Objective: To investigate the immunomodulating mechanisms of a Chinese herbal medicine Yi Shen Juan Bi (YJB) in treatment of adjuvant arthritis (AA) in rats. Materials and Methods: Levels of serum tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β) were measured by the Enzyme-Linked Immunosorbent Assay (ELISA). Expression of TNF-α mRNA and IL-1β mRNA in synovial cells was measured with the semi-quantitative technique of reverse transcription-polymerase chain reaction (RT-PCR), while caspase-3 was examined by western blot analysis. Results: The administration of YJB significantly decreased the production of serum TNF-α and IL-1β. It also decreased significantly the TNF-α mRNA, IL-1β mRNA, and caspase-3 expression in synoviocytes. Conclusions: YJB produces the immunomodulatory effects by downregulating the over-activated cytokines, while it activates caspase-3, which is the key executioner of apoptosis in the immune system. This may be the one of the underlying mechanisms that explains how YJB treats the rheumatoid arthritis.

Objectives: To study the antidiabetic activity of Barleria prionitis Linn in normal and alloxan-induced diabetic rats. Materials and Methods: Alcoholic extract of leaf and root of B. prionitis was tested for their antidiabetic activity. Albino rats were divided into six groups of six animals each. In three groups, diabetes was induced using alloxan monohydrate (150 mg/kg b.w., i.p.) and all the rats were given different treatments consisting of vehicle, alcoholic extract of leaves, and alcoholic extract roots of B. prionitis Linn (200 mg/kg) for 14 days. The same treatment was given to the other three groups, comprising non-diabetic (normal) animals. Blood glucose level, glycosylated hemoglobin, liver glycogen, serum insulin, and body weight were estimated in normal and alloxan-induced diabetic rats, before and 2 weeks after administration of drugs. Results: Animals treated with the alcoholic extract of leaves of B. prionitis Linn showed a significant decrease in blood glucose level (P<0.01) and glycosylated hemoglobin (P<0.01). A significant increase was observed in serum insulin level (P<0.01) and liver glycogen level (P<0.05), whereas the decrease in the body weight was arrested by administration of leaf extract to the animals. The alcoholic extract of roots showed a moderate but non-significant antidiabetic activity in experimental animals. Conclusion: The study reveals that the alcoholic leaf extract of B. prionitis could be added in the list of herbal preparations beneficial in diabetes mellitus.

Objective: Clonidine has been used as adjuvant to local anesthetics in order to extend the duration of analgesia in various regional and central neuraxial blocks. It is previously reported that clonidine added to bupivacaine increases analgesia duration in brachial plexus block. We evaluated the effect of this combination in supraclavicular brachial plexus block for upper limb orthopedic procedures. Materials and Methods: A randomized double-blind placebo controlled trial was done with 70 patients of American Society of Anesthesiologists Grade I or II status undergoing upper limb orthopedic procedures. Group A (n = 35) patients received 25 ml of 0.5% bupivacaine and 0.2 ml (30 mcg) clonidine, whereas group B (n = 35) received 25 ml of 0.5% bupivacaine and 0.2 ml normal saline through a supraclavicular approach for brachial plexus block. Vital parameters were recorded 10 min prior to block placement and every 3 min thereafter till the end of the procedure. Onset and duration of both sensory and motor blocks and sedation score were recorded. All patients were observed in postanesthesia care unit and received tramadol injection as soon as they complained of pain as rescue analgesic. Duration of analgesia was taken as the time from placement of block till injection of rescue analgesic. Results: Analgesia duration was 415.4 ± 38.18 min (mean ± standard deviation) in Group A (clonidine) compared to 194.2 ± 28.74 min in Group B (control). No clinically significant difference was observed in heart rate, blood pressure, and oxygen saturation. Sedation score was higher in the clonidine group. Conclusion: Addition of a small dose of clonidine to 0.5% bupivacaine significantly prolonged the duration of analgesia without producing any clinically important adverse reactions other than sedation.

