Side Effects Of Medicines Research Articles

The relevancy of patch testing in the exploration of the cutaneous side effects of herbal medicine

Background: Data on the cutaneous side effects of herbal medicine is scarce, especially with regard to allergy skin testing. Our objective was to determine the relevancy of patch testing in the exploration of the cutaneous side effects of herbal medicine. Material and Methods: A prospective study was conducted in the Department of Dermatology of the Hospital Institute of Social Hygiene of Dakar over a one-year period. Patch tests were given to patients with cutaneous side effects related to the exclusive use of herbal medicine. The plants recovered were turned into macerates and powders and mixed with Vaseline at concentrations of 5%, 20%, and 30%. Results: Patch tests were given to 31 of the 53 patients included. They were positive in 11 patients (35.48%). Positive patients displayed systemic eczema (n = 7/15 of cases), Stevens–Johnson syndrome (n = 2/3), contact eczema (n = 1/1), and fixed pigmented erythema (n = 1/2). Positive tests were obtained for 11 medicinal plants identified: Jatropha chevalieri (n = 2), Terminalia avicennoïde (n = 2), Detarium microcarpum, Acacia seyal, Acacia albida, Acacia italic, Sesamum indicum, Mangifera indica, Momordica charantia, Nauclea latifolia, and Anogeisius leiocarpus (in one case each). There was no statistically significant relationship between the type of cutaneous side effect and the test result (p = 0.388) and between the nature of the plant used and the test result (p = 0.402). Conclusion: In view of their high rates of positivity, patch tests could prove promising in the exploration of the cutaneous side effects of herbal medicine.

Add on effect of Somavalkala kashaya siddha basti in the management of diabetes mellitus: A case report

Diabetes mellitus is a major health problem for the world in the 21st century. The side effects of medicines and persistent complaints make diabetic patients seek alternative therapy. Basti (~therapeutic enema) acclaimed as Ardha chikitsa, is an important Shodhana (~detoxification) procedure in Panchakarma. In general, Basti is contraindicated in Prameha, but many special types of Basti are described in the literature that can be used in distinct cases. This study aims to explore the prospects of Basti chikitsa in the treatment of Prameha. A 56-year-old male suffering from diabetes taking metformin 500 mg tablet twice daily for five years presented with the complaints of polyuria, burning sensation in both upper and lower limbs, weakness and cramps aggravating gradually. HbA1C level (11.6) revealed an uncontrolled blood sugar levels. He was treated with Somavalkala kashaya siddha basti regimen for three months. The patient had significant relief in symptoms such as Prabhuta mutrata, Pipasa, Karapada daha, Karapada supti, Avil mutrata, Klaibya, and Daurbalya after complete course of therapy. The HbA1C level of patient which was 11.5 at the time of registration which lowered to the 6.9, i.e. nearly normal range. Fasting blood sugar and postprandial blood sugar levels were 121 mg/dl and 232 mg/dl, respectively, at the time of registration which reduced after Basti regimen. Thus, Somvalkala kashaya siddha basti appears to be useful in the treatment of diabetes mellitus.

Analgesic Activity of Salacia korthalsiana Miq (Polipog)

Pain has always been a cause of concern to humans. People often searched for remedy from plants because of the many documented side effects of commercial medicines. This study was conducted to determine the analgesic efficacy of the root decoction of Salacia korthalsiana Miq (Polipog) found in Mondragon Northern Samar. Acetic acid-induced writhing method was used to test the analgesic activity of polipog. Writhing test is a chemical method used to induce pain of peripheral origin by injection of irritant (ex. acetic acid). The manifestations of abdominal writhing in mice were described as an arching of back, extension of hind limbs and contraction of abdominal musculature. Analgesic activity of the test compound is inferred from decrease in the frequency of writhing. From the results obtained, polipog is comparable to the commercially available drugs in terms of analgesic efficacy.

