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   2013| April-June  | Volume 2 | Issue 2  
    Online since July 26, 2013

 
 
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CASE REPORTS
Fixed drug eruption due to fixed dose combination: A novel case
Sushil Kumar Varma, Shailesh Nagpure, Arup Kumar Misra, Pallavi Dhanvijay
April-June 2013, 2(2):130-132
DOI:10.4103/2278-344X.115691  
Fixed drug eruption is a well documented drug side effect and accounts for about 5-10% of cutaneous drug reactions. We describe a case of fixed drug eruption on lips and perioral region following consumption of a fixed dose combination in acute gastroenteritis. Fixed dose combination of Ofloxacin and Ornidazole is one of the most commonly used medications for acute gastroenteritis. Fixed drug reaction caused in this case was red, raised macule, which turned into blister and later followed by post-inflammatory hyperpigmentation. Delayed type IV hypersensitivity reaction is most probably the reason for the mechanism of fixed drug reaction.
  8,456 391 1
ORIGINAL ARTICLES
Formulation and evaluation of modified-release effervescent floating tablets of ofloxacin
Sarat Chandra Prasad Malisetty, Ravi Teja Allena, Swetha Sandina, HV Gangadharappa
April-June 2013, 2(2):99-107
DOI:10.4103/2278-344X.115685  
Aims: Ofloxacin is used as anti-microbial agent. Due to its high solubility in gastric pH, a floating drug delivery system was selected to improve the bioavailability and therapeutic efficacy of the drug. Settings and Design: The purpose of the study was to prepare and evaluate effervescent floating tablets of ofloxacin to prolong its gastric residence and increase bioavailability. Materials and Methods: Drug, semi-synthetic and natural polymers, such as HPMC K4M, Guar gum, Xanthan gum and Chitosan, were used. Sodium bicarbonate and citric acid were used as gas-generating agents and tablet compression was done by direct compression. The prepared tablets were characterized and were evaluated for in vitro floating behavior, swelling index, in vitro drug release studies and release kinetics. Results: Formulation F6 containing xanthan gum and chitosan in a 1:1 ratio attained sustained release for 12 h and drug release observed was about 76.7%. Swelling index was in the range 62.17 ± 1.49% to 194.02 ± 1.05%. Floating lag time was observed in the range 4.11-6.26 min. Conclusion: The in vitro results showed better drug release conditions, supported by follow-up in vivo studies, suggesting that this formulation is advantageous over the current marketed formulation, through increased gastric residence and bioavailability.
  7,535 708 1
CASE REPORTS
Open-coil orthopedic traction spring: An innovative approach for force delivery with face-mask therapy
Pavankumar Janardan Vibhute, Usha Shenoy, Punit Fulzele, Rohan Bhede
April-June 2013, 2(2):122-125
DOI:10.4103/2278-344X.115689  
Facemask therapy/reverse pull headgear is the popular method for maxillary protraction in maxillary deficient adolescence cases. Furthermore, various protraction methods and appliances have been developed, and evaluated extensively for their clinical efficiency. Their effectiveness enhanced with optimum orthopedic force magnitude and low-load deflection rate (LDR) and force constancy over a period of time. With the advent of NiTi springs or springs prepared from thinner wires, force decay has been markedly reduced. For use of NiTi, clinician has to depend upon prefabricated closed coil springs, which are expensive. Open-coil orthopedic traction spring (OCOTS) is developed utilizing 0.012" Australian stainless steel wire for orthopedic traction. This paper describes fabrication and clinical application of OCOTS, with numerous advantages. It sustains low LDR with optimum force magnitude. Its design is adjustable for desired length and force level. It is fail-safe for both activation and deactivation (i.e., it cannot be overstretched or over activated, and decompression limit of open-coil is also controlled by the operator).
  6,253 367 -
Management of phenytoin induced gingival enlargement associated with cerebral palsy: A challenge to the clinician
Anupama Shriram Rao, Amit K Walvekar, Subramaniam M Rao, Biju Thomas
April-June 2013, 2(2):126-129
DOI:10.4103/2278-344X.115690  
Phenytoin, which is the drug of choice for treatment of grandmal, psychomotor seizures associated with cerebral palsy, has serious side effect like gingival enlargement. Drug induced gingival enlargement is not only esthetically disfiguring but often impairs speech, mastication, nutrition and plaque control measures. In addition, poor oral hygiene, lack of motor coordination and muscular limitations in mentally disabled individuals results in increased susceptibility to periodontal disease. The present case report unfolds a complex nature of the management of phenytoin induced gingival enlargement, secondarily complicated by inflammation, and in the cerebral palsy patient. A supportive team work of periodontist, neurophysician, and general anesthetist plays a significant role in maintaining the quality of life in mentally disabled patient.
