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16th Issue

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2012-2013

The Indian Pharmaceutical Association Students’ Forum

Panache -Live The Monthly Newsletter !!! June, 2012 Our Mission: The Indian Pharmaceutical Association-Students’ Forum is a national body of pharmacy students under IPA. It is a platform to promote increased student interactions and activities bringing more co-operation at a national level. IPA-SF will also link the pharmacy students in India with the rest of the world through memberships and alliances with international organizations. The IPASF will serve as a unifying factor for the pharmacy students’ community in India bringing them under one umbrella and thus benefit in turn the profession and thus the future health of INDIA.

Cover Story: World Sickle Cell Day 19th June


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Students’ Speak - Cosmetic Surgeries – Risks and Precautions

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Editor’s Choice -The Greening of Pharma

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Student Exchange Program Cover Story- Sickle Cell Anaemia

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Special article : Dear Pharmacy Council, is MS Pharmacy valid? Homework

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Excecutive Council

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STUDENTS’ SPEAK Cosmetic Surgeries –Risks and Precautions

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Cosmetic surgeries are being increasingly used for correcting physical abnormalities as well as for enhancing normal physical features. Principles of cosmetic surgery are often also used in reconstructive surgery and treatment of burns. Some of the popular forms of cosmetic surgery include breast augmentation, osuction, nasal surgery, eyelid surgery and abdominoplasty. However, the risks associated with these surgeries are often less understood. The objective of this study was to identify the most common complications and effective precautionary methods.

A review of English-literature was conducted. Articles reporting the risks and complications of cosmetic surgery were identified from the PUBMED and EMBASE databases. Qualifying studies were accessed for the risks and precautionary measures for cosmetic surgeries. Data extraction was carried out by two reviewers for increasing the consistency. Some of the major risks found included bleeding, infection and an adverse reaction to anaesthesia. Some patients were found to have damaged nerves, tissues and blood vessels. Chronic pain was observed in the region of surgery. Patient safety was also found to be at risk due to the surgical nature of the procedure. A through physical and blood examination was found to be a strong precautionary measure. Knowledge about current and past medical history along with tobacco and alcohol usage also was found to be beneficial in reducing the risk of a complication post-surgery. Informed consent procedure was beneficial in managing patient expectations and also warning the patient of the potential risks. Patients should verify the credentials and past records of the performing medical practitioner. Compliance with GMP guidelines tends to increase patient safety. Increased risk of adverse events and complications post-cosmetic surgeries, can lead to increased healthcare utilization, costs and decreased quality of life. Taking simple precautionary measures and engaging the patients in decision making are key to achieving better health outcomes postsurgery.

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Editor’s Choice

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The Greening of Pharma Experts give some Big Pharma companies high marks for their environmental initiatives. Benchmarking efforts and new tools promise to make it easier for all drug companies, regardless of size, to improve performance and reduce costs. The famous complaint that “it's not easy being green” just won't cut it in the real world anymore. Drug manufacturers that have made concerted efforts to boost their energy efficiency or convert their manufacturing processes to greener chemistries have not only realized intangible image improvement, but very tangible bottom line benefits. Critical to any drug company's success is strongly articulated, top-down management support for environmental initiatives. Merck, Genentech and Procter and Gamble were among 20 major corporations that collaborated with Energy Star personnel and scenario consultants from Global Business Network to develop the position paper “Energy Strategy for the Road Ahead” last year. In this document, authors from industry and EPA proposed various hypothetical situations that might change the global energy scene through 2020 and how they would affect businesses. The group concluded that the following would be key to survival: · Executive commitment to continually improve energy efficiency across the entire corporation, including clear processes and tracking systems to identify opportunities. · An empowered corporate energy director and energy team supported by sufficient human and financial resources. · A corporate energy policy that is accounted for at the top levels of the corporation. · Aggressive, numeric energy goals that stretch performance targets to draw out creative innovations for meeting them. · Measurement and tracking of energy performance for all energy use, corporationwide, including benchmarking facility performance nationally and globally with similar companies, and a review system with accountability at all levels. · Communication of the value of energy savings, importance of improving use of energy and executive commitment by consistently recognizing accomplishments. These considerations are especially critical for pharmaceutical companies, because many of them are located in areas of the U.S. where energy costs are higher to begin with, such as New Jersey, Southern California, and the Chicago area. Although the industry is far from being the most energy-intensive, spending about 3% of its annual manufacturing costs on energy, that figure still adds up. “It's not insignificant by any means.” Reducing energy consumption requires having a program in place, staying on message and motivating people throughout the enterprise. Merck's CEO showed his support for energy efficiency two years ago, when he videotaped a “call to action” to all employees, setting a tone from the top level of the organization. A Well-Stocked Toolbox

