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The present generation of students has information at their hands with the advances in technology. The conventional teaching in monologue manner, just delivering bookish information and dictation are ineffective to inculcate knowledge and confidence in them. Attendance is another major challenge for the current educational system. Assessment patterns have improved from 'marking' to 'continuous grading' systems. However, the questions in examinations merely evaluate the memorizing and writing skills of the students. There is limited scope for students to think in a scientific and logical manner. In addition, there is a need for teaching-learning beyond the classrooms in emergencies like the prevailing pandemic of Coronavirus Disease / COVID-19. The adoption of Information and Communication Technology (ICT) tools will not suffice all these requirements. Interactive teaching-learning would help to convert bookish information into life-long knowledge. Case-based problem-solving questions would create the need for thinking. The blending of skills and knowledge will inculcate value and confidence in students along with their university degrees. A pre-study perception survey was performed to understand the educational needs of students and expectations of parents and the pharma industry, followed by activities to promote interactive teaching-learning in a selected institute. The post-study feedback survey revealed interesting results, which will, boosts effective knowledge dissemination along with improved student attendance.

The purpose of the present study is to highlight the discriminations if any, between the quality of low and high-cost medicines, which would help to select the right brand of medicine. In the present work, brands of medicines having high, medium, and low prices containing either of biopharmaceutical classification system class-II or class-IV drugs were comparatively evaluated for different pharmacopoeial standards as well as for biopharmaceutical classification system solubility and permeability. An ex vivo permeability test was carried out using a simple and non-invasive everted gut sac technique. Insignificant variation in pharmaceutical quality and permeability of the tested three types of brands was observed; however, the study could not consider the state of quality assurance facilities and parameters used while manufacturing these medicines. The study will help to make aware and assure medical and pharmacy practitioners and consumers for the selection of quality quality generic medicines.

Sorafenib tosylate (ST), a European Medicines Agency (EMEA) and the U.S. Food and Drug Administration (FDA) approved orally active anticancer drug for liver cancer therapy. However, ST shows low or...

Aims and Objectives: The aim of this study was to assess the cost of illness of the patients admitted to the intensive care unit (ICU). Materials and Methods: A prospective observational study was conducted on patients admitted and discharged from ICU above 18 years of any medical illness for 6 months in ICU in a tertiary care teaching hospital, Pune. Data such as demographic details, diagnosis, disease class, cost of drug therapy, and medical care cost were obtained. The cost was analyzed using the bottom-up method and statistical analysis of data was done using Pearson’s correlation coefficient and Mann–Whitney U test. Results: Of 400 patients, the average age was 54.27 years with a length of stay of 3.69 days and mortality rate of 12.25%. The average total cost per patient accounted for Rs. 52,840 and the per day cost was Rs. 14,319. Amongst various diagnoses, the cost incurred in alcoholic liver disease (ALD) accounted for Rs. 75,060 of the total cost, whereas the average per day cost observed in myocardial infarction (MI) was Rs. 15,495. The cost of drug therapy per patient was Rs. 5204.33 and total drug therapy accounted for 12.08%. The average number of drugs prescribed per patient was 8.44. Antimicrobial costs were observed as 28% of the total cost. The cost of antimicrobials was Rs. 1473 per patient. Medical care costs, including consultant and investigation charges per patient, were found to be Rs. 632 and Rs. 6861, respectively. Conclusion: The study reveals that ICU bed charges, miscellaneous charges, and drug therapy costs have more contribution to the direct medical cost of hospitalization.

INTRODUCTION Bioequivalence is established by comparing the bioequivalence study results of generic drugs with the reference listed drug. Several global regulatory agencies have published the guidance for locally acting orally inhaled drug products (OIDPs) for bioequivalence approaches. AREAS COVERED The prime intent of the present article is to compare the regulatory guidance for bioequivalence assessment of locally acting OIDPs published by global regulatory authorities. Regulatory recommendations on bioequivalence were based on assessment for different parameters such as inhaler device, formulation, reference product selection, in-vitro, and in-vivo studies. The United States Food and Drug Administration and Health Canada suggest an aggregated weight of evidence approach and the European Medicines Agency promotes a stepwise approach, whereas though the Indian authorities have not published guidance specifically on OIDPs but provided guidelines for bioavailability and bioequivalence studies. EXPERT OPINION For OIDPs, currently, there is no universally adopted methodology, and regulatory guidance has not been globally harmonized. By understanding and comparing bioequivalence recommendations for different regions, we can create more sensitive, and economic evaluation methods for OIDPs. This could open more alternatives of safe, effective generic OIDPs to the public.

