Arup Misra

All India Institute of Medical Sciences Mangalagiri · Pharmacology

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed drugs in post-operative period worldwide. Their nephrotoxic effects are documented and accounts for around 15.5% of all cases of drug induced renal failure. Acute renal failure following NSAIDs usage are reported in volume depleted patients which is further preci...

Background Pulmonary arterial hypertension (PAH) is a vascular disease characterised by restricted flow and high pressure through the pulmonary arteries, leading to progressive right heart failure and death. This study reports the global burden of PAH, leveraging all available data and using methodology of the Global Burden of Diseases, Injuries, a...

Background Upper respiratory infections (URIs) are the leading cause of acute disease incidence worldwide and contribute to a substantial health-care burden. Although acute otitis media is a common complication of URIs, the combined global burden of URIs and otitis media has not been studied comprehensively. We used results from the Global Burden o...

Healthcare workers (HCWs) are front-line warriors in the battle against the COVID-19 pandemic. Therefore, it is of interest to assess the psychological and physical effects of personal protective equipment (PPE) among HCWs caring for COVID-19 patients. This cross-sectional study utilized a validated, well-structured questionnaire consisting of 24...

Background Antimicrobial resistance (AMR) has evolved into a severe public health issue that defies all current control strategies and needs multidisciplinary, creative solutions. Antimicrobial stewardship (AMS) activities demand a set of tools and abilities that can be used by health systems. In view of the growing AMR and the difficulty for the s...

Background Gout is an inflammatory arthritis manifesting as acute episodes of severe joint pain and swelling, which can progress to chronic tophaceous or chronic erosive gout, or both. Here, we present the most up-to-date global, regional, and national estimates for prevalence and years lived with disability (YLDs) due to gout by sex, age, and loca...

Background and Aim The traditional drug delivery approach involves systemic administration of a drug that could be nonspecific in targeting, low on efficacy, and with severe side‐effects. To address such challenges, the field of smart drug delivery has emerged aiming at designing and developing delivery systems that can target specific cells, tissu...

Summary Background Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020–21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the p...

Background: Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to...

Antimicrobial stewardship programmes (AMSPs) decrease antimicrobial resistance, optimize usage of antimicrobials, and enhance patient outcomes. The Anatomical Therapeutic Chemical (ATC) is the foundation of the World Health Organization (WHO) global methodology, which groups the pharmacologically active substances of antimicrobials according to the...

Cardiovascular disease (CVD) is the most common cause of morbidity and mortality worldwide. Bromocriptine is a partial antagonist for D1 dopamine receptors while also serving as a selective agonist on D2 dopamine receptors as a dopamine receptor agonist. Apart from prolactin inhibiting action, bromocriptine has some beneficial effects on the blood...

Background Healthcare workers (HCWs) are part of the front-line warriors in this ongoing battle against the COVID-19 pandemic. We aim to assess personal protective equipment (PPE)-related side effects and both physical and psychological effects among healthcare workers (HCWs) caring for COVID-19 patients. Methods The present cross-sectional questi...

The COVID-19 pandemic, caused by SARS-CoV-2, has profoundly affected developing countries like India. This retrospective cross-sectional analysis investigated epidemiological, clinical characteristics, treatment strategies, and outcomes for hospitalized COVID-19 patients during the Massive SARS-CoV-2 Wave in India. Among 233 patients, the median ag...

Essential medicines are those that satisfy the “priority health care needs” of the population. EssentialMedicines are selected based on efficacy and safety and comparative cost-effectiveness with dueregards to public health relevance. The essential medicine list (EML) was created with the intentionof ensuring that certain medications are accessible...

Cohort studies have shown that both overweight and obesity have their impact by increasing hospitalization with COVID-19. We conducted a systematic literature search in PubMed, Google Scholar, and MedRxiv databases following the PRISMA guidelines. Statistical analyses were performed using STATA software version 16 MP (Stata Corp, College Station, T...

Background: Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases...

Background: COVID-19 outbreak is known to have a psychological impact on patients. Background and Objective: The main aim of the study was a to study the attitude and behavior of health care professionals (HCPs) in the emergency department towards chronic patients during COVID-19 pandemic and also the accessibility of healthcare system during COVID...

