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Papers by ekta arora

Journal of Research in Pharmacy Practice

International Journal of Community Medicine and Public Health, 2021

Another decade is suffering from the wrath of another coronavirus. On 31 December 2019, pneumonia... more Another decade is suffering from the wrath of another coronavirus. On 31 December 2019, pneumonia like cases of unknown etiology detected in Wuhan City, Hubei Province of China, was informed to the world health organization (WHO). This novel type of Coronavirus was isolated on 7 January, 2020 following which China shared its genetic sequence on 12 January, 2020 globally, for countries to use in developing specific diagnostic kits. Currently, this pandemic has spread to almost all countries of the world taking lives of millions of people globally. For disease control and prevention, correct and rapid information disclosure is a top fetch need. information, education and communication (IEC) campaigns should be launched to promote behavioral prevention strategies like frequent hand washing, cough etiquette, and use of masks when visiting public places. Also, public should be motivated to report fever and other risk factors for coronavirus infection, including travel history to affected...

Journal of Natural Science, Biology and Medicine, 2016

Infl ammatory bowel disease (IBD) is the chronic infl ammatory disorder of gastrointestinal tract... more Infl ammatory bowel disease (IBD) is the chronic infl ammatory disorder of gastrointestinal tract consisting of two subtypes: Ulcerative colitis and Crohn's disease. IBD occurs due to infi ltration of leukocytes in intestinal mucosa and derangements in intestinal barrier function. One of the most important steps in pathogenesis of IBD is the interactions between integrins on the surface of leukocyte. The α 4 β 7 integrin expressing T-cell is an important leukocyte involved in pathogenesis and represents a new drug target for the treatment of IBD. Vedolizumab is a humanized monoclonal antibody, which acts against α 4 β 7 integrin heterodimer and blocks the interaction of α 4 β 7 integrin with MAdCAM-1. It prevents leukocyte binding to endothelial surface and its extravasation into affected tissue. The effi cacy and safety of the vedolizumab have been established in many clinical studies. It has shown promising results in various clinical studies where a greater percentage of patients as compared to a placebo achieved and maintained clinical response, clinical remission, and corticosteroid-free clinical remission. Vedolizumab has been shown to be well tolerated with slightly higher risk of infections, headache, naspharyngitis as compared to placebo. This review focuses on the potential role of vedolizumab for the treatment of IBD.

Journal of Pharmacology and Pharmacotherapeutics, 2015

Thalassemias comprise a group of hereditary blood disorders. Thalassemia major presents with anem... more Thalassemias comprise a group of hereditary blood disorders. Thalassemia major presents with anemia within the first 2 years of life requiring frequent blood transfusions for sustaining life. Regular blood transfusions lead to iron overload-related complications. Prognosis of thalassemia has improved because of the availability of iron-chelating agents. Oral iron chelators are the mainstay of chelation therapy. Deferasirox is a new-generation oral iron chelator for once daily usage. We herein describe a patient of beta thalassemia major who developed an allergic manifestation in the form of erythematous pruritic skin rashes to the oral iron chelator deferasirox. This is a rare adverse reaction reported with deferasirox that led to a therapeutic dilemma in this particular case.

Perspectives in Clinical Research, 2015

Introduction : The medical education world-wide is adapting competency based learning; it is high... more Introduction : The medical education world-wide is adapting competency based learning; it is high-time that the medical syllabus is inculcated with integrated-medical ethics training. An educational training program with a pre- and post-test method of analysis has better student outcome with respect to retention, thinking and understanding. Objective: To assess the understanding and application of medical ethics in students after structured module based training. Methods : One hundred and fifty students of 1 st professional Bachelor of Medicine and Bachelor of Surgery (MBBS) were provided a 10 hours’ duration module based teaching of basic principles and core concepts of medical ethics in patient care. The assessment was conducted using a pre and post analysis questionnaire having 15 multiple choice questions with one correct response. Data were analysed using paired student’s t-test for comparing pre- and post-test scores. P < 0.05 was considered as significant Results : Total p...

