Objectives: To understand the pattern of use of opioid-substitution therapy (OST) and opioid abuse among patients on buprenorphine maintenance using urinalysis. Materials and Methods: The study was conducted at a tertiary care de-addiction center. We reviewed the laboratory record of all consecutive urine samples sent for drug analysis over a period of 1 year. In all, 179 consecutive urine samples were included in the analysis. The chi-square test was used to compare opioid abuse among those testing positive and negative for buprenorphine on urinalysis. Additionally, in order to assess the potential impact of the prescribed induction and maximum dose of buprenorphine on the findings, we carried out the independent-samples t test. Level of statistical significance was kept at P<0.05 for all the tests. Results: Urinalysis failed to detect buprenorphine in 44.7% of the samples. Rate of detection of dextropropoxyphene was significantly higher among buprenorphine-negative samples (P<0.005). The prescribed induction dose of buprenorphine was significantly lower among those testing positive for heroin. This was found for both buprenorphine-positive (P<0.005) as well as buprenorphine-negative samples (P<0.005). Conclusions: These findings support the routine use of urine drug screening among individuals on OST.

Objectives: To study the ability of the secondary metabolites of Cynodon dactylon to serve as an antagonist to angiotensin II type 1 receptor (AT ₁ ); activation of this receptor plays a vital role in diabetic retinopathy (DR). Materials and Methods: In silico methods are mainly harnessed to reduce time, cost and risk associated with drug discovery. Twenty-four compounds were identified as the secondary metabolites of hydroalcoholic extract of C. dactylon using the GCMS technique. These were considered as the ligands or inhibitors that would serve as an antagonist to the AT ₁ . The ACD/Chemsketch tool was used to generate 3D structures of the ligands. A molecular file format converter tool was used to convert the generated data to the PDB format (Protein Data Bank) and was used for docking studies. The AT ₁ structure was retrieved from the Swissprot data base and PDB and visualized using the Rasmol tool. Domain analysis was carried from the Pfam data base; following this, the active site of the target protein was identified using a Q-site finder tool. The ability of the ligands to bind with the active site of AT ₁ was studied using the Autodocking tool. The docking results were analyzed using the WebLab viewer tool. Results: Sixteen ligands showed effective binding with the target protein; diazoprogesteron, didodecyl phthalate, and 9,12-octadecadienoyl chloride (z,z) may be considered as compounds that could be used to bind with the active site sequence of AT ₁ . Conclusions: The present study shows that the metabolites of C. dactylon could serve as a natural antagonist to AT ₁ that could be used to treat diabetic retinopathy.

Objectives: To find the efficacy of serial extracts of Anisomeles malabarica in inhibiting proliferation of and inducing apoptosis in human cervical cancer cells, SiHa and ME 180, that are HPV 16-positive. Materials and Methods: The whole plant was extracted in n-hexane, chloroform, ethyl acetate, n-butanol, methanol, and water. The cells were treated with the extracts at increasing concentrations to find the IC ₅₀ , adopting MTT ([3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]) assay. Acridine orange (AO) and ethidium bromide (EB) and Hoechst 33258 staining were adopted to assess the mode of cell death, Annexin V-Cy3 staining to evaluate one of the early apoptotic features, JC-1 staining to assess the mitochondrial membrane depolarization, comet assay for DNA fragmentation, and cell cycle analysis for the distribution of cells after treatment. Results: n-Hexane and chloroform extracts were cytotoxic to the cervical cancer cells in dose- and duration-dependent manner. The cells that responded to the treatments revealed typical apoptotic features. Early features of apoptosis, phosphatidyl serine translocation and loss of mitochondrial trans-membrane potential, were observed in the treated cells, and comet assay revealed DNA damage. In the FACS analysis, the cells accumulated in the sub-G0/G1 phase of the cell cycle, except in n-hexane- and chloroform extract-treated SiHa cells at 24 h, which showed arrest in S- and G2/M phases. Conclusions: n-Hexane and chloroform extracts of A. malabarica inhibit proliferation of and induce death in HPV16-positive cervical cancer cells, mostly by apoptosis and to some extent by necrosis.

Objectives: To analyze the hematinic formulations available in Indian market for their varieties of dosage forms, iron salts used, content of elemental iron, frequency of administration, additional nutrients, and cost. Materials and Methods: Hematinic formulations listed in Indian Drug Review (2009) were analyzed for the iron salts contained and the elemental iron content. Preparations containing iron ± folic acid ± vitamin C were considered as 'acceptable' formulations. For proper comparison, cost of 100 mg elemental iron in each formulation was calculated. Acceptable oral formulations containing iron with folic acid were further classified according to iron salts, and the median cost of various iron salts was compared. We also identified oral solid formulations that required administration more than three times a day. Prices of 'acceptable' iron preparations were compared with that of 'irrational' formulations. Results: Out of 621 formulations, 365 were oral solid formulations, 232 were oral liquids, and 24 were for parenteral administration. Formulations containing iron salts like ferrous sulphate, ferrous sulphate (dried), carbonyl iron, and ferrous fumarate are cheaper than formulations containing other iron salts. Among the 365 oral (solid) iron formulations, we found 60 that would require administration more than three times a day to provide a therapeutic dosage of elemental iron. As compared to irrational formulations, the cost of acceptable formulations was in a significantly narrow range; however, the median cost of acceptable products was significantly higher than that of the irrational ones, except in case of the parenteral preparations. Conclusion: The drug regulation authorities should tune the drug price in such a way that rational formulations cost less than the irrational ones.

