a a r ic p a h l indian pharmaceutical association

AnofficialStudents'PharmaMagazineINDIANPHARMACEUTICALASSOCIATIONSTUDENTS’FORUMCEUA TM ICR AA LH AP SN SOAI CD IANI TIE OH NT PANACHELIVETheme“WorkforceForFutureNeeds”

TheWorldHealthOrganization(WHO)estimatesthatthereisaglobalhealthcareworkforceshortageof7.2million,whichispredictedtogrowto12.9millionby2035.Globally, people are living longer with multiple co-morbidities and require increased access and use ofmedicines. Pharmacists are a key component of thehealthcareworkforce,andinmanycountries,pharmacistsarethemostaccessiblehealthcareprofession.Thispaperidentifieskeyissuesandcurrenttrendsaffectingtheglobalpharmacy workforce, in particular workforce distribution,country economic status, capacity, andworkforcegenderbalance.

pasf.org

AnofficialStudents'PharmaMagazinePANACHE LIVE

Greetings!ItgivesmeimmensepleasuretoknowthatIPA-SFisreleasingitsmagazine“PANACHE'”duringthe11thNationalIPAStudents'Congress-2020tobeheldatVignanInstituteOfPharmaceuticalTechnology,Vishakhapatnam,AndhraPradeshduring28th-29thFebruary,2020.IcongratulatetheEditorialboardofPANACHEandalltheofficebearersoftheIPA-SFandwishthemtoplayakeyrolewithsignificantachievementsandendeavorsinfuture.Thethemeofthe11thIPA-SC“WorkForceforFutureNeeds”beckonsleadersfrompharmaindustry,regulatory,academics,research,hospitalandcommunitypracticetobedeliberateandpresenttheirvisionandviewsaboutthemajorroleapharmacystudentcanplayintheimprovementofpharmacyprofessioninIndiainyearstocome.Dr.T.V.NARAYANAPresidentIndianPharmaceuticalAssociation

Letter fromPresident,IPA


Greetings!ItakegreatpleasuretoinkashortmessageforPANACHE,thenews-letterofIPASF.IPASFisstrivingthebesttoservethepharmastudentsacrossthecountry.IfeelhonouredtobeamentorofIPASFandtobeabletocontributemyknowledgeinguidingtheteamtotherightdirection.Inanattempttoenhanceinterestaboutpharmacyinstudents,theIPASFteaminitiatedthispublication-PANACHE.PANACHEconsistsofnew,interestinganduptodateinformationaboutthelatestissuesanddevelopment of pharmacy. This provides a platform for the exchange of information andcreativeideasforthestudentsacrossthecountry.IreallyappreciatethecollectiveeffortofpublicationteamandthestrongsupportofteamIPASFforbringingoutaproductivemagazine,beneficialforstudents.

LetterfromPresidentEducationDivision,IPA

Dr.S.VidhyadharaPresidentEducationDivisionIndianPharmaceuticalAssociation


Greetings,FewmemorableexperiencesworkingwithIPA&IPASFandtheirmajorroleinsupportingyoureachyourgoals/destinyIbelievethatwithmypastexperiencesin internationalstudentgovernmentbodieslikeIPSF,IPA-SF,andIPA,leadingeventsandcommitteesinvolvingAlumniengagement,andastrongpassionforservingthestudentsanddevelopingtheirbondamongsteachotherandwithAlumniledmetoembodyandrepresentthequalitiesofleadership,integrity,andinnovationthateventuallyinspiredotherstudentstoutilizetheirmaximumpotential.IstartedmyjourneyatIPA-SFasamemberoftheeditorialcommitteeforPanacheandIguessIneverlookedbackfromthere.MymostmemorableexperiencewasrepresentingIndiaat theIPSFStudentCongressheld inNetherlands and Portugal, and eventually becoming the Chairperson of the InternationalPharmaceuticalStudents’FederationWorldCongressin2015whichwasheldinHyderabad,India.Itrepresentedstudentleadersfrom60+countries.Itwasmyprivilege,alearningcurveaswellassomeofthebestdaysofmylifewhichallowedmetomakesomanyfriendsallovertheworld.Iamstillintouchwiththemandhopefullywillbeforlife!Motivation/message to thepharma fraternity (mainlystudents):Neverstopexploring!EngageyourselvesinextracurricularactivitiesandprofessionalorganizationslikeIPAandIPA-SFwhilestudyingtostrengthenyourrelationshipandconnectionwithasmanypeersaspossible.Theserelationshipsyoubuildwillbenefityouinthelongrun.Mymessagetoeverystudentwhoisstilltryingtoidentifytheirpathistobemore,domoreanddreammore!

LetterfromFormerChairperson,IPASF

NehaDemblaFormerChairpersonIndianPharmaceuticalAssociationStudents’Forum


DearReaders,LifeisalwayschallengingwhenyouhavetopavethepathforthebuddingPharmacistswhoenterthefieldofPharmacywithallthezealandallofourteamconstantlyworktoopenupnewavenues.Despiteofthehurdleswefacetheonlyworkforcethatkeepsusaliveisthestudentswhoalwayssupportusandalwaysbecomethepillarsofcommitments.AtIPASF,sinceIhavebecomeachairperson,learningformehasgotadifferentmeaning,Iadmirethepotentialanddeterminationofthestudentswhohaveprovedtheirexcellenceineveryphaseoflifebeitacademics,co-curricularactivitiesandmanyothers.Ibelievethatweneedtoput-forthourtrustinourstudentsastheyarethebrightfutureofourgreatnation.ForthatreasonweatIPASFbelieveinprovidingplatformsforourstudentssothattheycanshowcasetheirtalents,caliberandstandaheadofallothersintheformofPanache.

L e t t e r f r o m C h a i r p e r s o n , I PA S F

PragnaEllaChairpersonIndianPharmaceuticalAssociationStudents’Forum


DearReaders,ItgivesmeanimmensepleasuretopresentthefirstissueofPanacheofmytenure2019-2020.BeingtheEditorofoneofthestudents'bestorganisationIPA-SFisitselfanachievement.I'mhappythatIPA-SFhasgivenmeaplatformtoshowcasemycreativityinthefieldofwords.I'moverwhelmedwithmy journey frombeing an editor of TimesOf India to editor of IPA-SF.PanacheisthebestPlatformforallthebuddingpharmacisttoshowandsharetheirknowledgeandcreativity.Istronglybelieve"GainingknowledgeisthefirststeptowisdomandSharingisthefirststepoflearning."ThiseditioncontainsthecreativityintheformofYoungPharmacistMind.Itcoverstheaspectofpharmacyintermsoffutureworkforce.Thisworkwouldn'tbepossiblewithoutthesupportofIPA-SFteam.IhopeandIwishPanacheisreceivedwellandlovedtoberead.SwathiPEditorIndianPharmaceuticalAssociationStudents’Forum

L e t t e r f r o m E d i t o r, I PA S F

CallforAbstracts.................................................................................. 53UpcomingEvents.................................................................................. 52

AnInternalPortfolio(2019-2021).......................................................Wanttojoin:7reasonstojoinIPA-SF.............................................. 12MediaandPublicationGratitude........................................................ 13IPA-SFCollaborationforNPW........................................................... 22MateriovigilanceProgrammeOfIndia.............................................. 37-39RoleOfPharmacistinPatientCounselling........................................ 40-44SpecialEditonOnCoronavirus........................................................... 45-48

ChairpersonExperienceinSouthKoreaatAASP............................ 23ProudcontributionOverseas............................................................... 24YoungresearchersMinds..................................................................... 25-29

9-11HowIPASFcanchangethePharmacyeducation.............................. 14-152018-2019IPASFHighlights................................................................ 16-17 InterviewwithDr.KrishnaElla-ChairmanandManagingDirectorofBharatBiotech.................................................................. 18-20

TreatmentOfNeuropathicPain.......................................................... 30-32PharmaVision2030:TheIndianIndustry–AGlobalLeader........ 33-36

DecennialCelebrationsofIPA-SFFormationDay.............................. 21

RattleYourBrain…….QuizTime…….............................................. 50StudentExchangeProgramme............................................................ 5149ChallengeYourMind……PuzzleTime..............................................

InsidetheIssue…. AnofficialStudents'PharmaMagazinePANACHE LIVE

AnInternalPortfolio(2019-2021)

RennyRozario:ViceChairperson(South)

Abhishek.A.Datta:ViceChairperson(West)MyjourneyinIPAasawholewasabiglearningcurve.IstartedasamemberofthefinancecommitteeofIPAMSB-SFwhichledtome leading the whole finance committee as a head. After asuccessful Rx 2019 under my leadership, I got enoughconfidencetoapplyforIPASF.Also,IPASFrecognisedmyskillsandgavemetheopportunitytobetheViceChairperson.ThisjourneyhasjustbeenapproximatelyayearbuttheamountofsheerknowledgeandexperienceIgainedishuge.IgotachancetoaddressstudentsacrossIndiaatIPC2019inChennai.IhopeIPASFwill promotemy social aswell as professional growth.Also,IwillstrivehardtoupholdthehighstandardsofIPASF.

"Riskmorethanwhatothersthinkissafeanddreammorethanwhat others think is practical". Being a Vice Chairperson Ialwayscareaboutthewell-beingofthegroupandItacklewithallthechallengestheyfaceanddealthemwithutmostcareandtrytoresolvethematearliesthour.Ifeelit'smyprivilegetobeinStudentsForumwhereweworktogethertofosterupthenewavenuesforthebuddingpharmacists. IqraAther:ViceChairperson(North)Keepingthisquoteinmind,I,asavicechairpersontrytointegratethedifferentrealmsandbringoutthebestofeverymemberinteam.BeingapartofaprestigiousorganizationlikeIPA-SFhastaughtmetokeepmyfeetonthegroundwhileaimingforthestars.IPASFisanunbiasedplatformforanyenthusiasticstudentwhowants towork towards thebettermentofpharmacyasahealthcareprofession.I'mhonoredtobethevicechairpersonofnorthzoneinIPASFandamazedtobeapartofsuchaunitedteam.Ilookforwardtoworkinthedirectionwhichmaintainsthenameofourorganization,IPASF.

SumitDas:ViceChairperson(East)AsbeingapartofIPASF,Iamhonoredtotaketheresponsibilityand provide the best opportunities for all pharmacyprofessionalsandraise theirvoices for their rightsandunitestudentstogethergloballytoshowtheirpotential.


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Being Positive in a Negative Situation is not a Naïve; it's aLeadership".Itgivesmeprideandhonortobethesecretaryofsuch a prestigious association. I feel highly responsible ofholding up a position like this. I bridge the gap betweenmembersofourteamandgetthemworkingasateam.Istrivefor theprogressofourpharmastudentsandourprofessionalongwithourcouncil.MyjourneywithIPA-SFhassculptedmeintoabetterpersonandhaspreparedmetofacetheworldthatposesmewithnewchallengeeachday,whichismypromisetothefuturepharmacists.WepromisetomouldandsculptyouthroughIPA-SF.#TogetherWeStand

LikhithaTadituri:JointSecretarySuccessissweet,butthesecretissweat.Thesearethewordsweneed to remember always for the upliftment of ourselves. Myjourney in IPASF has been very memorable and I'm lookingforward for many as such. Being a Joint secretary I take theresponsibilityofmaintainingalltherecordsofouractivitiesandhandling all the information carefully. I feel responsible forcheckingthecoordinationinbetweenourteam.I'llmakesurethatall themails andqueriesputby students andotherpharmacyprofessionalswillbeansweredontime.I'llensurethatI'llworkhardfortheupliftmentofourteamandI'mgladtobeamemberofIPASF. IshaAggarwal:AssociateEditorPutyourheart,mindandsoulintoevenyoursmallestacts.Thisisthesecretofsuccess.Iamhonoredtotakethisresponsibilityandobliged tobe thepart IPA-SF. Ihavebeenapartof IPAstudentforumfrompast2yearsworkingastheactivememberinIPA-DSB. With thorough enthusiasm and perseveranceplanningtobroadenawarenessthroughIPAtohelppharmacystudentstoattainalevelofexorbitantenthusiasm,insightandapprehension. RaviChandraCV:ContactPerson"Coming together is a beginning, keeping is progress andworkingtogetherisasuccess".AsaexecutivecouncilmemberofIPA-SF,Icontributefortheeffectivemanagementandsmoothrunningof thecouncil inaefficientway. Istronglybelieve inbuilding and promoting professionalism and social contactamongst the pharmacists fostering competence andprofessionaldevelopment.Imainlyinvolveinmaintainingandexpandingthenetworkofpharmacystudentsworldwideandworkfortheirbetterment. RahamthullaShaik:TreasurerIfeelitasanhonorforbeingapartofIPASF.AsatreasurerIamresponsible for Financial oversight, annual budgetmanagement,Ensuring thecompletionof financial reportingformsandactingasfinancialliaisonamongboardmembers.Ibelieve in " A good association is a half success ". I feeldelightedtobeassociatedwithsuchapassionateteamIPASF.

