International Journal of Current Pharmaceutical Research
International Journal of Current Pharmaceutical Research (Int J Curr Pharm Res) is a peer-reviewed, bimonthly (onward march 2017) open access journal. This Journal publishes original research work that contributes significantly to further the scientific knowledge in pharmacy and pharmaceutical sciences (Pharmaceutical Technology, Pharmacognosy, Natural Product Research, Pharmaceutics, Novel Drug Delivery, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest). The Journal publishes original research work either as a Full Research Paper or as a Short Communication. Review Articles on a current topic in the said fields are also considered for publication by the Journal.
ADVANCEMENTS AND CHALLENGES IN PSORIASIS MANAGEMENT: EXPLORING INNOVATIVE THERAPIES, DRUG DELIVERY SYSTEMS, AND HOLISTIC APPROACHES
The fast proliferation of skin cells that results in the production of red, scaly plaques-most frequently on the scalp, elbows, knees, and lower back-is the hallmark of psoriasis, a chronic, non-contagious skin illness. Psoriasis is generally acknowledged to be a complex illness involving immune system dysregulation and genetic predisposition; even if it’s precise origin is still unknown. Its development and exacerbation are also significantly influenced by environmental triggers, trauma, stress, and climatic circumstances. Itching, discomfort, dry skin, joint inflammation (psoriatic arthritis), and irregular nail growth are some of the clinical manifestations of psoriasis. Patients' physical, mental, social, and financial quality of life is greatly impacted by the illness, which frequently results in stigmatization, depression, and diminished capacity for day-to-day functioning. Although there are many therapeutic options available, there is no permanent cure, hence the main goals of illness management are symptom control and quality of life enhancement. Given the mounting evidence that psoriasis is a systemic inflammatory disease, understanding its comorbidities-such as diabetes and cardiovascular disease-is essential to provide patients with complete care. Biological therapies, phototherapy, non-biological systemic medications, and topical medicines are all used in modern treatment plans. Systemic and biologic medicines are essential for treating severe psoriasis, but topical therapies are the main choice for mild to moderate instances. These traditional treatments, however, are constrained by side effects, exorbitant expenses, and inconsistent patient reactions. Promising substitutes to improve therapeutic results are provided by the development of nano-carrier drug delivery systems, such as liposomes, phytosomes, niosomes, ethosomes, and transferosomes. These vesicular systems provide targeted, sustained drug release, improved bioavailability, and reduced systemic toxicity. Continued exploration and clinical validation of these innovative delivery platforms are crucial to overcoming the shortcomings of existing therapies and improving patient quality of life in psoriasis care.
Copyright (c) 2026 Tanvinder Kaur Kaur https://creativecommons.org/licenses/by/4.0
RAFT-FORMING DRUG DELIVERY SYSTEM: A FLOATATION-BASED STRATEGY FOR GASTRORETENTION
Gastroretentive drug delivery systems (GRDDS) have emerged as a promising strategy to enhance the therapeutic efficacy and bioavailability of orally administered drugs with a narrow absorption window or that are poorly soluble in higher pH environments. Among various approaches, the raft-forming system has garnered significant attention for its simplicity, efficacy, and patient compliance. These systems form a low-density, gel-like "raft" upon contact with gastric fluids, allowing the formulation to float and remain in the stomach for an extended duration. This enhances localized drug action and prevents gastric reflux by acting as a barrier between the stomach and esophagus, particularly benefiting conditions such as GERD, heartburn, and esophagitis. The design involves gel-forming agents like alginic acid and gas-generating components such as sodium bicarbonate, which facilitate in situ gelation and buoyancy. Despite formulation challenges related to pH sensitivity, polymer stability, and gastric motility variations, raft-forming systems offer several advantages, including rapid onset, prolonged activity, ease of administration, and reduced dosing frequency. This review highlights the anatomy and physiology relevant to gastric retention, mechanisms of raft formation, formulation strategies, and potential candidates, emphasizing the system’s growing role in advanced oral drug delivery.
Copyright (c) 2026 Sama Sulaika.M; Gomathi. J https://creativecommons.org/licenses/by/4.0
POLYMERIC SILVER NANOCARRIERS: INNOVATIVE DRUG DELIVERY STRATEGIES FOR ALZHEIMER’S DISEASE AND NEURODEGENERATIVE DISORDERS
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disorder marked by amyloid-β plaque accumulation, tau hyperphosphorylation, oxidative stress, neuroinflammation, and progressive cognitive impairment. The clinical effectiveness of conventional therapies is limited due to poor brain bioavailability, rapid systemic clearance, and the restrictive nature of the blood–brain barrier (BBB), resulting mainly in symptomatic relief rather than disease modification. In this context, polymeric silver nanocarriers (PSNs) have emerged as a promising nanotherapeutic approach for targeted and controlled drug delivery to the central nervous system. By integrating the antioxidant and anti-inflammatory properties of silver nanoparticles with the biocompatibility, stability, and controlled release characteristics of polymeric matrices such as PLGA, PEG, and chitosan, PSNs enable enhanced drug encapsulation, sustained release, and efficient BBB penetration through surface functionalization and receptor-mediated transport mechanisms. Preclinical in vitro and in vivo studies demonstrate that PSNs can effectively reduce amyloid-β aggregation, inhibit tau pathology, attenuate oxidative stress, and suppress neuroinflammatory responses, leading to improved neuronal survival and cognitive outcomes. Alternative delivery strategies, including intranasal and nose-to-brain routes, further improve therapeutic efficiency while minimizing systemic toxicity. Although challenges related to long-term safety, neurotoxicity, scalability, and regulatory approval remain, polymeric silver nanocarriers represent a versatile and multifunctional platform with significant potential for advancing disease-modifying therapies in Alzheimer’s disease.
