Vikram Bhandari - Academia.edu (original) (raw)

Papers by Vikram Bhandari

Local Anaesthetics - a Critical Review

Local anaesthetics are the safest and efficient drugs in producing insensibility to pain in discr... more Local anaesthetics are the safest and efficient drugs in producing insensibility to pain in discrete regions of the body. Because of their enviable record of efficacy and safety in producing insensibility to pain in discrete regions of the body, local anaesthetics are administered in more ways than perhaps any other group of therapeutic agents. Today dentistry has a wide variety of local anaesthetics that permits pain control to be tailored to the specific needs of the patient. This article provides a brief overview of local anaesthetics used in dentistry.

Pharmacovigilance of ChAdOx1 nCoV-19 (COVISHIELD) Vaccine after first and second dose in volunteers in Punjab, India

Asian Journal of Pharmacy and Pharmacology

Effect of intermittent fasting on various health parameters in obese type 2 diabetics: A pilot study

National Journal of Physiology, Pharmacy and Pharmacology

Background: Diabetes mellitus type 2 is fast becoming a cause of concern for governments world ov... more Background: Diabetes mellitus type 2 is fast becoming a cause of concern for governments world over and people at large as it has immense socio-economic impact. A diabetic patient usually goes through phases of being overweight, obese, and insulin-resistant before being classified as a patient of type 2 diabetes. Fasting, though practiced for centuries, is a novel approach for delaying progression and possibly reversing diabetes mellitus. Aim and Objectives: The aim of the study is to look for the effect of intermittent fasting on various health parameters in obese type 2 diabetics. Materials and Methods: The study was conducted at a tertiary care facility in Amritsar. Twelve obese volunteers in the age group of 20–60 years with type 2 diabetes mellitus not controlled with metformin alone were included in the study. All the participants were told to follow intermittent fasting protocol of 16:8 for a period of 4 weeks. At the beginning of the study, weight, height, body mass index, waist circumference, waist-hip ratio, fasting blood sugar, and serum insulin, were recorded in each participant. At the end of the 4 weeks period, all the measurements were repeated and compared with baseline values using the student t-test. Results: There was a highly significant decrease in the anthropometric indices and fasting blood sugar as compared to baseline values at the end of the 4-week period without any change in fasting serum insulin levels. Conclusion: There is a favorable effect of intermittent fasting on anthropometric indices and fasting blood sugar levels without any improvement in fasting serum insulin.

Correlation of body fat distribution and lipid profile in males of the Northwest region of Punjab

International Journal of Medical Science and Public Health

Background: The prevalence of obesity has substantially increased over the past few decades. Cent... more Background: The prevalence of obesity has substantially increased over the past few decades. Central obesity, in particular, has a major role in the development of various metabolic disturbances including deranged lipid profile which leads to increased risk of cardiovascular diseases. Timely assessment of any changes in lipid profile can help the prevention of cardiovascular diseases in obese men. Objectives: The objective of this study was to evaluate the association of abnormal waist-hip ratio (WHR) with the lipid profile in healthy men. Materials and Methods: The study was conducted in the tertiary care center of Amritsar. Two groups of 50 men each of the age group of 20–40 years were enrolled in the study. Group I included men with normal WHR while Group II included men with increased WHR. Lipid profile including cholesterol, triglycerides (TGs), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) was measured by standard methods. Statistical analysis was done by Student’s t-test and correlation was established using correlation coefficient. Results: Evaluation of lipid profile showed that serum cholesterol, TGs, LDL, and VLDL were higher in Group II than in Group I while HDL was lower in Group II than in Group I. Central obesity (WHR) has direct association with deranged lipid profile. Conclusion: It can be concluded that visceral or central obesity has direct correlation with the fasting lipid profile in men of the Northwest region of Punjab and WHR is a more reliable predictor of risk.

