International Journal of Basic & Clinical Pharmacology

Pharmacovigilance in rural India: challenges, opportunities and the way forward

Tue, 23 Jun 2026 00:00:00 +0530

Pharmacovigilance (PV) plays a crucial role in safeguarding drug safety, yet its reach in rural India, home to approximately 65% of the population, remains markedly limited compared to urban centres. Drawing from our experiences in adverse drug reaction (ADR) monitoring at peripheral health centres, this article explores key barriers, including inadequate awareness, infrastructural deficits, and sociocultural hurdles, that hinder effective PV implementation. It highlights opportunities through community health workers (CHWs), low-bandwidth mobile technologies, and innovative models such as Delay-Tolerant Networking (DTN) for offline reporting. Recommendations include embedding PV within existing national programs like the National Health Mission (NHM) and Ayushman Bharat Digital Mission (ABDM), enhancing contextualised training, and pursuing policy reforms through the PV Programme of India (PvPI). By systematically addressing these gaps, India can acheive more equitable drug safety, reduce preventable ADRs, and strengthen public health in its most underserved communities. This review offers practical, field-informed insights for policymakers, practitioners, and program implementers.

The silent pandemic: understanding the global burden of antimicrobial resistance

Tue, 23 Jun 2026 00:00:00 +0530

Antimicrobial resistance (AMR) is one of the most severe public health concerns of the 21st century and is reversing decades of progress made in the prevention and treatment of infectious diseases. AMR is a so-called "silent pandemic" since the condition progresses slowly and is completely unnoticed. But even AMR worldwide leads to considerable health, mortality and economic losses, with the most recent global report showing millions of such infectious diseases worldwide, and a very high number of deaths resulting from them, most of which are in the low- and middle-income countries. This review presents a global picture of AMR, clinical and public health-related issues along with key issues in terms of epidemiological surveillance, innovation and policy response. Factors driving the emergence and spread of resistance include the overuse and inappropriate use of antibiotics in human and animal health, poor infection control, substandard drugs, and environmental pollution. Also, we report that the health care sector is at significant risk due to AMR, which is a serious threat to the outcomes of routine surgeries, organ transplants, cancer treatment and the care of vulnerable patients. This in turn places substantial strain on health care systems. Worldwide and in different regions, monitoring programmes have been established that use genomics and Artificial Intelligence (AI) to study resistance pattern although they are still in a developing stage. Also, the development of new antibiotics in the pharma sector is a limited field, which in turn is pushing research into alternative options like phage therapy, nanotech-based solutions, Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and vaccines that target priority pathogens. Although the World Health Organisation’s (WHO) Global Action Plan and national AMR strategies play a key role in shaping the international policy landscape for this issue, significant gaps still exist in implementation, regulation, financing and stewardship. The solution lies in better data collection on health issues, responsible use of antibiotics, infection control, innovation and sustained political commitment, which will not only slow down the AMR pandemic but also help secure the health of future generations.

Pharmacovigilance and its impact on drug safety

Shiva Mishra — Tue, 23 Jun 2026 00:00:00 +0530

Pharmacovigilance is the science and activities concerned with the detection, assessment, understanding, and prevention of adverse effects or any other drug related problems. Pre-marketing clinical trials provide essential information on efficacy and safety of drugs. they are limited by small sample size and short durations which makes post-marketing surveillance crucial for identifying, rare, serious and long-term adverse drug reactions. Pharmacovigilance systems rely on spontaneous reporting, active surveillance and pharmacoepidemiological studies to generate safety signals and support regulatory decision making. Effective pharmacovigilance contributes to the rational use of medicines, enhances patient safety, and improves public health outcomes through continuous monitoring of benefit-risk ratio of medicinal products. Strengthening reporting systems and increasing awareness among healthcare professionals and patients remain key to improving pharmacovigilance practices globally.

Liposomal vitamin B5 (pantothenic acid): enhanced delivery, mechanisms, and clinical applications

Poulami G. Banerjee, Argha Chakraborty — Tue, 23 Jun 2026 00:00:00 +0530

Vitamin B5 (pantothenic acid) is a critical precursor for the synthesis of coenzyme A (CoA), facilitating essential metabolic pathways including the Krebs cycle and fatty acid synthesis. Despite its biological importance, conventional oral supplementation faces significant pharmacokinetic challenges, primarily the saturation of sodium-dependent multivitamin transporters (SMVT) and susceptibility to gastric degradation, which limit its systemic bioavailability. Liposomal encapsulation offers a biomimetic "Trojan horse" delivery mechanism that protects vitamin B5 from the acidic gastric environment. By utilizing a phospholipid bilayer, this technology enables non-saturable absorption pathways such as passive diffusion, endocytosis, and lymphatic uptake, effectively bypassing the competitive limitations of SMVT and the hepatic first-pass effect. Reported literature suggests that enhanced delivery of vitamin B5 through advanced formulations holds significant potential in several clinical domains: dermatological health: supporting skin barrier repair and addressing conditions such as acne, wound healing: facilitating tissue regeneration and dermatological repair, metabolic management: aiding in the regulation of dyslipidaemia through its role in lipid metabolism and steroid hormone synthesis, and neuroprotection: enhancing the synthesis of neurotransmitters like acetylcholine to support neurological health. While liposomal technology significantly optimizes the bioavailability and therapeutic potential of pantothenic acid, further clinical evidence is required to fully map its long-term efficacy across diverse populations. Future research should focus on addressing existing evidence gaps to establish standardized protocols for its application in chronic metabolic and neurological therapy.

Amiodarone causes QT prolongation in patients with atrial fibrillation complicating dyspepsia: a case report

Juniarto Mende, Graciano Aristides Maturbongs, Yohana Krisostoma Anduk Mbulang — Tue, 23 Jun 2026 00:00:00 +0530

A 62-year-old female patient presented to the hospital with complaints of dizziness, weakness, and fever for two days. On admission, her vital signs revealed an increased pulse rate and a temperature above normal. On the first day of hospitalization, her blood pressure rose to 145/94 mmHg before later fluctuating within the normal range. The patient's diagnosis included fatigue and febrile illness, dyspepsia, and AF RVR (Atrial fibrillation with rapid ventricular response). Subsequent laboratory tests showed elevated SGOT, SGPT, and CK-MB values above normal. Tests for HBSAg, anti-JAV, anti-HCV, and swab antigen were negative. During hospitalization, QT interval (QTc) prolongation was detected: the interval was 457 ms (Grade 1) on the second day and 481 ms (Grade 2) on the third day. Treatment began with Amiodarone 100 mg orally every 12 hours for the first two days. Additional medications included Bio Curliv (1 tablet every 8 hours orally), Zypraz (alprazolam) 0.25 mg once daily, tramadol 1 amp in 500 cc NaCl (infused over 8 hours as needed), Sistenol (N-acetylcysteine and paracetamol) 1 tablet every 8 hours orally, Norages (Metamizole) 1 ampoule on the first day, and Esomeprazole 1 tablet once daily. On the third day, Amiodarone was adjusted to 150 mg in 50 cc Dex 50% over 30 minutes, and then changed to 200 mg three times daily until discharge if the patient converted. Throughout treatment, pharmacists played an important role in monitoring for side effects, specifically QTc prolongation and elevated liver enzyme levels (SGOT and SGPT). Therefore, patients with AF require regular ECG monitoring to detect early QTc prolongation.

