Introducing a new drug to the market now costs an average of US$ 897 million and is a time consuming process. Discovering new uses for the old drugs offers the advantage of providing time tested drugs for the benefit of the patients. Serendipity plays an important role in this. This therapeutic option may provide cost effective treatment, especially for the developing countries with limited resources. This article focuses on the new potential uses of some common drugs. However, these options need to be pursued by more researches so that the potential benefits could be passed on to the patients.

Epilepsy affects 50 million people worldwide. Women may be afflicted with catamenial epilepsy, a form of epilepsy related to the menstrual cycle. In catamenial epilepsy, seizures are clustered around the monthly cycle. Despite the availability of several standard and newer antiepileptic drugs, there is no specific and effective therapy for catamenial epilepsy. Moreover, the exact pathophysiology of catamenial seizures remains unclear. It is well known that progesterone possess anticonvulsive properties. The level of this hormone drops near the end of the cycle, leaving women more vulnerable to catamenial epilepsy. Recent studies have shown how progesterone protects women against seizures. Progesterone plays two roles in the brain. First, it binds to progesterone receptors in the brain, which help regulate the reproductive functions. Second, progesterone gets metabolized to allopregnanol-one in the brain called a neurosteroid. We found that allopregnanolone plays a crucial role in seizure protection. The withdrawal from this neurosteroid, which occurs during the menstrual cycle, could provoke seizures. Consequently, we suggest that neurosteroid replacement could be a novel therapeutic approach for catamenial epilepsy.

Objective: The present study was undertaken to find out the preventive and curative role of lipoic acid (LA) and vitamin E (Vit. E) on doxorubicin (DOX)-induced oxidative stress and to make comparative evaluation between LA and vitamin E in this regard. Materials and Methods: Wistar albino rats were used in this experiment. DOX was administered intraperitoneally in six equal injections (each containing 2.5 mg/kg DOX at 48 h interval) to a total cumulative dose of 15 mg/kg over a period of 2 weeks to produce cardiotoxicity. Lipoic acid and vitamin E were administered as pretreatment and post-treatment. The biochemical parameters such as tissue glutathione (GSH), malondialdehyde (MDA), lactate dehydrogenase (LDH), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-s-transferase (GST), and glucose-6-phosphate dehydrogenase (G6PD) were monitored after 30 days. Results: Post-treatment with lipoic acid and vitamin E significantly protected the myocardium from the toxic effects of DOX, by reducing the levels of antioxidant enzymes such as CAT, SOD, GPx, GST, and G6PD towards normal and decreased the increased levels of malondialdehyde. It has also reduced the severity of cellular damage of the myocardium. The restoration of the endogenous antioxidant system clearly depicts that lipoic acid and vitamin E have produced their protective effect by scavenging the reactive oxygen species (ROS). Pretreatment with LA did not alter DOX-induced changes of histopathological parameters. Pretreatment with vitamin E has significantly increased the levels of blood and tissue GSH and significantly decreased the levels of MDA as compared to DOX-treated group. Vitamin E has significantly reduced the activities of the antioxidant enzymes except GSHR as compared to the DOX-treated group. Conclusion: The study strongly supports the use of these antioxidants in the treatment of DOX-induced cardiotoxicity; however, vitamin E is better for both preventive and curative therapy but LA can be used only for curative therapy.

Objective: To study the antianaphylactic, antihistaminic and mast cell stabilization activity of HK-07 in experimental animals. Materials and Methods: HK-07 is a polyherbal formulation containing extracts of various plant constituents. The compound HK-07 was evaluated using Wistar rats and Duncan Hartley guinea pigs. The antianaphylactic activity was investigated in rats using the active anaphylaxis model. The effect on mast cell stabilization was performed by ex vivo challenge of antigen in sensitized rat intestinal mesenteries. Antihistaminic activity was studied in guinea pigs using histamine-induced bronchospasm where preconvulsive dyspnea was used as an end point following exposure to histamine aerosol. Dose response studies of HK-07 were conducted at 125, 250, and 500 mg/kg, p.o. in anaphylactic shock-induced bronchospasm in rats. The optimal dose level was used for the remaining experimental models. Results: Treatment with HK-07 at 125, 250, and 500 mg/kg, p.o. showed significant reduction in signs and severity of symptoms (P <0.05), onset (P <0.001) and mortality rate (P <0.05) following anaphylactic shock-induced bronchospasm. HK-07 also significantly reduced the serum IgE levels (P <0.001) in animals compared to untreated controls. Treatment of sensitized animals with HK-07 at 500 mg/kg, p.o. for 2 weeks resulted in a significant reduction in the number of disrupted mast cells (P <0.001) when challenged with an antigen (horse serum). HK-07 significantly prolonged the latent period of convulsion (P <0.008) as compared to control following exposure of guinea pigs to histamine aerosol. Conclusion: The findings from various studies reveal that the antihistaminic and antianaphylactic activity of HK-07 may be due to the mast cell stabilizing potential, suppression of IgE, and inhibition of release of inflammatory mediators.