International Journal of Basic and Clinical Pharmacology, 2016

Background: Lithium is used commonly in bipolar illness. It is co administered with many other dr... more Background: Lithium is used commonly in bipolar illness. It is co administered with many other drugs like imipramine, fluoxetine to improve the clinical efficacy of the therapy. Co administrations of other drugs like NSAIDS and GIT drugs for various ailments are also common. As this drug possesses a narrow therapeutic range, effect of other drugs on its pharmacokinetic parameters is important to achieve its therapeutic goal as well as to avoid serious adverse effect. Methods: Total n= 30 human volunteers were enrolled in the study. After randomization subjects were divided into three study groups. Group 1 was given lithium (900mg) alone while group 2 and 3 were given lithium (900mg) and imipramine (25mg) at 0h. Group 3 patients were administered propantheline (15mg) 1 hr prior to lithium and imipramine. Results: In group 2 (Li+Imp) treatment with imipramine produced a significant decrease in C max (p<0.01), increase in Tmax (p<0.001) and a significant fall in AUC (p<0.001) of lithium. There was no significant change in Kel and hence no change in T1/2 was observed. In group 3 ((Li+Imp+Pro) addition of propantheline accentuated the imipramine induced fall in serum lithium concentration at all the sampling points as shown in Figure 1. It significantly accentuated the imipramine induced fall in Cmax of lithium (p<0.05) and prolonged the T max. There was no significant difference between Kel, T 1/2 and AUC of group 2 (Li+Imp) versus group 3 (Li+Imp+Pro). Conclusions: Propantheline even being the anticholinergic drug was unable to show its effect, this is due to high ceiling masking in antagonistic action of imipramine.

International Journal of Basic & Clinical Pharmacology, May 23, 2017

Nociceptive component of pain is the pain that results from activation of nociceptor neurons by i... more Nociceptive component of pain is the pain that results from activation of nociceptor neurons by intense mechanical, chemical, or thermal noxious stimuli like a scalpel blade cutting through skin. It signals the presence, ABSTRACT Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with coadministered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period. Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded. Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a period of 24 hours. Conclusions: Gabapentin in the doses used was found to be effective in postoperative pain in patients undergoing planned laparoscopic cholecystectomy. It was found to be safe and no serious adverse events were reported.

Pharmacovigilance is the pharmacological science relating to the detection, assessment, understan... more Pharmacovigilance is the pharmacological science relating to the detection, assessment, understanding, and prevention of adverse effects, particularly the long-term and short-term adverse effects of drugs or treatment. The World Health Organization (WHO) established pharmacovigilance Programme for International Drug Monitoring in response to the thalidomide disaster detected in 1961. India joined the WHO adverse drug reaction (ADR) monitoring program based in Uppsala, Sweden, in 1998. The Central Drugs Standard Control Organization (CDSCO), Directorate General of Health Services, under the aegis of the Ministry of Health and Family Welfare, Government of India, in collaboration with Indian Pharmacopoeia Commission, Ghaziabad, is a National Coordinating Centre (NCC). Adverse drug reaction monitoring centers (AMCs) under the Pharmacovigilance Programme of India (PvPI) play a vital role in the collection and follow-up of ADR reports from the patients, as drug trials in animals and humans (Phase I-III) do not predict accurately the adverse drug events. Patients with chronic kidney disease (CKD)/liver disease are at risk of enhanced drug-related events. These patients should be closely monitored for any adverse events and it should be reported. Thus, inculcating the habit of ADR reporting will help in generating data specific to Indian population and will contribute toward patient safety. This will also help in modifying the treatment given to the patients, as early identification of ADRs will help in reducing morbidity and mortality in patients.