Osteoporosis is a multifactorial progressive skeletal disorder characterized by reduced bone mass... more Osteoporosis is a multifactorial progressive skeletal disorder characterized by reduced bone mass and deterioration of bone microarchitecture. Fragility fractures, the consequence of osteoporosis, are responsible for excess mortality, morbidity, chronic pain, admission to hospitals and economic costs. Approximately 1.6 million hip fractures occur each year worldwide, the incidence is set to increase to 6.3 million by 2050. No treatment can completely reverse established osteoporosis. Currently available therapies include bisphosphonates, SERMs, HRT, denosumab, teriperatide, calcitonin and strontium renelate. Cathepsin K inhibitors (balicatib and odanacatib) are among recent drugs under development. Saracatinib is a novel orally available competitive inhibitor of Src kinase shown to inhibit bone resorption in vitro. Lasofoxifene, bazedoxifene, and arzoxifene aren new SERMs in late-stage clinical trials.

Journal of Education and Health Promotion, 2021

BACKGROUND: Many countries are implementing measures for social distancing to contain the spread ... more BACKGROUND: Many countries are implementing measures for social distancing to contain the spread of the coronavirus disease 2019 (COVID-19) pandemic. The Indian government also issued an order for complete lockdown of the country, with all the nonessential services, including most of the services for nonemergency health issues, being temporarily suspended. OBJECTIVES: This study aimed to understand the effect of pandemic lockdown on medical advice-seeking behavior and the medication practices of the non-COVID Indian patients confined to homes, who would have normally visited the outpatient departments (OPDs) for medical advice. MATERIALS AND METHODS: It was a questionnaire-based, cross-sectional study conducted online during the lockdown period. The questions dealt with medical advice-related practices, self-medication, the sources of medical advice, and the need to visit emergency department. Evaluation of data was done as for descriptive studies. RESULTS: A total of 106 people (34%) out of the 312 participants had either old or new health problems. Ninety-six of such people (90.5%) tried to manage their sufferings by either continuing the drugs prescribed earlier or by making phone calls to doctors along with taking the help of home remedies, if needed. Ten (9.5%) of the symptomatic participants did not consult any doctor waiting for natural course of relief. None of the participants practiced self-medication of modern medicine therapy. Only one participant (of the total 312) took hydroxychloroquine as self-medication for assumed prophylactic therapy against the COVID-19 infection. CONCLUSION: Most of the people with medical conditions, confined at home due to national lockdown, are coping with their problems without any irrational self-medication with modern medicines or any misuse of prophylactic therapy against the COVID infection. This seemingly positive trend may also have been due to the strict enforcement of the lockdown rules by the law enforcement agencies.

Journal of Family Medicine and Primary Care, 2020

Background: Coronavirus disease (COVID-19) has spread very fast worldwide as a pandemic causing u... more Background: Coronavirus disease (COVID-19) has spread very fast worldwide as a pandemic causing unprecedented morbidity and mortality. Most countries in the world have undergone emergency lockdown in an attempt to flatten the curve and reduce the load on healthcare systems. Objective: This study was done to assess the knowledge, attitude, and perception toward the disease among the home-bound Indian population during the lockdown. Methodology: This was a questionnaire-based descriptive cross-sectional study conducted online. Compilation and assessment of the online data in the form of responses were done as for descriptive studies. Results: Among the 320 participants of the study, the awareness about the epidemiological features, including the signs and symptoms of the disease, was very good (more than 99% in some aspects). The attitude toward the measures for prevention of disease at home and outside was also very good (more than 97%) in some aspects, with a scope of improvement in a few others. Only one-third had the knowledge of online (e-consultation) services floated by governments and hospitals for medical advice. Ten percent had the potential to misuse drugs as prophylaxis. Most of the participants perceived that they had no predictable idea about the shape of disease epidemiology in the near future and only hoped for things to get better. Conclusion: This study reflects that aggressive awareness drives have played an important role in the dissemination of knowledge and the development of informed positive attitude toward COVID-19. Few gaps in knowledge and practices related to disease epidemiology, safe practices, mobile app for tracking and the availability of e-resources for medical advice, still remain. These should be addressed more aggressively, to strengthen the efforts to overcome this unprecedented crisis.

