Design, in vitro and in vivo evaluation of glipizide Eudragit microparticles.

Glipizide microparticles made with Eudragit (RS 100 and RL 100), prepared by emulsion solvent evaporation technique were evaluated for various in-vitro properties viz. encapsulation efficiency, particle size and surface morphology, drug release pattern and in-vivo hypoglycaemic activity. The optimized formulation parameters were used to prepare smooth and spherical microparticles (2-32 microm) with higher entrapment efficiency (67-89%). Drug release patterns of glipizide microparticles of Eudragit RS 100 and Eudragit RL 100 with drug-to-polymer ratio of 1 : 4 (i.e. EGM14 and ELGM14) have shown gradual and extended release for 24 h with cumulative release of glipizide to the extent of 72.3% and 83.9%, respectively. However, EGM14 showed a significant in-vivo hypoglycaemic effect up to 12 h in rabbits while ELGM14 showed for 9 h. Hence, glipizide microparticles of Eudragit RS 100 (glipizide: polymer 1 : 4) is better suited for oral sustained release formulation.

A study on diabetes-related self-care plan and its determinants among diabetes patients in a Warangal region, Telangana, India

Abstract The prevalence of epidemiological diseases, including diabetes, has continued to increase because of the adaption of Western culture and the lack of self-care activities among patients with diabetes. Therefore, in this cross-sectional study, we aimed to assess self-care plans and determinants among diabetes outpatients in Warangal. We conducted a prospective observational study among diabetes outpatient clinic in Warangal, India over 6 months from October 2019 to March 2020. We used the expanded Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A P value of less than < 0.05 was considered statistically significant. Respondents (mean age, 52.3 (standard deviation (SD), 11.01) years) had an overall SDSCA score of 49.18 ± 3.57 (SD). Mean scores for the diet, physical activity, foot care, medication adherence, and blood sugar testing scales were 12.79 (SD, 1.61), 10.24 (SD, 1.77), 15.67 (SD, 1.5), 5.66 (SD, 1.17), and 4.80 (SD, 0.68), respectively. Patients' age, education, disease duration and hemoglobin A1C (HbA1C) levels of <7.5% (P < 0.001)) had significantly higher mean scores for blood sugar testing, diet, physical activity, and adherence (P < 0.001). The employment status is associated with all the domains of Summary of Diabetes Self-Care Activities (P < 0.001). Taken together, our results revealed that patients with diabetes in Warangal had poor self-care planning, highlighting the need for strengthening initiatives that generate awareness regarding diabetes and improving related self-care practices

Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital.

BACKGROUND: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients. METHODS: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study. Data were collected by reviewing patient files and then assessed for its appropriateness against the criteria developed in view of the Medication Appropriateness Index and Guidelines of the Indian Academy of Pediatrics. The results were expressed in frequencies and percentages. Chi-square test was used to analyze the data. A P < 0.05 was considered statistically significant. RESULTS: A total of 303 patients were studied during the study period. The mean age of the patients was 3.5 ± 0.6 years. The majority of children were admitted mainly due to chief complaint of fever (63%) and cough and cold (56.4%). The appropriateness of antibiotic prescriptions was higher in bloody and watery diarrhea (83.3% and 82.6%; P < 0.05). Cephalosporins (46.2%) and penicillins (39.9%) were the most commonly prescribed antibiotics, though the generic prescriptions of these drugs were the lowest (13.5% and 10%, respectively). The seniority of prescriber was significantly associated with the appropriateness of prescriptions (P < 0.05). Antibiotics prescription was higher in cold/cough and diarrhea (93.5%) in comparison to cough/cold (85%) or diarrhea (75%) alone. CONCLUSIONS: The study observed high rates of antibiotic utilization in Chidambaram during the treatment of cough/cold and/or diarrhea in pediatric patients. The findings highlight the need for combined interventions using education and expert counseling, targeted to the clinical conditions and classes of antibiotic for which inappropriate usage is most common.

A comparison of enoxaparin with unfractionated heparins in patients with coronary heart disease in an emergency department in rural South Indian tertiary care teaching hospital.