Objectives: To evaluate the acute effects of colony-stimulating factor (G-CSF) on ventricular arrhythmias after coronary occlusion in rats. Materials and Methods: Male Wistar rats (10 weeks) received G-CSF (100 μg.kg ^-1 ) or vehicle. Thirty minutes later, animals were infarcted by coronary occlusion under artificial respiration. Electrocardiogram was monitored for 30 min to evaluate ventricular arrhythmias. Results: G-CSF treatment reduced the number of premature ventricular beats and the number and duration of ventricular tachycardia. The incidence of ventricular fibrillation was significantly reduced by G-CSF (MI-Cont: 11.2 ± 2.4 vs. MI-GCSF: 5.4 ± 1 events; P < 0.05). However, total duration of ventricular fibrillation was not altered (MI-Cont: 84 ± 16 vs. MI-GCSF: 76 ± 13 sec). Conclusions: Acute administration of G-CSF before coronary ligature in rats reduces the incidence of ventricular premature beats and ventricular tachycardia, suggesting a possible direct electrophysiological effect of this cytokine independently of its genomic effects. However, the data suggest that G-CSF treatment may affect the spontaneous recovery from ventricular fibrillation. Acute G-CSF administration acts directly on cardiac electrophysiology, different from chronic treatment.

Objectives: To study the effect of acute and repeated dose administration of lyophilized aqueous extract of the dried fruits of Tribulus terrestris (LAET) on sexual function in sexually sluggish male albino rats. Materials and Methods: Aphrodisiac activity of the test drug was evaluated in terms of exhibited sexual behavior. In order to assess the effect of chronic T. terrestris exposure on the hypothalamus--pituitary--gonadal axis, testosterone level estimation and sperm count were carried out. Twenty-eight-day oral toxicity studies were carried out to evaluate the long-term effects of the LAET administration on different body systems. Results: A dose-dependent improvement in sexual behavior was observed with the LAET treatment as characterized by an increase in mount frequency, intromission frequency, and penile erection index, as well as a decrease in mount latency, intromission latency, and ejaculatory latency. The enhancement of sexual behavior was more prominent on chronic administration of LAET. Chronic administration of LAET produced a significant increase in serum testosterone levels with no significant effect on the sperm count. No overt body system dysfunctions were observed in 28-day oral toxicity study. Conclusions: Findings of the present study validate the traditional use of T. terrestris as a sexual enhancer in the management of sexual dysfunction in males.

Objectives: To compare the safety and efficacy of glucosamine HCl- sustained release (GLU-SR) with that of Glucosamine HCl- immediate release (GLU-IR) in patients with knee osteoarthritis (OA). Materials and Methods: This study involved 59 patients with knee OA, randomised to receive single oral dose of 1,500 mg, GLU-SR and GLU-IR for 60 days with 31 and 28 patients, respectively. The primary efficacy (pain and function) was assessed using visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Intention-to-treat principle, repeated measure of ANOVA and mixed model analysis were used. Results: The patients baseline, demographic and clinical characteristics were comparable between groups with female preponderance (71.20%). There was a significant reduction in algofunctional indices as primary outcome measure in both the groups across time (P < 0.001) and 29% lesser adverse events (AEs) in GLU-SR group, with no difference in the use of rescue medications. Conclusions: The study showed equal efficacy of the glucosamine formulations on algofunctional indices in reducing pain in patients with knee OA with less number of AEs in GLU-SR.

Bowel ischemia is a rare and potential life-threatening disorder. The reason for its rarity is the difficulty in its diagnosis. Vague and nonspecific clinical findings and limitations of diagnostic and treatment options make this disease a significant challenge. We hereby report two cases of non-occlusive mesenteric ischemia and the use of cilostazol in the successful management of such cases.

A 5-month-old male patient developed recurrent seizures and acute encephalopathy possibly due to first dose of diphtheria, pertussis (whooping cough), and tetanus (DPT) vaccine used for routine immunization. Postreaction computed tomography (CT) scan of brain, magnetic resonance imaging (MRI) of brain, and electroencephalogram were normal. Pertussis fraction of DPT vaccine is responsible for this reaction. It is suggested that acellular pertussis vaccine should be used instead of whole cell vaccine because it is associated with lower frequency of neurological complications, such as seizures, encephalopathy, and hypotensive episodes. However, acellular pertussis-containing vaccines are currently not affordable in most developing countries.