Sudhanshu Sekhar Mishra

Analgesic effect of ethanolic leaf extract of moringa oleifera on albino mice

Objectives: Moringa oleifera is a highly valued plant distributed in many countries of the tropic and subtropics. Moringa oleifera leaves are a potential source of phytochemical ingredients claimed to have analgesic property. Pain is an unpleasant sensation, which in many cases represents the only symptom for the diagnosis of several diseases. Therefore analgesic drugs lacking the side effect as alternative to nonsteroidal anti-inflammatory drugs (NSAIDs) and opiates are in demand by the society. The present study is undertaken to evaluate the analgesic activity of Moringa oleifera using acetic acid induced writhing test and Eddys hot plate test. Materials and Methods: It is a randomized control study. The present study was done using two experimental models. The albino mice were divided into six groups, each group consisting of 6 mice. A total of 36 mice were used in each of the two experimental models. Group I: Control (normal saline given orally at 2 ml/kg body weight); Group II: Standard (diclofenac 10 mg/kg i.p/ morphine 1 mg/kg i.p); Group III, IV, V, VI (ethanolic extract of Moringa oleifera (EMO) 50, 100, 200, 400 mg/kg, respectively). The EMO leaves were administered at 50, 100, 200, 400 mg/kg doses orally 1 hour before the experiments. For peripheral analgesic effect, acetic acid induced writhing test was used. The central analgesic effect was screened using Eddys hot plate method. The standard drug used in acetic acid induced writhing test was diclofenac and in Eddys hot plate test was morphine. Results: The EMO leaf showed significant (P < 0.01) analgesic activity at 100, 200, 400 mg/kg in the acetic acid induced writhing test showing 32.21%, 59.71% and 78.61% inhibition of writhes, respectively in comparison with the control. In the Eddys hot plate test EMO at 400 mg/kg showed significant (P < 0.01) analgesic activity from 15 min to 90 min with a mean rank ranging from 28.92 to 26.00, second mean rank following morphine in comparison with control. In both the tests, EMO showed significant (P < 0.01) analgesic activity in a dose-dependent manner. Conclusion: The ethanolic leaf extract of Moringa oleifera exhibited analgesic activity in both models showing its both central and peripheral analgesic actions.

Statistical Evaluation of Two Microbiological Diagnostic Methods of Pulmonary Tuberculosis After Implementation of a Directly Observed Treatment Short-course Program

Objectives: To evaluate the diagnostic accuracy of smear and culture tests of clinical samples of pulmonary tuberculosis after the introduction of the directly observed treatment short-course (DOTS) program. Methods: Using sputum samples from 572 individuals as a self-selected population, both Ziehl–Neelsen staining and culturing on Lowenstein–Jensen medium were carried out as diagnostic procedures. Using Bayes’ rule, the obtained data set was analyzed. Results: Of the 572 samples, 33 (0.05769) were true positive (results of both tests positive) cases; 22 samples (0.03846) were false positive (smear test positive and culture test negative) cases; 62 samples (0.10839) were false negative (smear test negative and culture test positive) cases; and 455 samples (0.79545) were true negative (results of both tests negative) cases. Values of test statistics, sensitivity, and specificity were used to compute several inherent other Bayesian test statistics. The a priori probability or prevalence value of tuberculosis in the targeted population was 0.166. The a posteriori probability value computed arithmetically was 0.6614 and that obtained by the graphical method was 0.62. Conclusions: The smear test was found to be dependable for 95.4% with stable TB infections, and it was not dependable for 34.7% without stable TB infections. The culture test could be regarded as the gold standard for 96.15% as seen with the data set, which was obtained after the implementation of the DOTS program.

Antipyretic effect of ethanolic extract of Moringa oleifera leaves on albino rats

Objective The aim of the study was to evaluate the antipyretic activity of ethanolic leaf extract of Moringa oleifera using Brewer′s yeast-induced pyrexia model. Materials and methods It was a randomized controlled experimental study. A total of 60 rats were taken, dividing them in six groups, each containing 10 rats. Ethanolic extract of M. oleifera (EMO) was administered at 50, 100, 200, and 400 mg/kg doses orally to the respective four groups. The control group was fed with normal saline at 2 ml/kg. A 20% suspension of Brewer′s yeast in normal saline was injected subcutaneously at a dose of 10 ml/kg body weight below the nape of neck of rats in all groups. Pyrexia developed after 10 h of Brewer′s yeast injection and the temperature was recorded. Animals which showed a rise in body temperature to at least 39°C were included in the study, allowing a minimal of six rats in each group, total of 36 rats. Drugs were given after development of pyrexia and temperatures were recorded. Paracetamol at 100 ml/kg orally was taken as the standard drug. Results The ethanolic leaf extract of M. oleifera showed significant (P < 0.05) antipyretic activity at 100, 200, and 400 mg/kg. Paracetamol showed significant antipyretic activity from 15 min of drug administration to 12 h. EMO at a dose of 50 mg/kg did not show antipyretic effect. The onset of action of EMO 100 mg/kg was found to be 2 h and that of 200 and 400 mg/kg was found to be 30 min. For all the doses, the antipyretic effect lasted up to 12 h. Conclusion The ethanolic leaf extract of M. oleifera exhibited significant (P < 0.05) antipyretic activity at 100, 200, and 400 mg/kg.

