1. Evaluation of Knowledge, Attitude and Practice about Self-medication Among Rural and Urban North Indian Population Akram Ahmad, Muhammad Umair Khan, Akshaya B. Srikanth, Bhuvnesh Kumar, Niraj Kumar Singh, Neelanchal Trivedi, Asim Ahmad Elnour, Isha Patel
Background: The practice of self-medication is very common in developing countries like India. Several problems have been reported to be associated with self-medication like wastage of resources, adverse drug reactions and antimicrobial resistance. Not many studies in past have explored the differences regarding the knowledge, attitude and practice of self-medication in rural and urban population of India. Subjects and Methods: The present study was a community based cross sectional study aimed to gather information about the self-medication practices, knowledge and attitude and its factors affecting self medication in the rural and urban population of Moradabad District, Uttar Pradesh from March 2014 to May 2014. Data for self medication were collected through a pre-designed and face validated from the studied population. All data were coded, entered and analyzed using the statistical package for Social sciences program version 20.0 (Chicago, IL, USA). Results: The response rate was 90.47%.The present study shows 100% study participants practiced self-medication. Majority of the participants are male (58.4%) and more than 63% belonged to rural area. Almost 60% respondents believed that OTC medications are safe. 75% participants believed chronic use of OTC drugs can cause ADRs. Majority of participants did not follow the recommendations while using these medicines. Participants belong to urban area was more aware of non-prescription drugs (p<0.05).NSAIDs are most commonly used medication among both urban and rural population respectively 67% and 37%. Conclusion: The prevalence of self-medication was high among rural population. The level of knowledge was more among urban population and NSAIDs were the highest consumed medicine among both rural and urban population. Population health awareness programs by pharmacists especially at retail pharmacy and continuing education are essential for controlling self-medication. Hence, there is a need to launch educational campaigns to bridge gap of knowledge especially in rural population. It is imperative that Government and other concerned organizations should promote rational self-medication and well-being in rural communities.
2. Evaluation of Chromogenic Agar and Direct Antimicrobial Susceptibility Testing in Rapid Diagnosis of Acute Urinary Tract Infection Sony Paul, Kannan I, Jeyakumari D, Premavathi R.K, Shantha S
Introduction: Urinary tract infection (UTI) is the most common type of infection and continues to be a major health problem. The increase in resistance of microorganisms to antimicrobial agents, especially in hospitalized patients, demands rapid identification of the pathogen. The current detection methods are time-consuming, most typically consisting of 2 to 3 day culture. Aim: In the present study an analysis of chromogenic agar in the rapid identification of bacteria from urine sample was done. Further, the accuracy of the primary antibiotic sensitivity was also evaluated. Materials and Methods: About 100 patients of different age groups and sex with apparent urinary tract infection were selected for the study. The clean catch midstream urine was collected in a sterile container and was transported immediately to the laboratory. HiCrome UTI agar (HiMedia,code No. M1353) was used in the present study. HiCrome agar is evaluated in comparison with the standard agars. Direct susceptibility testing is done as described previously on all urine specimens at the time that they were received in the laboratory. For comparison, the antimicrobial susceptibilities of isolates from pure cultures are determined by a standard disc diffusion method. Results: 64 and 68 specimens showed culture positive in UTI chromogenic agar and conventional media respectively. On statistical analysis, the difference is not found to be significant (p>0.05), thus showing that UTI chromogenic agar is equally efficient in the isolation of the microorganisms from the urine of UTI patients. The direct antibiotic sensitivity test has shown to be equally good to the conventional antibiotic sensitivity test (p>0.05). Conclusion: From the present study, it has been observed that the chromogenic agar and direct antibiotic susceptibility test can be used in conjugation thereby the culture and sensitivity results for urine specimen can be produced within 24 hours. This helps the physician to initiate the appropriate treatment in time. Apart from this, it also reduces the expenditure involved in the conventional culture and sensitivity test.
3. A New Combinational Therapy in the Treatment of Alzheimer’s Disease Nabeela Ali, Sandeep Maharaj, Sureshwar Pandey, Akram Ahmad, Muhammad Umair Khan, Sameer Dhingra
Memantine hydrochloride extended- release and donepezil hydrochloride (MH/DH), is a newly FDA approved combination drug as of the 23rd of December 2014 for use in the treatment of moderate to severe Alzheimer’s disease. Alzheimer’s disease affects an estimated 5.4 million Americans, 200 000 of whom are younger than 65 years. The MH/DH combination is a once a day capsule and is not intended to slow neurodegeneration in patients suffering from Alzheimer’s disease.