Background: Extended exposure to low levels of lead causes high blood pressure in human and laboratory animals. The mechanism is not completely recognized, but it is relatively implicated with generation of free radicals, oxidant agents such as ROS, and decrease of available nitric oxide (NO). In this study, we have demonstrated the effect of ascorbic acid as an antioxidant on nitric oxide metabolites and systolic blood pressure in rats exposed to low levels of lead. Materials and Methods: The adult male Wistar rats weighing 200-250 g were divided into four groups: control, lead acetate (receiving 100 ppm lead acetate in drinking water), lead acetate plus ascorbic acid (receiving 100 ppm lead acetate and 1 g/l ascorbic acid in drinking water), and ascorbic acid (receiving 1 g/l ascorbic acid in drinking water) groups. The animals were anesthetized with ketamin/xylazine (50 and 7 mg/kg, respectively, ip) and systolic blood pressure was then measured from the tail of the animals by a sphygmomanometer. Nitric oxide levels in serum were measured indirectly by evaluation of its stable metabolites (total nitrite and nitrate (NOc)). Results: After 8 and 12 weeks, systolic blood pressure in the lead acetate group was significantly elevated compared to the control group. Ascorbic acid supplementation could prevent the systolic blood pressure rise in the lead acetate plus ascorbic acid group and there was no significant difference relative to the control group. The serum NOc levels in lead acetate group significantly decreased in relation to the control group, but this reduction was not significantly different between the lead acetate plus ascorbic acid group and the control group. Conclusion: Results of this study suggest that ascorbic acid as an antioxidant prevents the lead induced hypertension. This effect may be mediated by inhibition of NOc oxidation and thereby increasing availability of NO.

Background: To study the anticonvulsant effect of different extracts of Centella asiatica (CA) in male albino rats with reference to Na ⁺ /K ⁺ , Mg ²⁺ and Ca ²⁺ -ATPase activities. Materials and Methods: Male Wistar rats (150±25 g b.w.) were divided into seven groups of six each i.e. (a) control rats treated with saline, (b) pentylenetetrazol (PTZ)-induced epileptic group (60 mg/kg, i.p.), (c) epileptic group pretreated with n-hexane extract (n-HE), (d) epileptic group pretreated with chloroform extract (CE), (e) epileptic group pretreated with ethyl acetate extract (EAE), (f) epileptic group pretreated with n-butanol extract (n-BE), and (g) epileptic group pretreated with aqueous extract (AE). Results: The activities of three ATPases were decreased in different regions of brain during PTZ-induced epilepsy and were increased in epileptic rats pretreated with different extracts of CA except AE. Conclusion: The extracts of C. asiatica, except AE, possess anticonvulsant and neuroprotective activity and thus can be used for effective management in treatment of epileptic seizures.

Background: The students are in the best position to comment on the effectiveness of any teaching system and they may be regarded as the best judges to assess the teaching and evaluation methods. Objective: This study was designed to obtain student feedback on teaching and assessment methods in the subject of pharmacology and use it for improvement. Materials and Methods: Based on student feedback from batch 2006, innovative strategies were implemented. To know the effect of these strategies feedback was obtained from subsequent batch 2007 using a written validated questionnaire covering various aspects of teaching and assessment methods. Results: Students were satisfied with all teaching methods except lecture, seminars and pharmacy exercises. Majority of the students showed preference for tutorials, short answer questions and revision classes. All students felt that there should be more time for clinical pharmacology and bedside teaching. The performance score of the students (batch 2007) indicated improvement in their scores (12%) when earlier feedback suggestions were implemented. The pass percentage of the subsequent batch in university examinations improved from 90 to 100%. Conclusion: The implementation of suggestions obtained from students resulted in improvement in their performance. Hence, it is very essential to synchronize teaching and evaluation methods with special requirements of medical students.

Objectives: To assess the effects of sodium valproate on rat sperm morphology, sperm count, motility, and histopathological changes in testis. Materials and Methods: Male Wistar rats (12 week old) were treated with sodium valpraote and sacrificed at the end of 2 ^nd , 4 ^th , 5 ^th , 7 ^th , 10 ^th and 15 ^th week after the last exposure to sodium valproate. Epididymal sperm count, sperm motility, sperm morphology, and histopathology of testes were analyzed. Results: Sperm count and sperm motility were decreased significantly by sodium valproate. The percentage of abnormal sperms increased in a dose-dependent manner. A histopathological study revealed that sodium valproate had caused sloughing of epithelial cells in testes. Conclusion: Sodium valproate causes reversible change in sperm motility, sperm count, morphology, and cytoarchitecture of testes.

