EDITORIAL..

Shifaclinpharm saw a very successful and eventful 2013 and as we move on to the New Year 2014, we have our roadmap set very clear with high hopes. The department has piloted continuing education programs for nurses, Pharmacists and other health care professionals. As part of these programs, few class sessions were held on ADR and MDR for the staff nurses of Alshifa hospital. The classes were well received by the participants and there was an extensive interaction on all the topics covered. Following every session, all participants were asked to provide feedback and the responses were overwhelmingly positive.

The chief minister of kerala, Mr. OommenChandi felicitated the Shifaclinpharm Newsletter and the details of the same are covered in the current issue. Four Journal club meetings were conducted by the department of pharmacy Practice and a certificate of appreciation was handed over to each participants. Students of Pharm.D received a great opportunity to witness a surgery in the ENT department and they described it as a great learning experience and also once in a life time opportunity. Their experience is highlighted in this issue of our newsletter.

Prof.Tarriq Sainudeen, a Research Asst from Canada, shared his experience of research and penned an article titled “Photodynamic Therapy (PDT): A new light to Cancer Therapy”which I believe will certainly give insight to the readers about the new approach to cancer therapy. Dr. Mohanta has contributed a thought provoking article entitled- “Revisiting Paracetamol”. This write-up focuses on the fundamental aspects of medical ethics, which will be an eye opener for regular blind users of paracetamol. I wholeheartedly thank the authors for their valuable article contribution in making our newsletter a success.

Our latest issue highlights on Pharma pulse, ADR bulletin, article on Vitamin-D, Department activities and detailed reports on free medical camp organized by Alshifa Hospital., report on IACP Etc. I sincerely hope this issue of Shifaclinpharm provides intellectual nourishment to all our readers. Keep reading!

Dilip. C,

Editor in Chief

Shifaclinpharmnews letter and clinpharmindia.blog

Member(WAME)World Association of Medical Editors

www.dicalshifa.org.

 

Glimpses Of Activities of Department.

                         Continuing education programme for Nurses at Alshifa hospital

       Launch of Resource material for Asthma and Paediatric epilepsy guidelines

                                Launch of pathophysiology quick review book

CREATING STEM CELLS WITH ACID BATHS

CREATING STEM CELLS WITH ACID BATHS

Scientists have found a way to create embryonic stem cells without introducing genetic material. The discovery could revolutionize medicine by giving doctors a way to repair diseased and damaged tissue. Just think about the situation , heart disease, blindness, skin burns-with organs and tissues grown from patient’s own cells.

Researchers have developed a way to create embryonic  stem cells by subjecting white blood cells to stress. This is negating the need for an embryo or introduction  of genetic material and bringing us a step closer to personalized medicine.As we all know cloning creates human embryonic stem cells. Recently researches has been done  by Haeuko  Obokata from the Riken center for developmental biology in Kobe,Japan.  They found that when  we  apply  various  stresses like bathing them in acid or putting  them in a low oxygen environment,nearly bring them to the brink of death, some of those cells lost their “blood identity” and reverted to a state equivalent to an embryonic  stem cell. They called those cells  Stap for Stimulus- Triggered Acqusition of Pluripotency

 When the scientists transferred the stap cells to a special growth facilitating solution,they began to multiply and look like stem cells,which can grow into any type of cell – skin,bone organ- depending on the environment into which they are placed. When the cells were injected to the mice embryo, they contributed the over all tissue of baby mice, which was found amusing to the researchers,

Not only this approach is more faster and far cheaper than the existing methods,but  it eliminates the controversy surrounding embryonic stem cell research, which  requires the destruction of an embryo, raising ethical concerns. The new approach also avoids the genetic risks of the alternative embryonic method called induced pluripotent stem cells.

Shamna sheriff

Second Pharm.D

PHARMA PULSE

 BY LINU MOHAN

ASST PROF

ALSHIFA COLLEGE OF PHARMACY

NANOPARTICLES TO TARGET  INFLAMMATORY CELLS

Any particle, less than 100 nm is known as nanoparticle. They are of great scientific interest as they are effectively a bridge between bulk materials and atomic or molecular structures. The inflammatory response (inflammation) occurs when tissues are injured by bacteria, trauma, toxins, heat, or any other cause.. In a normal immune response, neutrophils accumulate at an injury to act as the first line of host cellular defense against bacterial infection. 

But sometimes in chronic inflammation, neutrophils pile up at the location of the injury, sticking to the walls of the blood vessel and damaging the tissue. These pile ups are dangerous in lung injuries, where it develops severe breathing problems.

Non steroidal anti inflammatory agents and corticosteroids are the drugs nowadays using for management of this condition, which carry some significant side effects.

The recent study on nanoparticle resulted in the development of tiny pieces of protein that bind to a type of immune cell (neutrophils) responsible for acute and chronic inflammatory responses. They target the immune cells responsible for the chronic infection, without affecting normally functioning immune cells. The discovery reveals that nanoparticles can be used to deliver drugs in a highly targeted, specific fashion to activated immune cells. Thus it can used to treat a broad range of inflammatory diseases.