Copyright (c) 2026 Himanshu Kinkar, DIVYANSH DHARPURE, Dr. Dhanashri Tumme https://creativecommons.org/licenses/by/4.0
INSULIN BIOSYNTHESIS USING PLANT SYSTEMS
Traditional plant-based medicines have been used for centuries to treat and prevent various diseases. These remedies, derived from natural plant extracts, are often more affordable and accessible, especially in developing countries. In addition to being cost-effective, plant-based traditional medicines offer a wide range of biological activities, including antiallergic, anticancer, antibacterial, anti-inflammatory, antidiabetic, and antioxidant properties. These benefits make them valuable tools in managing chronic and infectious diseases. One of the most common chronic conditions worldwide is diabetes mellitus, a metabolic disorder characterized by persistent hyperglycemia and dysfunction in pancreatic β-cells. It results in abnormal carbohydrate, fat, and protein metabolism. While modern antidiabetic drugs are effective in controlling blood glucose levels, they are often associated with side effects such as weight gain, hypoglycemia, gastrointestinal discomfort, and long-term complications. As a result, there is increasing interest in natural alternatives that are safer, well-tolerated, and equally effective. Traditional plant-based medicines have shown great promise in both clinical practice and research, with several herbs demonstrating hypoglycemic effects and the ability to improve insulin sensitivity. According to the World Health Organization (WHO), nearly 80% of the population in developing nations relies on traditional medicine for their primary healthcare needs. This underscores the importance and potential of plant-derived therapies not only in the treatment but also in the prevention of diabetes and its complications. Promoting the integration of traditional remedies with modern medicine may contribute to a healthier, more sustainable approach to disease management.
Copyright (c) 2026 mrunal kolhe https://creativecommons.org/licenses/by/4.0
DICHLORODIPHENYLTRICHLOROETHANE (DDT) POISONING: A CASE REPORT
Objective: Dichlorodiphenyltrichloroethane (DDT) is a highly lipophilic organochlorine pesticide known for its environmental persistence and neurotoxicity. Although banned or restricted in many countries, sporadic cases of poisoning continue to occur due to illegal use and accidental exposure. Acute toxicity primarily affects the nervous system. Methods: We report a case of acute DDT poisoning in a 34 y old male who presented with gastrointestinal and neurological symptoms following accidental ingestion. The patient initially had stable vital parameters but subsequently developed respiratory failure and hypotension requiring mechanical ventilation and vasopressor support. Management was entirely supportive, as no specific antidote exists for DDT toxicity. Results: The patient showed progressive clinical improvement and was successfully extubated on the third day, with complete recovery. Conclusion: DDT poisoning, though uncommon, should be considered in patients presenting with unexplained neurological manifestations and a relevant exposure history. Early recognition and aggressive supportive management are crucial for favorable outcomes.
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
EVALUATION OF ANTI-DEPRESSANT ACTIVITY OF ETHANOLIC EXTRACT OF PIPER METHYSTICUM LEAVES IN MICE
Objective: The aim of this study to evaluate the anti-depressant activity of ethanolic extract of Piper methysticum leaves in mice. Methods: The animals were grouped into four groups, each comprising 6 mice. One of the group as control, receiving normal saline water and second group as standard, receiving fluoxetine, while the remaining two groups were administered the test drug (300 mg/kg and 600 mg/kg). All drug administrations were conducted orally 1 h prior to the acute study test procedure and daily for a 14 d period for the chronic study. Results: The administration of Piper methysticum doses resulted in a notable reduction in immobility duration during the Tail Suspension Test. In the Actophotometer assessment, mice exhibited a statistically significant increase in motor activity compared to the control group. The findings indicated that the ethanolic extract of Piper methysticum leaves at a dose of 600 mg/kg led to a significant increase in reduced glutathione and catalase activity. Simultaneously, there was a decrease in plasma corticosterone, lipid peroxidation, plasma nitrite, and protein concentration levels. Conclusion: The antidepressant efficacy of Piper methysticum at a dosage of 600 mg/kg in mice is comparable to that of fluoxetine.
Copyright (c) 2026 Deepali Thakur https://creativecommons.org/licenses/by/4.0
EVALUATION OF DIURETIC ACTIVITY OF ALCOHOLIC EXTRACT OF FLOWER BUDS OF NEOLAMARCKIA CADAMBA IN ALBINO RATS
Objective: To study the diuretic activity of Alcoholic Extract of Flower buds of Neolamarckia cadamba by Lipschitz method in albino Wistar rats. Methods: Metabolic cages were utilised to test the diuretic effect of Alcoholic Extract of Flower Buds of Neolamarckia cadamba in four Albino Wistar rats. Group I, the normal control, got vehicle (10 ml/kg or 1 ml of 0.9% NaCl/100 gm), group II received Frusemide (10 mg/Kg, p. o), and groups III and IV received low (200 mg/kg) and high (400 mg/kg) dosages of Alcoholic Extract of Neolamarckia cadamba flower buds Following Neolamarckia cadamba Alcoholic Extract treatment, rats were hydrated with saline (15 ml/kg, p. o) and put in metabolic cages at 25 °C±0.5 °C. Animals went 5 h without food or water. Each metabolic cage's urine volume was assessed after 5 and 24 h. Total urine volume, ion concentration (Sodium, Potassium, Chloride), and pH were measured. Results: In this model when compared to control group the Alcoholic Extract of Flower buds of Neolamarckia cadamba treated groups at different dose levels (200 and 400 mg/kg) have noted with significant increase in the urine volume and also significantly enhanced the excretion of Sodium, Potassium and Chloride ions in urine. In the urine pH no difference has been found. Conclusion: Results showed that single dose administration of standard Furosemide and Alcoholic Extract of Flower buds of Neolamarckia cadamba significantly increased the urine output along with an increase in elimination of Sodium, Potassium, and Chloride ions. Alcoholic Extract of Flower buds of Neolamarckia cadamba, 400 mg/Kg produced a comparable diuretic activity with standard Frusemide.