Methotrexate (MTX) is an extensively prescribed antimetabolite especially in the treatment of several pediatric cancers, though managing toxicities associated with methotrexate in high dose continues to be a challenge. A prospective study was carried out from April 2017 to October 2018. Children of either sex below 18 years at the time of enrolment and receiving high dose Methotrexate intravenous infusion over 24 h as a 2 g/m(2), 3 g/m(2) and 5 g/m(2) dose was included in the study. The serum methotrexate level was estimated after the start of 48 h HDMTX infusion by using the ARCHITECT methotrexate assay. Toxicity due to HDMTX was assessed by Common Terminology Criteria for Adverse Events v.5.0. A total of 244 HDMTX infusions were delivered to 62 ALL patients. From the total of 244 cycles, serum methotrexate level in 35 cycles after the start of 48 h HDMTX infusion was found to be ≥ 1.0 μmol/L with reported toxicities among 31 cycles (88.6%). In 209 cycles MTX level was found to be less than 1.0 is statistically significant as compared to other cycles (p

Bioequivalence (BE) is established between the brand drug and the generic drug to allow the linking of preclinical and clinical testing conducted on the reference listed drug. Regulatory agencies around the globe have come up with the guidance for locally acting orally inhaled drug products (OIDPs) for bioequivalence approaches. The prime intent of the present article is to compare approaches of different international regulatory authorities such as Health Canada, European Medicines Agency and the US Food and Drug Administration that have published guidance related to locally acting OIDPs. Moreover, the Central Drugs Standard Control Organisation, India, has published guidelines for bioavailability and bioequivalence studies. BE recommendations from global regulatory agencies were based on comparison for different parameters, namely inhaler device, formulation, reference product’s selection, in-vitro as well as in-vivo studies (pharmacokinetics, pharmacodynamics, and clinical studies). In the case of in-vivo studies, details about study design, dose choices, inclusion/ exclusion criteria of the subject, study period, endpoint study, and equivalence acceptance criteria were discussed in the present review article.

Tuberculosis (TB) is a contagious infection caused by Mycobacterium tuberculosis. It is a highly communicable disease which affects the lungs but if left untreated can also spread to brain or spine. According to the World Health Organization, TB is considered as one of the top ten causes of death throughout the world with ten million cases reported annually. Although TB occurs in most parts of the world yet two thirds of the new cases reported, happened in India, China, Indonesia, Philippines, Pakistan, Nigeria, Bangladesh, and South Africa. TB is treated with a combination of antibiotics which has to be consumed by patients over a year or more. At present the drugs and vaccines available for treatment of TB has no significant effect on controlling the disease due to the occurrence of multiple drug-resistant (Mdr) strains. Hence, this created an urgent need to develop drugs of natural origin. Drugs from natural sources have exceptionally rich chemical diversity and a wide spectrum antimicrobial activity. The current chapter states the recent developments that had occurred in the treatment of TB using natural compounds and also discusses the various natural anti-mycobacterial compounds.

Background: Pharmacist can directly influence disease management by providing community based Pharmaceutical Care services. Pharmacists must evolve from dispensers to medication management practitioners. Therefore their knowledge, attitude and practices are the key necessities, so that they can work along with physicians to significantly improve the health of the patients. Objective: To assess the Attitude and Practices of Pharmacists regarding Pharmaceutical Care. Methods: This prospective study administered validated Attitude and Practices questionnaire on a sample of 508 pharmacists belonging to government, community and corporate sectors of Pune district in India. The level of attitude and practices towards pharmaceutical care were assessed with simple descriptive analysis and the outcomes from focused group discussion with higher officials from all three sectors. Results: The responses of all participants were significantly low across all components of Pharmaceutical care practices including patient counseling, solving drug related problems, doing interventions, ADR management and informing drug interactions, whereas the attitude to provide these services was found to be very high. From Focused group discussion with officials, it was confirmed that Pharmacists did not practice much patient care services due to barriers like lack of proper education and training of pharmacists, weak implementation of existing laws, inadequate clinical knowledge and lack of recognition of the pharmacy profession by other healthcare professionals. Conclusion: The study concluded that in India, dispensing of medicines still remains as a dominant service provide by all pharmacists and there is very limited practice of Pharmaceutical Care in spite of positive attitude of pharmacists towards it. Key words: Pharmacists, Attitude and practice, Pharmaceutical care, India.

