Aim:Drug-drug interaction (DDI) is of major concern in patients with complex therapeutic regimens. The involvement of cardiovascular medicines in drug interaction is even higher. However, reports of DDI between these groups of drugs are few. The study aims to identify the potential DDI among hospitalized cardiac patients. Furthermore, we assessed the possible risk factors associated with these interactions.Subjects and Methods:The Type of study prospective observational study was conducted from May 2012 to August 2012 among hospitalized cardiac patients. Cardiac patients who were taking at least two drugs and who had a hospital stay of at least 24 h were enrolled. The medications of the patients were analyzed for possible interactions using the standard drug interaction database - Micromedex -2 (Thomson Reuters) × 2.0.Results:From a total of 150 enrolled patients, at least one interacting drug combination was identified among 32 patients. The incidence of potential DDI was 21.3%. A total of 48 potentially hazardous drug interactions were identified. Atorvastatin/azithromycin (10.4%), enalapril/metformin (10.4%), enalapril/potassium chloride (10.4%), atorvastatin/clarithromycin (8.3%) and furosemide/gentamicin (6.3%) were the most common interacting pairs. Drugs most commonly involved were atorvastatin, enalapril, digoxin, furosemide, clopidogrel and warfarin. Majority of interactions were of moderate severity (62.5%) and pharmacokinetic (58.3%) in nature. Increased number of medicines, prolonged hospital stays and comorbid conditions were the risk factors found associated with the potential DDI.Conclusions:This study highlighted the need of intense monitoring of patients who have identified risk factors to help detect and prevent them from serious health hazards associated with drug interactions.

Use of plant based drugs and chemicals for curing various ailments and personal adornment is as old as human civilization. Plants and plant-based medicaments are the basis of many of the modern pharmaceuticals we use today for our various ailments. The aim of the study was to find out the bioactive chemical constituents and to evaluate the antimicrobial activity of the ethanolic extract of traditionally used eight medicinal plants of Nepal. A qualitative phytochemical analysis was performed for the detection of alkaloids, glycosides, terpenoids, steroids, flavonoids, tannins and reducing sugar. The highest yield of ethanolic extract was found in Azadiracta indica (29.08%). Ocimum santrum contained all the chemicals except flavonoids and reducing sugar however the Colquhounia coccinea lacked alkaloids and reducing sugar. The antimicrobial activities of these plants extract were also observed. The extract of Rhododendron setosum and the essential oil of Eucalyptus globulus were most effective against Escherichia coli and Staphylococcus aureus respectively. But the extracts of Azadiracta indica and Elsholtzia fructicosa were found to be most effective against Klebsiella species.

This study presents the optimization of a simple HPLC-UV method for the determination of metformin in human plasma. Ion pair separation followed by UV detection was performed on deproteinized human plasma samples. The separation was carried out on a Discovery Reversed Phase C-18 column (250 × 4.6 mm, 5 μm) with UV detection at 233 nm. The mobile phase contained 34% acetonitrile and 66% aqueous phase. Aqueous phase contained 10 mM KH2PO4 and 10 mM sodium lauryl sulfate. Aqueous phase pH was adjusted to 5.2. The mobile phase was run isocratically. The flow rate of the mobile phase was maintained at 1.3 ml/min. The linearity of the calibration curve was obtained in the concentration range of 0.125-2.5 μg/ml and coefficient of determination (R (2)) was found to be 0.9951. The lowest limit of quantification and detection was 125 and 62 ng/ml respectively. No endogenous substances were found to interfere with the peaks of drug and internal standard. The intra-day and inter-day coefficient of variations was 6.97% or less for all the selected concentrations. The relative errors at all the studied concentrations were 5.60% or less. This method is time efficient and samples are easy to prepare with minimum dilution. So, it can be applied for monitoring metformin in human plasma.

Introduction: Low back pain is characterized by a range of symptoms which include pain, muscle tension or stiffness, and is localized between the shoulder blades and the folds of the buttocks, with or without spreading to the legs. Non-Steroidal Anti Inflammatory Drugs (NSAIDs) are the drugs of choice which provide an analgesic effect for acute low back pain.