Priyanka

Barriers to an early antimicrobial conversion from parenteral to non-parenteral routes are an important problem in the current scenario. Barriers such as a lack of appropriate guidelines for conversion therapies, a lack of culture sensitivity tests for selecting sensitive antibiotics, a lack of supervision by healthcare professionals on converted regimens, a lack of awareness among the patient population about the effectiveness of conversion therapy, and a lack of oral variant antibiotics for its intravenous agents on the market must be identified and resolved. The majority of barriers could be resolved by means of educational, interventional, and structural organizational changes. This may reduce the duration of parenteral antibiotic therapy and the consequent length of stay in hospital. This article review focuses on barriers involved in intravenous to oral antimicrobial conversion therapy and their rectifiable methods. Antibiotics are the most powerful weapons for infectious diseases and could be used in the most appropriate manner by resolving the barriers involved in such conversion therapies and improving the quality of life.

Screening of phytochemicals is a precious stair in the detection of bioactive principles present in particular medicinal plant and may lead to novel drug discovery. In the present study, Bacopa monnieri root extracts are tested for phytochemical and biochemical studies. Ethanolic extract shown good number of compounds compared to methanolic, ethyl acetate, aqueous and chloroform extracts. Phytochemical analysis of ethanolic tuber extract of Bacopa monnieri has shown the biological compounds like carbohydrates, cholesterol, Amino acids, Steroids, Alkaloids, Flavonoids, Cardiac glycosides, Saponins, Tannins, Terpenoids, Phlobatinins, Fattyacids, Coumarins and Phenols. The result suggests that the phytochemicals present in Bacopa monnieri tuber extracts may show antimicrobial, anti-inflammatory and antioxidant properties.

Dipeptidyl peptidase IV is a key regulator of insulin- stimulating hormones, glucagon-like peptide and glucose dependent insulinotrophic polypeptide. Thus it is a promising target for treatment of type 2 Diabetes mellitus. Inhibition of plasma Dipeptidyl peptidase IV enzyme lead to enhanced endogenous glucagon like peptide-1, GIP activity which ultimately results in the potentiating of insulin secretion by pancreatic cell and subsequent lowering blood glucose level, HbA [1c], glucose secretion, liver glucose production. One of the principal goals of diabetes management is to attain haemoglobin HbA [1c] treatment goals and prevent the onset or decrease the rate of occurrence of Microvascular conditions.2, 6 numerous treatment options are available for management of Type 2 Diabetes mellitus, various class of DPP IV inhibitor being explored such as Sitagliptin and Vildagliptin successfully launched. Several other novel DPP IV inhibitors are in pipeline, Unless there are clear contraindications, metformin monotherapy is prescribed, and if HbA [1c] targets are not attained after 3 months, 1 of several classes of agents could be added, such as sulfonylurea’s, Thiazolidinediones, dipeptidyl peptidase-4 inhibitors, - glucagon like peptide-1 receptor agonists, or basal insulin.2,6 Despite the broad range of therapeutic options, the attainment of HbA [1c] goals among patients with diabetes remains challenging, with just slightly more than half (52%) of diabetes patients attaining the common HbA [1c] goal of < 7.0%. The present review summarizes latest preclinical and clinical trial data of different DPP IV inhibitors with a special emphasis on their DPP8/9 fold selectivity and therapeutic advantages over GLP-1 based approach. Keywords: Diabetes 2, Dipeptidyl Peptidase-4, glucose-dependent insulinotrophic polypeptide, glucagon-like peptide-1.