A new family of biofunctionalized chitosan decorated nanocochleates-mediated drug delivery system was developed that involves uniquely combining nanocochleates with anticancer drug for controlled drug release, targeted delivery, improved bioavailability with reduced toxicity. This system was developed by loading of doxorubicin (DOX) to nanocochleates (DOX-NC) through conversion of negatively charged dimyristoylphosphatidylcholine (DMPC) phospholipid and cholesterol-bearing vesicles on addition of calcium ions, followed by encapsulation DOX-NC with folic acid conjugated chitosan (FA-CHI-DOX-NC). The release of DOX indicated strong pH dependence and implies hydrogen-bonding interaction between nanocochleates and DOX. Formulated FA-CHI-DOX-NC demonstrated higher in-vitro anticancer activity in folate overexpressed human breast cancer MCF-7 cells. The targeting effect for the FA-CHI-DOX-NC was also demonstrated. The concentration of the drug needed for growth inhibition of 50% of cells in a designed time period (GI50) was 9.1 µg/ml for DOX while it was decreased by 31.68% for the DOX-NC (6.2 µg/ml). Furthermore, the GI50 value of FA-CHI-DOX-NC was 4.4 µg/ml, i.e. a 51.64% decrease was observed as compared to DOX solution. Moreover, bioavailability of DOX from FA-CHI-DOX-NC increased by 4-fold with long circulation time, slower plasma elimination and no sign of tissue toxicity as compared to DOX solution. The proposed strategy is advantageous in terms of targeted drug delivery and has high potential to address the current challenges in drug delivery. Thus, the prepared new carrier offers a novel formulation that combines the unique properties of a biodegradable material, chitosan and nanocochleates for biomedical applications.

Objective: To assess knowledge, attitude, and practice (KAP) of organ donation (OD) among pharmacy students. Methodology: A web-based, cross-sectional study of students pursuing different pharmacy courses was conducted. A specially designed questionnaire was used to survey the students. Results: A total of 160 students responded to survey. Nearly, three-fourth students wished to donate organs to anyone, 83.1% wanted to donate by considering the health status of the recipient, and 98.1% feel that OD should be promoted. Some negative findings were as follows: less knowledge about some uncommon organs that can be donated, for example, blood vessels, bone, intestine, and heart valves; 76.3% students do not know the process of registering while 84.4% have not registered/pledged for OD. Average knowledge about law related to OD was also poor, i.e., 1.87. Conclusion: Overall KAP for OD was positive for except for a few issues. There is need to add some OD related topic/s in the pharmacy curriculum.

Background: Self-medication practice is common among health care professionals due to their professional exposure to drugs and knowledge of treatment of their disease. Objective: The aim was to assess self-medication practice among medical, pharmacy, and nursing students in a tertiary care hospital, Pune. Method: A cross-sectional survey was carried out over a period of three months. A self-administered questionnaire was used for data collection. Results: A total of 318 students participated in the survey; among them106 were medical, 106 were nurses and 106 were Pharmacy students. Out of the total participants, 52.5% were females. Among them, 280 (87.5%) were practicing self- medication. Most drugs for self-medication were obtained from the pharmacy or drug shops, and the most commonly used drugs were non-steroidal anti- inflammatory drugs(81.2%) and antipyretics (67.6%) and antibiotics (35.0%). However, 112 (35.0%) of health care professional students had received antibiotics without medical prescription in the past few months. Common reported illnesses were fever and chills (62.5%) followed by headache (40.0%) and common cold(35.0%).The main reasons for self- medication was that their knowledge about drugs and diseases helped them (67%) and their health problem was not serious(65%). 40 (12.0%) were against self -medication practice and their reasons were fear of misdiagnosis of illness and adverse effect of drugs. Conclusion: Our study concluded that self-medication was practiced with a range of drugs among health care professional students. Educating the students and creating awareness among them may decrease the chance of self-medication practice.