Effect of Ashwini Mudra as an adjuvant on pain in post-operative cases of ano-rectal diseases - An Ayurvedic management protocol

Ano-rectal disorders refer to the illness of the anal canal and rectum. Fissure in ano, Fistula in ano and haemorrhoids are among the most common ano-rectal conditions. In these cases, symptoms like pain, itching, burning, bleeding and swelling can significantly affect a patient's lifestyle. In Today’s Era, for pain management in post-operative cases of ano-rectal diseases, yoga plays an important role in pain management. Yoga is a way of living that aim towards a healthy mind in a healthy body. Ashwini mudra is a tantric practice used to generate and move prana (life force energy) upward along the spine, via the main energy channel of the subtle body known as sushumna nadi. The practice involves contracting the anal sphincter in a rhythmic way, thereby generating and containing intense energy within the lower body before pumping it upwards As the ano-rectal disease require long term conservative treatment and also surgical intervention. Due to this patients are suffering for long term problems. To minimize the side effects of medicine in post-operative cases, certain measures are needed. Yoga is a way of living that aims towards a healthy mind in a healthy body. Sushruta and Vagbhata have described that the total length of Guda is 4½ Angula only. Vagbhata had also told measurement of Guda as Atmapanitala (palm of hand) Ashwini mudra is very easy to perform and can be done during any time and by any age group.

The Effect of Hydro-Alcoholic Extract of Ocimum basilicum on CaCl2-Induced Cardiac Arrhythmias in Rats

: Ocimum basilicum (OB) contains more than 30 plant species that are found in different regions, especially in Africa. OB contains various substances, especially Chavikol, Methyl Ether or Strangol, Linalool, and Agenol, which have antioxidant, antihypertensive, antidiabetic, and anti-lipid properties. On the other hand, along with lifestyle changes, the prevalence of cardiovascular diseases, such as arrhythmias, which cause high mortality, is increasing. Moreover, the modern drugs used for arrhythmia can also induce another type of abnormal heart rhythm. Regarding the effectiveness and fewer side effects of herbal medicine, we decided to study the preventive effects of hydro-alcoholic extract of OB on CaCl2-induced arrhythmias in rats. Male rats (Sprague-Dawley) were divided into the control group (2 weeks, normal saline, gavage) and three groups receiving different concentrations of hydro-alcoholic extract of OB (100, 200, and 400 mg/kg, gavage for 2 weeks). The arrhythmia model was established using CaCl2 (IV, 140 mg/kg). The number of ventricular fibrillation (VF), ventricular premature (PVC), and ventricular tachycardia (VT) were studied. Also, the oxidative stress parameters, such as malondialdehyde (MDA) and superoxide dismutase (SOD), were measured in heart tissue samples. Statistical analysis was done using Fisher's exact test and ANOVA, and also, P < 0.05 was considered as a significant level. The obtained results showed that administration of OB caused a decrease in MDA and an increase in SOD levels, which were associated with improved electrocardiogram parameters and reduced cardiac arrhythmias, which suggests the therapeutic potential of the plant in cardiovascular disorders.

Role of optogenetics in pain management

Optogenetics is a biological technique that involves the use of light to control genetically modified neurons to express the channels of light-sensitive Ions. Optogenetics can also be referred to as Optical monitoring of neuronal activity in non-neuronal cells, and control of biochemical pathways. Optogenetics is less invasive than electrical stimulation response time in optogenetics is comparatively faster than other treatments. Chronic pain affects one-third of the population, and current treatments cause limited relief and serious side effects. An alternative approach to pain reduction would be the direct modulation of somatosensory pathways using optogenetics. Optogenetic treatment can be a very effective way to relieve chronic pain while avoiding conventional pain medicine's side effects. The use of optogenetics in pain management has greatly accelerated over the last decade. This review discusses the versatility of different optogenetic tools and its effective applications in the field of medicine.

