Drug information resources (Lexi comp-drug information, Micromedex, Epocrates etc. 345 (78.05\%), and Scientific literature 222 (50.23\%). They were followed by Health practitioners 206 (46.61\%) SFDA website 157 (35.52\%). Conclusion: The pharmacist{\textquoteright}s knowledge of High-risk/Alert medications is adequate in Saudi Arabia. However, an expanded basic and advanced understanding of High-risk/Alert areas is needed to improve pharmacy performance, patient safety, and quality of life in Saudi Arabia.

}, keywords = {Alert, Drugs., High-risk, Knowledge, Medications, Pharmacist}, doi = {10.5530/ijpcs.2022.11.13}, author = {Yousef Ahmed Alomi and Nouf Saad Al-Saban and Maha Hussein Almadany and Randa Jaroudi and Faisal Safouq Alanazi and Musleh Samil Reshidi} } @article {236, title = {National Survey of Pharmacy and Therapeutic Committee in Saudi Arabia: Meetings, Organization, and Management}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {December 2019}, pages = {237-241}, type = {Research Article}, chapter = {237}, abstract = {

Objective: Pharmacy and Therapeutic Committee (PTC) is required for the effective running of a hospital. In the beginning, there was no such concept of drug committee, but with the advent of time, the need for an effective PTC started increasing. In the PTC, the pharmacist, physicians and nurses play an important role, in addition to the presence of an administrative. This study aims to explore the importance of having effective meetings organization and management of PTC at Ministry of Health (MOH) hospitals in Saudi Arabia. The purpose of this study was to explore the meetings organization and management of PTC at MOH hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of PTC at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part consisted of 93 questions divided into four domains: Domain 1: the scope, structure and responsibilities; domain 2: the formulary management system; domain 3: evaluation of drug formulary and decision-making; and domain 4: organization and management of committee meetings. This questionnaire was prepared in an electronic format and was distributed all drug information centers at MOH hospitals. It analyzed organization and management of committee meetings through Survey Monkey system. Results: A total of 50 drug information centers responded to the questionnaire (100\% response rate). The person leads the discussion in PTC was a Chairman of the Committee (29 (58\%)), Chief of Pharmacy (13 (26\%)) and Director of Drug Information (3 (6\%)). The number of scheduled meetings per year (1{\textendash}4) was 18 (36\%) per hospital with a duration (1-2 hrs) at 48 (96\%). Most of discussions were related to medications of infectious diseases (26 (52\%)) and cardiovascular diseases (21 (42\%)). Most of the challenging recommendations that needed implementation was a lack of resources (37 (74\%)), lack of hospital administrator support (23 (46\%)) and lack of pharmacist role (18 (36\%)). Conclusion: The PTC is a demanding scientific resource and administrative support. Total quality management system, workload analysis, positive outcomes of PTC were lacking. Special education and training needs to be provided to all the healthcare providers with hospital administrator{\textquoteright}s support.

}, keywords = {Meetings, Ministry of Health, National Pharmacy and Therapeutic Committee, Organization and Management, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.52}, author = {Yousef Ahmed Alomi and Sultan Mohammed Al-Jarallah and Rasha Abdelsalam Elshenawy and Faiz A Bahadig Rph} } @article {237, title = {National Survey of Pharmacy and Therapeutic Committee in Saudi Arabia: Formulary Management System}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {December 2019}, pages = {227-231}, type = {Research Article}, chapter = {227}, abstract = {

Objective: Formulary management is an integrated patient care process which enables physicians, pharmacists and other healthcare professionals to work together to promote clinically sound cost-effective medication therapy and positive therapeutic outcomes. Effective use of healthcare resources can minimize overall medical costs, improve patient access to more affordable care and provide an improved quality of life. A formulary not only includes a list of medications and medication-associated products but also includes medication-use policies, important ancillary drug information, decision support tools and organizational guidelines. Therefore, in this study, we aimed to provide the guiding principles for the Formulary Management System at Ministry of Health (MOH) hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of Pharmacy and Therapeutic Committee at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part contained 93 questions divided into four domains. The scope, structure and responsibilities, the formulary management system, the evaluation of drug formulary and decision-making and the committee meetings organization and management. The electronic survey was distributed to 50 drug information centers at MOH hospitals. It analyzed the formulary management system at MOH hospitals in Saudi Arabia through Survey Monkey system. Results: A total of 50 drug information centers responded to our questionnaire. The statement with highest score was related to the committee formulary system of medications usage through ensuring the safety of prescribing, distribution, administration and monitoring of medications (3.8); the process for managing drug product shortages (3.76); and the medications are requested for the addition or deletion from the drug formulary (3.68). Most of the hospitals had an open drug formulary (30 (60\%)), with remaining responders having closed drug formulary (20 (40\%)) with the total number of medications in the drug formulary (300{\textendash}899) at 32 (64\%) of the responded hospitals. The average score of type of method related to drug usage evaluation statements was 3.36, with the statement with high average score was review of medication error report (3.94) and review of medication sentinel incident reports (3.48), whereas the statement with lowest score was an investigational drug therapy approved (2.88). Conclusion: Two-thirds of the hospitals had open drug formulary. Drug utilization evaluation system should review for the majority of the hospital. update the formulary management system required with close monitoring for all MOH hospitals in Saudi Arabia.

}, keywords = {Formulary Management System, Ministry of Health, National Pharmacy and Therapeutic Committee, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.50}, author = {Yousef Ahmed Alomi and Sultan Mohammed Al-Jarallah and Rasha Abdelsalam Elshenawy and Faiz A Bahadig Rph} } @article {235, title = {National Survey of Pharmacy and Therapeutic Committee in Saudi Arabia: Evaluation of Drug Formulary and Decision-Making}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {December 2019}, pages = {232-236}, type = {Research Article}, chapter = {232}, abstract = {

Objective: Ministry of Health (MOH) hospitals in Saudi Arabia should develop, organize and administer a formulary system that follows the principles to optimize patient care by ensuring access to clinically appropriate, safe and cost-effective medications. This can be achieved through the Pharmacy and Therapeutic Committee{\textquoteright}s (PTC) role in the evaluation of hospital{\textquoteright}s drug formulary and decision-making. The primary purposes of the PTC are policy development, communication and education and formulary management. Therefore, in this study, we aimed to explore the hospital drug formulary evaluation and decision-making at MOH hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of PTC at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part consisted on 93 questions divided into four domains. An electronic survey was distributed to all drug information centers at MOH hospitals and analyzed the evaluation of drug formulary and decision-making through the Survey Monkey system. Results: A total of 50 drug information centers responded to the questionnaire (100\%). Restricted drug usage (3.88), new drug entities (3.74), new dosage form (3.6) and new strength (3.6) were the majority of the requests for inclusion in the formulary. A total of 1-3 medications were evaluated monthly by the PTC at 41 (82\%) hospitals. Most of the healthcare providers were allowed to request for the addition or deletion of medications: PTC members 38 (76\%), attending medical staff 35 (70\%), pharmacy staff 10 (20\%) and formulary subcommittees 10 (20\%). The formal economic analysis of the drug formulary revision was rarely or never conducted at 26 (42\%) hospitals. The responsible person for the economic evaluation was drug information pharmacist (21 (42\%)), pharmacy department (nonspecific) (17 (34\%)) and the pharmacy and medical department (14 (28\%)). Conclusion: Evaluation of hospital{\textquoteright}s drug formulary and decision-making was not adequate at the majority of the hospitals. Education and training about drug evaluation with an emphasis on cost analysis and impact are mandatory. An electronic addition new medications with close formulary is required with close monitoring for all MOH hospitals in Saudi Arabia.