Methotrexate is extensively used in the treatment of various malignancies and autoimmune conditions. Methotrexate is associated with several toxicities, while hypersensitivity reactions to methotrexate are unusual, but have been reported in adult cancer patients. Hereby, we detail the case of a child with acute lymphoblastic leukaemia who developed a hypersensitivity reaction to high-dose methotrexate infusion (HDMTX) during the fourth cycle of HDMTX. The child was rechallenged with another brand of methotrexate; she started complaining of itching on trunk within 5 min of infusion. Few studies have reported that desensitization has been helpful in children with hypersensitivity reactions allowing the continuation of HDMTX. However, it was decided to omit parenteral methotrexate for this child. Cranial radiotherapy was given for CNS prophylaxis. In conclusion, unexpected hypersensitivity with methotrexate should be kept in mind during the treatment especially with high-dose infusion.

Methotrexate treatment has been associated with an array of liver-related adverse events like asymptomatic transaminase elevations, fatal necrosis and fibrosis. Here we present a child with relapse Pre B cell acute lymphoblastic leukaemia who developed and died of fulminant hepatic failure and pancytopenia soon after the administration of high-dose MTX. This case is unusual due to a series of adverse events that led to severe toxicity. The child received 1 g/m(2) dose of methotrexate infusion for 36 hours. The patient developed drowsiness with altered sensorium in the 72 hours after starting the infusion. Investigations revealed severe pancytopenia along with grossly deranged liver function tests and coagulation profile. On the fourth day of paediatric intensive care unit admission, the child went into cardiac arrest and could not be revived.

Background: The prevalence of anemia in pregnant women has remained unacceptably high worldwide despite the fact that routine iron supplementation during pregnancy has been almost universally recommended to prevent maternal anemia. The major problem with iron supplementation during pregnancy is compliance. The objective of this study was to correlate iron supplements compliance among pregnant women and incidence of anemia during pregnancy. Methods: A Prospective observational study was conducted over a period of nine months from August 2015 to April 2016 in the department of obstetrics and gynecology, Bharati Hospital and Research Center, Pune. Pregnant women more than 14 weeks who attended antenatal care unit were enrolled in this study. Data for compliance was collected by two methods - first by personal interview as well as looking for the empty iron tablet strips. Pregnant women were followed till the date of delivery and maternal outcome were noted. Results: Our results show that 64% were strictly compliant, 33% with partially complaint and 3% with non-complaint with iron supplements. The mean Hemoglobin concentration of pregnant women who strictly complies with iron supplements were 11.6 g/dl where the non-compliant and partially complaint to iron supplements were 9.7 g/dl. The prevalence of anemia was found to be more in partial and non-compliant to iron supplements (13% p value

Aim: To study prescribing pattern, comorbidities, and cost analysis in elderly hospitalized patients. Materials and Methods: A prospective, observational study was conducted to assess the prescribing pattern, drug utilization, and cost analysis in elderly patients at a tertiary care hospital in Pune. Data of 120 patients were used to carry out the analysis. Result: A total of 120 elderly inpatients were included in the study. Of these 120 patients, 62 were male and 58 were female; among them, maximum number of patients belong to 60-74 years age group. Common comorbidities found were anemia, lower respiratory tract infections (LRTI), urinary tract infection, hypertension, diabetes mellitus, etc. Mostly hospitalized patients were hypertensive (27.5%), diabetic (18.33%), and anemic (15.83%) followed by respiratory tract infections such as pulmonary Koch's, pneumonia, and LRTI. Two comorbid conditions were found in 33.33% of patients followed by 25% with one comorbid condition and 24.16% had three comorbid conditions; on an average, three comorbidities were found in a total number of patients. Major classes of drugs prescribed for treatment were cardiovascular drugs (22.60%), antibiotic (20.13%), antiplatelet (7.26%), and antidiabetic drugs (6.43%). The average cost per patient was calculated 5016.48 international normalized ratio, which includes physician, nursing, bed charges, and therapy cost. Conclusion: This study concludes that the prescribing pattern of elderly patients with age group 60-74 years were commonly prescribed for cardiovascular drugs and antibiotic, whereas this proportion was low compared to patients with age >74 years and prescribing pattern also resulted in financial burden on patients healthcare cost.

