Department Of Pharmacology Research Articles

A PROSPECTIVE, OBSERVATIONAL DRUG UTILIZATION STUDY IN THE DERMATOLOGY OUT-PATIENT DEPARTMENT OF A GOVERNMENT HOSPITAL, NANDYAL, ANDHRA PRADESH

Objective: The data regarding drug utilization in dermatology departments of southern parts of India is limited. Recent studies on drug utilization in dermatology across India, reported high prescription of branded drugs, low adoption of essential drugs and polypharmacy. Hence, this study was conducted to analyze the drug utilization pattern for common skin diseases as per WHO prescribing indicators. Methods: This study was done in the Out-patient department (OPD) of dermatology at Government General Hospital (GGH), Nandyal, in collaboration with department of Pharmacology for a period of 4 mo and Institutional ethical committee (IEC) permission was taken before conducting the study. Results: A total number of 344 prescriptions were analyzed. Average number of drugs per prescription was 2.5 (including Fixed drug combination (FDC) drugs). Total number of drugs accounted to 860. Majority of prescriptions have 3 drugs per prescription (57.1%) and only 8.7% of prescriptions have more than 3 drugs per prescription. Analyzed data as per World Health Organization (WHO) prescribing indicators indicate 74% of prescribed drugs were from National List of Essential Medicines (NLEM), 2.5% were FDC drugs and 13.14% of the drugs prescribed were antibiotics. Polypharmacy was noted to be only 0.7% in the study. Conclusion: A periodic audit of prescriptions will reduce errors and motivate the health care professionals for rational drug use. Special consideration is to be given to extended public health initiatives to prevent skin infections because they account for about 70% of diseases in daily life.

ASSESSMENT OF THYROID FUNCTION DISORDERS AMONG THE SUBJECTS ATTENDING CENTRAL LABORATORY OF A TERTIARY CARE HOSPITAL: AN OBSERVATIONAL, CROSS-SECTIONAL STUDY

Objective: Thyroid disorders are the most common endocrine disorders worldwide and India is not an exception. Several factors may determine the prevalence of thyroid dysfunction including age, gender, geographical and ethnic background, and most importantly iodine intake. Therefore, data related to thyroid disorders from one population cannot be extrapolated to another. In this study, we aimed to assess the disorders of thyroid function among the subjects attending the central laboratory of a tertiary care hospital. Methods: This observational, cross-sectional study was conducted in the Department of Pharmacology and the Department of Biochemistry of the same institute over a period of 3 months. All subjects of either sex attending the central laboratory of the institute for estimating thyroid function on their outpatient visit during the study period were included. Subjects who were on any medications known to alter the thyroid hormone status or diagnosed with a thyroid disorder and/or on therapy were excluded. A pre-designed and pre-tested data collection form was used for taking interviews to collect relevant data including sociodemographic characteristics, comorbid conditions, thyroid illness, and investigational reports. Results: A total of 132 subjects were included in the study. The majority of them were female (72.27%) and residents of urban areas (52.27%). The most common comorbid conditions and presenting symptoms were hypertension (25.76%) and fatigue (46.97%), respectively. The majority of the subjects were found to be euthyroid (81.81%). About 18.19% of the study subjects were having thyroid disorders, most commonly subclinical hypothyroidism (SCH) (13.64%), followed by primary hypothyroidism (2.27%), secondary hyperthyroidism (1.52%), and subclinical hyperthyroidism (0.76%). Thyroid disorders were mainly found in females, such as primary hypothyroidism (66.67%), SCH (66.67%), and subclinical hyperthyroidism (100%). The majority of the thyroid disorders were found in the age group of 26–50 years (20.27%), where females were found to have more primary hypothyroidism (3.17%), and SCH (12.70%). Conclusion: The findings of our study call for a review of current practices regarding thyroid disorders to include active screening of thyroid function among the subjects at greater risks and an emphasis on regular monitoring of the thyroid status.

Cross-validation of pharmacokinetic assays post-ICH M10 is not a pass/fail criterion.

The ICH M10 guideline establishes global standards for bioanalytical method validation for pharmacokinetic assays, focusing on data reliability and accuracy across studies. A significant component is cross-validation, which should be performed to ensure data comparability when multiple methods or laboratories are involved in a single study or across studies where comparison will be performed. However, ICH M10 does not specify acceptance criteria for cross-validation, creating challenges for the industry because traditionally many laboratories have always utilized acceptance criteria to "pass" or "fail" the study. This editorial discusses how bioanalytical labs should conduct cross-validation for PK assays post-ICH M10, highlighting the role of statistical methods and the need for close collaboration with clinical pharmacology and biostatistics departments. Proper implementation and strategic focus on relevant studies are essential for effective cross-validation.