  6,075 383 -
SHORT COMMUNICATION
Understanding the needs of persons with disabilities in rural and urban Mysore: A step towards exploring the unreached
Syed Yunus Zama, NC Ashok, Praveen Kulkarni
April-June 2013, 2(2):133-137
Context: It is estimated that about 10% of the people in the world are disabled. The disability rate in the developed regions is 8.5% and in the developing regions is 4.8%. A disabled person who is in the prime of his/her youth has every right to equal opportunity and must therefore be offered a range of assistance. Aims: The aim of this study was to estimate the prevalence of disabilities in rural and urban areas of Mysore and to assess the needs of people with disabilities. Settings and Design: Cross-sectional study. Materials and Methods: This cross-sectional study was conducted in an urban slum of Mysore city and a rural and urban and rural field practice area of a medical school. The study included 6,000 persons who were permanently residing in the study areas. Qualitative survey using focus group discussions were conducted for assessing the needs of persons with disability. Statistical Analysis Used: Descriptive statistics such as mean, standard deviation, percentages, and Chi-square test. Results: The prevalence of disability in the urban area was 19.27% and that in the rural area was 28.07%. There was a need for sending the children with disability to general schools and also to improve the facilities related to rehabilitation through the government and Non Government Organizations (NGOs). Conclusions: The overall prevalence of disability was observed to be higher in the rural areas as compared to the urban area. Needs of persons with disabilities were pertaining to education, rehabilitation, and provision of essential services.
  5,755 344 -
ORIGINAL ARTICLES
Self-reported occupational health problems among dentists in Himachal Pradesh, India: A descriptive survey
Vinay Kumar Bhardwaj, Rajeshwar Prasad Luthra, Deepak Sharma, Anil Chug, Manish Sahore, Aditya Sharma
April-June 2013, 2(2):115-121
DOI:10.4103/2278-344X.115688  
Background: Occupation-related health problems are associated with risk or danger as a consequence of the nature of working conditions. Unique working conditions in dentistry can affect the health of dentists. Aim: The aim of this study is to collect information from dentists in Himachal Pradesh concerning common occupation-related health problems, their knowledge and the precautions they commonly took to avoid such problems. Settings and Design: Questionnaire survey conducted on a systematic random sample of 465 dentists among 1395 dentists registered in the state dental council. Materials and Methods: Questionnaires were sent by mail in September 2011 to systematic random sample of 465 dentists. The dentists were asked to complete the questionnaire and return it by mail using the stamped addressed envelope provided. Statistically Analysis Used: The data were analyzed using the software Statistical Package for the Social Sciences version 15 (SPSS Inc., Chicago). Z test was used for statistical comparison. Results: The response rate from the dentists was 81.7%. The most common problem experienced was musculoskeletal pain (46.1%) followed by allergic dermatitis of the hands (7.6%). Nearly, all of the respondent dentists wore gloves (100%) and face masks (97.4%) during work. 1/10 th respondents reported that they had received instructions or training through interactive workshops in occupational health and safety. Conclusions: There seems to be a substantial demand for continuing education on occupational health and safety among dentists in Himachal Pradesh. Hence, more emphasis on occupational health and safety is put into dental training with more continuing education activities on occupational health and safety to practicing dentists.
  5,238 504 1
MINI REVIEW
Phase 0 trials (microdosing): A new paradigm in clinical research
Prasan R Bhandari
April-June 2013, 2(2):75-80
DOI:10.4103/2278-344X.115680  
Microdosing offers a technique to augment drug development by commencing human studies earlier to Phase 1 studies. A systematic search for articles in the PubMed was performed MedLine up to August 2012. The rationale is to support in the go versus no-go decision-making process and to reject early non-promising molecules from the drug pipeline. Selection of several probable frontrunners can be accomplished at the clinical stage instead of in preclinical studies. The microdosing technique can be easily utilized for a molecularly targeted promising drug compound with a known mechanism of action. It offers beneficial data concerning accessibility and biodistribution that can be used in many assessments furthering the development of the molecule. However, the use of microdose pharmacokinetic studies as a vital tool in drug development is still to catch on. While this methodology assures probable expenditure reductions and a significant increase in productivities of the drug development practice, foremost obstacles still must be overcome before the procedure becomes routine practice. Clear guidelines in Europe and the USA have had a supporting effect. The dearth of permitting requirements for microdosing studies in Indian regulation, in spite of low-risk and obvious application for the local drug development industry, is inconsistent with the nation's hopes to be among the bests in pharmaceutical research.
