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Antivitamins are compounds that negate the biological effects of vitamins. They have been successfully exploited for the development of various classes of drugs. In the early 19th century, the antifolate prontosil was developed for the treatment of puerperal fever. Since then, numerous other antifolates have been used to treat a wide range of infections. Antifolates, such as methotrexate, are potent anticancer agents and antivitamin K, such as warfarin, are used as anticoagulants. Despite several years of research, most antivitamin-based drugs are limited to vitamin K and B9, and the development of antagonists for other vitamins is still in the nascent stage. In the era of antimicrobial resistance, antivitamins can be considered as a promising alternative to develop newer antimicrobials and are worth exploring further. This review discusses key antivitamins at different stages of development which have potential utility as antibiotic drug candidates. The summary of studies of antivitamins in clinical development is also narrated.

Objectives: Pertussis seroprotection among neonates depends on maternal antibodies before receiving their first childhood acellular pertussis (DTaP) vaccination. Therefore, childbearing women need to have adequate seroprotection, either before conception or during the antenatal period, to protect their neonates from contracting neonatal pertussis. Given the global rise in neonatal pertussis incidence, there is a need to address the importance of protection against this infection by promoting booster vaccinations among female medical students as a preventive measure for their future generation. This paper addresses a part of our study on the seroprevalence of anti-PT IgG antibodies in female medical students who are more prone to acquire infections from the patients during their clinical rotations. Methods: A cross-sectional study was conducted for three months by recruiting female medical students of RAK Medical and Health Sciences University, Ras Al Khaimah, UAE. The antibody levels (IgG) of pertussis (anti-PT) in blood sera of the study population were quantitated by enzyme-linked immunoassay. A 60 – 125 IU/mL titer was considered the positive titer level (p-value Results: Among 90 ethnically different student participants (mean age of 21 years), forty-four percent (n=40) showed detectable titers of anti-PT IgG antibodies. Whereas fourteen percent of participants (n=13) had high positive titers above 125U/mL, four percent (n=3) showed positive titers ranging from 60-125IU/mL. Two percent (n=2) were in borderline with 55 - Conclusion: Only forty-four percent had detectable titers of anti-PT IgG antibodies, among whom fourteen percent (n=13) had high positive titers indicating recent infection. The results signify a low level of seroprotection among female medical students that emphasizes the need to promote booster vaccination for the high-risk group who work in the health profession.

Objective: To synthesize peer-reviewed knowledge on the frequency of different types of chemotherapy medication errors. Methods: The data were collected from studies published between January 1, 2000, and March 3, 2018, and are identified through online resources such as Medline/PubMed, PubMed Central, Agency for Healthcare Research, and Quality and the Cochrane Library. The manuscripts published in peer-reviewed scientific journals in English language were included in the study. Initially, 19,723 articles were retrieved and finally 11 were found to be eligible to include in the review and were assessed for quality. Error percentages were calculated from the ratio of error type (numerator) to sample size (denominator: medication orders or prescriptions). Results: Overall, the chemotherapy medication errors ranged from 0.004% to 41.6% among various studies. Chemotherapy medication errors ranged from 0.1% to 24.6% in prescribing, 0.40% to 0.50% in preparation, 0.03% in dispensing, and 0.02% to 0.10% in administering phases. Conclusion: Prescribing phase had the highest number of chemotherapy medication errors reported, and least was reported during dispensing phase. We also noticed a need for harmonization for reporting of medication errors.

Background: Vitamin D which is involved in the maintenance of bone mineral homeostasis has been found to portray various pleiotropic effects. Although it has been widely accepted that serum 25-hydroxy Vitamin D level above 30 ng/ml is considered optimal for the biological actions of Vitamin D, there is a need to explore the levels of Vitamin D reported among Indians from various regions of the country. Hence, this systematic review aims to appraise the status of Vitamin D levels reported from apparently healthy Indians across various parts of India. Methodology: A comprehensive literature search was carried out to identify the range of Vitamin D levels among apparently healthy individuals from various parts of India, with the search term “Vitamin D and India” in the search portals of PubMed, Google Scholar, Indmed, and ScienceDirect. A total of 2998 articles were retrieved by the above search strategy, of which only forty studies fulfilled the criteria to be included in the systematic review. Studies done in various states were compiled under the respective zones based on the classification of Indian zones as specified in Zonal maps of India. Results: The level of Vitamin D from all the forty included studies ranged from 3.15 ± 1.4 to 52.9 ± 33.7 ng/ml. The effect size of Vitamin D level was higher in the South Zone compared to other zones. Conclusion: The present study shows that Vitamin D deficiency is prevalent among apparently healthy Indians living in different regions of India, irrespective of their exposure to sunlight.