Virulence and resistance genes in <i>Campylobacter spp</i> isolated from asymptomatic children at Kibera slum in Nairobi, Kenya

BACKGROUND Campylobacter spp. are among the global causes of food poisoning and harbour virulence and resistance genes which play a role in invasion and antibiotic resistance. This study aimed to detect selected resistance and virulence genes in archived Campylobacter spp. isolated from children in Kibera, Nairobi, Kenya. MATERIALS AND METHODS This was a retrospective laboratory-based cross-sectional study on archived samples of Campylobacter spp. at the Department of Public Health, Pharmacology and Toxicology, University of Nairobi. Campylobacter isolates were cultured on modified charcoal cefoperazone deoxycholate agar (mCCDA) media. The presence of selected virulence genes and resistance genes was detected by multiplex polymerase chain reaction (mPCR). STATA13 was used in data analysis. Binary logistic regression was used to ascertain the association between the genes and the Campylobacter spp. RESULTS The Campylobacter spp. under this study were Campylobacter jejuni (C. jejuni) (50%), Campylobacter coli (C. coli) (38%) and Campylobacter lari (C. lari) (12%). The virulence genes detected were cgtB 37 (25%), pldA (20%), cdtA (17%), cdtB (16%), cdtC (6%), wlaN (5%), iam (4%), ciaB (4%) and VirB11 (3%). The virulence gene waaC was not detected in any of the isolates. The resistance genes detected were TetA (42%), Tet B (26%), GyrB (18%) and GyrA (14%). CONCLUSION The study revealed the presence of various virulence and resistance genes in Campylobacter spp. isolated from children. This information could help guide the development and enhancement of guidelines for the management of Campylobacter infections.

Assessment of the quality of life of GPs in situations of high epidemic risk

The purpose is to assess the characteristics of the decrease in the quality of life of GPs working in a specialized COVID-19 hospital, a multidisciplinary hospital, and a poly clinic during the pandemic of the novel coronavirus infection COVID-19, as well as early diagnosis, prediction, and prevention of a decrease in the quality of life in this category of medical workers. Material and research methods. The study was carried out on the basis of the Department of Occupational Diseases and Clinical Pharmacology named after honored scientist of the Russian Federation professor V. V. Kosarev, FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation, and the Department of Occupational Pathology, Regional Center for Occupational Pathology of the Samara City Hospital No. 5. The study was carried out within the framework of a complex theme «Systematic ap proach to early diagnosis, prevention, and prediction of the impact of low-intensity pro duction factors on workers’ health» of the Department of Occupational Diseases and Clinical Pharmacology named after honored scientist of the Russian Federation profes sor V. V. Kosarev, FSBEI HE Samara State Medical University (state registration number AAAA-A18‑118122190069‑6, registration date — December 21, 2018). The study was approved by the local ethics committee of the FSBEI HE Samara State Medical University of the Ministry of Health of the Russian Federation on November 23, 2021. The study included the following groups of examined medical workers: group 1 consisted of physicians of internal medicine working in a COVID hospital (in the «red zone») (n = 111); group 2 included GPs working in a multidisciplinary hospital (n = 106); group 3 consisted of GPs working in a polyclinic (n = 102); group 4 was the control group (n = 190) comprising employees of engineering, technical, and economic specialties not relat ed to work in medical organizations (healthy). To assess the psychophysiological state and quality of life of medical workers during the pandemic of the novel coronavirus infection COVID-19, the SF-36 questionnaire [J. E. Ware, 1993], designed to study all components of the quality of life, was used. The obtained data were processed using the Statistica package from StatSoft (USA). Results. The professional activities of GPs providing medical care in the «red zone», mul  tidisciplinary hospitals, and clinics are associated with the exposure of physicians to a number of risk factors in the working environment and the labor process, related to the provision of regular or occasional care to infected COVID-19 patients, which, under con ditions of exposure to an increased level of occupational stress, leads to a decrease in the quality of life in these categories of health workers. The decrease in the quality of life among medical workers in medical institutions of various profiles during the pandemic of the novel coronavirus infection COVID-19 is due to the fact that health workers faced many additional difficulties during this period: sleep deprivation, stress, strain, and chronic fa tigue. Chronic fatigue can affect behavior, communication, learning, and decision-making, which overall leads to a decrease in the qualit y of life of medical workers. Conclusion. Thus, the obtained data indicate that when identifying risk factors for a de crease in the quality of life in medical workers working in situations of high epidemic risk, there is the need to use specialized rehabilitation measures with relaxation techniques, art therapy, as well as professional adaptation programs, physiotherapeutic techniques, such as electrosleep and reflexology, and, if possible, resort treatment in health care centers, local sanatoriums, etc. with visits to psychotherapy offices, as well as psychopharmaco logical medications.

