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In the modern era, the Indian Ayurvedic system of Medicine is believed to treat diseases from the root cause. The ayurvedic system claims to have many indigenous plants and herbal preparations, which provide therapeutic benefit in the treatment of kidney diseases. Aim - To study the benefits of herbal preparation Eladi quatha for kidney disease Urothalisis. Method - This study was undertaken to explore the effects of Eladi quatha in animals to treat kidney stone diseases. However, no safety profile for this formulation has been reported to date; thus, in this study, freshly prepared Eladi quatha was evaluated for acute toxicity. Acute toxicity test was evaluated as per OECD 423 guidelines with 5000 mg/kg as a limit test in Wistar strain Albino rats. Test formulations were administered to overnight fasted animals and parameters like body weight, behavioral changes, and mortality were assessed for 14 days. Hematological and biochemical parameters were assessed on the 14th day after administration. Result - No significant changes were noted in terms of behavioral changes, mortality, and body weight. The samples did not affect any of the hematological parameters. However, an increase in blood urea level was observed. Conclusion - This study concludes that freshly prepared Eladi quatha is relatively safe up to the dose of 5000 mg/kg. However, further chronic toxicity evaluation is necessary to establish its safety profile on chronic administration. [ABSTRACT FROM AUTHOR]

Adverse drug reactions (ADRs) are a significant drug-related cause of disease and death. Pharmacovigilance (PV) plays a key role in the management of ADRs. To assess the pharmacist's knowledge, attitudes and behavior of ADRs among community and hospital pharmacists in Gujarat, a validated questionnaire was developed and used to assess the understanding, attitudes and behavior of community and hospital pharmacists. 166 community pharmacists and 37 hospital pharmacists agreed to complete the ADR questionnaire. According to the study, the response of male pharmacists was higher than that of female pharmacists. In response to knowledge and practice, only the proportion of community pharmacists reporting ADR was 25 %, far lower than hospital pharmacists, who reported 65 %. Factors that encouraged the pharmacist to report ADR were the incredibly potent drug reactions, responses to the new product, and also well-recognized drug reactions documented in this study. In this study, 35 (94 %) hospital and 118 (75 %) community pharmacists guided and advised patients on their side-effects; while 25 (68 %) hospital and 115 (70 %) community pharmacists advised patients on what to do if they developed side-effects. The results of this study suggest that community pharmacists and hospital pharmacists in Gujarat need to improve their knowledge of the ADR. Pharmacists, on the other hand, should be participating in ADR awareness-raising events and refresher courses. [ABSTRACT FROM AUTHOR]

Natural prescriptions are yet serving for the treatment of a significant number of the wellbeing needs of huge populace of the world. Nevertheless, the quality control and quality confirmation stay a test in light of the fact that polyherbal plan has high fluctuation of synthetic parts included. No single part is answerable for the adequacy of the home grown detailing either in single structure or in blend with other natural medications. This makes a test in laying out inside quality control norms and normalization of completed natural medications. Systematically, the interest of Ayurvedic details are expanded however, because of absence of value control boundaries there might be issues in acknowledgment as like allopathic medications. Additionally occasionally, there are opportunities for connection between the recommended medications and spices. In this way, normalization of homegrown drugs is exceptionally fundamental to guarantee dependability particularly concerning quality, immaculateness, adequacy and wellbeing of the detailing. Numerous arrangements are been referred in Ayurvedic books for the treatment of urolithiasis. Eladi kwath is one such known plan, which is exceptionally compelling. In this review, Eladi kwath is exposed to organoleptic examination, pharmacognostical examination, phytochemical investigation, and subjective examination, natural investigation to recognize the presence of different parts its quality as per WHO Rules. The examination uncovered the presence of essential and auxiliary metabolites. Aim - To study the benefits of herbal preparation Eladi quatha for kidney disease Urothalisis. Method - This study was undertaken to explore the effects of Eladi quatha in animals to treat kidney stone diseases. However, no safety profile for this formulation has been reported to date; thus, in this study, freshly prepared Eladi quatha was evaluated for acute toxicity. Acute toxicity test was evaluated as per OECD 425 guidelines with 5000 mg/kg as a limit test in Wistar strain Albino rats. Test formulations were administered to overnight fasted animals and parameters like body weight, behavioral changes, and mortality were assessed for 14 days. Hematological and biochemical parameters were assessed on the 14th day after administration. Result - No significant changes were noted in terms of behavioral changes, mortality, and body weight. The samples did not affect any of the hematological parameters. However, an increase in blood urea level was observed. Conclusion- This study concludes that freshly prepared Eladi quatha is relatively safe up to the dose of 5000 mg/kg. However, further chronic toxicity evaluation is necessary to establish its safety profile on chronic administration. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of Chronic renal failure (CRF) in the Indian subcontinent and to identify risk factors and treatment regimens for CRF. Methods: A prospective observational study was carried out for 7 months. A total of 200 patients with a level of creatinine >1.5 mg/dl were enrolled. CRF prevalence was measured using the hospital's inpatient department registry and medical records. The risk factors and prescribing were evaluated from the patient file report. Results: The prevalence rate of CRF was 13.7%. Male patients (59%) dominate the entire group of patients. Most patients (n = 52) were found between the age group of 71–80 years with a mean age of 62.67 ± 16.33 years. Drugs such as diuretics, and hypoglycemics were indicated to treat comorbidities. The average number of drugs per prescription were 7.43 ± 2.75 with high use of antimicrobial agents (88%). Out of 156 drugs prescribed, 76 were from essential as per essential Drug List 2017. Hypertension (P = 0.0072) and diabetes (P = 0.0084) were major concerns as risk factors followed by the drugs used for dyslipidemia, and recurrent infections. Conclusion: The prevalence rate was found to be 13.7% with significant association with risk factors such as hypertension, diabetes, and nonsteroidal anti-inflammatory drugs, dyslipidemia, chronic infections, smoking, and renal calculus for CRF. The pattern of prescribing was suitable and with few irrationalities. [ABSTRACT FROM AUTHOR]