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Any drug manufacturing professional can easily find resources on improving energy efficiency (for more information, visit PharmaManufacturing.com's new online Green Resources Library). Among the tools that Energy Star provides are: · A Website that facilitates sharing of energyefficiency best practices among companies; · A reference manual, “Energy Efficiency Improvement and Cost Saving Opportunities for the Pharmaceutical Industry,” sponsored by EPA and developed by researchers at Lawrence Berkeley National Laboratory (LBNL) in September 2005 (also in our online Green Resources Library). Joining them shortly will be the Pharmaceutical Manufacturing Energy Performance Indicator (EPI), a benchmarking tool, now in the final stages of review and approval. Its goal is to enable corporate-and industry-wide benchmarking and to rate the energy efficiency of a single U.S. pharmaceutical manufacturing facility. The Indicator will use basic inputs to provide a percentile ranking of an individual plant's energy efficiency by comparing it to the industry's average and “efficient” (defined as the 75th percentile) plants. On behalf of and for use by the Energy Star Program, indices have been developed like this for automotive assembly and cement manufacturing, as well as other sectors. “Energy management is about measuring. You don't manage what you don't measure,” “As more companies [with different types of facilities] come on board, and the people using the index raise issues about its applicability to their particular situations, we'll need to make revisions,” which is fine with him, he says, because the more specific and granular the data, the more the tool can be adjusted to maximize its usefulness. “The most interesting problems are never the easy ones.” The Energy Star Program has, as yet, had little success in attracting “more strictly manufacturingfocused” companies — contract manufacturers, that is — into the mix. Neither are many biologics manufacturing operations represented, nor any foreign facilities (however, plants that are located in Puerto Rico but owned by U.S.-based companies are included). Whereas Big Pharma companies can be guarded about revealing manufacturing-related information in some contexts. Even with the somewhat limited data that has been available there have been challenges in figuring out how to organize the information coming in from manufacturers. Each facility may house a number of different types and combinations of operations, he says, and there may be considerable variability between amount of product produced and the finished product cost from one product to another. Researchers then categorized each location (which might include multiple buildings, each of which might have a different function or combination of functions). The entire data set was then pooled across facilities and across the years for which data were submitted. “We looked at factors such as what activity is going on in a particular location, how much the space is being utilized (hours per sq. ft.), each facility's location and the climate variations among locations,” Boyd explains.