The 75-Year Anniversary of the Department of Physiology and Pharmacology at Karolinska Institutet-Examples of Recent Accomplishments and Future Perspectives.

Karolinska Institutet is a medical university encompassing 21 departments distributed across three departmental or campus groups. Pharmacological research has a long and successful tradition at the institute with a multitude of seminal findings in the areas of neuronal control of vasodilatation, cardiovascular pharmacology, neuropsychopharmacology, receptor pharmacology, and pharmacogenomics that resulted in, among many other recognitions, two Nobel prizes in Physiology and Medicine, one in 1970 to Ulf von Euler for his discovery of the processes involved in storage, release, and inactivation of neurotransmitters and the other in 1982 to Sune Bergström and Bengt Samuelsson for their work on prostaglandins and the discovery of leukotrienes. Pharmacology at Karolinska Institutet has over the last decade been ranked globally among the top 10 according to the QS World University Ranking. With the Department of Physiology and Pharmacology now celebrating its 75-year anniversary, we wanted to take this as an opportunity to showcase recent research achievements and how they paved the way for current activities at the department. We emphasize examples from preclinical and clinical research where the dpartment's integrative environment and robust infrastructure have successfully facilitated the translation of findings into clinical applications and patient benefits. The close collaboration between preclinical scientists and clinical researchers across various disciplines, along with a strong network of partnerships within the department and beyond, positions us to continue leading world-class pharmacological research at the Department of Physiology and Pharmacology for decades to come. SIGNIFICANCE STATEMENT: Pharmacological research at Karolinska Institutet has a long and successful history. Given the 75-year anniversary of the Department of Physiology and Pharmacology, this perspective provides an overview of recent departmental achievements and future trajectories. For these developments, interdisciplinary and intersectoral collaborations and a clear focus on result translation are key elements to continue its legacy of world-leading pharmacological research.

Outcomes of acetaminophen infusion on visual analogue scale with varying pain intensity during labour, A randomized controlled trial

Objective: Acetaminophen (Paracetamol) is the most widely used analgesic. We aimed to determine its efficacy in labour with varying pain intensity, to make labour less painful for women. Methods: This randomized controlled trial was conducted on primigravida’s in their active phase of first stage of labour at Pharmacology department of Army Medical College, National University of Medical Sciences in collaboration with Gynecology department of Pak Emirates Military hospital, Rawalpindi. It was a registered trial with trial number of IRCT20220308054220N1. Duration of study was from May 2022 to October 2022. Patients were divided into two groups, Group-I received two doses of I/V 100 ml normal saline whereas Group-II received I/V two doses of 1000 mg acetaminophen in 100 ml normal saline. Calculated sample size was 130, 65 in each group. Visual analogue scale was used as a tool for data measurement. Data was analysed using split plot anova test. Results: Mean VAS in acetaminophen infusion group was found to be less than placebo for 1st dose, but this effect was apparent only one hour after 2nd dose intervention. The difference in means between groups was statistically significant only for 1st dose with p-value of 0.003 (for second dose p-value 0.21). In acetaminophen infusion group, for both doses mean VAS decreased as an immediate effect of drug, but then it increased with time. The difference in VAS between intervals had p-value of <0.001 for 1st dose and 0.005 for 2nd dose. Conclusion: Acetaminophen is an effective non opioid labour analgesic in active phase of first stage of labour. doi: https://doi.org/10.12669/pjms.40.10.8425 How to cite this: Najeeb W, Komal N, Noor M, Khan MA, Chaudry A. Outcomes of acetaminophen infusion on visual analogue scale with varying pain intensity during labour, A randomized controlled trial. Pak J Med Sci. 2024;40(10):2163-2169. doi: https://doi.org/10.12669/pjms.40.10.8425 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Comparison of Problem-based Learning and Didactic Lecture as a Teaching–Learning Method among Undergraduate Medical Students: An Interventional Study

