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Context: Nonsteroidal antiinflammatory drugs (NSAIDS) are mainstay of therapy in various inflammatory conditions. Its long-term use is associated with acid peptic diseases requiring prophylaxis with antiulcer drugs. Thus the question arises whether inhibition of gastric acid secretion affects the bioavailability of NSAIDS. Thus prescribing NSAIDS together with H2 blockers seems to be a safe strategy but the combination becomes less effective for its primary intention. Aims: To evaluate the effect of combination therapy on efficacy of NSAIDs in terms of analgesic, antiinflammatory and antipyretic activity. Settings and Design: Experimental study in albino rats. Materials and Methods: Evaluation of analgesic activity was done by acetic acid writhing model, antiinflammatory activity was assessed using carrageenin-induced paw edema and for antipyretic activity yeast was used (n = 6). Gastric juice pH was analyzed. Statistical Analysis: Comparison between different groups was done by one-way analysis of variance (ANOVA) followed by Tukey's test using Graph pad prism software version 5.01. The analgesic, antiinflammatory, and antipyretic activity was significantly reduced when aspirin, diclofenac and piroxicam were combined with famotidine. There was a pH rise in H2 blockers pretreated groups, which was more with famotidine as compared with ranitidine pretreated group. Conclusions: Prescribing NSAIDs and H2 blockers together seems to be safe strategy but the drug combination becomes less effective for its primary intention of reducing pain, fever, and inflammation. [ABSTRACT FROM AUTHOR]

Context: The cognitive and psychomotor functions may become impaired in epileptic patients due to underlying etiology, effect of seizures and side-effects of antiepileptic drugs. It is desirable for the drug to have a minimal effect on cognitive abilities. Few studies have evaluated the psychomotor effects of newer antiepileptic agents and hence do not have the proper evidence base for their psychomotor adverse effects. Aims: The aim of this study is to evaluate the effects of gabapentin (GBP), vigabatrin (VGB), valproate (VAL) on psychomotor functions. Settings and Design: Randomized, prospective, double-blind, placebo (PLB) controlled crossover study. Subjects and Methods: A total of 24 healthy volunteers were included to administer single oral doses of GBP 300 mg, VGB 500 mg, sodium valproate 200 mg and PLB following a Latin square design. The objective parameters - six-digit cancellation test, digit symbol substitution test, critical licker fusion test, arithmetic ability test, digit span test, hand steadiness test and subjective parameters like visual analog scale (VAS) were tested at 0, 1, 2 and 3 h. Statistical Analysis Used: Repeated measures ANOVA was used to compare the difference in mean score. Fisher's exact test was used for statistical analysis of adverse effects. Results: Sodium valproate impaired all subjective and objective psychomotor functions while GBP, VGB did not show any impairment when compared with PLB. GBP when compared with VGB, no difference was observed in any test, but when both the drugs were compared with sodium valproate, statistically significant difference at the end of third hour was observed. Conclusions: VGB and GBP have few adverse cognitive and psychomotor effects as compared with sodium valproate, therefore are safe as add on therapy or monotherapy. [ABSTRACT FROM AUTHOR]

Context: Prescribing is a challenging task requiring knowledge of essential medicine (EM), rational use of medicines (RUM) and personal drugs (P-drug). Though the majority of clinicians recognize the importance of RUM, most of them have not been able to apply this knowledge in their medical practice. Aims: The aim of the following study is to assess knowledge, attitude and practice of clinicians about RUM, EM, P-drugs, and sources of drug information. Settings and Design: A cross-sectional, questionnaire based study. Subjects and Methods: Study was carried out in 100 respondents including faculty members and junior residents (JRs) in a tertiary-care teaching hospital. Statistical Analysis: Univariate analysis was carried out using fisher's exact test. Results: Nearly 93% respondents were aware about EM, but only 79% prescribe them. Percentage is significantly higher in respondents of age more than 30, having clinical experience <5 years and in faculty members as compared to residents. Nearly 87% respondents were aware about RUM, but only 83 % practice it. Though 30 % respondents practiced P-drug concept only 1% were aware about STEP criteria. Practicing P-drug concept was significantly more in JRs compared to faculty members (P < 0.0001). None of the respondents were aware about the number of drugs in National List of EMs of India. Conclusions: It is an encouraging finding that higher percentages of clinicians were aware about EM and also prescribed it. However, level of understanding related to P-drug concept and existence of essential medicines list are much below par. Also prescribing by trade name and heavy dependency on medical representatives for drug information is the matter of concern. [ABSTRACT FROM AUTHOR]