Monthly Publishing Peer Reviewed Journal

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1. Prescribing Patterns of Anti-Hypertensives Among Hypertensive Patients in General Medicine Department at A Teritiary Care Teaching Hospital
Divya Gopineni, Kavya N S, Sai Jyothi D, Neema farheen A

Hypertension is one of the prominent causes of high mortality and morbidity that occur in approximately one in three adults worldwide.  It is the most common long-lasting medical problem urging visits to health care providers. The global incidence is similar between both men and women, but differs with age. This study was done to evaluate drug utilisation pattern of antihypertensive drugs among hypertensive patients. This is a prospective observational study carried out in Department of General Medicine for a period of 6 months. A total of 410 patients who have hypertension and other comorbidities are included in the study. 203 patients have single comorbidity with hypertension. 247 prescriptions contain 6-10 drugs. In 410 prescriptions, 795 Anti-Hypertensive drugs were prescribed and Amlodipine was the most commonly prescribed drug (31.44%).

2. Biosynthesis of Phytochemicals Coated Silver Nanoparticles Using Aqueous Extract of Leaves of Cassia alata – Characterization, Antibacterial and Antioxidant Activities
A Vijayakumar, A Sinthiya
Green synthesis of nanoparticles (NPs) using plant extracts is fascinating high research interest and gaining importance in biomedical applications. Silver nanoparticles (SNPs) were crystallized from Ag+ to Ag0 using aqueous extract of Cassia alata leaves as a reducing agent. Antibacterial, free radical scavenging and antioxidant activities of phytochemicals coated SNPs were evaluated. The formation and the stability of SNPs was confirmed using UV-Vis spectroscopy. The SNPs were exhibited surface Plasmon absorption maxima at 436 nm. The functional groups of phytochemicals participated in the biosynthesis were identified by Fourier transform-infrared spectroscopy. Topography and morphology of synthesized SNPs were examined using field emission scanning electron microscope (FESEM) and high-resolution transmission electron microscopy (HRTEM) respectively. The presence of elemental silver was confirmed energy-dispersive spectrum of the nanoparticles. Images of HRTEM and FESEM confirmed that the synthesized SNPs were monodispersed and spherical in shape. Crystalline nature of the SNPs was evidenced by the selected area electron diffraction patterns with bright circular spots. X-ray diffraction patterns unveiled that the particles were crystalline in nature with face centered cubic structure. The size distribution from 20 to 85 nm and average size 56.5 nm of SNPs were obtained by dynamic light scattering analysis. The inhibition of growth of bacteria tested was highly dependent on the concentration of the extract and the SNPs. The SNPs were exhibited better percentage inhibition at 1000 µg/ml on DPPH˙ (65.72 ± 0.74), CUPRAC (1.925 ± 0.06) and DMPD˙ (57.83 ± 1.24) assays. They showed higher activity than the extract at 300 µg/ml on FRAP (1.641 ± 0.07) assay. Among the extract, standard and SNPs tested for antioxidant activity, SNPs showed the highest activity at 300 µg/ml on TAC (0.224 ± 0.01) assay.

3. Assessment of Knowledge, Attitude and Practice of Mothers with Severe Acute Malnutrition Children Regarding Child Feeding
B Manohar, N Surendra Reddy, P Vyshnavi, P Sravya Sruthi
Background: Mother is the principle provider of the primary care that her child needs during the first five years of life. The type of care she provides depends to a larger extent on her knowledge and understanding of some aspects of base nutrition and health care. So if mothers are made more aware about feeding practices of infant and other health care practices then, it will go long away to improve the status of severity of malnutrition. Objective: To assess knowledge, attitude and practice of mothers with Severe Acute    Malnutrition children regarding child feeding. Materials and method: Study design: Descriptive study, Study period: six months, Study population: 120, Inclusion criteria: Mothers having Children of age group infants to pre-school child (0-5years), admitted with Severe Acute Malnutrition with or without co-morbidities in Nutritional Rehabilitation Centre. Place of the study:  Nutrition Rehabilitation Centre (NRC), Department of Paediatrics, SVRR Government General Hospital (S.V.R.R.G.G.H), Tirupati. Methodology: Assessment of knowledge, attitude and practice of mothers was done by using a questionnaire containing 53 questions. Outcomes measured: knowledge, attitude and practice of mothers regarding child feeding. Results: The present study revealed that out of 120 mothers 69 (57.5%) have adequate knowledge followed by 36 (30%) have moderately adequate, 15 (12.5%) have inadequate knowledge. But in practice only 40 (33.33%) mothers showed adequate feeding practices, remaining 62 (51.66%) showed moderately adequate practices, 18 (15%) have showed inadequate feeding practices. On an average, out of 120 mothers 43 (35.83%) shows favourable attitude, 35 (29.16%) shows moderately favourable, 42 (35%) shows negative attitude towards the child feeding. Conclusion: The study has shown there are some gaps in terms of knowledge and practice of mothers. Awareness of mothers regarding child nutrition exists but it can be further improved to make their knowledge into practice. This study emphasizes the need to improve knowledge and confidence of mothers through appropriate counselling and support by the clinical pharmacist in association with other health care professionals with the ultimate goal of preventing malnutrition.

4. A Study on Antiplatelets and Anticoagulants Utilisation in A Tertiary Care Hospital
Muneeshwar Reddy T, Durga Prasad T S, Swetha S, Nirmala G, Siva Ram P
Cardiovascular and cerebrovascular diseases were becoming predominant now a day due to the dramatic life style changes as well as the sedentary occupations in the people, which make them to find the medical interventions to prevent further morbidity and mortality. We explored the utilisation of antiplatelets and anticoagulants in the cardiovascular and non-cardiovascular indications by performing a prospective observational study using the patient medication records and through direct patient interview. About 131(65.5%) were males and elderly with occupation coolies in key share. Commonly observed modifiable risk factors were high blood pressure, alcohol, smoking, high blood sugar. Aspirin was the most commonly utilized drug in 146(61.86%) patients among antiplatelets followed by clopidogrel i.e., in 77(32.64%) patients. Combination of aspirin and clopidogrel was observed in the 4(87.25%) patients. Enoxaparin and acenocoumarol were the commonly utilized anticoagulants in 14(38.89%) and 13(36.12%) patients respectively. Combinations of the anticoagulants were preferred in only 7(3.5%) patients whereas combinations of antiplatelets along with anticoagulants were preferred in 20(10%) patients. Platelet count was the most commonly measured parameter compared to Bleeding time (BT), Clotting time (CT), Prothrombin time (PT), International normalized ratio (INR) and activated partial thromboplastin time (aPTT). In our study we have observed that use of antiplatelet and anticoagulants in high risk as well as contraindicated cases that have led to adverse outcomes. So the choice of therapy based on the patients risk status and comorbidities will aid in the better prognosis that can be possible through clinical pharmacist interventions along with physician.