}, keywords = {Decision-Making, Drug Formulary, Evaluation, Ministry of Health, National Pharmacy and Therapeutic Committee, Saudi Arabia}, doi = {10.5530/ijpcs.2019.8.51}, author = {Yousef Ahmed Alomi and Sultan Mohammed Al-Jarallah and Rasha Abdelsalam Elshenawy and Faiz A Bahadig Rph} } @article {215, title = {National Survey of Pharmacy and Therapeutic Committees in Saudi Arabia: Scope, Structure and Responsibilities}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {8}, year = {2019}, month = {December 2019}, pages = {222-226}, type = {Research Article}, chapter = {222}, abstract = {

Objectives: The Pharmacy and Therapeutics (PTC) committee, sometimes aptly named the Formulary Committee. PTC is charged with determining the hospital formulary, decisions are made about the inclusion or exclusion of new pharmacotherapeutic and diagnostic agents for inpatients and outpatients. This committee is typically composed of a multidisciplinary team of pharmacy, physician, nursing and hospital clinical and administrative leadership. The aim of the study was to explore the Therapeutic Committee at MOH hospitals in Saudi Arabia: scope, structure and responsibilities. Methods: It is a 4-month cross-sectional survey of National Survey of Pharmacy and Therapeutic Committee at MOH hospitals in Saudi Arabia. The survey consisted of 93 questions divided in two parts: the first part collects the demographic information, the second part contains questions on 4 domains: (1) scope, structure and responsibilities, that is including questions about the pharmacy and therapeutic committee membership, clear mission, vision and values of the pharmacy and therapeutic committee, the responsibilities of the PTC committee and the Sub-committees of Pharmacy and Therapeutic Committee, (2) formulary management system, (3) evaluation of drug formulary and decision-making, (4) committee meetings organization and management. The survey was distributed to the fifty-drug information centers at Ministry of Health hospitals. The survey was in an electronic format with analyzed scope, structure and responsibilities through the survey monkey system. Results: The total number responders were fifty drug information centers. Of those, 48 (96\%) was Saudi and 2 (4\%) was non-Saudi. There were 16 (32\%) females and 34 (68\%) were males. Most of the PTC committee members consisted of a chief of pharmacy department 45 (90\%), medical director 41 (82\%), physician medical 40 (80\%) and head of drug information center 32 (64\%). The highest score statements related to committee were the functions of PTC (3.78), objectives (3.61), mission (3.57), with least one was a vision (3.56) and values (3.5). The most responsibility scoring statement was distributed the addition and deletion (4.08), all the departments receive the copy of the revised formulary (4.04), drug evaluation and selection for the hospital was (3.9), drug policy development was (3.9), while the lowest scores were Holds educational programs within the hospital (3.25) and drug monitoring system was (3.57). Most of the subcommittee existed antibiotic committee 38 (76\%), medication safety committee 38 (76\%), followed by drug utilization committee 9 (18\%) and therapeutic guidelines committee 9 (18\%). Conclusion: One-third of hospital missed drug information center pharmacist as the member of PTC committee and the pharmacy qualifications of committee members need to improve. Update the committee system and close monitoring required for all MOH hospitals in Saudi Arabia.

}, keywords = {Ministry of Health, National, Responsibilities, Saudi Arabia, Scope, Structure}, doi = {10.5530/ijpcs.2019.8.49}, author = {Yousef Ahmed Alomi and Sultan Mohammed Al-Jarallah and Rasha Abdelsalam Elshenawy and Faiz A Bahadig Rph} } @article {71, title = {A Questionnaire Based Study Regarding the Knowledge, Attitude and Practice of Self-Medication Among Second Year Undergraduate Medical Students}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {6}, year = {2017}, month = {October 2017}, pages = {1-5}, type = {Original Article}, chapter = {1}, abstract = {

Background: Self-medication is becoming very common in our routine life which is an unhealthy and risky practice.Present study was done to determine the knowledge, attitude and practice of self-medication among second year undergraduate medical students of a private medical college in Bhopal, Madhya Pradesh. Material and methods: A pre-validated questionnaire was prepared and distributed among the students.Data was collected and analysed using Microsoft Excel and the results expressed as counts and percentages. Results: Total 139 students participated in the study voluntarily and most common reason for taking Self-medication was that there was no need to visit the doctor for minor illness. In maximum students, source of information of the drugs used for Self-medication was previous prescription and source of the drugs was medical store. Only 39\% MBBS students accepted the fact, that they always visited a qualified practitioner whenever they fell ill. Most of the students took Self-medication for headache followed by cough, cold and fever. Out of total 139 students, most of the students took NSAIDS as Self-medication followed by lozenges. Conclusion: This study showed that students of second year MBBS after studying pharmacology became more aware about the drugs and hence do not hesitate in taking Self-medication which is a wrong practice.

}, keywords = {Attitude, Knowledge, Practice, Questionnaire, Second Year MBBS, Self-medication}, doi = {10.5530/ijpcs.6.1.1}, author = {Rajanish Kumar Sankdia and Mehul Agrawal and Parabathina Bindu Rekha and Nitin Kothari} } @article {73, title = {Self-Medication Practices with Antibiotics among Second Year Medical Students of Government Medical College, Raigarh, Chhattisgarh}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {6}, year = {2017}, month = {October 2017}, pages = {15-19}, type = {Research Article}, chapter = {15}, abstract = {

Background: Self medication practice especially using antibiotics has tremendously increased in the society that leads to unwanted consequences such as drug resistance. Objective: The objective of this study was to evaluate the self-medication practices with antibiotics among the second year medical students of Government Medical College, Raigarh. Materials and Methods: It was a questionnaire based descriptive study. A prevalidated questionnaire, which contained both open and close ended questions were given to the second year medical students. Data were analyzed using Excel sheet and results were expressed as counts and percentages. Results: Females outnumber males in this study, 27 versus 20. The most common indication for which self-medication was opted was fever with cough and cold. The information about the antibiotic was obtained from a past prescription from a physician. The most common antibiotic that was used by most of students was azithromycin. Conclusion: There was a high level of self-medication with antibiotics in our study, but this high level of self-prescription seen is also having some disadvantages, as improper duration of use might lead to development of resistance.

}, keywords = {Antibiotics, Azithromycin, Co-Prescription, Drug Resistance, Self-medication}, doi = {10.5530/ijpcs.6.1.3}, author = {Pramood Kumar Gupta and Presenjit Raut} } @article {72, title = {A Study on Siddha Urinary Diagnostic Methodology Neerkkuri and Neikkuri in Adhiratha Azhutham (Hypertension)}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {6}, year = {2017}, month = {October 2017}, pages = {6-14}, type = {Original Article}, chapter = {6}, abstract = {

Background: In Siddha system of medicine, diagnosis of the disease is based on Ennvagai thervukal (Eight fold examination), in which Neerkkuri Neikkuri (Urine examination) is one among them. It is an effective and sensitive measure for the diagnosis and prognosis of diseases. Objectives: This study was conducted to establish the validity of prognostic and diagnostic patterns of Neikkuri (Oil on urine sign)in hypertension patients and to assess the association between the Neikkuri patterns with respect to pH and specific gravity of urine. Methods and Material: Urine samples of 40 diagnosed patients of hypertension aged between 30 to 60 years were collected. Ten healthy volunteers were also selected as control group for comparison. Biochemical analysis was done in the urine samples with urine reagent strip to confirm health status of the subjects. A drop of sesame oil was dropped over 50 ml of each urine sample and behaviour (shape of the oil spread, direction and spread time) was observed. Results: Half of the samples of urine of hypertension patients showed circular shape initially and then vacuolating to turn out into a sieve pattern and in remaining others at least a single vacuolation amounting to ring pattern indicative of Pitham were shown. Also, the urine of the hypertension patients were characterised by straw colour and aromatic odour, absence of froth and specific gravity 1.003-1.010.Volume of urine voided ranged from 1-1.5 lit and pH between 5.1-6.In most of the cases the dissemination dynamics of oil drop observed were of slow spreading nature which indicates good prognosis. Conclusion: It is concluded that hypertension has got mixed prognosis which may indicate the variation in the amenability of hypertension to the treatment. The study explored the veracity of the investigative procedure in diagnosis and prognosis of hypertension with Neikkuri examination.

