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Blood sample collection in small laboratory animals
S Parasuraman, R Raveendran, R Kesavan
July-December 2010, 1(2):87-93
DOI:10.4103/0976-500X.72350  PMID:21350616
  69,215 11,652 252
How to calculate sample size in animal studies?
Jaykaran Charan, ND Kantharia
October-December 2013, 4(4):303-306
DOI:10.4103/0976-500X.119726  PMID:24250214
Calculation of sample size is one of the important component of design of any research including animal studies. If a researcher select less number of animals it may lead to missing of any significant difference even if it exist in population and if more number of animals selected then it may lead to unnecessary wastage of resources and may lead to ethical issues. In this article, on the basis of review of literature done by us we suggested few methods of sample size calculations for animal studies.
  55,497 15,808 427
Critical appraisal skills programme
Jatinder Singh
January-March 2013, 4(1):76-77
  37,648 6,756 80
Sugar substitutes: Health controversy over perceived benefits
Kirtida R Tandel
October-December 2011, 2(4):236-243
DOI:10.4103/0976-500X.85936  PMID:22025850
Sugar is an inseparable part of the food we consume. But too much sugar is not ideal for our teeth and waistline. There have been some controversial suggestions that excessive sugar may play an important role in certain degenerative diseases. So artificial sweeteners or artificially sweetened products continue to attract consumers. A sugar substitute (artificial sweetener) is a food additive that duplicates the effect of sugar in taste, but usually has less food energy. Besides its benefits, animal studies have convincingly proven that artificial sweeteners cause weight gain, brain tumors, bladder cancer and many other health hazards. Some kind of health related side effects including carcinogenicity are also noted in humans. A large number of studies have been carried out on these substances with conclusions ranging from "safe under all conditions" to "unsafe at any dose". Scientists are divided in their views on the issue of artificial sweetener safety. In scientific as well as in lay publications, supporting studies are often widely referenced while the opposing results are de-emphasized or dismissed. So this review aims to explore the health controversy over perceived benefits of sugar substitutes.
  30,317 4,896 77
Switch over from intravenous to oral therapy: A concise overview
Jissa Maria Cyriac, Emmanuel James
April-June 2014, 5(2):83-87
DOI:10.4103/0976-500X.130042  PMID:24799810
Majority of the patients admitted to a hospital with severe infections are initially started with intravenous medications. Short intravenous course of therapy for 2-3 days followed by oral medications for the remainder of the course is found to be beneficial to many patients. This switch over from intravenous to oral therapy is widely practiced in the case of antibiotics in many developed countries. Even though intravenous to oral therapy conversion is inappropriate for a patient who is critically ill or who has inability to absorb oral medications, every hospital will have a certain number of patients who are eligible for switch over from intravenous to oral therapy. Among the various routes of administration of medications, oral administration is considered to be the most acceptable and economical method of administration. The main obstacle limiting intravenous to oral conversion is the belief that oral medications do not achieve the same bioavailability as that of intravenous medications and that the same agent must be used both intravenously and orally. The advent of newer, more potent or broad spectrum oral agents that achieve higher and more consistent serum and tissue concentration has paved the way for the popularity of intravenous to oral medication conversion. In this review, the advantages of intravenous to oral switch over therapy, the various methods of intravenous to oral conversion, bioavailability of various oral medications for the switch over program, the patient selection criteria for conversion from parenteral to oral route and application of intravenous to oral switch over through case studies are exemplified.
  24,812 3,749 59
Toxicological screening
S Parasuraman
April-June 2011, 2(2):74-79
DOI:10.4103/0976-500X.81895  PMID:21772764
Toxicity testing of new compounds is essential for drug development process. The preclinical toxicity testing on various biological systems reveals the species-, organ- and dose- specific toxic effects of an investigational product. The toxicity of substances can be observed by (a) studying the accidental exposures to a substance (b) in vitro studies using cells/ cell lines (c) in vivo exposure on experimental animals. This review mainly focuses on the various experimental animal models and methods used for toxicity testing of substances. The pre-clinical toxicity testing helps to calculate "No Observed Adverse Effect Level" which is needed to initiate the clinical evaluation of investigational products.