AdityaSrinivasKambala:Hon.SecretaryAnofficialStudents'PharmaMagazinePANACHE LIVE

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AnnaThomas:PublicRelationsOfficerIt'smyprivilegetobeapartofIPA-SFandtoworkasateamfortheupliftmentoftheyoungpharmapeople.BeingthePRO,Ihave to forma strong relationswith thepublic especially inhandlingalltheaspectofpubliccampaigns.Theabilitytobuilda professional network is the crucial skill that should bemaintained. IPA-SF is a great platform for the students toexpressthemselvesandtoenhancetheirprofessionalstatus.

BharatTyagi:StudentExchangeOfficerIamverymuchthrilledandobligedtobepartofsuchesteemedorganizationwhichnotonlycaterstotheneedsofthepharmaindustry but also keeps in mind the need for empoweringstudents so that they can excel in life and do good to thepharmacyprofessionasawhole.IPASFprovidesbestplatformforpharmastudentstoindulgeinactivitiesandshowcasetheirtalentsonaNationallevel.Iamobligedtodomydutytomybestpotential.#TogetherWeStand

HarishKumarSingh:PublicHealthOfficerThe field of pharmacy is constantly expanding and being amemberofIPASF,Itaketheprivilegeandopportunitytolookforwardtolearnnewtechniquesandexplorenewdevelopment.I have been a part of IPA student forum from past 6 yearsworking as the active member in IPA-BIT. I believe it's oursolemnresponsibilitytotogetherbuildpharmacyasahealthyprofession.

YogendraKanchapu:PharmacyEducationOfficer"Youreapwhatyousow".Educationistheonewhichmakesyousufficientandskillsaretheonewhichmakeyouefficient.BeingPharmacyEducationOfficer,Iconcentrateoneventsforadvocacy of traditional education, whilst promoting thedevelopment of supportive skills in the pharmacy studentcommunity.Weconstantlythrivetobeinpaceacrosstheglobalhorizon.Weunderstandtheneedforequalityforeducationandthroughoutourlivesandmostimportantlywebelieveingivingeverypharmacistaopportunitytoearntheliving.


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Wanttojoinus 7ReasonstojoinIPA-SF:

IPAOOSF AssociationStudents’Forum Official_ipasf

1. IPASF is composed of 24 states which includes more than 3 lakhFriendship:pharmacystudentswhogatherupatanyPharmaevent.2. ByparticipatinginvariousIPA-SFGeneralandregionalevents.Exposure:3. BybecomingapartoftheIPASFteamLeadershipandprofessionaldevelopment:or through leaders in training and Patient Counseling, Clinical Skills, andCompoundingeventsandcompetition.4. Throughpublishing inour regularly released IPASFNewsletterPersonalgrowth:PANACHE,ourscientificpublicationPharmaTimes.5. By improvingpublichealthwithopportunities forcampaignPublicengagement:organizationandimplementationona local levelandengagement in internationalaffairsandissuesimpactingpharmacystudents.6. By receiving national level awards for high involvement in IPASFRecognition:Activitiesthatimprovepublichealthandpharmacyadvocacyonnationalscale.7. Through joining Student Exchange Programme. ByCultural competency:communicating with people of different background one can have a soundknowledgeabouttheprofession.


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IPASFIPASFofficialofficial_ipasf IPA_SF

IPASF

IPAOOSF AssociationStudents’Forum Official_ipasf


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MediaandPublicationGratitude……Thankstosocialmedia!Socialmediaisapartofourdailylife;wecannotimagineourlifewithoutit.Wethemillennialliveonsocialmedia;ithasaccomplishedalotofamazingthings.Okay…tostartwith,doyouuseFacebook,Twitteroranyothersocialmediaplatform?Hold on if you are reading this you have probably known this byclickingintooneofourIPASFs’socialmedia.Socialmediaimpactedoursocietyandourgenerationlikenoothereverbefore.Let'shaveapeepintothepast…shallwe?IfIwouldsaysomebodyfromthepastthatwecansitunderthesameroofandworkflawlesslyandeffortlesslytogetheron various projects with different nationalities. Well, he would just say it isimpossiblekeepinginthedistance,languageandpoliticalissuesasobstacles.Inthepast, the interactionwas restricted. The strangerswere consideredas athreat.Ourcommunicationwasrestrictedtofamily,friendsandneighbors.Howcana student fromMadhyaPradeshwill know theworkof students inKerala?Howstudents fromdifferentstatesworktogetherwiththesamegoal"togetherwestand."Weareintheerawerelearningismadeeasyandinteresting.ThankstosocialmediawhichhelpedIPASFtogrow...tobeknown!Wereachedtothestudentsacrossthecountrythroughsocialmediaplatformsandacknowledgedthatweshare the samepassionandcommitment towards thepharmacyworld. Theworld is for young students like us let's work together and pave our futuretogether.

HowIPASFcanbringchangeinthepharmacyworld……IPA-SFpromotethescienceandartsofPharmacyinallaspectsandworkforitswelfare on a broader picture. It impartsuitable education and training to thememberspreparingfortheprofessionofpharmacyortothosealreadyengagedintheprofessionandtoundertake,carryonor promote scientific and technicalresearch, experiments and tests of allkinds in pharmaceutical and alliedsciences. It provides amedium to editandpublish,journals,books,magazines,documents and other publications forpromotingthecausesoftheprofessionofPharmacyand finally to hold seminars,symposia, conferences and exhibitionsforpromotingthecausesofprofessionofPharmacy.The major challenge faced by thepharmacists in India is reorganization.Theserviceprovidedbypharmacistsatvariouscapacitiesgoesunnoticed.Thereare many burning issues like cadreformation, promotional channel, gradepayand recruitmentundergovernmentestablishment, job security, pay andworking environment etc, in privateestablishment. At present, IPA is thelargest association of pharmacists inIndia.Soon,wewill haveourpresenceacross the country. IPA-SF will enablethem to become the better futurepharmacists, while abiding with thehighest eth ical and professionalstandards.Thiswillbecatalyzingoveralldevelopment, honing their academic,

leadershipandprofessionalskillsfortheirbenefitinturntheprofessionandthusthehealthofINDIA.IPA-SFeversinceitsinceptionhasbeentrying to bring all pharmacists andpharmacy associations together, underits umbrella, as IPA-SF believe that aunifiedvoiceisrequiredtocatertoallthemajorissuesbeingfacedbypharmacistfraternity today. The association isworking on the grade pay, cadreformation and promotional avenues.There has been very little scope forpharmacy graduates. We have beenrepresenting thegovernmentatvariouslevelstoaccommodatethisvastpoolofprofessionalsfortheirambitiousprojectslike rural health/ community healthprogrammes.Takingseriousnoteonourdemands,thegovernmentinitsnationalhealth policy has incorporated thepharmacistsasoneoftheprofessionalstobetrainedforhandlingpatientsattheprimarylevels.IPAiscurrentlylookingforthe permanent recruitment of variouspostsofpharmacistslyingvacantorarefilledoncontractbasis.IPA-SFmadeahugeimpact;firstlytheywonthe'BestStudentForumintheWorld'award, indicating the recognition byglobalcommunityofstudents.Throughthe i r assoc ia t ion w i th IPSF andparticipating in theworldcongress, theIndianpharmacystudentswillgainskillsets such as strong networking,

AnofficialStudents'PharmaMagazinePANACHE LIVEAnofficialStudents'PharmaMagazinePANACHE LIVE

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AnofficialStudents'PharmaMagazinePANACHE LIVEunderstandingglobal scenarios, opportunities for career enhancement, leadershiptraining and development of organizational skills. They will also understand theimportanceofhavingaconstitution,valueofstronginternaldemocracyandplannedwayinwhichorganizationscanrun.AllthesewouldhelpourstudentsbuildaverystrongIPA-SF.Participationintheworldcongresswouldhelpstudentslearnhowtovoicetheiropiniontotherightpeopletogetthemuch-requiredexposure.ThroughthisworldcongressourcountryandourculturewouldgetbetterexposureleadingtoastrongerrelationshipbetweenIPSFandIPA-SF,whichwouldopendoorsforourstudentstoWHOandUNthroughIPSF.IPAhasaverybroadagenda,ofwhichindustryisanintegralpart.IPAwouldliketomakealleffortstobringaboutaculturalchangeintheindustrythatwouldpromotequalityawarenessineveryaspectanddevelopapatient-centricfocus.IPAwouldliketoworktowardsdevelopingthefuturepharmacistsfullyequippedwithknowledgeaboutcurrentandfuturerequirementsthroughconstantinteractionswithallstakeholders.IPAenvisages its role in thedevelopmentofcommunityandhospitalpharmacists,whichwouldplayamajorroleincreatingabetterhealthcaresysteminourcountry.


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AnofficialStudents'PharmaMagazinePANACHE LIVE Highlightsof2018-2019Expert session on “Challenges and opportunities forpharmacy practice in India and abroad”at MalibaPharmacyCollege.MalibaPharmacyCollegeorganizedonedayexpertsessionon“ChallengesandopportunitiesforpharmacypracticeinIndia”and“PharmacyeducationatuniversitiesinUSA”on18thJanuary2019.TheguestspeakerwasDr.M.ChandraSekar,Professor,DepartmentofPharmaceuticalScience,UniversityofFindlay,USA.ActivitiesofIPA-SFASNPharmacyCollegeChapter1.WorldLeprosyDay:OntheoccasionofWorldLeprosyeradicationDay,ASNPharmacycollegeinassociationwithGretnaltesReferralCenter,Morampudi,APconductedawarenessprogrammewiththepatientsinthehospital.Studentsdonatedblanketsandmedicinestothepatientsinthisevent.WHOGoodWillBrand Ambassador of Leprosy Eradication “YoheiSasakawa”andhisteamattendedthisevent.2.WorldCancerDay:ASN Pharmacy College, organised an awarenessprogrammeforschoolstudentsatNehruNiketanSchoolatTenali.StudentsofASNPCalongwithIPA-SFNationalCouncil members, Pragna Ella and Manideep hadconducted an awareness lecture on “Types ofCancersanditPreventiveMeasures”to9thstandardstudentsandconductedQuizandDrawingCompetition.On the occasion ofWorld Kidney Health day, we haveinvitedDR.K.V.NarendraM.S,M.Ch.,toconductguestlecture for the kidney health to the students and othercollegemanagement.WeconductedEssayWritingforthestudentson“KidneyHealth forEveryone” toencouragetheawarenessaboutKidneyhealth.3.WorldKidneyDay:

AwarenessrallyatParulUniversity,Vadodara(Gujarat)inassociationwithIPASFontheoccasionofAIDSday16

AnofficialStudents'PharmaMagazinePANACHE LIVE FreemedicalcampondiabetesatIPASFPatnaChapterActivityatVIGNANCollegeDuvvada.Ahealthyvillageprojectpromoteslocalactionsbythecommunitymembers, mobilizing human and financial resources to buildhealthy environments and promote healthy behaviours. Thisguideisintendedtoprovidecommunityleaderswithinformationtoassisttheminimplementingandsustainingahealthyvillagesproject.Itcoverstopicssuchaswaterandsanitationdrainage,domestic and community hygiene and provision of healthservicesprovidingextensivesourcematerials.ActivitiesatCHIPSChapterCHIPSOIREE2019:CHIPSOIREEisaninter-pharmacycollegecompetition.Apart fromacademicswewanttobringthebestinculturalevents.Weconductedseveralevents.Awardedthewinners.CurrentAspectsonQuality&IndustrialOrientationTrainingbyPTI(17-19June2019):MEDICALAFFAIRSWORKSHOP:AOneDay-"MEDICALAFFAIRSWORKSHOP"wasorganisedbyCHIPSinassociationwithAccreditationCouncilforMedicalAffairs(ACMA),IPA,EducationDivisionandIPA,AndhraPradeshStateBranch.Dr.SakaramGarale,Head-SouthEastAsia,ACMAconducted theworkshoponthetopics-Insightsoncurrentmedicalaffairs,EvolutionofmedicalaffairsinpharmaandMSL:Akeystakeholderinnewagemedicalaffairs.StudentsChapters......Ourlittlesteps.1.ASNPharmacyCollege,Tenali,AP.2.ChebroluHanumaiahInstitueofPharmaceuticalSciences,Chowdavaram,Guntur,AP.3.VignanPharmacyCollege,Vadlamudi,Guntur,AP.4.VVIPS,Gudlavaleru,Krishnadistrict,AP.5.AnnamacharyaCollegeofPharmacy,Rajampet,AP.6.ViganInstituteOfPharmaceuticalTechnology,Duvvada,AP.7.VikasCollegeofPharmaceuticalSciences,Suryapeta,Hyderabad,Telangana.8.VijayaInstituteofPharmaceuticalSciencesForWomen,Vijaywada,AP.9.VIPER,Narasapur,Hyderabad,Telangana. 17

AnofficialStudents'PharmaMagazinePANACHE LIVEAnInterviewwithDr.KrishnaEllaChairmanandManagingDirectorofBharatBiotech.