  4,919 490 1
REVIEW ARTICLES
Novel solid self-emulsifying pellets: An approach for enhanced oral delivery of poorly soluble drug
Natarajan Jawahar, B Vivekananda Raju
April-June 2013, 2(2):63-68
DOI:10.4103/2278-344X.115678  
In recent years, it has been a great challenge for lipophilic drugs to get converted into an orally administered formulation with sufficient bioavailability. Over 40% of the new chemical entities are poorly soluble, which lead to decreased bioavailability, higher inter- and intra-subject variability, and lack of dose proportionality. Self-emulsifying drug delivery system has come to the fore for the enhancement of oral bioavailability. The prime characteristic - their ability to form fine oil-in-water (o/w) emulsion or micro-emulsions upon mild agitation following dilution by an aqueous phase - is quite promising. The present review discusses the feasibility of producing solid self-emulsifying pellets using the extrusion/spheronization technique and their development; it also focuses on related problems and possible future research directions.
  4,383 378 -
ORIGINAL ARTICLES
Microwave assisted synthesis, characterization and evaluation for their antimicrobial activities of some novel pyrazole substituted 9-anilino acridine derivatives
Rajagopal Kalirajan, V Muralidharan, Selvaraj Jubie, S Sankar
April-June 2013, 2(2):81-87
DOI:10.4103/2278-344X.115682  
Objective: The paper focuses on the microwave synthesis of a new series of 9-anilinoacridine derivatives 4a-g, 5a-g, and 6a-g. Materials and methods: The compounds were confirmed by physical and analytical data. The synthesized compounds when screened for in vitro anti-microbial activity showed promising activity for many compounds. The in vitro anti-microbial activities of the synthesized compounds were evaluated against some bacteria and fungi strains. Results and Discussions: The results suggested that, the products 4a-g, 5a-g, and 6a-g exhibited good inhibitory effect against most of the tested organisms. Especially, 4b, 5a, 5d, 6b, and 6e were shown to be most effective against Bacillus subtilis, Escherichia coli at the concentration of 25 μg/ml and Candida albicans at the concentration of 50 μg/ml.
  4,344 393 8
Seasonality of tuberculosis in rural West Bengal: A time series analysis
Ranadip Chowdhury, Abhijit Mukherjee, Somnath Naska, Mrinmoy Adhikary, Saibendu Kumar Lahiri
April-June 2013, 2(2):95-98
DOI:10.4103/2278-344X.115684  
Background: There is a recent concern about the global climatic change that is expected to have broad health impacts. The health effects of extreme weather events include a spectrum of wide variety of impacts. According to a study in Northern India, tuberculosis (TB) diagnosis peaked between April and June, and it reached a nadir between October and December. However, no seasonality was reported from South India. Aims: This study is aimed to assess the seasonality of TB in rural West Bengal and to develop a univariate time series model. Settings and Design: Retrospective record-based study was carried out at Amdanga tuberculosis unit (TU), North 24-parganas, West Bengal. Materials and Methods: A total of 1507 new TB cases were registered in the TB register of the TU during January-2008 to December-2011 period were taken for this study. Statistical Analysis: Seasonal adjusted factor (SAF), autocorrelation function (ACF), partial autocorrelation function (PACF), and seasonal autoregressive integrated moving average (SARIMA) methods were applied by using the SPSS 16.0 version. Results: ACF and PACF at lag 12 shows significant pick suggesting seasonal component of the TB series. SAF showed peak seasonal variation from March to June and nadir from October to December in additive model. Univariate model by expert-modeler in the SPSS showed SARIMA ((0,0,0)(1,2,0) 12 could best predict the model with 54.3% variability. Conclusion: A seasonal pattern of TB was observed. This information would be usefulfor administration and managers to take extra care to arrange and provide extra facilities during the peak seasons.
  4,214 421 3
REVIEW ARTICLES
The potential therapeutic targets for cervical cancer
L Priyanka Dwarampudi, K Gowthamarajan, R Shanmugam, K Madhuri, P Nilani, MN Satish Kumar
April-June 2013, 2(2):69-74
DOI:10.4103/2278-344X.115679  
In case of invasive cervical carcinoma several molecular events were reported and these molecular events resulting in multiple genetic abnormalities. In order to control these tumors multiple molecular therapeutic targets are needed with different molecular mechanisms. Unfortunately, these molecular targets were in early stages of development. Because of less degree of success of conventional therapeutics for late stages of cervical cancer and lowering of prognosis of patients there is an increase in interest for the development of potential therapeutic targets for cervical cancer. This review article emphasizes the current molecular targeted agents; with special attention to estrogen receptors for human papilloma virus infected cervical cancer.
