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Objective: To evaluate the effects of botropase on various clotting factors in human volunteers. Materials and Methods: It was a prospective open label study conducted on human healthy volunteers. After the baseline screening, subjects fulfilling inclusion criteria were enrolled. On the study day, 1 ml of botropase was administered intravenously and after an hour same dose of botropase (1 ml) was given by intramuscular (IM) route. The efficacy and safety parameters were monitored up to 72 h from the time of intravenous (IV) administration. Results: A total of 15 volunteers, belonging to 24-35 years of age were included in the study. Botropase significantly reduced the plasma level of fibrinogen and fibrin degradation products after 5 min of IV administration (P < 0.05). In addition, factor X was observed to reduce constantly by botropase administration suggesting enhanced turnover between 5 and 20 min of IV administration. Although botropase reduced clotting and bleeding time in all the volunteers, the data remains to be statistically insignificant. Conclusion: Present study demonstrated the safety and efficacy of botropase in human healthy volunteers. The study has shown that it is a factor X activator and reduces effectively clotting and bleeding time. [ABSTRACT FROM AUTHOR]

Introduction: People with limited health literacy are more likely to make medication errors, and they have less health knowledge, worse health status, more hospitalizations, and higher healthcare costs than people with adequate literacy. The objective of this study is to assess the health literacy status among patients who are able to read and understand English attending a tertiary care hospital by using Rapid Estimate of Adult Literacy in Medicine [REALM] technique and to compare the health literacy levels to educational status and other baseline characteristics. Material and Methods: A widely used word recognition method [REALM] was used to assess the HL status of 200 patients attending a tertiary care hospital in Southern India. The number of correctly pronounced words was used to assign a grade-equivalent reading level. Scores 0 to 44 indicate reading skills at or below the 6th grade level, scores from 45 to 60 represent skills at the 7th or 8th grade level, and scores above 60 indicate skills at the high-school level or higher. Results: HL status was found below adequate level in more than 50% of the patients. Younger age group showed better HL scores compared to those aged more than 25 years. General education level or the medium of education does not truly reflect HL levels as brought out in the study. Even those with postgraduate qualification had poor HL skills. Conclusion: The study was carried out to find out the HL levels among patients attending a tertiary care hospital. It was assumed that the general education levels may not reflect true HL status. In view of the results of this study it can be concluded that patient's HL skills should not be taken for granted and adequate attention should be paid in educating and briefing patients whenever patients are required to interpret and understand health care related documents. [ABSTRACT FROM AUTHOR]

Introduction: Antimicrobial drug resistance is a fast emerging problem worldwide. It is a consequence of the use, particularly of the misuse of drugs. In most of the developing countries, antibiotics can be purchased without prescriptions, even when the practice is not legal. Presently, in India, Schedule H, under the Drug and Cosmetics Act and Rules, provides a list of over 536 drugs which include Antimicrobial Agents [AMAs], which are required to be sold on the prescription of a registered medical practitioner. Objectives: To evaluate the Over the Counter (OTC) sales of antimicrobial agents in allopathic pharmacies [community] within the city corporation limits. To describe the degree of difficulty which is faced in obtaining antibiotics without a prescription. To find out as to what advice, if any, was given by the pharmacists with regards to the administration of the medicines which had been sold. Methods: Three diseases were simulated by two medical students who presented as patients in randomly selected pharmacies at an Urban location. They then requested the pharmacists for medications for their illnesses. AMAs were requested for, if they were not issued at the first instance. Results and Discussion: Nearly 50% of the pharmacists declined to issue AMAs. Amoxicillin was the most common of the AMAs which were dispensed by the pharmacists. The duration and the frequency of the treatment which was advised by the pharmacists were mostly wrong. Conclusion: This study showed that the practice of dispensing AMAs without prescriptions was widely prevalent among the dispensaries which were located even in urban areas. Not only were the AMAs dispensed, but also they were dispensed without taking any history of hypersensitivity. What makes the practice worse is that the duration and the frequency of administration of these drugs are wrongly advised more often than not. [ABSTRACT FROM AUTHOR]

Background: Occupational accidents are a major point of concern in industries. The academic community should take the first step to address the long-neglected concerns of occupational safety. Objective: To assess the prevalence and pattern of occupational accidents. Materials and Methods: A record-based, cross-sectional study was done in three tile factories of Mangalore city, in Karnataka. A total of 416 workers were analyzed for the year 2004, and data regarding age, sex, job duration, type and nature of injury, body parts involved, and time of injury were collected in a prestructured proforma. Statistical Analysis: Proportions, Chi-square test, Univariate and Multivariate analysis. Results: The overall prevalence rate of accidents was found to be 18.5%. It was found that almost around 86% of the accidents had affected the limbs (upper limb 24.7%, lower limb 61%), around half (52%) of the injuries were contributed by superficial injuries, 40% of accidents were due to stepping/striking against objects and while handling. Hand tools and machinery in motion contributed to around 20% of the accidents. Accidents were more common among the younger age group and less-experienced workers. Multiple logistic regression analyses revealed that the age group of 30-39 years had an independent significant association with accidents (OR = 0.21, P = 0.04). Conclusion: Accidents in tile industries are an important occupational health problem in this area of the country. There is a need for proper safety training of the workers. [ABSTRACT FROM AUTHOR]