A novel approach in treating Tolosa-Hunt syndrome with injectable dexamethasone and cyclophosphamide: a case report

Aleesha Bind Shihab, Megha Ann George, K. Arun Chander Yadav, V. L. Arul Selvan — Tue, 23 Jun 2026 00:00:00 +0530

This case report describes about the treatment efficacy of the combination therapy of injection dexamethasone followed by single dose of pulsed intravenous cyclophosphamide in a 53-year-old male patient diagnosed with Tolosa Hunt syndrome (THS) with normal immunoglobulin G4 (IgG4) level. This patient with history of type 2 diabetes mellitus, systemic hypertension, coronary artery disease presented with complaints of left sided headache, blurring of vision with diplopia. On further examination and investigation patient was diagnosed with THS. The patient was managed with intravenous steroid followed by single dose of intravenous steroid sparing agent. Treatment with intravenous steroid sparing agent led to rapid and significant clinical remission. He was discharged with a plan of combination therapy with oral steroid and steroid sparing agent and follow up recommendation.

Lamotrigine-induced severe cutaneous adverse reaction in a patient with N-methyl-D-aspartate receptor autoimmune encephalitis

Omkar Sonavane, Suneel Majagi — Tue, 23 Jun 2026 00:00:00 +0530

Current case report is regarding a 20-year-old female patient presenting with N-methyl-D-aspartate (NMDA) receptor antibody-positive autoimmune encephalitis and new-onset seizures who developed rapidly progressive erythematous pruritic rash after administration of tablet lamotrigine followed by escalation of its dose and which was combined with tablet sodium valproate and tablet lacosamide. Cutaneous involvement was diffuse but mucosal surfaces were spared. Laboratory investigations revealed mild transaminitis and monocytosis without systemic involvement. A probable lamotrigine‑induced severe cutaneous adverse drug reaction was diagnosed based on temporal association and Naranjo causality assessment. Prompt discontinuation of lamotrigine and initiation of systemic corticosteroids resulted in complete clinical resolution. Present case highlights risk of occurance of severe cutaneous adverse drug reactions caused by oral lamotrigine when co-administered with sodium valproate which is known to cause enzyme inhibition as well as in the presence of immune dysregulation. There is a need to take precautions where these conditions exist. Early recognition and timely withdrawal of the offending drug are critical to prevent progression to Steven Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).

Pustular autoimmune progesterone dermatitis in pregnancy: a rare presentation

Sukhmani Kaur Brar, Harmandeep Kaur, B. K. Brar — Tue, 23 Jun 2026 00:00:00 +0530

Autoimmune progesterone dermatitis (AIPD) is a rare, hormonally mediated dermatosis characterized by recurrent premenstrual skin eruptions caused by hypersensitivity to endogenous or exogenous progesterone. Although symptoms often subside during pregnancy due to hormonal adaptation, re-exposure to progesterone can trigger disease flares. A 30-year-old woman presented with complains of generalized erythematous and itchy eruption with few pustular lesions on the face for 5 days. Upon enquiring she revealed that she is 2 months pregnant and started on oral micronized progesterone prescribed for obstetric support. Laboratory investigations were normal, and histopathology showed a perivascular lymphocytic infiltrate with dermal edema, suggestive of hypersensitivity. Based on the temporal association between progesterone exposure and lesion recurrence, a diagnosis of autoimmune progesterone dermatitis was established. The withdrawal of progesterone, along with treatment using antihistamines and a short course of corticosteroids, resulted in complete resolution. The patient remained symptom-free throughout pregnancy and postpartum, with no recurrences during 18 months of follow-up. This case underscores the diagnostic significance of exogenous progesterone induced autoimmune progesterone dermatitis. Awareness of this rare condition is essential, particularly during pregnancy, for prevention and effective management.

Euphorbia prostrata extract-based combination therapy in diabetic wound healing: clinical outcomes from a case report

Kunal Khobragade, Pradnya Salvi, Nilesh Borkar — Tue, 23 Jun 2026 00:00:00 +0530

Chronic wounds in patients with diabetes mellitus remain a major clinical challenge due to impaired microcirculation, persistent inflammation and delayed collagen remodeling, often resulting in prolonged morbidity and consideration of surgical intervention. We report the successful conservative management of a chronic non-healing leg wound in a 55-year-old woman with poorly controlled type 2 diabetes mellitus who presented with a painful wound of more than two months’ duration, unresponsive to routine surgical outpatient department (OPD) dressings and initially advised for skin grafting. The patient was treated with a combination of EP extract therapy Sitcom cream dressing twice daily 3 months and Sitcom Forte tablet 1 BD x1 month and OD x 2 months alongside with antidiabetic medication. Early wound healing and clinical response was noted within 7-10 days, including pain reduction and improved granulation tissue quality. Progressive wound size reduction from peripheral wound towards centre, epithelialization and ultimately complete wound closure with minimal scarring were achieved by end of three months, importantly by sparing wound skin grafting and no local or systemic adverse effects reported. This case suggests that Euphorbia prostrata–topical and oral combination was having significant wound healing potential in diabetic patients, possibly related to its anti-inflammatory, antioxidant, venotonic and hemostatic properties. Larger controlled studies are warranted to confirm efficacy and define its role within comprehensive diabetic wound care.

ADR•X: an interpretable, leakage-aware machine learning framework for sertraline adverse drug reaction signal detection using FAERS pharmacovigilance data

Tue, 23 Jun 2026 00:00:00 +0530

Adverse drug reactions (ADRs) are among the leading causes of preventable patient harm globally, and while the FDA Adverse Event Reporting System (FAERS) offers the most comprehensive post-marketing safety repository available, most published machine learning (ML) studies that work with this database introduce information leakage by incorporating outcome-derived disproportionality metrics—proportional reporting ratios (PRR) and reporting odds ratios (ROR)—directly as model features, thereby inflating performance estimates and undermining real-world generalisability. This study presents ADR•X, a LightGBM-based, leakage-aware framework designed to detect sertraline ADR signals from FAERS data using an approximately 208-variable feature space spanning patient demographics, physicochemical molecular descriptors, pharmacogenomic indicators, biology-guided multi-omics proxy variables, and mechanistic interaction terms, with all PRR-, ROR-, and frequency-derived variables explicitly excluded. Two model configurations were evaluated: an unweighted baseline and an inverse class-frequency-weighted variant. The baseline achieved an AUC-ROC of 0.53–0.54 and the imbalance-adjusted model reached 0.55–0.56. Global SHAP analysis identified dose mg, metabolic overload score, and polypharmacy flag as the three most influential predictors, while all remaining features clustered near zero, confirming the absence of leakage-driven dominance. The framework was deployed as a reproducible Streamlit research portal and is intended exclusively for population-level hypothesis generation, not individual clinical risk prediction. Modest AUC values reflect the bounded information content of voluntary reporting systems and represent honest signal estimation rather than model inadequacy. ADR•X demonstrates that biologically plausible and interpretable ADR signal detection is achievable from FAERS data without sacrificing methodological integrity.

The role of gut microbiota in drug metabolism: implications for personalized medicine: a systematic review

Abhiraj R. Deshmukh, Nainish B. Mehta, Girish S. Joshi, Prathamesh S. Sawant — Tue, 23 Jun 2026 00:00:00 +0530

Interindividual variability in drug response remains a significant challenge in clinical pharmacology. Emerging evidence suggests that the gut microbiota contributes to variability in drug metabolism, efficacy, and toxicity. A systematic search of PubMed, Scopus, Nature Portfolio, and relevant pharmacology journals was conducted for studies published between January 2019 and August 2025 using predefined keywords related to pharmacomicrobiomics and drug-microbiota interactions. Peer-reviewed human and animal studies evaluating mechanistic or clinical implications were included. Study selection and reporting followed PRISMA 2020 guidelines. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized trials, the Newcastle-Ottawa Scale for observational studies, and SYRCLE’s tool for animal studies. Data were synthesized qualitatively due to methodological heterogeneity. Of 2,847 identified records, 158 studies met inclusion criteria. Clinically significant microbiota-drug interactions were observed across multiple drug classes including cardiac glycosides, anti-inflammatory agents, chemotherapeutics, antidepressants, immunosuppressants, and immunotherapies. Mechanisms included direct microbial biotransformation, metabolite reactivation, modulation of host metabolic pathways, and immune-mediated effects. These interactions were associated with altered pharmacokinetics and variable therapeutic outcomes. The gut microbiota is an important determinant of drug response variability. Incorporating microbiome-based insights into pharmacotherapy may enhance individualized treatment strategies. Further well-designed clinical studies are needed to support routine clinical implementation.

