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   2013| January-June  | Volume 3 | Issue 1  
    Online since May 18, 2013

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Formulation and design of sustained release matrix tablets of metformin hydrochloride: Influence of hypromellose and polyacrylate polymers
Harekrishna Roy, Chandan K Brahma, Sisir Nandi, Kirti R Parida
January-June 2013, 3(1):55-63
DOI:10.4103/2229-516X.112242  PMID:23776841
Aim: The current paper was an attempt to design a sustained release dosage form using various grades of hydrophilic polymers, Hypromellose (hydroxyl-propyl methylcellulose [HPMC] K15M, HPMC K100M and HPMC K200M) and Polyacrylate polymers, Eudragit RL100 and Eudragit RS100 with or without incorporating ethyl cellulose on a matrix-controlled drug delivery system of Metformin hydrochloride. Materials and Methods: Laboratory scale batches of nine tablet formulations were prepared by wet granulation technique (Low shear). Micromeritic properties of the granules were evaluated prior to compression. Tablets were characterized as crushing strength, friability, weight variation, thickness, drug content or assay and evaluated for in-vitro release pattern for 12 h using Phosphate buffer of pH 6.8 at 37 ± 0.5°C. The in-vitro release mechanism was evaluated by kinetic modeling. Results and Discussion: The results obtained revealed that HPMC K200M at a concentration of 26% in formulation (F6) was able to sustain the drug release for 12 h and followed the Higuchi pattern quasi-Fickian diffusion. With that, combined effect of HPMC K15M as an extragranular section and Eudragit RS100 displayed a significant role in drug release. Dissolution data were compared with innovator for similarity factor (f2), and exhibited an acceptable value of ≥50 Three production validation scale batches were designed based on lab scale best batch and charged for stability testing, parameters were within the limit of acceptance. There was no chemical interaction found between the drug and excipients during Fourier Transform Infrared Spectroscopy (FTIR) and Differential scanning calorimetry study. Conclusion: Hence, combinely HPMC K200M and Eudragit RS100 at a suitable concentration can effectively be used to sustain drug release.
  16,741 1,596 8
Yawning and its physiological significance
Sharat Gupta, Shallu Mittal
January-June 2013, 3(1):11-15
DOI:10.4103/2229-516X.112230  PMID:23776833
Although yawning is a commonly witnessed human behavior, yet it has not been taught in much detail in medical schools because, until the date, no particular physiological significance has been associated with it. It is characterized by opening up of mouth which is accompanied by a long inspiration, with a brief interruption of ventilation and followed by a short expiration. Since time immemorial, yawning has been associated with drowsiness and boredom. However, this age old belief is all set to change as the results of some newer studies have pointed out that yawning might be a way by which our body is trying to accomplish some more meaningful goals. In this review, we have tried to put together some of the important functions that have been proposed by a few authors, with the hope that this article will stimulate the interest of newer researchers in this hitherto unexplored f ield.
  13,228 984 5
A review of drug isomerism and its significance
Naveen Chhabra, Madan L Aseri, Deepak Padmanabhan
January-June 2013, 3(1):16-18
DOI:10.4103/2229-516X.112233  PMID:23776834
Isomerism finds its importance in the field of clinical pharmacology and pharmacotherapeutics, as isomers differ in their pharmacokinetic and pharmacodyanmic properties. Drug isomerism has opened a new era of drug development. Currently, knowledge of isomerism has helped us in introducing safer and more effective drug alternatives of the newer as well as existing drugs. Many existing drugs have gone chiral switch i.e., switching from racemic mixture to one of its isomers. Cetrizine to levocetrizine is one of such examples, where effective and safer drug has been made available. In this article, we have attempted to review the basic concepts of stereochemistry and chirality and their significance in pharmacotherapeutics. Various pharmacological aspects such as pharmacokinetic and pharmacodynamic variations resulting out of chirality has been discussed in detail in this article.