Current Trends in diagnosis & Treatment

Introduction: Adverse drug reactions (ADRs) constitute a significant economic burden on society. ... more Introduction: Adverse drug reactions (ADRs) constitute a significant economic burden on society. ADRs to skin are common; however, information about their incidence, severity, and ultimate health effects is scanty. The aim of the present study was to detect, document, assess, and report the suspected ADRs in the Department of Dermatology at a tertiary care teaching hospital, Amritsar, so as to treat ADRs and also stop the indiscriminate use of drugs in clinical practice. Materials and methods: A prospective study was undertaken in patients presenting with ADRs in the outpatient Department of Dermatology in the tertiary care teaching hospital, Amritsar, Punjab, from June 2015 to May 2018. The data obtained were collected, compared, and reviewed, calculating the percentage to assess their significance and evaluation. A total of 152 ADRs were detected during the study period. Results: The most common age group presenting with adverse cutaneous drug reactions (ACDRs) was 18-35 years (54%) and the most common ADR was urticaria (30.2%) followed by fixed drug eruptions (16.4%). The most common drugs responsible for ACDRs were non-steroidal anti-inflammatory drugs (NSAIDs) and fluoroquinolones followed by systemic steroids, oral contraceptive pills, ampicillin, angiotensin converting enzyme (ACE) inhibitors, antimalarial, clofazimine, and so on. According to the WHO causality assessment, 13.0% cases were certain, 56.1% were probable, and 30.7% were possible in nature. On severity assessment by the modified Hartwig and Siegel scale, 72.3% ACDRs were mild, 25% were moderate, and 2.05% cases were of severe category. Preventability assessment by the modified Schumock and Thornton scale revealed that 69.1% ACDRs were definitely probable, 20.51% were probably preventable, and 13.8% were not preventable. Conclusion: The study findings indicate that ADR reporting helps in identifying the most common drugs associated with dermatological reactions. Thus it helps us to provide better patient treatment by the early identification and management of dermatological reactions.

Current Trends in diagnosis & Treatment

Pharmacovigilance is the pharmacological science relating to the detection, assessment, understan... more Pharmacovigilance is the pharmacological science relating to the detection, assessment, understanding, and prevention of adverse effects, particularly the long-term and short-term adverse effects of drugs or treatment. The World Health Organization (WHO) established pharmacovigilance Programme for International Drug Monitoring in response to the thalidomide disaster detected in 1961. India joined the WHO adverse drug reaction (ADR) monitoring program based in Uppsala, Sweden, in 1998. The Central Drugs Standard Control Organization (CDSCO), Directorate General of Health Services, under the aegis of the Ministry of Health and Family Welfare, Government of India, in collaboration with Indian Pharmacopoeia Commission, Ghaziabad, is a National Coordinating Centre (NCC). Adverse drug reaction monitoring centers (AMCs) under the Pharmacovigilance Programme of India (PvPI) play a vital role in the collection and follow-up of ADR reports from the patients, as drug trials in animals and huma...

Awareness among pregnant women regarding the use and safety of drugs during pregnancy in the state of Punjab: A cross-sectional observational study

International Journal of Medical Science and Public Health

Background: Indiscriminate use of drugs and cosmetics among a pregnant woman is always a challeng... more Background: Indiscriminate use of drugs and cosmetics among a pregnant woman is always a challenge in the antenatal care for health-care providers especially in developing countries. There is a potential risk to the growing fetus due to irrational use of drugs and cosmetics during pregnancy awareness, and adequate knowledge of their use can prevent many drug-induced complications during pregnancy. Objective: The objective of the study was to evaluate the awareness among pregnant women regarding the use and safety of drugs and cosmetics. Materials and Methods: A cross-sectional observational study was conducted in various antenatal clinics of the state of Punjab. 500 pregnant women were enrolled in the study and the questionnaire was prepared in the local language to assess the knowledge and beliefs of pregnant women. Data analysis was done using Chi-square test. Results: A very few pregnant women had knowledge that drugs have any effect on the fetus and less than half believe that drugs should be taken only by consultation by the doctor. Majority pregnant women believe that sufficient time and attention are not given by a doctor during an appointment. Only 2% of women had the idea of antenatal sessions. More than half of the pregnant women considered alternative remedies to be more safe in pregnancy while a very few had the idea that cosmetics are safe in pregnancy. Conclusion: Thus, it can be concluded that the majority of participants in the study have poor knowledge regarding benefits and adverse effects of the use of drugs and cosmetics during pregnancy.