AIM: Antithrombotic therapy with heparin plus antiplatelets reduces the rate of ischemic events in patients with coronary heart disease. Low molecular weight heparin has a more predictable anticoagulant effect than standard unfractionated heparin, is easier to administer, does not require monitoring and is associated with less ADRs. The purpose of the present study was to evaluate and compare the clinical and cost outcomes of Enoxaparin with a standard unfractionated heparin in patients with coronary heart disease. MATERIALS AND METHODS: This was a noninvasive prospective observational descriptive study carried out at a multi-specialty tertiary care teaching hospital situated in rural Tamil Nadu, India. Male and female coronary heart disease (CHD) patients aged 35-75 years newly diagnosed or those having a history of CHD were included. The intervention group received enoxaparin for 5 days. A series of resting the electrocardiogram, prothrombin time and ADRs were measured in all patients during days 1 and 21 respectively. RESULTS: Compared to unfractionated heparin group of patients, the average prothrombin time was significantly higher (P < 0.0001) whereas hypokalemia was significantly lower (P < 0.02) in enoxaparin group of patients. Even though recurrence of angina and ADRs such as bleeding, nausea, headache and sudden cough occurred less frequently in the enoxaparin group of patients compared to unfractionated heparin group of patients, the differences were not significant. CONCLUSIONS: Antithrombotic therapy with enoxaparin plus aspirin was safer and more effective than unfractionated heparin plus aspirin, in reducing the incidence of ischemic events in patients with unstable angina or myocardial infarction in the early phase.

Impact of medication and psychological behaviour assessment by community pharmacists in type 2 diabetes mellitus patients after hospital stay.

BACKGROUND: Drug related problem (DRPs) is a key factor which will affect the outcome of therapy and safety. OBJECTIVE: To assess the DRPs in type 2 diabetes mellitus (T2DM) patients and psychological aspects of patients by community pharmacists to observe the rate of DRP. METHODS: Prospective randomized controlled intervention study involved T2DM patients and conducted in two community pharmacies at Kanpur from January 2012 to December 2012. The assessment of DRPs was based on the PCNE. Changes in glycosylated hemoglobin (HBA1c), low density lipoproteins (LDL), blood pressure(BP), foot examinations, changes medical and medication utilization were studied. Using as control group, received usual care, and interventional group provided, intervened with use of the standard treatment guidelines (STG). Researcher provided the knowledge to community pharmacists and patients. Baseline and interventional data were collected at 0,3,6,9 and 12 months. RESULTS: Over the 12 month study, participants' average HBA1C reduced from 8.9% at initial visit to 7.5%. During this time, the eye examination rate was raised from 31% to 48%, and the foot examination rate was raised from 35% to 50%. CONCLUSION: The intervention of pharmacists showed little influence on any of the intermediate health outcomes in T2DM.

Evaluation of Anti-Inflammatory; Antinociceptive and Antipyretic Effects of Methanol Extract of Cleome Chelidonii

The methanol extract of Cleome chelidonii whole plant was investigated for its anti-inflammatory; antinociceptive and antipyretic activities at the doses of 50; 100 and 200 mg/kg of body weight. The experimental paradigms used were carrageenan-induced pedal edema for anti-inflammatory activity; acetic acid-induced writhing and hot plate methods to assess antinociceptive activity and yeast-induced hyperpyrexia to evaluate the antipyretic activity. In acute phase inflammation; at dose of 200 mg/kg of body weight after 3 hours treatment with methanol extract of C. chelidonii in carrageenan showed a maximum inhibition of 54.6(P 0.05) when compared with standard drug aspirin (10 mg/kg); which showed decreased formation of granuloma tissue by 60.6(P 0.01). The methanol extract possesses significant (P 0.05) antinociceptive activity in both paradigms. In rats a significant (P 0.01) reduction in hyperpyrexia was also produced by the extract. This study exhibits that the methanol extract of entire plant of C. chelidonii possesses anti-inflammatory; antinociceptive and antipyretic activities