Study of utilization pattern and patient compliance of oral anti-hyperglycemic drugs in a tertiary care teaching hospital in Eastern India

Background: Diabetes mellitus is a major chronic health problem globally, so the patterns of drug utilization study of oral anti-hyperglycemic drugs are of chief concern to promote rational drug use in diabetics and make available the valuable information for the healthcare providers. Objective: This study was performed to determine the drug utilization pattern of oral anti-hyperglycemic drugs in Type-2 diabetes mellitus (T2DM) patients in a tertiary care teaching hospital in Eastern India. Materials and Methods: A prospective, observational, and noncomparative study was carried for 12 weeks in T2DM patients on oral anti-hyperglycemic drugs for at least 1 week. Results: Total 230 patients were enrolled with mean age of 54.66 ± 13.24 years and duration of diabetes was 8.71 ± 7.78 years. Among these, 78 (33.91%) were in the age group 51–60 years, 132 (57.39%) had a diabetic history of <10 years, and 168 (73.04%) had associated hypertension. Mean number of drugs prescribed were 7.01 ± 2.73. Total numbers of patients receiving more than five drugs were 162 (70.43%). The biguanide (85.21%) was the most commonly prescribed oral anti-hyperglycemic drugs followed by sulfonylureas (58.26%). The 97 (75.78%) female patients were shown good compliance as compared with 72 (70.58%) males. Conclusion: Metformin (Biguanide) was the most commonly prescribed oral anti-hyperglycemic drugs for Type-2 diabetes. This study indicates the clinical monitoring of the patients compliance to the prescribed drug for achieving good glycemic control is also recommended, along with other comprehensive management such as life style changes, dietary modification, treatment of complications, and co-morbidities related to diabetes.

A Study on the Drug Utilization Pattern in Patients with Chronic Kidney Disease with Emphasis on Antibiotics

Objective: To study and describe the utilization pattern of various classes of drugs including antibiotics in patients with chronic kidney disease (CKD). Materials and Methods: A total of 185 CKD patients were finally recruited after strictly obeying the selection criteria in this cross-sectional, observational study that was conducted over a period of 6 months in Nephrology Department of a tertiary care teaching hospital. Relevant data were extracted by interviewing the patients and from prescriptions, case records, and investigational reports. Results: Mean age of CKD patients was 45.81 ± 11.16 with male predominance (58%). CKD Stage III comprised of the maximum number (28%) of patients. Polypharmacy was executed in 83% of these patients. Hypertension (95%), diabetes (87%), and anemia (86%) are the most common co-morbidities. The five most frequently prescribed drugs were diuretics (100%), anti-ulcer agents like proton pump inhibitors and H 2 blockers (98%), anti-hypertensives (95%), vitamins and minerals supplements including calcium (92%), and hematinics (85%). Infectious diseases like respiratory tract infection (37%) and urinary tract infection (34%) had shown to have a high prevalence in CKD patients. Cefoperazone, metronidazole, piperacillin + tazobactam were the most prescribed parenteral antibiotics. Azithromycin and levofloxacin were the extensively used oral antibiotics. Conclusion: This study demonstrates the variability of drug utilization in CKD patients. Drug utilization studies on a regular basis give a framework to pharmaceutical companies and healthcare providers and help to build management strategies. However, the right choice of drugs and inappropriate doses will reduce the incidence of nephrotoxicity and ultimately result better clinical outcomes. Managing infections and prescribing antibiotics in CKD are crucial and hence claim rationalization of the use of antibiotics to improve the quality of life of CKD patients.

Therapeutic evaluation of “Ayush Tulsi Jiwan Plus” oil for chronic musculoskeletal pain relief

Background: Chronic pain of musculoskeletal origin is a very common symptom and has major effect on the physical, mental, and economic aspects of the patients. There is always a crave among physicians and patients for effective analgesic, curable preparation that can be locally applied. Aim: The aim of this study is to assess the efficacy and safety of “Ayush Tulsi Jiwan Plus” oil in chronic pain management of musculoskeletal origin. Materials and Methods: Fifty patients of chronic musculoskeletal pain of unknown origin of mild to moderate condition were advised to apply “Ayush Tulsi Jiwan Plus” oil locally twice daily for 6 weeks and examined weekly. After completion of the treatment, the efficacy of the therapy was assessed on the basis of the subjective criteria such as perception of pain, tenderness, swelling, and joint mobility. Results: In this study, mean baseline score versus last visit score of pain (2.84 ± 0.68 vs. 1.33 ± 0.76), tenderness (1.64 ± 0.74 vs. 0.36 ± 0.56), and swelling (0.64 ± 0.85 vs. 0.38 ± 0.66) was significantly decreased, and also clinical improvement was seen in the study participants along with no evidence of adverse drug reactions. Conclusion: The analysis of the overall effect of this “Ayush Tulsi Jiwan Plus” oil preparation was found efficacious and topically safe in chronic pain conditions. However, further study will be required with larger sample size and in heterogeneous population to elicit long-term effect of this polyherbal preparation.