Parasympathetic nervous system changes after the menopause: A comparative study

National Journal of Physiology, Pharmacy and Pharmacology

Comparative analysis of sympathetic nervous system activity in pre and #8209;menopausal and post-menopausal women

National Journal of Physiology, Pharmacy and Pharmacology

Background: Post-menopausal women suffer from various complications like autonomic dysfunction wh... more Background: Post-menopausal women suffer from various complications like autonomic dysfunction which predisposes them to cardiovascular morbidity. Decline in estrogen levels after menopause is associated with increased cardiovascular risks. Timely evaluation of such derangements and active intervention can play an important role in the prevention of cardiovascular morbidity. Aims and Objective: The aim is to compare the sympathetic autonomic nervous system activity in pre-menopausal and age-matched post-menopausal women. Materials and Methods: This study was conducted on two groups of 40 women each. Group I included pre-menopausal women and Group II included post-menopausal women. Sympathetic nervous system assessment was done using cold pressor test (CPT), handgrip test (HGT), and blood pressure (BP) response to standing. Statistical analysis was performed using Student’s t-test. Results: Evaluation of sympathetic functions between the two groups showed that the mean rise in systolic BP (SBP) in response to CPT was lower in Group I than in Group II (P < 0.01). Mean rise in the diastolic BP (DBP) in response to HGT was also lower in Group I as compared to Group II (P < 0.01). Fall in SBP on standing in Group I was more than in Group II (P < 0.01). Conclusion: Sympathetic nervous system evaluation showed sympathetic hyperactivity in the post-menopausal group as compared to the premenopausal group.

International Journal of Basic & Clinical Pharmacology

Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects... more Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with co-administered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period.Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded.Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a per...

Improved pharmacokinetic and pharmacodynamic attributes of artemether-lumefantrine-loaded solid SMEDDS for oral administration

The Journal of pharmacy and pharmacology, Jan 15, 2017

To evaluate the in-vivo efficacy of solid SMEDDS containing combination of artemether and lumefan... more To evaluate the in-vivo efficacy of solid SMEDDS containing combination of artemether and lumefantrine. Formulation development of solid SMEDDS containing combination of artemether and lumefantrine was carried out using spray drying technique. These S-SMEDDS were evaluated for reduction in parasitemia and mortality as well as subacute toxicity in mice. Haematology, biochemical parameters and histopathology were performed for evaluating safety of formulation. Pharmacokinetic characterization of both drugs was performed after oral administration in rats. Optimized solid SMEDDS containing low, medium and high dose were more effective in reducing parasitemia and mortality of mice as compared to marketed tablets containing high dose of these drugs. Single oral administration of solid SMEDDS containing high-dose combination could maintain plasma concentration of lumefantrine above the minimum effective concentration for ≈4 days. Solid SMEDDS containing low-, medium- and high-dose combinat...

International Journal of Basic and Clinical Pharmacology, 2016

Background: Lithium is used commonly in bipolar illness. It is co administered with many other dr... more Background: Lithium is used commonly in bipolar illness. It is co administered with many other drugs like imipramine, fluoxetine to improve the clinical efficacy of the therapy. Co administrations of other drugs like NSAIDS and GIT drugs for various ailments are also common. As this drug possesses a narrow therapeutic range, effect of other drugs on its pharmacokinetic parameters is important to achieve its therapeutic goal as well as to avoid serious adverse effect. Methods: Total n= 30 human volunteers were enrolled in the study. After randomization subjects were divided into three study groups. Group 1 was given lithium (900mg) alone while group 2 and 3 were given lithium (900mg) and imipramine (25mg) at 0h. Group 3 patients were administered propantheline (15mg) 1 hr prior to lithium and imipramine. Results: In group 2 (Li+Imp) treatment with imipramine produced a significant decrease in C max (p<0.01), increase in Tmax (p<0.001) and a significant fall in AUC (p<0.001) of lithium. There was no significant change in Kel and hence no change in T1/2 was observed. In group 3 ((Li+Imp+Pro) addition of propantheline accentuated the imipramine induced fall in serum lithium concentration at all the sampling points as shown in Figure 1. It significantly accentuated the imipramine induced fall in Cmax of lithium (p<0.05) and prolonged the T max. There was no significant difference between Kel, T 1/2 and AUC of group 2 (Li+Imp) versus group 3 (Li+Imp+Pro). Conclusions: Propantheline even being the anticholinergic drug was unable to show its effect, this is due to high ceiling masking in antagonistic action of imipramine.