}, keywords = {Athiratha Azhutham, Hypertension, Neerkkuri, Oil on Urine Sign, Siddha, Urine Examination}, doi = {10.5530/ijpcs.6.1.2}, author = {Sardar Hussain Fasila Banu and Padmini Parvathy and Srinivasan Venkatachalam and Murugan Ramamurthy and Selladurai Elansekaran and Gnanaraj Johnson Christian} } @article {109, title = {Comparative Analysis of Alternate Day and Daily Regimen of Atorvastatin in Dyslipidaemic South Indian Patients}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {December 2016}, pages = {97-102}, type = {Research Article}, chapter = {97}, abstract = {

Background: Atorvastatin is the most commonly used drug for the treatment of dyslipidaemia. Long term administration of statins helps in the reduction of cardiovascular morbidity and mortality associated with dyslipidaemia. Number of studies have shown that alternate day dosing of statins is efficacious and safe alternative to daily dosing. Objectives: To compare the efficacy and tolerability of daily and alternate day regimen of Atorvastatin in the treatment of na{\"\i}ve dyslipidaemic South Indian patients. Materials and Methods: It is an open labeled, prospective, parallel, comparative interventional study. Ninety patients satisfying the inclusion criteria were randomized in to group 1 (n=45) and group 2 (n=45) and received atorvastatin 10 mg daily and alternate days respectively for 3 months. Pretreatment and post treatment anthropometric measurements, biochemical and lipid parameters were recorded. Patients were followed at fortnightly intervals for 3 months to check the patient compliance and adherence to treatment. Data were analyzed by suitable statistical methods. Results: There was a statistically significant reduction of total cholesterol, triglycerides, LDL, VLDL and increase of HDL cholesterol in both groups. Post treatment between group comparison shows a significantly higher reduction of LDL in group 1 than group 2 patients. All other lipid parameters were significantly similar between the groups at 12 weeks follow-up. Daily and alternate day treatment were well tolerated by the patients of both the group and there was no untoward incident during the study period. Conclusion: Alternate day administration of atorvastatin causes a beneficial alternation of lipid parameters which helps in reducing the cost and adverse effects.

}, keywords = {Adverse events, Alternate day, Atherosclerosis, Atorvastatin, Hyperlipidaemia}, doi = {10.5530/ijpcs.5.4.1}, author = {Shanmugasundaram Rajamani and Maharani Balagurumoorthy} } @article {77, title = {Comparison of Ultrasound Guided Technique with Conventional Landmark Technique for Supraclavicular Brachial Plexus Nerve Block in Patients Undergoing Upper Limb Surgery}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {March 2016}, pages = {1-4}, type = {Research Article}, chapter = {1}, abstract = {

Background: Brachial plexus blockade is a time tested anesthetic technique for upper limb surgeries. Among the various approaches of brachial plexus block, supraclavicular block, once described as the {\textquotedblleft}spinal of the arm,{\textquotedblright} offers dense anesthesia of the brachial plexus for surgical procedures at or distal to the elbow. Landmark technique has been traditionally used for performing this block. But blind technique often requires multiple trial-and-error needle attempts, resulting in increase in procedure time, procedure-related pain and complications including pneumothorax, which is very risky. In developing countries like India, ultrasound is a relatively new technique and is increasingly being used for performing nerve blocks for acute as well as chronic pain procedures. Objective: We performed this study to evaluate safety and clinical usefulness of ultrasound technology for supraclavicular brachial plexus blocks. Methods: We included 60 adult patients of either sex undergoing surgeries for fracture of lower end of humerus or fracture of forearm bones. Patients were divided into two groups. In one group, surface landmark technique was used while in other group, supraclavicular nerve block was performed under ultrasound guidance by double injection technique. All patients received 10 ml each of 2\% lignocaine with adrenaline, 10 ml 0.5\% bupivacaine and 10 ml of saline. Surgery was started after confirming adequacy of block. Ineffective blocks were replaced with general anesthesia and insufficient pain control during surgery was supplemented with fentanyl. Results: There was no significant difference between patient groups with regard to demographic data. Supraclavicular plexus nerve block was placed in all 60 patients. Block failure was seen in 5 patients in landmark technique group and in one patient in USG group. The time of onset of sensory and motor block was shorter in USG group than landmark technique group. Intra-op analgesic was required in 5/30 patients in blind group and 3/30 patients in USG group. Post-op analgesia was for longer duration in USG guided group as compared to blind group. Conclusion: Ultrasound guidance is clinically very useful for supraclavicular brachial plexus block. It allows visualization of underlying structures, movement of needle and direct spread of local anesthetic and thus making the procedure safer and more effective.

}, keywords = {Landmark, Nerve block, Supraclavicular brachial plexus block, Ultrasound, Upper limb surgery}, doi = {10.5530/ijpcs.5.1.1}, author = {Punam Raghove and Karampal Singh and Susheela Taxak and Mangal Ahlawat and Sarla Hooda} } @article {114, title = {Does Pre-Test Accelerate Learning Pattern In Undergraduate Medical Students? A Prospective Study in a Tertiary Care Teaching Hospital in Tamilnadu}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {December 2016}, pages = {109-112}, type = {Original Article}, chapter = {109}, abstract = {

Objectives: Our objective was to asses if pre-test accelerates learning pattern in undergraduate medical students. Materials and Methods: A prospective study was conducted by the Department of Pharmacology at SRM Medical College Hospital and Research Centre, Kancheepuram district, Tamilnadu. A total of 121 IInd year MBBS students were divided into A and B batches with 61 and 60 students respectively. Objective type questions were prepared from the chapter {\textquotedblleft}Haematinics{\textquotedblright} and were validated which contained extended match questions. B batch students were informed about the theory class topic the next day which will be preceded by a pre test and a post test at the end of the lecture. They were even given a copy of the topics from which questions were framed. A batch students were unaware about this plan of having pre and post tests the following theory class. On the day of lecture, all the students were given pre-test questions (total no: 20). The answer sheets were collected at the end of specified time period and evaluated. At the end of the lecture class, post test was conducted. Marks were tabulated with a maximum score of 20. Statistical analysis: Paired t-test was used to analyze the data obtained. Mean, Standard deviation and standard error of mean were calculated by feeding the data in SpSS software. Results: Both A and B batches have performed well in post-test than pre-test. p\<0.001.Girls have scored more than boys in pre and post test. p\<0.001. Discussion and Conclusion: Pretest and post-test way of evaluating students is an effective and feasible way of fun learning. The method of assessment using pre and post test questionnaire should be made mandatory in all medical schools/colleges after every theory class.

}, keywords = {Haematinics, Medical Education, Pharmacology, Post Test, Pre-Test}, doi = {10.5530/ijpcs.5.4.3}, author = {Akila Lakshmikandhan and Balaji Ramraj and Jamuna Rani Ravinder} } @article {99, title = {Dose Dependent Amitriptyline Induced Sexual Dysfunction in a Migraine Patient}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {June 2016}, pages = {62-64}, type = {Case Report}, chapter = {62}, abstract = {

Amitriptyline is a tricyclic antidepressant. It is one of the preferred first linedrug for prophylactic treatment of migraine. Here we report a case of amitriptyline induced sexual dysfunction in a 40 year old male patient who was diagnosed with Migraine without aura.

}, keywords = {Amitriptyline, Migraine, Sexual dysfunction}, doi = {10.5530/ijpcs.5.2.5}, author = {Kavitha BB and Nischal Reddy and Shashank Ballur} } @article {93, title = {Evaluation of Changes in Bleeding Time in Hypertensive Patients on Amlodipine - A Prospective Observational Study}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {June 2016}, pages = {45-48}, type = {Research Articles}, chapter = {45}, abstract = {

Background: Platelet hyperactivity is a risk factor in hypertensive patients that paves the way to atherothrombosis causing cardiovascular and cerebrovascular events. Counteracting platelet aggregation is an established step in preventing thrombotic events. Calcium channel blockers are one among the recommended antihypertensive agents according to 2013 ESH/ESC (European Society of Hypertension and European Society of Cardiology) guidelines. In addition to lowering blood pressure they are known to have antiplatelet activity. Dihydropyridine class of L-type calcium channel blockers are the most potent group and shares this activity. Anti-platelet aggregatory effect of these agents could supplement its anti-hypertensive property and could prove to be desirable in the treatment of hypertensives with high risk of atherosclerotic and thromboembolic risk. So the present study aims to explore the anti-platelet activity of Amlodipine. Objectives: To evaluate the anti-platelet activity of Amlodipine in hypertensive patients. Methods and Materials: Sixty subjects were enrolled in the study. Test group comprised of thirty patients with essential hypertension, who were prescribed Tab Amlodipine at doses 5 mg or 10 mg once daily orally. Patients included in study group were regularly on Amlodipine for at least one month. 30 normotensive subjects, who are not on any drug affecting platelet function like Aspirin, dipyridamole, statins etc. acted as control group.Duke method of Bleeding time estimation was used to assess changes in Bleeding time. Statistical analysis: Student{\textquoteright}s unpaired t-test was used to compare Amlodipine test group with the normotensive control group. Results were expressed as Mean bleeding time {\textpm} SEM. SPSS software version 20 was used for statistical calculations. Results: The mean bleeding time of Amlodipine group was 2.214 minutes {\textpm} 0.028 SEM. The control group had a mean bleeding time of 1.998 minutes {\textpm} 0.036 SEM. The result gave a statistically significant p value of \<0.001. Average duration of treatment was 3.683 years. Conclusion: The statistically significant bleeding time observed in Amlodipine group suggest that it has anti-platelet activity.