Knowledge, Attitude, and Practice of Self Medication among Medical Students of Mashhad University of Medical Sciences, Mashhad, Iran

Introduction: Self-medication is a double-edged sword the proper application of which is appreciated by the World Health Organization (WHO) guidelines since it can reduce the unnecessary pressure on the health care system. However, self-medication can lead to severe consequences if utilized inappropriately. Furthermore, self-medication practice is an important social health issue in medical students as educated people and would-be physicians. This study aimed to determine the knowledge, attitude, and practice of self-medication in medical students of Mashhad University of Medical Sciences, Mashhad, Iran. Materials and Methods: This cross-sectional questionnaire-based study included 296 medical students at distinct levels of education. The data were analyzed in SPSS software (version 26). Results: Based on the findings, more than 80% of the students were aware of the complications, drug interactions, and importance of accurate use; however, only 9.1% and 27% of the participants were aware of the side-effects of herbal medicine and dietary supplements, respectively. Out of the total 296 participants, 83.5% of the cases declared that they did care about the side effects of medicines, and 81.3% of the students believed that a medical degree was essential for medicine prescription. In a confrontation with minor ailments, 21.9% of the cases practiced self-medication, and the majority (57.4%) of the used medicines were painkillers. The main reasons for self-medication was the underestimation of the disease (57.8%). Moreover, positive attitudes toward the safety of self-medication (P=0.04) and knowledge about medicine (p <0.001) were the major reasons for the self-medication practice in senior students, compared to juniors. However, no significant difference was found between seniors and juniors in terms of self-medication practice (P=0.85). Conclusion: Regarding the adverse effects of self-medication, drug dependency, microbial resistance, and high prevalence of self-medication among participants, it is suggested to provide educational programs on the adverse effects of self-medication. In addition, appropriate measures should be taken to control and prevent an easy access to medications.

Evaluation of Hydro-alcoholic Extract of Clerodendrum myricoides (Hochst. Vatke) Leaves and Its Solvent Fractionsin Pentylenetetrazole-Induced Convulsion in Mice

Introduction: Epilepsy is a chronic neurological disorder that affects people of all ages. Herbal medicines are widely used across the globe due to their wide applicability and therapeutic efficacy. The low side effects of traditional herbal medicines have encouraged many types of research into antiepileptic activity. Clerodendrum myricoides is a plant whose leaves extract is traditionally used as an anticonvulsant in Ethiopia. &#x0D; Objective: The point of this investigation was to assess the anticonvulsant effect of the hydro-alcoholic extract and solvent fractions of C. myricoides leaves against pentylenetetrazole-induced seizures in mice. &#x0D; Methods: Comparison of mean latency to onset of convulsion, mean duration of convulsions, and the proportion of percentage protection against seizure of the plant extract was tested against PTZ-induced seizures. Three different doses were used by giving them orally 30 minutes before subcutaneous pentylenetetrazole (80 mg/kg) administration with the positive (diazepam 2 mg/kg) and negative (physiological saline 10 mg/kg) control groups. Data were presented as the mean ± standard error of the mean and analyzed using a one-way analysis of variance (ANOVA) and followed by post-hoc Tukey’s multiple comparisons test. Fisher’s exact test was used for the percentage protection. P &lt; 0.05 was considered statistically significant.&#x0D; Results: The crude extract of C. myricoides, with the doses of 300, 600, 1,200 mg/kgshowed a significant delay in mean latency to onset of seizures [299.33±30.129 sec (p&lt; 0.05); 387.167± 27.6 sec (p&lt;0.01); 417.833±31.9 sec (p&lt;0.001); respectively)]; decrease in the duration of convulsion [27.333±1.585 sec (p&lt;0.05); 16.833±1.537 sec (p&lt;0.01); 10.50±0.671 sec (p&lt;0.001) respectively]; and a proportion of percentage protection of mice against seizure [16.33% (1/6) (p&lt; 0.05); 33.33% (2/6) (p&lt;0.01); 50% (3/6) (p&lt;0.001) respectively] in a dose-dependent manner compared to the control group [92.833±13.006 sec; 34.167±3.683 sec, 0% respectively]. C. myricoides anticonvulsant activity was less than that of diazepam [1001.16± 68.430 sec, 4.500±0.619, 83.33 sec, 83.33% respectively for the doses]. Its solvent fractions, however, didn’tshow a significant anticonvulsant effect.&#x0D; Conclusion: The hydroalcoholic leaves crude extract of C. myricoides has anticonvulsant activity but its solvent fractions do not have comparable significant effects.