International Journal of Risk & Safety in Medicine, 2019

BACKGROUND Recent years have seen a surge in pharmacovigilance (PV) related activities in India. ... more BACKGROUND Recent years have seen a surge in pharmacovigilance (PV) related activities in India. In the present study the impact of these initiatives on medical students from across the country was evaluated to identify their effectiveness, lacunae and arrive at remedial measures. METHODS A cross-sectional, questionnaire based study was conducted. The survey questionnaire consisted of 28 multiple response items. The areas covered included subject knowledge (theoretical and practical), attitude and awareness towards pharmacovigilance. RESULTS The survey participants (n = 253) were from 71 medical colleges and 17 states across India. While 60% of the participants were familiar with the term 'Pharmacovigilance', many could not distinguish side effect and adverse drug reaction. The majority was unaware that 'Periodic Safety Update Report' (PSURs) is a mandatory pharmacovigilance activity by the industry. 91% felt reporting is a useful practice and causes for under-reporting are a lack of awareness followed by attitude, misconceptions about what to report, fear of litigation and interestingly the least important is lack of time. However, most were reluctant to have reporting as mandatory tool; they would rather use it voluntary. CONCLUSION In spite of collaborative and synchronized efforts by various agencies there is a need to further improve the PV milieu in India by confidence building exercises, imparting training on PV programme, updating of the current knowledge on PV and also sustaining motivation.

Perspectives in Clinical Research, 2014

Conventional antihypertensives like beta-blockers are well known to cause impairment of psychomot... more Conventional antihypertensives like beta-blockers are well known to cause impairment of psychomotor performance. [3-6] On the other hand, drugs modifying the renin-angiotensin-aldosterone system (RAAS), such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have shown better cognitive outcomes. [7,8] Aliskiren is the fi rst drug in a new class of antihypertensives (renin inhibitors) that inhibit the RAAS by directly targeting the enzyme renin, the fi rst step in the RAAS. [9,10] The drug is indicated for the treatment of high BP, either alone or in combination with other agents. [11,12] Aliskiren's use is likely to increase in the near future like its counterparts, as more and more experience is gained with its use by clinicians.

Perspectives in Clinical Research, 2014

The present study was undertaken in 20 healthy human volunteers to evaluate the effect of a herba... more The present study was undertaken in 20 healthy human volunteers to evaluate the effect of a herbal bioenhancer, Carum carvi on pharmacokinetics of rifampicin, isoniazid, and pyrazinamide in fixed dose combination (FDC). Materials and Methods: It was a prospective, two-period, open-label, cross-over experiment on 20 healthy human male volunteers. The volunteers were administered a single dose of FDC containing rifampicin (450 mg), isoniazid (300 mg), and pyrazinamide (1000 mg) and after 10 days washout period the same FDC along with C. carvi extract (100 mg) was administered. Blood samples were collected at different time-points and analyzed by high-performance liquid chromatography (HPLC). Detailed pharmacokinetic parameters were calculated, which included C max , area under curve (AUC), time to reach maximum plasma concentration (T max), clearance (Cl), volume of distribution (V d), and half-life (t ½). Results: Additions of C. carvi extract lead to increase in plasma levels of rifampicin, isoniazid, and pyrazinamide. The bioavailability indices C max of rifampicin increased from 4.57 ± 0.19 to 5.95 ± 0.19 (P = 0.000) and AUC increased from 40.11 ± 1.69 to 53.01 ± 1.88 (P = 0.000). Similarly, C max of isoniazid increased from 2.66 ± 0.16 to 3.62 ± 0.16 (P = 0.000) and AUC from 17.72 ± 0.78 to 22.87 ± 0.94 (P = 0.000). The bioavailability indices of pyrazinamide also revealed an increase in C max from 18.81 ± 0.79 to 25.06 ± 1.14 (P = 0.000) and AUC from 107.65 ± 4.42 to 137.71 ± 5.92 (P = 0.000), respectively. Conclusion: C. carvi acts as a bioenhancer and modifies the kinetics of antitubercular treatment (ATT) favorably.