Copyright (c) 2026 Akash https://creativecommons.org/licenses/by/4.0
EVALUATION OF DIURETIC ACTIVITY OF ETHANOLIC EXTRACT OF LEAVES OF PIPER BETEL IN ALBINO RATS
Objective: To assess the diuretic capability of the alcoholic extract of Piper betel leaves, the current research was planned to make use of the Lipschitz technique on albino rats. Methods: Four groups of albino rats were used for the experiment, and diuretic activity was assessed in metabolic cages. Group I served as the control and received normal saline (10 ml/kg, p. o. or 1 ml of 0.9% NaCl/100 g). Group II received the standard diuretic drug frusemide (10 mg/kg, p. o). Groups III and IV were treated with the alcoholic extract of Piper betel leaves at doses of 200 mg/kg and 400 mg/kg, respectively. Following drug or extract administration, all animals were hydrated with normal saline (15 ml/kg, p. o.) and placed individually in metabolic cages maintained at 25 °C±0.5 °C. Food and water were withheld during the 5 h study period. At the end of 5 h, urine was collected and analyzed for total volume, pH, and electrolyte content (sodium, potassium, and chloride ions). Results: Compared to the control group, both doses of the Piper betel leaf extract significantly increased urine output and promoted greater excretion of sodium, potassium, and chloride ions. No remarkable differences in urinary pH were observed between the groups. Conclusion: A single administration of frusemide as well as the alcoholic extract of Piper betel leaves enhanced urine production and electrolyte excretion. At the higher dose (400 mg/kg), the extract demonstrated a diuretic effect comparable to that of the standard drug frusemide.
Copyright (c) 2026 Nishant Yadav https://creativecommons.org/licenses/by/4.0
AN OBSERVATIONAL STUDY ON EMPIRICAL THERAPY IN ICU PATIENTS WITH SEPSIS IN A TERTIARY CARE HOSPITAL
Objective: Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to an infection. This study investigated antibiotic prescribing patterns, antimicrobial resistance, and their impact on prognosis and quality of life in critically ill patients with sepsis. Methods: A prospective observational study was conducted at Srinivas Institute of Medical Science and Research Centre. For over six months, 174 ICU patients diagnosed with sepsis were assessed. Patient demographics, infection source, Sequential Organ Failure Assessment (SOFA) scores, antibiotic regimens, and clinical outcomes were collected. Results: The study population was predominantly male (69.54%) with a mean age of 54 y. Piperacillin/Tazobactam (46.55%) and Meropenem (36.78%), both classified as WHO Watch antibiotics of AWaRe Classifications, were the most commonly prescribed antibiotics. This suggests a potential deviation from WHO guidelines and raises concerns about antibiotic resistance. Pseudomonas (15%) was the leading pathogen, exhibiting high resistance levels. While SOFA scores did not significantly differ between survivors and non-survivors, they correlated with length of stay, indicating disease severity. The SF-20 questionnaire revealed poor health perception and reduced social functioning across all age groups in surviving patients, impacting quality of life. Conclusion: This study highlights a trend of over-prescription of broad-spectrum antibiotics, potentially deviating from WHO recommendations. The dominance of highly resistant g-negative bacteria underscores the need for targeted antibiotic selection based on local resistance patterns. SOFA scores reflected disease severity but did not predict mortality. The study emphasizes the lasting impact of sepsis on patients' physical, social, and mental well-being, suggesting the importance of comprehensive post-discharge rehabilitation programs.
Copyright (c) 2026 Minchu Arunkumar Sunkadakatte , A R Shabaraya, Jessica Maryiola Fernandes, Chandana K Adiyodi, Muhammed Shamil N P, Sudhamshu K Tantry https://creativecommons.org/licenses/by/4.0
EVALUATING THE COST-EFFECTIVENESS OF AMLODIPINE WITH ATENOLOL VERSUS AMLODIPINE WITH TELMISARTAN IN A RURAL COMMUNITY HEALTH CENTER, ANDHRAPRADESH
Objective: The objective of this study was to compare the cost-effectiveness of two antihypertensive combinations, Amlodipine with Atenolol and Amlodipine with Telmisartan, among hypertensive patients attending a rural community health centre in Andhra Pradesh. The study aimed to evaluate the economic efficiency of these regimens in relation to their clinical outcomes. Specific objectives included assessing the clinical effectiveness of both combinations in controlling systolic and diastolic blood pressure and determining their respective cost-effectiveness ratios for the target population. The findings were intended to identify a clinically effective and economically sustainable antihypertensive therapy suitable for resource-limited rural healthcare settings. Methods: A prospective observational study was conducted over two months among 106 hypertensive patients, divided equally into two treatment groups (n1 = 53; n2 = 53). Blood pressure measurements were recorded at baseline and during two follow-up visits at one-month intervals. Drug costs were obtained from the hospital pharmacy index. Clinical effectiveness was assessed through reductions in systolic and diastolic blood pressure, and pharmacoeconomic evaluation was performed using cost-effectiveness ratios and incremental cost-effectiveness ratio (ICER). Results: Both combinations produced significant reductions in systolic blood pressure readings (p<0.05) mean diastolic blood pressure reduction was almost similar in both groups, while mean systolicblood pressure reduction was significant. Pricing analysis showed substantially lower costs for the Amlodipine+Atenolol regimen. Cost-effectiveness analysis revealed more favourable outcomes for Amlodipine+Atenolol (C/E = 1.24) compared with Amlodipine+Telmisartan (C/E = 1.86). The ICER value (8.26) indicated that the Telmisartan combination provided minimal additional benefit at a significantly higher cost. Conclusion: Although both regimens effectively lowered blood pressure, Amlodipine+Atenolol demonstrated markedly superior cost-effectiveness. This combination represents a more affordable and sustainable option for hypertension management in rural primary care settings, supporting its preferential use in resource-limited populations.