Introduction Diabetes mellitus (DM) and the 2019 coronavirus (COVID-19) appear to interact in both directions. There is mounting proof that patients with DM have a worse COVID-19 prognosis than those without it. Pharmacotherapy is also known to affect in view of the possible interplay between drugs and the pathophysiology of the above conditions in...

Background : Amisulpride is a benzamide derivative classified as an atypical antipsychotic due to its low affinity for 5-HT2 receptors and negligible extrapyramidal side effects, as well as specific dopamine D2 and D3 receptor antagonism. Case Presentation : We report a rare case of a drug induced hyperprolactinemia and gynecomastia in a 29 year o...

Background: A significant surge of cases of mucormycosis is seen in individuals with COVID-19 with presence of diabetes mellitus (DM) and usage of corticosteroids. We aim to conduct a systematic analysis of the cases involving presence of mucormycosis and to find out its association with COVID-19, diabetes mellitus, and corticosteroids. Method:...

Background: Coronavirus disease-2019 (COVID-19) pandemic has engulfed the whole world with millions getting infected and losing their lives. Health care professionals (HCPs) who are in the front line of fighting with COVID-19 are particularly vulnerable and it is crucial to protect them from COVID-19. In this regard, the Indian Council of Medical...

Background: Pancytopenia is a triage of anemia, leukopenia, and thrombocytopenia. The etiology causing pancytopenia varies depending upon factors such as age, sex, occupation, and geographical distribution. Unfortunately, the major treatises of hematology have not given emphasis on the hemorrhagic manifestation of different etiologies causing pancy...

Background: Polypharmacy and inappropriate prescriptions are the most highlighted health issues among geriatric population, as they have multiple comorbidities. The objective of this study was to assess prescriptions using the World Health Organization (WHO) core indicators and Beers Criteria to discover polypharmacy and inappropriate prescriptions...

Background: Rheumatoid arthritis (RA) is an autoimmune disease, which mistakenly attacks the joints and induces the inflammatory changes that thicken the joints (the synovium) resulting in swelling and pain in and around the joints. It causes pain, joint deformity, and also affects the quality of life. The joint is affected symmetrically. It also...

Gout is a metabolic disorder characterized by hyperuricemia. Asymptomatic hyperuricemia ought not to be treated until arthritis; renal calculi or tophi become evident. The cornerstone of therapy of acute attack is often nonste-roidal anti-inflammatory drugs (NSAIDs), barring specific situations wherein colchicine and corticosteroids do have a role....

Background: Vitamin D is an important vitamin required to maintain an important physiological function of the body. The body should maintain an optimal level of vitamin D to maintain skeletal and metabolic functions. It was observed that inverse relationship is maintained by vitamin D level in the body with musculoskeletal symptoms and metabolic di...

Medication error (ME) is an adverse preventable event which happens due to the inappropriate use of medication that leads to patient harm. Such events may be related to professional practice, health‑care products, procedures, and systems including prescribing, communication, product labeling, packaging, and nomenclature, compounding, dispensing, di...

Background: Vitamin D is an important vitamin required to maintain normal skeletal as well as nonskeletal functions. The daily supplementation of vitamin D not only have poor adherence to the regimen but also of doubtful efficacy in deficient patients. Objectives: The aim of this study was to compare the effect of oral high‑dose vitamin D regimen...

Diabetic peripheral neuropathy (DPN) is a common presentation in Type 2 diabetes in the long run. Neuropathic pain is the most common disabling symptom of DPN. Previous studies suggest beneficial role of cannabis in animal model for neuropathic pain. Cannabinoid receptors (CB1 and CB2) are found at sites associated with pain processing and they als...

Objectives Schizophrenia, a highly heterogeneous & biological disorder of the brain, is associated with biochemical, metabolic & cardiovascular derangements. Vitamin D is known to have the role as a neuro-modulator/neuroprotection in the brain. Prevalence of metabolic syndrome in schizophrenia is very high & it further increases with the use of aty...

