Search

Background: If postoperative acute pain remains unrelieved, it may result in significant morbidity and mortality. Preemptive analgesic initiated before surgery offers premature analgesia even before exposure to an initial noxious stimulus bestowing effective postoperative analgesia. In developed countries, it is regularly practiced as a part of well-defined protocol. In our country however, only a few centers practice it and that too irregularly and with undefined protocol. Few studies support preemptive analgesic efficacy of novel antiepileptic agent gabapentin. Though lamotrigine is a proven analgesic in animal models of chronic pain and clinical studies of gabapentin-resistant neuropathic pain, a literature search revealed scarce data on its preemptive analgesic efficacy. Aims: The present study is designed to study the preemptive analgesic efficacy of lamotrigine in comparison with diclofenac sodium in postoperative pain control. Materials and Methods: This randomized clinical trial included 90 patients of both sexes, between 18 years and 70 years undergoing major surgeries. Patients were randomly allocated into placebo, control, and test groups and received the respective treatment 30 min before the induction of anesthesia. Aldrete score and pain score were recorded using visual analog scale (VAS), facial rating scale (FRS), and behavioral rating scale (BRS) at awakening and at 1 h, 2 h, 4 h, 6 h, and 24 h. Postoperative rescue analgesic consumption for 24 h was recorded. Results: Significantly higher pain scores were observed in the placebo group postoperatively for 2 h on all pain scales (P < 0.05), whereas in the control group it was significantly higher at 1 h (P < 0.05). The test group patients were more comfortable throughout the study and postoperative analgesic requirement was significantly less (P < 0.05). Conclusions: The study recommends the use of single oral dose lamotrigine as preemptive analgesic for effective postoperative pain control. [ABSTRACT FROM AUTHOR]

This study was conducted to observe the effect of vitamin B± supplementation on glycemic control in poorly controlled hyperhomocysteinemic type 2 diabetic patients by measuring HbA1c levels at baseline and 4 weeks. Patient having serum homocysteine more than 15 μmol/L or vitamin B± less than 223 pg/mL were enrolled in this study. One group received methylcobalamin 500 μg daily with their usual anti-diabetic therapy and the other group received only suitable anti-diabetic drug therapy. Methylcobalamin 500 μg was given daily for period of 4 weeks. Glycemic control was measured by levels of HbA1c, blood sugar at baseline and at 4 weeks. Serum homocysteine levels was reduced from 21.5 ± 2.6 to 15.4 ± 6.4 (p=0.04) with vitamin B± supplementation at 4 weeks. At 4 weeks, HbA1c decreased from 9.9 ± 0.9 to 8.7 ± 0.5 (p<0.01) in vitamin B± deficient patients after vitamin B± supplementation. There is role of vitamin B± in glycemic control in poorly controlled type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

Background: The preclinical incision pain models and clinical studies in healthy volunteers have demonstrated the central serotonergic analgesic mechanism, paracetamol analgesia. This has been evidenced by raised serotonin concentrations in the brain following paracetamol administration in a few studies. The inhibition of paracetamol analgesia by 5-HT3 antagonists suggests that this analgesia is 5-HT3 mediated. However, in a few studies, 5-HT3 antagonists themselves exhibited an analgesic action. Various studies in this context stated intricate results. The present study was intended to understand the pharmacodynamic interaction between paracetamol and ondansetron in postoperative patients. Methods: This randomized clinical trial included 32 postoperative cases of either sex, ages between 18 and 70 years. The patients were randomly allocated into the placebo and test groups and received respective treatment at the end of surgery. The pain score was recorded using Visual Analogue Scale (VAS) and Face, Legs, Activity, Cry, Consolability (FLACC) behavioral scale at awakening and every 30 min for the next 3 h. The postoperative rescue analgesic consumption for 24 h was recorded. The data were analyzed using OpenEpi and SciStatCalc statistical software. Results: A significantly higher pain score was observed in the placebo group postoperatively for 60 min on VAS (p<0.05 and p<0.01), whereas the FLACC behavior scale score was significantly higher at 120 and 150 min (p<0.05). The test group patients were more comfortable throughout the study, and the postoperative analgesic requirement was significantly lesser (p<0.05). Conclusions: The pharmacodynamic interaction between paracetamol and ondansetron coadministration does not block but instead increase paracetamol analgesia, reduce the postoperative analgesic requirement, and improve the postoperative comfort level. [ABSTRACT FROM AUTHOR]

Objective: While studying the effects of ethanol extract Achyranthes aspera (EEAA) on wound healing in alloxan induced diabetic rats we happened to notice its hypoglycemic and hypolipidemic effects and this has motivated us to study its effects on histopathology of the pancreas in alloxan induced diabetic rats to understand probable mechanism of its action. Methods: The whole plant of Achyranthes aspera was obtained in January 2010, from local regions of Pune; shed dried, powdered & was macerated with 95% ethanol for two weeks at room temperature. The extract was then filtered and concentrated by evaporation. The extract was assayed for antidiabetic and hypolipidemic effects using standard biochemical and Histopathological test methods. Results: The 95% EEAA given orally at a dose of 400 mg/kg showed significant antidiabetic activity as evidenced by decreased BSL and normalized beta cells in photomicrograph of hematoxylin and eosin stained sections of pancreas of diabetic rats. Conclusion: EEAA may serve as natural tonic for pancreas in diabetic patients. [ABSTRACT FROM AUTHOR]

Circadian rhythmicity is present in almost every aspect of the living world and effects of drugs on various life forms are no exception. This study was undertaken to find out the circadian variation in the analgesic activity of aspirin and to correlate the variations with the blood levels of salicylate at that time. The model used was the application of radiant heat to the tail of rats for analgesic activity. Aspirin exhibited maximum activity when administered at 12:00 h, although this difference was not statistically significant. Also, there was no correlation between the levels of salicylate in the blood and the activity of aspirin. Due to the presence of this trend towards increased activity at 12:00 h, it may thus be worthwhile to conduct similar studies, in patients of chronic arthritis, in order to find out the time(s) at which, aspirin if administered will be most useful. [ABSTRACT FROM AUTHOR]

The role of the time of administration of phenytoin on its serum levels and pharmacodynamic parameters was studied in two comparable groups of patients of grand mal—epilepsy stabilized on serum phenytoin therapy. In these patients, phenytoin was advised to be taken as a single daily dose either at 08.00 (Group M) or 20.00 (Group E) every day. A serum phenytoin level profile over 24 hours was obtained and all patients were clinically followed up for six months. Maximum serum concentration (C-max) of phenytoin was achieved significantly faster (p < 0.001) in patients of Group E. The total number of serum samples having toxic concentrations and also the incidence and severity of toxic effects of phenytoin was less in Group E. The study suggests that bedtime administration of phenytoin in patients of grand mal—epilepsy may lead to faster absorption of the drug and less side effects as compared with drug administration in the morning. [ABSTRACT FROM AUTHOR]