A study was planned to evaluate the prevalence, nature, and severity of drug-drug interactions (DDI) in geriatrics. A prospective observational study was carried out in hospitalized patients. DDIs were evaluated using a medscape drug interaction checker. Data of 300 patients were collected who were followed up for 3 days and analyzed over a period of 7 months. The prevalence rate of DDI was 90.3 %, as 271 out of 300 prescriptions showed drug-drug interaction. Out of 300 patients, 4797 possible DDIs were identified, of which 39 (0.81 %) were contraindicated, 290 (6.04 %) serious drug interactions, 3312 (68.85 %) significant interactions and 1156 (24.09 %) minor interactions. Out of 4797 possible DDIs, 2962 (62.91 %) were pharmacodynamics. 1835 (37.08 %) were pharmacokinetic type. Antihypertensive class of drug showed potential for DDIs. Total 244 (81.33 %) cases were found with potentially inappropriate medicines(PIM). The prevalence of DDIs in geriatric patients was 90.3 %. Poly pharmacy and multiple associated conditions in the elderly were the major contributing factors for DDIs. [ABSTRACT FROM AUTHOR]

Byline: Jalpa. Suthar, Varsha. Patel Objective: To determine the quality of prescribing in hypertension in primary and secondary health care settings using the Prescription Quality Index (PQI) tool and to [...]

Blood Pressure is the product of the cardiac output (CO) and Total Peripheral Resistance (TPR). Hypertension means elevation of arterial blood pressure. Anti-Hypertensive drugs are the agents which either decreases or normalize the elevated blood pressure. Objective: To study the prescription pattern of anti-hypertensive agents in the General Medicine department of Private Medical Hospital, Ahmedabad, Gujarat. Methodology: A cross sectional observational study was carried for one month duration. Results: During study, 100 hypertensive cases were collected. Among which 55% were males and 45% were females who were prescribed with anti-hypertensive agents. From various anti-hypertensive drugs, six major classes were commonly prescribed to the patients. It includes Diuretics (Ds), Calcium Channel Blockers (CCBs), Angiotensin Receptor Blockers (ARBs), Beta Adrenergic Blockers (BABs), Alpha Adrenergic Blockers (AABs) and Angiotensin Converting Enzyme Inhibitors (ACEIs). ARBs were prescribed in 31 prescriptions whereas; AABs were given in 4 patients only. Conclusion: Among beta blockers, Metoprolol was the most frequently utilized anti-hypertensive drug (31.48%) and Ramipril was the least utilized drug (1.36%). The telmisartan+amlodipine FDC was the common prescribed in patients with indication of CVS complications. [ABSTRACT FROM AUTHOR]

