The current health care system of the world is dependent on the modern medicine which focusses on curative rather than preventive aspects of medicine. The modern medicine has increased the life expectancy and quality of human life by delivering remedial measures for several diseases. This was possible because of advances in research and availability of evidences to practice medicine. However, in lowincome and middle-income countries, drugs account for 20—60% of health-care costs. The large proportion of these costs is paid out-of-pocket by patients which could be due to inadequate or no coverage by health insurance. To make the condition worse, a third of the world's population lack access to essential medicines. Cost of drugs is one of the factors contributing to the problem of access to medicines. It is estimated that, in India, out-of-pocket health expenditure traps 2.2% of the population below the poverty line each year. In addition, the Indian health system has to face many other challenges like inadequately controlled infections, emerging epidemic of chronic diseases associated with western lifestyle in the near future. Hence, reforming the health system focussing on both preventive and curative aspects of health care services to make it rationale, affordable and accessible is the need of the hour.

Background: Siddha system of medicine is one among the great heritages of India. Iron deficiency anemia is described as “azhal paandu” in siddha system and more formulations are mentioned in literatures to treat anemia. Kadukkai maathirai (KM) is one of the widely used drugs for the treatment of iron deficiency anemia with good patient compliance. It was claimed that this drug is devoid of adverse effects which are seen with other oral iron preparations. Objective: Present study was carried out to standardize kadukkai maathirai by evaluating its physical and chemical properties using modern scientific instruments. Materials and methods: KM was prepared following standard procedures mentioned in the Siddha Hospital Pharmacopeia. Physical properties such foreign matter, loss on drying, total ash content, acid insoluble ash, alcohol soluble extract value and water soluble extract value were evaluated. Amount of iron and heavy metals such as cadmium, mercury, arsenic and lead were estimated. HPTLC chromatogram and photograph were also done. KM was again formulated into tablet form by standard procedures. Kadukkai maathirai tablet (KMT) was analysed for Angle of Repose, bulk density, tapped density, carr’s index, Hausner’s ratio, general appearance (shape, color, texture and odor), thickness, uniformity of weight, coating uniformity, coating process efficiency, hardness and friability. Result: Amount of iron in KM was 18.03%. Whereas amount of heavy metals such as mercury (0.0578 ppm), cadmium (0.0064 ppm), arsenic (0.0405 ppm) and lead (0.2144 ppm) were within the permissible limit . Conclusion: In KM, iron is combined with few herbals which is claimed to facilitate oral bioavailability of iron and nullify iron induced side effects. As heavy metals are within the permissible limit, KM could be considered as safe drug. HPTLC fingerprint could serve for future references.

Background: The drug utilization study identifies the problems that arise from drug usage in healthcare delivery system and highlights the current approaches to the rational use of drugs. Objective: To study the trends in prescribing antimicrobials in an ENT outpatient department (OPD) of a tertiary care hospital for upper respiratory tract infections (URTI). Materials and method: An observational study was conducted in the OPD of ENT at Bapuji Hospital, Davangere, Karnataka, India from May to July 2011. Prescriptions of all patients were collected; relevant information entered in a preformed proforma and analyzed using the drug utilization 90% [(DU-90%)] method. The results were presented in percentages and analyzed using DU-90% method. Result: A total of 300 prescriptions were analyzed. The common cases for which antimicrobials prescribed were infections like pharyngitis, acute suppurative otitis media (ASOM), chronic suppurative otitis media (CSOM), tonsillitis, laryngitis. It was noted that 142 patients (47.33%) received amoxicillin alone, 52 patients (17.33%) received combination of amoxicillin and clavulanic acid, 43 patients (14.33%) received cefixime, 40 patients (13.33%) received cefuroxime and 23 patients (7.66%) received azithromycin, levofloxacin and other antimicrobials. Conclusion: The present study showed that among the various antimicrobials used, only four antimicrobials figured in DU-90% segment which were amoxicillin, combination of amoxicillin and clavulanic acid and cephalosporins like cefixime and cefuroxime. Though azithromycin and levofloxacin are also frequently used drugs in upper respiratory tract infections, in this study they did not figure in the DU-90% segment.

Background: Drinking-water is purified by various methods like UV irradiation, heat treatment, adding disinfectants like chlorine etc. Aims of purification include reducing turbidity and elements, increasing taste and removing microbes. There is no single method available which can fulfill entire expectation. Siddha literatures claim that the purification could be achieved by soaking certain herbals. Objective: The present study was done to evaluate the water purifying property of Phyllanthus emblicawood. Materials and method: 1.5 L of water was taken in two different containers. Control container water was kept as such. Phyllanthus emblica wood pieces (75 g) were soaked in test container. After 48 hrs, two groups of water were filtered and investigated for physical properties, elements and level of microorganisms. Result: The color, odor, turbidity, conductivity, total dissolved solids, total alkalinity, calcium, iron, chloride and nitrate level were increased in the test container. pH, total hardness, sulphate and magnesium levels were decreased in the test container. Level of Escherichia coli, total coliforms and faecal coliforms were reduced in the test container. Conclusion: Soaking Phyllanthus emblica wood improves the purity of water. This beneficial property of Phyllanthus emblica may be used in the purification of drinking water.

Background: Incorporation of Personal drug (P-drug) selection exercise into medical undergraduate curriculum was recommended to reduce irrational prescribing during future practice. At Melaka Manipal Medical College (MMMC), India, P-drug selection exercise was included in pharmacology curriculum in 2010 for 2nd year MBBS students. Objective: The study was conducted to develop a module to teach P-drug selection and to investigate students’ perceptions regarding P-drug selection teaching and assessment. Materials and method: Module was developed to teach P-drug selection for an acute attack of angina and dry cough based on a manual called as ‘Guide to Good Prescribing’ developed by the WHO Action Program on Essential Drugs. Power point slides, handouts with drug costs and current guidelines were used during teaching learning activities. Later students were assessed on P-drug selection by asking them to derive a P-drug for an acute attack of angina. Students’ answers were assessed using a checklist. Later students’ perceptions regarding P-drug selection teaching and assessment were collected using a questionnaire. Data was analyzed using SPSS 16. Students’ responses were expressed as median and inter quartile range. Responses to open ended questions were tabulated in the decreasing order of frequency of appearance. % of students who scored =4 (= pass) marks was noted. Result: 90% (95/106) of students responded in the questionnaire. Most of the items in the questionnaire related to teaching and assessment had a median score of =3. 94.3% of students had scored =4 in P-drug selection exercise. 84% of students felt that P-drug selection teaching helped them to understand pharmacology better. They wanted more such exercises and more explanation to understand P-drug concept better. Conclusion: Study led to development of P-drug selection teaching module acceptable to students. Furthermore it also provided scope for the refinement of newly developed module based on students’ perceptions.