Background Didactic lecture (DL) is a teaching method that has been there for a long time in our educational system, but student involvement is minimal. Problem-based learning (PBL) differs in that it involves students in the learning process. Various skills are learned, such as self-learning, group discussion, communication skills, teamwork and knowledge retention. Critical thinking, analysis and the ability to solve real problems are some benefits of PBL, which can help medical students understand clinical scenarios and analyse, interpret and come up with possible solutions based on sound knowledge. Thus, there is a need to assess the effectiveness of PBL in recall, interpretation and problem-solving skills as compared to the traditional lecture method, as there are very few Indian studies related to PBL in Indian medical students. Materials and Methods A non-randomised interventional study was carried out in the Department of Pharmacology at East Point Medical College, Bengaluru. Groups A and B, each with 60 medical students, participated in PBL and DL for either of the two competencies (myocardial infarction and iron deficiency anaemia). After the completion of the DL and PBL sessions, 20 multiple-choice questions (MCQs) were given to the students. The effectiveness of the teaching method was determined by comparing the mean scores of MCQs of both groups. Results The group scores were compared using an independent sample t-test and expressed as mean ± standard deviation. The total mean score of PBL for the topic myocardial infarction (11.00 ± 2.64, p value = .001) was statistically significant compared with the total mean score in the DL group (9.38 ± 2.52), and the total mean score of PBL for the topic iron deficiency anaemia (15.28 ± 3.53, p value = .001) was significant compared to the total mean score in the DL group (12.98 ± 3.61), respectively. The mean score for recall and problem-solving for the topic of myocardial infarction was statistically significant in the PBL group compared to the DL group. The mean score for recall, interpretation and problem-solving for the topic of iron deficiency anaemia was statistically significant in the PBL group compared with the DL group. Conclusion PBL showed marked improvement in recall, interpretation and problem-solving abilities compared with DL. So, including PBL as a teaching–learning method can promote active and student-centered learning.

Incidence of Benzodiazepine Use and Misuse Among Adults in Selected Areas of Bangladesh

Background: Benzodiazepines (BDZ) are widely prescribed for anxiety and insomnia in Bangladesh, but their misuse has become a major public health concern. Objective: The aim of this study was to identify the incidence and patterns of use and misuse of BDZ in Bangladesh, and to explore the factors contributing to their misuse. Methodology: A cross-sectional study, including 368 current BDZ users, was conducted in the department of Pharmacology, Monno Medical College, Manikganj, during January, 2021 to December, 2022. The participants were selected randomly. Structured questionnaires were used to include participants’ personal information, drug use characteristics, physiological and psychological effects of drugs usage. Verbal consent was taken from each of the respondents. Results: In this study, 268(72.83%) of the participants were male, where 157(42.66%) were from the age group 31-40 years and 139(37.77%) were single. Among the study population, 51(13.86%) were students, 79(21.47%) had monthly family income above 50,000 Bangladeshi taka. Many of the participants reported that they used BDZs to relieve stress/pressure (108, 29.35%), followed by 95(25.82%) to manage insomnia, 79(21.47%) for relieving anxiety, depression and to get pleasure and others The mostly used drug was clonazepam (112, 30.43%), followed by diazepam (108, 29.35%) and others. Most of the users were influenced by friends (115, 31.25%). The common side effects of using BDZs were confusion (47, 12.77%), fatigue (45, 12.22%), drowsiness (37, 10.05%), and others. The mostly experienced withdrawal effect was headache (86, 23.28%), followed by insomnia (59, 16.25%), confusion (50, 13.48%) and others. Conclusion: BZDs were widely used in selected areas of Bangladesh with high incidence of misuse. The most common reason of misuse was self-medication. Increasing awareness program should be taken for safe and effective use of the drug. Journal of Monno Medical College December, 2023; 9 (2):68-72

A CROSS-SECTIONAL STUDY ON KNOWLEDGE AND PRACTICE REGARDING MENSTRUAL HYGIENE AMONG FEMALE NURSING STUDENTS IN A TERTIARY CARE HOSPITAL

Objectives: Menstruation, though a normal physiological process in the females of reproductive age group, is surrounded by various misconceptions and social taboos. Inadequate knowledge and unhygienic menstrual practices can adversely affect female health. Poor menstrual hygiene practice has been negatively associated with infection of the reproductive and genitor-urinary tract, cervical cancer, absenteeism from school, or drop-out, poor academic performance, lower self-esteem, and poor quality of life. We conducted this study to evaluate the knowledge and practices regarding menstruation in female nursing students in a tertiary care hospital. Methods: An observational, cross-sectional, questionnaire-based study was conducted over for three months on female B.Sc nursing students in the first year to the fourth year through face-to-face interview at the department of Pharmacology in a tertiary care hospital. Data regarding socio-demographic profile, knowledge of obstetric and gynaecological factors, perception of menstruation, and hygienic practice of the participants during their menstruation were collected. Results: Responses from 165 participants were analyzed. The mean (± SD) age of the students was 19.64 (± 1.09) years. Most of their parents had education up to a diploma and above (47.27% among mothers and 70.9% among fathers). The majority of the participants used to experience dysmenorrhea (52.72%) and had pre-menarcheal ideas about menstruation (78.18%). Mother was the most common source of information (54.54%) followed by teachers (16.96%) and media (13.33%). The majority knew the source (89.09%) and cause (100%) of menstrual bleeding. A considerable portion (45.45%) thought menstruation as the sign of conception. The majority (96.36%) used commercially made sanitary pads, and used to dispose of the used sanitary pads in the dustbin (98.19%) by wrapping them with paper (98.19%). Conclusion: Present study found an encouraging picture regarding knowledge and hygienic practices during menstruation among the participants. Education about menstrual hygiene needs to be imparted at the grass root level. In this regard Anganwadi and health care workers, teachers and media can play a major role. All mothers need to be taught about the importance of hygienic practices during menstruation, convey correct information to their daughters, and should be encouraged to break the age-old myths and taboos associated with menstruation.

