Objectives The present study attempted to explore the relationship between non-adherence with medication and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus (DM) in a private hospital located in South India. Methods A prospective study was carried out from January 2015 to December 2015. This study included 86 type 2 DM patients with diabetic peripheral neuropathy. The patients were followed-up for three months, once a month. Blood samples were taken to test for fasting blood sugar (FBS), postprandial blood sugar (PPBS) and HbA1c. A Morisky scale questionnaire was used to assess patients' medication adherence and a biothesiometer was used to screen the degree to which patients were affected by diabetic peripheral neuropathy. Patient counselling, which focused on the need for maintaining glycaemic control and the importance of medication adherence, was carried out during each follow-up. Results Of the 120 screened subjects, 86 patients were included in the present study. A majority (76.7%) were overweight, and 51% had DM for the past 11–15 years. ANOVA was used to compare patients' glycaemic status, peripheral diabetic neuropathy screening and medication adherence in all three follow-up visits, and p < 0.0001 was considered as significant. Significant improvement in medication adherence and reduction of the peripheral diabetic neuropathy severity ( p < 0.0001) were observed from patients' first to third visits. Conclusions Patient education is prudent for improving medication adherence, a result that can potentially promote optimal glycaemic control and can reduce the prevalence of diabetic peripheral neuropathy in patients with DM. Health-care practitioners play a pivotal role in educating the diabetic population about medication adherence.

Cancer chemotherapy-induced cognitive impairment (chemobrain) is a major complication that affects the prognosis of therapy. Our study evaluates the nootropic-like activity of levetiracetam (LEVE) against doxorubicin (DOX)-induced memory defects using in vivo and molecular modelling. Rats were treated with LEVE (100 and 200 mg/kg, 30 days) and chemobrain was induced by four doses of DOX (2 mg/kg, i.p.). Spatial memory parameters were evaluated using an elevated plus maze (EPM) and Y-maze. Additionally, acetylcholinesterase (AChE) and the neuroinflammatory biomarkers cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), nuclear factor-κB (NF-κB), and tumor necrosis factor-alpha (TNF-α) were analyzed using brain homogenate. PharmMapper was used for inverse docking and AutoDock Vina was used for molecular docking. LEVE treatment significantly diminished the DOX-induced memory impairment parameters in both the EPM and Y-maze. In addition, the drug treatment significantly reduced AChE, COX-2, PGE2, NF-κB, and TNF-α levels compared to DOX-treated animals. The inverse docking procedures resulted in the identification of AChE as the potential target. Further molecular modelling studies displayed interactions with residues Gly118, Gly119, and Ser200, critical for the hydrolysis of ACh. Analysis of the results suggested that administration of LEVE improved memory-related parameters in DOX-induced animals. The ‘nootropic-like’ activity could be related to diminished AChE and neuroinflammatory mediator levels.

Cancer chemotherapy is known to cause cognitive defects in patients. Our study investigated the effect of piracetam (PIRA; 200 or 400 mg/kg) against doxorubicin (DOX)-induced cognitive deficits in a rat model. The cognitive parameters were analyzed using elevated plus-maze, novel object recognition, and Y-maze tests. Acetylcholinesterase (AChE), neuroinflammatory mediators (cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), nuclear factor-κB (NF-κB), tumor necrosis factor-alpha (TNF-α)), apoptotic proteins (B-cell lymphoma-2 (Bcl-2), Bcl2 associated X protein (Bax), cysteine aspartate specific protease-3 (caspase-3)), oxidative parameters (malondialdehyde (MDA), catalase (CAT), and glutathione (GSH)) were also determined in the brain. PIRA administration offered significant protection against DOX-induced cognitive deficits in all maze tests and restored cholinergic functions via a significant reduction in AChE levels. Additionally, PIRA suppressed DOX-induced neuroinflammatory mediators (COX-2, PGE2, NF-κB, and TNF-α), pro-apoptotic proteins (Bax and caspase-3), and oxidative stress (MDA). Besides, it facilitated antioxidant (CAT and GSH) levels. Hence, our study highlighted that the neuroprotective activity of PIRA against DOX-induced cognitive deficits can be linked to reductions of AChE levels, neuro-inflammatory mediators, pro-apoptotic proteins, and oxidative stress.

No abstract

Objective: To compare the pharmacy students’ performance on an interactive web-based virtual pharmacy tool versus in-person objective structured clinical examination (OSCE). Methods: The academic performance of fourth-year pharmacy students in patient interview, counseling and medication dispensing were assessed using MyDispense, a virtual pharmacy practice online case scenario, versus physical OSCE. The grades of the same students in both exams were compared, and the students were administered a questionnaire to explore their perception of virtual experience after completion of the exercise. The internal consistency and reliability of the case scenarios and questionnaire were examined by calculating Cronbach’s alpha coefficient. Results: There was a significant increase (p = 0.01) in the average test scores of the virtual exam than the in-person OSCE. Similarly, female students had higher performance on virtual simulation than OSCE (p = 0.03). However, a comparison of the online MyDispense and OSCE assessment grades did not find a direct correlation (Spearman’s rho = 0.060). The results from the self-administered questionnaire demonstrated high students’ satisfaction and effective application of their knowledge through MyDispense for targeted patient interview, counseling and communication skills. Conclusion: The MyDispense virtual experience was well-perceived by the students as a useful online learning tool for pharmacy practice. However, there was no direct correlation between online and in-person OSCE assessment grades.