Osteoporosis is a chronic disease of the osseous system characterized by decreased bone strength and increased fracture risk. It is due to an imbalance in the dynamic ongoing processes of bone formation and bone resorption. Currently available osteoporosis therapies like bisphosphonates, selective estrogen receptor modulators (SERMs), and denosumab are anti-resorptive agents. Parathyroid hormone analogs like teriparatide are the only anabolic agents currently approved for osteoporosis treatment. The side-effects and limited efficacy of the presently available therapies has encouraged extensive research into the pathophysiology of the disease and newer drug targets for its treatment. The novel anti-resorptive agents being developed are newer SERMs, osteoprotegerin, c-src (cellular-sarcoma) kinase inhibitors, αVβ3 integrin antagonists, cathepsin K inhibitors, chloride channel inhibitors, and nitrates. Upcoming anabolic agents include calcilytics, antibodies against sclerostin and Dickkopf-1, statins, matrix extracellular phosphoglycoprotein fragments activin inhibitiors, and endo-cannabinoid agonists. Many of these new drugs are still in development. This article provides an insight into the emerging drugs for the treatment of osteoporosis.
Aims:To assess the role of diabetic education in increasing awareness about hypoglycemia and decreasing hypoglycemic symptoms in diabetics.Materials and Methods:This is a longitudinal study involving the use of a structured questionnaire for obtaining baseline information related to knowledge, attitude and practices (KAP) of diabetic patients regarding hypoglycemia. Then the patients were given diabetic education by the treating doctor regarding hypoglycemia, its symptoms and prevention; the effect of which was assessed by repeating the same questionnaire after a month. The occurrence of hypoglycemic symptoms was also compared before and after diabetic education.Results:There is a significant improvement in all parameters like KAP with diabetic education. The hypoglycemic episodes also decrease significantly.Conclusions:Proper diabetic education is seen to improve the knowledge and attitude of the diabetic patients toward hypoglycemia. This leads to improved practices of such patients and decrease hypoglycemic episodes in them.
Background: Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. World Health Organization has defined certain parameters to promote rational drug use in all countries. This study was designed to assess the prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators.Methods: A total of 2155 prescriptions were evaluated. Each prescription was evaluated for average number of drugs prescribed per patient per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines from Essential drug list prescribed. These indicators help us to check polypharmacy, practice of prescribing drugs by brand names, antibiotic overuse, preference of injectables and non-adherence to Essential drug list.Results: The average number of drugs prescribed per patient per encounter was calculated to be 3.25±0.24. The percentage of medicines prescribed by generic names was 35.89%. Percentage of encounters with an antibiotic prescribed was 48.21 % and with an injection prescribed was 1.85%. The percentage of medicines form NLEM was 76.36%.Conclusions: The values of WHO prescribing indicators obtained from this study show that there are some areas where the prescribers need to improve their prescribing practices.
Lornoxicam is a member of the oxicam group of nonsteroidal antiinflammatory drugs (NSAIDs), producing analgesic and antipyretic effects through the non-selective inhibition of cyclo-oxygenase-1 and -2. Besides its inhibitory effect on COX1 and COX-2 peripheral receptors, is also increases endogenous dinorphin and beta-endorphin levels promoting central analgesic and anti-inflammatory effects. Recently, lornoxicam has been introduced in Indian market in oral, intravenous and intramuscular formulations. Lornoxicam is completely absorbed after oral administration, reaching peak plasma concentrations of 280 mg/L within 2.5 hours after a 4 mg dose. After intramuscular injection maximum plasma concentrations are achieved after approximately 20-25 minutes. Lornoxicam is extensively metabolished in liver by cytochrome P4502DC9 to inactive metabolite 5'-hydroxy-lornoxicam. The mean elimination half life is 3 to 4 hours. There is plenty of literature available on the effect of lornoxicam on chronic and acute pain management. These preliminary finding require confirmation in further comparative studies.
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