Evaluation of health-related quality of life and adherence among pre-extensively drug-resistant tuberculosis patients receiving either Bedaquiline or Delamanid regimen at a teaching hospital in Eastern India

ABSTRACT Background: The foremost concern and challenge in managing drug-resistant tuberculosis is ensuring a high health-related quality of life (HRQoL). The effectiveness of pre-extensively drug-resistant (Pre-XDR) tuberculosis management hinges on patients adhering to therapy, a crucial factor in averting the development of drug-resistant strains, ultimately enhancing HRQoL. Methodology: This analytical longitudinal study spanned two years at a teaching hospital and involved collaboration between the Departments of Pharmacology and Pulmonary Medicine. A case record form was utilized to gather baseline data, encompassing patient demographics, medication details, WHO BREF HRQoL scores, and treatment adherence. Patients were classified as either adherent or nonadherent using three distinct criteria: the guidelines of the Revised National Tuberculosis Programme (RNTCP), the Morisky-Green-Levine Scale (MGLS), and the Batalla test. The sample size was determined based on 30% nonadherence rates from preliminary analysis of prior data, resulting in 86 patients included in the study. The association between the improvement of HRQoL score from the baseline with the predictor variables was assessed with a linear regression model. Comparison of nonadherence with the different predictors of the study population was assessed with binary logistic regression model. Results: Analysis of demographic data revealed no notable differences in age and BMI between the Bedaquiline and Delamanid groups. However, there was a gender-related difference in treatment distribution, with more men in the Bedaquiline group. Other factors, such as marital status, socioeconomic status, employment status, stigma/discrimination, comorbidity, and addiction, showed no significant differences between the groups. Comparing HRQoL scores at baseline and after six months showed substantial improvements in all domains, indicating a positive impact of the treatment. Linear regression analysis revealed a strong association between QoL improvement and adherence. Adherence patterns did not significantly differ between the two treatment groups, as assessed by various criteria. The patients with high stigma, newly diagnosed Pre-XDR cases, and the presence of adverse events had higher odds of nonadherence. Conclusion: This study highlights the substantial impact of Bedaquiline and Delamanid treatment on the HRQoL of Pre-XDR TB patients in Eastern India. Adherence to treatment plays a crucial role in improving QoL, and factors like stigma, newly diagnosed Pre-XDR patients, and adverse drug reactions influence adherence adversely. The findings emphasize the importance of patient support and education to enhance treatment outcomes.

Evaluation of the hepatoprotective effect of curcumin alone or in combination with vitamin C in methotrexate-induced hepatotoxicity in mice.

To assess the hepatoprotective effect of curcumin and/or vitamin C in methotrexate-induced hepatotoxicity. The experimental study was conducted at the Department of Pharmacology, College of Medicine, and the Iraqi Centre for Cancer and Medical Genetic Research, Mustansiriya University, Baghdad, Iraq, from Nov 12, 2020, to June 1, 2021, and comprised Swiss albino female mice aged 3-4 months and weighing 30-40g each. The mice were divided into 5 groups and treated for 10 days. Group 1 received distilled water, group 2 received single-dose methotrexate on the 10th day of the trial, group 3 was treated with curcumin plus methotrexate, group 4 was treated with vitamin C plus methotrexate, and group 5 was treated with curcumin and vitamin C plus methotrexate. Parameters measured were serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase, as well as hepatic tissue malondialdehyde, superoxide dismutase and glutathione. Data was analysed using SPSS 16. There were 35 mice; 7(20%) in each of the 5 groups. Hepatoprotection produced by curcumin as reflected by a decrease in lactate dehydrogenase and malondialdehyde levels was significant (p<0.05). Vitamin C also produced a significant hepatoprotection, demonstrated by a decrease in alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase and malondialdehyde levels. The combination of curcumin and vitamin C reflected an additive effect demonstrated by a significant decrease in malondialdehyde (p<0.05). Curcumin and/or vitamin C provided hepatoprotection against methotrexate-induced hepatotoxicity through modulation of oxidative stress biomarkers.