Gabapentin for post-operative nausea and vomiting: a pilot study

International Journal of Basic Clinical Pharmacology, 2014

Local Anaesthetics - a Critical Review

Local anaesthetics are the safest and efficient drugs in producing insensibility to pain in discr... more Local anaesthetics are the safest and efficient drugs in producing insensibility to pain in discrete regions of the body. Because of their enviable record of efficacy and safety in producing insensibility to pain in discrete regions of the body, local anaesthetics are administered in more ways than perhaps any other group of therapeutic agents. Today dentistry has a wide variety of local anaesthetics that permits pain control to be tailored to the specific needs of the patient. This article provides a brief overview of local anaesthetics used in dentistry.

Pharmacovigilance of ChAdOx1 nCoV-19 (COVISHIELD) Vaccine after first and second dose in volunteers in Punjab, India

Asian Journal of Pharmacy and Pharmacology

Effect of intermittent fasting on various health parameters in obese type 2 diabetics: A pilot study

National Journal of Physiology, Pharmacy and Pharmacology

Background: Diabetes mellitus type 2 is fast becoming a cause of concern for governments world ov... more Background: Diabetes mellitus type 2 is fast becoming a cause of concern for governments world over and people at large as it has immense socio-economic impact. A diabetic patient usually goes through phases of being overweight, obese, and insulin-resistant before being classified as a patient of type 2 diabetes. Fasting, though practiced for centuries, is a novel approach for delaying progression and possibly reversing diabetes mellitus. Aim and Objectives: The aim of the study is to look for the effect of intermittent fasting on various health parameters in obese type 2 diabetics. Materials and Methods: The study was conducted at a tertiary care facility in Amritsar. Twelve obese volunteers in the age group of 20–60 years with type 2 diabetes mellitus not controlled with metformin alone were included in the study. All the participants were told to follow intermittent fasting protocol of 16:8 for a period of 4 weeks. At the beginning of the study, weight, height, body mass index, waist circumference, waist-hip ratio, fasting blood sugar, and serum insulin, were recorded in each participant. At the end of the 4 weeks period, all the measurements were repeated and compared with baseline values using the student t-test. Results: There was a highly significant decrease in the anthropometric indices and fasting blood sugar as compared to baseline values at the end of the 4-week period without any change in fasting serum insulin levels. Conclusion: There is a favorable effect of intermittent fasting on anthropometric indices and fasting blood sugar levels without any improvement in fasting serum insulin.

Correlation of body fat distribution and lipid profile in males of the Northwest region of Punjab

International Journal of Medical Science and Public Health

Background: The prevalence of obesity has substantially increased over the past few decades. Cent... more Background: The prevalence of obesity has substantially increased over the past few decades. Central obesity, in particular, has a major role in the development of various metabolic disturbances including deranged lipid profile which leads to increased risk of cardiovascular diseases. Timely assessment of any changes in lipid profile can help the prevention of cardiovascular diseases in obese men. Objectives: The objective of this study was to evaluate the association of abnormal waist-hip ratio (WHR) with the lipid profile in healthy men. Materials and Methods: The study was conducted in the tertiary care center of Amritsar. Two groups of 50 men each of the age group of 20–40 years were enrolled in the study. Group I included men with normal WHR while Group II included men with increased WHR. Lipid profile including cholesterol, triglycerides (TGs), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) was measured by standard methods. Statistical analysis was done by Student’s t-test and correlation was established using correlation coefficient. Results: Evaluation of lipid profile showed that serum cholesterol, TGs, LDL, and VLDL were higher in Group II than in Group I while HDL was lower in Group II than in Group I. Central obesity (WHR) has direct association with deranged lipid profile. Conclusion: It can be concluded that visceral or central obesity has direct correlation with the fasting lipid profile in men of the Northwest region of Punjab and WHR is a more reliable predictor of risk.