Comparative evaluation of bispectral index and hemodynamic changes during induction of anaesthesia with propofol and thiopentone

Tue, 23 Jun 2026 00:00:00 +0530

Background: Induction requires sufficient anaesthetic depth to prevent patient awareness while maintaining hemodynamic stability. The research study used Bispectral index (BIS) measurements to test the effectiveness of thiopentone and propofol as general anaesthesia induction agents.

Methods: A randomised prospective trial with masked members of the study overcame the logistical issues of recruiting 60 ASA I patients of between18-65 years of age for consecutive first time surgical procedures, with all patients recruited on a non first case basis. The 60 patients were placed randomly into two groups for receiving either thiopentone 5 mg/kg (Group T) or propofol 2 mg/kg (Group P) as their induction agents. The study was conducted for 600 seconds with the first data collection point being at the start of the procedure (0) and at 24 seconds after induction, including BIS measurements along with heart rates and mean arterial pressure.

Results: BIS values were found to decrease following propofol use by a total of 33.7±7.43 while thiopentone was 44.8±10.61. The total duration of a BIS<60 was greater for propofol than thiopentone (190.13±91.0 seconds versus 70.53±41.3 seconds). At 240 seconds post administration, propofol BIS was 43.9±15.12 and thiopentone was 65±6.8. It was also determined that thiopentone provided better hemodynamic stability since it caused very little decrease in mean arterial pressure or heart rate.

Conclusions: Propofol was better than thiopentone in preserving sufficient hypnotic depth during induction and intubation, but thiopentone had better hemodynamic stability.

Generation and validation of a new linear regression equation of mandibular first permanent molar and its comparative evaluation for predictive accuracy with already established regression equation of cervical vertebrae: a radiographic study

Tue, 02 Jun 2026 00:00:00 +0530

Background: Accurate skeletal age estimation is essential for orthodontic treatment planning and forensic identification. This study aimed to generate a new linear regression equation for age estimation using the pulp chamber crown trunk height ratio (PCTHR) of the permanent mandibular first molar and to compare its accuracy with the established cervical vertebral maturation index (CVMI) regression equation.

Methods: This observational analytical cohort study included 305 subjects aged 9–14 years. Orthopantomograms (OPGs) and lateral cephalograms were obtained. Pulp chamber height (PCH) and crown root trunk height (CRTH) of the mandibular first molar was measured using Image J 1.46r software, and PCTHR was calculated. Cervical vertebral bone age was calculated using the Mito et al regression equation: Cervical vertebral bone age (years)=−0.20 +6.20×(AH3/AP3) + 5.90×(AH4/AP4) + 4.74×(AH4/PH4). A linear regression equation for age estimation using PCTHR was derived from 305 subjects and validated on a subset of 90 subjects (15 per age group). Accuracy was compared using correlation coefficient (R), R², mean absolute error (MAE), and root mean square error (RMSE). Statistical analysis was performed using statistical package for the social sciences (SPSS) version 25.0 (IBM Corp., Armonk, NY, USA).

Results: The mean age of the 305 subjects was 12.01±1.634 years. PCH showed a weak negative correlation with age (r=–0.110). The derived regression equation was: predicted age (9–14 years) =11.362–(0.456×PCH) + (0.222×CRTH). The model explained 75% of the variance (R²=0.750, R=0.866) with MAE 0.719 years and RMSE 0.854 years. The CVMI model showed stronger correlation (R=0.895, R²=0.800) with lower error (MAE 0.599 years, RMSE 0.763 years).

Conclusions: Both PCTHR and CVMI methods are effective for skeletal age estimation in Indian children aged 9–14 years. CVMI demonstrated superior accuracy, but the PCTHR method offers a useful non-invasive alternative using routine OPGs without additional radiation.

Pradhan Mantri Bharatiya Janaushadhi Pariyojana and the perception of medical students towards generic medicines in North Karnataka: a cross-sectional study

Shamin Eabenson, M. R. Gudadinni, M. C. Yadavannavar, A. M. Rangoli — Thu, 04 Jun 2026 00:00:00 +0530

Background: Rising healthcare costs are a big concern in a populous nation like India. In April 2008, the Indian government introduced the Janaushadhi initiative, which offers inexpensive generic medications, in an effort to curb rising health costs. In Indian homes, a significant amount of out-of-pocket costs are related to medications. This study aims to assess the perception regarding Janaushadhi program among medical students in Karnataka. Access to medicines, affordability, practical implementation of the project was ascertained through this study. Medical students who are the doctors of the future, their preference for branded or generic medicines were ascertained in this study.

Methods: A cross-sectional study, done among 157 Medical Students of Vijayapura District from January to February 2026. The participants were selected using convenience sampling technique. Data was collected using a structured questionnaire, that assessed the perception on Janaushadhi Program, which was distributed as Google form.

Results: The participants were from the age group of 17 years to 26 years and were MBBS medical students from 1^st year. The majority of the participants were females 95 (60.5%), and males 62 (39.5%). 77.1% were aware about generic medicines, 65.6% understood the difference between generic and branded medicines. 128 (81.5%) thought that Jan Aushadhi medicine stores should be made available in every hospital.

Conclusions: The majority of medical students who participated in this study 128 (81.5%) thought that generic medicines were less costly than branded medicines. 29 (18.5%) thought that generic medicines were not cheaper than branded medicines. There is association between gender and knowledge on Janaushadhi questions. Further studies should be done in this field and medical students should be given information regarding generic medicines.

A study to evaluate the effectiveness of role-play as a teaching-learning method for communication skills among second-year students

Anuradha M. Gandhi, Prakruti P. Patel, Chetna K. Desai — Tue, 23 Jun 2026 00:00:00 +0530

Background: Selection of teaching learning (TL) Methods are important to improve student’s interest in learning. The study was conducted to evaluate effects of demonstration and role play for method of administration and communication for use of metered dose inhaler (MDI).

Methods: Pretest, brief lecture (questionnaire about TL methods (Demonstration (Group A) and role play (Group B) for use and communication of MDI by trained faculties), evaluation of student’s demonstration (WHO recommended steps for MDI administration and Calbary-Cambridge guide for communication) followed by post test and feedback (students and faculties). Data were analyzed at the end of study using Chi square test and Likert scale.

Results: Demonstration preferred by group A (Demonstration) (53.6%) and group B (Role play) (56.3%) (Pre-test) and role play (98.2%, 62.1) for dosage formulation (Post-test). WHO steps for MDI use demonstrated by >50% students of both groups. Communication skills were significantly higher in role play {nonverbal (p<0.05-greet the patient, offering seat; p<0.001-nodding head, eye to eye contact), verbal communication (p<0.001) and active listening (p<0.001)}. Students either strongly agree or agree for demonstration (53% and 21.05%, respectively) and role play (48.54% and 31.03%, respectively) as useful for understanding and role play useful to develop communication skills (33% and 23.3%, respectively). Faculty feedback indicates both methods are useful for understanding and develop doctor patient relationship; role play to remember (56.43%) and develop communication skills (43%).

Conclusions: Both TL methods useful to develop cognitive skills and role play for communication skills.

