Ankita Wal

Biological Activities of Lupeol

Pentacyclic lupane-type triterpenes, exemplified by lupeol [lup-20(29)-en-3b-ol], principally found in common fruit plants such as olive, mango, strawberry, grapes, etc., were reported to possess beneficial effects as a therapeutic and preventive agent for a range of disorders. Although lupeol exhibits an array of biological activities like anti-inflammatory and anti-arthritic activities both in in vitro and in vivo systems, extensive exploration to establish its role as a chemopreventive compound is warranted. Last 15 years have seen tremendous efforts by researchers worldwide to develop this wonderful molecule for its clinical use toward the treatment of a variety of disorders. These studies also provide insight into the mechanism of action of lupeol and suggest that it is a multi-target agent with immense anti-inflammatory potential targeting key molecular pathways which involve nuclear factor kappa B (NF-jB), cFLIP, Fas, Kras, phosphatidylinositol-3-kinase in a variety of cells. It is noteworthy that lupeol at its effective therapeutic doses exhibits no toxicity to normal cells and tissues. The perception of chemoprevention lies still in its infancy. Intervention to slow down, arrest or reverse the process of carcinogenesis by the use of either natural or synthetic substances individually or in combination therapy has emerged as a promising and pragmatic medical approach to reduce cancer risk.

Pharmacist involvement in the patient care improves outcome in hypertension patients

Objective: The main objective of this study was to assess the effects of pharmaceutical care interventions in patients with essential hypertension in Lakshmi Pat Singhania Institute of Cardiology, Kanpur, India. Methods: The study was carried out from July 2010 to August 2011. Pharmaceutical care was provided for 54 patients (intervention group) which was comprised of the patient education, the prescription assistance and the life style modifications and motivation for health. Then the clinical outcome as well as health related quality of life (HRQOL) were compared with the control group (48 patients) in which the pharmaceutical care was not provided. Furthermore, the effect of pharmaceutical care intervention on HRQOL was assessed using Short Form-36 (SF-36), a general health related quality of life questionnaire used to evaluate the QOL of patients. Blood pressure (BP) measurements and QOL survey was performed at baseline and at the follow-up session. Findings: The difference between blood pressure readings from the baseline to the second follow-up was significant for systolic [(P = 0.0001), 12.24 mmHg] and diastolic BP [(P = 0.001), 5.17 mmHg] in the intervention group. The questionnaire used to evaluate the QOL of patients also showed improvement in the mean score for intervention group. Conclusion: Results from our study showed that applying pharmaceutical care to hypertensive patients can help in the control of these patients’ blood pressure, and consequently lower the risk that hypertension poses in cardiovascular disease. Successful implementation of pharmaceutical care has the potential to increase patients’ satisfaction with their pharmacists’ activities and may increase patients’ expectations that pharmacists will work on their behalf to assist them with their healthcare needs.

Medicinal Value of Euphorbia Tirucalli

Natural products play an important role in drug discovery and many approved therapeutics as well as drug candidates have been derived from natural sources. They have been the source of most of the active ingredients of medicines. The beneficial medicinal effects of plant materials typically result from the combinations of secondary products present in the plan. These secondary metabolites constitute the medicinal value of a drug plant, which produces a definite physiological action on human body. The plant of Euphorbia tirucalli belongs to the family Euphorbiaceae, which is commonly known as Barki-thohar. This plant is native of America but has become acclimatized and grows freely in all parts of India. This is a common medicinal plant of India; the plant′s milky juice and stem bark are used. Milky juice in small doses is a purgative but in large doses it is acrid, counter-irritant, and emetic. E. tirucalli latex seems to reduce the specific cellular immunity associated with the virus Epstein-Barr injection by activating the virus lytic cycle. The bark/latex of E. tirucalli presents pharmacological activities as anantibacterial, molluscicide, antiherpetic, and antimutagenic. It also shows cocarcinogenic and anticarcinogenic activities. In the northeast of region in Brazil, the latex of E. tirucalli is used as a folk medicine against syphilis. As an antimicrobial; a laxative agent to control intestinal parasites to treat asthma, cough, earache, rheumatism, verrucae, cancer, epithelioma, sarcoma, and skin tumors. E. tirucalli contains a large quantity of terpenes and sterols among its constituent and the following substances, which have been isolated; alcohol eufol, alfaeuforbol, and taraxa sterol e tirucallol (Imai, 1994; This review highlights on the existing information particularly on the phytochemistry and various pharmacological properties of E. tirucalli, which may provide incentive for proper evaluation of the plant as a medicinal agent.