WellhaveyouallheardaboutZIKAvirusandhowitcreatedapanicamongpeople....thankstotheeffortsofIndianEntrepreneurwhohasdevelopedWorld'sfirstZIKAVaccine.Wewereprivilegedtotaketheinterviewofsuchaninspirationalpersonality.

Q.Whatisyourbirthplace?MybirthplaceisChennai.Tiruttaniismynative place. Nemili about 60kms fromChennaithat'smybirthplace.Q. Is there anything that you arepassionatesinceyourchildhood?InmychildhoodIwaspassionateaboutscience. I was always inspired byscience.SinceI'mfromfarmingfamily,Ialways looked up to farmers problem.Howmuchthefarmersstruggleandthattoomymothershewasworkingsohardtomake the familykeepgoingand I'veseenthehardship.

Q.WhomotivatedyoutostarttheBharatBiotech?Bothmymother andmy wife. My wifewanted tocomeback to India.She feltthat we didwell enough inUS let's dosomething for our society (India) eitherjoborwhateveritis.Andmymothertoldme one simple thing "son you have 9inches stomach how much ever youmake inUS you cannot eatmore than9inchesstomach…comebacktoIndia.IhavemyagricultureI'llfeedyour9inchesstomach..Iwon'tletyoustarveevenforasingleday.I'llfeedyoutillI'malive.Youdowhateveryoulike."18

Q.Whytheriskofinnovativecompany?Innovativeisalwaysarisk.Thechanceofsuccessisonlyfewthat'swhyinnovationcreatesmoreriskthananyothergenericbusiness.Q.WhydidyouchosetoestablishyourbusinessventureinHyderabad?It happened by chance. Initially I hadplanned on setting up my venture inBangalore but due to certain turn ineventsIchosetheHyderabadcity.AndnowwhenIthinkofitIfeelitwastherightdecision and it might've also been areasonforthesuccessofBharatBiotech.Q.Whatareyoupassionateaboutinlife?I am passionate about science andtechnology.Thesetwofieldshavealwaysdrawnmyinterest.Iwantedtousetheseinterestsinservingthepeople.Q.Canyoutellustheaccomplishmentsthatchangedyourcareer?I'm basically an agriculture graduatenowhereconnectedto thevaccinefieldandIneverunderstoodwhatavaccineisbutwhatconnectedmeistheskillsetinUS.TheskillsetwasIwasamolecularbiologist. Gene knock out and Geneexpression.Icantakeoutthegeneandputthegeneback..andI'vedonemyPhDinAnalyticalThinkingprocess.Thesetwothingshelpedmetoshapeuptosoughtofunderstandthebusinessangle.Q. What changes would you like tosuggestforpharmacyeducation?Pharma is an amazing science it reallyconnects the chemistry and biology.

What I'msurprised iswhytherearenotmany start ups in pharmacy alone.Wehave many engineering starts ups…sowhat is missing? I really want tounderstandthereasonbehindthisandIwant to ta lk about th is wi th thestudents….whatisgap?Isittheskillthatismissingortheconceptualthinkingthatismissing.Wecandoalotofbusinessesin pharmacy. People think business isaboutthemoneyincrores…startfromasmallsetupandbuildon.Thinksimple.Thestepsaresmallbutthejourneywillbelong.Useyourskillandbuildthingsyou’llgettheconfidence.Q. As a leader what all the qualities astudentshouldposses?Whateveryouaredoing..youdothebest.That’scalledaleadership.Youuseyourskill set and imagination to solveproblemsofthesociety,Formethatistheleadership.Oneshouldhaveapassiontosolveproblems.Itisanacquiredthingtohelpthecommunity.Q. Hard work or luck which onesupportedyousir?Onlyhardwork. I don’t believe in luck.Luck is for people who believe inastrology.Formeworkisworship.Q.HardworkorSmartwork?Thereisnosmartworkifyoudon’tworkhard.Whenyouworkhardyou’llbecomesmartinworkingassimpleasthat.Q. Do you think the fresher who isgraduating from thecollegeshouldgetsomeworkexperienceand thenstarta


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business or all the academic skills areenoughtodirectlystartthebusiness?Ifthekidshaveideasfromthebeginningthenthereisnoneedforworkexperienceandjusttryitout.Somekidstheygettheideaaftergettingintoworkspace…soitall depends. Experience will be helpfulany day. Can I think of becoming anentrepreneur after my university? No. Ihad th is idea a f ter my teachingexperiencewhenIworkedasafaculty.Q.Whatdo youwant to say about thebudding pharmacist coming out thecollegewhoareinterestedinresearch?Pharma has become too centric frompharma.Yourdegreemaybepharmacybut you study a lot of things likemicrobiology, organic chemistry so onand so forth. One can get into variousfields like food companies, vaccinecompanies or d iary sc iences. Apharmacystudentcancontributebetterinthisfield.Drugmakingisnottheonlythingshould thinkabout thealternativepaths.Explorethenewareasofsciences.Research th ink ing is miss ing inpharmacythatmeanstheskillsetisnotgood.Shouldhavethecoreknowledge.Gettheindustryexposure.DothePhDsget into companies. Work on theanalyticalskills.Q. Do you think degree matters morethanworkexperience?Both matters. It’s like whether gooddriving is enough or need the license.Onlygooddrivingwillnothelpyouneedboth.

Q.Ifyouaregivenwithachancewouldyouchangetheprofession?I change my profession in every 2years…Ichangedfromhumansciencetoveterinary science….now veterinary tofoodscience.Idon’tlikedoingthesamething…change is the only constant forme.Q.Whatmessagedoyouwanttogive?Focusandskillsetisallyouneedtogetinto the new generation economy. Weneed more pharmacist with researchthinking.


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PharmacyWorldAStudents’PerspectiveeventontheoccasionofDecennialCelebrationsofIPA-SFFormationDayThe student forum members of TheIndian Pharmaceutical Associationreceived the responses from studentsfromall the fourzones throughout thenation-North,East,WestandSouth.Pha rmacy Wo r l d - A S t uden t ' sPerspective (PW -ASP) was a videochallenge event for students for B.Pharm,M.Pharm and Pharm.D.Thestudentscreatedavideowithadurationof3minutesexpressingtheirviewsonthetheme along with answering twoquestions in particular. The questionswere“Whatwastheproudestmomentforyou being a pharmacist?” and “Whatmakes pharmacy a unique and nobleprofession?'’50participants in total fromallover thecountry:-1) 8participantsfromNORTHZONE2) 40participantsfromSOUTHZONE3) 2participantsfromWESTZONE.

Thewinnersofthiseventare:-1) Dhirajmehta,B.NUniversity,Udaipur(North)2) GeethaMallika,ShriVishnuCollegeof PharmacyWestGodavari district(South)3) AnjanaV.Dinesh,SRIPMS,TamilNadu(South)4) ReshnaNair,ParulUniversity,Gujarat(West)Thesewinnershavebeenrewardedwitha memento and a ce r t i fica te o fappreciation and also complimentaryregistration for PHARMARIA-2019 atDelhi.


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IPA-SFcollaborationforNPW......IPA in collaboration with IPA-SF hadorganized a “Comic Poster MakingCompetition”, “Patient counseling VideoMaking Competition” and “Leaflet MakingCompetition” on the Occasion of 58thNationalPharmacyWeek.WinnersgotanE-Certificate,CashReward,andacopyofIPAPublications.


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MyExperienceat9thAASP,Suwon,SouthKorea...ChairpersonIPA-SFTheIndianPharmaceuticalAssociationandIgoalongwaybackwefirstmetin2015asadelegate at IPA-SF World Congress atMarriott,Hyderabad.DuringmyprogressiveyearsatIPA-SFIhadgottheopportunitytoworkasvolunteerforfoodcommitteeat68thIPCVishakapatnamwith the help and guidance of excellentmentorslikeDr.T.V.NarayanaSir,Dr.RaoV.S.VVadlamudi.IgottheopportunitytoapplyforthepositioninIPA-SF.FinallynowIamtheChairperson to IPA-SF 2019-2021. I amgoingtosharemyexperiencein9thAASPatAjou University, Suwon, South Korea. I

remember thedaywhen Ifirst receivedanemail notifying that my application gotselectedforAASP–2019Travelgrant.I am so thankful to T. V Narayana Sir,President of IPA for givingme the goldenopportunitytoattendtheconference.AsianAssociation of Schools of Pharmacy is aplatform to connect and integrate thediversityintheworldofPharmacyandcreatetheopportunityforgenerationofnewideasblend of cul tures and exchange ofknowledge. It was definitely moment ofcrowing glory for India at the 9th AASPSuwon,SouthKorea.TheAASP2019onJuly3rd-5thturnedtobeaneventthatIwillcherishandholdinstantfortherestofmy life. Iwassimplyamazedtoexperience thescaleof thisevent. IPAhassponsored me 25000 rupees check to

participate in this conference as an IPA-SFrepresentative.Whileintheconference,thefirstday(July3rd)isapre-conferencewhereallthespeakersexplained about the regulations in theircountriesalloverAsiawhereasthe2ndand3rd day were blended with a informativelectures by the international speakers andeminent personalities like Dr. V. S. VVadlamudiandDr.T.VNarayanaSir.gaveanexcellentlecturesoneducationperspectivesin India on the 2nd day poster entitledevolutionofHepato-protectiveactivityofEmoOil.Asapartoftravelgrant,theyofferedfreeregistration,food-75000KRWcashandaniceaccommodation.Ienjoyedthediversitythatsuchacongresshadofferintermsofculturesand collaboration between students andprovidedarichlearningexperience.Finally,Iwanttothanktwoimportantpersonsbeh ind my journey, A . S iva KumarCorrespondentASNGroupofInstitutionsandDR.K.VenkataRamana,ASNPC,Tenali,CECMemberIPAaswithoutthosepeoplesupportand suggestionswouldn't be able tomakethistrip.Theyaremyinspirationandallowedmelookatourpharmacycareerinadifferentlight.Allinall,itwasanunforgettableconferenceandIsuggesteveryIndianstudenttotryandattendatleastoneInternationalConferencein their student life to experience ourPharmacyasaglobalcelebration.PlatformslikeIPAandIPA-SFsupportstoreachnewerheightsinourprofession.VivalaPharmacie"!"


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SatyavardhanRaoNittuPharm.DIntern

AryaCollegeofPharmacy,Telangana.

AkhilaDadwai Pharm.DIntern

AryaCollegeofPharmacy,Telangana.