Evaluation the effects of Omega-3 and vitamin C alone or in combination on Methotrexate-Induced hepatotoxicity (in mice).

To assess the effect of pretreatment with omega-3 alone or in combination with vitamin C on hepatotoxicity raised by methotrexate. The experimental study was conducted at the animal house of the Iraqi Centre of Cancer Research and Medical Genetics and the Department of Pharmacology, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq, from November 2020 to July 2021, and comprised Swiss albino mice who were divided into 5 groups. Group A was treated with normal saline, group B was injected with methotrexate 20mg/kg intraperitoneally, group C was pretreated with omega 3 100mg/kg, group D was pretreated with vitamin C 100mg/kg, and group E was pretreated with concomitant vitamin C and omega 3 100mg/kg. The intervention lasted 9 days in each group, and were injected with methotrexate on day 10. The mice were sacrificed under chloroform anaesthesia after 48 hours. Blood sample was taken for biochemical examination. One part of liver was preserved in formalin 10% for histopathological study. Of the 35 mice, there were 7(20%) in each of the 5 groups. There was a significant increase in malondialdehyde and lactate dehydrogenase levels and a decrease in the superoxide dismutase and glutathione (p<0.05). Pretreatment with omega-3 and vitamin C ameliorated the hepatotoxicity induced by methotrexate due to strong antioxidant, anti-inflammatory and anti-apoptotic effects.

Evaluation of concurrent use of Vitamin C and Niclosamide against methotrexate-induced liver injury in mice.

To examine the effect of using vitamin C and niclosamide together on liver damage caused by methotrexate. The study was conducted at the Pharmacology Department and the Iraqi Center for Cancer and Medical Genetics Research, College of Medicine, Mustansiriya University, Baghdad, Iraq, from November 2020 to July 2021, and comprised albino mice who were randomly assigned to 5 groups. Group 1 comprised controls, groups 2 to 5 was received methotrexate, niclosamide 70mg/kg/day, vitamin C 100mg/kg/day, and a combination of niclosamide and vitamin C, respectively. Mice in groups 3, 4 and 5 also received an intraperitoneal injection of methotrexate 20mg/kg to induce hepatotoxicity. After 48 hours of the injection, the mice were sacrificed under chloroform anaesthesia. Cardiac blood samples were drawn for biochemical examination. The liver, after being washed, was divided into two parts; one part was taken for histological examination, and the other was preserved in formalin 10% for histopathological analyses. Data was analysed using SPSS 16. Of the 35 mice, there were 7(20%) in each of the 5 groups. The overall age ranged between 9-12 weeks and weight between 18-38gm. The results show significant hepatoprotection ( p-value <0.05) produced by both niclosamide and Vitamin C separately, reflected by a decrease in ALP, ALT, and LDH, while the combination of (niclosamide and Vitamin C) showed no additive effect (p>0.05) on enhancement of liver function. Niclosamide alone was found to be superior than in combination with vitamin C for treating methotrexate-induced liver damage.

Awareness and Knowledge of Adverse Drug Reactions and Pharmacovigilance Among Medical and Nursing Students and Staff in a Tertiary Care Hospital.

Background Pharmacovigilance is defined as the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or other drug-related problems. Underreporting of adverse drug reactions (ADRs) is a global issue, and adequate knowledge among healthcare professionals is essential. Engaging young doctors and nursing professionals in pharmacovigilance is crucial for promoting ADR reporting. Objectives The objective of this study is to evaluate the knowledge and awareness of ADRs and pharmacovigilance among medical and nursing students and staff in a tertiary care hospital in Vijayapura, India. Methods A cross-sectional, observational, questionnaire-based study was carried out using a validated questionnaire that included a total of 19 questions related to knowledge and awareness aspects. This was distributed electronically using Google Forms. By using the convenience sampling method, a sample size of 96 participants was calculated for each group (medical and nursing), and this was rounded to 100 participants per group to account for potential dropouts and to ensure the strength of this study. All the questions were peer-reviewed by expert faculties from the Department of Pharmacology. Results The data analysis showed that medical students and staff had superior knowledge of ADRs and pharmacovigilance. Nursing students and staff exhibited greater awareness of the nearest pharmacovigilance center and ADR monitoring centers in India. Nursing students and staff were more active in ADR and pharmacovigilance awareness programs. Conclusions This study clearly shows the importance of flexible attitudes and robust education in pharmacovigilance and ADR reporting among healthcare professionals. Executing simulation-based training can strengthen the skills and confidence of both medical and nursing professionals in ADR reporting and pharmacovigilance.