  21,625 4,984 132
Improving bioscience research reporting: The ARRIVE guidelines for reporting animal research
Carol Kilkenny, William J Browne, Innes C Cuthill, Michael Emerson, Douglas G Altman
July-December 2010, 1(2):94-99
DOI:10.4103/0976-500X.72351  PMID:21350617
  17,199 2,254 333
Measurement of invasive blood pressure in rats
Subramani Parasuraman, Ramasamy Raveendran
April-June 2012, 3(2):172-177
DOI:10.4103/0976-500X.95521  PMID:22629093
Blood pressure (BP) is one of the vital parameters used to assess the cardiovascular functions of a mammal. BP is commonly recorded using invasive, noninvasive, and radio telemetry methods, but invasive blood pressure (IBP) recording is considered the gold standard. IBP provides a direct indication of the effect of the investigational products on the circulatory system. Recording the IBP in rodents is an essential part of the preliminary screening of any product to determine its effect on the cardiovascular system. The present article describes the measurement of the IBP in Wistar rats/Sprague Dawley rats.
  17,201 2,140 3
A novel potential role of Vitamin K2-7 in relieving peripheral neuropathy
Dilip S Mehta, Yogesh A Dound, Shashank S Jadhav, Abhay A Bhave, Milind Devale, Ashok D B Vaidya
October-December 2018, 9(4):180-185
Objective: To assess the efficacy, tolerability and safety of vitamin K2-7 in patients with peripheral neuropathy (PN). Materials and Methods: This study was conducted in 100 patients with PN suffering from VBD or T2DM. Vitamin K2-7 capsules (200 mcg) were given orally for 8 weeks followed up to the 12th week. Symptoms included tingling and numbness along with weakness, fatigue, and cramps. The intensity of the symptoms of PN was assessed on a Visual Analog Scale (VAS). Results: At baseline, the VAS score was 6–9 for VBD group and 8–10 for T2DM group. After treatment with Vitamin K2-7 by the 12th week, VAS score had reduced to 1–2 in both groups. The decrease was statistically significant (P < 0.0001). Conclusion: For the first time, in larger sample size, it has been shown that Vitamin K2-7, 200 mcg for 8 weeks, has a therapeutic activity for the symptoms of PN in VBD and T2DM. The reduction in symptoms was persistent in spite of de-challenge of Vitamin K2-7. Vitamin K2-7 was also well tolerated by all the patients. Thus, it can be concluded that Vitamin K2-7 has potential therapeutic effects for PN due to VBD or T2DM.