Aliskiren: An orally active renin inhibitor

Renin inhibitors are antihypertensive drugs that block the first step in the renin-angiotensin system. Their mechanism of action differs from that of the angiotensin-converting enzyme inhibitors and angiotensin-receptor antagonists, but like these drugs, renin inhibitors interrupt the negative feedback effects of angiotensin II on renin secretion. The renin–angiotensin–aldosterone system (RAAS) has long been recognized to play a significant role in hypertension pathophysiology. Certain agents that modify the RAAS can control blood pressure and improve cardiovascular outcomes. Optimization of this compound by Novartis led to the development of aliskiren – the only direct renin inhibitor which is clinically used as an antihypertensive drug. Aliskiren is the first of a new class of antihypertensive agents. Aliskiren is a new renin inhibitor of a novel structural class that has recently been shown to be efficacious in hypertensive patients after once-daily oral dosing. In short-term studies, it was effective in lowering blood pressure either alone or in combination with valsartan and hydrochlorothiazide, and had a low incidence of serious adverse effects. It was approved by the Food and Drug Administration in 2007 for the use as a monotherapy or in combination with other antihypertensives. Greater reductions in blood pressure have been achieved when aliskiren was used in combination with hydrochlorothiazide or an angiotensin-receptor blocker. The most common adverse effects reported in clinical trials were headache, fatigue, dizziness, diarrhea, and nasopharyngitis. Aliskiren has not been studied in patients with moderate renal dysfunction; as an RAAS-acting drug, it should be prescribed for such patients only with caution.

Management of coronary artery disease in a Tertiary Care Hospital

Aims: The objective of the study was to study the prescribing patterns of drugs used in the coronary artery disease (CAD) and to identify, which drug is mostly prescribed at that hospital. Settings and Design: This was a prospective observational survey including case series analysis of patients with CAD who met the inclusion criteria. It was conducted in the cardiology unit of multidisciplinary Tertiary Care Hospital in Kanpur. Materials and Methods: Data of patients who met the inclusion criteria was collected in specially designed case record forms. It was designed to include the patient data such as, demographics, risk factors, clinical and biochemical characteristics, procedures and investigations performed during the hospital stay, in-hospital and discharge drug therapy. Statistical Analysis Used: Descriptive statistics were performed for baseline characteristics, risk factors and medication use. All the analyses were performed using Statistical Package for Social Sciences version 16.0. Results: Subjects of age groups 65-74 (33.34%) were found to be more susceptible to CAD. In this study, we see that Aspirin, Clopidogrel and Statins were mostly prescribed in this hospital. Conclusions: In this study, Aspirin and Clopidogrel were mostly prescribed. According to 2009 focused updates of American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the management of patients with ST-elevation Myocardial Infarction. So in this hospital prescription for CAD were according to the guideline.

ROLE OF VARIOUS RISK FACTORS ASSOCIATED WITH CARDIOVASCULAR DISEASE S

Coronary Artery Disease (CAD) is the l eading cause of cardiovascular mortality world wide. Increasing rate of CAD mortality and projected rise in CAD mortality for 2020 in the developing world necessitates immediate prevention and control measures. Cardiovascular disease (CVD) is generally du e to reduced blood flow to the heart, brain or body caused by atheroma or thrombosis. It is increasingly common after the age of 60, but r are below the age of 30. Plaques (plates) of fatty atheroma build up in different arteries during adult life. These ca n eventually cause narrowing of the arteries, or trigger a local thrombosis (blood clot) which completely blocks the blood flow. Despite scientific evidence that evidence based drug therapy reduce mortality in patients with established CAD, these therapies continue to be underutilized in patients receiving conventional care. It is essential to identify and manage risk factors for coronary artery diseases and to implement unique and creative approaches to stimulate better adherence to practice guidelines, to improve the quality of care given to patients with CAD. Reduction of SBP, DBP, heart rate, and body fat%, total cholesterol, triglycerides and LDL after regular yogic practices is b eneficial for cardiac and hypertensive patients. Emphasis focusing on conv entional risk factors, lifestyle modifications, smoking cessation, reduction of central obesity through dietary modification and exercise, can be proved to be the key interventions for preventing CAD.