Andrographolide (AN), a diterpenoid lactone, is one of the prime phytoconstituents of Andrographis paniculata. AN possesses various therapeutic benefits such as hepatoprotective, analgesic, anti-inflammatory, anti-tumor, anti-hyperglycemic, anti-oxidant activities. However, AN has not reached its milestone therapeutic potential as clinical studies have suggested that a conventional dosage form of AN showed low oral bioavailability (2.67%). The factors attributed to low bioavailability included specific site absorption, hydrolysis in weak alkaline environments, first pass metabolism, P-gp excretion in the terminal intestine, biliary excretion and poor aqueous solubility (3.29 μg mL−1). A successful AN therapy warrants an apt delivery system that will enhance its bioavailability. Current approaches for developing an improved delivery system for AN are mainly focused on overcoming solubility and toxicity issues. The path to identify new molecules with better therapeutic efficacy will continue to be an integral part of health care systems but here the authors have emphasized on ‘better delivery of drugs’, which is going to further refine therapy. The different formulation approaches investigated so far have shown much promise experimentally in improving the bioavailability of AN. However, a product for human use is still far away. Since its isolation and characterisation in 1911 several developments related to AN have occurred. This review is the first comprehensive account of the pharmaceutical aspects of AN with special emphasis on its delivery that have occurred over the last century.

Liposomes and liposomes-based drug delivery systems are promising carriers in the rapidly evolving field of nanomedicine. Liposomes are receiving growing attention in the scientific domain owing to their distinctive structural characteristics, physiological features and biological properties. These versatile lipid vesicles represent unique platforms for drug delivery, targeting, diagnostics, imaging as well as theranostics. The main objective of the present article is to present insights into the pulmonary delivery of these versatile cargos for nanomedicine. Inhalable liposomes for pulmonary delivery present unique advantages as they are formulated from phospholipids similar to endogenous pulmonary surfactant. The article begins by unfolding the important background information about liposomes and their key advantages as nanomaterials. In the subsequent section, various liposomes and proliposome formulations are summarized with a special emphasis on their physicochemical properties, aerosolization performance and in-vivo aerodynamic behavior. Additionally, this article includes a segment devoted to recent status on clinical trials of liposomal formulations for treating pulmonary diseases. Moreover, the present article contains a section dedicated to the market potential and scientific challenges related to inhalable liposomes. In summary, this article is a comprehensive report of inhalable liposomes to appear in recent years.

Targeted drug delivery across the blood-brain barrier is an extremely challenging quest in the fight with fatal brain ailments, with the major hurdles being short circulation time, reticuloendothelial system (RES) uptake, and excretion of nanocarriers. PEGylation has emerged as a boon for targeted drug delivery to the brain. It is well established that PEGylation can increase the circulation time of nanocarriers by avoiding RES uptake, which is indispensable for increasing the brain's uptake of nanocarriers. PEGylation also acts as a linker for ligand molecules to achieve active targeting to the brain. Using PEGylation, novel approaches are being investigated to facilitate ligand-receptor interactions at the brain endothelium to ease the entry of therapeutic drugs into the brain. In addition, PEGylation made it simpler to assess the brain tissue for delivering diagnostic molecules and theranostic nanocarriers. The potential of PEGylated nanocarriers is being investigated vastly to boost the therapeutic effect several fold in the treatment of brain diseases. This review sheds light on the contribution of PEGylated nanocarriers, especially liposomes, polymeric nanoparticles, and dendrimers for brain-specific delivery of bioactives.

Pulmonary disease represents a major global health issue. They are commonly treated by various synthetic molecules. But, frequent high-dose of oral and injectable drugs may lead to severe side effects and this juncture demands inhaled formulations that facilitate effective drug delivery to the lower airways with negligible side effects. Natural phytoconstituents or phytoalexin (i.e. plant antibiotics) have showed an unique treatment array with minimum side effects and great capability to treat intrapulmonary and extrapulmonary diseases compared to synthetic drugs. Moreover, the progress of disciplines such as nanotechnology, material science and particle engineering allows further improvement of the treatment capability and efficiency. This article review and analyze literatures on inhaled phytoconstituents which were published in the last 10 years. Additionally, it will also offer the researcher with some basic background information for phytoconstituents profile, formulation requirements and drug delivery systems.