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Editor’s Choice

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Pharma Plants More Variable In particular, the question, “What is the rate of production?” He explains, “That's not difficult to answer in an automotive assembly plant or a cement plant, where a measure like energy use per unit of product produced will be pretty stable. But in pharmaceuticals, that figure can vary wildly from one product to another. So we settled on facility size, utilization of floor space and hours of operation as the basis for comparison.” One thing he would urge pharmaceutical companies with multi-building campuses to do, in order to generate more granular – and thus more enlightening and useful – data, is to “submeter” their facilities. That is, on a multi-building campus, each building should have its own separate energy meter. The cost of doing that is relatively minimal, and the initiative will pay for itself within one year, because it allows an energy manager to immediately find where energy is being wasted, the EPA/DOE's joint Labs21 Program (http://labs21.lbl.gov) is also looking at how laboratory facilities measure their energy usage and trying to understand the implications for individual labs. In the pharmaceutical industry, some companies are just now getting submeters installed on their various buildings. In other industries, you have companies like Toyota that can pull up a program that will show you, in real time, how much energy each air compressor in a given plant is using. What About the Production Process? Curbing energy usage is one way — and a cost-effective way at that — to “go green,” but it is neither the only way to reduce one's carbon footprint nor the only way to cut costs. “Green chemistry” is another approach, and it is not competitive with, but is complementary to, energy-efficiency initiatives. In energy management, one looks at all the elements that are external to the drug product and, for the most part, to the process by which it is manufactured. Green chemistry raises the question, “How can we achieve the same end-product using a different set of inputs and reactions such that we eliminate waste from the process?” Answering that question, requires first determining how “green” (or not) your existing processes are. Or, “You don't [or can't] manage what you don't measure.” What is unanswered is the ethical, ecological and economic value of green chemistry. While the views questions regarding the relative energy efficiency of a process as “hard to get a handle on,” the huge, immediate opportunities for reducing the environmental impact of pharmaceutical manufacturing are in green chemistry, at least for API manufacturing.” More specifically, the two big issues the Roundtable is tackling are 1) the development of metrics that would help pharma companies answer the question, “How do we measure how green our processes are?” and 2) identifying “the 10 worst reactions that need green replacements.” Development of a more sophisticated metric is under way, but in the meantime, one can begin to get a handle on the relative greenness of a process by measuring the number of kilograms of waste generated and dividing it by the kilograms of API produced. “By and large, the industry has gotten much better at reducing waste — in many processes, most of the active and the reagents are recovered and recycled.” However, what isn't recovered or recycled is packaged and sent away to be disposed of, which usually means burned, and that's not a desirable outcome. The first principle of green chemistry is that it's better not to produce waste in the first place. As for the “10 worst reactions” issue is that each company brought its own “10 worst” list to the Roundtable, and there was a fair amount of overlap among the lists. Thus, it wasn't hard for the members to reach a consensus on their first 10 targets. Some of the reactions they wanted to change are those they run now, and some are aspirational — that is, reactions they'd like to run if they could find a greener way to do them.

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Editor’s Choice

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Meanwhile, of course, many individual pharmaceutical companies (including Roundtable members) are doing their own research into green chemistry. Pfizer has maintained its program and Merck has made considerable headway over the last several years. Green chemistry, with its guiding principles of preventing waste, maximizing atom economy, and employing catalysis wherever possible dovetail perfectly with the company's philosophy of how to develop and manufacture drug products. In an FDA-regulated industry where products and processes must be validated prior to receiving marketing approval, “it is much more difficult to change the process post-launch,” Volante points out. Thus, he says, by the time of product launch, “it is our goal to have already applied green chemistry practices wherever possible to minimize waste and environmental impact, and to have evaluated whether we're doing it as efficiently as possible. We're leveraging cost efficiency and atom economy to avoid building waste into the process. That way, we can reap the benefits of that process from day one of the launch.” In addition to its big picture, keep-the-end-inmind approach to process development, Merck has demonstrated a commitment to greener processes by investing heavily in catalysis, which is “extremely rare in the pharmaceutical industry.” “Although some companies are starting to adopt our model. We believe that if we can do things catalytically, we can achieve even higher levels of efficiency.” Green chemistry efforts have allowed it to reduce waste by over 80% and to completely eliminate aqueous waste streams. But if the ROI associated with such efforts isn't enough, “Some people in pharma may hesitate to explore green chemistry alternatives because they think it will cost a lot of money, but we got green chemistry going, in a year when there was a prohibition on new initiatives,” “By reducing waste and the costs associated with disposing of or recycling that waste, green chemistry ends up saving you money.”

References: 1. Energy Strategy for the Road Ahead: Scenario Thinking for Business Executives and Corporate Boards, Global Business Network, San Francisco, Calif., 2007

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S.E.O:Gabriela Keerthana +91 8019289075 seoindiasp@gmail.com

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Cover Story

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Sickle Cell Anaemia What exactly happens???.... Anemia is a condition in which your blood has a lower than normal number of red blood cells. This condition also can occur if your red blood cells don't contain enough hemoglobin. Sickle cell anemia is the most common form of Sickle cell Haemoglobin sickle cell disease (SCD). SCD is a Normal haemoglobin Forms long, inflexible chains serious disorder in which the body makes sickle-shaped red blood cells. “Sickleshaped” means that the red blood cells are shaped like a crescent. Normal red blood cells are disc-shaped and look like doughnuts without holes in the center. They move easily through your blood vessels. Red blood cells contain an ironrich protein called hemoglobin . This protein carries oxygen from the lungs to the rest of the body. Sickle cells contain abnormal hemoglobin called sickle hemoglobin or hemoglobin S. Sickle hemoglobin causes the cells to develop a sickle, or crescent, shape. Sickle cells are stiff and sticky. They tend to block blood flow in the blood vessels of the limbs and organs. Blocked blood flow can cause pain, serious infections, and organ damage Sickle-cell disease is widespread affecting many peoples in Africa, the Mediterranean, the Arabian Gulf and India. It's no wonder that this disease is well known to everyone,the only concern behind writing about this matter is the extent to which it has widespread. Signs and Symptoms Related to Anemia!! The most common symptom of anemia is fatigue (feeling tired or weak). Other signs and symptoms of anemia may include: · Shortness of breath · Dizziness · Headaches · Coldness in the hands and feet · Paler than normal skin or mucous membranes · Jaundice