Virtual pharmacy as a component of the electronic educational environment at the Department of Pharmacology in order to increase the clarity and efficiency of assimilation of educational material (the role of increasing the clarity of educational material in the electronic information educational environment to improve the education resultat the Department of Pharmacology of the First Pavlov State Medical University of

Aim. To study the effectiveness of a virtual pharmacy as an element of an electronic information educational environment at the Department of Pharmacology.Material and methods. A total of 250 3rd year students of the Faculty of General Medicine and 196 2nd year students of the Faculty of Dentistry of the First Pavlov State Medical University of St. Petersburg. To achieve these goals, structured interviews, focus groups, and subsequent analysis were used. The performance of third-year students at the Faculty of General Medicine was assessed before and after the introduction of digital tools for visualizing material using elements of a virtual pharmacy.Results. A survey of students found high interest in using visual methods and, in particular, a virtual pharmacy. Clinical and pharmacological tasks using a virtual pharmacy significantly facilitated the acquisition of pharmacological knowledge and were rated positively by the majority of students. An analysis of the academic success of students who with a virtual pharmacy resource found that the average score increased and they began to pass the tests on the first try. When collecting data, Google forms were used, which, due to anonymity, made it possible to receive detailed proposals from students for improving the virtual pharmacy and teaching methods using the electronic information educational environment.Conclusion. The study showed that the virtual pharmacy method has established itself as an effective pedagogical tool that has made it possible to increase the visibility of difficult educational material and the efficiency of learning new knowledge.

Exploring the Potential of Turmeric as a Natural Antibacterial Agent: In Vitro Evaluation of Crude Paste and Aqueous Extract

Background: There is growing concern in the use of natural antimicrobial compounds due to the emergence of antibiotic resistance. One such contender is turmeric (Curcuma longa), an herb known for its usage in medicine for centuries; nowadays, however, its prospects in pharmacology are being actively discussed. Since access and utilization of modern health care is scarce in Bangladesh, such natural cures are worth researching. Objective: To assess the in vitro antibacterial activity of turmeric’s crude paste and aqueous extract against Staphylococcus aureus and Escherichia coli. Methods: The study was carried out in the Department of Pharmacology with the collaboration of Department of Microbiology, Mymensingh Medical College, Bangladesh, over a period of one year from July 2010 to June 2011, and it consisted of three experiments: Effects of crude turmeric paste incorporated in nutrient agar media, Minimum Inhibitory Concentration of Aqueous Turmeric Extract and Amikacin by broth dilution method, and Subculture method to confirm bactericidal effect. Results: CTP demonstrated effective growth of S. aureus at 10% concentration and E. coli at 30% concentration. The MIC of ATE was found to be 800 μg/ml for S. aureus and 2000 μg/ml for E. coli. The MIC for amikacin was 10 μg/ml for both organisms. These effects have been further substantiated in subculture studies regarding their bactericidal properties. Conclusion: From the findings of the current study, it is evident that both turmeric and its crude paste had profound antibacterial effects against S. aureus and E. coli, though the effect of crude paste was observed to be stronger than that of the aqueous extract. Although not as strong as Amikacin, its organic nature and possibility of side effects make it worth pursuing. Hence, this work adds to the literature on the fact that turmeric has health benefits as highlighted by traditional medical practice and points to the need to find new natural sources of .............

Daptomycin Dosage Optimization in Renal Impairment Using Model-Informed Precision Dosing.

Daptomycin's efficacy and toxicity are closely related to its exposure, which can vary widely among individuals. The patient, a 59-year-old male with an estimated glomerular filtration rate (eGFR) of 12 mL/min/1.73 m² and a weight of 64 kg, was treated with 850 mg of daptomycin every other day for infective endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA). For patients with an estimated glomerular filtration rate of less than 30 mL/min/1.73 m², the dosing recommendations are not explicitly defined in the endocarditis guidelines. Subsequently, the pharmacology department was contacted to adjust the dosage. A population pharmacokinetic model developed by Dvorchik et al. was used for Bayesian estimation of the patient's pharmacokinetic parameters. The 24-hour area under the curve (AUC24) of daptomycin was calculated at steady state using peak and trough plasma samples. The minimum inhibitory concentration (MIC) of the MRSA strain was 0.25 mg/L. An AUC24/MIC ratio below 666 is associated with higher mortality risk, while an AUC24 above 939 h·mg/L correlates with increased risk of muscular toxicity. Initial AUC24 estimation was 1091 h·mg/L. Following a dosage reduction to 700 mg every other day, the AUC24 increased to 1600 h·mg/L. Further reduction to 500 mg every other day brought the AUC24 down to 750 h mg/L, with two subsequent measurements showing consistent AUC24 values of 500 h·mg/L, which is within the target range. Daptomycin ended 6 weeks after the initial negative blood culture, with no adverse effects or recurrence of MRSA infection. This case underscores the need for therapeutic drug monitoring and a multidisciplinary approach to adjust daptomycin doses in patients with renal impairment.