Design and evaluation of a competency-based pharmacology elective module on rational use of medicines for undergraduate medical students

Archana Dhavalshankh, Vijay Devthankar, Sagar Garmode — Tue, 23 Jun 2026 00:00:00 +0530

Background: Competency-Based Medical Education (CBME) emphasizes the development of practical prescribing competencies among undergraduate medical students. Traditional pharmacology teaching often provides limited opportunities for applied learning related to rational drug use. Elective modules introduced under CBME offer opportunities for competency-oriented experiential learning. Objectives were to design and evaluate a competency-based pharmacology elective module focusing on rational use of medicines among undergraduate medical students.

Methods: A prospective educational interventional study was conducted in the Department of Pharmacology at a tertiary care teaching institution. Undergraduate MBBS students who opted for the pharmacology elective participated in a structured two-week module incorporating interactive lectures, problem-based learning, case-based discussions, prescription writing exercises, reflective learning, and continuous formative assessment. Pre-test and post-test assessments were conducted to evaluate learning attainment. Student feedback was collected using a structured Likert-scale questionnaire and analysed using descriptive statistics.

Results: A total of 30 students participated in the elective module and all completed the program successfully. The module was implemented as per the planned schedule and all learning activities were completed. Student feedback demonstrated high satisfaction regarding module relevance (100%), effectiveness of teaching–learning strategies (100%), and usefulness of case-based discussions (100%). Most students reported improved understanding of rational prescribing principles and applied pharmacology concepts.

Conclusions: The competency-based pharmacology elective module was feasible, well accepted, and effectively implemented within the CBME framework. Structured experiential learning modules may serve as an effective strategy for strengthening rational prescribing competencies among undergraduate medical students.

An observational study on the efficacy and safety of Enzotein plus in post-surgical recovery in critically ill patients by improving nutritional indices

Tue, 23 Jun 2026 00:00:00 +0530

Background: Critically ill patients, especially those requiring mechanical ventilation and suffering from sepsis or multiorgan dysfunction, are at increased risk of malnutrition, muscle wasting, and prolonged recovery. Protein supplementation is essential, but enteral feeding via Ryle’s or jejunal tubes may impair proteolytic enzyme activity, limiting protein absorption. Thus, this study aimed to evaluate Enzotein plus, a formulation containing whey protein, proteolytic enzymes, and essential micronutrients for its clinical and biochemical benefits in such patients.

Methods: This observational study involved 100 post-surgical critically ill patients conducted at Department of General Surgery, Goa Medical College, Bambolim, Tiswadi, Goa from March-2022 to October 2022. Patients received Enzotein Plus (one sachet containing 68 g/dose) for 14 days via oral or RT/JT administration. Primary outcomes included serum albumin, haemoglobin, packed cell volume (PCV), body weight, and cumulative organ failure-free days. Secondary outcomes included ICU stay, mortality, infection rate, pressure sores, and diarrhoea severity. Statistical analysis used SPSS v21, employing repeated measures ANOVA, Tukey’s post hoc, and chi-square tests (p<0.05).

Results: Significant improvements were observed in serum albumin (p<0.001), haemoglobin (p=0.022), PCV (p<0.001), and body weight (p<0.05). Wound healing increased from 50% to 97% over 14 days. Pressure sores and diarrhoea incidence decreased. Mortality was 2%, infection rate 24%, and mean ICU stay 4.6±8.1 days. Organ failure-free days averaged 8.9±9.2.

Conclusions: Enzotein Plus demonstrated significant clinical and nutritional benefits with a favourable safety profile. Its use may enhance recovery in critically ill, post-surgical patients. Larger randomized controlled trials are recommended for validation.

Empathy and equanimity toward caregivers: a pre-post study on AETCOM module 2.8 in phase II MBBS students

Nayer Rashid, Jasleen Kaur, Pankaj Gupta, Jyoti Maria, Bharat Vaishnav — Tue, 23 Jun 2026 00:00:00 +0530

Background: Empathy and equanimity are essential competencies in medical education, influencing patient outcomes and caregiver engagement. The attitude, ethics, and communication (AETCOM) module introduced by the National Medical Commission aims to cultivate these attributes among undergraduate medical students; however, empirical evidence of its effectiveness remains limited. Aim was to evaluate the impact of AETCOM Module 2.8 on empathy and equanimity toward caregivers among phase 2 MBBS students using a pre-post study design.

Methods: This pre-test/post-test study included 89 phase 2 MBBS students (88 completed post-test). The intervention comprised interactive sessions including discussions, role-plays, and reflective exercises. A validated Likert-scale questionnaire assessed four domains: understanding caregivers’ challenges, communication and professionalism, equanimity and emotional self-management, and overall empathy. Quantitative data were analysed using paired t-tests, while qualitative reflections underwent thematic analysis.

Results: Overall empathy scores increased significantly from 57.9±8.63 to 62.7±7.21 (p<0.001). Significant improvements were observed in understanding caregivers’ challenges (+1.3), communication and professionalism (+0.9), and equanimity (+1.3) (all p<0.001). Neutral and negative responses decreased by over 35%. Qualitative reflections highlighted increased awareness of caregivers’ holistic burdens and a commitment to empathetic, composed clinical interactions.

Conclusions: AETCOM module 2.8 significantly enhanced empathy and equanimity among MBBS students. Integrating interactive and reflective learning approaches within medical curricula can foster compassionate, professional, and emotionally resilient future physicians.

Study of the renoprotective effect of Citrus limon juice and Emblica officinalis extract on renal toxicity induced by carbon tetrachloride in Wistar rats

Tue, 23 Jun 2026 00:00:00 +0530

Background: The renoprotective effects of Citrus limon juice and Emblica officinalis are not considered till now. Both of them have a strong antioxidant effect.

Methods: Seven groups with six rats in each group. I: Normal control (1 ml distilled water/oral route), Group II: disease control (1 ml distilled water/oral route), group III: Acetylcystine (950 mg/kg), Group IV: Citrus limon (6 ml/kg/oral route), group V: Emblica officinalis (700 mg/kg/oral), Group VI: Citrus limon with Emblica officinalis (6 ml/kg + 700 mg/kg/oral route) Group VII-Citrus limon with Emblica officinalis and acetylcystine (6 ml/kg + 700 mg/kg + 950 mg/kg oral). Only a single dose of CCl₄ was given by intraperitoneal injection of 1.5 ml/kg of 20% carbon tetrachloride dissolved in olive oil for induction of renal injury. One-way ANOVA and paired t-tests were used to analyze data.

Results: The BUN of animals in standard control (Group III) and Citrus limon juice with Emblica officinalis alone and in combination (Groups IV, V, and VI) and in combination with the standard drug and Citrus limon juice with Emblica officinalis test groups was significantly lower than the disease control group (Group II) (p<0.05). Effect on serum creatinine: As seen, serum creatinine was significantly reduced in the positive control (Group III) as compared to the disease control (Group II 4.3) (p<0.001).

Conclusions: The present study demonstrated the renoprotective effect of citrus limon juice and Emblica officinalis in Wistar rats.

Comparative study of efficacy and safety of escitalopram versus opipramol in the treatment of major depressive disorder: one-year, prospective, open label, randomized and add on therapy in a tertiary care hospital

Veenakshi Bhagat, Shamiya Sadiq, Rakesh Banal, Brij Mohan Gupta — Tue, 23 Jun 2026 00:00:00 +0530

Background: A randomized, prospective, open label, comparative study was conducted to evaluate and compare the Efficacy and safety of escitalopram versus opipramol in patients suffering from major depressive disorder (MDD).