Journal of Research in Pharmacy Practice

International Journal of Community Medicine and Public Health, 2021

Another decade is suffering from the wrath of another coronavirus. On 31 December 2019, pneumonia... more Another decade is suffering from the wrath of another coronavirus. On 31 December 2019, pneumonia like cases of unknown etiology detected in Wuhan City, Hubei Province of China, was informed to the world health organization (WHO). This novel type of Coronavirus was isolated on 7 January, 2020 following which China shared its genetic sequence on 12 January, 2020 globally, for countries to use in developing specific diagnostic kits. Currently, this pandemic has spread to almost all countries of the world taking lives of millions of people globally. For disease control and prevention, correct and rapid information disclosure is a top fetch need. information, education and communication (IEC) campaigns should be launched to promote behavioral prevention strategies like frequent hand washing, cough etiquette, and use of masks when visiting public places. Also, public should be motivated to report fever and other risk factors for coronavirus infection, including travel history to affected...

Journal of Natural Science, Biology and Medicine, 2016

Infl ammatory bowel disease (IBD) is the chronic infl ammatory disorder of gastrointestinal tract... more Infl ammatory bowel disease (IBD) is the chronic infl ammatory disorder of gastrointestinal tract consisting of two subtypes: Ulcerative colitis and Crohn's disease. IBD occurs due to infi ltration of leukocytes in intestinal mucosa and derangements in intestinal barrier function. One of the most important steps in pathogenesis of IBD is the interactions between integrins on the surface of leukocyte. The α 4 β 7 integrin expressing T-cell is an important leukocyte involved in pathogenesis and represents a new drug target for the treatment of IBD. Vedolizumab is a humanized monoclonal antibody, which acts against α 4 β 7 integrin heterodimer and blocks the interaction of α 4 β 7 integrin with MAdCAM-1. It prevents leukocyte binding to endothelial surface and its extravasation into affected tissue. The effi cacy and safety of the vedolizumab have been established in many clinical studies. It has shown promising results in various clinical studies where a greater percentage of patients as compared to a placebo achieved and maintained clinical response, clinical remission, and corticosteroid-free clinical remission. Vedolizumab has been shown to be well tolerated with slightly higher risk of infections, headache, naspharyngitis as compared to placebo. This review focuses on the potential role of vedolizumab for the treatment of IBD.

Journal of Pharmacology and Pharmacotherapeutics, 2015

Thalassemias comprise a group of hereditary blood disorders. Thalassemia major presents with anem... more Thalassemias comprise a group of hereditary blood disorders. Thalassemia major presents with anemia within the first 2 years of life requiring frequent blood transfusions for sustaining life. Regular blood transfusions lead to iron overload-related complications. Prognosis of thalassemia has improved because of the availability of iron-chelating agents. Oral iron chelators are the mainstay of chelation therapy. Deferasirox is a new-generation oral iron chelator for once daily usage. We herein describe a patient of beta thalassemia major who developed an allergic manifestation in the form of erythematous pruritic skin rashes to the oral iron chelator deferasirox. This is a rare adverse reaction reported with deferasirox that led to a therapeutic dilemma in this particular case.

Perspectives in Clinical Research, 2015

Introduction : The medical education world-wide is adapting competency based learning; it is high... more Introduction : The medical education world-wide is adapting competency based learning; it is high-time that the medical syllabus is inculcated with integrated-medical ethics training. An educational training program with a pre- and post-test method of analysis has better student outcome with respect to retention, thinking and understanding. Objective: To assess the understanding and application of medical ethics in students after structured module based training. Methods : One hundred and fifty students of 1 st professional Bachelor of Medicine and Bachelor of Surgery (MBBS) were provided a 10 hours’ duration module based teaching of basic principles and core concepts of medical ethics in patient care. The assessment was conducted using a pre and post analysis questionnaire having 15 multiple choice questions with one correct response. Data were analysed using paired student’s t-test for comparing pre- and post-test scores. P < 0.05 was considered as significant Results : Total p...