ProudContributionOverseas…..WearethefirstPharm.DinternsfromIndiabeingselectedfortheInternationalVisitingResearch Scholars program at University of Florida in the Department ofPharmacotherapy and Translational Research for a short-term research trainingprograminPharmacogenomicResearch.OurResearchfocusesonCRISPRLibraryscreeningforIdentificationofnovelDrugTargetsandDrugDiscoveryinAML;PharmacogenomicsandToxicitiesofAnti-cancerDrugsinAML.Other activities involved:Weekly Journal Club Presentations, LabMeetings, Topicdiscussions,Conferences.ThistypeofinternshipsareidealforstudentswhointendtopursuehigherstudiesandestablishthemselvesinthefieldoftranslationalResearch.


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YoungPharmacistMindsPOLYPILLINCARDIOVASCULARDISEASE Contributedby:NiharikaToom;St.Peter'sInstituteofPharmaceuticalSciences,Warangal,Telangana.Theconceptofpolypill inCADpatientswhichwasproposedinacitedpaperofwaldandlawinyear2003.Itistoreducetheburdenofpolypharmacyandimprovethe adherence of cardiovascualardiseasepatients.Theyintroducedthepolypillcomprisingofsixdrugs(aspirin,statin,betablocker,angiotensinconvertingenzymeinhibitior,diuretic,folicacid)bythis80%ofpatientburdencanbereduced.Theresearchwasdoneoverdecadesforthe outcomes ofmaintaining the bloodpressure, cholesterol, clot busters toreduce the mortality and morbidity ofCVDpatient.Thisreviewconcludesaboutprospectiverole of polypha-rmacy burden andadherenceofpolypillinCADpatients.SUMMARYOFARTICLE:Thelastyeardevlopmentofpolypillhavebeen witnessed in clinical trails for thepreventionofCVDwithminimumofoneanti hypertensive drug along withantiplatelet and statin. Most of thepolypillswereincurrentresearchwhichiscomparedwithplacebotrialsweredone

to calculate the adherence, prevention,burdenofmedication,riskassessmentsand adverse effects of drugs in CADpatients.STR N T OLYPILLE GH SOFPADHERENCE: Management of CAD isalarmingchallengefortheadherencetomedicationinlong-termusagepatients,unknowledgable patients, patients whowereasymptomatic,overconfidenceandnegligentonhealth.Thepolypill is introducedtoreducetheburden of polypharmacy and increasethe adherence of the patients andconfirmed by the long-term researchstudies.Inperiodof12weeks,twoshorttermstudiescompared thepolypillandplaceboshowedthehighadherenceandother three intermediate to long-termstudies proved the high adherence topolypillwhichisequivalenttoplacebo.Thespacestudysuggestthatindividualparticipantswerewithlowadherenceatbase line. Meanwhile the individualswithoutclinicalCVDhadabetterriskratioofadherenceonpolypillthanusualcare.Thusonavailabledatathepolypillshowsmore adherence rate than the othermedicationpattern.


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Dr.Reddy’sLaboratories,India RED HEARTPILL1 Aspirin[75mg],atenolol[50mg],lisinopril[10mg],simvastatin[40mg].Dr.Reddy’sLaboratories,India RED HEARTPILL2 Aspirin[75mg],hydrochlorthiazide[12.5mg],Lisinopril[10mg],simvastatin[40mg].FerrorInternational,Spain TRINOMIA/SINCRONIUM Aspirin[100mg],ramipril[2.5,5 or10mg],atorvastatin[20mg].FerrorInternational,Spain TRINOMIA Aspirin[100mg],ramipril[2.5,5 or10mg],simvastatin[40mg].CadilaPharmaceuticalsLtd,India POLYCAP Atenolol[50mg],hydrochlorthiazide[12.5mg]ramipril[5mg],simvastatin[20mg],optionalaspirin[100mg]Cipla,India STARPILL Aspirin[75mg],losartanpotassium[50mg],atenolol[50mg],atorvastatin[10mg].Cipla,India POLYPILL Amlodipine[2.5mg],losartan[25mg],hydrochlorthiazide[12.5mg],simvastatin[40mg]Alborz DarouPharmaceuticalcompany,Iron POLYIRAN Aspirin[81mg],enalapril[5mg];orvalsartan[40mg],hydrochlorthiazide[12.5mg],atorvastatin[20mg]ZydusCadila,India RAMITORVA Aspirin[75mg],ramipril[5mg],atorvastatin[10mg].

Manufacturer Brandnames Activepharmaceuticalingredients

QUALITYOFLIFE;TheUMPIREstudyconcludes that there issignificantlyhigherrateinthepolypillgroupcompared to usual care group it showsbetter patient adherence with goodoutcomesonpolypillItshowsbetterqualityof life and decreases the mortality andmorbidityinCADpatients.CARDIOVASCULAR RISK FACTORCONTROL;Polypillwiththecombinationofmultipledrugin a capsule or tablet it shows righttherapeuticagentsforthepreventionofCVD,ensuringofthephysiochemicalcompatibilityoftheagentswithinapolypill

Itisveryimportantthateveryagentinthepillcontains specific biopharmaceuticalpha rmacok ine t i c w i t h t he des i r edpharmacodynamiceffectforthetargetedriskfactor.In thismethod they have been conductedclinical trials toassess theeffectof5drugpolypillanddesignedthenameofTIPSONESTUDYwhichwasphase2clinicaltrialsThe5 drug polypill contains [aspirin,100mg,s i m v a s t a t i n 2 0mg R am i p r i l 5mghydrochlorthiazide 12.5mg and Atenolol50mg] against 8 groups which shows thesimilareffectswithcombinationpill.


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Thereisnoevidenceofintoleranceinpolypillby increasing theactive ingredients inonepill.Thestudieswereconcludedbasedonthediagnosticpatternsansoutcomesofthepatient was compared with polypill andindividualpillgroup.Baselinedesiredeffectswereobtainedbythetrials.Thus polypill trials shows better patientoutcomes,reductionandpreventionofriskfactors without any adverse effects andincompatibilitiesinthepreparationofpolypillthanusualcare.LIMITATIONSTitrationofdose:Doctorsweretrainedandtaughtwithtitrationof doses to prevent and control the riskfactorsbut there is a inconvenience in theadjustmentofdosesinpolypill.Thelackoftherapeuticapproachmayshowwithoneoranother component in the polypill. Andbased on the above line, studies wereconducted according to guidelines andinterpretedwithbetteroutcomescomparedwithindividualgroups.Impactofdrugintolerance:Themainconcern in thepolypillhasbeenthatasideeffectofanyonecomponentmaylead to discontinuation of whole pill.However,studiesconcludedthatbetterriskfactorcontrolsuggestingthatthisincreaseddiscontinuation was offset by otheradvantages of polypill including betteradherence.Lowacceptabilityandmassmedicalization:Thepolypillhasnowbeenaroundforseveralyears.ThestudyofpolypillandawarenesshavealsonotedinsomecountrieslikeIndia,andhandableinstores.Butnothandpickedcommercially and the reasons should beexplored.

Thealarmingfalloutofthisapproachisthepoorcomplianceandnonadherencetodailyactivtiesinpolypillusers.FUTUREDIRECTIONS:The main drawback of the concept iscustomization of polypill in most neededcountrylikeIndia, in individualpatients.Byth i s easy p resc r ib ing o f d rugs bypractitionersmayleadstocustomizationofpillincategorizeslikestroke,CHDandhighriskofprevention inCVDpatients. For thesecondarypreventioninstrokepatientsthepolypillhasaoneofthebetablockeralongwithaspirin,statin,diureticorACEinhibitoror both depending on the blood pressureloweringlevel.Thepolypillalsotobetestedin multiple components like life style[physical activity, healthy diet, optimumbody weight] to interpret their respectiveroles in prevention. The polypill for CADincluding aspirin should be available toguide therapy based on individual risk ofpatientsandchoiceof4to6polypillsinsteadof1 fordifferentpatientsmay increase thepolypill prescriptions among physicians.Worldhealthorganizationhasintroduced9targets for the reduction of prematuremortalityfromnoncommunicablediseasesby25%by2025.Inthat2maydirectlyrelatetopharmacotherapywhichensures50%ofpatients receiving drug therapy for theprevention of heart diseases and 80% ofavailabilityofessentialmedicinesalongwithgenericstotreatdiseasesinbothpublicandprivate facilities. There is a poor rate oftherapyforunavailabilityandunaffordabilityofmedicines inmiddle class, upper class,lowerclasscountries.Theaffordabilityandavailability of the medicines should beimproved by providing public and privatehealthcareprogrammes


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Listofcurrentlyavailablepolypillsforresearchandclinicaluse:Someofthecommonsideeffectsofpolypillinclude;cough,muscleachesandstomachirritation.PRODUCINGCOUNTRIES:Polypill, drug to lower blood pressure, isproducedinIranbythesupportofExecutionofImamKhomeini'sOrderwasdesigned14yearsagoandcalled"PolyIran".AccordingtothestudyconductedbydoctorsfromTehranUniversity, theUniversity of Birmingham inBritain and other institutions published byThe Lancet, it worked quite well in a newstudy,slashingtherateofheartattacksbymore thanhalfamongthosewhoregularlytook the pills.The pill in the study, whichinvolved the participation of 6,800 ruralvillagersaged50 to75 in Iran,containedacholesterol-loweringstatin,2blood-pressuredrugsandalow-doseaspirin.Certain "cardiovascular polypills" arecurrently available in India and have beenextensivelystudiedthere.Also,cardiologistsin Spain are developing a polypill forsecondarycardiovascularprevention.TREATMENTOFPOPULATIONRISK:Some preventive-use advocates proposethateveryoneoveragivenageshouldtakesuch medications for preventive health,irrespective of individual risk factor levels.The idea is that most people in westerncountries are at high overall risk, thusloweringriskfactorlevelswillprovidebroadbenefit. This approach emphasizes theperspectivethatriskfactorsarecontinuous,and the r ig id d ichotomies such as"hypertension" and "no hypertension”may

beover-simplifiedandcanbeviewedinsteadascontinuumsofinter-connectedfactors.Inthisparadigm,doctorswouldbetreatingpopulation risk rather than individual riskfactor thresholds as is currentmainstreampractice.So,ifeveryonewasgivenarelevantkindofpolypill,theaveragebloodpressureand cholesterol levels in the populationwouldfall,thusreducingoverallpopulationrisk. Perhaps ironically, this is in a sensegoing in the opposite direction frompersonalized medicine, since mass-produced or fixed-dose-combinationpolypillsareinsometensionwiththegoalsofpersonalizedmedicine,dueto"fixed"natureof the "dose combinations. "Proponents ofthis population-focused approach contendthat the advantages of drug consolidationcan outweigh any reduct ion in thepersonalization of drug and\or the dosese lec t ion . A lso , depending on thedemographic distribution andmarket size,there may be room for some differentalternativeversionsoscertaingeneralFDCstobemanufacturedwithdifferencesintheirrespectivedosagesand/ordrugs.Awidelydistributedpolypillcouldcontainthreebloodpressuremedicationsatlowdose:adiuretic,suchasHydrochlorthiazide,abetablockersuchasAtenolol,andanACEinhibitorsuchasLisinopril;andthesecouldbecombinedwithastatinsuchasSimvastatin,Aspirinatadose of 75 mg, and folic acid, which hasbeen shown to reduce the level ofhomocysteineintheblood,whichisanotherriskfactorforheartdisease.CONCLUSION:In this whole journey, the polypill haswandered and attains acceptability in thepharmacotherapeuticworld.


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Fromthestudiesthereisahighfavourofthepolypillintermsofincreasingadherenceanddecresing the polypharmacy burden with high blood pressure and dislipidemia incardiovascularriskpatients.AccordingtothetrialsthereisanextentofimpactonmajorCVDeventswouldbecomeevidentinthefuturewithaoutcomes.Itprobablyleadstoincreaseinacceptabilityamongphysiciansandhealthcaresystem.Meanwhilestrategieswerebuilduptoprevent CVD through judicial use of drugsmust be effectively implemented through thehealthcaresystem.Thepolypillcannotbesubstituteinsystembut,canbeeasilyfitintothesystem. The pros and cons of the above concept can show the higher adherence withreductioninburdenofpolypharmacyandslightadverseeffectscanbeeasilyminimizedwithpolypillsincomingera.