  11,939 1,500 58
Recent advances in antibacterial drugs
Jaswant Rai, Gurpreet Kaur Randhawa, Mandeep Kaur
January-June 2013, 3(1):3-10
DOI:10.4103/2229-516X.112229  PMID:23776832
The incidence of antimicrobial resistance is on continued rise with a threat to return to the "pre-antibiotic" era. This has led to emergence of such bacterial infections which are essentially untreatable by the current armamentarium of available treatment options. Various efforts have been made to develop the newer antimicrobials with novel modes of action which can act against these multi-drug resistant strains. This review aims to focus on these newly available and investigational antibacterials approved after year 2000, their mechanism of actions/resistance, and spectrum of activity and their phases of clinical trials. Newer unexploited targets and strategies for the next generation of antimicrobial drugs for combating the drug resistance and emerging pathogens in the 21 st century have also been reviewed in the present article.
  10,009 1,300 15
Teratoid Wilms' tumor in a child: A report of a rare case
Anuradha Sinha, Jyoti Prakash Phukan, Gautam Bandyopadhyay, Sumana Mukherjee
January-June 2013, 3(1):72-74
DOI:10.4103/2229-516X.112248  PMID:23776845
Teratoid Wilms' tumor is an unusual variant of nephroblastoma in which heterologous tissue predominates. We report a case of teratoid Wilms' tumor in a 2-year-old male. Right sided abdominal mass was the presenting complaint. Ultrasonography of the abdomen showed a mass in the right kidney. Histopathological examination revealed blastemal, epithelial, and mesenchymal components along with areas presenting heterologous elements. More than 75% predominance of squamous differentiation with the keratin pearl formation was observed. The patient underwent nephrectomy and was followed post-operatively for 1 year and was normal.
  6,492 355 2
Bedaquiline: First FDA-approved tuberculosis drug in 40 years
Rajiv Mahajan
January-June 2013, 3(1):1-2
DOI:10.4103/2229-516X.112228  PMID:23776831
  5,521 955 93
Significance of nuclear morphometry in benign and malignant breast aspirates
Aparna Narasimha, B Vasavi, ML Harendra Kumar
January-June 2013, 3(1):22-26
DOI:10.4103/2229-516X.112237  PMID:23776836
Background: Breast carcinoma is one of the most common cancers occurring in the female population world-wide. Normal cells gradually transform to form the cancer cells through several stages. Nuclear changes occurring during these transformational steps need to be assessed objectively. Hence nuclear morphometry can be used as a diagnostic tool. Aim: To compare the nuclear morphometric parameters of benign and malignant breast aspirates. Study Design: Cytology was used to categorize aspirates from the breast lumps in to malignant (30 cases), and benign (30 cases). Nuclear parameters were calculated using the Image J 1.44C morphometric software. Several nuclear size parameters were analyzed. Results: The nuclear area, perimeter, diameter, compactness, and concave points were found to be statistically significant ( P < 0.05) parameters in differentiating benign, and malignant aspirates. Conclusion: Nuclear morphometry was thus, a useful objective tool in the differentiating benign, and malignant breast lesions.
  5,215 473 6
Role of aqueous extract of Azadirachta indica leaves in an experimental model of Alzheimer's disease in rats
M Raghavendra, Rituparna Maiti, Shafalika Kumar, SB Acharya
January-June 2013, 3(1):37-47
DOI:10.4103/2229-516X.112239  PMID:23776838
Background: Alzheimer's disease (AD), a progressive neurodegenerative disorder characterized by multiple cognitive deficits, is often accompanied by behavioral disorders and mood changes. Because of the non-availability of proper curative/preventive therapy for AD, the present study was designed to evaluate the possible role of Azadirachta indica in experimental AD in rats. Materials and Methods: Experimental AD in rats was produced by nucleus basalis magnacellularis lesion with ibotenic acid (IB) and intacerebroventricular administration of colchicine (Col). Different behavioral tests and biochemical analysis were performed to explore the role to A. indica in AD. Results: A. indica exhibited anxiolytic activity in the open field test in Col lesion animals, which was comparable to that of diazepam. In the Elevated plus maze test, A. indica significantly alleviated IB and Col-induced anxiety. IB and Col-induced depression was mitigated by A. indica, and the results were comparable to that of imipramine. In Morris' water maze test, A. indica pre-treatment improved reference memory, working memory and spatial learning, which are at par with the effects of donepezil. Both IB and Col-induced deficits in active avoidance learning and retention of learned behavior were significantly reversed by A. indica. IB and Col-induced increased lipid peroxidase activity was significantly reversed by A. indica (reductions in malondialdehyde level). A. indica stabilized rise in superoxide dismutase and a decreasing trend in acetylcholine-esterase (AChE) activity was seen with IB and Col lesions. A. indica had no effect over the AChE activity. Conclusion: A. indica might be effective in clinical AD by virtue of its cognition enhancement, antidepressant and antianxiety properties.