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Background: Acanthosis nigricansis was viewed recently as a possible marker of an increased risk for diabetes. Acanthosis Nigricans (AN) can help in identifying the patients with an increased risk for Type 2 Diabetes Mellitus (T2DM) among Polycystic Ovary Syndrome (PCOS) cases. Hence, this study was carried to know the prevalence of AN in PCOS and its correlation with diabetes mellitus and the body mass. Methods: A prospective, longitudinal study in the patients with PCOS, who attended the Department of Medicine, Kasturba Medical College [KMC] Hospital, Attavar, Mangalore, Karnatka, India between December 2008 to April 2010, was carried out. A total of 119 patients with PCOS were included in the study. A complete history, along with the demographic data of the patients who were aged between 15-35 years, were considered for the analysis. Results: AN was observed in 56% of the PCOS patients. The Body Mass Index (BMI) and the waist circumference were significantly higher in the PCOS patients with AN, as compared to those without AN. Among the 119 PCOS patients,77% were found to have BMI values which were above the normal. Among the obese PCOS patients, 58% had BMI values of more than 30kg/m2 as compared to 19% of the patients who did not have AN. Type 2 DM was observed in 77% of the PCOS patients with AN, while none of the PCOS patients were found to be diabetic among those without AN. A family history of DM in the first degree relatives was present in all the patients with AN. The results were analyzed by the Mann Whitney U test for the continuous data and by the Chi square test for the categorical data. Conclusion: The PCOS patients who had a family history of diabetes and obesity with a body mass index of more than 30 kg/m2 and a waist circumference of ≥ 90 cm were more likely to develop AN, which is a marker of hyperinsulinaemia and insulin resistance. Identifying such PCOS patients will stimulate the discussions of the lifestyle modifications in the primary care setting. [ABSTRACT FROM AUTHOR]

Vanilla planifolia grown for its attractive aroma has rich medicinal value as evidenced by its antimutagenic, anti-invasive and anti-inflammatory activities. An analgesic activity mediated by opioid receptors has been suggested in earlier studies. Inbred adult wistar rats of either sex weighing 150-200grams were used for the study. Rats were randomly assigned to four groups [Control, morphine 2mg/kg, Vanillin 10mg/kg, Vanillin 100mg/kg] of six animals each. Eddy's hot plate method was used to evaluate analgesic activity. Naloxone pretreatment was employed to demonstrate any activity mediated through opioid receptors. There was significant increase (P<0.001) in latency period at 10mg/kg and 100 mg/kg doses of vanillin when compared to control. Naloxone pre-treatment significantly reduced the latency period in hot-plate test with both the doses of vanillin. Vanillin at a dose of 10 mg/kg and 100 mg/kg demonstrated a significant increase in latency period, displaying a potential central analgesic activity probably mediated through opioid receptors. [ABSTRACT FROM AUTHOR]

Background: Ayurveda, an ancient Indian system of medicine, mentions several plants that are useful in the correction of metabolic disorders such as diabetes mellitus. Plants have been exemplary source of drugs in the treatment of diabetes mellitus [DM]. Many of the currently available drugs have been directly or indirectly derived from them. In spite of being hundreds of claimants none have gained enough momentum in clinical practice as most of them lack scientific validation. YXK12 is a commercially available polyherbal product recently introduced in the market and manufacturers claim the product to have anti diabetic properties. This study was undertaken to evaluate the hypoglycaemic effect of this drug in Alloxan induced diabetic rats. Materials and methods: Alloxan monohydrate is used to induce diabetes mellitus in Wistar rats. Hypoglycemic effect of two doses of the drug YXK12 is evaluated in these rats and the results are compared to the effects of a placebo and the standard hypoglycaemic drug Glibenclamide. Results: Blood glucose lowering effect of YXK12 in the higher dose of 2000mg/kg was found statistically significant [p=0.001]. Lower dose of 1000mg.kg did not show statistically significant hypoglycaemic effect when compared to placebo control. Conclusion: The dose which has produced hypoglycaemic effect in rats is equivalent to the highest doses of the product recommended for patients of diabetes mellitus. This dose [2000mg/kg in rats] if converted to human dose is equivalent to highest human dose recommended. As lower doses have not demonstrated any hypoglycemic activity, lower doses in humans needs to be evaluated. [ABSTRACT FROM AUTHOR]

