Manish Barvaliya | BHAVNAGR UNIVERSITY (original) (raw)

Papers by Manish Barvaliya

Avicenna journal of phytomedicine, 2014

Materials and Methods : Thirty-six Wistar male rats were randomly divided into six equal groups. ... more Materials and Methods : Thirty-six Wistar male rats were randomly divided into six equal groups. Group A animals received distilled water for 28 days. Group B to group F animals received 1% v/v ethylene glycol in distilled water for 28 days and group B served as ethylene glycol control. Groups C and D (preventive groups) received aqueous extract of leaves of B. pinnatum 50 and 100 mg/kg intraperitoneally, respectively for 28 days. Groups E and F (treatment groups) received aqueous extract of leaves of B. pinnatum 50 and 100 mg/kg intraperitoneally, respectively from 15(th) to 28(th) day. On days 0 and 28, 24 hrs urine samples were collected for urinary volume and urinary oxalate measurement. On day 28, blood was collected for serum creatinine and blood urea level monitoring. All animals were sacrificed and kidneys were removed, weighed, and histopathologically evaluated for calcium oxalate crystals deposition. Administration of aqueous extract of leaves of B. pinnatum reduced urine ...

Indian journal of pharmaceutical sciences, 2013

Neuromuscular weakness is often found in patients receiving zidovudine therapy due to mitochondri... more Neuromuscular weakness is often found in patients receiving zidovudine therapy due to mitochondrial damage. Effect of zidovudine was evaluated in indirectly and directly stimulated isolated rat phrenic nerve hemidiaphragm preparations, by cumulative dose response curve with square wave pulses, 0.5 ms duration of 2 Hz at every 10 s. To understand the observed effect of zidovudine, interaction studies were carried out with rocuronium. Dose response curve of rocuronium was compared in the absence and in the presence of 1.2 and 12 mmol/ml zidovudine. In another set of experiment, intact animals were treated with zidovudine 50 and 100 mg/kg for 15 days and phrenic nerve hemidiaphragm was obtained for in vitro experiment. Effect of zidovudine (30 mmol/ml) on twitch responses inhibited by dantrolene 50 μmol/ml, magnesium chloride 8 mmol/ml, rocuronium 10 μmol/ml, succinylcholine 25 μmol/ml and lignocaine 600 μmol/ml was studied. Zidovudine (3-30 mmol/ml) significantly augmented the twitch ...

British journal of clinical pharmacology, Jan 11, 2014

A 49 years old male hypertensive patient developed myalgia and muscle weakness with elevation of ... more A 49 years old male hypertensive patient developed myalgia and muscle weakness with elevation of serum creatinine phosphokinase 5 times than the upper normal limit. Exclusion of other causes, positive de-challenge and re-challenge confirmed telmisartan as an offending agent. The reaction did not occur with olmesartan. Differences in lipophilicity and peroxisome proliferator activated receptor- gamma activating properties might be responsible for development of reaction with telmisartan but not with the olmesartan. Telmisartan should be used cautiously in patient receiving other myotoxic drugs. This case highlights the need to evaluate olmesartan as a safer alternative among angiotensin receptor blockers for patients at high risk of myotoxicity.

International journal of critical illness and injury science, 2013

The aim of this study is to evaluate the drug utilization pattern and pharmacoeconomic analysis i... more The aim of this study is to evaluate the drug utilization pattern and pharmacoeconomic analysis in critical care unit (CCU). Indoor case papers of patients admitted in CCU between January 2008 and December 2010 were analyzed for demographic variables; indications; duration of CCU stay; proportion of common drugs used. Use of antimicrobials was evaluated based on the culture report and empirical regimen used. Defined daily dose (DDD)/100 bed-days were calculated. Various World Health Organization prescribing indicators were evaluated. Cost of drugs was calculated from Indian Drug Review (2010). A total of 397 cases were evaluated with a mean age of 44.62 years (95% confidence interval [CI]: 42.56-46.69). Average duration of CCU stay was 4.15 days (95% CI: 3.79-4.51). The average number of drugs prescribed per patient was 13.54 (95% CI: 13.05-14.04). Total drug utilization in terms of DDD/100 bed-days was 226.27. Metronidazole, cefotaxime, atropine, adrenaline, dopamine, dobutamine, d...

Perspectives in clinical research, 2014

To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary ca... more To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary care teaching hospital. Retrospective analysis was performed for cases of elderly patients admitted between January 2010 and December 2010. Data on age, gender, diagnosis, duration of hospital stay, treatment, and outcome were collected. Prescriptions were assessed for the use of potentially inappropriate medications in geriatric patients by using American Geriatric Society Beer's criteria (2012) and PRISCUS list (2010). A total of 676 geriatric patients (52.12% females) were admitted in the medicine ward. The average age of geriatric patients was 72.69 years. According to Beer's criteria, at least one inappropriate medicine was prescribed in 590 (87.3%) patients. Metoclopramide (54.3%), alprazolam (9%), diazepam (8%), digoxin > 0.125 mg/day (5%), and diclofenac (3.7%) were the commonly used inappropriate medications. Use of nonsteroidal anti-inflammatory drugs (NSAIDs) in heart...