The Outcomes of Scientific Debates Should Be Published: The Arivale Story

There is an ongoing scientific debate regarding the merits and shortcomings of P4 Medicine (predictive, preventive, personalized, and participatory) and O4 Medicine (overtesting, overdiagnosis, overtreatment, and overcharging). P4 Medicine promises to revolutionize scientific wellness through longitudinal big data collection, denoted as "dense phenotyping," which could uncover early, actionable signs of disease, thus allowing earlier interventions and possible disease reversal. On the other hand, O4 Medicine draws attention to the potential side effects of P4 Medicine: overtesting, overdiagnosis, overtreatment, and overcharging fees. Preliminary data from the P4 Medicine concept have been recently published. A novel biotechnology company, Arivale, provided customers with services based on P4 Medicine principles; however it could not sustain its operations and closed its doors in April 2019. In this report, we provide our own insights as to why Arivale failed. While we do not discount that in the future, improved testing strategies may provide a path to better health, we suggest that until the evidence is provided, selling of such products to the public, especially through the "direct to consumer" approach, should be discouraged. We hope that our analysis will provide useful information for the burgeoning fields of personalized medicine, preventive medicine, and direct to consumer health testing.

Perception of Conventional Medicine and Herbal Medicine Usage Amongst Diabetic Patients: A Qualitative Study in Negeri Sembilan, Malaysia

INTRODUCTION: The concomitant intake of herbal medicine and conventional medicine amongst patients is steadily increasing worldwide. However, concerns have been raised regarding potential adverse effects and drug interactions when consuming both medications together. Therefore, this work aimed to comprehending the perception of Type 2 Diabetic Mellitus (T2DM) patients on conventional medicine and the manner of its use with herbal medicine in managing diabetes mellitus. &#x0D; &#x0D; METHODS: A qualitative study was conducted among 28 diabetic patients in four government clinics under the jurisdiction of the state of Negeri Sembilan, Malaysia. Purposive sampling was employed to recruit informants who consumed herbal medicine alongside their prescribed conventional medicine. This study employed semi-structured interviews, which were all digitally recorded, transcribed, and analysed thematically. &#x0D; &#x0D; RESULTS: This study found that most of the patients perceived the negative side effects of conventional medicine, which led them to consider incorporating herbal medicine in treating diabetes. Such perception was influenced by the personal experiences of their family members and friends. A majority of the informants utilised herbal medicine as a complementary consumption to conventional medicine as opposed to implementing it as an alternative. However, they would alter the dosage and intake time of conventional medicine for several reasons, such as to complement their herbal medicine intake, being fed-up with conventional medicine, and reduce the risk of its side effects. Lastly, this study revealed that some of the patients noted their intention to discontinue conventional medicine, while some even tried to quit.&#x0D; &#x0D; CONCLUSIONS: A complete understanding of patient&amp;rsquo;s perceptions regarding conventional medicine and its usage with herbal medicine will aid healthcare providers to deliver education on the importance of conventional medicine usage compliance. Additionally, people should be aware that its combination with herbal medicine when consumed may present adverse effects and subsequently cause serious health problems.

EHealth technologies assisting in identifying potential adverse interactions with complementary and alternative medicine (CAM) or standalone CAM adverse events or side effects: a scoping review

BackgroundWhile there are several existing eHealth technologies for drug-drug interactions and stand-alone drug adverse effects, it appears that considerably less attention is focussed on that of complementary and alternative medicine (CAM). Despite poor knowledge of their potential interactions and side effects, many patients use CAM. This justifies the need to identify what eHealth technologies are assisting in identifying potential 1) adverse drug interactions with CAM, 2) adverse CAM-CAM interactions or 3) standalone CAM adverse events or side effects.MethodsA scoping review was conducted to identify eHealth technologies assisting in identifying potential adverse interactions with CAM or standalone CAM adverse events or side effects, following Arksey and O’Malley’s five-stage scoping review framework. MEDLINE, EMBASE, and AMED databases and the Canadian Agency for Drugs and Technologies in Health website were systematically searched. Eligible articles had to have assessed or referenced an eHealth technology assisting in identifying potential one or more of the three aforementioned items. We placed no eligibility restrictions on type of eHealth technology.ResultsSearches identified 3467 items, of which 2763 were unique, and 2674 titles and abstracts were eliminated, leaving 89 full-text articles to be considered. Of those, 48 were not eligible, leaving a total of 41 articles eligible for review. From these 41 articles, 69 unique eHealth technologies meeting our eligibility criteria were identified. Themes which emerged from our analysis included the following: the lack of recent reviews of CAM-related healthcare information; a large number of databases; and the presence of government adverse drug/event surveillance.ConclusionsThe present scoping review is the first, to our knowledge, to provide a descriptive map of the literature and eHealth technologies relating to our research question. We highlight that while an ample number of resources are available to healthcare providers, researchers, and patients, we caution that the quality and update frequency for many of these resources vary widely, and until formally assessed, remain unknown. We identify that a need exists to conduct an updated and systematically-searched review of CAM-related healthcare or research resources, as well as develop guidance documents associated with the development and evaluation of CAM-related eHealth technologies.