Copyright (c) 2026 Sathyamurthy Seelisetty, Bharathi Uppu, Amruth Kiran Kumar M https://creativecommons.org/licenses/by/4.0
COMPARISON OF 0.75% HYPERBARIC ROPIVACAINE WITH FENTANYL AND 0.75% HYPERBARIC ROPIVACAINE WITH DEXMEDETOMIDINE FOR SPINAL ANAESTHESIA IN ELECTIVE LOWER LIMB SURGERIES
Objective: Spinal anaesthesia is a preferred technique for lower limb surgeries due to its reliability and safety. Adjuvants like fentanyl and dexmedetomidine are commonly added to local anaesthetics to enhance block characteristics. To compare the sensory and motor block characteristics, haemodynamic profile, sedation, duration of analgesia, and complications of intrathecal 0.75% hyperbaric ropivacaine with fentanyl versus dexmedetomidine in elective lower limb surgeries. Methods: After institutional ethics committee approval, 60 ASA I–II patients aged 18–60 y scheduled for elective lower limb surgeries were randomised into two groups (n=30 each). Group I received 2 ml of 0.75% hyperbaric ropivacaine+25 µg fentanyl, and Group ii received 2 ml of 0.75% hyperbaric ropivacaine+10 µg dexmedetomidine intrathecally. Onset and duration of sensory and motor block, haemodynamics, sedation (Ramsay score), postoperative pain (VAS), and side effects were recorded. Data were analysed using Student’s t-test and chi-square test; p<0.05 was considered significant. Results: Onset of sensory (Group I: 2.76±0.08 min vs Group ii: 2.72±0.08 min; p=0.134) and motor block (Group i: 1.58±0.40 min vs Group ii: 1.38±0.37 min; p=0.053) was comparable. Duration of sensory block (Group I: 275.10±16.46 min vs Group ii: 310.13±14.94 min; p<0.001), motor block (Group I: 113.77±13.01 min vs Group ii: 124.30±6.91 min; p<0.001), and analgesia (Group I: 226.40±18.09 min vs Group ii: 280.60±13.90 min; p<0.001) was significantly longer in Group ii. Haemodynamic parameters and sedation scores remained stable and comparable. Incidence of side effects was similar. Conclusion: Intrathecal dexmedetomidine as an adjuvant to 0.75% hyperbaric ropivacaine provides significantly longer sensory and motor blockade and postoperative analgesia compared to fentanyl, with similar haemodynamic stability and side-effect profile.
Copyright (c) 2026 Soumith Kethavath, Tanveer, Simrit Kaur, Tejinderpal Kaur Grewal, Shamnad, Tripat kaur bindra https://creativecommons.org/licenses/by/4.0
KNOWLEDGE, ATTITUDE, AND PERCEPTION OF MEDICAL INTERNS TOWARDS ANTIMICROBIAL STEWARDSHIP IN A TERTIARY CARE HOSPITAL
Objective: To assess the knowledge, attitude, and perception of medical interns regarding antimicrobial stewardship programme in Government Medical College, Anathapuramu. Methods: A Cross-sectional, questionnaire-based study (KAP) was conducted in Medical Interns of 150 members in Government Medical College, Ananthapuramu. Only 128 medical interns participated in the study. The study was carried out between September 2025 and October 2025 among medical interns. Data entered and analysed using Statistical Package for Social Sciences (SPSS) software version 21.0 for Windows. Results: The total 128 interns are participated in a study in which males are about 42.2% and females are 57.8% Overall, interns showed good awareness and positive attitudes toward antimicrobial stewardship but suboptimal practices. This discrepancy underscores the need for structured training and real-world mentorship to translate knowledge into consistent stewardship behaviour. Conclusion: The current study demonstrates the dire need of medical interns for further education about antimicrobial stewardship. Hence, it is strongly recommended to provide a comprehensive, regular, standard and up-to-date educational training in all medical institutions, recommended to advocate curriculums and policies that build up antimicrobial stewardship programs. There is a critical need for structured education, training, and supervised clinical exposure to strengthen antimicrobial stewardship practices among medical interns.
Copyright (c) 2026 MANSOOR BASHA P. https://creativecommons.org/licenses/by/4.0
TRANEXAMIC ACID ON PERIOPERATIVE BLOOD LOSS IN SPINE SURGERY: A PROSPECTIVE OBSERVATIONAL STUDY
Objective: To evaluate the efficacy and safety of tranexamic acid in reducing perioperative blood loss and transfusion requirements in patients undergoing spinal surgery. Methods: This prospective observational study was conducted at MVJ Medical College and Research Hospital from January 2022 to February 2023. Patients undergoing spinal surgery who received perioperative TXA were assessed for intraoperative blood loss, postoperative drain output, transfusion requirements, and adverse events, including thromboembolic complications. Results: The use of TXA was associated with a significant reduction in intraoperative blood loss, postoperative drain output, and transfusion requirements. No increase in thromboembolic or other major adverse events was observed. Conclusion: Perioperative administration of tranexamic acid is a safe and effective blood conservation strategy in spinal surgery, significantly reducing blood loss and transfusion needs without increasing thromboembolic risk.
ACCURACY AND TEACHABILITY OF ARTIFICIAL INTELLIGENCE CHATBOTS IN SOLVING PHARMACEUTICAL CALCULATIONS: A DESCRIPTIVE STUDY
Objectives: This study evaluated the accuracy and teachability of widely available AI chatbots in performing pharmaceutical calculations, including adult and paediatric dosing, IV infusion rates, and dilution/concentration problems. Methods: A descriptive study was conducted in the Department of Pharmacology, Sri Venkateswara Medical College, Tirupati. Five free-access AI chatbots (A–E) were given 35 questions each. Responses were compared with gold standard answers. Incorrect answers were corrected through feedback, and performance was reassessed. Data were analysed descriptively using Microsoft Excel. Results: Accuracy varied across chatbots, with Chatbot A performing best (89%) and Chatbot D close behind (86%). All chatbots performed well in simpler tasks such as percentage and ratio calculations (86%), whereas paediatric dosing, IV infusion, and dilution/concentration problems were more error-prone. Following feedback, teachability was high: Chatbots A, B, and D corrected all errors (100%), while C and E improved to 91% and 82%, respectively. Conclusion: AI chatbots show potential as educational and clinical support tools for pharmaceutical calculations. They handle simpler tasks reliably and can improve performance after feedback. Nevertheless, supervision remains crucial for complex calculations to ensure patient safety. When integrated carefully, AI chatbots can complement traditional learning and clinical practice.