The entire world is facing a worst situation of pandemic ever. It’s been more than 18 months after the initial reports on Covid from China, and the pandemic is still going.  As per the data available over the WHO website as of 23 June 2021, there have been 178,837,204 confirmed cases of COVID-19, including 3,880,450 deaths, reported to WHO. As of 21 June 2021, a total of 2,414,347,324 vaccine doses have been administered. Despite of having more than 15 vaccines for Covid-19; the challenge to treat a patient with a define line of treatment remains the same. In the present review we have made an attempt to summarize the various medicines which are being used by medical practitioner in India and overseas. Use of different drug molecules like Remdesivir, Tocilzumab, Hydroxychloroquine, Azithromycine, Ivermectin, Steroids, Doxicycline, Ecosprine, Low molecular weight Heparin, Lopinavir and Ritonavir, Nitazoxanide, Baricitinib etc. were highlighted; although the list is long. A focus is made on the different types of vaccines available till date and their status in various countries.

Surgery is the art of practice or work of treating diseases, injuries or deformities by manual or operative procedures. Before the start of operative procedures, a very brief course of antibiotics is initiated. This study aims to study the antibiotic utilization in surgical prophylaxis. This was a prospective and observational study conducted on 303 patients for a period of 06 months with the approval of institutional ethical committee from the Apollo multi specialty hospital & research center. Those who satisfied the study criteria were consented and participated for the study. Among 303 patients 183 male and 120 females were enrolled for the study. Most of the participants were in the age group of 31- 40 years. 205 patients had a clean- contaminated wound. Inj. Cefuroxime was the most prescribed prophylactic and post-surgical antibiotic in this study to avoid surgical site infection. None of the patients had developed any surgical site infections and the results which were satisfiable. Rational therapy with antibiotics helped patients to improve the quality of life by reducing financial and physical burden.

Cancer is a disease of abnormal, uncoordinated, uncontrolled and purposeless cell division in any part of body. The leading cause of death in women is due to breast cancer that accounts for 12.7% around the globe. This study aims to describe the prescribing trends and possible avenues for improving of chemotherapy drugs in breast cancer patients. The prospective observational was conducted among 178 patients in the Medical Oncological Department of Apollo Multispecialty Hospital and Research Center for a period of 6 months. The data was assessed and evaluated using statistical tool. The number of patients receiving adjuvant, neoadjuvant and palliative therapy was 131,10 and 37 respectively. The most commonly prescribed drug as monotherapy in adjuvant, neoadjuvant and palliative therapy was paclitaxel (14.5%) or zoledronic acid (14.5%), trastuzumab (40%) and zoledronate (45.9%) respectively. The most commonly prescribed combinational regimens drug in adjuvant, neoadjuvant and palliative therapy was Cyclophosphamide with Docetaxel (15.30%), Cyclophosphamide with Docetaxel (20%) or cyclophosphamide with Epirubicin (20%) and Letrozole with zoledronate (21.6%). Dexamethasone, ondansetron and pantoprazole (100%) were co administered in all the patients during their chemotherapy cycles. The observed side effects were back pain, anemia, neutropenia, insomnia, anxiety, myalgia, cough. The prescribed chemotherapy drugs for the breast cancer meet the criteria of patient’s adherence. Breast cancer is a prevalent type of cancer that require long term therapy and monitoring to evaluate and refine the therapeutic regimen of breast cancer to provide the extension and better quality of life.

The aim of the present investigation was to design a mucoadhesive liposomal system of Prednisone for the treatment of arthritis, severe allergic reaction multiple sclerosis that is capable of delivering entrapped drug over an extended period of time. Mucoadhesive liposomal formulations were prepared by different concentration of lecithin and cholesterol by thin film hydration technique followed by coating of liposomes by 0.2 % w/v of chitosan and Liposomes were evaluated for entrapment efficiency, particle size, zeta potential, surface morphology and in-vitro drug release and stability study of coated formulation. Particle size of the F4, F5 and F6 formulation was found to be 212 nm, 131 nm and 340 nm respectively and zeta potential were -164.9 mV, 165 mV and -9.6 mV, respectively. Highest entrapment efficiency was observed in the ranged of 83 % to 98% for formulation F1 Ë—F8 and CF1-CF2 were 90.87 % to 94.68%.  The percent drug release from F1-F8 was varied and affected by drug loading, soyalecitin and cholesterol concentration and followed non-Fickian diffusion mechanism. 2x3 factorial design were applied and studied the effect of parameter on entrapment efficiency and in vitro drug release at 2hrs, 6hrs, 12 hrs by using QI Macros R software.