  4,119 420 1
LETTERS TO EDITOR
Liesegang rings: An unusual mimicker in renal cyst
Shubha P Bhat, Kishan HL Prasad, Prajwal Ravinder, Panna Hegde
April-June 2013, 2(2):139-140
DOI:10.4103/2278-344X.115694  
  4,130 269 2
ORIGINAL ARTICLES
Risky sexual behavior related to human immunodeficiency virus/acquired immunodeficiency syndrome among seasonal labor migrants: A cross-sectional study from far Western Region of Nepal
Dillee Prasad Paudel, Rakesh Ayer
April-June 2013, 2(2):88-94
Background: Human immunodeficiency virus/acquired immunodeficiency syndrome is a global public health problem; enormously affecting the national economy, social development and human rights with posing a challenge to human civilization. Seasonal labor migrants are the most at risk population for HIV/AIDS and their risky sexual behaviors exacerbate its transmission. The aim of the study was to explore the HIV/AIDS related sexual behavior of migrant workers. Materials and Methods: A cross-sectional study was carried out among 372 migrant workers backing to Nepal from Banbasa border of India-Nepal during August-October 2010. Migrants having permanent residents of far western region, Nepal were individually contacted at the entry point of Nepal and interviewed in a confidential environment after obtaining informed consent. Data were analysed using the SPSS (16.0 version). Descriptive and inferencial statistics were applied considering P < 0.05 as significant. Results: Altogether, 372 male migrant workers (mean age± S.D.: 29.6 ± 1.9 years) were study participants. About 19.35% were illiterates 34.68% had primary education, 61.29% were married, and 74.20% were Hindus. About 53.22% were from schedule caste, and 41.94% had monthly income < 3000 Nepali rupees (NRs). About 45.77% were porter followed by 29.84%, 12.10% and 11.29% as construction workers, home servant, and hotel/supermarket helpers, respectively. Cent percent had any form of sexual contact and 45.96% had >3 sex partners. Most (82.25%) had vaginal sex and 43.54% reported the consistent use of condom. About 64.76% had sex after drinking alcohol. Age, education, monthly income and nature of works were significant with risky behaviors. Conclusion: Inconsistent condom use, multiple sexual partners and sex after drinking alcohol have a cumulative effect on the risk of HIV transmission.
  3,832 306 -
Stigma and underutilization of facility-based sexually transmitted infection services undermine human immunodeficiency virus testing in rural communities of Rivers State, Nigeria
Charles I Tobin-West, Ayebatari M Lawson
April-June 2013, 2(2):108-114
DOI:10.4103/2278-344X.115686  
Context: Human immunodeficiency virus (HIV) testing is a critical step in limiting the spread of the virus and ensuring access to prevention, treatment, care and support. Aims: The study examines the consequences of stigma and underutilization of facility-based sexually transmitted infection (STI) services on the uptake of HIV testing in rural communities of Rivers State, Nigeria, in other to provide information necessary to address the problem. Materials and Methods: A cross-sectional study was conducted between the 1 st and 30 th July 2011 among men and women of reproductive age living in rural communities of Rivers State, Nigeria, using a multistage sampling technique. Data were analyzed using the Epi-info version 6.04d, with confidence limit set at 95%. Results: A total of 596 participants: 270 men (45.3%) and 326 women (54.7%) were interviewed. Their mean age was 26.59 ± 7.77 years. Only 226 (37.9%) of them had ever tested for HIV. Most had stigmatizing attitudes towards HIV positive persons, 164 (71.6%) and had not tested for HIV (χ2 = 8.85, df = 1, P = 0.003). Of those who reported STIs, only 45.7% received treatment from a health facility, against 188 (54.3%) who did not. Consequently, only 90 (67.2%) of them were tested for HIV compared to 44 (32.8%) who received treatment from informal care providers (χ2 = 8.41, df = 1, P = 0.000). Conclusions: Stigma and low patronage of facility-based STI services undermine HIV testing. Anti-HIV campaigns must be consciously designed to prevent and correct stigmatization, emphasize the relationship between HIV and STIs and the significance of seeking appropriate care from health facilities.
  3,475 257 3
EDITORIAL
IJHAS: One year and counting
B Suresh
April-June 2013, 2(2):61-62
DOI:10.4103/2278-344X.115677  
  2,812 252 -
LETTERS TO EDITOR
Immediate over delayed implant placement philosophy as a novel approach in oral implantology
Puneet Kumar, Prince Kumar, Suresh Yadav, Shallu Tyagi
April-June 2013, 2(2):138-138
DOI:10.4103/2278-344X.115693  
  2,666 232 -
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