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2014

Epidemiological data on drug-induced anaphylactic reactions are limited in India and are largely ... more Epidemiological data on drug-induced anaphylactic reactions are limited in India and are largely depending on studies from developed countries. The aim was to analyze the published studies of drug-induced anaphylaxis reported from India in relation with causative drugs and other clinical characteristics. The electronic databases were searched for Indian publications from 1998 to 2013 describing anaphylactic reactions. The information was collected for demographics, set up in which anaphylaxis occurred, causative drugs, incubation period, clinical features, associated allergic conditions, past reactions, co-morbid conditions, skin testing, IgE assays, therapeutic intervention and mortality. Reactions were analyzed for severity, causality, and preventability. Data were extracted and summarized by absolute numbers, mean (95% confidence interval [CI]), percentages and odds ratio (OR) (95% CI). From 3839 retrieved references, 52 references describing 54 reactions were included. The mean ...

Journal of pharmacology & pharmacotherapeutics, 2014

To evaluate drug utilization pattern in terms of defined daily dose along with pharmacoeconomic a... more To evaluate drug utilization pattern in terms of defined daily dose along with pharmacoeconomic analysis in geriatric patients admitted in medical ward of a tertiary care hospital. Retrospective medical record analysis was performed for indoor cases of the geriatric patients (age ≥65 years) admitted in medicine ward from January 2010 to December 2010 were analyzed for demographics, indications for admission, various systems involved, duration of hospital stay, various drugs prescribed, and adverse drug reaction. The drugs were categorized by anatomical therapeutic classification and defined daily dose was calculated. The World Health Organization prescribing indicators were assessed. Cost of the drugs was calculated to assess the economic burden. Cardiovascular diseases were the common cause for admission. Antiplatelet drugs-B01AC (93%), H2 blockers-A02BA (77.22%), antiemetics-A03FA (67.6%), vasodilators-C01D (55%), and hypolipidemic drugs-C10AA (52%) were commonly utilized groups. ...

Journal of Pharmacology and Pharmacotherapeutics, 2012

A 12-year-male child developed toxic epidermal necrolysis (TEN) probably due to lamotrigine. The ... more A 12-year-male child developed toxic epidermal necrolysis (TEN) probably due to lamotrigine. The patient was on antiepileptic therapy (sodium valproate and clonazepam) since 6-7 months, and lamotrigine was added in the regimen 1-2 months back. A serious cutaneous reaction is more likely to occur during the first 2 months of starting lamotrigine. The use of lamotrigine as an add-on to valproate may have precipitated the reaction. Other drugs were ruled out based on the incubation period of TEN. Drug interactions should be kept in mind with multiple antiepileptic therapies. The patient died because of the severity of reactions and delay in starting the treatment with steroids. One must be vigilant in early detection of the reaction.

Indian Journal of Pharmacology, 2012

A nine year old female patient presented with complaints of severe colicky abdominal pain, vomiti... more A nine year old female patient presented with complaints of severe colicky abdominal pain, vomiting, and tingling with numbness for 3 days. Acute necrotizing pancreatitis associated with tetany due to anti-retroviral therapy was diagnosed. Stavudine was the probable causal agent. Unfortunately, the patient died due to severity of the reaction. High index of suspicion and early withdrawal of the offending drug may prevent further harm in such cases.

Indian Journal of Pharmacology, 2011

Indian Journal of Dermatology, Venereology, and Leprology, 2013

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe c... more Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare severe cutaneous drug reactions. No large scale epidemiological data are available for this disorder in India. Aims: To carry out a systematic review of the published evidence of the drug-induced SJS and TEN in Indian population. Methods: Publications from 1995 to 2011 describing SJS and TEN in Indian population were searched in PubMed, MEDLINE, EMBASE and UK PUBMED Central electronic databases. Data were collected for the causative drugs and other clinical characteristics of SJS and TEN from the selected studies. Results: From 225 references, 10 references were included as per selection criteria. The major causative drugs were antimicrobials (37.27%), anti-epileptics (35.73%) and non-steroidal anti-inflammatory drugs (15.93%). Carbamazepine (18.25%), phenytoin (13.37%), fluoroquinolones (8.48%) and paracetamol (6.17%) were most commonly implicated drugs. Regional differences were observed for fluoroquinolones, sulfa drugs and carbamazepine. Total 62.96% of patients showed systemic complications. Most common complications were ocular (40.29%) and septicemia (17.65%). Higher mortality was observed for TEN as compared to SJS (odd ratio-7.19; 95% confidence interval (CI) 1.62-31.92; p = 0.0023). Observed mortality is higher than expected as per SCORTEN score 3. Duration of hospital stay was significantly higher in TEN (20.6 days; 95% CI 14.4-26.8) as compared to SJS (9.7 days; 95% CI 5.8-13.6; p = 0.020). Cost of management was significantly higher in TEN (` 7910; 95% CI 5672-10147; p < 0.0001) as compared to SJS (` 2460; 95% CI 1762-3158). No statistical data were described for steroid use in the studies included. Conclusion: Carbamazepine, phenytoin, fluoroquinolones and paracetamol were the major causative drugs. TEN is showing higher mortality, morbidity and economic burden than SJS. How to cite this article: Patel TK, Barvaliya MJ, Sharma D, Tripathi C. A systematic review of the drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Indian population. Indian J Dermatol Venereol Leprol 2013;79:389-98.

Indian journal of pharmacology, 2011

A 3-year-old female patient developed chorea possibly due to an interaction between phenytoin, ph... more A 3-year-old female patient developed chorea possibly due to an interaction between phenytoin, phenobarbital and clobazam used for generalized tonic clonic seizures. Phenytoin withdrawal resulted in recovery within 24 hours. Post reaction computerized tomography (CT)-scan of brain was normal. Combined use of anti-seizure drugs and interactions between them may be responsible for the reaction. Therapeutic drug monitoring is important while prescribing two or more anti-seizure drugs.