CURRENT TRENDS IN PRESCRIBING PATTERN OF ANTI-MIGRAINE DRUGS IN PATIENTS OF MIGRAINE AT A TERTIARY CARE TEACHING HOSPITAL

Background. An inappropriate prescribing pattern of antimigraine drugs by doctors may often encourage inappropriate self-medication by patients because of the asymmetry of medical information. Objective. The study is aimed to assess the current trends in prescribing patterns of anti-migraine drugs, rationality of prescription, and pattern of migraine severity in patients of migraine. Methods. A cross sectional study was conducted at a tertiary care teaching hospital. All the prescribing details including patient’s demographic details, diagnosis, details of drug therapy (drug name, dose, duration, and frequency) were recorded. Rationality of prescription was assessed using the WHO core drug prescribing indicators and the pattern of severity of migraine was assessed using MIDAS scoring system. Results. Out of 85 patients, 71 were female (83.5%), mostly around 21-30 years of age, and 27 (31.7%) patients had other comorbidities. Naproxen was the most commonly used NSAID for termination of acute migraine attack (15.3 %). The most common drugs prescribed for prophylaxis included beta adrenergic blockers (Propranolol, 14.66%), antidepressants (Amitriptyline, 9.33% and Fluoxetine 3.33%), and antipsychotics (Prochlorperazine, 4.66%). Domperidone (17.30%) was the most commonly prescribed antiemetic. Prescription of triptans was low (2.66%) with Rizatriptan as the most commonly prescribed triptan. Conclusions. The current study revealed that further improvements are required in prescribing practices especially in average number of drugs per prescription, prescription of drugs with generic names, and prescription of drugs of the essential drugs list.

Modulation of N-nitrosodiethylamine (NDEA) induced oxidative stress by vitamin E in rat erythrocytes

Nitrosamines, such as N-nitrosodiethylamine (NDEA), induced oxidative stress due to the generation of reactive oxygen species, which are capable of initiating peroxidative damage to the cell. The present study was designed to establish whether pre-treatment with vitamin E (40 mg/kg body wt, intraperitoneally (ip), twice a week for 4 weeks) to NDEA induced rats provides protection against oxidative stress caused by NDEA. A single necrogenic dose of NDEA (200 mg/kg body wt) was administered intraperitoneally (ip) to the rats with or without vitamin E pre-treatment and the animals were sacrificed on Day 7, 14 or 21 after NDEA administration. Lipid peroxidation (LPO) and the activities of antioxidant enzymes were determined in erythrocytes as indices of oxidative damage. The result showed elevated levels of LPO in erythrocytes with NDEA treatment, however, vitamin E pre-treated rats administered NDEA showed decreased LPO (Day 14 and 21). Superoxide dismutase (SOD) enzyme activity and the glutathione (GSH) content increased with NDEA treatment and remained high in vitamin E pre-treated group. Catalase (CAT), glutathione reductase (GSH-R) and glutathione-S-transferase (GST) enzyme activities declined with NDEA treatment; however, vitamin E pre-treated rats administered NDEA, showed elevation in the enzyme activities. Glutathione peroxidase (GSH-Px) activity increased in erythrocytes in vitamin E pre-treated rats administered NDEA, while SeGSH-Px activity was not affected significantly. This study demonstrates that the pre-treatment with vitamin E prior to the administration of NDEA was effective in counteracting and modulating oxidative stress in rat erythrocytes in a time-dependent manner.

Antioxidant potential of thyme extract: alleviation of N-nitrosodiethylamine-induced oxidative stress

Protective role of thyme extract against N-nitrosodiethylamine (NDEA)-induced oxidative stress has been evaluated in albino rats. For this, one group of rats were fed diet supplemented with thyme extract (0.5%) and served as the test group, whereas animals of the other group fed on normal diet served as the control group. The rats were fed on respective diets for a period of 2 weeks after which stress was induced to half the animals of each group by i.p. administration of NDEA at 200 mg/kg body weight. Animals were killed 48 h post stress-induction period. Feed intake and body weight decreased significantly in both test and control groups, the effect being less in test group. Increase in osmotic fragility and in-vitro lipid peroxidation (LPO) on stress induction was of lower degree in the test group. NDEA toxicity was mainly reflected in liver as evidenced by increased activities of plasma aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase. The effect was of lower degree in test group as compared with that in the control group. Increase in urea levels observed following NDEA administration was also of lower degree in test groups. Blood glutathione (GSH) levels increased more so in test group compared with control group on stress induction. The activities of superoxide dismutase (SOD), peroxidase (Px), and catalase (CAT) activities decreased significantly on stress induction in erythrocytes. LPO increased in all the tissues through varying degree, and the increase was appreciably of lower degree in test group. The activity of SOD increased significantly in both test and control group on stress induction, whereas activities of Px and CAT decreased following NDEA treatment, and the effects were of lower degree in test group. Thus, supplementation of diet with thyme extract can improve antioxygenic potential and hence help to prevent oxidative stress.

Xylanase production with xylan rich lignocellulosic wastes by a local soil isolate of Trichoderma viride

In the present study, cultural and nutritional conditions for enhanced production of xylanase by a local soil isolate of Trichoderma viride, using various lignocellulosic substrates in submerged culture fermentation have been optimized. Of the lignocellulosics used, maize straw was the best inducer followed by jowar straw for xylanase production. The highest activity achieved was between 14 to 17 days of fermentation. A continuous increase in xylanase production was observed with increasing level of lignocellulosics in the medium and highest activity was observed with maize straw at 5% level. Xylanase production with higher levels of lignocellulosics (3 to 5%) of maize, jowar and barseem was found to be higher as compared to that with commercial xylan as carbon source. Sodium nitrate was the best nitrogen source among the six sources used. Maximum xylanase production was achieved with initial medium pH of 3.5–4.0 and incubation temperature of 25ºC.The enzyme preparation was effective in bringing about saccharification of different lignocellulosics. The xylanase production could be further improved by using alkali treated straw as carbon source.

Interaction of pea (Pisum sativum L.) lectins with rhizobial strains

Lectins from two varieties (PG-3 and LFP-48) of pea have been purified by affinity chromatography on Sephadex G-50. The specific activity increased by 23 and 25 folds, respectively. These lectins from both the varieties were found to be specific for mannose. The purified fluorescein isothiocyanate (FITC)-labelled lectins showed binding reaction with homologous as well as heterologous strains of Rhizobium spp. The results revealed that pea lectins are not highly specific to their respective rhizobia. Moreover, these lectins showed a greater stimulatory effect on homologous Rhizobium leguminosarum strains.