Methods: A total of 100 patients from psychiatry OPD diagnosed with major depression were included in the study after fulfilled the inclusion and exclusion criteria. The eligible participants were randomly allocated into one of the following two treatment groups after randomization block permeation method i. e., pharmacologically equivalent dose range of the two drugs as follows: group 1: Tab. escitalopram 10-20 mg OD for 6 weeks. Group 2: Tab. opipramol 50 mg-100 mg BD for 6 weeks. All patients were given the respective tablets for 2 week and were asked to come for follow up after 2^nd, 4^thand 6^th week of treatment. At first visit baseline parameters like weight, BMI, CBC, LFT_s, RFTs, lipid profile, blood glucose, ECG and use of concomitant medicines were recorded and subsequently measured again at the end of 4^th and 6^th week. Evaluation parameters were assessed by using HAM (D and A) scale and Naranjo causality assessment scale.

Results: Escitalopram group exhibited a better improvement in HAM-D score in comparison to Opipramol group. Escitalopram group exhibited a better improvement in CGI-SOI, CGI-GI, CGI-EI score in comparison to Opipramol group. On intergroup comparison, no statistically significant difference (p<0.05) was seen between the groups at 6 weeks of treatment. It was observed that 32 patients in Escitalopram arm and 35 patients in opipramol group required the rescue treatment (tab. Clonazepam).

Conclusions: we conclude from our study that escitalopram group showed better improvement in management of symptoms of depression than opipramol.

Evaluation of anxiolytic effect of pantoprazole on Swiss albino mice

Tue, 23 Jun 2026 00:00:00 +0530

Background: Anxiety disorders are one of the most common psychiatric disorders and they affect over 7% of the global population. It substantially compromises daily life, productivity, and social functioning. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines provide only limited relief and are often burdened by side effects including sedation, sexual dysfunction, and dependence. This has created a crucial need for safer therapeutic alternatives. Among the commonly used proton pump inhibitors- pantoprazole has demonstrated neuroprotective and anti-inflammatory properties in preclinical studies. These outcomes raise the possibility that pantoprazole may also exert anxiolytic effects, which have not yet been explored.

Methods: Thirty female Swiss albino mice were divided into five groups, each consisting of 6 animals. The groups were- control (saline), standard (diazepam 5 mg/kg i.p.), and pantoprazole-treated groups (10, 15, 20 mg/kg orally). Drugs were administered daily for 14 days. Mice were assessed using the Elevated Plus Maze (EPM) and Actophotometer on the 1^st and 15^th day to determine whether pantoprazole produced anxiolytic effects with acute and chronic dosing.

Results: Pantoprazole treatment at 20 mg/kg dose significantly reduced anxiety-like behavior. Mice that were treated with pantoprazole spent more time in the open arms of the EPM compared to the control group. The 20 mg/kg of pantoprazole group produced an effect (p<0.001) which was comparable to diazepam’s anxiolysis. Locomotor activity remained unchanged across pantoprazole groups, indicating that its anxiolytic effect was not confounded by sedation.

Conclusions: This experimental study provides the first evidence that pantoprazole at 20 mg/kg dose, exerts significant anxiolytic effects in Swiss albino mice. There were no changes in locomotor activity by the pantoprazole group, signifying no sedative side effects. These results showcase pantoprazole’s possible utility as a novel or an adjunctive therapeutic agent for anxiety disorders. Although further studies on mechanisms of action and clinical trials are required, these findings open an avenue for repurposing a well-tolerated drug in the management of anxiety.

A prospective study on the utilization pattern of antimicrobial agents among inpatients in the medicine ward of K. R. Hospital, Mysore Medical College and Research Institute

Varsharani, Kishore M. Sreekantaiah, A. M. Satesh, Rakesh Mahesh — Tue, 23 Jun 2026 00:00:00 +0530

Background: Drug utilization studies are crucial to assess prescribing patterns and promote rational use of antimicrobial agents, thereby reducing resistance and treatment costs.

Methods: A prospective observational study was conducted on 100 inpatients receiving antimicrobial therapy. Data were collected from patient records and analyzed using descriptive statistics to determine demographic details, prescription patterns and WHO core prescribing indicators.

Results: Of the 100 patients, 56% were female and 44% were male. Respiratory tract infections were the most common diagnosis (32%), followed by gastrointestinal infections (23%), urinary tract infections (15%) and viral fever (11%). Cephalosporins were the most frequently prescribed antimicrobials with ceftriaxone in 38% of prescriptions, followed by penicillin (28%), fluroquinolones were-(15%), aminoglycosides-(8%) and macrolides-(6%), carbapenems-5%. Generic prescriptions accounted for only 62% of total drugs. Furthermore, 78% of drugs were prescribed from the essential drug list. The average number of drugs per prescription was 4.2.

Conclusions: Antimicrobial utilization showed predominant use of cephalosporins and piperacillin combinations. Although most drugs were prescribed from the essential list, adherence to rational prescribing practices can be improved through antibiotic policies and regular prescription audits to minimize resistance and optimize cost-effectiveness.

Bridging genomic medicine and clinical practice: a cross-sectional analysis of knowledge, attitudes, and implementation of genetically tailored pharmacotherapy among doctors in a tertiary care hospital

Muhammed Razi M., Hema N. G. — Tue, 23 Jun 2026 00:00:00 +0530

Background: Pharmacogenomics is the study of how genetic variation influences drug response, impacting both efficacy and safety. It explains interindividual differences in drug action sometimes accounting for up to 95% of variability and has roots in discoveries like glucose-6-phosphate dehydrogenase deficiency related haemolysis with primaquine. By enabling personalized medicine, pharmacogenomics can optimize therapy, minimize adverse effects, and guide drug development. Despite its promise, challenges remain in genetic testing validity and defining clinical utility, especially for complex genes like CYP2D6.

Methods: This cross-sectional KAP study at Mysore Medical College and Research Institute surveyed doctors using a 25-item validated Google form questionnaire (6 demographic, 6 knowledge, 5 attitude, and 8 practice questions), with digital informed consent and ethical clearance. Data were distributed via WhatsApp groups, cleaned, and analysed using descriptive statistics across all domains.

Results: A total of 110 medical professionals participated in the survey. Awareness of the term pharmacogenomic testing was high (87.3%), but self-rated knowledge was mostly poor to fair (61.8%), and familiarity with major resources such as Clinical Pharmacogenetics Implementation Consortium (CPIC) and PharmGKB was limited (>60% reporting poor awareness). Attitudes were largely positive, with more than half agreeing that pharmacogenomic testing can optimize drug choice and dosing and improve efficacy while reducing adverse drug reactions. However, practical use was low: only 12.7% reported institutional test availability and 81.8% had never recommended testing. Most respondents rarely or never discussed pharmacogenomics with patients (65.4%).

Conclusion: Overall, a significant gap exists between awareness and implementation, indicating a need for improved education, institutional support, and access to testing.

Infographic-supported pharmacology teaching in undergraduate medical education: a qualitative study of student experiences

Shruti Singh, Rajesh Kumar Meena, Prashant Kumar Singh, Sourik Shee — Tue, 23 Jun 2026 00:00:00 +0530

Background: Pharmacology is often perceived by medical students as cognitively demanding because of high information density and complex mechanistic reasoning. Infographics have emerged as visual tools that may support conceptual integration and reduce cognitive burden, yet qualitative evidence regarding how students experience infographic-supported pharmacology teaching remains limited.

Methods: A qualitative descriptive study was conducted among Phase 2 MBBS students during routine pharmacology teaching across five system blocks (autonomic nervous system, autacoids, cardiovascular, central nervous system, and endocrine pharmacology). Infographics were systematically developed, validated through expert consensus, and piloted before implementation. Following the intervention, 125 students provided narrative feedback through an anonymous survey. Data were analyzed using deductive thematic analysis guided by cognitive load, multimedia learning, and dual coding theories.