Objectives Schizophrenia, a highly heterogeneous & biological disorder of the brain, is associated with biochemical, metabolic & cardiovascular derangements. Vitamin D is known to have the role as a neuro-modulator/neuroprotection in the brain. Prevalence of metabolic syndrome in schizophrenia is very high & it further increases with the use of aty...

Cytosine-adenine-guanine (CAG) expansion mutation of the huntingtin (HTT) gene leads to a neurodegenerative disorder known as Huntington's disease (HD). The polyglutamine neurodegeneration leads to neuronal dysfunction that may eventually lead to progressive psychiatric and cognitive impairment due to neuronal cell death. Oxidative stress results i...

INTRODUCTION: Adverse drug reaction (ADR) is a public health problem which constitutes one of the leading causes of morbidity and mortality worldwide. In India, only a few studies reported cancer chemotherapy‑induced ADRs. The objectives of the present study were to assess the organ system involved, frequency, severity, and preventability of the AD...

Warfarin is one of the most frequently prescribed oral anticoagulant. Necrosis and/or gangrene ofskin and other tissues is an uncommon but serious risk associated with warfarin. The incidence of warfarin inducedtissue necrosis is about 0.01 % to 0.1%.Case description: A 62-year-old male presented to emergency with a complaint of skin discoloration...

INTRODUCTION: Adverse drug reaction (ADR) is a public health problem which constitutes one of the leading causes of morbidity and mortality worldwide. In India, only a few studies reported cancer chemotherapy-induced ADRs. The objectives of the present study were to assess the organ system involved, frequency, severity, and preventability of the AD...

DRESS syndrome (drug rash, eosinophilia and systemic symptoms) is an idiosyncratic drug reaction characterized by rash, fever, lymphadenopathy and internal organ involvement. This syndrome causes a diverse array of clinical symptoms, anywhere from 2 to 8 weeks after initiating the offending drug. Many drugs including aromatic anticonvulsants can in...

Bisphosphonate therapy is beneficial in breast cancer patients by reducing the development of bone metastases and also improves survival in breast cancer. However, mechanism behind this beneficial effect is still unclear. This review explored few recent studies to identify the mecha-nism behind Bisphosphonate anticancer effect and possible new targ...

Poor prognosis of thyroid cancer and advanced disease together with absence of effective therapeutic measures, has induced recent intensified basic and clinical research in this area. Complete total thyroidectomy is the treatment of choice for PTC, FTC, and MTC. Radioiodine is routinely recommended in high-risk patients and considered in intermedia...

Background Medicinal plants have the potential treasure to treat medical conditions for a long time based on error and trial method. Agave americana has been known as century plant or American aloe. The leaves contain genins, saponins, steroidal flavonoids, isoflavones, and coumarins. It has long been used for anti-inflammatory effects. Objectives...

OBJECTIVE The objective of this study is to determine the nature and severity of adverse drug reactions (ADRs) in pediatric patients. MATERIALS AND METHODS In this retrospective cohort study, we extracted the data from all the available pediatric ADR forms submitted to ADR monitoring center (AMC) from May 2014 to December 2016. The data including...

Metabolic syndrome is a cluster of conditions that include high blood pressure, hyperglycemia, increase abdominal obesity and raised cholesterol or triglyceride levels which will increase the risk of heart disease, stroke and diabetes. The prevalence increases with age and racial ethnicity. Increased inflammatory mediators in the metabolic syndrome...

Introduction: Diabetes mellitus is a metabolic disease which is a major health care issue in geriatric population of Southeast Asian countries. Inappropriate prescriptions and polypharmacy are important prescribing issues with diabetic geriatric patients due to its associated co-morbid conditions. Beers criteria and WHO core indicators are develope...

Gingival overgrowth (GO) is one of the common findings in clinical practice. There could be several causes including drugs associated with the GO. Carbamazepine (CBZ) and amlodipine are the drugs which are infrequently documented as a cause in inducing the gingival hyperplasia. Certain drugs in the body fluid might limit the population of plaque ba...