Osteoporosis is a multifactorial progressive skeletal disorder characterized by reduced bone mass... more Osteoporosis is a multifactorial progressive skeletal disorder characterized by reduced bone mass and deterioration of bone microarchitecture. Fragility fractures, the consequence of osteoporosis, are responsible for excess mortality, morbidity, chronic pain, admission to hospitals and economic costs. Approximately 1.6 million hip fractures occur each year worldwide, the incidence is set to increase to 6.3 million by 2050. No treatment can completely reverse established osteoporosis. Currently available therapies include bisphosphonates, SERMs, HRT, denosumab, teriperatide, calcitonin and strontium renelate. Cathepsin K inhibitors (balicatib and odanacatib) are among recent drugs under development. Saracatinib is a novel orally available competitive inhibitor of Src kinase shown to inhibit bone resorption in vitro. Lasofoxifene, bazedoxifene, and arzoxifene aren new SERMs in late-stage clinical trials.

Journal of Education and Health Promotion, 2021

BACKGROUND: Many countries are implementing measures for social distancing to contain the spread ... more BACKGROUND: Many countries are implementing measures for social distancing to contain the spread of the coronavirus disease 2019 (COVID-19) pandemic. The Indian government also issued an order for complete lockdown of the country, with all the nonessential services, including most of the services for nonemergency health issues, being temporarily suspended. OBJECTIVES: This study aimed to understand the effect of pandemic lockdown on medical advice-seeking behavior and the medication practices of the non-COVID Indian patients confined to homes, who would have normally visited the outpatient departments (OPDs) for medical advice. MATERIALS AND METHODS: It was a questionnaire-based, cross-sectional study conducted online during the lockdown period. The questions dealt with medical advice-related practices, self-medication, the sources of medical advice, and the need to visit emergency department. Evaluation of data was done as for descriptive studies. RESULTS: A total of 106 people (34%) out of the 312 participants had either old or new health problems. Ninety-six of such people (90.5%) tried to manage their sufferings by either continuing the drugs prescribed earlier or by making phone calls to doctors along with taking the help of home remedies, if needed. Ten (9.5%) of the symptomatic participants did not consult any doctor waiting for natural course of relief. None of the participants practiced self-medication of modern medicine therapy. Only one participant (of the total 312) took hydroxychloroquine as self-medication for assumed prophylactic therapy against the COVID-19 infection. CONCLUSION: Most of the people with medical conditions, confined at home due to national lockdown, are coping with their problems without any irrational self-medication with modern medicines or any misuse of prophylactic therapy against the COVID infection. This seemingly positive trend may also have been due to the strict enforcement of the lockdown rules by the law enforcement agencies.

Journal of Family Medicine and Primary Care, 2020

Background: Coronavirus disease (COVID-19) has spread very fast worldwide as a pandemic causing u... more Background: Coronavirus disease (COVID-19) has spread very fast worldwide as a pandemic causing unprecedented morbidity and mortality. Most countries in the world have undergone emergency lockdown in an attempt to flatten the curve and reduce the load on healthcare systems. Objective: This study was done to assess the knowledge, attitude, and perception toward the disease among the home-bound Indian population during the lockdown. Methodology: This was a questionnaire-based descriptive cross-sectional study conducted online. Compilation and assessment of the online data in the form of responses were done as for descriptive studies. Results: Among the 320 participants of the study, the awareness about the epidemiological features, including the signs and symptoms of the disease, was very good (more than 99% in some aspects). The attitude toward the measures for prevention of disease at home and outside was also very good (more than 97%) in some aspects, with a scope of improvement in a few others. Only one-third had the knowledge of online (e-consultation) services floated by governments and hospitals for medical advice. Ten percent had the potential to misuse drugs as prophylaxis. Most of the participants perceived that they had no predictable idea about the shape of disease epidemiology in the near future and only hoped for things to get better. Conclusion: This study reflects that aggressive awareness drives have played an important role in the dissemination of knowledge and the development of informed positive attitude toward COVID-19. Few gaps in knowledge and practices related to disease epidemiology, safe practices, mobile app for tracking and the availability of e-resources for medical advice, still remain. These should be addressed more aggressively, to strengthen the efforts to overcome this unprecedented crisis.