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AnofficialStudents'PharmaMagazinePANACHE LIVETREATMENTOFNEUROPATHICPAINIntroductionNeuropathicpaincomprisesawiderangeofheterogeneous conditions caused bylesions or diseases of the somatosensorysystem, either at the peripheral or at thecentral level. Neuropathic pain is oftensevereanddifficulttomanage,resultinginachronicconditionthatnegativelyaffectstheoverall functioning and quality of life inpatients. The use of effective therapies tocontrol pain and its consequences are,therefore,ofprimaryimportance.Basedonthefactthataveragingacrossallneuropathicpainconditions,approximately60%ofpatientshadLocalizedNeuropathicPain(LNP),definitionforLNPbasedontheInternational Association for the Study ofPain (IASP): LNP is a type of neuropathicpaincharacterizedbyacircumscribedandconsistentareaofmaximumpain.ClinicalPresentationsThe blockade of nerve conduction inneuropathic conditions causes nervedysfunction,whichcanresultinnumbness,weakness and loss of the deep tendonreflexes in the af fected nerve area.Neuropathicconditionsalsocauseaberrantsymptomsof spontaneous, (continuousorintermittentwhichiscommonlydescribedasburning, shooting or shock-like) stimulus-evokedpain(includesallodynia-painevokedby a non-painful touch) and hyperalgesia(increased pain evoked by a painfulstimulus). Allodynia canbe causedby thelighteststimulation,suchasskincontactwithclothing or a light breeze. These sensoryabnormalities may extend beyond nervedistributions, which may lead to theinappropriate diagnosis of a functional or

psychosomatic disorder. The diagnosis ofneuropathic pain is based primarily onh i s t o r y a nd fi nd i ng s o n ph y s i c a lexamination.Screening and Assessment tools todifferentiate neuropathic pain from non-neuropathicpain i) Leeds Assessment of NeuropthicSymptoms and Signs (LANSS)- Patientsymptomsareselfassessed;Physicalexams igns are measured by hea l thcareprofessional. S-LANSS (self report-LANSStest is themodifiedversion thatallows thepatienttoperformphysicalexamination. ii) Neuropathic Pain Questionnaire – Selfreported assessment is only tool toincorporate symptoms related to weatherchanges.iii)IDPain-Shortandeasytouseforpatientselfassessment. iv) Standardized Evaluation of Pain- Forsymptoms and physical assessment, havehighest accuracy in diagnosing low backpainandscanningcanbecompletedin10-15minutes.First-LineDrugsforNeuropathicPainAntidepressantsAntidepressantsareamongtheoldestdrugsusedforthetreatmentofneuropathicpain,originallycametobeusedinthetreatmentofchronicpain,and inparticularneuropathicpain,becausesomeofthepatientssufferingfromchronicpainarealsodepressed,andthese drugs rel ieve pain as well asdepression. Pain relief has since beendescribedindepressedandnon-depressedpatientswithchronicpain.Thereliefcanbemorerapidinsomepatientsandappearstoo c c u r a t a l o w e r d o s e t h a n t h e

N.SherlyShulamite;SIMScollegeofPharmacy,Guntur,AndhraPradesh.

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antidepressant effect. An early concept ofthemechanismofantidepressantanalgesiawas that these drugs are capable ofpotentiating the activity of the descendinginhibitorypathwaysextendingfromthebrainstemto thedorsalhornof thespinalcord,mainly by inhibiting the re-uptake ofs e ro ton i n and no rad rena l i ne t ha tdescending fibers release into the spinalsynapsesbetweennociceptors(orfirst-orderneurons)andthespino-thalamicneurons(orsecond-order neurons). Alternatively, theycanactivateinterneuronsthatinturnreleaseinhibitorysubstancessuchasendogenousopioids or gamma- aminobutyric acid(GABA), as in the case of serotonin at itsmetabotropicreceptorsornoradrenalineatalpha-1 adrenergic receptors. The mosteffective antidepressants for neuropathicpain appear to be TCAs, in particulardes ip ramine , ami t r ip ty l i ne and i t smetabolite,nortriptyline,and imipramine, ithasbeenshownthatamitriptylinecanactasalocalanestheticbyblockingvoltage-gatedsodium channels. TCAs may directlyinterfere with central sensitization byblockingNMDAreceptorsinthespinalcord.TCAshavebeenproventobeefficaciousinseveral neuropathic conditions, includingpainful polyneuropathy, post-herpeticneuralgia, peripheral nerve injury, andpainfuldiabeticneuropathy.Duloxetinehasshownconsistentefficacyinpainful diabetic neuropathy and low backpain.Dosingofduloxetineissimplewith60mg once or twice daily appearing to beequally effective. Nausea is the mostcommonadverseeffectofduloxetine,whichappears to be reduced by lowering thedosageto30mgoncedailyfor1weekbeforeincreasingto60mgoncedaily.Anticonvulsants Acting at Voltage-Gated

CalciumChannelsPregabalinandgabapentinarebothderivedfromGABA,buttheyhavenoeffectontheGABAergic system. Their mechanism ofactionincludesbindingtothealpha-2/delta-1 subunit of the voltage-gated calciumchannels in several areas of the centralnervous system (CNS) and spinal cord.Voltage-gated calcium channels arelocalized on pre-synaptic terminals, wheretheycontrolneurotransmitterrelease.Beingvoltage-sensitive,theyopeninresponsetoactionpotentialsarisingfromtheperipheryandallowtheinfluxofcalciumions,whichisessential forthefusionofsynapticvesiclesand release of neurotransmitters into thesynapticcleft.Thisisthegeneralmechanismby which these channels are involved inneurotransmitter release in the spinal cordand in various areas of the CNS. Voltage-gated calcium channels are comprised ofdifferent subunits: the alpha subunit isresponsible for the formation of the porethrough which calcium ions enter into thecell,whereasthealpha-2/delta-1,beta,andgammaareaccessorysubunits.Thealpha-2/delta-1 subunit is responsible for thetrafficking, localization, and stabilization ofthechannelintheplasmamembrane.In general, pregabalin andgabapentin arewelltolerated.Themostcommonlyreportedadverse effect of pregabalin is dizziness,followedbysomnolence,drymouth,edema,and blurred vision. For gabapentin,dizziness, somnolence and confusion andperipheraledema.Forbothdrugs,adverseeffectsaredose-dependentandreversible.Second-Line and Third-Line Drugs forNeuropathicPainTopicalLidocaineLidocaine, in the formof5%patches,wasefficaciousandhadanexcellenttolerabilityprofile in patients with post-herpetic


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neuralgiaandallodynia,aswellasinpatientswith allodynia due to neuropathic pain.Lidocaine blocks voltage-gated sodiumchannels, because topical lidocaine canpenetrate no deeper than 8–10 mm, it istherefore indicated in well- localizedneuropathic pain. Its efficacy has beendocumented in different types of localizedneuropathic pain, including post-herpeticneuralgia,painfuldiabeticneuropathy,post-surgical andpost-traumaticpain related toincision of the skin. The most commonadverse effects of lidocaine aremild localreactions due to its topical application.Lidocaine'slackofsystemicabsorptionanddrug interactions can be particularlybeneficialinolderpatients.OpioidsStrong opioids, such as morphine,oxycodone,andhydromorphone,andweakopioids, such as tramadol, are efficaciouswhencomparedwithotherdrugsused forneuropathic pain. Nevertheless, they havealwaysbeenconsideredsecond-linedrugs,andmore recently third-line drugs, due toadversedrugreactionsandconcernsaboutabuse,diversion,andaddiction.Theanalgesiceffectofopioidsisduetotheiraction in thebrain,brainstem,spinalcord,and, under certain circumstances, onperipheral terminals of primary afferentneurons. All endogenous opioid peptides,including endorphin, enkephalins, anddynorphins,bindtoseventransmembraneGprotein-coupled receptors, which aredivided into three classes: mu, delta, andkappa receptors. Opioid receptors arecoupledtoinhibitorGproteins,withreceptoractivationinhibitingtheadenylatecyclaseaswellastheintracellularproductionofcAMP.However,thecouplingofopioidreceptorstocalciumandpotassiumchannelsisthought

to be a central mechanism of analgesiaproduction by both endogenous andexogenousopioids.OtherDrugsA number of additional drugs have shownefficacyinthetreatmentofneuropathicpain,thesedrugsrepresentthethirdorevenfourthlineoftreatmentoptionsforneuropathicpainand include specific antidepressants(bupropion) and antiepi leptic drugs(carbamazepine, lamotrigine), and topicallow-concentration capsaicin. In general,thesedrugsshouldbereservedforpatientswho are unable to tolerate or who fail torespond second-line medications to first-line.ConclusionThepharmacotherapyofneuropathicpainischallengingandformanypatientseffectivetreatment is lacking. There are severalreasons for this, including insufficientknowledge on efficacious drugs and theirappropriate use in cl inical practice.Neuropathic pain is also associated withinterference with sleep, depression, andanxiety that, if not properly treated, willnegatively influence the responses toanalgesicdrugs.Therefore,evidence-basedrecommendationsforthepharmacotherapyof neuropathic pain are essential. On theotherhand,comorbiditiesarealsoapracticalproblem, because patients taking drugreactionsortherapeuticfailure.Although new innovative molecules areneeded for the success fu l cure o fneuropathicpain,adeeperunderstandingofthe mechanism of action of currentlyavailabledrugsisanessentialsteptowardsan effective clinical approach that tailorstherapies both to the specific neuropathicdisease and to the needs of an individualpatient.


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PHARMAVISION2030:THEINDIANINDUSTRY–AGLOBALLEADERIndia'slifesciencesindustryhastraversedasuccessfuljourneyinthepast50years.Froman era of import dependency in the pre-1970s,high-qualitylocalplayersmovedthecountry toward self-sufficiency in lifesciences by the 1990s. Since then, worldclass capabilities have helped the Indianindustrybuildastrongglobalpresence. Inthis journey, the industry has achievedseveral successes and has contributedsignificantly to the Indian economy andhealthcare outcomes, in both India andabroad. • Significant contributions to theIndianeconomy:Thelifesciencesindustryisnowthethird-largestcontributorinreducingIndia's merchandise trade deficit. TheindustrygeneratesaroundUSD10billionoftrade surplus every year, allowing it toneutralise around 4 to 5 per cent of totalenergyimportsforIndia.Inaddition,italsogenerates a significant number of jobs forIndia.Ourestimatesindicatethataround2.5millionpeoplearecurrentlyemployedbytheindustry (including some of the industriessuchaschemists,stockists,etc.). • Strong position in the global lifesciencesindustry:Indiahasalsobeenableto build a strong position across varioussegmentsofthemarket.Inpharmaceuticals,India is now the eighth largest country byvaluegloballywithoneofthehighestgrowthrates.Ithasalsobeenabletobuildastrongposition inkeymarketssuchastheUS. Inclinicaltrials,Indiacontinuestobeoneofthetop 15 destinations globally based on thenumber of trials conducted between 2003and2013.

•Contributionsindrivingaccessandaffordability: Indian industry has been adriver for access and affordability in lifesciences. Indian drugs are available at anaffordable price as compared to marketsglobally.Further,Indiaistheprimarysupplierof essential medicines for numerousdiseases, helping save millions of livesglobally. India's contribution extends todevelopedmarketssuchastheUSaswell,where through its position in the genericsmarket,theindustryissignificantlyreducinghealthcarespend. •World-classcapabilitiesacrossthevaluechain:The lifesciences industryhasalsobuiltstrongcapabilitiesacrossallpartsof the value chain. Inmanufacturing, Indiacontinues to have the highest number ofFDA-approved formulation plants outsidethe US. In R&D and regulatory, Indianindustryhasaccountedfor32percentoftheANDAfilingslastyear,secondonlytotheUSat44percent.Theindustryisnowalsomakingsomeinitialmovement in the innovation space. Thejourney so far has been a source ofcelebration, but the road ahead for theindustry is challenging. There are somepositive aspects that brighten the horizon(e.g., strengths that the industry cancontinue to leverage, and opportunities, iftapped,thatcouldhelptheindustrygrow),butnewchallengesanddiscontinuitiesinthemarketcontinuetoemerge.Threeprominentchallengesthattheindustryfaces: • Changing market dynamics:Changes in the market landscape arethrowingupnewchallengesfortheindustry.