}, keywords = {Amlodipine, Antiplatelet activity, Bleeding time, Hypertension}, doi = {10.5530/ijpcs.5.2.2}, author = {Pallavi Mahadeva Kamath and Suresh Surappla Rudrappa and Arun Suresh and Narendranath Sanji and Shashikala Gowdara Hanumanthareddy and Imran Maniyar} } @article {95, title = {Muscle Relaxant Property of 1(4-carboxy phenyl)-4,4,6-trimethyl-1H, 4H pyrimidine-2 thiol (a Pyrimidine Derivative) in Ex vivo Smooth and Skeletal Muscle Preparations}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5 }, year = {2016}, month = {June 2016}, pages = {49-54}, type = {Research Articles}, chapter = {49}, abstract = {

Background: Pyrimidine and its derivatives demonstrate a wide range of biological and pharmacological activities. Objective: To study the smooth muscle and skeletal muscle relaxant activity of a pyrimidine derivative 1 (4-carboxy phenyl)-4,4,6-trimethyl-1H,4H pyrimidine- 2 thiol (4CPTP), the chemical structure of which is similar to phenobarbitone. Material and Methods: Spasmolytic activity of 4CPTP was studied using rabbit ileum and guinea pig ileum preparation. Skeletal muscle relaxant activity was assessed on frog rectus abdominis preparation. Mean height of contractions with graded doses of phenobarbitone and 4CPTP along with mean inhibition of contractions were calculated. Statistical analysis was done using chi square test. Results: The test compound produced dose dependent decrease in acetylcholine and barium chloride induced contractions of rabbit ileum, histamine induced contractions of guinea pig intestine and acetyl choline induced contractions of frog rectus abdominis. Conclusion: 4 CPTP possesses spasmolytic and neuromuscular blocking activity in our ex vivo studies.

}, keywords = {Neuromuscular blocker, Phenobarbitone, Pyrimidines, Spasmolytic}, doi = {10.5530/ijpcs.5.2.3}, author = {Prem Kumar Verma and Garima Bhutani and Seema Rani and Rahul Saini} } @article {101, title = {A Study of Adverse Drug Reactions in Patients Treated with Penicillins in a Rural Tertiary Care Hospital}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {June 2016}, pages = {41-44}, type = {Research Article}, chapter = {41}, abstract = {

Background: Adverse drug reactions (ADR) are rated as the fifth leading cause of death among all diseases. Approximately 5-8\% of all hospitalization worldwide is due to ADR. Objectives: The present study was conducted with the aim of analyzing the pattern of Adverse Drug Reactions occurring from penicillins, their manifestations and severity. Methods: A non interventional observational prospective study was conducted over 2 years from Jan 2014 to Dec 2015 in KIMS Narketpally. The red boxes for dropping the filled yellow adverse drug reactions forms were installed in all the wards and outpatient departments. Additional information and missing data was obtained personally by either consulting the physician or through case sheets. Results: The most common penicillin implicated in causation of adverse drug reactions was combination of amoxicillin and clavulanic acid (54\%), followed by Piperacillin (21\%). Most of the reactions were of moderate severity. The most commonly observed adverse drug reactions were dermatological reactions (37\%). Majority of the adverse drug reactions belonged to probable category (71\%) according to WHO scale. Conclusion: Dermatological reactions are the most common adverse drug reactions occurring due to penicillin and combination of amoxicillin and clavulanic acid was the most common causative penicillin. The health care providers should make an attempt for early detections of ADRs and be vigilant about safety profile monitoring of the prescribed medicines. This will not only decrease the morbidity and mortality but also the health care cost.

}, keywords = {Adverse drug reactions, Amoxicillin, Penicillin, Pharmacovigilance}, doi = {10.5530/ijpcs.5.2.1}, author = {Shivaraj Basavaraj Patil and Shrinivas R Raikar and Bhaskar HN and M Janardhan and Y Venkata Rao and Vahila} } @article {106, title = {Ulcer Protective Action is Improved by Washing Fresh Aloe vera Gel: A Comparative Study with Unwashed Gel in Indomethacin and Ethanol Induced Ulcers in Rats}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {5}, year = {2016}, month = {September 2016}, pages = {83-89}, type = {Original Article}, chapter = {83}, abstract = {

Introduction: The Aloe vera and its components has been widely suggested for its ulcer protective action. Traditional Indian Siddha medical literature claims that washing the fresh Aloe vera gel (FAVG) has improved ulcer protective action due to the removal of bitter yellow latex. In this study, we compared the ulcer protective effect of unwashed as well as washed fresh Aloe vera gel in rats. Methods: We prepared washed and unwashed FAVG. Albino rats were fed with normal saline, ranitidine suspension, washed and unwashed FAVG for 8 days. Drugs have been tested in two ulcer models, in which indomethacin (20mg/kg) and ethanol (80\%) were used for the induction of ulcer after animals were fasted for 24 hours. The animals were sacrificed and stomach was cut open to calculate mean ulcer index and a section was sent for histopathological examination. One Way ANOVA was done for analysis. Results: In indomethacin induced ulcer model, the mean ulcer index in control, ranitidine, washed and unwashed FAVG treatment groups were 7.67 {\textpm} 1.51, 1.92 {\textpm} 1.12, 2.17 {\textpm} 1.16 and 4.0 {\textpm} 1.09 respectively. The percentage of ulcer protection in washed FAVG treatment (71.71\%) is comparable with ranitidine treatment (74.97\%), whereas the unwashed FAVG showed only 47.84\% ulcer protection. In ethanol induced ulcer model, the mean ulcer index in control, ranitidine, washed and unwashed FAVG treatment groups were 7.83 {\textpm} 1.51, 1.83 {\textpm} 0.82, 2.33 {\textpm}1.37 and 4.17 {\textpm} 1.47 respectively. The percentage of ulcer protection in washed FAVG treatment (70.24\%) is comparable with ranitidine treatment (76.63\%), whereas the unwashed FAVG showed only 46.74\% ulcer protection. In both the above ulcer models, washing the FAVG showed statistically significant (p\<0.05) reduction in ulcer index and improved ulcer protection. Conclusions: Washed fresh Aloe vera gel has shown higher ulcer protective activity compared to unwashed gel.

}, keywords = {Aloe latex, Aloe vera gel, Ayurveda, Ethanol, Gastric Ulcer, Indomethacin, Siddha}, doi = {10.5530/ijpcs.5.3.4}, author = {Jyoti Tara Manandhar Shrestha and Roanak Shrestha and Maya Shrestha and Saurab Raj Joshi and Merina Rajbhandari} } @article {113, title = {Cost, Benefit and Risks Associated with in-Campus and off-Campus Accommodations of Medical Students: A cross-Sectional Study}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {4}, year = {2015}, month = {Sept 2015}, pages = {58-62}, type = {Original Article}, chapter = {58}, abstract = {

Background: Students{\textquoteright} accommodation might influence their growth, behaviour and study performance. There is no clarity yet about safety issues, trends in substance abuse and on effect of type of accommodations on students{\textquoteright} academic performance. Objectives: To compare students{\textquoteright} perceptions regarding in campus and off campus accommodations with respect to cost, benefit and risks associated with them and also to investigate whether type of accommodation affect medical students{\textquoteright} academic performance. Materials and Methods: In this cross sectional study, the data was collected using newly designed validated questionnaires from students who had stayed in campus accommodation (n=100) and students who had stayed in off campus accommodation (n=100). Data was analyzed using SPSS version 16. The group wise comparison was made using Mann-Whitney test. A p value of \< 0.05 was considered as statistically significant. Results: The difference in the direct cost related to in campus and off campus accommodation was INR 43, 800/month with in-campus accommodation exceeding over off campus accommodation. Off-campus accommodation was perceived as more comfortable than in-campus accommodation, promoting collaborative learning and alcohol and substance abuse (p\<0.05) compared to in-campus accommodation. In addition, students who stayed in the campus performed significantly better academically than those who stayed outside the campus. Conclusion: The outside hostel accommodation is favorable to students in terms of direct cost and benefits. However, risks, including alcohol and substance abuse must be considered and appropriate precautions should be taken and counseling must be provided to students to avoid these risks.