International Journal of Basic and Clinical Pharmacology, 2016

Background: Lithium is used commonly in bipolar illness. It is co administered with many other dr... more Background: Lithium is used commonly in bipolar illness. It is co administered with many other drugs like imipramine, fluoxetine to improve the clinical efficacy of the therapy. Co administrations of other drugs like NSAIDS and GIT drugs for various ailments are also common. As this drug possesses a narrow therapeutic range, effect of other drugs on its pharmacokinetic parameters is important to achieve its therapeutic goal as well as to avoid serious adverse effect. Methods: Total n= 30 human volunteers were enrolled in the study. After randomization subjects were divided into three study groups. Group 1 was given lithium (900mg) alone while group 2 and 3 were given lithium (900mg) and imipramine (25mg) at 0h. Group 3 patients were administered propantheline (15mg) 1 hr prior to lithium and imipramine. Results: In group 2 (Li+Imp) treatment with imipramine produced a significant decrease in C max (p<0.01), increase in Tmax (p<0.001) and a significant fall in AUC (p<0.001) of lithium. There was no significant change in Kel and hence no change in T1/2 was observed. In group 3 ((Li+Imp+Pro) addition of propantheline accentuated the imipramine induced fall in serum lithium concentration at all the sampling points as shown in Figure 1. It significantly accentuated the imipramine induced fall in Cmax of lithium (p<0.05) and prolonged the T max. There was no significant difference between Kel, T 1/2 and AUC of group 2 (Li+Imp) versus group 3 (Li+Imp+Pro). Conclusions: Propantheline even being the anticholinergic drug was unable to show its effect, this is due to high ceiling masking in antagonistic action of imipramine.

International Journal of Basic & Clinical Pharmacology, May 23, 2017

Nociceptive component of pain is the pain that results from activation of nociceptor neurons by i... more Nociceptive component of pain is the pain that results from activation of nociceptor neurons by intense mechanical, chemical, or thermal noxious stimuli like a scalpel blade cutting through skin. It signals the presence, ABSTRACT Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with coadministered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period. Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded. Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a period of 24 hours. Conclusions: Gabapentin in the doses used was found to be effective in postoperative pain in patients undergoing planned laparoscopic cholecystectomy. It was found to be safe and no serious adverse events were reported.

Pharmacovigilance is the pharmacological science relating to the detection, assessment, understan... more Pharmacovigilance is the pharmacological science relating to the detection, assessment, understanding, and prevention of adverse effects, particularly the long-term and short-term adverse effects of drugs or treatment. The World Health Organization (WHO) established pharmacovigilance Programme for International Drug Monitoring in response to the thalidomide disaster detected in 1961. India joined the WHO adverse drug reaction (ADR) monitoring program based in Uppsala, Sweden, in 1998. The Central Drugs Standard Control Organization (CDSCO), Directorate General of Health Services, under the aegis of the Ministry of Health and Family Welfare, Government of India, in collaboration with Indian Pharmacopoeia Commission, Ghaziabad, is a National Coordinating Centre (NCC). Adverse drug reaction monitoring centers (AMCs) under the Pharmacovigilance Programme of India (PvPI) play a vital role in the collection and follow-up of ADR reports from the patients, as drug trials in animals and humans (Phase I-III) do not predict accurately the adverse drug events. Patients with chronic kidney disease (CKD)/liver disease are at risk of enhanced drug-related events. These patients should be closely monitored for any adverse events and it should be reported. Thus, inculcating the habit of ADR reporting will help in generating data specific to Indian population and will contribute toward patient safety. This will also help in modifying the treatment given to the patients, as early identification of ADRs will help in reducing morbidity and mortality in patients.

