Background: The cornerstone of management of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS) infection is highly active antiretroviral therapy (HAART). However, antiretroviral drugs are highly toxic and are associated with various adverse drug reactions (ADRs). Therefore, many patients require the withdrawal of the drug or even discontinue the treatment resulting in the treatment failure. Aims and Objectives: To study the demographic details and type of ADRs in patients receiving ART and to do causality, severity, and preventability assessment of the spontaneously reported ADRs. Materials and Methods: This was a retrospective cross-sectional observational study conducted for 18 months from January 2015 to June 2016 in Rajendra Institute of Medical Sciences, Ranchi. Spontaneously reported ADR data were evaluated for the patient demography, type of ADRs, drugs/regimes responsible, and body system affected. ADRs were assessed for their causality, severity, and preventability as per the standard scales. Results: Out of 356 patients given ART 197 ADR reports received which showed slight male predominance. 86.80% cases fell in 25-54 years age group with a mean age of 38.38 ± 10.74 years. The majority were neuropsychiatric (29.44%) and gastrointestinal-hepatobiliary (24.87%) followed by hematologic, dermatologic, and metabolic ADRs. Regimen containing tenofovir, lamivudine, and efavirenz were responsible for maximum number of ADRs (49.23%) followed by zidovudine, lamivudine, nevirapine (23.85%). 88.85% of ADRs were possible, 9.14% probable, and 2.03% certain according to the World health organization-Upsala monitoring centre causality assessment. 67.51% ADRs were mild followed by 29.44% moderate and 3.04% severe. 21.82% ADRs were definitely preventable, 37.06% probably preventable, and 41.12% not preventable. Conclusion: Although HAART is effective in decreasing AIDS-related deaths, it is associated with a number of ADRs. To maintain the patient compliance judicious use of ART and continuous monitoring of ADRs and their effective treatment prevention is advocated.

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Background: Diabetes is one of the largest global health emergencies of the 21st century and its co-existence with hypertension is frequent. These conditions often require polypharmacy with possible risk of drug interaction. This study is conducted to investigate the effect of amlodipine on blood glucose level in euglycemic and diabetic rats and its pharmacodynamic interaction with glibenclamide.Methods: Rats were divided into six groups of 6 rats in each group. Group 1 and 3 were non-diabetic given 1% Gum acacia and amlodipine respectively. Group 2, 4, 5 and 6 were made diabetic by using nicotinamide and streptozotocin injection intra peritoneally and given 1% Gum acacia, glibenclamide, amlodipine and amlodipine + glibenclamide respectively for the period of 28 days. Fasting Blood Glucose (FBG) levels were measured before induction of diabetes, 72 hrs after the induction, on day 0, 7th, 14th, 21st and 28th day.Results: Amlodipine produced no significant effect on FBG level in non-diabetic rats but in diabetic rats statistically significant hyperglycemia were observed on day 21st and 28th of study with the ‘p’ value (<0.05). Glibenclamide treated rats shows better controlled FBG level throughout study than concomitant administration of glibenclamide with amlodipine. Significant rise in blood FBG level with ‘P’ value (<0.05) were observed in amlodipine + glibenclamide treated group on 21st and 28th day of study.Conclusions: This study suggest amlodipine produce no effect on the FBG level of normal rats but causes significant hyperglycemia in diabetic rats. Hypoglycemic effect of glibenclamide gets blunted when co-administered with amlodipine.

Hypertension is a risk factor for cardiovascular diseases which also causes progressive kidney damage leading to chronic kidney disease (CKD), so the rate of progression of CKD can be controlled by reducing blood pressure (BP). Many anti-hypertensive drugs are available. Cilnidipine is a new-generation calcium channel blocker (CCB). This meta-analysis is aimed to generate pooled evidence about the effectiveness of cilnidipine as an anti-hypertensive and to explore its reno-protective actions. Pubmed, Scopus, Cochrane Library, and Google Scholar were searched from January 2000 to December 2022 to include the studies. The pooled mean difference, along with 95% CI, was computed using Revman 5.4.1 software (Revman International, Inc., New York City, New York). The Cochrane risk-of-bias assessment tool was used for bias assessment. This meta-analysis was registered in PROSPERO with Reg. no. CRD42023395224. This metaanalysis included seven studies with 289 participants in the intervention group and 269 in the comparator group, and were selected from Japan, India, and Korea. Systolic blood pressure (SBP) was significantly reduced in cilnidipine treated group among hypertensives with CKD subjects weighted mean difference (WMD) was 4.33, and the 95% confidence interval (CI) was 1.26 to 7.31 as compared to the other group. Cilnidipine also shows a significant reduction in proteinuria with WMD 0.61 and 95% CI 0.42 to 0.80. Both groups were similar in adverse drug reactions (ADR). Cilnidipine is a more effective anti-hypertensive as compared to Amlodipine or other CCBs, mainly in reducing SBP. Besides this, cilnidipine also shows better reno-protective action because it also significantly reduces proteinuria in such patients.

Background: A regular and effective prescription audit is a key tool to ensure rational use of drugs and to assess drug utilization in the health care system. This study is first of its kind, in Rajendra Institute of Medical Sciences (RIMS), Ranchi, highlighting comparative assessment of prescriptions of online booked appointments in department of medicine and dermatology via online registration system (ORS) using WHO prescribing indicators. This ORS is an integral part under Digital India Initiative.Methods: This was a comparative, observational study conducted in Department of Pharmacology of RIMS, Ranchi. The study period was 6 months from 1 March 2019 to 31 August 2019. Prescriptions details of outpatient department (OPD) patients were collected from the government authorized pharmacy facility “Dawai Dost “at RIMS. 75 prescriptions from each of the departments were analyzed.Results: 75 prescriptions from patients who attended medicine and dermatology outpatient department (OPD) during the study period, after registering appointment via ORS, was collected and comparative assessment was done. This audit highlights important correctable parameters although legibility was not the major concern. Adherence to National List of Essential Medicines (NLEM) was 45% and 49% for department of medicine and dermatology respectively.Conclusions: The prescription audit process should be done regularly to assess ORS prescription to ensure high quality rational prescribing and support Digital India initiative. Adherence to NLEM of India should be 100%. The latest NLEM of India should be provided to the concerned departments and feedback should be provided to the physicians.