4. The HypoglycemicEffect of Dorema aucheri (Bilhar) Extract in Diabetic Type 2 Patients: A First Clinical Trial Amirhossein Tavana, Fatemeh Pourrajab, Seyed Hossein Hekmatimoghaddam, Seyed Hossein Khalilzadeh, Mohammad Hassan Lotfi
Dorema aucheri (Bilhar) is one of the medicinal plants traditionally used for treatment of diabetes in Iranian medicine. The effect of this plant has already been investigated on animal models; however, this is the first study conducted on human subjects. The aim of this study is to investigate the hypoglycemic and hypolipidemic effects of D. aucheri aqueous extract in type 2 diabetes patients. The study was a double-blind, one hundred Iranian male and female patients with type 2 diabetes were enrolled. The patients were randomly allocated into two groups. One group (n = 50) received D. aucheri leaves extract while the other group (n = 50) received placebo.Fasting blood samples were collected at the beginning of the study and after two months for determination of blood glucose level, HbA1c, lipid profiles, ALT and AST. Our analysis showed that serum fasting blood glucose level, HbA1c and lipid profiles were significantly improved in patients in the D. aucheri group compare with placebo group. However, there were no differences between groups in plasma level of hepatic enzymes AST and ALT. This study suggests that D. aucheri extract has a potential hypoglycemic and hypoglycemic and hypolipidemic action in patients with type 2 diabetes. However, further studies are needed to elucidate mechanisms of actions.
5. A Survey Report of Perceptions of Needs and Self- Management Capacity Among Diabetic Patients in Selected Rural Villages in Kancheepuram District, Tamil Nadu T Suseelal
Understanding the needs of rural diabetic patients in managing diabetes mellitus (DM) is now of foremost importance to control DM equitably in India. Objective: A needs assessment regarding the awareness of diabetes and capacity for self management among a group of diabetic patients as a pilot study to develop content for home based health education material. Design: A cross-sectional study using a quantitative approach. Setting: 3 rural villages in Kattankulathur Block of Kancheepuram District, Tamil Nadu,India. Participants: 30 patients who had been undergoing treatment for DM selected by Convenience sampling. Results: Overall 72.5% of diabetic patients are motivated to have knowledge and refer to it to manage DM on their own. 66.67% of diabetic patients believe that DM is manageable in terms of self-testing, self-weighing, and physical exercise when combined with routine medicine. However, 52.50% of diabetic patients is conscious of barriers to self-management including time to go to hospital, money for treatment, dietary change and access to advice about exercise. Overall 64.17% of patients perceived a need for or benefit from professional guidance. Conclusion: It has been concluded that rural diabetic patients in India are highly Motivated to gain knowledge about self-managing DM and establish a management plan; they are also confident to varying degrees in their ability to self-manage. They strongly favored professional guidance and peer support. Based on the study findings an intervention strategy for home-based care was developed using a nurse as the main agent.
6. Overcoming Dental Fear with Sedation Dentistry – An Update Niha Naveed
Some people don’t look forward to dental appointments any more than they look forward to visits to a physician. Most dental procedures aren’t painful. However, just being examined can make people feel stressed. For those with dental phobia, however, the thought of a dental visit is terrifying. They may be so frightened, in fact, that they’ll do just about anything to avoid a dental appointment. A phobia is an intense, unreasonable fear. People can fear a specific activity, object or situation. People with dental phobia often put off routine care for years or even decades. To avoid it, they’ll put up with gum infections, pain, or even broken and unsightly teeth. For this, proper pharmacological interventions should be carried out. Sedation is sometimes touted as “the solution for overcoming dental anxiety or phobia”.
7. Secondary Metabolites from Cycas lacrimans Vincent Antonio S. Ng, Esperanza Maribel Agoo, Chien-Chang Shen, Consolacion Y. Ragasa
Chemical investigation of the sarcotesta of Cycas lacrimans, a plant endemic to the Philippines afforded β–sitosteryl-3β-glucopyranoside-6′-O-palmitate (1), a mixture of alkyl 4-hydroxy-trans-cinnamate esters (2a) and alkyl 4-hydroxy-cis-cinnamate esters (2b), β-sitosterol (3), unsaturated triacylglycerols (4), and methyl fatty acid esters (5). The structures of 1–5 were identified by comparison of their NMR data with those reported in the literature.