Current Trends in diagnosis & Treatment

Introduction: Adverse drug reactions (ADRs) constitute a significant economic burden on society. ... more Introduction: Adverse drug reactions (ADRs) constitute a significant economic burden on society. ADRs to skin are common; however, information about their incidence, severity, and ultimate health effects is scanty. The aim of the present study was to detect, document, assess, and report the suspected ADRs in the Department of Dermatology at a tertiary care teaching hospital, Amritsar, so as to treat ADRs and also stop the indiscriminate use of drugs in clinical practice. Materials and methods: A prospective study was undertaken in patients presenting with ADRs in the outpatient Department of Dermatology in the tertiary care teaching hospital, Amritsar, Punjab, from June 2015 to May 2018. The data obtained were collected, compared, and reviewed, calculating the percentage to assess their significance and evaluation. A total of 152 ADRs were detected during the study period. Results: The most common age group presenting with adverse cutaneous drug reactions (ACDRs) was 18-35 years (54%) and the most common ADR was urticaria (30.2%) followed by fixed drug eruptions (16.4%). The most common drugs responsible for ACDRs were non-steroidal anti-inflammatory drugs (NSAIDs) and fluoroquinolones followed by systemic steroids, oral contraceptive pills, ampicillin, angiotensin converting enzyme (ACE) inhibitors, antimalarial, clofazimine, and so on. According to the WHO causality assessment, 13.0% cases were certain, 56.1% were probable, and 30.7% were possible in nature. On severity assessment by the modified Hartwig and Siegel scale, 72.3% ACDRs were mild, 25% were moderate, and 2.05% cases were of severe category. Preventability assessment by the modified Schumock and Thornton scale revealed that 69.1% ACDRs were definitely probable, 20.51% were probably preventable, and 13.8% were not preventable. Conclusion: The study findings indicate that ADR reporting helps in identifying the most common drugs associated with dermatological reactions. Thus it helps us to provide better patient treatment by the early identification and management of dermatological reactions.

Current Trends in diagnosis & Treatment

Pharmacovigilance is the pharmacological science relating to the detection, assessment, understan... more Pharmacovigilance is the pharmacological science relating to the detection, assessment, understanding, and prevention of adverse effects, particularly the long-term and short-term adverse effects of drugs or treatment. The World Health Organization (WHO) established pharmacovigilance Programme for International Drug Monitoring in response to the thalidomide disaster detected in 1961. India joined the WHO adverse drug reaction (ADR) monitoring program based in Uppsala, Sweden, in 1998. The Central Drugs Standard Control Organization (CDSCO), Directorate General of Health Services, under the aegis of the Ministry of Health and Family Welfare, Government of India, in collaboration with Indian Pharmacopoeia Commission, Ghaziabad, is a National Coordinating Centre (NCC). Adverse drug reaction monitoring centers (AMCs) under the Pharmacovigilance Programme of India (PvPI) play a vital role in the collection and follow-up of ADR reports from the patients, as drug trials in animals and huma...

Awareness among pregnant women regarding the use and safety of drugs during pregnancy in the state of Punjab: A cross-sectional observational study

International Journal of Medical Science and Public Health

Background: Indiscriminate use of drugs and cosmetics among a pregnant woman is always a challeng... more Background: Indiscriminate use of drugs and cosmetics among a pregnant woman is always a challenge in the antenatal care for health-care providers especially in developing countries. There is a potential risk to the growing fetus due to irrational use of drugs and cosmetics during pregnancy awareness, and adequate knowledge of their use can prevent many drug-induced complications during pregnancy. Objective: The objective of the study was to evaluate the awareness among pregnant women regarding the use and safety of drugs and cosmetics. Materials and Methods: A cross-sectional observational study was conducted in various antenatal clinics of the state of Punjab. 500 pregnant women were enrolled in the study and the questionnaire was prepared in the local language to assess the knowledge and beliefs of pregnant women. Data analysis was done using Chi-square test. Results: A very few pregnant women had knowledge that drugs have any effect on the fetus and less than half believe that drugs should be taken only by consultation by the doctor. Majority pregnant women believe that sufficient time and attention are not given by a doctor during an appointment. Only 2% of women had the idea of antenatal sessions. More than half of the pregnant women considered alternative remedies to be more safe in pregnancy while a very few had the idea that cosmetics are safe in pregnancy. Conclusion: Thus, it can be concluded that the majority of participants in the study have poor knowledge regarding benefits and adverse effects of the use of drugs and cosmetics during pregnancy.