Objective: The present study was undertaken with the aim to detect extent of drug use in elderly at medicine outpatient department at tertiary care hospital and to evaluate inappropriate prescribing with the help of Beers' criteria 2002. Materials and Methods: The study was carried out at medicine out patient department of our hospital. 407 geriatric patients were included during the study period of three and half months. The data was collected in a proforma which included the patients' details and the prescriptions. Results: The results reveal that 7.42% of total drugs were prescribed in an inappropriate manner and 23.59% of total patients received at least one inappropriate drug prescription. Administration of a drug which is avoided in elderly forms a common category of inappropriate drug use. Antihistamines, anticholinergic, sedatives and hypnotics and cardiac glycosides are the most common drug groups prescribed in inappropriate manner. Conclusion: To conclude, this study shows high prevalence of inappropriate use of drugs in geriatric practice suggesting urgent need for sincere efforts to improve the situation.

Objective: To investigate the total alkaloid fraction of the methanol extract of leaves of Hygrophila auriculata for its hepatoprotective activity against CCl4-induced toxicity in freshly isolated rat hepatocytes, HepG2 cells, and animal models. Materials and Methods: Mature leaves of H. auriculata were collected, authenticated, and subjected to methanolic extraction followed by isolation of total alkaloid fraction. Freshly isolated rat hepatocytes were exposed to CCl4 (1%) along with/without various concentrations of the total alkaloid fraction (80-40 μg/ml). Protection of human liver-derived HepG2 cells against CCl4-induced damage was determined by the MTT assay. Twenty-four healthy Wistar albino rats (150-200 g) of either sex were used for the in vivo investigations. Liver damage was induced by administration of 30% CCl4 suspended in olive oil (1 ml/kg body weight, i.p). Results: The antihepatotoxic effect of the total alkaloid fraction was observed in freshly isolated rat hepatocytes at very low concentrations (80-40 μg/ml). A dose-dependent increase in the percentage viability was observed when CCl4-exposed HepG2 cells were treated with different concentrations of the total alkaloid fraction. Its in vivo hepatoprotective effect at 80 mg/kg body weight was comparable with that of the standard Silymarin at 250 mg/kg body weight. Conclusion: The total alkaloid fraction was able to normalize the biochemical levels which were altered due to CCl4 intoxication.

The present study was conducted to evaluate the possible antibacterial activity of Anabaena extracts. Anabaena was isolated from a natural source and cultured in vitro. after suitable growth, cyanobacterial culture was harvested using different solvents. Extracts, thus prepared, were evaluated for their antibacterial potential by agar-well diffusion assay against bacterial species of clinical significance. MIC values were determined further to check the concentration ranges for significant inhibition. HPTLC analysis was done to separate the components of active crude extract in an attempt to identify the bio-active chemical entity. Methanol extract exhibited more potent activity than that of hexane and ethyl acetate extracts. No inhibitory effect was found against Pseudomonas aeruginosa, Salmonella typhi, and Klebsiella pneumoniae. Staphylococcus aureus required about 256 μg/ml of the crude methanol extract for effective inhibition. HPTLC evaluation at λ 254 nm was performed for the separation of a complex mixture of the methanol extract. The results provide evidence that Anabaena sp. extracts might indeed be potential sources of new antibacterial agents.

Thrombocytopenia is an uncommon but potentially life-threatening complication of certain antitubercular drugs and is characterized by rapid destruction of platelets whenever offending drug is taken by a susceptible person. We report a case of pyrazinamide-induced thrombocytopenia in a patient receiving anti tubercular drugs.

Cross-sensitivity due to paroxetine and sertraline, the SSRIs, is rarely reported in the literature. We report an adverse drug reaction to paroxetine and sertraline in a patient of panic disorder, who initially developed a maculopapular, erythematous, pruritic rash in the third week with sertraline 50 mg/day. The rash resolved within 2 days of its discontinuation and oral supplementation of diphenhydramine and betamethasone. 10 days following discontinuation of sertraline, the patient was shifted on sustain release paroxetine 12.5 mg/day when another skin reaction with the same appearance and distribution appeared on day 4 of it, suggesting a possibility of cross-sensitivity, a drug class effect. This case report intends to improve the awareness among clinicians to use caution when choosing an alternative SSRIs.

Amisulpride is an atypical antipsychotic used for the management of schizophrenia and other conditions like dysthymia. It has also been used for the management of bipolar disorders as an add on therapy. Here, we report a patient of schizophrenia who developed a manic episode while on amisulpride.