Objective: To determine the in vitro antifungal activity of Pallavicinia lyellii , a liverwort and to obtain clues about the active principle(s) and toxicity, if any. Materials and Methods: The in vitro antifungal activity of P. lyellii was studied against four test fungi ( A. niger, A. fumigatus, F. oxysporum and C. albicans ) using disc diffusion and direct dilution methods. Water, alcohol, and hexane extracts of P. lyellii were tested and the most active alcohol extract was subjected to sequential solvent fractionation. The promising hexane fraction was subjected to thin layer chromatography on silica gel and each spot on the gel was tested for activity and the active spot was chemically analyzed. The alcohol extract was evaluated for its short-term toxicity in mice. Results: Water, alcohol, and hexane extracts of P. lyellii showed varying levels of activity against the test fungi; the alcohol extract exhibited maximum activity. Out of the 4 test fungi , A. fumigatus was found to be the most sensitive . The alcohol extract was devoid of conspicuous short-term toxicity to mice. An active hexane fraction was separated from alcohol extract and from this fraction a steroid component with remarkable antifungal activity was isolated using thin layer chromatography (TLC). Conclusion: From P. lyellii a steroidal fraction with remarkable in vitro antifungal activity has been isolated. Further, the extract is devoid of conspicuous toxicity based on short-term toxicity evaluation in mice.

Objective: To study the effects of vitamin E deficiency and supplementation of vitamin D and bone metabolism in female Sprague-Dawley rats. Materials and Methods: Rats weighing between 200 and 250 g were divided into six groups, that is, rats fed on (a) normal rat chow diet (RC), (b) vitamin E-deficient diet (VED) (c) VED diet supplemented with 60 mg/kg a-tocopherol acetate (ATF), (d) VED diet supplemented with 60 mg/kg γg-tocotrienol (GTT), (e) VED diet supplemented with 60 mg/kg Tocomin ® (TOC) and (f) baseline control group which was killed without treatment (BC). Treatment was given for 2 months. Serum 1,25-dihydroxyvitamin D3, serum total calcium, urine calcium, left femur, and fourth lumbar vertebra calcium content and left femur length were measured. Results: In the VED and ATF groups, activation of vitamin D to 1,25-dihydroxyvitamin D3 was inhibited and calcium reabsorption in the kidneys were increased. Both the effects seen in ATF and GTT groups were observed in the TOC group. The GTT group was protected from the effects of the vitamin E-deficient diet. Calcium content of the fourth lumbar vertebra was also decreased by vitamin E- deficiency, which was not reversed by vitamin E supplementation. Conclusion: γg-tocotrienol and not α-tocopherol protects vitamin D metabolism and calcium homeostasis from the effects of vitamin E-deficiency.

Objective: To evaluate the various drug information queries received, and to assess the quality of services provided by the drug information center of the pharmacy practice department. Materials and Methods: The drug information queries received during ward rounds, by telephone, direct access, intranet etc. were documented in the drug information request and documentation forms prepared by the department. These forms were evaluated retrospectively for a period of 12 months, from July 2003 to June 2004, for various parameters like status of the enquirer, specialty of practice, mode of receipt of query, purpose of query, type of query etc. The quality of drug information services provided was assessed both from the receivers' as well as from the providers' perspective. The receivers' perspective was evaluated on the basis of the feedback questionnaire circulated, and the providers' perspective was evaluated by using the guidelines from the DSE/WHO seminar. Results: A total of 666 drug information queries were received during the study period. Upon evaluation, it was found that most of the beneficiaries of the service were the physicians (82%) and postgraduate students (16%) of the department of medicine. The analysis of the feedback questionnaire showed that most of the enquirers (92.5%) utilized the drug information service regularly and appreciated the quality of services provided by the drug information center. Evaluation of queries answered by the center from the providers' perspective revealed that they were within the acceptable limits of quality. Conclusion: The drug information services provided by the pharmacy practice department of Kasturba Hospital, Manipal, caters to the need of health care professionals and eventually towards better patient care.

Objective: To evaluate the efficacy and safety of a 'Quick cycle' neoadjuvant chemotherapeutic regime in squamous cell carcinoma (SCC) of cervix and monitor the response to chemotherapy using Squamous Cell Carcinoma Antigen (SCC-Ag) as tumor marker. Materials and Methods: Thirty patients with SCC of cervix (Stage I-IV) entered the study to receive three courses of multiagent neoadjuvant chemotherapy (vincristine, cisplatin and bleomycin) in a weekly regime. SCC-Ag was evaluated in these patients' pre and post-chemotherapy. Results: Patients with stage IB2 had a complete response and two of seven patients with stage IIB became operable. The overall response rate was 47.8% and complete response rate was 8.7%. Decrease in tumor volume post-chemotherapy was significant (P<0.002). Toxicity including myelosuppression was minimal. A statistically significant decrease in SCC-Ag (stage II and III) was seen post-chemotherapy (P <0.04 and 0.005, respectively). Conclusion: The weekly chemotherapeutic regime was found to be safe and effective and SCC-Ag is a useful tumor marker for monitoring response to chemotherapy.