}, keywords = {Academic Performance, Accommodation, Benefits, Cost, Medical Students}, doi = {10.5530/ijpcs.4.3.5}, author = {Vasudha Devi and Sabrina Najiha Binti Mohamad Ashari and Syahirah Binti Abd Rashid and Muhammad Azim Bin NurAdlan and Mohamed Mazlan Bin Mohamed Musadiq} } @article {110, title = {Effect of Kungiliya Vennai and Kalchunna Thailam on Excision Wound Healing in Albino Wistar Rats}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {4}, year = {2015}, month = {Sept 2015}, pages = {52-57}, type = {Original Article}, chapter = {52}, abstract = {

Background: Kungiliya vennai and Kalchunna thailam are the two indigenous herbal formulation being used for healing of wounds in siddha medicine. Objectives: The objective of our study was to evaluate the wound healing property of topical application of kungiliya vennai (KV) and kalchunna thailam (KT) on excision wound in Sprague Dawley rats. Methods: Four groups of eight Sprague dawley female rats in each group were used for the study. Under anesthesia, excision wound of 300mm2 size was created using scissors. Group 1 served as control with no drugs applied. Group 2, 3 and 4 were applied with mupirocin, KV and KT respectively daily until wound was completely healed. Parameters observed were \% wound contraction rate and epithelialization period. Biopsy of wound for histology was taken on day 12 as well as the healed wound was taken after the wound was healed. Results were analyzed by one-way analysis of variance (ANOVA) followed by Tukey{\textquoteright}s test by keeping p\<0.05 as statistically significant. Results: Kalchunna thailam has increased wound contraction rate only during initial days, but not statistically significant. Kungiliya vennai treatment has increased vascularity with presence of tissue eosinophils when compared to control rats. There was a regeneration of adnexal skin structures in the Kungiliya vennai treated rats, which is not seen in other groups. The epithelialization period was significantly (p\<0.001) hastened in Group 3 (15.83 days) and 4 (15.17 days) compared to control group (21.33 days). Conclusion: The topical application of kungiliya vennai and kalchunna thailam promoted wound healing in rats. Kungiliya vennai has the additional property of regenerating adnexal structures such as hair follicles, sweat glands and sebaceous glands.

}, keywords = {Calcium, Kungiliya Vennai, Shorea Robusta, Siddha Medicine, Wound}, doi = {10.5530/ijpcs.4.3.4}, author = {Vishal Bhat and Arul Amuthan and Barizah Binti Mohamed Rosli and Nur Amirah Binti Khairuddin and Fatin Shahira Binti Md. Isa} } @article {130, title = {Impact of Severity of Poly Pharmacy on Medication Adherence in Patients with type II Diabetes Mellitus}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {4}, year = {2015}, month = {Dec 2015}, pages = {94-97}, type = {Research Article}, chapter = {94}, abstract = {

Background: Diabetes mellitus is a complex chronic disease and people with diabetes estimated to reach 552 million by 2030 worldwide. World Health Organization stated that only 50\% of patients diagnosed with a chronic illness were fully compliant with their treatment regime. Objectives: To test the hypothesis that adherence decreases with increase in number of medications prescribed in patients with type II diabetes mellitus. Materials and methods: It was a comparative cross sectional study conducted in the department of medicine, medical college, Kozhikode. Patients visiting in the outpatient department of general medicine who satisfy the inclusion criteria were enrolled into the study. Patient medication adherence was measured by medication adherence questionnaire. Results analyzed using student{\textquoteright}s t test. Results: A total of 218 type II diabetic patients enrolled in this 6 months study in which minor poly pharmacy accounts for 18 patients, and the remaining were major poly pharmacy regime. The average number of drugs prescribed was 4.71 {\textpm} 2.12. The mean value of medication adherence score is more in major poly pharmacy group (3.48) when compared with minor poly pharmacy group (1.96). Higher the value of medication adherence score lower is the value of medication adherence of the patient. Conclusion: Polypharmacy continues to be a significant issue and little research has been conducted regarding the relationship between medication adherence and poly pharmacy. Medication adherence is affected by certain factors other than the number of drugs prescribed.

}, keywords = {Compliance, Diabetes Mellitus, Medication Adherence, Patients, Polypharmacy}, doi = {10.5530/ijpcs.4.4.5}, author = {Manju Cheenkallel Sreenivasan and Rinisha Razak and Athira Balakrishnan and Chandni Radhakrishnan} } @article {206, title = {Learning Habits of Undergraduate Medical Students in Pharmacology}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {4}, year = {2015}, month = {September 2015}, pages = {63-67}, type = {Original Article}, chapter = {63}, abstract = {

Background: Learning pharmacology may be challenging to medical students as drug information is expanding and students are required to adopt suitable study habits to remember pharmacological aspects to develop higher cognitive skills for better academic performance. Objective: To compare the learning habits of students of various levels of academic performances in pharmacology. Methods and Material: Study was cross sectional in which students{\textquoteright} learning habits and examination scores in pharmacology were collected in a questionnaire. The questionnaire had Likert type items (1: never{\textendash}5: every time) related to learning habits of students that could influence academic performance in pharmacology. It was distributed to 2nd year MBBS students (n=243) after the two assessments in pharmacology. Based on the \% of marks obtained in previous assessments, students were categoriesed into 5 groups (1=\<50, 2=50-59, 3=60-69, 4=70-79, 5=80-100). Statistical analysis used: The categorical variables were described as median and interquartile range. Learning habits of students of various level of academic performances were compared using non parametric tests. A p value of \<0.05 was considered as significant. Results: Group 1 less frequently revised the topics more than two times compared to the group 2 (p=0.015) and 5 (p=0.002). Compared to groups 1, 2 and 3, group 5 had started the preparation \>3 days before the scheduled pharmacology class test (p\<0.05). Compared to failed students, students who passed had revised topics more than 2 times and had set the target score of \>60\% and did not momorise the topics by mere byhearting. Conclusion: Reinforcement in the form of revisions, goal setting and developing deeper understanding of concepts have emerged as major determinants of students{\textquoteright} performance in examination in pharmacology. Hence, students should be made aware of these aspects to improve the quality of studies.

}, keywords = {Academic Performance, Learning Habits, Medical, Pharmacology, Students}, doi = {10.5530/ijpcs.4.3.6}, author = {Vasudha Devi and Zulhashime bin Zulkifli and Abdul Hadi bin Abd Rahman and Nurul Wahida Amalin binti Razali and Nur Atiqah binti Md Salehuddin} } @article {126, title = {Towards Standardization{\textendash}A New Protocol for Oil drop test (Neikuri) in Healthy Subjects}, journal = {International Journal of Pharmacology and Clinical Sciences |}, volume = {4}, year = {2015}, month = {Dec 2015}, pages = {83-89}, type = {Research Article}, chapter = {83}, abstract = {

Background: Oil drop test (Neikuri), a method of urine examination used in Siddha Medicine, an Indian system of medicine. In this test, patient urine is collected in a vessel, over which a drop of sesame oil is placed and the behavior of the oil drop on the urine surface is noted. However, due to lack of a standardized protocol for this test and advancement of modern diagnostic facilities, the utility value of this test has decreased to a greater extent. Objectives: To develop a new protocol for oil drop test in healthy subjects, so that it can be used as a standard reference to compare with other pathological conditions. Methods and Material: Urine samples of 12 healthy volunteers aged between 18 to 25 years were collected. Biochemical analysis was done in the urine samples with urine reagent strip to confirm health status of the subjects. 12 μl of sesame oil was dropped over 30 ml of each urine sample and behavior (shape of the oil spread, direction and spread time) was observed. Results: Majority of the samples showed circular shape and the most appropriate time to record it after 15 min of the test procedure. Conclusion: This test protocol can be taken as a standard technique for Oil drop test. However, further studies must be done in larger population so that it can be used as a non invasive and cost effective diagnostic/prognostic tool.