Background: Sepsis can be defined as the body’s response to an infection. Sepsis in children remains a significant cause of morbidity and mortality worldwide. Objectives: This study focuses on the etiological factors, risk factors, and clinical characteristics of sepsis in neonate and pediatric patients. Patients and Methods: A prospective study was conducted over a six-month period in the pediatric and neonatal intensive care units of Bharati hospital and research centre, Pune. Fifty-two patients aged 0 - 12 years who were diagnosed with sepsis were included in the study. Data collected from the cases included demography, history, etiology, and diagnosis. Air contamination was assessed using the settle plate method. Results: The incidence rate of sepsis was found to be 2.04%. Children aged 0 - 3 months accounted for the greatest percentage of admissions (57.6%). The male to female ratio was 1.7:1. Common etiologies that presented as risk factors included pneumonia, meningitis associated with catheterization, and very low birth weight. The most commonly seen organisms were gram-negative (Klebsiella, Enterococcus) and (Methicillin-resistant Staphylococcus aureus) MRSA. Microbiological testing was conducted in different wards of the hospital to determine the risk of developing sepsis, and it was found that the highest colony count was present in the labor rooms. On the basis of the onset of sepsis, patients were classified into early onset sepsis (3.84%) and late onset sepsis (9.61%). SIRS (systemic inflammatory response syndrome) with severe sepsis (51%) was the most prominent clinical characteristic of sepsis. There was a significant relationship between the severity of sepsis and mortality (P < 0.001). Conclusions: Sepsis remains the most common cause of mortality, with gram-negative infection and catheterization being the most significant risk factors. The more severe the sepsis, the greater the chances of mortality.

Andrographolide, a diterpene bioactive of Andrographis paniculata (Acanthaceae family), has long been used in India and China as a complimentary medicine. Yet, there is no detailed toxicological information to guarantee its safe use. In the present study, acute and subacute toxicity of andrographolide was assessed via oral route on rodents. In acute toxicity tests, mice (n = 6/group/sex) received andrographolide at oral doses of 1, 2, 3, 4, and 5 g/kg, whereas in subacute acute tests Wistar rats (n = 6/group/sex) received 250 and 500 mg/kg for 21 consecutive days. Hematological, biochemical, and histological analysis were performed in all animals. No death or hazardous signs were observed from acute toxicity study indicating that the LD50 of andrographolide by oral treatment was greater than 5 g/kg body weight in both male and female mice. No significant changes in body weight gain, food intake, behavior, mortality, hematological, biochemical, vital organ weight, and histopathology were observed from subacute toxicity study. However, a significant increase in white blood corpuscle (WBC) (7–14 %) and lymphocyte (21–24 %) counts coupled with a reduction in urea (17–24 %) suggested immune-stimulant and renal protective activity of andrographolide. The data support the safety of andrographolide which assure its medicinal use as an alternative medicine.

Objective To assess and compare the requirement of preanaesthetic agents to maintain anesthesia within the group of control and groups receiving Clonidine and Dexmedetomidine and reduction in cost due to reduced intraoperative anaesthetic and analgesics requirement. Method Three groups of control, clonidine and dexmedetomidine were made. Twenty patients of American Society of Anesthesiologist's grade I & II category for ≥ 3 hours of surgery and >18 years of age were involved in the study of six months duration in each group. Hemodynamic variables of all patients were continuously recorded and maintained. Then, during surgery with anesthesiologists we have quantified the amount of drugs spared by use of these alpha2 agonists. Results Dexmedetomidine and Clonidine were found hemodynamically stable during intubation compared to Control. Dexmedetomidine group showed 25% reduction in Isoflurane and 40% reduction in Diclofenac requirement compared to Clonidine group. The average Fentanyl dose was reduced by 33% and 44 % in Clonidine and Dexmedetomidine group respectively compared to Control group. Diclofenac and propofol requirement was found to be less in dexmedetomidine group than of clonidine. Thus, on average for surgery involving Clonidine INR 1065 per patient were charged while in Dexmedetomidine only INR 833. Significant cost benefit upto INR 463 per patient can be achieved with better hemodynamic control by Dexmedetomidine compared to Control requiring INR 1296. Conclusions Intraoperatively dexmedetomidine showed significant cardiovascular stability compared to clonidine. Also, Dexmedetomidine group showed significant drug sparing effect of Isoflurane, Thiopentone and Fentanyl than Control group. A clinical pharmacist can assist anesthesiologist's in apt selection of drugs.