Background: Olanzapine is a highly tolerable and easily affordable atypical antipsychotic drug which has been commonly prescribed in both inpatient and outpatient settings for several mental disorders. Olanzapine overdose is commonly seen in psychiatric patients, who attempt suicide by intoxicating themselves with their own prescribed medications....

Background: Medicinal plants have immense potential since ancient time based on error and trial method. Agave americana has been known since antiquity, as century plant or American aloe. The leaves contain steroidal saponins, isoflavones and coumarins. It has long been used on the wound. Objectives: This study was designed to evaluate the wound hea...

Insomnia is highly prevalent and is associated with a range of psychological, psychiatric, and medical conditions. Insomnia affects health by influencing cognitive, emotional and social functioning. Circadian and sleep homeostatic processes play an important role in insomnia development and its maintenance. Several efficacious treatments, both phar...

Gout is a metabolic disorder that usually presents as recurrent episodes of acute arthritis due to deposition of crystals in joints and cartilages. Despite the availability of several drugs for gout, its management is still less than adequate. There is always a search for newer, safer, and more potent urate-lowering therapies for treating patients...

Breast cancer is the leading cause of death in women. Epirubicin and cyclophosphamide (EC) is one of the chemotherapeutic regimens used for the treatment of breast cancer. We describe a case treated with EC regimen and who presented to us with symptoms suggestive of diabetes mellitus postchemotherapy. Absence of family history of diabetes and norma...

Surgical site infection is one of the most common hospital acquired infection. Antibiotics are given prior to surgery to reduce the burden of infection. Antibiotic of right choice at right dose and given at right time achieve the right concentration in the tissue to reduce the microbes responsible for surgical site infection. It should be economica...

Rational use of antibiotics in tertiary care hospital

Objectives: The present study was undertaken to determine the anti-depressant and anti-anxiety effects of hydroethanolic extract of Piper betle leaves commonly known as “paan”. Materials and Methods: Hydroethanolic extract of Piper betle leaves in the doses of 100,200 and 400 mg were administered orally for successive 14 days to young Swiss albino...

Medicinal properties of Agave americana

Acute renal failure is a life threatening condition. Nonsteroidal antiinflammatory drugs (NSAIDs) and cephalosporins are widely used postoperative drugs. NSAID-induced acute renal failure has been reported in the past. In this case, drug interaction and decompensated state of the patient precipitate the condition. NSAIDs inhibit prostaglandins synt...

Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a severe cutaneous drug reaction with a high mortality. Immune response is the possible cause in its pathogenesis. Levofloxacin is one of the most commonly used quinolones and has been reported to cause of TEN. On the other hand, furazolidone was proposed to augment the action of...

Pharmacovigilance is a new discipline which deals with adverse drug or any drug related problems. Pharmacovigilance programme was not bed of roses but its path is laid with challenges and barriers. It is facing obstacles from deficiency from professional health personal to web-based sale of drugs, counterfeit drug to self-medication, etc. It is an...

Obesity is a chronic disease and a major health problem which require long term treatment in developed and affluent society of developing countries. Pharmacotherapies for obesity have to be given for a long duration with lifestyle modifications. Anti-obesity drugs acts through various targets in the body which reduce the food intake, decrease absor...

Advances and molecular targets in Alzheimer’s disease

Fixed drug eruption is a well documented drug side effect and accounts for about 5-10% of cutaneous drug reactions. We describe a case of fixed drug eruption on lips and perioral region following consumption of a fixed dose combination in acute gastroenteritis. Fixed dose combination of Ofloxacin and Ornidazole is one of the most commonly used medi...

Antipsychotic agents are the most prescribed drug for schizophrenia and accounts to cause adverse cutaneous reactions in approximately 5% of the individuals for whom they are prescribed. Flagellate hyperpigmentation with photosensitivity may be unusually caused by amisulpride therapy in schizophrenic patient. The most important step in minimizing t...

Isoniazid and orlistat were reported to have inhibitory effect on mycobacterial ES-31 serine protease in vitro and bacterial cell growth in axenic culture. To study the cumulative effect and understand drug - drug interaction, if any, when isoniazid and orlistat used in combination. Inhibition of mycobacterial ES-31 serine protease by different com...