Ethanolic Extract of Citrus reticulata Peel Inhibits the Migration of WiDr Colon Cancer Cells

Colorectal cancer is third rank on the cancer cases in Indonesia. To cure the cancer needs big cost and lot of effort. On the other side, the side effect of medicine or chemotherapy on patient need to reduce. Cancer cell spread to other tissue based on its migration and invasion ability. Citrus reticulata peel contains flavonoid such as Tangeretin and Nobiletin, both of this compounds have anticancer activity. The aims of this study is to reveals the potency of ethanol extract of Citrus reticulata peel on the inhibition of migration on WiDr colon cancer cells. The toxicity of ethanol extract of Citurs reticulata peel on WiDr colon cancer line was measured using 3-(4,5-dimethyltiazol-2-il)-2,5-diphenyltrazolium bromide (MTT) assay and investigate the cell migration was using scratch wound healing assay. The ethanol extract of Citrus reticulata peel showed the value of inhibitory concentration 50 (IC50) was 184.5 μg/mL, this result categorize as moderate cytotoxic. Meanwhile the migration assay showed that the deceleration of migration occurred on 0.5 IC50, 0.33 IC50 and 0.25 IC50 during 24 h and 36 h incubation, event thought there were not significant different (p&gt;0.05). The ethanol extract of Citrus reticulata peel has a potential migration inhibition on WiDr cell line.Keywords: Citrus reticulata, WiDr cell line, migration

In-Vitro Antifungal Efficacy of Zingiber Officinale

ABSTRACT:Synthetic medicines are being replaced by those derived from natural resources because of cost burden and side effects of synthetic medicines. Zingiber officinale (Ginger) has been act as home remedy against the microbial infections. Its fresh juice has radio protective action that could be helpful in avoiding gamma radiation which exert harmful effects during the period of cancer treatment. It exhibited chemo defensive and antineoplastic action as well as has been useful to cure the inflammation in the body. Present study investigated in vitro antifungal efficacy against Aspergillus niger, Aspergillus oryzaea, Fusarium oxysporum and Fusarium tricinctum using disc diffusion technique. Maximum inhibitory zone against Aspergillus niger produced after 96 hours i.e. 46.66 ±2.5mm and minimum after 48 hours i.e. 41.66 ± 2.5mm. Maximum inhibitory zone against Aspergillus oryzaea was produced after 96 hours i.e. 23.33±1.73 mm and minimum at 48 hours i.e. 17.66 ± 1.73 mm. Maximum inhibitory zone against Fusarium oxysporum was produced after 96 hours i.e. 24.00 ± 1.5mm and minimum at 48 hours i.e. 18.00 ±1.5mm. Maximum inhibitory zone against Fusarium tricinctum was produced after 96 hours i.e. 38.33 ± 2.00 mm and minimum at 48 hours i.e. 35.00 ± 2.00 mm. These concentrates may have been proved to be effective antimicrobials and can be exploited in controlling superfluous microbial growth.