  4,774 615 10
An increase of granulosa cell apoptosis mediates aqueous neem (Azadirachta indica) leaf extract-induced oocyte apoptosis in rat
Anima Tripathi, Tulsidas G Shrivastav, Shail K Chaube
January-June 2013, 3(1):27-36
DOI:10.4103/2229-516X.112238  PMID:23776837
Objective: Neem plant (Azadirachta indica) has been extensively used in Ayurvedic system of medicine for female fertility regulation for a long time, but its mechanism of action remains poorly understood. Hence, the present study was aimed to determine whether an increase of granulosa cell apoptosis is associated with aqueous neem leaf extract (NLE)-induced oocyte apoptosis. Materials and Methods: Sexually immature female rats of 20 days old were fed NLE (50 mg/day) for 10 days and then subjected to superovulation induction protocol. The morphological changes in cumulus oocyte complexes (COCs), rate of oocyte apoptosis, hydrogen peroxide (H 2 O 2 ), total nitrite, and cytochrome c concentrations, inducible nitric oxide synthase (iNOS), cytochrome c, p53, Bcl2 and Bax expressions, deoxyribonucleic acid (DNA) fragmentation, and estradiol 17β level in granulosa cells collected from preovulatory COCs were analyzed. Results: Aqueous NLE increased H 2 O 2 concentration and decreased catalase activity, increased iNOS expression and total nitrite concentration, increased p53, Bax, and p53 expressions but decreased Bcl2 expression, increased cytochrome c concentration and induced DNA fragmentation in granulosa cells. An increased granulosa cell apoptosis resulted in reduced estradiol 17β concentration and induced apoptosis in ovulated oocytes. Conclusion: We conclude that aqueous NLE-induced granulosa cell apoptosis through the mitochondria-mediated pathway, reduced estradiol 17β concentration and induced apoptosis in ovulated oocytes. Thus, granulosa cell apoptosis mediates NLE-induced oocyte apoptosis during female fertility regulation in rat.
  4,596 515 31
Ticagrelor: The first approved reversible oral antiplatelet agent
Divya Goel
January-June 2013, 3(1):19-21
DOI:10.4103/2229-516X.112234  PMID:23776835
Platelet aggregation plays an important role in the pathophysiology of acute coronary syndrome (ACS). Aspirin is the most widely used antiplatelet agent and acts by inhibiting thromboxane A 2 -induced platelet activation. But it does not prevent platelets activation and aggregation by other signaling pathways like adenosine diphosphate (ADP) and Glycoprotein IIb/IIIa. Ticagrelor is the first oral reversible ADP (P2Y12) receptor antagonist. As compared to clopidogrel, ticagrelor has rapid onset as well as offset of action because of its reversible binding to P2Y12 receptor. It has potential to change the standard drug therapy of patient of ACS as shown in Platelet inhibition and patient outcomes (PLATO) trial, but long-term studies are required to further evaluate its efficacy and safety in these patients.
  2,958 542 7
Foundation programme: A student's perspective
Rakesh Mittal, Rajiv Mahajan, Niti Mittal
January-June 2013, 3(1):52-54
DOI:10.4103/2229-516X.112241  PMID:23776840
Context: Various colleges and universities worldwide develop and implement students' orientation programs to acclimatize them to the campus environment, familiarize them with the teaching programs and its importance has been stressed in the document "Vision 2015" planned by the Medical Council of India (MCI). Objectives : To evaluate the feedback questionnaire after conclusion of two day :Foundation Program" for MBBS 2nd Professional students, conducted by the medical education unit at a tertiary care Medical Institute. Material and Methods : After the conclusion of two day "Foundation Program", a pre-designed, anonymous questionnaire was received from all the students who participated in the program. Results : Of the 100 participants, 67% of the participants labeled the foundation program a very good exercise. Students' view regarding the factors that facilitated their learning were good topics (covered important aspects pertaining to the clinical phases), good presentations, good and experienced speakers, and interactive faculty. Conclusion : Such orientation programs lay a strong foundation for better understanding and learning of under-graduate courses, and should be a regular feature in the curriculum.