}, keywords = {Neikuri, Oil Drop Test, Oil Spread Direction and Time, Oil Spread Shape, Siddha Diagnostic Technique}, doi = {10.5530/ijpcs.4.4.3}, author = {Ahamed Basha Abdul Bari and Prince Johnson Samuel and Mathangi Damal Chandrasekar and Ramnath Shyamala and Siva Shankar Rangasamy} } @article {134, title = {Comparison of Safety, Efficacy and Cost Effectiveness of Intravaginal Misoprostol and Intracervical Dinoprostone for Induction of Labour}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {September 2014}, pages = {68-72}, type = {Research Article}, chapter = {68}, abstract = {

Background: Misoprostol is more efficacious than dinoprostone for induction of labour. But the adverse effects pro-duced by misoprostol were different. The aims of this study was to compare the safety, efficacy, cost effectiveness of intravaginal misoprostol and intracervical dinoprostone for induction of labour and their effects on intrapartum complications, mode of delivery and neonatal outcome. Materials and Methods: This is a randomized, parallel, two tailed, prospective, open label comparative trial. Sixty pregnant women were included in the study and it was carried out in the Department of Obstetrics, Government General Hospital, Kurnool Medical College, Kurnool during the period Dec. 2009 - June 2010. Out of 60 patients, 30 received miso-prostol 25 mcg intravaginally and 30 received dinoprostone 0.5 mg intracervically. Analysis and comparison of various parameters like induction- delivery interval, mode of delivery, neonatal outcome, foeto-maternal complications and cost of the drug were done. Mean and standard deviation of all observations were calculated and tabulated with the help of {\textquoteleft}Microsoft Excel{\textquoteright}. Comparison was done by applying student{\textquoteright}s t -test. Statistical significance was assigned at P\<0.05. Results: Misoprostol is more efficacious for cervical ripening and labor induction than dinoprostone. Misoprostol group had more number of vaginal deliveries, lesser requirement of oxytocin for labor augmentation, more number of vaginal deliveries within 12 hrs, less induction failures and was cost effective. However, it was reported to have slightly higher incidence of uterine contractility abnormalities and foetal complications. Conclusion: Misoprostol is more efficacious than dinoprostone. However uterine contraction abnormalities, fetal com-plications should be carefully assessed by close monitoring of labor by intrapartum cardiotocography and partogram.

}, keywords = {Cervical ripening, Induction - delivery interval, Induction failure, Labor induction, Tachysystole}, author = {Dara Aruna Kumari and Gujjala Radhika} } @article {119, title = {An Open Label, Randomized, Comparative Study of Antiscabietic Drugs Permethrin, Gamma Benzene Hexachloride and Ivermectin in Patients of Uncomplicated Scabies}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {3}, year = {2014}, month = {June 2014}, pages = {15-21}, type = {Research Article}, chapter = {15}, abstract = {

Background: To determine efficacy and cost effectiveness of antiscabietic drugs (permethrin, gamma benzene hexa-chloride and ivermectin) in patients of uncomplicated scabies. Materials and Methods: This was a prospective, randomized clinical study conducted in 210 diagnosed patients of scabies (\>12years of age) from January 2011 to October 2011.They were randomly allocated into one of the three groups. Group A received topical permethrin (5\% cream), Group B received topical gamma benzene hexachloride (1\% lotion) and Group C received oral ivermectin (tab 200mcg/kg). All the three groups received treatment two times- at the time of first visit and one week later. The patients were followed up at the end of first and third week. At each visit, cure rate was assessed by clinical and itching grading score and compared to determine the efficacy. Cost effectiveness was compared on basis of cost in INR to treat one case successfully. Results: Cure rate at the end of first week was 83.87\% in Group A, 78.18\% in Group B and 55.17\% in Group C while cure rate in the three treatment groups at the end of third week was 93.55\% in Group A, 80.00\% in Group B and 98.28\% in Group C. Thus at the end of first week Group A showed better cure rate while at the end of third week Group C was equally efficacious to Group A. The cost (INR) to treat one patient was 69.19 for permethrin, 37.50 for gamma benzene hexachloride and 24.42 for ivermectin. Conclusion: A single application of permethrin is superior to both ivermectin and gamma benzene hexachloride while ivermectin in two dose regimen is equally efficacious to permethrin and more cost effective than the other two conven-tional antiscabietic drugs. Oral ivermectin can be used as an alternative to permethrin.

}, keywords = {Antiscabietic, Gamma benzene hexachloride, Ivermectin, Permethrin}, author = {Maurya Meenakshi and Kaushik Sadhna and Srivastava Neeraj and Verma Deepak and Parihar Renu} } @article {158, title = {Anti Stress Effect of Centella asiatica Leaf Extract on Hippocampal CA3 Neurons {\textendash} A Quantitative Study}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {2}, year = {2013}, month = {March 2013}, pages = {25-32}, type = {Research Article}, chapter = {25}, abstract = {

Background: Centella asiatica (CeA) is a small perennial herbaceous creeper, growing in moist soil belonging to the umbelliferae family. In Ayurvedic medicine, CeA is popular as a brain tonic to promote brain growth and enhance memory. In addition to its memory enhancing and anxiolytic effects it also has anti-thrombotic activity, antibacterial effects, antinociceptive and anti inflammatory properties. However its neuroprotective effect has not been reported so far. In the present study the neuroprotective effect of CeA leaf extract on hippocampal CA3 neurons was investigated. Materials and Methods: Three months old albino mice were divided into four groups. Group (i) was normal control, Group (ii) was saline control, Group (iii) was stress group, Group (iv) was stress + CeA treated group. Group (iii) mice were stressed in a wire mesh restrainer for 6 hours/day for 6 weeks. Group (iv) mice were also stressed like group (iii) but they received orally CeA leaf extract throughout the stress period. After 6 weeks, brain was removed, hippocampus was dissected and processed for Golgi staining. Hippocampal neurons were traced using camera lucida focused at 400X magnification. The concentric circle method of Sholl was used to quantify the dendrites. Results: There was a decrease in the number of dendritic branching points and dendritic intersections in the hippocampal CA3 neurons in group (iii). However, there was a sharp contrast observation in group (iv) which was subjected to restraint and treated with CeA leaf extract. Conclusion: CeA leaf extract has neuroprotective effect against the stress induced neuronal atrophy in mice.

}, keywords = {Dendritic branching points and dendritic intersections, Hippocampus, Restraint stress}, author = {Hemamalini and Muddanna S. Rao} } @article {156, title = {Effect of Flunarizine on Blood Glucose Levels in Normal Albino Rats Through Oral Glucose Tolerance Test}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {2}, year = {2013}, month = {March 2013}, pages = {19-24}, type = {Research Article}, chapter = {19}, abstract = {

Background: Flunarizine is commonly used for migraine prophylaxis. It is a calcium channel blocker which blocks the L-type, T-type and N-type of calcium channels of pancreatic beta cells and other cells. It is believed to cause alterations in blood glucose levels secondary to its effect on calcium channel dependent insulin secretion. Objective: To evaluate the effect of flunarizine on blood glucose levels in normal albino rats through oral glucose tolerance test (OGTT) Materials and Methods: Flunarizine and distilled water were given orally for 5 days to the test (T) and control (C) groups of 6 normal albino rats respectively (N = 6). OGTT was conducted on both the groups on the 5th day and blood glucose levels were analyzed at 0, 60 and 150 minutes. Data was analyzed with one way ANOVA and independent samples t -test. Results: Flunarizine caused hyperglycemia at all durations of the OGTT with a maximum difference of 26\% at 0 hour. The extent of worsening was maximum at 60 - 0 minute interval in both the instances i.e. test group value compared with control (T-C) and control values compared with itself (C-C). The comparison of extent of hyperglycemia revealed that T-C showed 17\% (47mg/dl) more hyperglycemia than the C-C (40 mg/dl). Conclusion: Flunarizine has hyperglycemic effects in normal albino rats when given for 5 consecutive days orally even at the dose used for prophylaxis of migraine in human beings. A word of caution is thus advised when using flunarizine in impaired glucose tolerance or diabetic subjects.