Molecular targets of immunotoxic action of drugs

The aim of the article is to generalize information on possible molecular targets that ensure the implementation of the immunotoxic effects of drugs for the subsequent improvement of the methodological apparatus of immunotoxicological studies of new drugs and assess the prospects of the development of new directions of immunopharmacology. The results of the information search for official data provided by manufacturers of medicines registered in the Russian Federation (guidelines for use, clinical recommendations, reports on biomedical and clinical research), as well as data from pharmacological monitoring of the safety of their use conducted by Roszdravnadzor of the Russian Federation are summarized.Guidelines for the use of 524 current international non-patent medicines, covering a total of more than 5000 generics in various forms, releases and dosages, were analyzed. The object of the search was data on undesirable side effects of medicines related to the human immune system.The analysis showed that the immunotoxic effect is described for 40,6% of 524 active pharmacological agents. Clinical and pathogenetic characteristics allowed us to identify several cluster groups that can be characterized as immunotoxic syndromes: allergic, immunosuppressive, lymphotropic, generalized cytokine reaction, reactivation of the immune response, and immune activation of oncogenesis. Molecular targets of immunotoxic action were determined based on the known mechanisms of action of the analyzed drugs.

Gastroprotection in the treatment of erosive and ulcerative lesions of the stomach and small intestine

In article the reasons of erosive and ulcer injuries of a stomach, a small intestine are described. Special attention is paid to intake of nonsteroid anti-inflammatory medicines, microcirculation violation. Side effects of nonsteroid anti-inflammatory medicines and inhibitors of a proton pomp are in detail considered. Groups of patients with erosive and ulcer injuries of a stomach, small intestine with dyspepsia to which purpose of inhibitors of a proton pomp is not shown are allocated. Rebamipide can be appointed for prevention and treatment of erosive and ulcer injuries of a stomach, a small intestine with dyspepsia, both with inhibitors of a proton pomp, and in the form of monotherapy for the purpose of a gastroprotection to patients when use of inhibitors of a proton pomp is inexpedient. The gastroprotection algorithm depending on a condition of a gastric acid secretion of patients is offered.

Roles of Basic Subjects in Pharmacist Education

As a teacher of biochemistry in a school of pharmacy, a basic subject in pharmacist education, I try to include applied topics such as the biochemical mechanisms of diseases and side effects of medicines in relation to basic knowledge of biochemistry for advanced subjects that students will learn in later years. In aging societies, many people visiting community pharmacies are elderly who tend to have health concerns other than diseases diagnosed by physicians. If asked, community pharmacists should be able to give advice on potential problems patients might have, in addition to giving explanations of medicines prescribed. Basic subjects covered in university pharmacy courses should be the most useful in such community settings.

Potential side effects of medicine on patients with tuberculosis fixed-dose combination in dr. Pirngadi Hospital, Medan

Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, which by only using a few new antibiotics, can kill the bacteria. Tuberculosis treatment has several stages, namely intensive and advanced stages. Compliance with the use of OAT is an imported factor in the success of TB treatment. The use of many drugs can cause side effects that result in patients stopping treatment when it creates the TB treatment process to fail. Improved adherence can do by using a fixed-dose combination OAT. In the intensive phase, the patient will get a fixed-dose combination containing a mixture of four antibiotics. The purpose of this study is to evaluate the potential side effects that occur during fixed-dose combination OAT treatment at an intensive stage and see the level of compliance of patients taking TB drugs. Observational sampling in TB patients was taking OAT at an acute stage by looking at side effects that arise during treatment and then analyzed using statistics and algorithm Naranjo. The results showed the most common potential side effects for fixed-dose combination OAT in the intensive stage were itching, headache and nausea with a percentage of 72% each, joint pain 45%, stomach pain 36.4%, lack of appetite and rashes 27.3% each and reddish color in the urine 18.2%. The results of the analysis using Naranjo logarithm obtained results eight, which means the side effects might cause due to the use of the drug. The results of patient compliance achieved a 100% compliance rate

Complementary and Alternative Medicines for the Treatment of Hepatitis C: Perspectives of Users and CAM Practitioners.