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Cover Story

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SOME RARE INSTANCES‌.. The.case relates to a negress of 26 years. Her symptoms on admission (pain in the lower abdomen, fever, and vaginal discharge) were such as to consign her to the gynaecological department. There a tentative diagnosis of adnexitis with subacute pelvic peritonitis was made, for although sickle-cells were observed their significance was weakened by the urgency of the localized abdominal symptoms and also by the absence of any confirmatory sign in the relatives of the family. Sudden onset of pain and other symptoms in the upper abdomen, particularly on the right side, suggested acute cholecystitis and transfer to the surgical department. Here the condition on opening the abdomen was disclosed as a case of sickle-cell anaemia complicated by mesenteric tuberculosis. After the operation, which was followed by transfusion of 500 cc. of blood, the patient improved rapidly. "Emphasis is directed to the fact that most patients with sickle-cell anaemia are susceptible to tuberculosis probably because of their lowered resistance to infection." The authors also conclude that a diagnosis of an " acute surgical abdomen " in a negro patient is hazardous without a previous search for sickle-cells.

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Cover Story

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SO HOW DOES IT AFFECTS US???? Sickle cell anemia can destroy the organs of the body. Pain and swelling in the toes, feet and ankles might be one of the first signs of sickle cell anemia. Blocked blood vessels can also cause pain in the hands. Sickle cells can block blood flow to other organs, including the spleen, lungs, brain, eyes and the blood vessels that supply the heart and lungs. Infection and pneumonia are possible. Eye damage, disability from hemorrhagic or ischemic stroke , enlargement of the spleen, and pulmonary artery hypertension are possible effects of sickle cell anemia. Leg ulcers can occur from poor blood flow to the skin. Kidney failure can occur. Red blood cell destruction that releases too much bilirubin into the bloodstream can lead to gallstones and gallbladder attacks that cause nausea and abdominal pain. I DIDN'T KNOW THIS… Fifty percent of patients with sickle cell anemia survived beyond the fifth decade. A large proportion of those who died had no overt chronic organ failure but died during an acute episode of pain, chest syndrome, or stroke. Early mortality was highest among patients whose disease was symptomatic. A high level of fetal hemoglobin predicted improved survival and is probably a reliable childhood forecaster of adult life expectancy. SO HOW CAN I TREAT IT??? · Management of vaso-occlusive crisis · Management of chronic pain syndromes · Management of chronic hemolytic anemia · Prevention and treatment of infections · Management of the complications and the various organ damage syndromes associated with the disease · Prevention of stroke · Detection and treatment of pulmonary hypertension Hydroxyurea therapy can HELP the clinical course of sickle cell anemia in some adults with three or more painful crises per year. Maximal tolerated doses of hydroxyurea may not be necessary to achieve a therapeutic effect. The beneficial effects of hydroxyurea do not become manifest for several months, and its use must be carefully monitored. The long-term safety of hydroxyurea in patients with sickle cell anemia is uncertain. - Pratik Pangaonkar sybpharm SVB’s college of pharmacy