}, keywords = {Blood glucose level, Flunarizine, Hyperglycemic, Oral glucose tolerance test}, author = {Suresha RN and Ashwini V and Pragathi B and Kalabharathi HL and Satish AM and Pushpa VH} } @article {172, title = {Evaluation of Efficacy of Sedative and Analgesic Effects of Single IV Dose of Dexmedetomidine in Post-operative Patients}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {2}, year = {2013}, month = {September 2013}, pages = {75-81}, type = {Research Article}, chapter = {75}, abstract = {

Background: In the post-operative period, it has always been an important consideration for clinicians, to keep the patient comfortable, calm and pain free. So there is a constant need for an ideal sedative for postoperative patients. Alpha 2 adrenoreceptor agonists such as dexmedetomidine could provide an answer to this problem because they have several relevant physiological properties like sedation, anxiolysis, analgesia and arousability. Hence, the current study was undertaken to evaluate the efficacy of dexmedetomidine in post-operative patients in order to avoid polypharmacy. Materials and Methods: Thirty patients who were operated under general anesthesia electively were randomly selected . All patients received 1 μg/kg bodyweight of dexmedetomidine intravenously with normal saline making up to 10 ml over 20 minutes. If the verbal numerical scale (VNS) of pain was mild (i.e. 1 to 3) one hour after extubation. The patients were assessed for degree and duration of sedation, hemodynamic changes, episodes of side effects, requirement of analgesics at every 5 min for first 30 min, every 10 min for next 1hr, every 15 min for next 1 h, and eve-ry 30 min for next 1h, every 1 h for 3h and 6th hourly till 24h. The need for rescue analgesic was noted. Results: The mean duration of sedation was 129.6 {\textpm} 41.02 min, degree of sedation was -1 at 30 min, duration of analgesia 241.5 min, and mean degree of analgesia was 0 at 30 min, mean degree of sedation was -1. Mean time of administration of rescue analgesia was 170 min. Mean heart rate was 67.8 {\textpm} 5.24/min and mean arterial pressure was 78.0 {\textpm} 8.97mm of Hg, mean respiratory rate was 15.8 {\textpm} 2.33 breaths/min, mean partial pressure of oxygen SpO2 was 99.5 {\textpm} 0.56\%. No patient had any episode of shivering, vomiting, hypotension and respiratory depression. Conclusion: Single IV dose of dexmedetomidine could provide adequate sedative, analgesic and anxiolytic effects with no accompanying respiratory depression, thereby minimizing polypharmacy.

}, keywords = {Dexmedetomidine, Diclofenac, Post-surgical patients, Postoperative patients, RASS scale, Rescue analgesics, VNS scale}, author = {Manasa CR and Padma L and Shivshankar and Ranjani Ramanujam} } @article {166, title = {Population Approach Group of India (PAGIN) 2013: A Report}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {2}, year = {2013}, month = {June 2013}, pages = {58-60}, type = {Scientific proceeding}, chapter = {58}, abstract = {

Population Approach Group of India(PAGIN) is a non-profit organization focused on the training of pharmacometric community in India. Pharmacometrics is a science that specializes in data analysis and modeling using mathematical and statistical methods for handling pharmacokinetic (PK), pharmacody-namics (PD) and disease progression models.

}, keywords = {Nill}, author = {M. Surulivel Rajan} } @article {183, title = {A Prospective Single Arm Open Pilot Trial to Study the Antioxidant Property of Ayurvedic Massage Therapy in Healthy Individuals}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {2}, year = {2013}, month = {September 2013}, pages = {121-125}, type = {Short Communication}, chapter = {121}, abstract = {

Ayurveda, the kernel of the ancient Indian wisdom, reckons abhyanga as a daily regimen owing to its univocal properties like jaraapaha (~delaying ageing process) pushtirit (nourishing), shramahara (removing tiredness) pushtya-yu (~ bestowing longevity) etc. Hence, this study was envisioned to show the antioxidant property of abhyanga on healthy individuals. Recruited voluntary healthy individuals both male and female between eighteen to seventy years of age were given Ayurvedic oil massage with simple gingili oil every day in empty stomach for forty five minutes for a period of seven days. The fasting blood samples of the subjects were collected before and after the study. The study was explicated utilizing the method of Koracevic et al method for the determination of total antioxidant status (TAS) and spectrophotometric method for accomplishing the thiol assay. The mean value with respect to the TAS was 0.88 before the treatment and 0.92 after the treatment and that of thiol was 317.39 and 311.66 before and after the therapy respectively. In TAS, p- value was 0.016 which is \< 0.05 and there was a decrease in serum thiols which was not statistically significant. However, the study establishes the antioxidant property of abhyanga and necessitates further comprehension of the same.

}, keywords = {Abhyanga, Antioxidant, Ayurveda, Massage, Panchakarma}, author = {K.J.Malagi and Shripathi Adiga H and Anjali Rao and Revathi Shenoy and Madhusudhan Kamath and A. Sapna Devi} } @article {153, title = {A Study to Evaluate Effect of Ephedrine on Intubating Conditions and Haemodynamic Parameters using Low Dose Rocuronium with Different Induction Agents}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {2}, year = {2013}, month = {March 2013}, pages = {9-13}, type = {Research Article}, chapter = {9}, abstract = {

Background: There has been a search for an ideal muscle relaxant which might provide ideal intubating conditions in ultra short duration with minimal side effects. Objective: To compare the intubating conditions and haemodynamic response one minute after rocuronium (0.6 mg/kg) administration, using three different induction techniques i.e. thiopentone, propofol and propofol with ephedrine. Materials and Methods: Seventy five adult patients were randomized into one of three groups: groups-A and B received thiopentone and propofol respectively and group -C received propofol with ephedrine. All groups received rocuronium 0.6mg/kg following administration of their respective drugs. Tracheal intubation was performed one minute later. An experienced anaesthesiologist assessed the intubating conditions. Haemodynamic parameters were recorded before induction of anaesthesia, post induction and one and three minutes after intubation. Results: Patient{\textquoteright}s characteristics and baseline haemodynamic parameters were comparable in all three groups. Intubating conditions were significantly better in propofol-ephedrine group as compared to other two groups. Following intubation, rise in heart rate and blood pressure was more marked in propofol-ephedrine group as compared to other groups. Conclusion: Rocuronium 0.6 mg/kg provides better intubating conditions at one minute with propofol-ephedrine combination as compared to propofol alone or thiopentone.

}, keywords = {Ephedrine, Hemodynamic, Intubating conditions, Propofol, Rocuronium, Thiopentone}, author = {Karampal Singh and Suresh Singhal and Punam Raghove} } @article {174, title = {Areca Catechu: Effect of Topical Ethanolic Extract on Burn Wound Healing in Albino Rats}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {Sept 2012}, pages = {74-78}, type = {Research Article}, chapter = {74}, abstract = {

Background:\ Areca nut (Areca catechu\ Linn.) is commonly used for skin ulcers in Indian traditional medicine. Areca nut oil is prepared and is applied topically for burn wound healing. However, scientific study has not been conducted so far. Hence, this study was aimed to evaluate burn wound healing activity of Areca catechu.\ Objective:\ To evaluate the burn wound healing property of Areca catechu kernel in normal as well as dexamethasone treated rats.\ Materials and Methods:\ Ethanolic extract of Areca catechu kernel was prepared and an ointment was made with 2\% of this extract. Burn wound was induced by standard procedure. Rats with burn wound model received either vehicle, standard drug or test drug. Two other groups were injected with dexamethasone to delay the wound healing process. The dexamethasone treated groups received either vehicle or test drug topically. Wound contraction rate and period of epithelialization were measured. The collected data were subjected to statistical analysis.\ Results:\ The wound contraction rate was significantly increased in Areca catechu treated group in all the days compared to control. Period of epithelialization was faster in the drug treated group than control group. The dexamethasone treated group showed a significant delay in wound healing process when compared to control. Test drug showed a significant reversal in wound contraction rate and epithelialization period in dexamethasone suppressed burn wound healing model.\ Conclusion:\ This study has shown the wound healing property of Areca catechu. Further study is required to know the compounds responsible for its wound healing property and to understand the mechanism of action.