Results: Eight themes emerged and were organized into four overarching domains: cognitive learning impact, learner engagement, instructional design usability and recommendations. Students reported improved conceptual clarity, enhanced engagement, and efficient revision through infographic-supported learning. Visual structuring helped integrate mechanisms of action with clinical application. However, negative case analysis revealed that overly dense visuals could increase cognitive strain or encourage superficial learning. Students emphasized that infographics were most effective when integrated with interactive instructor guidance rather than used as standalone resources.

Conclusions: Carefully designed infographics may enhance conceptual integration, engagement, and revision efficiency in pharmacology education when aligned with principles of cognitive load management and active teaching. Their effectiveness depends on appropriate visual density and integration within active teaching strategies.

Open-label and single-arm clinical study to evaluate the efficacy and safety of EqualsTwo® skin healing cream in mild-to-moderate eczema

Tue, 23 Jun 2026 00:00:00 +0530

Background: Atopic dermatitis (AD) is a chronic relapsing inflammatory dermatosis with substantial clinical and psychosocial burden. Safety concerns and poor adherence with corticosteroids and calcineurin inhibitors have increased interest in non-steroidal, plant based topical alternatives. This study aimed to evaluate the efficacy, tolerability, and patient-reported acceptability of EqualsTwo^® Skin Healing Cream (Investigation product), a coconut-based emollient with botanical extracts in infants, children, and adults with mild-to-moderate eczema.

Methods: A 14-day open-label, single-arm, single-center study enrolled 58 participants (39 infants/children; 19 adults). Primary endpoints were the three-item severity (TIS) score (pediatric) and eczema area and severity index (EASI) score (adults). Secondary endpoints included Mexameter® MX 18 erythema assessment, skin pH measurement, dermatologist/pediatrician skin evaluations, and structured patient/parent-reported questionnaires. Nonparametric and paired statistical analyses were performed (significance: p<0.05).

Results: At day 14, adult EASI and pediatric TIS scores improved by 30.9% and 79.7%, respectively (both p<0.0001). Secondary outcomes showed a 7.6% erythema index reduction, modest pH normalization, and consistent improvements in dryness, pruritus, and irritation, with universal patient/parent satisfaction and no hypersensitivity reactions. Limitations include the uncontrolled open-label design, short duration, small sample (n=58), single-center recruitment, mild-to-moderate disease scope, and absence of validated quality-of-life or objective barrier function measures.

Conclusions: EqualsTwo^® skin healing cream demonstrated statistically significant improvements in disease severity and symptom burden across pediatric and adult AD populations, with excellent tolerability and no adverse reactions. These findings support its potential as a safe, non-steroidal adjunct emollient therapy.

Assessment of medication adherence and quality of life and their association with myocardial infarction during percutaneous coronary intervention

M. Joshna, J. Akhila, K. Jagadeesh, C. Indhu Prakash Reddy — Tue, 23 Jun 2026 00:00:00 +0530

Background: Myocardial infarction (MI) patients undergoing percutaneous coronary intervention (PCI) require careful management. Medication adherence and quality of life (QOL) are crucial for preventing future cardiovascular events. Optimizing these factors improves patient outcomes and long-term health.

Methods: This prospective observational study was conducted over six months in omini hospital, Kurnool. A total of 70 hypertensive CKD patients were enrolled and divided into two groups: Group A received Cilnidipine 10 mg daily, and group B, received Telmisartan 40 mg daily. Patients were evaluated for changes in renal in systolic and diastolic blood pressure, renal function markers (serum creatinine, urea, uric acid, proteinuria), and incidence of adverse effects.

Results: MI as a leading cause of death in India, predominantly affecting men aged 51-60 due to factors like changing lifestyles, dietary habits, family history, and social behaviors.

Conclusions: MI has emerged as a major cause of mortality in India, particularly affecting men in the 51-60 age range due to shifting dietary patterns, sedentary lifestyles, genetic predispositions, and social habits. Patients treated with PTCA, in accordance with American Heart Association protocols, showed noticeable improvement in their QOL after a four-month follow-up, with male participants reporting more substantial progress compared to females. Medication adherence evolved positively especially among male patients in the target age group. This study emphasizes that stronger medication compliance plays a key role in enhancing post-treatment QOL.

Enhanced glycemic control and organ protection with empagliflozin microemulsion in alloxan-induced diabetic mice

Abu Muqarim Hayat, Jyoti Singh, Mahesh Kumar Posa — Tue, 23 Jun 2026 00:00:00 +0530

Background: Diabetes mellitus (DM) is a serious challenge for worldwide health and is predominant in most populations living with type 2 diabetes (T2DM), thus new drug strategies must be created to enhance drug delivery and use. Empagliflozin is also a sodium-glucose cotransporter-2 (SGLT2) inhibitor that has high solubility and low intestinal permeability, thereby making its bioavailability in traditional formulations is limited. To overcome these drawbacks, we have formulated an empagliflozin microemulsion, which we expect to enhance permeability and therapeutic efficacy.

Methods: The microemulsion was formulated according to a double emulsion technique with olive oil, Tween 80, ethanol, and xanthan gum, and followed by analysis on physical properties, stability, and drug release kinetics. The microemulsion was compared to the empagliflozin tablet for glycemic control and protection of organs in alloxan-induced diabetic Swiss albino mice.

Results: The formulation yielded spherical droplets (0.2-0.3 µm), high encapsulation efficiency (EE) (84.9%), and sustained in vitro release (76% after 12 h). The in vivo findings indicated the microemulsion was more effective, with 63.50% reduction in blood glucose levels vs. 55.70% for the tablet, and a significant recovery of body weight (30.16 g vs. 28.93 g). Histopathological examination of microemulsion group revealed restored pancreatic islets and normal renal structures in contrast to significant destruction in diabetic controls.

Conclusions: These results emphasize the ability of the microemulsion to enhance the pharmacodynamic profile of empagliflozin and can be considered as a new alternative to classical drugs in diabetes treatment. This study highlights significance of the above therapeutic benefits including patient compliance in a novel phase of drug delivery systems.

Impact of patient’s socioeconomic status on drug prescribing decisions among physicians: a qualitative analysis

Tue, 23 Jun 2026 00:00:00 +0530

Background: A qualitative descriptive study was conducted among 50 physicians from public and private healthcare sectors using purposive sampling. Data was collected through semi-structured, open-ended interviews to explore physician’s views on how patient socioeconomic status (SES) influences prescribing patterns. Responses were analyzed thematically to identify key determinants and strategies used by physician’s to address socioeconomic disparities.

Methods: A qualitative descriptive study was conducted among 50 physicians from public and private healthcare sectors using purposive sampling. Data was collected through semi-structured, open-ended interviews to explore physician’s views on how patient SES influences prescribing patterns. Responses were analyzed thematically to identify key determinants and strategies used by physician’s to address socioeconomic disparities.

Results: Physicians widely acknowledged SES as a major determinant of prescribing decisions with affordability influencing drug selection, dosage and treatment duration especially in chronic and elective care. Common adaptive strategies included prescribing cost-effective regimens, providing free samples, and referring patients to government schemes such as Jan Aushadhi and NPCBVI. While most physicians recognized the affordability benefits of generic drugs, scepticism regarding their bioavailability and clinical efficacy persisted. Ethical and emotional strain was evident, particularly when physicians had to balance optimal therapy with patients’ financial constraints. Emergency and critical care prescribing remained largely SES neutral.

Conclusions: Patient’s SES significantly shapes prescribing decisions in non-emergency contexts. Enhancing access to affordable medicines, strengthening trust in generics through regulatory oversight, and integrating pharmacoeconomic and socioeconomic sensitivity training into medical education are essential to promote equitable, patient-centered prescribing practices.