RennyRozario;SriRamakrishnaInstituteofParamadicalSciences,Coimbatore,TamilNadu.AnofficialStudents'PharmaMagazinePANACHE LIVE

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Forinstance,sourcesofgrowthinthemarketcontinuetoshifttoareaswheretheindustrydoesnothaveastrongpresencetoday(e.g.,emerging markets, complex generics).Prices and margins continue to be underpressure,drivenbycustomerconsolidationin developed markets and evolvingregulations in few emerging markets. Thedynamics of doing business are alsoundergoingashiftwith therecentspateofmergers and acquisitions, increase inimportance of scale, and changes inregulatory guidelines, requiring players tobuildnewcapabilitiestosucceed. • Dilution of some core drivers ofsuccess: Much of the credit for India'ssuccesshistoricallygoestotheadvantagesthatIndiaofferedintermsofaffordablecosts,reliabilityofsupply,anditsabilitytoreleaseproducts rapidly in market. However, thereality is shifting. Cost position is underthreat with players in developed marketsbecomingmorecompetitiveandplayers indeveloping markets moving up the valuechain. Indian players are facing anincreasing number of quality issues,especially for theUS,which isaffecting itssupplyreliability.Finally, recentchanges intheregulatory landscapearealsoaffectingthe ability of Indian players to releaseproductsrapidly. •Gaps in the industry'scompetitiveability:Changesinmarketdynamicsarealsoaccentuat ing gaps in the industry 'scompeti t iveness, which can have aconsiderableimpactontheindustry'sabilityto sustain its growth in the future. First,growing dependence on imports forKSM/intermediatesisacauseofconcern.Itcouldleadtoissuesrelatedtotheavailability

ofessentialmedicinesinthecountry,impactthecostpositionandfirst-to-filecapabilityofIndian players. Second, India's position inthe innovation space continues to benascent dr iven by gaps across theinnovationecosystem.Giventhatinnovationcouldrepresentthenextwaveofgrowthforthe industry, aweakposition in innovationwouldsignificantlyimpactgrowthoutlookfortheindustry.Thesechallengescandragdownanindustrywith immense potential. Our estimatesindicatethatfailingtoaddresstheseissuescouldpullthegrowthratedownto8to10percentoverthecomingyears,alsoimpactingtheindustry'sabilitytoservethelocalmarketandmaintainitshard-earnedglobalposition.Itis,therefore,importantatthisjunctureforthe industry and the government to cometogetherandalignonacommonvisionthatwould help the industry unlock its fullpotential.Inthiscontext,webelievethattheindustry can aspire towards a vision of"Expanding India's global leadership andrelevance, while driving domestic access".The industry can focus on three goals torealizethisvision. 1. Become the world's largest and mostreliabledrugsupplierthroughleadershipincost,qualityanddevelopmentexcellence. 2. Provide access to affordable, qualitydrugstoeveryIndianandbringlatestdrugsto Indianmarket through initiatives by theindustryandthegovernment.3.Establishglobally recognizedpresencefor Indian industry in pharma innovation,throughindustryenterpriseandconductiveenvironmentcreatedbythegovernment.


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By achieving this vision, the industry willcontinuemaking significant contribution totheeconomyandhealthcareoutcomes: Sustained economic contribution:Underthisvision,theindustrywillsustainitsgrowthtrajectoryof11to12percentandgrow7to8times to a size of USD 190 billion to 200billion by 2030. This growth will allow theindustrytodrive5to6timesgrowthintradebalance contribution to around USD 55billion to 60 billion by 2030. This will helpneutralize around13 to 15per cent of theestimatedenergyimportsforIndiaby2030.The industry will also create nearly fourmillionnewjobsforthecountryoverthenext15years. Becoming the world's largest and mostreliable drug supplier: The Indian lifesciencesindustrycanaspiretobecometheworld'slargestsupplierofdrugsgloballybyvolumeandthirdlargestbyvalue.Thiscanbeenabledby the leadershipposition thatthe industry can secure in the US, and inotheremergingmarkets.Beyondvalue,theindustry will also continue its contributiontowards saving mi l l ions of l ives bymaintaining the supply of essent ialmedicinesanddrivingsignificantreductioninhealthcarespendacrossmajormarkets. Providing every Indian access to high-quality, affordable drugs, and bringing thelatestdrugstoIndia:Theindustrycanworktowards a goal of further deepening drugpenetrationintheIndianmarket.Webelievethat by adopting innovative models andgovernmentsupport,theindustrycanaspiretodrivea3–4timesincreaseinthenumberoftreatedpatientsacrossdiseaseareas.Theindustrycanalsocontinuetoplayacrucialrole in ensuring the availability of new

upcomingdrugstoIndianpatients.BuildingagloballyrecognizedpositionforIndia in the innovation space: India couldadopt an enterprise-led approach to driveinnovation, given its strong and dynamiclocal industry. Under this approach, webelievethattheindustrycanaspiretobuildastrong innovation pipeline (around 1 NMEand10–12incrementalinnovationlaunchesperyearby2030),drivesignificanteconomicupside(exportsofaroundUSD16billionto18billionby2030),anddeliverbetterhealthoutcomesforthecountry.To achieve this vision, all the stakeholdershavetoactontheirstrengthsandprovideanenabling environment for the industry togrow. In particular, we believe that theindustry could focus on six imperatives toenhance its competitiveness, deepenpenetrationinexistingandnewmarkets,anddriveacommonagendatosustaingrowth: •Driveinnovationatscalebymaking"smart"choicesontheportfolio,buildingnewtechno-commercial capabil i t ies, andrevampingtheoperatingmodel(e.g.,usingnew approaches such as adaptive triald e s i g n t o op t im i z e app r oach f o rdevelopment) • Expand presence in emergingmarketsthroughafocusedapproachandbybuilding a "global" supply chain andorganization(e.g.,focustobuild1-2"homemarkets" beyond India, re-configure themanufacturingnetwork) •Adopt innovativebusinessmodelstoenabledeeperpenetrationandaccesstodrugs even in rural India (e.g., usingtechnologytodriveaccessandlowercost,providingintegratedcareforpatients).


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• Upgrade quality systems andinfrastructure, and enhance capabilities tomaintain India's image of a reliable, high-quality pharmaceuticals supplier (e.g.,preventative culture, capability building inthefront-line). • Build new-age capabilities tosustaincostandspeed-to-marketadvantageeven across the newly emerging marketsegments(e.g.,usingautomationandnewtechnology to lower costs; embeddingQualitybyDesign(QbD)toensure"firsttimeright"dossiers).Collaborate more meaningfully within theindustry to support growth of the industry(e.g., capability building of quality teamsacross players) The government couldconsidersupportingthisjourneybycreatingaconduciveenvironmentfortheindustrytoundertake the above actions. In particular,thegovernmentcouldlookatfourinitiatives: Buildanenablingregulatoryenvironmentto facilitate the"easeofdoingbusiness"byprovidingclarityonguidelinesinafewareas (e.g., clinical trials, approvalpathwayfordifferentproductcategories). Help improve quality standards bystrengthening the capacity/capability ofquality inspectors and harmonising thequalityframeworkwithglobalguidelines. EnsureIndia'sself-sufficiencybyhelpingenhancecompetitivenessofthelocalAPIindustry(e.g.,bysettingupadedicatedAPI/intermediate manufacturing clusterwithresourcesharingandincentives). Create a conducive environment for

innovation by strengthening the localtalent/researchbase(e.g.,byreviewingthe curriculum in the top 10 to 12academic institutes) and enhancingincentivesforinvestmentsinR&D.Vision 2030 builds on the successfultrajectory of the Indian life sciencesindustry. It lays out the path forward tounlock the industry's true potential. Thiscanbecomearealityifallthestakeholderscollaborateandbuildonthestrengthsthatwould help the sector achieve a highertrajectory.


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MATERIOVIGILANCEPROGRAMMEOFINDIAMEDICAL DEVICES: Medical device isdefined as any instrument, equipment,materialorotherarticleusedonitsownorjointly,includingsoftwarerequiredforittofunctioncorrectly,which is intendedbythemanufacturertobeusedonhumansforthefollowingpurposes:• for diagnostic, prevention, control,treatingordiminishinganillness• for diagnostic, control, treating, fordiminishingorcompensatinganinjuryorhandicap,• for studying, replacing or modifyingpart of the anatomy or a physiologicalprocess• formastering conception andwhoseprincipal intended action in or on thehuman body is not obta ined bypharmacological or immunologicalmeans or by metabolism but whosefunctioncanbeassistedinsuchaway.MATERIOVIGILANCE:Materiovigilancemeansclosemonitoringof any undesirable performance orcharacteristic fluctuations of a medicaldevice bymeans of a systemwhich iscapable of identifying, collecting,reporting with estimate of undesirableoccurrences and reacting to themwithfield safety corrective actions or devicerecallduringpost-marketingphaseofaMedicalDevice.Materiovigilance Programme of India(MvPI) After several horrific cases of

malfunctioning medical devices, likebabiesbeingburnttodeathduetoshortcircuits in incubators or hip implantscausingbloodpoisoningetc. The Ministry of Health and familyWelfare (MoHFW)has approved thecommencement of "MateriovigilanceProgramme of India (MvPI)" videapprovaldated10/02/2015inanefforttoensuresafetyofmedicaldevices. MvPI has been launched by DrugControlGeneralofIndiaon6thJuly2015at Indian Pharmacopoeia Commission(IPC)Ghaziabad. IPCGhaziabadfunctionsasNationalCoordinationCentreforMvPI.SreeChitraTirunalInstituteofMedicalSciences & Technology (SCTIMST),Thiruvananthapuram, functions asNationalCollaboratingCentreforMvPI.TechnicalsupportwillbeprovidedbyNationalHealthSystemResourceCentre(NHSRC)forMvPI.OBJECTIVESOFMvPI:• To create a nationwide system forpatientsafetymonitoring• To analyze the risk–benefit ratio ofmedicaldevicesuses• To generate evidence-based data onthesafetyofmedicaldevices• To support CDSCO in the decision-makingprocessontheuseofmedicaldevices.