Background: Palmar plantar erythrodysesthesia (PPE) is a dose limiting toxicity of anticancer agents. In some cases it may mandate for discontinuation of anticancer agents. Evaluation of data of PPE among reported adverse drug reactions (ADRs) from the Department of Medical Oncology could quantify the burden. Aim: To evaluate and analyse the PPE among reported ADRs from medical Oncology. Materials and Methods: The data of all cases of reported PPE were collected during January 2012 to September 2013 and were analysed with WHO causality assessment scale. The severity was clinically graded. The follow-up data regarding outcome of ADRs were also noted. Results: During the study period of 21 months a total of 1418 ADRs have been reported from 1076 patients. Among them PPE was reported from 31 cases (2.9%). Majority (32.2%) of these patients were on chemotherapy for breast cancer. Patient’s age ranged from 17 to 68 y and the median age was 50 y. There were 18 female (58%) and 13 male patients (42%). Capecitabine was the leading drug involved in PPE, reported with 20 cases (64.5%), and followed by docetaxel with 5 cases (16.1%). Majority (67.7%) of the reactions was categorized as certain and 64.5% was grade II severity clinically. Conclusion: Our findings show that PPE accounts for 2.9% of total reported ADRs from Medical Oncology during 21 months. Majority of the reactions were classified as certain. Capecitabine is commonly implicated drug.

A 59 year old female consumer was started on therapy with oyster shell calcium in combination with vitamin D3 and she presented with swelling below the ear, after two doses. She stopped the drug by herself and the swelling disappeared in one day. She started the drug one day after recovery and again she developed the swelling. She was advised to stop the drug with a suggestion to take lemon to enhance parotid secretion and the swelling subsided. Calcium plays major role in salivary secretion and studies have shown reduced parotid secretion in rats, deficient of vitamin D. But in humans involvement of calcium and vitamin D3 in parotid secretion is unknown. However, the patient had no history of reaction though she had previously taken vitamin D3 with calcium carbonate which was not from oyster shell. Hence, we ruled out vitamin D3 in this reaction and suspecting oyster shell calcium as a culprit. This adverse drug reaction (ADR) was assessed using World Health Organization (WHO) causality assessment, Naranjo's and Hartwig severity scales. As per WHO causality assessment scale, the ADR was classified as "certain". This reaction was analyzed as per Naranjo's algorithm and was classified as probable. According to Hartwig's severity scale the reaction was rated as mild. Our case is an example of a mild but rare adverse effect of oyster shell calcium carbonate which is widely used.

Objectives: (1) To teach students about the pharmacology of autonomic nervous system through three different visual aids; (2) To evaluate the student’s knowledge acquired through visual aids, by pre- and post-test; (3) To get student’s feedback on three teaching methods. Materials and Methods: Subjects: MBBS students beginning the pharmacology course. Visual aids used: PowerPoint (PPT) slides, computers with Ex Pharm 2000 software (computer assisted learning [CAL]), graphic illustrations. Evaluation: Before initiating the lectures, the students are given a pre-test to assess their knowledge. Then, the students are taught with graphic illustrations, CAL, and PPT slides. After each teaching method, posttest with questions at more advanced level will be posed to probe their understanding. The students who are present for pre-test and at least two post-tests are alone included for statistical analysis. Students are grouped into three (Groups A, B and C) based on the marks they have received. Group A includes students who score below 50% and Group B between 50% and 75%. Group C includes above 75%. All the groups are compared between and within for all three modes of teaching. Finally, students will fill questionnaire to express their view on these teaching methods. Results: There was statistical significance between pre-test and all post-tests as compared by Mann–Whitney U test. The mean score within the Groups A and B were compared by paired t test which also showed significance ( P < 0.05). Statistical analysis by paired t test showed P value as highly significant (0.000). However, the comparison of mean score among Group C showed no statistical significance. Students expressed their opinion on each teaching method. Conclusion: Visual aids facilitate the learning process. In our study, all visual aids complemented each other and imparted a good knowledge to students.