Preliminary evaluation of the anti-Candida, antibiofilm and phytochemical potential of Graphis ceylanica Zahlbr

Biprajeet Dey, Debapiya Das, Vedant Vikrom Borah — Tue, 23 Jun 2026 00:00:00 +0530

Background: Graphis ceylanica Zahlbr., a script lichen, was screened for its antioxidant, TLC profile and antibiofilm potentials.

Methods: The methanol fraction (MF) and hexane fraction (HF) from an acetone extract were screened for DPPH scavenging, phosphomolybdate total antioxidant capacity (TAC), total phenolic content (TPC), and total flavonoid content (TFC), along with antibiofilm assays against Candida albicans and C. tropicalis.

Results: MF displayed higher antioxidant activity than HF, with TAC (A695=1.382±0.02), TPC (=87.81±1.5 mg GAE/g), and TFC (=5.63±0.29 mg QE/g), thus confirming phenolic enrichment of the MFs reported in other Graphis species. TLC profiling revealed multiple UV-active bands consistent with depsides, depsidones, and aromatic metabolites characteristic of Graphidaceae. Both fractions exhibited promising DPPH scavenging activity, with 46.51% for MF and 40.47% for HF. Most importantly, strong antibiofilm effects against both Candida strains were evident, with HF at 3-5 mg/ml and MF at 50-100 mg/ml, inhibiting >75-95% of biofilm formation.

Conclusions: Therefore, the current study highlights G. ceylanica as a chemically diverse and bioactive lichen, presenting the first baseline evidence of its antioxidant and antibiofilm properties.

Comparative glycemic efficacy and safety of sitagliptin versus gliclazide in uncomplicated type 2 diabetes mellitus: a 6-month prospective study

Ravi Shekhar Singh, Shilpa Shankarrao Ingle, Manisha Rajkumar Dehankar — Tue, 23 Jun 2026 00:00:00 +0530

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder requiring effective glycemic control while minimizing adverse effects such as hypoglycemia. Sitagliptin and gliclazide are commonly used oral antidiabetic agents with different mechanisms of action and safety profiles, but comparative data in uncomplicated T2DM are limited.

Methods: This prospective, open-label, observational cohort study was conducted from July 2024 to August 2025 in patients aged 18-70 years with uncomplicated T2DM. A total of 291 patients were included and allocated into two groups based on treating physician’s discretion. Group A received sitagliptin (100 mg once daily) and group B received gliclazide (30 mg once daily). Patients were followed for six months. Glycemic parameters including fasting blood glucose (FBG), postprandial blood glucose (PPBG), and glycated hemoglobin (HbA1c) were assessed at baseline, 3 months and 6 months. Adverse drug reactions were recorded. Intra-group comparisons were performed using paired t-tests and inter-group comparisons were analyzed using unpaired t-tests, with p<0.05 considered statistically significant.

Results: Both groups showed significant reduction in FBG and PPBG over six months (p<0.05). At 6 months, FBG decreased from 162.3±18.5 to 138.2±14.7 mg/dl in the sitagliptin group and from 164.1±19.2 to 124.5±13.9 mg/dl in the gliclazide group (p<0.05). PPBG decreased from 248.6±26.4 to 198.7±20.3 mg/dl in the sitagliptin group and from 251.2±27.1 to 175.8±19.6 mg/dl in the gliclazide group (p<0.05). HbA1c reduction was greater in the gliclazide group (8.3±1.0 to 6.8±0.6) compared to the sitagliptin group (8.2±0.9 to 7.5±0.7) (p<0.01). The incidence of hypoglycemia was significantly lower in the sitagliptin group (2.05%) compared to the gliclazide group (8.28%) (p<0.05).

Conclusions: Gliclazide provides superior glycemic control, whereas sitagliptin offers a better safety profile with a lower risk of hypoglycemia. Treatment should be individualized based on patient characteristics and clinical priorities.

A study on drug utilization pattern of antiplatelet and anticoagulant drugs in the medicine department of a tertiary care teaching hospital

Kalaikumar K., Rakshana M., Dhanapal C. K., Umarani R. — Tue, 23 Jun 2026 00:00:00 +0530

Background: Antiplatelet and anticoagulant therapies are essential in the prevention and management of thromboembolic disorders, particularly cardiovascular and cerebrovascular diseases. Evaluation of prescribing patterns is necessary to ensure rational drug use and minimize adverse events. This study assessed the utilization patterns, prescribing appropriateness, drug interactions, adverse drug reactions and treatment outcomes of antiplatelet and anticoagulant therapy.

Methods: A six-month prospective observational study (November 2024 to April 2025) was conducted in the medicine ward, Coronary care unit, and Medicine intensive care unit of a tertiary care teaching hospital in Tamil Nadu. Data from 100 patients receiving antiplatelet and anticoagulant therapy were collected using a structured proforma and analyzed using JASP software.

Results: Most patients were aged 51-70 years and were predominantly male. Hypertension (61%) and diabetes mellitus (47%) were the most common comorbidities, while coronary artery disease was the leading indication for therapy. Aspirin (93%), clopidogrel (74%) and heparin (47%) were the most frequently prescribed drugs. Dual antiplatelet therapy was commonly utilized and 41% of patients received combination therapy. Seventeen potential drug interactions and five adverse drug reactions were identified. Significant differences in treatment outcomes were observed among drug groups (p<0.05). Ninety percent of prescribed drugs were in accordance with standard treatment guidelines.

Conclusions: Antiplatelet and anticoagulant therapies were widely used for thromboembolic disorders, with prescribing practices largely consistent with treatment guidelines and favorable treatment outcomes. However, polypharmacy, potential drug interactions and adverse drug reactions highlight the need for continuous prescription monitoring and individualized patient care.

Assessment of medication errors and prescribing patterns in orthopaedic inpatients at a tertiary care hospital

Tue, 23 Jun 2026 00:00:00 +0530

Background: The objectives of the study were to assess medication errors and prescribing patterns among orthopaedic inpatients at a tertiary care hospital and evaluate compliance with National Accreditation Board for Hospitals (NABH) medication safety standards across prescribing, transcribing, dispensing, and administration processes.

Methods: A cross-sectional observational study was conducted over six months in the Orthopaedic Department of a tertiary care teaching hospital. A total of 110 case records were reviewed. Medication errors were identified using NABH standards, including prescription, transcription, dispensing, and administration errors. Errors were further classified based on severity using the NCC MERP index. Data were analyzed using appropriate statistical methods.

Results: Among 21,312 medication-use opportunities evaluated, 750 medication errors were identified (overall error rate 3.52%). Prescription errors were most frequent (599;7.78%), followed by transcription (122;6.87%), dispensing (23;0.55%), and administration errors (6; 0.08%). Common prescribing errors included non-use of generic names (51.6%), omission of dosage (13.5%), and inappropriate capitalization (8.0%). Most errors were of minor to moderate severity and unlikely to cause direct patient harm. Antibiotics and non-steroidal anti-inflammatory drugs were the most commonly implicated drug classes.

Conclusion: Medication errors were predominantly related to prescribing practices. Strengthening prescription protocols, encouraging generic prescribing, and implementing regular pharmacist-led audits can enhance medication safety and improve compliance with NABH standards.

A comparative study of the safety of risperidone with olanzapine in patients of new-onset psychosis

Ashish Bansal, Atal Sood, Sukhjit Singh, Sushma Sawaraj — Tue, 23 Jun 2026 00:00:00 +0530

Background: Patients with new-onset psychosis are particularly sensitive to adverse effects of antipsychotic medications, which may influence treatment adherence and long-term outcomes. Risperidone and olanzapine are commonly used second-generation antipsychotics with differing safety profiles. This study aimed to compare the safety of risperidone and olanzapine in patients with new-onset psychosis using standardized assessment tools.