8. Study of Zinc and Glycated Hb Levels in Diabetic Complications. B. Jyothirmayi, M. Vasantha
Aim & Objective: Zinc has a significant role in various physiological metabolisms as it is an important cofactor for numerous enzymes. Alterations in serum concentrations of zinc in type 2 DM has been reported by several studies. We tried to evaluate the association of zinc and HbA1C in diabetic complications. Diabetes and its complications usually lead to increased production of free radicals which disturbs the internal milieu. Antioxidant enzymes like SOD are decreased due to low zinc concentrations resulting in tissue damage and various complications. Materials and Methods: In present study 50 type 2 DM persons diagnosed clinically with micro vascular complications like neuropathy and retinopathy are included as study group and 50 diabetic people without any complications as control group. Fasting blood samples were collected to analyse Zinc and HbA1C. HbA1C was estimated by HPLC method in D10 analyser. Zinc was analysed by colorimetric kit method. Results: There was significant decrease in serum concentrations of Zinc in study group when compared to control (50±12.5, 95 ± 20.42) (p≤ 0.001) HbA1C was significantly high in study group when compared to control (9.5.7±2.5.) (6.5±1.5) (p≤0.001). The correlation of HbA1C and zinc was done using Pearsons correlation coefficient and is inversely related = -0.4. Conclusion: In DM, HbA1C influences the profile of trace elements especially zinc and can be explained as one of the cause for delayed wound healing especially in patients with complications. Good glycemic control and zinc supplementation can prevent the complications.
9. Effectiveness of Tenofovir (TDF) / Emtricitabine (FTC) Versus Zidovudine (AZT) / Lamivudine (3TC) in Combination with Efavirenz (EFV) IN Antiretroviral-Naive HIV-Infected Patients IN Eritrea Emnet Kibrom Medhanie, Lukman M, Muhammad Nasrum Massi, Marianti A. Manggau
Highly active antiretroviral therapy (HAART), currently recommended is the cornerstone of management of patients with HIV infection. Nucleoside reverse transcriptase inhibitor (NRTI) zidovudine (AZT) and nucleotide reverse transcriptase inhibitor (NtRTI) tenofovir (TDF) are the most common medications given in first-line ART. This research to evaluate the effectiveness of Tenofovir DF, Emtricitabine versus Zidovudine, Lamivudine in combination with Efavirenz in Naive HIV-infected patients. A retrospective cross-sectional study on 94 adult Naive HIV-infected patients received TDF+FTC+EFV and AZT+3TC+EFV on adult age greater than 18 came for two years follow-up and had baseline CD4 cell counts. Data was extracted from the patient’s medical record. T-test was used to compare the mean increase in CD4 cell counts between the two independent groups (TDF versus AZT) at various time of interval. In two-years follow-up, patients in TDF+FTC+EFV, maintained their drug regimen. This research has shown the beneficial effects and safe of TDF+FTC+EFV over AZT +3TC+EFV as first line treatment for HIV infected patients in two years of follow-up in terms of CD4 cell response and well tolerance. Since this study has been done for short period of time with different mean CD4 cell counts baseline, further studies to evaluate the safety and effectiveness of long term use of TDF+FTC+EFV in Naive HIV infected patients with same mean CD4 cell counts baseline are needed.
10. Standardization the Crude Extracts of all Urtica plant Species Growing in Palestine for Quality Control of Cosmeceutical and Pharmaceutical Formulations Nidal Amin Jaradat
Background: The safety and the therapeutic efficacy of plants medications are mainly dependent on the quality controls and standards by which they are made for, to give powerful actions when prescribing them. Medicinal plants and their extracts have been used as sources of medicine, cosmetics and food in virtually all nations and cultures and the usage of plants as a source of cosmetics and medications among different population seems to never stop, even with the recent chemical synthetic medicines revolution. Objective: This study aimed to evaluate the standard of crude extracts yields of the active constituents for all species of Urtica plants leaves (Urticakioviensis Rogow., Urticamembranacea Poir. ex Savigny,Urticapilulifera L. and Urticaurens L.) growing wildly in Palestine and used for treatment of various diseases as well as used in cosmetics and food. Method: Serial exhaustive extraction method using polar and nonpolar solvents for four species of Urtica leaves without boiling to avoid the hydrolysis of the active phytochemical compound. Results: The best percentage of the aqueous extract yield was for Urtica kioviensis 609mg (24.36% of the total starting powder weight), while the best organic extract yield was also for Urtica kioviensis 72mg (2.88% of the total starting powder weight). Conclusion:Urtica kioviensis, Urtica pilulifera, Urtica urens aqueous serial exhaustive extraction yield and Urtica kioviensis organic exhaustive extraction yield can pass the quality control for manufacturing of cosmetics formulations and pharmaceutical preparations.