  16,426 511 -
CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials
Kenneth F Schulz, Douglas G Altman, David Moher
July-December 2010, 1(2):100-107
DOI:10.4103/0976-500X.72352  PMID:21350618
  14,474 2,455 236
Measures of central tendency: Median and mode
S Manikandan
July-September 2011, 2(3):214-215
DOI:10.4103/0976-500X.83300  PMID:21897729
  13,399 1,892 41
Antibiotic sensitivity profile of bacterial pathogens in postoperative wound infections at a tertiary care hospital in Gujarat, India
Nutanbala N Goswami, Hiren R Trivedi, Alpesh Puri P Goswami, Tejas K Patel, CB Tripathi
July-September 2011, 2(3):158-164
DOI:10.4103/0976-500X.83279  PMID:21897707
Objective: To find out the most common bacterial pathogens responsible for post-operative wound infection and their antibiotic sensitivity profile. Materials and Methods: This prospective, observational study was carried out in patients of postoperative wound infection. Samples from wound discharge were collected using a sterile swab and studied for identification of isolates by Gram stains and culture growth followed by in vitro antibiotic susceptibility testing performed by disc diffusion method on Mueller Hinton agar. Results: Out of 183 organisms, 126 (68.85%) isolated organisms were gram negative. Staphylococcus aureus, 48 (26.23%), was the predominant organism. S. aureus was sensitive to rifampicin (89.58%), levofloxacin (60.42%), and vancomycin (54.17%). Pseudomonas aeruginosa was sensitive to ciprofloxacin (83.78%), gatifloxacin (51.35%), and meropenem (51.35%). Escherichia coli was sensitive to levofloxacin (72.41%) and ciprofloxacin (62.07%). Klebsiella pneumoniae was sensitive to ciprofloxacin (63.16%), levofloxacin (63.16%), gatifloxacin (63.16%), and linezolid (56.52%). Proteus mirabilis was sensitive to ciprofloxacin (75%) and linezolid (62.50). Proteus vulgaris was sensitive to ampicillin+sulbactam (57.14%) followed by levofloxacin (50%). Conclusions: There is an alarming increase of infections caused by antibiotic-resistant bacteria, particularly in the emergence of VRSA/VISA, meropenem, and third generation cephalosporin resistant Pseudomonas aeruginosa. Linezolid showing sensitivity against Gram negative bacteria.
  13,082 1,605 18
Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis
Jaykaran Charan, Jagdish P Goyal, Deepak Saxena, Preeti Yadav
October-December 2012, 3(4):300-303
DOI:10.4103/0976-500X.103685  PMID:23326099
Objectives : To explore the effect of vitamin D supplementation in prevention of respiratory tract infections on the basis of published clinical trials. Materials and Methods : Clinical trials were searched from various electronic databases. Five clinical trials were suitable for inclusion. Outcome was events of respiratory tract infections in vitamin D group and placebo group. Data was reported as odds ratio with 95% confidence interval. Both random and fixed model was used for analysis. Analysis was done with the help of Comprehensive meta-analysis software 2. Results : Events of respiratory tract infections were significantly lower in vitamin D group as compared to control group [Odds ratio = 0.582 (0.417 - 0.812) P = 0.001] according to random model. Results were similar in fixed model. On separate analysis of clinical trials dealing with groups of children and adults, beneficial effect of vitamin D was observed in both, according to fixed model [Odds ratio = 0.579 (0.416 - 0.805), P = 0.001 and Odd ratio = 0.653 (0.472 - 0.9040, P = 0.010 respectively]. On using random model beneficial effect persisted in children's group but became nonsignificant in adults group [Odds ratio = 0.579 (0.416 - 0.805), P = 0.001 and Odd ratio = 0.544 (0.278 - 1.063) P = 0.075 respectively]. Conclusion : Vitamin D supplementation decreases the events related to respiratory tract infections. There is need of more well conducted clinical trials to reach to a certain conclusion.
  10,822 3,730 110
Mesotherapy - The french connection
G Sivagnanam
January-June 2010, 1(1):4-8
DOI:10.4103/0976-500X.64529  PMID:21808584
Mesotherapy involves the use of multiple intradermal or subcutaneous injections of a mixture of compounds in minute doses, by means of very fine needles, directly over/near the affected sites. Originally invented in France to manage painful medical conditions, it is presently the buzz word in the field of cosmetic dermatology, chiefly to get rid of disfiguring fat. Depending upon the condition treated, the drugs injected, the techniques followed and the number of sessions involved vary. The wider reception of mesotherapy by its stakeholders are probably due to factors like inexpensive equipments, relatively minimal training for providers, much reduced dosage need of the drugs with resultant minimal untoward effects, quicker realization of benefits, minimal invasiveness/pain involved and not the least it is an outpatient procedure. Despite so many plus points, it has to be noted that currently there is a dearth of rigorous scientific studies to prove its efficacy and safety. Further, the average cost per session alone ranges from 200 USD to 600 USD.