  2,240 320 2
Subcutaneous nodule: A case of Dirofilaria
Reshmina D'Souza, Ramakrishna Pai Jakribettu, H Sunil Sudharsana, P Sathyamoorthy Aithala
January-June 2013, 3(1):64-65
DOI:10.4103/2229-516X.112243  PMID:23776842
Human subcutaneous dirofilariasis is a rare helminthic infection. It is caused by filarial worms of the Genus Dirofilaria, which is the natural parasites of dogs, cats, foxes, and wild mammals. Zoonotic filariasis caused by Dirofilaria species is rarely seen in the region of Dakshina Kannada. Most of them are seen in patients who are along the border of the district which shares its boundary with the state of Kerala, where dirofilariasis is constantly reported to occur. Here, we report a case of subcutaneous dirofilariasis, presenting as a subcutaneous nodule on the left cheek of a 28-year-old male from Cochin (Ernakulam), Kerala, South India. Two live worms were recovered from the subcutaneous nodular swelling.
  2,241 146 1
Awareness about prescribed drugs among patients attending Out-patient departments
Jaswinder Singh, Narinder Singh, Rahat Kumar, Vikram Bhandari, Navpreet Kaur, Sheveta Dureja
January-June 2013, 3(1):48-51
DOI:10.4103/2229-516X.112240  PMID:23776839
Background: Communication skills play an important role in establishing doctor-patient relationship is widely recognized throughout the world. The information passed on to the patients affects the treatment outcomes. Objectives: The present study was undertaken to evaluate the level of awareness among OPD patients about prescribed drugs. Materials and Methods: A total of two hundred sixty four patients having a valid prescription from a doctor practicing in allopathic system, visiting 4 different chemist shops in a North Indian city were enrolled in the study. All the enrolled patients were given a preformed questionnaire to be answered on the spot. Results: It was found that though a considerable number of patients were aware about the therapeutic effects of the drugs and the manner of administration of the medicines; they lacked information regarding the side effects, warnings and the information their doctor may require at the next consultation. Conclusion: The study highlighted the fact that doctors need to spend more time with the patients to make them active participants in the drug therapy.
  2,066 288 5
Gastroesophageal junction adenocarcinoma metastasizing to gingiva
Smita S Masamatti, Amitkumar Bapuso Pandav, Medha P Kulkarni, Kalpana R Sulhyan
January-June 2013, 3(1):69-71
DOI:10.4103/2229-516X.112247  PMID:23776844
Malignant tumors rarely metastasize to the oral cavity and account for about 1% of all oral tumors. Metastasis to soft-tissue of the oral cavity is much rarer than jaw bones. Because of the rarity, metastatic tumors in the oral region are challenging for diagnosis. Primary tumors which metastasize to mouth are the most commonly lung, breast, and kidney. Oral cavity metastases represent distant spread and are associated with poor prognosis with short survival. We present a case of the gastroesophageal junction adenocarcinoma with metastasis to the oral soft-tissue.
  1,974 233 2
Infantile rhabdomyofibrosarcoma: A potentially underdiagnosed aggressive tumor
Narendra Chaudhary, Tanuja Shet, Anupama Borker
January-June 2013, 3(1):66-68
DOI:10.4103/2229-516X.112244  PMID:23776843
Infantile Rhabdomyofibrosarcoma (IRMFS) is a rare clinicopathological entity that resembles infantile fibrosarcoma (IFS) but has ultrastructural and immunohistochemical evidence of rhabdomyoblastic differentiation. We report a 2 years and 6 months old boy who presented with a slowly progressive large soft-tissue mass in left axillary region. After complete excision, histopathology report revealed diagnosis of IFS. Review of the histopathology with immunohistochemistry (positive for desmin) revealed diagnosis of IRMFS. He was treated with aggressive adjuvant chemotherapy. He was in complete remission 6 months after completion of chemotherapy. In view of poor prognosis and aggressive treatment approaches for IRMFS, it must be differentiated from IFS to avoid under treatment.
  1,930 252 1