Objective: To determine the quality of prescribing in hypertension in primary and secondary health care settings using the Prescription Quality Index (PQI) tool and to assess the reliability of this tool. Materials and Methods: An observational cross-sectional study was carried out for 6 months in order to assess quality of prescribing of antihypertensive drugs using Prescription Quality Index (PQI) at four primary (PHC) and two secondary (SHC) health care facilities. Patients attending these facilities for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor (score of ≤31), medium (score 32-33) and high quality (score 34-43) based on PQI total score. Psychometric analysis using factor analysis was carried out to assess reliability and validity. Results: Total 73 hypertensive patients were included. Mean age was 61.2 ± 11 years with 35 (48%) patients above 65 years of age. Total PQI score was 26 ± 11. There was a signifi cant difference in PQI score between PHC and SHC (P < 0.05) Out of 73 prescriptions, 43 (59%) were of poor quality with PQI score <31. The value of Cronbach's α for the entire 22 criteria of PQI was 0.71 suggesting good reliability of PQI tool in our setting. Conclusions: Based on PQI scores, quality of prescribing in hypertensive patients was poor, somewhat better in primary as compared to secondary health care facility. PQI is reliable for measuring prescribing quality in hypertension in Indian set up. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the cardioprotective effects of Gynostemma pentaphyllum Makino in isoproterenol-induced myocardial infarction in rats and to evaluate the role of phosphatidylinositol 3-kinases (PI3K) in cardioprotection., Methods: The protective effect of the hydroalcoholic leaf extract of Gynostemma pentaphyllum (LEGP) on the heart was investigated against isoproterenol (ISO)-induced MI in rats. Preliminary phytochemical screening was performed followed by molecular docking. For the in vivo studies Wistar albino rats (Male) were divided among different groups. Different parameters were evaluated such as heart weight index, Electrocardiogram (ECG) analysis, triphenyl tetrazolium chloride assay, cardiac enzyme markers, oxidative stress, antioxidant enzymes, PI3K levels, and histopathology of cardiac tissue., Results: Results showed that LEGP improved the electrocardiogram, reduced infarct size, and decreased the levels of cardiac enzyme markers and oxidative stress, while antioxidant enzymes and PI3K levels were increased., Conclusion: LEGP protected the heart against ISO-induced MI in rats by improving hemodynamic, biochemical and histological attributes. These protective effects were produced by the phytoconstituents of the LEGP through modulation of the PI3K signalling pathway., Competing Interests: None., (AJTR Copyright © 2024.)

Objective: Several tools have been introduced to evaluate the quality of prescribing. The aim of this study was to determine the quality of prescribing in hypertension and bronchial asthma in tertiary health care (THC) setting using the new Prescription Quality Index (PQI) tool and to assess the reliability of this tool., Methods: A prospective cross-sectional study was carried out for 2 months in order to assess the quality of prescribing of antihypertensive and antiasthmatic drugs using recently described PQI at THC facility. Patients with hypertension and bronchial asthma, attending out-patient departments of internal medicine and pulmonary medicine respectively for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor, medium and high quality based on total PQI scores., Results: A total of 222 patients were included. Mean age was 56 ± 15.1 years (range 4-87 years) with 67 (30.2%) patients above 65 years of age. Mean total PQI score was 32.1 ± 5.1. Of 222 prescriptions, 103 (46.4%) prescriptions were of high quality with PQI score ≥34. Quality of prescribing did not differ between hypertension and bronchial asthma (P > 0.05). The value of Cronbach's α for the entire 22 criteria of PQI was 0.71., Conclusion: As evaluated by PQI tool, the quality of prescribing for hypertension and bronchial asthma is good in about 47% of prescriptions at THC facility. PQI is valid for measuring prescribing quality in these chronic diseases in Indian setting.

Objective: To evaluate prevalence, types, and severity of potential adverse drug-drug interaction in medicine out-patient department., Materials and Methods: A single-point, prospective, and observational study was carried out in medicine OPD. Study began after obtaining approval Institutional Ethics Committee. Data were collected and potential drug-drug interactions (pDDIs) were identified using medscape drug interaction checker and were analyzed., Result: A total of 350 prescriptions with mean age 52.45 ± 14.49 years were collected over a period of 5 months. A total of 2066 pDDIs were recorded with mean of 5.90 ± 6.0. The prevalence of pDDI was 83.42%. Aspirin was most frequently prescribed drug in 185 (10.15%) out of total of 1821 drugs It was also the most frequent drug implicated in pDDI i.e. in 48.16%. The most common pDDI identified was metoprolol with aspirin in 126 (6.09%). Mechanism of interactions was pharmacokinetic in 553 (26.76%), pharmacodynamic in 1424 (68.92%) and 89 (4.30%) having an unknown mechanism. Out of all interactions, 76 (3.67%) were serious, 1516 (73.37%) significant, and 474 (22.94%) were minor interaction. Age of the patients (r = 0.327, P = 0.0001) and number of drugs prescribed (r = 0.714, P = 0.0001) are significantly correlated with drug interactions., Conclusion: Aspirin being the most common drug interacting. The use of electronic decision support tools, continuing education and vigilance on the part of prescribers toward drug selection may decrease the problem of pDDIs.