  12,593 1,951 17
Lercanidipine in the management of hypertension: An update
Guido Grassi, Nicolàs R Robles, Gino Seravalle, Francesco Fici
October-December 2017, 8(4):155-165
DOI:10.4103/jpp.JPP_34_17  PMID:29472747
Calcium channel blockers (CCBs), particularly dihydropyridine-CCBs, (DHP-CCBs), have an established role in antihypertensive therapy, either as monotherapy or in combination with other antihypertensive drugs. Two hundred and fifty-one papers published in PubMed in English between January 1, 1990, and October 31, 2016, were identified using the keyword “lercanidipine.” Lercanidipine is a lipophilic third-generation DHP-CCB, characterized by high vascular selectivity and persistence in the smooth muscle cell membranes. Lercanidipine is devoid of sympathetic activation, and unlike the first and second generation of DHP-CCBs, it dilates both the afferent and the efferent glomerular arteries, while preserving the intraglomerular pressure. In addition, lercanidipine prevents renal damage induced by angiotensin II and demonstrates anti-inflammatory, antioxidant, and anti-atherogenic properties through an increasing bioavailability of endothelial nitric oxide. It is associated with a regression of microvascular structural modifications in hypertensive patients. The efficacy of lercanidipine has been demonstrated in patients with different degrees of hypertension, in the young and elderly and in patients with isolated systolic hypertension. In patients with diabetes and renal impairment, lercanidipine displays a renal protection with a significant decrease of microalbuminuria and improvement of creatinine clearance. Lercanidipine is well tolerated and is associated with a very low rate of adverse events, particularly ankle edema, compared with amlodipine and nifedipine. In conclusion, lercanidipine produces a sustained blood pressure-lowering activity with a high rate of responder/normalized patients, associated with a favorable tolerability profile.
  11,730 2,713 8
An overview of the extraarticular involvement in rheumatoid arthritis and its management
Subham Das, Prasanta Padhan
July-September 2017, 8(3):81-86
DOI:10.4103/jpp.JPP_194_16  PMID:29081614
Rheumatoid arthritis (RA) is an autoimmune systemic disease characterized by long-standing inflammation and significant joint destruction. Despite significant research and success toward the treatment modalities, complete remission still remains a challenge. Even then a number of early and late extraarticular manifestations (EAMs) of the disease further complicate the disease progression. Various EAM encountered in RA can involve more than one organ or system in the body and their clinical features also show lot of variations, mostly involving cutaneous, cardiovascular, and pulmonary systems. The mortality associated with EAM may also be quite high in RA, sometimes more than the disease itself. These EAMs are difficult to diagnose and even more difficult to treat since no clear consensus exists among the rheumatologists as to their correct classification and also due to the fact that no clearcut guidelines are available for their treatment. With this background knowledge, the present review focuses on the various EAMs of RA, their classification, clinical features, and general management overview.
  13,116 839 -
The blood blues: A review on methemoglobinemia
Sheba Rani David, Nora Syahirah Sawal, Muhammad Nur Salam Bin Hamzah, Rajan Rajabalaya
January-March 2018, 9(1):1-5
Methemoglobinemia is a blood disorder in which there is an abnormal amount of methemoglobin (MetHb) formation, thus unable to release oxygen effectively to body tissues. This is mainly because MetHb is the altered state of hemoglobin (Hb) wherein the ferrous iron of heme has been oxidized to the ferric state. This review paper discusses in detail about the different types of methemoglobinemia and their causes with biochemical pathway and mechanisms. Patients with high MetHb in the blood will appear blue when they have cyanosis but can be cured with the methylene blue solution. However, a proper management should be laid out for strategic treatment. This review will be useful to health-care providers, pharmacists, biochemists, and researchers to understand the basics of methemoglobinemia and its current treatment with guidelines. This review will benefit the readers to understand and will be a ready reference for methemoglobinemia.