Effects of the Anti-Inflammatory Properties of Bitter Leaf (Vernonia amygdalina) Ethanolic Extract on Streptocuccus Pyrogenes Induced Wister Rats

Aim: To investigate the effectiveness of V. amygdalina leaf extract on the remediation of the cytological and physiological damages on albino rats caused by streptococcus pyogenes. Study Design: Randomized Controlled Trial (RCT) design with multiple treatment groups. Research was done at the department of Science Laboratory Technology, University of Calabar, Cross River state, between March 2023 and June 2023. Methodology: Bitter extract was obtained through Soxlet extraction, and screened for the presence of secondary metabolites using standard phytochemical screening procedures. A pure culture of S. pyogenes was gotten from Microbiology Laboratory University of Calabar. Thirty five albino rats (100-175g), obtained from the Pharmacology department, University of Calabar were placed in 7 groups (A-G). Rats in groups A-F each was injected with the bacterium, observed for five days. Group A-E rats were subsequently treated with 0g/200 ml, 20g/200 ml, 40g/200 ml, 60g/200 ml, and 100g/200ml crude extract of bitter leaf respectively. While group F was treated with standard antibiotics. 0.5ml Cefuroxime Axetil tablets usp was injected into the rats. Group G rats served as negative control. Results: Results showed the presence of alkaloids, acidic compounds, tannins, flavonoids and Saponins. Haematocrit increased slightly in group A-E (18.3-46.3%) treated with 0g/200ml, 20g/200ml, 40g/200 ml, 60g/200 ml, and 100g/200ml concentrations of the extract, respectively. But more in group F (50.2%) that received antibiotics treatment, when compared with the control. Similar trend was observed for haemoglobin (Hb) values (15.3g/dl) and red blood cell (RBC) counts (3.0 x1012/l) that increased with increasing concentration of 100g/200ml extract treatment and antibiotics treatment (Hb = 15.7g/dl; RBC = 3.3 x1012/l) respectively. The white blood cell counts decreased with antibiotic treatment. Conclusion: Study established that in vivo administration of bitter leaf extract on albino rats was best at 60g/200 ml, and 100g/200ml in ameliorating haematotoxicity caused by S. pyogenes.

Role of oral hypoglycaemic drugs in preventing complication in non-alcoholic fatty liver disease with type 2 diabetes mellitus.

To determine the prevalence of non-alcoholic fatty liver disease, and the effect of oral hypoglycaemic drugs and lifestyle modifications in reducing fatty liver changes and liver enzymes in these patients. The comparative, observational study was conducted at the Department of Pharmacology, Sohail University, Karachi, from October 2022 to October 2023, and comprised patients of either gender having elevated liver enzymes and ultrasound finding of fatty liver changes along with raised glycated haemoglobin, transaminases, total cholesterol and triglycerides. The participants were prescribed oral hypoglycaemic agents by endocrinologists. Those given empaglifazolin + metformin were in group A, empaglifazolin + linglaptin in group B, sitaglaptin + metformin in group C, metformin alone in group D and sitaglaptin alone in group E. Lifestyle modifications were advised in all the treatment groups, while control group F was only advised lifestyle modifications. The intervention lasted 3 months. Investigations included B-mode ultrasound liver, liver enzymes and glycated haemoglobin, which were done at baseline and after the intervention. Data was analysed using SPSS 25. Of 200 patients, 40 were males and 160 were females in ratio of 1:4. The overall mean age was 48±16 years. There were 154(77%) patients who had non-alcoholic fatty liver disease with type 2 diabetes mellitus, while 46(23%) had only fatty liver changes. There were 50(25%) patients in group A, 30(15%) in group B, 30(15%) in group C, 40(20%) in group D, 10(5%) in group E and 40(20%) in group F. Post-intervention improvement was noted in 48(24%) patients, with 20(41.7%) of them being in group A. The prevalence of non-alcoholic fatty liver disease with type 2 diabetes was high. Combination of empagliflozin + metformin along with lifestyle modifications was highly effective in reducing fatty changes and the level of liver enzymes.