Methods: A prospective, randomized, open-label comparative study was conducted in a tertiary care hospital in the sub-Himalayan region of India. Seventy-four consenting adults with newly diagnosed psychosis were randomized into two groups: risperidone (2-8 mg/day, n=36) and olanzapine (5-30 mg/day, n=38). Participants were followed for six months with assessments at baseline, 1, 3, and 6 months. Safety evaluation included clinical adverse effects, biochemical parameters, and extrapyramidal symptoms using the abnormal involuntary movement scale (AIMS) and extrapyramidal symptom rating scale (ESRS).

Results: Baseline characteristics were comparable between groups. Both treatments were associated with weight gain, with a greater metabolic impact observed in the olanzapine group. Significant increases in blood glucose and lipid parameters were noted with olanzapine at six months compared with risperidone (p<0.05). Liver enzyme elevations were more frequent with olanzapine but remained clinically manageable. Extrapyramidal symptoms were more pronounced in the risperidone group, particularly during early treatment, as reflected by higher AIMS and ESRS scores. Most adverse effects were mild to moderate and improved over time.

Conclusions: Both risperidone and olanzapine are relatively safe in new-onset psychosis but exhibit distinct adverse-effect profiles. Olanzapine is associated with greater metabolic disturbances, whereas risperidone shows a higher propensity for extrapyramidal symptoms. Individualized drug selection with appropriate monitoring is essential to optimize treatment outcomes.

Evaluating the effectiveness of communication skills teaching in phase II MBBS students of a tertiary care teaching hospital in Northern India

Himani Gupta, Nayer Rashid, Seema Gupta, Nancy Khajuria — Tue, 23 Jun 2026 00:00:00 +0530

Background: Communication skills are an essential component of medical practice and are incorporated into undergraduate training through AETCOM modules. This study evaluated the effectiveness of structured communication skills teaching among Phase II MBBS students.

Methods: This educational intervention study was conducted among phase II MBBS students at Government Medical College, Jammu. Students underwent pre-intervention assessment, followed by structured training using AETCOM Module 2 through lectures and role-play. Post-intervention assessment was done using the Kalamazoo essential elements communication checklist (KEECC-A) and Communication Skills attitude scale. Data were summarized using frequencies and percentages.

Results: A total of 168 Phase II MBBS students participated in the communication skills training and attitude assessment. Post-intervention, students demonstrated a more positive attitude towards communication skills, with the majority recognizing communication as an essential component of effective medical practice and an important competency alongside medical knowledge. Kalamazoo essential elements communication checklist assessment was completed by 145 students which revealed strongest performance in information gathering, information sharing, and relationship building. However, comparatively lower performance was observed in understanding patient and family perspectives, reaching agreement, providing closure, and demonstrating empathy, indicating areas requiring further reinforcement.

Conclusions: Structured communication skills training improves attitudes and competencies among medical students. Early integration of such training is essential for effective patient care.

A questionnaire based cross-sectional study on knowledge, attitude and practice of haemovigilance among the postgraduates at a tertiary care hospital

Varsharani, Kishore M. Sreekantaiah, A. M. Satesh, Rakesh Mahesh — Tue, 23 Jun 2026 00:00:00 +0530

Background: Haemovigilance plays a critical role in ensuring the safety and efficacy of blood transfusion practices by systematically monitoring, reporting and analysing adverse transfusion reactions. In India, the Haemovigilance Programme was initiated in December 2012, to enhance transfusion safety through a structured national surveillance system.

Methods: This observational questionnaire-based cross-sectional study was conducted among postgraduates at a tertiary care institute. A total of 100 postgraduates participated in the study. The questionnaire covered aspects of knowledge regarding the haemovigilance attitudes towards adverse event reporting and actual reporting practices. Data collection was carried out electronically using google forms.

Results: Our study was conducted among 100 postgraduate medical students. A significant majority (86%) reported being familiar with the Haemovigilance programme of India. Furthermore, 69% of respondents were aware that any transfusion reaction is eligible for reporting, Encouragingly, 94% of the participants agreed that reporting adverse transfusion reactions contributes positively to patient safety and care. Despite this high level of awareness and a favourable attitude toward haemovigilance, only 30% of the participants had ever reported a transfusion reaction, highlighting a noticeable gap between knowledge and actual practice.

Conclusions: The findings reveal that while postgraduate medical students demonstrate substantial awareness and a positive attitude toward haemovigilance. These results emphasize the need for further training and reinforcement of hemovigilance practices to enhance patient safety and effective blood transfusion monitoring.

Antihyperlipidemic potential of methanolic extract of whole plant Chlorophytum comosum (Thunb.) Jacques in poloxamer 407 induced hyperlipidemia in Wistar Albino rats

T. Sangeetha, T. Abi, M. Jeevajothii, K. Jeevitha, R. Kayalvizhi, F. Nishvanth — Tue, 23 Jun 2026 00:00:00 +0530

Background: Hyperlipidaemia is a major risk factor for cardiovascular diseases, and natural remedies are being explored for safer therapeutic options. Chlorophytum comosum (Thunb.) Jacques has potential medicinal properties, but its antihyperlipidemic activity has not been thoroughly investigated. The objective was to evaluate the acute oral toxicity and antihyperlipidemic potential of the methanolic extract of Chlorophytum comosum (MECC) in Wistar Albino rats.

Methods: Acute oral toxicity was assessed following OECD 2001 guidelines at doses of 300 mg/kg and 2000 mg/kg. Hyperlipidaemia was induced using Poloxamer 407 (1 g/kg, i.p.). Animals were treated with MECC at low and high doses (200 and 400 mg/kg) for 21 days, while atorvastatin (10 mg/kg) was used as the standard. Body weight, lipid profile parameters (total cholesterol, triglycerides, LDL, VLDL, HDL), and liver histopathology were evaluated.

Results: MECC showed no mortality or significant adverse effects, indicating its safety. Treatment with MECC resulted in dose-dependent improvements in body weight and lipid profile parameters, comparable to those observed with atorvastatin. Histopathological analysis revealed that high-dose MECC maintained near-normal hepatic architecture, indicating hepatoprotective effects.

Conclusion: MECC is non-toxic and exhibits significant antihyperlipidemic activity, suggesting its potential as a therapeutic agent for managing hyperlipidaemia.

Pharmacist-led care for minor illnesses in India: an urgent need for a regulatory framework

Krishnanshu Chowdhury, Sembagamuthu Sembiah, Soumitra Mandal — Tue, 23 Jun 2026 00:00:00 +0530

Minor illnesses such as common colds, uncomplicated skin conditions, and mild gastrointestinal disturbances represent a significant share of primary care visits in India, despite being self-limiting and suitable for protocol-based management at the community level. The growing burden of these conditions places avoidable pressure on overstrained primary health facilities. In this context, community pharmacists, the most accessible healthcare professionals in India, could be empowered to deliver safe, protocol-driven management of minor illnesses. While informal pharmacist consultations are widespread, the absence of a formal framework, regulatory clarity, and standardized training continues to impede safe and accountable practice. While existing literature in India has largely focused on pharmacists’ roles in dispensing and chronic disease management, structured pharmacist-led models for minor illness care remain largely unexplored.

Targeting dietary microplastic exposure: an emerging frontier in clinical pharmacology

Kaustubh Bhardwaj, Siddhant Mehrotra — Tue, 23 Jun 2026 00:00:00 +0530

Microplastics have quietly entered the human body, yet clinical medicine continues to treat them as a distant environmental issue rather than an immediate biological concern. Emerging evidence suggests that brine water used in kimchi preparation can act as potential source of microplastics contamination particularly when derived from sea salt or contaminated water sources. When ingested microplastics can persist within the gastrointestinal tract and actively interact with the gut ecosystem, challenging the long-held assumption that they are biologically inert.