  13,023 915 -
L-asparaginase in the treatment of patients with acute lymphoblastic leukemia
Rachel A Egler, Sanjay P Ahuja, Yousif Matloub
April-June 2016, 7(2):62-71
DOI:10.4103/0976-500X.184769  PMID:27440950
Acute lymphoblastic leukemia (ALL) is a hematologic malignancy that predominantly occurs in children between 2 and 10 years of age. L-asparaginase is an integral component of treatment for patients with ALL and since its introduction into pediatric treatment protocols in the 1960s, survival rates in children have progressively risen to nearly 90%. Outcomes for adolescent and young adult (AYA) patients, aged 15-39 years and diagnosed with ALL, have historically been less favorable. However, recent reports suggest substantially increased survival in AYA patients treated on pediatric-inspired protocols that include a greater cumulative dose of asparaginase. All  currently available asparaginases share the same mechanism of action - the deamination and depletion of serum asparagine levels - yet each displays a markedly different pharmacokinetic profile. Pegylated asparaginase derived from the bacterium Escherichia coli is used as first-line therapy; however, up to 30% of patients develop a treatment-limiting hypersensitivity reaction. Patients who experience a hypersensitivity reaction to an E. coli-derived asparaginase can continue treatment with Erwinia chrysanthemi asparaginase. Erwinia asparaginase is immunologically distinct from E. coli-derived asparaginases and exhibits no cross-reactivity. Studies have shown that with adequate dosing, therapeutic levels of Erwinia asparaginase activity can be achieved, and patients switched to Erwinia asparaginase due to hypersensitivity can obtain outcomes similar to patients who do not experience a hypersensitivity reaction. Therapeutic drug monitoring may be required to ensure that therapeutic levels of asparaginase activity are maintained.
  11,074 2,698 78
Vitamin D: The "sunshine" vitamin
Rathish Nair, Arun Maseeh
April-June 2012, 3(2):118-126
DOI:10.4103/0976-500X.95506  PMID:22629085
Vitamin D insufficiency affects almost 50% of the population worldwide. An estimated 1 billion people worldwide, across all ethnicities and age groups, have a vitamin D deficiency (VDD). This pandemic of hypovitaminosis D can mainly be attributed to lifestyle (for example, reduced outdoor activities) and environmental (for example, air pollution) factors that reduce exposure to sunlight, which is required for ultraviolet-B (UVB)-induced vitamin D production in the skin. High prevalence of vitamin D insufficiency is a particularly important public health issue because hypovitaminosis D is an independent risk factor for total mortality in the general population. Current studies suggest that we may need more vitamin D than presently recommended to prevent chronic disease. As the number of people with VDD continues to increase, the importance of this hormone in overall health and the prevention of chronic diseases are at the forefront of research. VDD is very common in all age groups. As few foods contain vitamin D, guidelines recommended supplementation at suggested daily intake and tolerable upper limit levels. It is also suggested to measure the serum 25-hydroxyvitamin D level as the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D2 or vitamin D3 is recommended for deficient patients. A meta-analysis published in 2007 showed that vitamin D supplementation was associated with significantly reduced mortality. In this review, we will summarize the mechanisms that are presumed to underlie the relationship between vitamin D and understand its biology and clinical implications.
  11,706 1,809 10
Accessibility and use of essential medicines in health care: Current progress and challenges in India
Dipika Bansal, Vilok K Purohit
January-March 2013, 4(1):13-18
DOI:10.4103/0976-500X.107642  PMID:23662019
Essential Medicine Concept, a major breakthrough in health care, started in 1977 when World Health Organization (WHO) published its first list. Appropriate use of essential medicines is one of the most cost-effective components of modern health care. The selection process has evolved from expert evaluation to evidence-based selection. The first Indian list was published in 1996 and the recent revision with 348 medicines was published in 2011 after 8 years. Health expenditure is less in India as compared to developed countries. India faces a major challenge in providing access to medicines for its 1.2 billion people by focusing on providing essential medicines. In the future, countries will face challenges in selecting high-cost medicines for oncology, orphan diseases and other conditions. There is a need to develop strategies to improve affordable access to essential medicines under the current health care reform.