Trends in the prescription pattern change periodically with the advent and introduction of novel drugs, changing insights and regular revision of national and international guidelines. We sought to determine the prescribing patterns and cost of antidiabetic drug in South Indian population. Retrospective collection of data in diabetic cohorts was carried. A total of 200 diabetic patients who have attended the diabetic clinic, KMC, Attavar, Mangalore were collected from the hospital records with 100 patients each in the years 2005 and 2010. The data collected for each patient was - demographic data, associated comorbidities, fasting and postprandial blood glucose levels, Hba1c, antidiabetic medications and investigations performed during each visit. Drug therapy adviced during each visit were collected and total cost per visit was calculated. Compared to diabetic patients in the year 2005 the number of diabetic patients above the age 60yr and patients with comorbidities were more in 2010. Dispensing pharmacy data indicate significant decrease in the prescription of sulfonylurea in 2010 compared to 2005. There was only marginal increase in total direct cost per visit since five years. Average cost per visit in 2005 was Rs.363 and Rs.377 in 2010. Among patients with one or more comorbidities there was 87 rupees increase in the cost per visit in 2010 compared to 2005. Prescription of monotherapy with sulfonylurea was significantly reduced in 2010 compared to prescriptions in the year 2005. The cost per visit remained same at both the years at Rs.377. Nevertheless, this is considered high particularly in developing countries like India and requires serious reforms to reduce the cost. [ABSTRACT FROM AUTHOR]

Shilajit, an ayurvedic drug is a blackish-brown exudation obtained as a mineral resin or as a plant fossil. Experimental study has shown shilajit has nootropic and anxiolytic activities. The nootropic and anxiolytic actions have been attributed to the ability of shilajit to induce an increase in rat brain dopaminergic activity and a decrease in 5-HT turnover. Shilajit is one of the components of NR-ANX-C (a poly-herbal preparation), which has proven anticataleptic activity in a previous study conducted by us. Increased dopamine turnover in the rat brain with Shilajit and the anticataleptic activity of NR-ANX-C prompted us to assess the anticataleptic activity of Shilajit. Inbred albino mice were divided into five groups, each containing six animals. Both, the test drug, the Shilajit and the standard drug scopolamine were dissolved in 1% gumacacia solution. Catalepsy was induced with haloperidol (1.0 mg/kg; i.p.). The first group received the vehicle (10.0 ml/kg), the second group received scopolamine (1.0 mg/kg) and the remaining three groups of animals received the test compound Shilajit ( 2.5, 6.25 & 12.5 mg/kg) were assessed after single and repeated dose administration for seven days, 30 minutes prior to the haloperidol. In the present study, pretreatment of aqueous extract of shilajit protected the mice from catalepsy induced by haloperidol as effectively as the standard drug scopolamine and in fact better than scopolamine on repeated administration. Our study suggests that Shilajit can be explored as an adjuvant drug in preventing and treating the extrapyramidal side effects of antipsychotic agents in clinical practice. [ABSTRACT FROM AUTHOR]

Metformin is an oral antidiabetic agent, widely used in the treatment of type 2 diabetes mellitus. The serious side effect of metformin therapy is lactic acidosis. Contraindications for metformin therapy include renal insufficiency. A cut off value of 60 ml/min in creatinine clearance is suggested. Hundred type 2 diabetics receiving metformin as monotherapy or in combination with insulin/other oral antidiabetic agents, were enrolled in the study. Patients were on metformin for atleast one month prior to being enrolled. Patients' demographic data were taken. Baseline serum creatinine and bicarbonate were estimated. Creatinine clearance (Clcr ml/ min) was calculated. Patients were grouped into group 1-4 depending upon the doses of metformin they received. Patients were again grouped based on their Clcr as groupA (Clcr < 60 ml/min), group B (Clcr > 60.01 ml/min). Data was analysed using student's t test. Out of 100 patients 52 were males, 48 females. Mean age and SD of males and females were 69.92 +/- 6.95 and 66.85 +/- 5.72 respectively. Comparison of mean bicarbonate level in different doses of metformin did not show any statistical significance. But comparison of bicarbonate levels based on Clcr were highly statistically significant (p = 0.0084). In three patients whose bicarbonate level was very low (15, 16.4 and 19.2 mmol/L), doses of metformin was reduced and after one month their bicarbonate levels returned to normal (27.4, 25.6 and 26.2 mmol/L). Hence serum bicarbonate can be a marker to assess metformin induced acidosis in geriatrics patients with low creatinine clearance.