ShaikRahamthulla;ChebroluHanumaiahInstituteofPharmaceuticalSciences,Guntur,AndhraPradesh.AnofficialStudents'PharmaMagazinePANACHE LIVE

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MedicalAdverseEventReportingForm:

•Tocommunicate thesafety informationon theuseofmedicaldevices tovariousstakeholderstominimizetherisk•Toemergeasanationalcenterofexcellenceformateriovigilanceactivities•Tocollaboratewithotherhealthcareorganizationsandinternationalagenciesfortheexchangeofinformationanddatamanagement.ThepurposeofMateriovigilanceistostudyandfollowincidentsthatmightresultfromusingmedicaldevices.Itenablesdangerousdevicestobewithdrawnfromthemarketandtoeliminatefaultsinmedicaldeviceswiththeintentionofconstantlyimprovingthequalityofdevicesandprovidingpatientsanduserswithincreasedsafety.Whatcanbereported:•Anydysfunctionoranychangeofthecharacteristicsand/orperformanceofadevice,anyinadequacyinthelabelingorinstructions,whichmightleadtodeathorseriousrelapseinthestateofhealthofapatient,auserorathirdparty.•Anytechnicalormedicalreasonrelatedtothecharacteristicsorperformanceofadevice.•NotonlyseriousincidentsbutalsothecaseswheretherewasariskofaseriousincidentbutthatincidentwasavoidedduetotheattentionandactionoftherelevantpeopleWheretoReport:DulyfilledMedicalDeviceAdverseEventReportingFormcanbesendtoSreeChitraTirunalInstituteofMedicalScienceandTechnology(SCTIMST),NationalCollaborationCentre-Materiovigilance Programme of India, Biomedical Technology Wing,Poojappura,Thiruvananthapuram695012,Kerala,India.Or• [email protected]• CallonTollfreeHelplineno.18001803024toreportAdverseevent.• [email protected]• MedicalDeviceAdverseEventMonitoringCentres(MDMCs):TherearemanyMDMCsalloverthecountryindifferentstates like Karnataka, Chandigarh, Punjab, Delhi, West Bengal, Uttar Pradesh,Puducherry,Tamilnadu,Rajasthan,Bihar,Kerela,Odisha,AndhraPradesh,MadhyaPradesh.Conclusion:Given that many countries do not have a Post-Market surveillance/vigilanceprogramme;itisdesirablethatabeginningismade.Althoughacomplexscienceinitself,requiringsupportofmanydomainsincludingclinicalmedicineaswellasclinicalengineering/biomedicalengineering,capacitiesexistincountriestopromotesafeand


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ROLEOFPHARMACISTINPATIENTCOUNSELLINGINTRODUCTIONAccording to the Joint InternationalPharmaceutical Federation (FIP)/WorldHealth Organization (WHO) guidelinesforgoodpharmacypractice,themissionofpharmacypracticeisto"contributetohealthimprovementandtohelppatientswith health problems tomake the bestuse of theirmedicines". Pharmacist-ledcounselling isan importantservice thathas been associated with improvedcl inical outcomes, quali ty of l i fe,drug/disease knowledge, satisfaction,and reduced health service utilizationamongpatients.There is no accepted definition ofcounselling.AccordingtoPuspitasarietal., researchers either operationallydefine counselling or refer to specificcounselling guidelines in the literature.Pharmacy researchers operationallydefine counselling as giving advice orproviding information on medications,whileothers focusmoreon thegoalofcounselling, i.e. ensuring that patientsunde r s t and t he op t ima l u se o fmedications to improve their quality ofl i fe. In a review focusing on theconceptualization and measurement ofpharmacist-patient communication,Shah and Chewning discuss thedifferences in counselling definitionsbetween the professional counsellingliteratureandotherpublishedpharmacyliterature. The professional counsellingliterature,representedbyaninternationalin terd isc ip l inary journal , defines

counsellingasan"individualizedprocessinvolving guidance and collaborativeproblemsolvingtohelpthepatientbettermanage their health problems", whileotherpublishedpharmacyliteratureusesthe term "counselling" to refer to theprovisionofinformationregardinghowtotake the drug product proper ly.Furthermore,theterms"communication"," counse l l i ng " , " educa t i on " , and"information provision" have been usedinterchangeably in the l i terature,disregarding subtle differences in theirmeaning.Patienteducation,forexample,is defined as "a planned learningexperience using a combination ofmethodssuchasteaching,counselling,and behavior modification techniquesthat influence patients knowledge andbehavior". Thus, according to thisdefinition, counselling is an aspect ofpatienteducation.In addition to dispensing prescriptionand non-prescription medications,community pharmacists have greatpotentialtobethefirstcontactforpatientsseeking treatment for minor ailments.Community pharmacists also have anincreasing role inpublichealth throughthe promotion of healthy lifestyles.Pharmacist-patient interactions in thecommunity setting may also addressdiet, device use, exercise, referrals, orother non-medication issues. Thecommun i t y se t t i ng o f f e r s manyadvantages,suchaslongopeninghours,accessibility,andfamiliarity.

Divyankkhanna;DelhiPharmaceuticalSciencesandResearchUniversity,NewDelhi.AnofficialStudents'PharmaMagazinePANACHE LIVE

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Studies investigating the counsellingpractices of community pharmacistshave indicated that their elicitation ofinformationpriortosupplyingmedicine,detection of drug interactions, andcounselling content are of sub-optimalquality. Counselling in a communitysettingisacomplexprocess,whichmayexplain the poor quality of communitycounsellingpractices.Previous reviews have examined theimpactofcommunitypharmacyservices,such as counsel l ing, on pat ientoutcomes,qualityofcounselling,verbalcounselling rates, types of informationprovided during counselling, and theconceptualizations, definitions, andmeasurements of pharmacist-patientcommunicationinthecommunitysetting.Few studies, however, have examinedinterventions to improve communitypharmacy services. Patwardhan et al.reviewedliteraturepublishedupto2010on i n t e r ven t i ons f o r enhanc ingcommunity pharmacists' cognitiveservices, defined as professionalservices provided by pharmacists to apatient that are either judgmental oreducationalinnature.Watkinssearchedsixdatabasesupto2014forliteratureonimplementation strategies for clinicalguidelinestocommunitypharmacyandtheir impact on the quality of careprovided by community pharmacists,such as adherence to recommendedpractices or guidelines. In December2017,Seubertetal.publishedareviewofliterature published between 2000 and2017oninterventionsaimedatimprovingcommunicationbetweenconsumersand

p h a r m a c y p e r s o n n e l d u r i n gconsultations for medicines that areprovidedwithoutaprescription.These reviews focused on generalcognitive services rather than oncounselling specifically; on specificinterventions,suchasguidelines;oronspecificgroupsofmedications.Todate,however, no systematic reviews havefocused on interventions for improvingcounselling in different situations,inc lud ing prescr ip t ion and non-prescription medications, consultationsforminorailments,andhealthpromotion.Given the subopt imal qua l i ty o fcounselling noted earlier, we need toclose the gap in knowledge regardingwhichinterventionsmightleadtooptimalcounsellinginthecommunitysetting.The primary aim of this review was toidentify, describe, and determine theeffect iveness of interventions forimproving the counselling practice ofcommunitypharmacists.Thesecondaryaimwastoproviderecommendationsforfuture studiesdue to the evidencegapidentified in this review. In this review,"counselling"isusedasabroadumbrellaterm that encompasses all definitionsoutlinedinthebackgroundsection.OBJECTIVES1. Pat ient should recognize theimportanceofhiswellbeing.2 . A work ing re lat ionship and afoundationforcontinuousinteractiona nd consu l t a t i o n s hou l d b eestablished.3.Patientunderstandingofstrategiestodealwithmedicationsideeffectsand


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druginteractionshouldbeimproved.4. Shou ld ensure be t te r pa t ien tcompliance.5.Patientbecomesaninformed,efficientand active participant in diseasetreatmentandself-caremanagement.6.Pharmacistshouldbeperceivedasap r o f e s s i ona l who o f f e r s t h epharmaceuticalcare.7.Drug interactions and adverse drugreactionsshouldbeprevented.IMPORTANCEOFPHARMACISTMedicines play an important role inmedical care and effectiveness oftreatmentdependsonboththeefficacyofmedicationandpatientadherencetothetherapeutic regimen. Adherence tomedications(AMs)isessentialtoachievethe best possible pharmacotherapyoutcomes. Evidence shows that non-AMs result in higher health care costs,longer hospitalization, and increasedmorbidityandmortality.On the other hand, hospitalization andsubsequent discharge home are high-risk periods for potential medicationconfusion and errors and often involvediscontinuityofcare,multiplechangesinmedication regimens, and inadequatepatient education, which can lead toadverse drug events (ADEs) andavoidablehealthcareutilization.Patient'stransit ion from hospital to home,subsequentlychanges to theirpreviousmedication regimens, and also non-adherencetoprescribedmedicationafterdischarge are common during thesetransitionsofcareandincreasetheriskofpost-dischargecomplications.

It has been reported that one in fivehospitalizations iscomplicatedbypost-discharge adverse events, and 66% oftheseeventsarerelatedtomedications.Numerousfactorshavebeenidentifiedtoa f f ec t Ams , i nc lud ing cogn i t i veimpairments,lackofunderstandingandknowledge about health condition,higher prevalence of chronic diseases,higher number of prescription andnonprescriptionmedications,complexityof the regimen and poor access tomedicines, poor provider-pat ientcommunication, inadequate knowledgeabout a drug and its use, not beingconvincedoftheneedfortreatment,fearof adverse effects of drug, and finallylong-termdrugregimens.Inaddition,33-69% of medication-related hospitaladmissionsintheUnitedStatesaredueto medication non-adherence with aresult in cost of approximately $100billionperyear.Medication adherence is a complexbehavior which can be influenced bypatients, providers, and health systemfactors.Asinglemethodcannotimprovemedication adherence. Instead, acombination of various adherencetechniques should be implemented toimprove patient's adherence to theirp r e s c r i b ed t r e a tmen t . S e v e r a lin tervent ions including remindersystems, follow-up programs by healthcare prov iders , and in format iontechnologytoolshavebeendevelopedtoovercome patient and health careprovider-relatedbarriers.


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Pharmacists are poised to play animportant role in improving medicationmanagement during transitions of careand reducing readmission rates.Pharmacist's interventions (also knownaspharmaceuticalcareplans)aremeansof solving the drug therapy problemsidentified in pharmaceutical care.Pharmaceutical care requires directrelationship between a pharmacist andanindividualpatient.Pharmacistsresponsibilityistooptimizepatient’smedicationtherapy.Inordertothat, theyhave thepotential toeducatepatients about the importance ofcontinued therapy and adherence athome also to resolve any uncertaintiesthat patients may have regarding theirmedications. Patient 's medicationdischarge counseling provides anopportunity for pharmacists to improvepa t ien ts ' the rapeut ic ou tcomes.Pharmacistfollow-upafterdischargehasmixedeffectsonEmergencyDepartment(ED) visits, hospital readmission, andcosts.Ourobjectivesweretoidentifytheeffectofpatientcounselingatdischargeand their follow-up by pharmacists ontreatmentoutcomes.STEPS TO EFFECTIVE PATIENTCOUNSELLINGAlthough every pharmacist implementsindividualized techniques to counselpatients, various skills are vital tosuccessfulpharmacist.Followingare10featuresofeffectivepatientcounseling:1.EstablishTrustPharmacists are among the mostaccessible and trusted health care

professionals. When initiating a patientcounselingsession,pharmacistsshouldintroducethemselveswithabrief,friendlyg r ee t i ng t o make pa t i en t s f ee lcomfortable enough to ask questionsabout their medication therapies andhealthconditions.2.CommunicateVerballyPharmacistscanencouragedialoguebyasking questions. They should assesswhatthepatientalreadyknowsabouthisor her chosen therapy and tailor thecounseling to meet the needs of eachindividualpatient.3.CommunicateNonverballyInadditiontoverbalcommunication,itisessentialforpharmaciststobeawareofnonverbal communication, such asmaintainingeyecontactwiththepatient,todemonstrateinterestintheinformationthepatientisrelaying.4.ListenWhen counsel ing pat ients aboutmedication therapy, listening to theconcerns, questions, and needs of thepatientisessential.Listeningskillscanbecategorized into 4 classes: passivelistening, acknowledgment responses,encouragement,andactivelistening.5.AskQuestionsWhen posing questions to the patient,pharmacistsalsoshouldstatethereasonforaskingcertainquestions,soasnottooffendthepatient.6,7Askingopen-endedquestionsenablespharmaciststogathermoreinformationthatmayleadtootherquestions and/or provide valuableinformation to thepharmacist to furtherassessthepatient.


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6.RemainClinicallyObjectiveItisimportantforpharmacistsnottoallowpersonalbeliefseitherethicalorreligioustoaffecttheirabilitytocounselapatienteffectively.7.ShowEmpathyandEncouragementWhen a pharmacist displays empathyandencouragement,apatientmay feelmorecomfortablediscussinghisorhermedical condition andmedication use,thus enabling the pharmacist to obtainpertinent information on the patient'sneedsandconcerns.8.Tailor Counseling to Meet PatientNeedsTheabilitytotailorpatientcounselingtomeet individual needs is cri t ical.Pharmacistsshouldbeawareofpatientswithdisabilitiesandbepreparedtotreatthemwithrespectandunderstanding.10.MotivatePatientsEffective counseling not only providespatients with the pertinent informationthey need to use their medicationcorrectly,italsomotivatesthemtoadheret o t h e i r med i c a t i o n r e g imen s .Pharmacists can motivate patients bydiscussing the benefits of medicationadherence, offering support, andexplaining the pros and cons oftreatment.