  11,952 1,067 6
The curious case of zinc for diarrhea: Unavailable, unprescribed, and unused
B Gitanjali, K Weerasuriya
October-December 2011, 2(4):225-229
DOI:10.4103/0976-500X.85933  PMID:22025848
  10,834 2,091 10
Measures of central tendency: The mean
S Manikandan
April-June 2011, 2(2):140-142
DOI:10.4103/0976-500X.81920  PMID:21772786
  10,771 1,893 15
Rabeprazole and esomeprazole in mild-to-moderate erosive gastroesophageal reflux disease: A comparative study of efficacy and safety
Rituparna Maiti, Jyothirmai Jaida, PL John Israel, Narendar Koyagura, Sruthi Mukkisa, Anuradha Palani
July-September 2011, 2(3):150-157
DOI:10.4103/0976-500X.83278  PMID:21897706
Objective: To compare the efficacy and safety of rabeprazole and esomeprazole in mild-to-moderate erosive gastroesophageal reflux disease (GERD). Materials and Methods: A randomized, single-blinded, outdoor-based clinical study was conducted on 60 patients of mild-to-moderate erosive GERD. After baseline clinical assessment and investigations, rabeprazole (40 mg) was prescribed to 30 patients and esomeprazole (40 mg) to another 30 patients for 4 weeks. The efficacy variables were change in GERD symptom scoring, endoscopic findings, and Quality of Life in Reflux and Dyspepsia (QOLRAD) scoring over 4 weeks. Result: Heartburn, acid regurgitation, and overall GERD symptom scoring (P = 0.01) were significantly decreased with rabeprazole in comparison to esomeprazole. The comparative study of all five domains of the QOLARD questionnaire including overall scoring revealed a statistically significant improvement in the rabeprazole group. Endoscopic findings in the rabeprazole group showed an absolute improvement of 30% and relative improvement of 55% over esomeprazole. Both the drugs were well tolerated having no significant difference in the incidence of adverse effects. Conclusion: Rabeprazole (40 mg) is a better choice for mild-to-moderate GERD compared with esomeprazole (40 mg) because of its better efficacy and safety profile.
  10,626 1,896 2
Evaluation of the aphrodisiac activity of Tribulus terrestris Linn. in sexually sluggish male albino rats
Surender Singh, Vinod Nair, Yogendra K Gupta
January-March 2012, 3(1):43-47
DOI:10.4103/0976-500X.92512  PMID:22368416
Objectives: To study the effect of acute and repeated dose administration of lyophilized aqueous extract of the dried fruits of Tribulus terrestris (LAET) on sexual function in sexually sluggish male albino rats. Materials and Methods: Aphrodisiac activity of the test drug was evaluated in terms of exhibited sexual behavior. In order to assess the effect of chronic T. terrestris exposure on the hypothalamus--pituitary--gonadal axis, testosterone level estimation and sperm count were carried out. Twenty-eight-day oral toxicity studies were carried out to evaluate the long-term effects of the LAET administration on different body systems. Results: A dose-dependent improvement in sexual behavior was observed with the LAET treatment as characterized by an increase in mount frequency, intromission frequency, and penile erection index, as well as a decrease in mount latency, intromission latency, and ejaculatory latency. The enhancement of sexual behavior was more prominent on chronic administration of LAET. Chronic administration of LAET produced a significant increase in serum testosterone levels with no significant effect on the sperm count. No overt body system dysfunctions were observed in 28-day oral toxicity study. Conclusions: Findings of the present study validate the traditional use of T. terrestris as a sexual enhancer in the management of sexual dysfunction in males.
  10,811 1,467 34
Push, promote or educate…musings of a pharmacologist on drug promotion
Chanolean Shashindran
October-December 2014, 5(4):225-226
DOI:10.4103/0976-500X.142427  PMID:25422560
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