Parasympathetic nervous system changes after the menopause: A comparative study

National Journal of Physiology, Pharmacy and Pharmacology

Comparative analysis of sympathetic nervous system activity in pre and #8209;menopausal and post-menopausal women

National Journal of Physiology, Pharmacy and Pharmacology

Background: Post-menopausal women suffer from various complications like autonomic dysfunction wh... more Background: Post-menopausal women suffer from various complications like autonomic dysfunction which predisposes them to cardiovascular morbidity. Decline in estrogen levels after menopause is associated with increased cardiovascular risks. Timely evaluation of such derangements and active intervention can play an important role in the prevention of cardiovascular morbidity. Aims and Objective: The aim is to compare the sympathetic autonomic nervous system activity in pre-menopausal and age-matched post-menopausal women. Materials and Methods: This study was conducted on two groups of 40 women each. Group I included pre-menopausal women and Group II included post-menopausal women. Sympathetic nervous system assessment was done using cold pressor test (CPT), handgrip test (HGT), and blood pressure (BP) response to standing. Statistical analysis was performed using Student’s t-test. Results: Evaluation of sympathetic functions between the two groups showed that the mean rise in systolic BP (SBP) in response to CPT was lower in Group I than in Group II (P < 0.01). Mean rise in the diastolic BP (DBP) in response to HGT was also lower in Group I as compared to Group II (P < 0.01). Fall in SBP on standing in Group I was more than in Group II (P < 0.01). Conclusion: Sympathetic nervous system evaluation showed sympathetic hyperactivity in the post-menopausal group as compared to the premenopausal group.

International Journal of Basic & Clinical Pharmacology

Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects... more Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with co-administered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period.Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded.Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a per...

Improved pharmacokinetic and pharmacodynamic attributes of artemether-lumefantrine-loaded solid SMEDDS for oral administration

The Journal of pharmacy and pharmacology, Jan 15, 2017

To evaluate the in-vivo efficacy of solid SMEDDS containing combination of artemether and lumefan... more To evaluate the in-vivo efficacy of solid SMEDDS containing combination of artemether and lumefantrine. Formulation development of solid SMEDDS containing combination of artemether and lumefantrine was carried out using spray drying technique. These S-SMEDDS were evaluated for reduction in parasitemia and mortality as well as subacute toxicity in mice. Haematology, biochemical parameters and histopathology were performed for evaluating safety of formulation. Pharmacokinetic characterization of both drugs was performed after oral administration in rats. Optimized solid SMEDDS containing low, medium and high dose were more effective in reducing parasitemia and mortality of mice as compared to marketed tablets containing high dose of these drugs. Single oral administration of solid SMEDDS containing high-dose combination could maintain plasma concentration of lumefantrine above the minimum effective concentration for ≈4 days. Solid SMEDDS containing low-, medium- and high-dose combinat...

International Journal of Basic and Clinical Pharmacology, 2016

Background: Lithium is used commonly in bipolar illness. It is co administered with many other dr... more Background: Lithium is used commonly in bipolar illness. It is co administered with many other drugs like imipramine, fluoxetine to improve the clinical efficacy of the therapy. Co administrations of other drugs like NSAIDS and GIT drugs for various ailments are also common. As this drug possesses a narrow therapeutic range, effect of other drugs on its pharmacokinetic parameters is important to achieve its therapeutic goal as well as to avoid serious adverse effect. Methods: Total n= 30 human volunteers were enrolled in the study. After randomization subjects were divided into three study groups. Group 1 was given lithium (900mg) alone while group 2 and 3 were given lithium (900mg) and imipramine (25mg) at 0h. Group 3 patients were administered propantheline (15mg) 1 hr prior to lithium and imipramine. Results: In group 2 (Li+Imp) treatment with imipramine produced a significant decrease in C max (p<0.01), increase in Tmax (p<0.001) and a significant fall in AUC (p<0.001) of lithium. There was no significant change in Kel and hence no change in T1/2 was observed. In group 3 ((Li+Imp+Pro) addition of propantheline accentuated the imipramine induced fall in serum lithium concentration at all the sampling points as shown in Figure 1. It significantly accentuated the imipramine induced fall in Cmax of lithium (p<0.05) and prolonged the T max. There was no significant difference between Kel, T 1/2 and AUC of group 2 (Li+Imp) versus group 3 (Li+Imp+Pro). Conclusions: Propantheline even being the anticholinergic drug was unable to show its effect, this is due to high ceiling masking in antagonistic action of imipramine.

Gabapentin for post-operative nausea and vomiting: a pilot study

International Journal of Basic Clinical Pharmacology, 2014