Copyright (c) 2026 Dr.K.G.SATHEESH KUMAR, Dr.U.BHARATHI https://creativecommons.org/licenses/by/4.0
ANTIMICROBIAL PRESCRIPTION PRACTICES AMONG THE INPATIENTS OF E. N. T DEPARTMENT USING WHO AWARE CLASSIFICATION: A CROSS-SECTIONAL STUDY
Objective: To collect antimicrobial prescriptions of patients admitted to the E. N. T ward. To analyze the collected antimicrobial prescriptions of E. N. T inpatients based on the WHO AWaRe classification. Methods: An observational cross-sectional study was conducted in the Department of E. N. T at a tertiary care hospital in Tirupati, Andhra Pradesh, from January to June 2025, after obtaining approval from the Institutional Ethics Committee. All inpatient prescriptions containing at least one antibiotic, irrespective of age, gender, or indication, were included. Written informed consent was obtained from adult participants, and assent from parents for minors. The original prescriptions were returned after documentation, and photocopies or photographs were analyzed. Antibiotics were classified according to the WHO AWaRe classification (2023), and WHO core prescribing indicators were applied to assess rational drug use. Results: Out of 310 prescriptions analyzed, Amoxyclav (82.58%) from the Access group was most frequently prescribed, followed by Watch group antibiotics-Ceftriaxone (13.55%) and Cefixime (3.87%). No Reserve antibiotics were used. The average number of drugs per encounter was 5.13, and 100% of prescriptions contained antibiotics. Injections were used in 86.4%, 97% of drugs were from the Essential Medicine List, and 100% were prescribed by generic name. Conclusion: The predominance of Access group antibiotics indicates partial adherence to WHO guidelines; however, polypharmacy and high antibiotic use highlight the need to strengthen antimicrobial stewardship in the E. N. T department.
Copyright (c) 2026 Dr.K.G.SATHEESH KUMAR, Dr.U.BHARATHI, Dr. L.MEENAKSHI, Dr.M.ASHA LATHA https://creativecommons.org/licenses/by/4.0
COMPARATIVE EFFICACY OF SACUBITRIL/VALSARTAN VERSUS RENIN–ANGIOTENSIN SYSTEM INHIBITORS IN ADULT HEART FAILURE: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Objective: To evaluate the comparative effect of sacubitril/valsartan versus angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on all-cause mortality in adults with heart failure using evidence from randomized controlled trials. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted in accordance with PRISMA 2020 guidelines. Electronic databases including PubMed, Scopus, Google Scholar, and the Cochrane Library were searched to identify eligible studies. Trials enrolling adults with heart failure and directly comparing sacubitril/valsartan with an ACE inhibitor or ARB were included. The primary outcome was all-cause mortality. Risk ratios with 95% confidence intervals were pooled using an inverse-variance fixed-effect model. Results: Three randomized controlled trials comprising more than 18,000 participants met the inclusion criteria. Sacubitril/valsartan was associated with a statistically significant reduction in all-cause mortality compared with ACE inhibitors or ARBs (pooled RR = 0.89; 95% CI: 0.83–0.95). Statistical heterogeneity was low (I² = 12.7%). The observed mortality benefit was largely driven by trials enrolling patients with reduced ejection fraction. Conclusion: This meta-analysis demonstrates that sacubitril/valsartan confers a modest but significant reduction in all-cause mortality compared with conventional renin–angiotensin system inhibitors in adults with heart failure. These findings support the preferential use of angiotensin receptor–neprilysin inhibition in appropriate patients, particularly those with reduced ejection fraction, while highlighting the need for further randomized evidence in other heart-failure phenotypes.
Copyright (c) 2026 Dr. Pranab Das, Dr. Bodhisatya Das https://creativecommons.org/licenses/by/4.0
TREATMENT OPTIMIZATION IN RECURRENT DERMATOPHYTOSIS: A PROSPECTIVE, RANDOMIZED, COMPARATIVE STUDY OF EXTENDED-DURATION VERSUS HIGH-DOSE TERBINAFINE AND ITRACONAZOLE
Objective: To compare efficacy and safety of terbinafine versus itraconazole administered in double dose and prolonged duration in patients with recurrent tinea corporis and cruris. Methods: This prospective, randomized study included 166 patients in four groups: A (terbinafine 250 mg once daily (OD), 4 w), B (terbinafine 500 mg OD, 2 w), C (itraconazole 100 mg twice daily (BD), 4 w), and D (itraconazole 200 mg BD, 2 w). Primary outcomes were clinical/mycological cure, global assessment, safety; secondary outcomes included quality of life, escape treatment, adherence. Significance was set at p<0.05. Results: Group C had highest efficacy (92.7% clinical cure and 100% mycological cure) with lowest recurrence. Liver Function Tests (LFTs) showed no significant abnormalities across all groups. No therapy discontinuations/serious Adverse Drug Reactions (ADRs) were reported. Dermatology Life Quality Index (DLQI) improved significantly from baseline to treatment end and 6 w post-treatment, indicating substantial and sustained improvement. Treatment compliance was high across all groups (≥90%), with no significant difference. Conclusion: Itraconazole 100 mg BD for 4 w was most effective, well-tolerated regimen, highlighting benefit of extended duration over increased dose in recurrent dermatophytosis.
Copyright (c) 2026 Rashi Singh, Dr. Savita Verma, Dr. Surabhi Dayal, Dr. Sapna Vashisth https://creativecommons.org/licenses/by/4.0
TO EVALUATE THE EFFECT OF INTRALESIONAL VIT D-3 INJECTION IN CUTANEOUS WARTS
Objective: To study the demographic characteristics, clinical types, and treatment response patterns of patients with cutaneous warts attending a dermatology outpatient department. Methods: This was a descriptive observational study including patients diagnosed with cutaneous warts. Demographic details, clinical characteristics, including type, number, and duration of warts, and management outcomes were recorded. Treatment response was assessed based on clinical resolution following treatment sittings. Results: The study population comprised 51% females and 49% males, with a mean age of 28.83±9.53 years. The most affected age group was 21–30 years (42%). Palmar warts were the most common clinical type (42%), followed by verruca plana (29%) and plantar warts (27%). The mean number of warts was 5.43±2.36, and the mean duration of disease was 6.45±3.25 mo. Most patients required four treatment sittings (67%). Complete response was observed in 48% of patients, while 21% showed partial response and 31% had no response to treatment. Conclusion: Cutaneous warts predominantly affected young adults and presented with varied clinical morphology and lesion burden. Multiple treatment sittings were often required, with variable therapeutic responses. These findings highlight the chronic nature of cutaneous warts and the need for individualized management strategies.