     

 (Nanoparticles from tiny pieces of protein that bind to a type of immune cell)

GEL FOR SEALING CORNEAL INCISION AFTER CATARACT SURGERY

A cataract means clouding of the lens of the eye. The condition is extremely common, and most cataracts are a result of the aging process. Although many cataracts are not significant enough to require treatment, surgical removal of cataracts is usually safe and effective, resulting in improvement of vision.

During cataract surgery, an eye surgeon makes a small incision in the cornea through which the patient’s natural lens is removed and the artificial lens is inserted. In many cases the incision is small and self-sealing after the artificial lens is in place. However, if fluid leaks from the incision, the surgeon may need to close the wound.  

Now the U.S. Food and Drug Administration approved the first gel sealant for use in stopping fluid from leaking through the incision in a patient’s cornea after cataract surgery with intraocular lens placement in adult. Prior to today’s approval, stitches were the only option for closing a leaking corneal incision after cataract surgery.

The Sealant kit comes as two liquid solutions that the surgeon mixes together just prior to sealing the incision. Using a foam-tipped applicator provided in the kit, the surgeon applies the mixture directly to the incision. Within 20 seconds of applying the liquid to eye tissue, a gel forms that adheres to the eye and seals the incision. The gel gradually breaks down over the course of seven days and is cleared from the body by the eye’s natural tears. 

                                                                                          

MEDICAL DEVICES FLOWING IN BLOOD STREAM.

Implantable devices powered wirelessly by electromagnetic radio waves are introduced. They are very tiny devices that they can travel through our blood stream. They reach the target site in the human body and perform various diagnostic and therapeutic procedures. It is useful in, performing microscopic imaging study of the target tissue, removing a blood clot etc.

 The discovery helps significantly to prolong survival of the cancer patients after being implanted at or near the site of tumor. By emitting targeted radiation at the malignant cells the device helps to avoid the deleterious effects of conventional radiation therapy for cancer.

  The existing devices, like heart probes, chemical and pressure sensors, cochlear implants, pacemakers, and drug pumps, would be stationary within the body. But this device could travel through the bloodstream to deliver drugs, perform analysis, and removing plaque from sclerotic arteries.

CLOBAZAM INDUCED DERMATOLOGICAL REACTIONS

CLOBAZAM INDUCED DERMATOLOGICAL REACTIONS

SHINU.C,

ASST PROFESSOR,

ALSHIFA COLLEGE OF PHARMACY

                              Clobazam is a benzodiazepine which affects chemicals in the brain that may become unbalanced and cause anxiety. It is used in combination with other medications to treat seizures caused by Lennox-Gastaut syndrome, a severe form of childhood epilepsy.

                              FDA is warning the public that the anti-seizure drug clobazam can cause rare but serious skin reactions that can result in permanent harm and death. Patients taking clobazam should seek immediate medical treatment if they develop a rash, blistering or peeling of the skin, sores in the mouth, or hives. Health care professionals should discontinue use of clobazam and consider an alternate therapy at the first sign of rash, unless it is clearly not drug-related.    

                              These rare but serious skin reactions, called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), can occur at any time during clobazam treatment. However, the likelihood of skin reactions is greater during the first 8 weeks of treatment or when drug is stopped and then re-started. All cases of SJS and TEN in the FDA case series have resulted in hospitalization, one case resulted in blindness, and one case resulted in death.

                        Patients should not stop taking drug without first talking to their health care professionals.  Stopping the drug suddenly can cause serious withdrawal problems, such as seizures that will not stop, hallucinations (hearing or seeing things that are not real), shaking, nervousness, and stomach or muscle cramps. 

                        clobazam may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking clobazam:

More common

·         Difficulty with swallowing

·         fever

·         shakiness and unsteady walk

·         unsteadiness, trembling, or other problems with muscle control or coordination

Less common

·         Change in speech pattern

·         restlessness

·         slurred speech

·         trouble sitting still

·         trouble with speaking

Some side effects of clobazam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Patient Information

·         Advise patient to check with health care provider before taking with other CNS depressants, including alcohol.

·         Caution patients about operating hazardous machinery, including automobiles, until they are reasonably certain that clobazam does not affect them adversely (eg, impair judgement, thinking, or motor skills).

·         Inform patients to consult their health care provider before changing the dose or abruptly discontinuing clobazam. Advise patients or caregivers that abrupt withdrawal may increase their seizure risk.

·         Counsel women to also use non hormonal methods of contraception when clobazam is used with hormonal contraceptives and to continue these alternative methods for 28 days after discontinuing treatment to ensure contraceptive reliability.

·         Counsel patients, caregivers, and families that antiepileptic drugs may increase the risk of suicidal thoughts and behaviors and advise them of the need to be alert for the emergence of worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts of self-harm. Instruct them to immediately report behaviors of concern.

·         Instruct patients to notify their health care provider if they become pregnant or intend to become pregnant during therapy. Instruct patients to notify their health care provider if they are breast-feeding or intend to breast-feed during therapy.