Genetic predisposition to oxcarbazepine induced Stevens-Johnson syndrome

Stevens–Johnson syndrome (SJS) is a rare immunologic reaction that may involve skin or various mucosal surfaces. The etiology may range from multiple pharmacologic agents to viral infections. Associated findings can range from minimal skin and mucosal involvement to extensive dermal exfoliation, nephritis, lymphadenopathy, hepatitis, and multiple serologic abnormalities. We report a female patient of 38 years with a history of drug allergy who was administered oxcarbazepine for the management of right partial bronchial seizure due to left parasagittal mass lesion following which she developed papular rashes all over the body and diagnosed as SJS. Although carbamazepine (CBZ) is the most common cause of SJS, a new anticonvulsant, oxcarbazepine, which is structurally related to CBZ, has been shown to induce SJS.

Pharmacognostic Evaluation of Roots of Benincasa Hispida (Thunb.) Cogn.(Cucurbitaceae)

Received: September 13, 2017 Revised: January 22, 2018 Accepted: March 05, 2018 Abstract: Background: Herbals have been proven to be offering a wide number of medicinal uses and are having multiple benefits when considered as a complete system of medicine. Benincasa plant is rich in phytoconstituents, present almost in every part of the plant. Roots are the parts on which minimum work has been done.

Development, Characterization and Transdermal Delivery of Dapsone and an Antibiotic Entrapped in Ethanolic Liposomal Gel for the Treatment of Lapromatous Leprosy

Received: November 30, 2017 Revised: April 5, 2018 Accepted: April 16, 2018 Abstract: Background and Objective: Applying Ethosomal Gels (EGs) in transdermal drug delivery systems has evoked considerable interest because of their good watersolubility and biocompatibility. The aim of present study was to prepare and characterize ethosomes of antileprotic drug Dapsone (DAP) together with an antibiotic Cloxacillin Sodium (CLXS) which may deliver these drugs to targeted site more efficiently than marketed gel preparation of DAP and also overcome the problems related with oral administration of CLXS.

A REVIEW ON IMPLICATIONS OF BIOLOGICAL RHYTHMS ON LONG-HAUL TRAVELLERS IN DIFFERENT TIME ZONES AND SEDENTARY LIFESTYLE: WORSENING OF DIABETES MELLITUS

Incidences of Diabetes mellitus (DM) gets worsen on frequent long-haul travel in different time zones and sedentary lifestyle. An extensive review of the published articles related to diabetes, the effect of lifestyle modification (exercise and diet) and travelling of diabetic people across different time zones were done and these were accessed from Pubmed-Medline, Web of Science, Cochrane Library, EMBASE, Lancet and Diabetes Care. The study done by different scientists were compared and interpreted for the worsening of cases of DM. For long-haul travel in different time zones, it was observed that, due to metabolic disturbances, serious consequences of DM were observed in flight, but that can be prevented if pre-advice are taken by the patients and strictly followed. The cumulative incidences of diabetes of 10 cases were compared and mean cumulative incidences of control group (following sedentary lifestyle) was 42.77% and of intervention group (following healthy diet and moderate physical activity) was 22.11% confirming that implementation of the healthy diet and exercise as regular physical activity caused the lowering of cumulative incidences of diabetes. According to the research conducted on frequent flyers and sedentary lifestyle, the hypothesis quoted by various scientists is that DM is a metabolic disorder which easily gets affected by the frequent changes in the metabolism leading to its high incidences. Thus, the concept of chronobiology comes into light that requires more research to correlate the disturbed biological rhythm (Circadian cycle) to the incidences and severity of DM condition (worsening or increased incidences of DM).