Copyright (c) 2026 Vineet Singh, Mohammad Mudassir, Sushil Yadav https://creativecommons.org/licenses/by/4.0
FORMULATION AND EVALUATION OF A NANOEMULGEL CONTAINING INDOMETHACIN AND BROMELAIN FOR LOCALIZED ANTI-INFLAMMATORY ACTIVITY
Objective: This study aimed to develop and evaluate a topical nanoemulgel containing indomethacin and bromelain for effective localized anti-inflammatory therapy. Methods: Nanoemulsions were formulated using eucalyptus and nirgundi oils as the oil phase, Tween 20, and propylene glycol as the surfactant and co-surfactant. Pseudo-ternary phase diagrams identified the largest nanoemulsion region at Smix 1:1. The nanoemulsions were incorporated into Carbopol 934 to obtain nanoemulgel. Preformulation studies and FTIR and DSC analyses confirmed drug-excipient compatibility, while molecular docking showed strong binding of indomethacin and bromelain to inflammatory targets, including COX-2 and TNF-α. The physicochemical parameters of nanoemulgel, including globule size, PDI, zeta potential, pH, viscosity, spreadability, and extrudability, were evaluated. In vitro anti-inflammatory activity was assessed using protein denaturation and HRBC membrane stabilization assays, while permeation was studied using Franz diffusion cells. Results: The formulations (F1-F5) demonstrated nanoscale droplets ranging from 119.6 to 189.4 nm, with zeta potential between −12.0 and −19.2 mV. The pH values were between 6.50 and 6.73, and the viscosity was approximately 21.355–21.392 mPa·s. The spreadability was measured between 33.01 and 39.32 g·cm/s, and extrudability ranged from 61.00% to 74.81%. The in vitro anti-inflammatory activity of formulations F3 and F4 was significant and comparable to that of a marketed indomethacin gel. Franz diffusion studies indicated an increase in cumulative permeation over time, with high flux and permeation coefficients. Conclusion: The developed nanoemulgels, particularly F3, exhibited satisfactory rheological properties, enhanced drug permeation, and significant anti-inflammatory activity comparable to that of a marketed indomethacin gel formulation.
Copyright (c) 2026 Samidha Golatkar, Madan D. Pomaje, Apeksha Rahate, Parnika Kadam https://creativecommons.org/licenses/by/4.0
COMPARATIVE STUDY OF FNAC AND CELL BLOCK WITH COMBINED RESULT OF BOTH IN DIAGNOSIS OF BREAST LESIONS
Objective: Breast lesions, ranging from benign to malignant, are common in clinical practice, cancer in breast being a major health issue in India. FNAC is widely used for diagnosis but has limitations that the cell block technique can address by preserving tissue architecture. This study compares the diagnostic performance of FNAC, cell block, and their combined use. Method: A prospective study involved thirty-two female patients with palpable breast lump. Both cytology smears and cell block preparation has been performed from fine needle aspiration (FNAC) material and compare it with histopathology as the gold standard. Diagnostic metrics were evaluated for each method. Results: FNAC identified most of benign and malignant cases. Cell block provided additional information, improving the ability to differentiate between benign and malignant lesions. The combined approach offered the most comprehensive diagnostic results. FNAC is effective but may struggle with atypical or suspicious lesions. The cell block provides better tissue architecture and clarity, which is particularly useful in difficult cases. The combination of both methods improves the diagnostic process, helping reduce the need for invasive procedures. Conclusion: Combining FNAC with the cell block technique significantly improves the ability to diagnose breast lesions accurately. This approach should be considered for enhanced clinical decision-making and patient management.
COMPARISON OF ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK AND LOCAL SKIN INFILTRATION FOR POSTOPERATIVE ANALGESIA IN ADULT PATIENTS UNDERGOING LUMBAR SPINE SURGERY UNDER GENERAL ANAESTHESIA
Objective: To compare the efficacy of ultrasound-guided Erector Spinae Plane (ESP) block with local skin infiltration for postoperative analgesia in adult patients undergoing lumbar spine surgery under general anaesthesia. Methods: Sixty ASA I-II patients aged 18-80 y undergoing elective lumbar spine surgery were randomized into two groups of 30 each. Group E received ultrasound-guided bilateral ESP block with 0.25% Bupivacaine 10 ml on each side (total 20 ml), while Group l received local skin infiltration with 20 ml of 0.25% Bupivacaine. Visual Analogue Scale (VAS) scores, time to first rescue analgesia, hemodynamic parameters (heart rate, blood pressure, mean arterial pressure, SpO2), and adverse effects were assessed at 15 min, 30 min, 1 h, 1.5 h, 2 h, 4 h, and 6 h postoperatively. Results: Group E demonstrated significantly lower VAS scores at all time intervals compared to Group l (p<0.05). The time to first rescue analgesia was significantly prolonged in Group E (1.95±0.48 h) compared to Group l (1.63±0.43 h, p=0.01). Group E showed better hemodynamic stability with significantly lower pulse rate and mean arterial pressure at 6 h (p<0.05). SpO2 was significantly higher in Group E at 15 min, 30 min, 2 h, and 4 h (p<0.05). No adverse effects were observed in either group. Conclusion: Ultrasound-guided erector spinae plane (ESP) block provides superior postoperative analgesia, prolongs the time required for rescue analgesia, reduces opioid consumption, and maintains better hemodynamic stability compared to local skin infiltration in patients undergoing lumbar spine surgery.