CONCLUSIONItisimpossibletocounseleverypatient.Whereas the use of written counselinginformationcanbebeneficial,itdoesnotreplace the interaction between thepharmacistandthepatient.Pharmacistsshould seize every opportunity tocounsel patients about their treatmentregimensandensurethatpatientsclearlyunderstand the proper use of theirmed ica t ion . Es tab l i sh ing car ingrelationships encourages patients toseek counsel, thus increasing thel ikel ihood of posit ive therapeuticoutcomes.Everytimeapharmacisttakestheopportunitytocounselpatients,heorshe empowers pat ients wi th theinformation necessary to impact thequality of their health. Although everypharmacisthasadifferentperceptionofwhatpatientcounselingshouldentail,allpharmacists should strive for one goalwhencounselingpatients:toensurethatpatients are well informed about theproperuseoftheirmedications.The patient counseling by pharmacistsalsoenablesthedoctorstospendmoretimeon examination anddiagnosis thepatientsasthecounselingpart is takencareofbythepharmacist.Italsohelpsinmany ways to improve the quality ofhealthcare system with better patientcareandtherapeuticoutcome.


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SPECIALEDITONONCORONAVIRUSHumancoronaviruses(HCoV)werefirstidentified in the 1960s in the noses ofpatients with the common cold. Twohumancoronavirusesareresponsiblefora large proportion of common coldsOC43and229E.Coronaviruses were given their namebasedon thecrown-likeprojectionsontheir surfaces. "Corona" in Latinmeans"halo"or"crown.”Among humans, infection most oftenoccursduringthewintermonthsaswellasearlyspring.Itisnotuncommonforaperson tobecome illwithacold that iscausedbyacoronavirusandthencatchitagainaboutfourmonthslater.This is because coronavirus antibodiesdonotlastforaverylongtime.Also,theantibodies foronestrainofcoronavirusmaybeuselessagainstotherstrains.SymptomsCold-orflu-likesymptomsusuallysetinfrom two to fourdaysafter coronavirusinfection, and they are typically mild.However,symptomsvaryfrompersontoperson,andsomeformsoftheviruscan

befatal.Symptomsinclude:•sneezing•arunnynose•fatigue•acough•inrarecases,fever•asorethroat•exacerbatedasthmaHuman coronaviruses cannot becultivatedinthelaboratoryeasily,unlikethe rhinovirus, another cause of thecommoncold. Thismakes it difficult togauge the coronavirus' impact onnationaleconomiesandpublichealth.There isnocure,so treatments includetaking care of yourself and over-the-counter(OTC)medication:• Restandavoidoverexertion.• Drinkenoughwater.• Avoidsmokingandsmokyareas.•Take acetaminophen, ibuprofen ornaproxentoreducepainandfever.• Use a clean humidifier or cool mistvaporizer.Thevirusresponsiblecanbediagnosedbytakingasampleofrespiratoryfluids,suchasmucusfromthenose,orblood.Different typesofhumancoronavirusesvaryintheseverityofillnesstheycauseandhowfartheycanspread.There are currently seven recognizedtypes of coronavirus that can infecthumans.Commontypesinclude:•229E(alphacoronavirus)•NL63(alphacoronavirus)


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•OC43(betacoronavirus)•HKU1(betacoronavirus)Rarer, more dangerous types includeMERS-CoV, which causes Middle EastRespiratory Syndrome (MERS), andsevere acute respiratory syndrome( S ARS - C o V ) , t h e c o r o n a v i r u sresponsible for SARS. In 2019, adangerousnewstrainstartedcirculating,butitdoesnotyethaveanofficialname.Healthauthoritiesarecurrentlyreferringto it as 2019Novel Coronavirus (2019-nCov).There has not been a great deal ofresearch on how a human coronavirusspreadsfromonepersontothenext.However, it is believed that the virusestransmit using secreted fluid from therespiratorysystem.Coronaviruses can spread in thefollowingways:• Coughing and sneezing withoutcovering the mouth can dispersedroplets into the air, spreading thevirus.• Touching or shaking hands with apersonthathastheviruscanpassthevirusfromonepersontoanother.•Makingcontactwithasurfaceorobjectthat has the virus and then touchingyournose,eyes,ormouth.•Onrareoccasions,acoronavirusmayspreadthroughcontactwithfeces.People in the US are more likely tocontractthediseaseinthewinterorfall.Thediseaseisstillactiveduringtherestoftheyear.Youngpeoplearemostlikelytocontractacoronavirus,andpeoplecan

contractmorethanoneinfectionoverthecourse of a lifetime. Most people willbecome infected with at least onecoronavirusintheirlife.Itissaidthatthemutatingabilitiesofthecoronavirus are what make i t socontagious.Topreventtransmission,besuretostayat home and rest while experiencingsymptomsandavoidclosecontactwithother people. Covering the mouth andnosewithatissueorhandkerchiefwhilecoughing or sneezing can also helppreventthespreadofacoronavirus.Besuretodisposeofanyusedtissuesandmaintainhygienearoundthehome.2019-nCovIn2019,theCentersforDiseaseControlandPrevention(CDC)startedmonitoringthe outbreak of a new coronavirus.Authorities first identified the virus inWuhan,China.Theyhavenamedit2019NovelCoronavirus(2019-nCov).Morethan1,000peoplehavecontractedthevirusinChina.Healthauthoritieshaveidentifiedseveralotherpeoplewith2019-nCov around the world, including fiveindividuals in the United States. OnJanuary31,2020,theviruspassedfromone person to another in the US. TheWorldHealthOrganization (WHO)havedeclared a public health emergencyrelatingto2019-nCov.Someofthefirstpeoplewith2019-nCovhad links to an animal and seafoodmarket. This initially suggested thatanimals transmit the virus to humans.


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However, people with a more recentdiagnosis had no connections with orexposuretothemarket,suggestingthathumanscanpassthevirustoeachother.Information on the virus is scarce atpresent . In the past , respiratoryc o n d i t i o n s t h a t d e v e l o p f r omcoronaviruses,suchasSARSandMERS,havespreadthroughclosecontacts.However,whilesomevirusesarehighlycontagious, i t is less c lear wi thcoronavirusesastohowrapidlytheywillspread.Symptoms vary from person to personwith a 2019-nCov infection. It mayproducefewornosymptoms.However,itcanalsoleadtosevereillnessandmaybefatal.Commonsymptomsinclude:•fever•breathlessness•coughIt may take 2–14 days for a person tonoticesymptomsafterinfection.Novaccineiscurrentlyavailablefor2019-nCov. However, sc ien t i s t s havereplicatedthevirus.Thiscouldallowforearlydetectionandtreatment inpeoplewho have the virus but are not yetshowingsymptoms.SARSSevere acute respiratory syndrome(SARS) was a contagious diseasecausedbytheSARS-CoVcoronavirus.Ittypicallyledtoalife-threateningformofpneumonia.

The virus startedoff in theGuangdongProvinceinsouthernChinainNovember2002, eventually reaching Hong Kong.Fromthere,itrapidlyspreadaroundtheworld,infectingpeoplein37countries.SARS-CoV is unique. It can infect boththeupperandlowerrespiratorytractandcanalsocausegastroenteritis.ThesymptomsofSARSdevelopoverthecourseofaweekandstartwithafever.Earlyoninthecondition,peopledevelopflu-likesymptoms,suchas:•drycoughing•chills•diarrhea•breathlessness•achesPneumonia,aseverelunginfection,maydevelopafterward.Atitsmostadvancedstage,SARScausesfailureofthelungs,heart,orliver.During the epidemic, there were 8,098confirmed cases of SARS with 774fatalities.Thisisequaltoamortalityrateof9.6percent.Complicationsweremorelikely in older adults, and half of allinfectedpeopleovertheageof65yearswho became ill did not survive. It waseventuallybroughtundercontrolinJuly2003.MERS, caused by the MERS-CoVcoronavirus,wasfirstrecognizedin2012.This severe respiratory illness firstsurfacedinSaudiArabiaand,sincethen,hasspreadtoothercountries.Thevirus


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hasreachedtheU.S.,andthelargestoutbreakoutsidetheArabianPeninsulaoccurredinSouthKoreain2015.Symptomsincludefever,breathlessness,andcoughing.Theillnessspreadsthroughclosecontactwithpeoplewhohavealreadybeeninfected.However,allcasesofMERSare linked to individuals who have recently returned from travel to the ArabianPeninsula.MERSisfatalin30to40percentofpeoplewhocontractit.


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ChallengeYourMind…… PuzzleTime.


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RattleYourBrain…….QuizTime.1.Whichof the followingcapsule sizes has thesmallestcapacity?A.5B.4C.0D.0002. The solution used torinsevaginaiscalledas:A.DouchesB.IrrigationC.EnemaD.Diluent3.IodineisstoredinA . Thyro id g land asthyroglobulinB.LiverC.IntestineD.Skin4. The most importantfunction of a gene is tosynthesizeA.EnzymesB.HormonesC.RNAD.DNA5. Which one of thisfollowing properties isa p p l i c a b l e t osuspension?A.BrownianmovementB.LaminarflowC.Stokes'lawD . R a p i d r a t e o fsedimentation

6. The therapeutic indexofadrugisameasureofitsA.SafetyB.EfficacyC.PotencyD.Dosevariability7 . A n t i b o d i e s a r eproducedfromA.T-cellsB.NKcellsC.B-cellsD.Eosinophils8.TheopticalaminoacidisA.GlycineB.ThreonineC.SerineD.Valine9. Transgenic animalsimprovethequalityofA.MilkB.EggsC.MeatD.Alloftheabove10.VitaminKisfoundinA.FishB.GreenleafyplantsC.MeatD.Milk11. The percentage ofsucroseinsimplesyrupisA.65.8%w/wB.66.7%w/wC.66.8%w/wD.65.6%w/w

1 2 . F o r a n i d e a ls u s p e n s i o n , t h esedimentation volumeshouldbe:A.EqualtooneB.LessthanoneC.MorethanoneD.Zero13.Whichcompoundisan a t u r a l emu l s i f y i n gagent?A.AcaciaB.Polysorbate20C.LactoseD.Polysorbate801 4 . T h e f o l l o w i n ghormoneisclassified

A.AnandrogenB.AnestrogenC.AprogestinD.Agonadotropin15. Milk sugar is knownas:A.FructoseB.GlucoseC.LactoseD.Sucrose


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StudentExchangeProgramme"Sailawayfromthesafeharbor.Catchthetradewindsinyoursails.ExploreDreamDiscover"Student exchangeprogrammeNeedoftheHour!!1 . Students nowadays are moreinterested to do internships be a smallonemonthortwomonthinternshiporayearlongoneinotherreputedcountriessuchasCanada,USA,MiddleEastetc.2. These internships help providestudentswithvaluablecertificateswhichwill add value in their C.V and alsoprovide them with a platform at globallevel which will help them understandglobalscenario.3. Potential students should be short-listed based upon their academicexcellenceandothercapabilities,willandinterestforsuchprogrammes.4.Mostlythesummerandwinterbreakscan be chosen as the time for suchprogrammestooccur.5. In India aswell if good relations areestablished in top reputed pharmacycol leges across India then suchprogrammescanbeconductedhereaswellinIndia.6. These programmes could be a one

month,twomonth,sixmonth,ninemonthoryearlonginternships.(stipendcanbeprovidedtostudentsforsameformakingitmoreappealingandvaluable)7. These could be just exchangeprogramme between two colleges oruniversities wherein IPASF can be abridge or mediator between those twoinstitutes,forspreadingthenetwork.8.IPASFcandomanysuchprogrammesifMOUsaresignedbyforeigninstitutesand that way students can becomemembersoftheprestigiousorganisationaswell.9. Like membership drive ,studentexchange programmedrives in variouscolleges across India for giving eachstudent chance to participate for thesame.10.Effectivebudgetthatcanbestudentfreindlycanbedevisedatthefirstplace.


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� � ’� � � � � � � �28-29,February2020(Friday-Saturday)Venue : Vignan Institute of Pharmaceutical Technology, Duvvada, Visakhapatnam, Andhra PradeshPhone: 0891-2511222 / 2589777 Email: [email protected] Web: www.ipasf.org, www.vignanpharma.com

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LastDateofAbstractSubmission15-02-2020 LastDateofRegistration25-02-2020VisitUsat:www.ipasf.org

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