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Dear Pharmacy Council, is MS Pharmacy valid? For two years MS (Pharmacy) is being offered as a on–professional programme thanks to PCI's refusal to engage with the degree. And students stand to lose‌. IN January 2010, the Pharmacy Council of India (PCI) came out with a policy circular (view top section of the image) stating that the Master of Pharmacy programme offered by universities has not been approved by the Pharmacy Council, and hence MS programmes are not approved by the PCI for the purpose of registration as a pharmacist under the Pharmacy Act to practice the profession OR any other purpose such as teaching in approved pharmacy institutions. When NIPER students and faculty protested, PCI came up with an even stranger press release (view bottom section of the image), which while reiterating the fact that MS programme is unapproved, PCI has not even considered the quality or otherwise of the MS programmes offered by NIPER. Why this ostrich mentality? According to Prof. Ramanathan, a renowned pharma scholar, this indicates a complete abdication of responsibility by the PCI. While it is well within its rights to say a programme cannot be approved as a requirement to practise a profession (in this case pharmacy), it needs to apply its mind and come out with a cogent argument as to why it is so. The learned professor's contention is that the PCI cannot just wash its hands off by saying a degree does not come under its purview. Affected students concur wholeheartedly. The denial or registration as a pharmacist does not rankle them so much. Ajesh (name changed), a student, dismisses it saying it is immaterial as the eligibility of MS is a B.Pharm, which is an approved degree. What matters is being denied an opportunity to teach in a pharmacy college. According to Prof.Ramanathan, the least that the PCI could do is to draw up equivalence between an MPharm and MS and see if the programme meets up to the standard. But the outright refusal to consider it smacks of intolerance, he says. What is the way out? It has been two years since the programmes were launched. At least one batch would have passed out. It is high time the PCI gets on with the business of engaging with multiple academic offerings. World over professional bodies prescribe the relevant skills and knowledge that will make one eligible to practise a profession. One could achieve and show proof of competency, through multiple means. So whether it is an MS or MPharm degree, if the programme meets the standards set it must be approved. Our repeated efforts to get a response from PCI were in vain. Careers360 has filed an RTI to PCI seeking its stand on the matter. We will take this up in the coming months so that students who have put in two years of study are not left in the lurch for no fault of theirs.

Reference: career360.com/may2012

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Facts about pharmacy 1. Antipyretic and analgesic are different. 2. Antimuscarinic and Anticholinergic are same. 3. Phenobarbitone a drug from Barbiturates class. 4. Side effects of Anti-psychotic drugs is anti-parkinsons, is reverse of this is not true.

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EXECUTIVE COUNCIL FOR THE YEAR 2012-13 POSITION

NAME

CO NTACT NO.

E-MAIL ID

Chairperson

Chittoory Ratna Geetardha Kondeti Ranjit Reddy Mohit Durve Bha ra th Vika s Fra nklin Israel Sirra Aditya Nar

9581322211

chittooryrg @g ma il.com

9962645850

ranjithreddykondeti@gmail.com

9920820009 9538138189 7207625682 9769176435

Anuj Sha h

9930077486

durvester@gmail.com bharathvikas007@gmail.com fra nklinindia.franklin14@gmail.com naraddy@ya hoo.co.in panachelive@gmail.com sha h.anuj507@gmail.com

Gabriela Keerthana

8019289075

seoindiasp@gmail.com

P.Ajay

9550942300

ajju.nani@gmail.com

Paya l Kikila

9820665989

payal.k89@gmail.com

A.Pa van Kuma r

9581398978

pavankumar.a chanta@gmail.com

C.Charndra Sheka r

9533332309

chanduvips@gmail.com

Samhitha Reddy

7396312163

samhithareddy91@gmail.com

Vice Chairperson Hon. Secretary Jt. S ecretary Hon. Treasure Editor Public Relation Officer Student Exchange Officer Pharmacy Education Officer IPA-S F Contact Person Public Health Officer National Blood Donation Co-ordinator National Anti-TB Co-ordinator

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CALL FOR ARTICLES EXECUTIVE COUNCIL FOR THE YEAR 2010-2011

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1. The selection of articles will solely be the discretion of the Publication Committee of IPA-SF. 2. Every article should have a word limit between 150 to 200 words. 3. Articles should be typed in any normal font (Times New Roman) and should have a font size 12 and sent to panachelive@gmail.com in Microsoft Word Format. 4. Articles should be the Author's original work. If the article has been directly picked up from some source then it may amount to plagiarism and such Author's will be barred from any future participation. 5.The names of any references used should be clearly mentioned. 6.The names of any Co-author/s should also be mentioned. 7.The name of the institution/company of the Author/Co-author/s should be mentioned. 8.The efforts of the Authors and Co-authors whose articles have been selected will be duly acknowledged.

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