IMPACT OF STRUCTURED PEER-ASSISTED LEARNING ON ANATOMY TOPICS: A JIGSAW METHOD APPROACH
Objective: To evaluate the effectiveness of structured peer-assisted learning using the Jigsaw method in improving understanding, retention, teamwork, communication skills, and overall academic performance among Phase-I MBBS students in anatomy. Methods: A pre-test and post-test interventional study was conducted among 150 Phase-I MBBS students in the Department of Anatomy, Government Medical College, Mahabubnagar. Students participated in a structured Jigsaw learning session covering selected anatomy topics. A 15-item multiple-choice questionnaire was administered before and after the intervention. Scores were analyzed using paired statistical methods. Results: The mean pre-test score was 7.0±2.1, which improved significantly to 14.0±1.3 in the post-test. The improvement was statistically significant (p<0.0001) with a very large effect size (Cohen’s d = 1.85). There was a marked reduction in low scorers and a substantial increase in high achievers. Conclusion: Structured peer-assisted learning using the Jigsaw method significantly enhanced comprehension, retention, communication skills, teamwork, confidence, and overall academic performance among MBBS Phase-I students. The method aligns well with CBME objectives and represents an effective student-centered teaching strategy in anatomy education.
Copyright (c) 2026 Parimala Sirikonda, Mohd Imtesal Ali Zishan, Dr Mariya, Niveditha Sirikonda https://creativecommons.org/licenses/by/4.0
DRUG UTILIZATION STUDY IN THE PATIENTS OF MYOCARDIAL INFARCTION AT A TERTIARY CARE HOSPITAL
Objective: To evaluate the pattern of drug utilization, demographic characteristics, routes of administration, duration of hospital stay, and clinical outcomes in patients with myocardial infarction admitted to a tertiary care hospital. Methods: This was a hospital-based observational study conducted over a period of six months in the Pharmacology Department in coordination with the Cardiology Department of a tertiary care hospital in southern Rajasthan. A total of 100 patients with confirmed diagnosis of myocardial infarction were included. Data regarding demographics, drug prescriptions from admission to discharge, routes of administration, fixed-dose combinations, and clinical outcomes were collected from inpatient records and analysed descriptively. Results: The majority of patients were aged 61–70 y (37%), followed by 51–60 y (32%), with a marked male predominance (82%). Most patients recovered (93%), while in-hospital mortality was 7%. Combination routes of drug administration (oral, sublingual, and parenteral) were used in 84% of patients. Half of the patients had a hospital stay of 3–4 d. Antiplatelet drugs were prescribed to 99% of patients, with dual antiplatelet therapy being most common (73%). Statins (94%), beta-blockers (88%), anticoagulants (85%), and nitrates (89%) were widely used. Proton pump inhibitors were prescribed to all patients, while antibiotics were used in 51%. Fixed-dose combinations, particularly aspirin with clopidogrel and statins, were frequently prescribed. Conclusion: The study demonstrates a high level of adherence to evidence-based guidelines in the pharmacological management of myocardial infarction at the tertiary care hospital. The prescribing pattern reflects rational use of essential cardiovascular drugs and effective acute management, as evidenced by favourable clinical outcomes. However, the use of certain non-cardiac medications highlights the need for regular prescription audits to further promote rational drug use.
PATIENT-LEVEL MISCONCEPTIONS AS DETERMINANTS OF ORAL HYPOGLYCEMIC AGENT USE: A CROSS-SECTIONAL ANALYSIS
Objective: To examine patient-level misconceptions related to oral hypoglycemic agent use and their association with treatment patterns using a cross-sectional analysis of outpatient data. Methods: This cross-sectional study used an outpatient drug utilization survey involving adults with type 2 diabetes mellitus receiving OHAs, either alone or in combination with insulin. Patient-level misconceptions were inferred from reported medication-related behaviors that deviated from evidence-based diabetes management principles. Descriptive analyses were performed to assess the prevalence of identified misconception domains and their distribution across treatment patterns. Results: Among 59 patients included in the analysis, treatment permanence misconceptions were observed in 27.1% of participants, while safety-related misconceptions were identified in 18.6%. Treatment permanence misconceptions were more common among patients receiving oral hypoglycemic agents alone compared with those receiving combined OHA–insulin therapy. Safety-related misconceptions were present in both treatment groups, but were more frequent among patients on OHA monotherapy. Conclusion: Patient-level misconceptions regarding oral hypoglycemic agent use are common and vary according to treatment exposure. Addressing these misconceptions through patient-centered education and consistent counselling may be essential for promoting rational and sustained use of oral hypoglycemic agents in routine diabetes care.
Copyright (c) 2026 Dr Sophia B Modi, Dr Sunilkumar G https://creativecommons.org/licenses/by/4.0
EVALUATION OF PRESCRIPTION PRACTICES IN THE MEDICINE WARD OF A TERTIARY CARE TEACHING HOSPITAL IN WEST BENGAL: AN OBSERVATIONAL STUDY
Objective: Rational prescribing is crucial for ensuring patient safety, optimizing therapeutic outcomes and minimizing healthcare costs. Irrational prescription practices remain a major concern, particularly the inappropriate use of antimicrobials. Prescription audit serves as a key tool to assess and improve prescribing behaviour, ensuring adherence to standard treatment guidelines. This study aimed to assess the prescribing patterns with special emphasis on the use of antimicrobials and evaluate the rationality of prescriptions in relation to standard treatment guidelines and the principles of essential medicines use. Methods: A cross-sectional, observational study was conducted at Barasat Government Medical College and Hospital over three months. A total of 365 prescriptions were collected through simple random sampling from the medicine wards and hospital records, of which 334 were eligible for analysis. Prescriptions were evaluated using WHO core drug use indicators, and data were analysed descriptively using Microsoft Excel 2021. Results: Generic prescribing was observed in 100% of prescriptions, and 91.3% of drugs were from the National List of Essential Medicines (2022). The average number of drugs per prescription was 5.51, indicating moderate polypharmacy. Antibiotics were prescribed in 0.76 prescriptions reflecting cautious antimicrobial use. Only 35.04% of prescriptions documented a diagnosis, and patient advice was recorded in just 5.39%. The use of injectable formulations (average 4.27/prescription) was relatively high. Conclusion: Prescribing practices largely adhered to rational drug use principles, but areas such as diagnostic documentation, patient counselling, and antimicrobial stewardship require strengthening. Regular audits and training are recommended to further enhance rational pharmacotherapy.