}, keywords = {Areca Catechu, Ayurveda, Burn Wound, Epithelialization, Siddha, Wound Contraction}, author = {Deepak Kumar Verma and Masuram Bharat and Deepak Nayak and Tara Shanbhag and Venkatesh Shanbhag and Ravindra Singh Rajput} } @article {157, title = {Ethnobotanical Survey Regarding the Management of Liver Disorders by Traditional Healers of Vellore District, Tamil Nadu, India}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {April 2012}, pages = {24-31}, type = {Research Article}, chapter = {24}, abstract = {

Background:\ The present study was based upon the ethnomedico-botanical survey on health practices by the tribal and non tribal vaidyas (healers).\ Objectives:\ Present paper reports inventory of health practices on liver disorders used by vaidyas of Vellore district, Tamil Nadu, India.\ Materials and Methods:\ A structured interview was conducted for 64 vaidyas covering areas like understanding the disease, perception about cause, symptoms, classification of this disease, diagnostic and prognostic methods used, treatment given, sources of plant materials used, process methods adopted, dosage, dietary practices followed and referral for further treatment.\ Results:\ More than 60\% of village vaidyas had clear understanding regarding the various aspects of liver diseases. The study identified 47 species of medicinal plants, 30 formulations and various dietary practices used by the vaidyas in the management of liver disorders.\ Conclusion:\ This study documents treatment and practices followed by vaidyas. Scentific srudies done using these formulations/practices may help health practioners to practice evidence based medicine.

}, keywords = {Medicinal Plants, Siddha, Tamil Nadu/ Traditional Healers, Tribals, Vellore District}, author = {T. Thirunatayanan and S. Rajkumar} } @article {187, title = {Knowledge and Awareness of Food and Drug Interactions (FDI): a Survey Among Health Care Professionals}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {Dec 2012}, pages = {105}, type = {Research Article}, chapter = {97}, abstract = {

Background:\ Most of the food and drug interactions (FDI) remain unnoticed and under reported due to either lack of proper history, follow up or unawareness. Certain foods and specific nutrients in foods, may affect the overall bioa-vailability, pharmacokinetics, pharmacodynamics and therapeutic efficacy of medications. FDI occur due to extension of drug action or due to interaction between the drug and herbal medicines as well as dietary supplements and food products.\ Objectives:\ To evaluate the knowledge, attitude and awareness regarding the common FDI among the doctors in their day to day practice.\ Materials and Methods:\ Survey included randomly selected 200 doctors divided into 3 groups [65 Professors, 83 Post Graduates (PGs) and 52 Interns] from JSS Tertiary care hospital, Mysore, India. Assessment was through FDI Questionnaire which consisted of 32 questions (included dichotomous, multiple choice and open ended ques-tions). The differences between groups were compared using one-way ANOVA followed by Bonferroni{\textquoteright}s post-hoc test. The level of significance was set at p \< 0.05.\ Results:\ The mean scores (mean {\textpm} SD) on the overall test were 26 {\textpm} 4.08, 22.89 {\textpm} 3.72, 21.35 {\textpm} 4.2 for professors, PGs and interns respectively, with 31 being a perfect score. Professors had good knowledge about FDI compared to others (p \< 0.001). Only 33\% participants have noticed FDI during their practice. A majority of doctors had heard, felt necessary to report and update their knowledge about FDI along with adequate patient counseling.\ Conclusion:\ The study showed professors had better expertise compared to others. Intensive FDI training and integration of knowledge among healthcare professionals, especially in the younger health care professionals, is a requisite.

}, keywords = {Adverse drug reactions, Drug interactions, Food and Drug Interactions, Questionnaire}, author = {Jyoti M. Benni and Jayanthi MK and Basavaraj R and Tubaki and Renuka M} } @article {164, title = {Protective Role of Black Cumin (Nigella sativa) on Isoproterenol Induced Myocardial Infarction in Rats}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {June 2012}, pages = {45-53}, type = {Research Article}, chapter = {45}, abstract = {

Background:\ For many years, serologic markers have been used to assist cardiologists in the diagnosis and management of patients with myocardial infarction (MI). Once the serologic markers such as cardiac marker enzymes come to normal level upon a treatment, it clearly shows the treatment drug has the role in the management of MI.\ Objectives:\ The present study is designed to evaluate the effect of\ Nigella sativa\ seeds called black cumin on isoproterenol induced myocardial infarction in experimental rats.\ Materials and methods:\ The rats were randomly divided into four groups of 6 rats each. Group 1 rats received 1.0 ml of 0.5\% carboxymethyl cellulose (CMC) throughout the experimental period and served as the control. Group 2 rats received CMC as in group 1 and isoproterenol (85 mg/kg body weight) intraperitoneally twice at an interval of 24 hours on the 14th and 15th days. The rats in group 3 received black cumin (150 mg/kg body weight) intragastrically for a period of 15 days. Group 4 rats received black cumin and isoproterenol as said above and the experiment was terminated on 16th day and animals were sacrificed by cervical decapitation after an overnight fast. Blood was collected for the estimation of biochemical parameters and heart dissected out for biochemical estimation and histopathological examination.\ Results:\ Along with VLDL, TG, cholesterol, free fatty acids, the levels of marker enzymes in serum such as AST, ALT, LDH, CK, and tissue lipid profile of TG, cholesterol, free fatty acids were significantly decreased (p \< 0.05), whereas the levels of CK-MB and HDL, LDL in serum and tissue lipid profile of phospholipids were significantly increased (p \< 0.05) in rats pretreated with black cumin compared to that of the group which received isoproterenol alone.\ Conclusion:\ Pretreatment with black cumin offered a protective effect against isoproterenol induced myocardial infarction in rats as evidenced by cardiac markers and lipid profile of the heart tissue.

}, keywords = {Black Cumin, Cardiac Markers, lipid peroxidation, Myocardial Infarction}, author = {M. Murugesan and M. Ragunath1 and T. Prabu1 and S. Nadanasabapathi and M. Sakthivel and V. Manju} } @article {205, title = {Survey of Tamil Siddha Manuscripts in Possession of Traditional Healers in Northern Tamil Nadu}, journal = {International Journal of Pharmacology and Clinical Sciences}, volume = {1}, year = {2012}, month = {September 2012}, pages = {68-73}, type = {Research Article}, chapter = {68}, abstract = {

Background: Traditional Medicine throughout the world has been passed on to the next generation mostly by oral tradition. The two codified medical traditions of India, Ayurveda and Siddha have also been similarly promoted and the medical literature is in the poetic form for continuity and easy memorization. Subsequently they were written down in palm leaves. Not all palm manuscripts, treasure of knowledge have been converted into books. Objective: To collect and digitize the traditional Siddha medical knowledge documented in the Siddha palm manuscripts in the possession of Traditional healers. Materials and Methods: The Centre for Traditional Medicine, Tamil Nadu, India, carried out survey among different practitioners of Traditional Medicine in northern Tamil Nadu, to locate and collect palm manuscripts and followed it with preservation, cataloging and digitization using digital scanners and photographic equipment. Results: Two hundred and fifty six works were analyzed and this paper presents the age, authorship, subject content and status of the palm manuscripts. Conclusion: The traditional knowledge present in the palm manuscripts are undergoing decay and the persons with knowledge to decipher are less. Hence there is an urgent need to decipher and publish the contents as books.

}, keywords = {Ayurveda, India, Palm manuscripts, Siddha, Survey, Tamil Nadu, Traditional knowledge}, author = {S Rajkumar and N Srinivasan and T Thirunarayanan and R Sangeetha} }