Background Despite substantial progress in the treatment of hepatitis C through the use of direct-acting antivirals which have been shown to cure the disease, complementary and alternative medicines (CAM) are popular among patients as a substitute or complement of allopathic medicines. This study aimed to explore the perspectives of patients and CAM practitioners on the use of CAM for the treatment of hepatitis C in Pakistan. Methods A cross-sectional design was adopted. Participants (CAM practitioners and patients) were recruited from the capital and two provinces: Khyber Pakhtunkhwa and Punjab of Pakistan. A survey using paper-based questionnaires, each specific for patients and CAM practitioners, was conducted to gather information pertaining to demography, disease status, treatment history, and participants' perspectives (about the disease, reasons to switch to CAM, and referring source). Results A total of 417 respondents (n = 284 patients, n = 133 practitioners) were recruited. Of the total patients, 170 (59.9%) had started CAM during the previous three months. There were 168 (59.2%) of the total patients who had used allopathic treatments for hepatitis C prior to their use of CAM. The confidence in CAM (24.6%), high cost (19%), and unbearable side effects (52.1%) of allopathic medicines were the main reasons to switch to CAM treatment. Majority (49.3%) of the patients were referred to CAM on the recommendations of relatives or care givers (17.3%) whereas only 9.5% were referred by health care professionals. Out of 133 practitioners, 48 (36.1%) were practicing herbal medicines. From practitioners' perspectives, club-moss (Lycopodium clavatum) was the best treatment option for hepatitis C. The majority, 73 (54.9%), of the patients had chosen to use CAM because of the side effects of allopathic medicines. Patients who had previous “good experience” with CAM were the most common referral source (56.4%) for CAM use in hepatitis C. Conclusions Patients' beliefs in CAM, side effects of allopathic therapy, high cost of allopathic medicines, and referrals from previous CAM users are key factors in the switching of hepatitis C patients to CAM.

In vitro anti arthritic activity of Opuntia stricta

Rheumatoid arthritis (RA) is a chronic inflammatory and systemic auto immune disease affecting people predominantly between the ages of 20-50 years with unpredictable course. About 1% of the world&#39;s population is afflicted by rheumatoid arthritis and is two to three times more common in women than men. Allopathic medications have been prescribed to alleviate symptoms of this disease which results into associated side effects like heart attack, stroke, stomach ulcers, bleeding from the digestive tract, and kidney damage etc. Hence the use of herbal medicine is becoming popular due to toxicity and side effects of allopathic medicines. The present study reveals that plant Opuntia stricta possess in vitro anti arthritic activity. In vitro anti arthritic activity done by protein denaturation method. The activity may be due to presence of secondary metabolites. The plant extracts showed anti arthritic activity in a concentration dependent manner and the activity was increased on increasing the concentration of extracts.

Factors Associated with Treatment Compliance among Tuberculosis Patients Receiving Directly Observed Treatment Short Course Therapy

Tubercular infection is still a pervasive public health problem in Nepal despite the massive efforts of National Health Service stakeholders. This study was carried out to identify the factors associated with treatment compliance among Tuberculosis Patients Receiving DOTS in 11 centres of Pokhara valley. A cross-sectional descriptive study design was used to collect information from 142 Tuberculosis patients. Purposive sampling method was used and chi-square test was used at 5% level of significance. Pattern of compliance was categorized as; compliance and non-compliance. Out of 142 respondents, majority (94.37%) of respondents was compliant and minority (5.63%) was non-compliant. Among non-compliant patients, (75.0%) of respondents missed their medicine in intensive phase and the reasons for non-compliance were carelessness of patients, forgetfulness of patients, confusion of staff, side effects of medicines and agitation by political parties. The study found no significant association of treatment compliance with demographic factors, patient related factors, health service factors and social factors (p&gt;0.05). The finding was satisfactory that the compliance of TB patients was high i.e. (94.37%) of respondents were compliant. About (6.00%) of respondents were non-compliant. The reasons for non-compliance were due to their own cause rather than health service factors. They themselves were responsible for being non-compliant. Tuberculosis, being a major public health problem; six percent non-compliance is still a serious health problem and being non-compliant; these patients can transmit tuberculosis to many other healthy people in the family and community. Therefore, tuberculosis patients should be more conscious on treatment compliance to improve their health as well as of family and community.&#x0D; Key words: Compliance, non-compliance, DOTS Therapy