AIM:To evaluate the impact of pharmaceutical care on the clinical outcomes of patients enrolled in a pharmacist-coordinated diabetes management program in a rural health setup.SETTINGS AND DESIGN:Patients were registered into ‘control’ and ‘intervention’ groups by randomization at three primary health centers. The study was an open-label parallel study.MATERIALS AND METHODS:Medical records were prospectively reviewed. Capillary blood glucose level, blood pressure and demographic data were collected at baseline and at the follow-up visits. Pharmacists gave counseling to the intervention group during every visit and their health-related quality of life (HRQoL) was assessed with the Ferrans and Powers questionnaire.STATISTICAL ANALYSIS:Single factor ANOVA and the t-test were used to compare the results using SPSS version 0.9 software and MS Excel worksheets.RESULTS:The intervention group (n = 104) showed well-controlled BMI, whereas the control group (n = 50) showed significant increase in the BMI. Mean blood glucose level in the intervention group reduced to 25 units from baseline (P = 0.0001) but was significantly increased in the control group (P = 0.0001). ANOVA showed that from the second follow-up onward there was significant decrease in blood glucose levels. Overall, the HRQoL scores increased by 45% in the intervention group and decreased by 2% in the control group.CONCLUSIONS:The pharmaceutical care program was effective in improving the clinical outcome and HRQoL of diabetes patients in rural India. Such ‘pharmaceutical care’ models should be fine-tuned and implemented widely.

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plant kingdom has been described as a reservoir of many novel biologically active molecules of medicinal value. [2] Recently there has been a surge of interest in the therapeutic potential of medicinal plants as antioxidants in reducing free radical-induced tissue injury. Alstonia scholaris belongs to the family apocyanaceae which consists of about 250 genera and 2000 species of tropical trees, shrubs and vines. [3] Almost all parts of this plant are used in medicine and the bark has antihelminthic and astringent properties. It has been used in treating chronic diarrhea, dysentery and abnormal bowel movements. [4] The objective of the present study was to screen the phytochemicals and assess the antioxidant activity of the solvent extracts of bark and leaf of Alstonia scholaris. Free radical scavenging ability of the extracts were tested using antioxidant assays, viz., DPPH assay, ABTS assay and FRAP assay. MATERIALS AND METHODS The bark and leaves of Alstonia scholaris were collected from VIT University campus, Vellore and authenticated by Plant Biotechnology division, VIT University, Vellore. The samples were washed thoroughly and dried. The dried samples were pulverized and 100g of the powered samples were refluxed with ethyl acetate, butanol and water in the ratio 1:10(w/v). The extracts were then concentrated using rotary flash

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Lamotrigine is the most widely used anti‐epileptic drug in pregnancy because of its low teratogenicity. However, there is an increased metabolism and clearance of lamotrigine in pregnancy contributing to suboptimal drug therapy and poor disease control, prompting the need for proactive dosage adjustments. The present study aimed to develop a pharmacometric model‐based framework for recommending an optimal dosage regimen for lamotrigine in pregnancy. A systematic review was performed to obtain aggregate data from the literature on the clearance of lamotrigine in pregnancy. The data were incorporated into simulations using PUMAS software to estimate the plasma concentrations at the preconception stage and during the 3 trimesters of pregnancy. Simulated drug exposures for different doses were investigated to ascertain plasma concentrations similar to the preconception value and above the minimum effective concentration. The simulated mean steady‐state trough plasma concentrations of lamotrigine were significantly decreased in pregnant women over the course of the 3 trimesters (3.17 ± 0.93 mg/L, 2.14 ± 0.86 mg/L, and 1.51 ± 0.65 mg/L, respectively), compared with non‐pregnant women (4.31 ± 1.14 mg/L) (P < .001). The simulation studies revealed that doses of 150 mg, 175 mg, 225 mg, and 250 mg twice daily in the preconception stage and the 3 trimesters, respectively, achieve the target concentrations. Thus, the model‐informed dosage regimen of lamotrigine proposed in this study shall be used to initiate appropriate dosing in pregnant women; however, the safety and efficacy of the drug must be assured through therapeutic drug monitoring in order to avoid therapeutic failure of lamotrigine in pregnancy.