International Journal of Risk & Safety in Medicine, 2019

BACKGROUND Recent years have seen a surge in pharmacovigilance (PV) related activities in India. ... more BACKGROUND Recent years have seen a surge in pharmacovigilance (PV) related activities in India. In the present study the impact of these initiatives on medical students from across the country was evaluated to identify their effectiveness, lacunae and arrive at remedial measures. METHODS A cross-sectional, questionnaire based study was conducted. The survey questionnaire consisted of 28 multiple response items. The areas covered included subject knowledge (theoretical and practical), attitude and awareness towards pharmacovigilance. RESULTS The survey participants (n = 253) were from 71 medical colleges and 17 states across India. While 60% of the participants were familiar with the term 'Pharmacovigilance', many could not distinguish side effect and adverse drug reaction. The majority was unaware that 'Periodic Safety Update Report' (PSURs) is a mandatory pharmacovigilance activity by the industry. 91% felt reporting is a useful practice and causes for under-reporting are a lack of awareness followed by attitude, misconceptions about what to report, fear of litigation and interestingly the least important is lack of time. However, most were reluctant to have reporting as mandatory tool; they would rather use it voluntary. CONCLUSION In spite of collaborative and synchronized efforts by various agencies there is a need to further improve the PV milieu in India by confidence building exercises, imparting training on PV programme, updating of the current knowledge on PV and also sustaining motivation.

Perspectives in Clinical Research, 2014

Conventional antihypertensives like beta-blockers are well known to cause impairment of psychomot... more Conventional antihypertensives like beta-blockers are well known to cause impairment of psychomotor performance. [3-6] On the other hand, drugs modifying the renin-angiotensin-aldosterone system (RAAS), such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have shown better cognitive outcomes. [7,8] Aliskiren is the fi rst drug in a new class of antihypertensives (renin inhibitors) that inhibit the RAAS by directly targeting the enzyme renin, the fi rst step in the RAAS. [9,10] The drug is indicated for the treatment of high BP, either alone or in combination with other agents. [11,12] Aliskiren's use is likely to increase in the near future like its counterparts, as more and more experience is gained with its use by clinicians.

Perspectives in Clinical Research, 2014

The present study was undertaken in 20 healthy human volunteers to evaluate the effect of a herba... more The present study was undertaken in 20 healthy human volunteers to evaluate the effect of a herbal bioenhancer, Carum carvi on pharmacokinetics of rifampicin, isoniazid, and pyrazinamide in fixed dose combination (FDC). Materials and Methods: It was a prospective, two-period, open-label, cross-over experiment on 20 healthy human male volunteers. The volunteers were administered a single dose of FDC containing rifampicin (450 mg), isoniazid (300 mg), and pyrazinamide (1000 mg) and after 10 days washout period the same FDC along with C. carvi extract (100 mg) was administered. Blood samples were collected at different time-points and analyzed by high-performance liquid chromatography (HPLC). Detailed pharmacokinetic parameters were calculated, which included C max , area under curve (AUC), time to reach maximum plasma concentration (T max), clearance (Cl), volume of distribution (V d), and half-life (t ½). Results: Additions of C. carvi extract lead to increase in plasma levels of rifampicin, isoniazid, and pyrazinamide. The bioavailability indices C max of rifampicin increased from 4.57 ± 0.19 to 5.95 ± 0.19 (P = 0.000) and AUC increased from 40.11 ± 1.69 to 53.01 ± 1.88 (P = 0.000). Similarly, C max of isoniazid increased from 2.66 ± 0.16 to 3.62 ± 0.16 (P = 0.000) and AUC from 17.72 ± 0.78 to 22.87 ± 0.94 (P = 0.000). The bioavailability indices of pyrazinamide also revealed an increase in C max from 18.81 ± 0.79 to 25.06 ± 1.14 (P = 0.000) and AUC from 107.65 ± 4.42 to 137.71 ± 5.92 (P = 0.000), respectively. Conclusion: C. carvi acts as a bioenhancer and modifies the kinetics of antitubercular treatment (ATT) favorably.