DRUG UTILIZATION IN PATIENTS WITH ACUTE POISONING: AN OBSERVATIONAL STUDY
Objective: Acute poisoning is one of the major public health problems in the developing world and one of the key causes of emergency cases and deaths. Having a rational use of drugs is important in enhancing results. The objective of this study isto assess the use trends of medicines in acute poisoning individuals. Methods: It is a prospective observational study carried out in nine months (September 2024-May 2025) at a tertiary care teaching hospital in Jaipur, Rajasthan. The use of drugs was evaluated through the World Health Organization prescribing indicators. Results: 248 patients were involved. In 82.25% of the encounters, antibiotics were prescribed, and injectable drugs were prescribed in all the patients. mean of the number of drugs per encounter was 12.3. A total of 78.22 % of patients have been reported to have been cured, and the mortality rate was 5.24%. Conclusion: The paper shows that there is a high consumption of antibiotics and injectable medicines in cases of acute poisoning. The use of antimicrobial stewardship programs and regular prescription audits is needed to enhance rational drug use.
NEBULIZED BUDESONIDE AS ADD-ON TO STANDARD THERAPY IN CHILDREN AGED 5-14 YEARS WITH ACUTE EXACERBATION OF ASTHMA
Objective: Out of the top 20 chronic conditions for global ranking of disability adjusted life years in children, asthma is one of them and specifically in the mid-childhood ages i. e, 5–14 y it ranks amongst the top 10 diseases, so we planned this study to see the efficacy of nebulized budesonide as add-on to standard therapy in children aged 5-14 y with acute exacerbation of asthma. Methods: This was a prospective, randomized, open labelled, interventional study conducted in 5-14 y old patients of moderate to severe asthma having acute exacerbation. Thirty children with acute exacerbation of asthma presenting in the Paediatric department at PGIMS, Rohtak were randomized and assessed for efficacy according to PRAM score. Results: PRAM Score at various follow-up time intervals was recorded in both groups and it was observed that mean±SD of PRAM Score at baseline, at 30 min, at 60 min and at 180 min showed non-significant difference during inter-group comparison. At discharge PRAM score was 0.39±0.50 and 0.32±0.48 in group I and group II respectively. Conclusion: This study showed that both nebulized budesonide as an add-on and standard therapy in children aged 5-14 y with acute exacerbation of asthma showed significant improvement in respiratory status in terms of relief of respiratory symptoms with good safety profile and greater satisfaction with nebulized.
Copyright (c) 2026 Dr. Arvind Narwat https://creativecommons.org/licenses/by/4.0
COMPARATIVE EFFICACY OF SODIUM–GLUCOSE COTRANSPORTER-2 INHIBITORS VERSUS PLACEBO ON CARDIOVASCULAR MORTALITY IN ADULTS WITH HEART FAILURE: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Objective: To evaluate the effect of sodium–glucose cotransporter-2 (SGLT2) inhibitors compared with placebo on cardiovascular mortality in adults with heart failure using evidence derived exclusively from randomized controlled trials. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted in accordance with PRISMA 2020 guidelines. Electronic databases were searched to identify eligible trials enrolling adult patients with heart failure that directly compared an SGLT2 inhibitor with placebo and reported cardiovascular mortality. Data were extracted from full-text publications, and risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using an inverse-variance fixed-effect model. Statistical heterogeneity was assessed using Cochran’s Q test and the I² statistic. Results: Four large, double-blind randomized controlled trials comprising 20,725 participants met the inclusion criteria. Across individual studies, SGLT2 inhibitor therapy was consistently associated with a lower risk of cardiovascular death compared with placebo. The pooled analysis demonstrated a statistically significant reduction in cardiovascular mortality with SGLT2 inhibitors (pooled RR = 0.88; 95% CI: 0.81–0.96). Statistical heterogeneity was negligible (I² = 0%), indicating high consistency across trials. Conclusion: This meta-analysis demonstrates that SGLT2 inhibitors significantly reduce cardiovascular mortality in adults with heart failure. The consistency of benefit across heart-failure phenotypes and the low heterogeneity support the robustness of these findings and reinforce the role of SGLT2 inhibitors as a foundational component of contemporary heart-failure therapy.
Copyright (c) 2026 Dr. Pranab Das, Dr. Mahaprasad Pal, Dr. Wasim Akram, Dr. Bodhisatya Das https://creativecommons.org/licenses/by/4.0
EFFECT OF MINERALOCORTICOID RECEPTOR ANTAGONISTS ON CARDIOVASCULAR MORTALITY IN ADULTS WITH HEART FAILURE: AMETA-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Objective: To evaluate the effect of mineralocorticoid receptor antagonists on cardiovascular mortality in adults with heart failure using evidence from randomized controlled trials. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted in accordance with PRISMA 2020 guidelines. Electronic databases, including PubMed, Scopus, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched for eligible studies. Trials enrolling adult patients with heart failure and comparing MRAs with placebo were included. Cardiovascular mortality was the primary outcome. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for individual studies and pooled using an inverse-variance fixed-effect model. Statistical heterogeneity was evaluated using Cochran’s Q test and the I² statistic. Risk of bias was assessed using the Cochrane Risk of Bias tool, and certainty of evidence was evaluated using the GRADE framework. Results: Three large, double-blind randomized controlled trials comprising 11,032 patients met the inclusion criteria. Treatment with MRAs was associated with a significant reduction in cardiovascular mortality compared with placebo. The pooled analysis demonstrated a 20% relative reduction in cardiovascular mortality (pooled RR = 0.80; 95% CI: 0.73–0.86). No significant heterogeneity was observed among the included studies (I² = 0%). All trials were judged to have a low risk of bias, and the certainty of evidence for the primary outcome was rated as high. Conclusion: Mineralocorticoid receptor antagonists significantly reduce cardiovascular mortality in patients with heart failure. These findings provide high-certainty evidence supporting their use as an essential component of guideline-directed medical therapy.