Background. Oxybenzone, a broad spectrum sunscreen agent widely used in the form of lotion and cream, has been reported to cause skin irritation, dermatitis, and systemic absorption. Aim. The objective of the present study was to formulate oxybenzone loaded microsponge gel for enhanced sun protection factor with reduced toxicity. Material and Method. Microsponge for topical delivery of oxybenzone was successfully prepared by quasiemulsion solvent diffusion method. The effects of ethyl cellulose and dichloromethane were optimized by the 32 factorial design. The optimized microsponges were dispersed into the hydrogel and further evaluated. Results. The microsponges were spherical with pore size in the range of 0.10–0.22 µm. The optimized formulation possesses the particle size and entrapment efficiency of 72 ± 0.77 µm and 96.9 ± 0.52%, respectively. The microsponge gel showed the controlled release and was nonirritant to the rat skin. In creep recovery test it had shown highest recovery indicating elasticity. The controlled release of oxybenzone from microsponge and barrier effect of gel result in prolonged retention of oxybenzone with reduced permeation activity. Conclusion. Evaluation study revealed remarkable and enhanced topical retention of oxybenzone for prolonged period of time. It also showed the enhanced sun protection factor compared to the marketed preparation with reduced irritation and toxicity.

Objective: Suicide is known to be a phenomenon in low-, middle-, and high-income countries and occurs in all sociodemographic groups. It ranges from acute to fatal lethal attempts which occur in the context of a social crisis. Deliberate self-poisoning for suicide is a growing public health concern with frequent emergency department admissions. An epidemiological surveillance is essential for every region to understand the pattern, underlying psychological factors, and the scope of preventive measures.Methods: The 2-year retrospective study describes the epidemiology and influencing factors of suicides by self-poisoning in patients admitted to a Government Hospital and a Teaching Hospital in Pune, Maharashtra, from January 1, 2014 to December 31, 2015.Result: Out of 1010 poisoning cases reported, 539 were suicidal self-poisoning. Significantly males more than females were brought to the hospitals due to deliberate self-poisoning (1:0.86, χ2=38.05; p

Objective: The present study aims to determine the pattern of antibiotic utilization at the surgery department of a tertiary care hospital.Method: A prospective observational study was conducted over a period of 6 months period in surgical ward at Bharti Hospital and Research Centre, Pune, a 1000 bedded teaching hospital. Patients above 18 years and receiving antibiotic therapy pre and post-surgery were included in the study.Results:160 patients with surgical operations were included in the study.The disease spectrum was classified into respective system-wise surgical procedures of which 49.37% cases are skin & soft tissue infections, 25.62% cases of general surgical procedure, 12.5% cases of gastrointestinal surgical procedure, 11.25% cases of urinary system and 1.25% case of head neck system. 20.62% of the study patients had hernia, 18.12% patients had cellulitis, 16.87% patients had diabetic foot ulcer, 16.25% patients had abscess, and 10.62% patients had appendicitis and cholelithiasis. In this study, it was found that 471 antibiotics were used in total of 160 patients, among which highest group of antibiotics prescribed were third generation Cephalosporin (28.23%) followed by Penicillins (23.56%). The most frequently prescribed antibiotics were Metronidazole − 19.74% among the Nitroimidazoles followed by Ceftriaxone − 19.53% of the class Cephalosporins.Conclusion: The rate of prescribing of broad-spectrum antibiotics has increased demonstrably which may result in development of bacterial resistance; however development of guidelines for antibiotic prescription and use of appropriate drugs for the diseases can minimize the unfavourable use of antibiotics and cost of healthcare.

A 63-year-old woman, after 5 years of resection of craniopharyngioma, developed recurrence of tumor with acute onset of psychotic symptoms. After 4 years of resection of craniopharyngioma, the patient presented with psychotic symptoms of varied delusion of reference, persecution, black magic and occasional auditory hallucinations. On physical examination, she showed no neurological deficit. Her blood investigations were at normal levels. Her recent magnetic resonance imaging brain scan showed large cystic lesion supposed to be a recurrent mass in sellar and suprasellar regions. After 2 months of antipsychotic treatment, her delusions and hallucinations were much decreased to extent that now she can do some household work. Her psychosis was controlled while she awaits neurosurgical intervention for recurrent craniopharyngioma. Acute psychosis is rarely found in elderly people and after few years of craniotomy for craniopharyngioma resection. So, the psychosis can be associated with the recurrence of craniopharyngioma. Such psychosis needs surgical intervention for primary cause.