The intension of present work is to incorporate economically cheap, easily available but effective herbal ingredient in personal hygiene products. Leaves of species Psidium Guajava belonging to familyMyrtaceae(Guava) have many properties like antibacterial, anti-cancer, anti-diabetic, anti-oxidant etc. The leaf extract of guava has traditionally been used for its health benefits. Toothpaste is a dentifrice used clean, maintain and improve the health of teeth. Toothpaste is mainly used to promote oral cleanliness and also acts as an abrasive that helps to prevent dental plaque and food particles from the teeth. The main aim of this investigation is to incorporate the herbal ingredient to that toothpaste that can effectively cleanse oral bacteria. Guava leaves were obtained from domestic garden. Guava leaves were washed with distilled water and shade dried for three days and then powdered for extraction. Guava leaf extraction was performed by Soxhlet apparatus with 70% ethanol for its antibacterial activity. This extract was used as principle ingredient for herbal toothpaste. Toothpaste formulation performed at laboratory level. The formulation was subjected to various evaluation tests like pH, spreadability, foaming ability, moisture content and zone of inhibition. All the results of evaluation tests found within the limits. For getting antibacterial property extraction is done against ethanol and agar well diffusion method used to identify its antibacterial activity shown by guava leaf extract on Escherchia coli, staphylococcus aureus depends on saponins, tannins and flavonoids. Even the extract can be used directly for treatment of inflamed gum. Pentacyclictri-terpenoidguajanoic acid is main constituent of guava leaf extract.

Present generation is a fast moving generation and no doubt about the potency of allopathic medicine, they provide fast result, but the darkest side of this medicine is their several side effects and contraindications. On the other hand the Ayurvedic medicines are good substitution for those medicines because of their less or no side effect and their ability to cure the problem from their root. The present study is based on the pharmacological activity of Dhanwantari’s Ditoxifie capsule. This drug is having great potential to deal with ache of muscles or joints, frequent headaches, low energy or frequent being tired, frequent cold or sickness, coughs or a sore throat, runny nose or sinus congestion, dense or yellow urine, painful bowel movements, acne or oily skin, lack of taste and many more. In the present work, experiments were conducted to evaluate the possible anthelmintic effects of Ditoxifie capsule on Indian earthworm (Pheretima posthuma) at 400mg/ml, 600mg/ml, and 800mg/ml concentration. Results were expressed in terms of time for paralysis and time for death of worms.

The aim of this study was to assess the drug utilization pattern of parenteral antibiotics in medicine units. A prospective and observational study was done on patients admitted in medicine indoor. Information regarding patient demographic details, patient medication history, and reason for admission, medication details and lab investigations. Patient drug therapy details such as diagnosis, clinical condition, therapy details such as name of the antibiotics, dose, route, frequency, duration of treatment were collected and recorded in performa. Rationality was assessed by using standard guidelines, micromedex, and NFI. Drug interactions and ADR were assessed  by using standard text books like stockley drug interactions text book 8th edition. And Micromedex. A 310 patients received parenteral antibiotics in the medicine units was found to be 12.54%. amongst incidence of use of parenteral antibiotics was highest in medicine unit B (42.12%). Cephalosporins (64.54%) were the most frequently prescribed class of  parenteral antibiotics. ceftriaxone (53.63%) was the frequently used antibiotic. Cefriaxone is commonly prescribed for viral fever. 43% of major drug interactions were identified. It is essential that appropriate guidelines on the use of parenteral antibiotics are implemented to prevent irrational use of antibiotics.