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Murādnagar, India

Sikka P.,LLRM Medical College | Kaushik S.,P.A. College | Kumar G.,Mlb Medical College | Kapoor S.,ITS CDSR | And 2 more authors.
Journal of Pharmacy and Bioallied Sciences

Objective : to study the probable site of antinociceptive action of SSRI (fluoxetine, escitalopram) and atypical antidepressants (mirtazapine, venlafaxine) and their interaction with morphine and naloxone. Materials and Methods : the study was conducted on albino mice (25-35 grams) of either sex. Different doses of morphine (0.5 and 1 mg/kg), fluoxetine (2, 5 and 10 mg/kg), venlafaxine (30, 40 and 50 mg/kg), mirtazapine (3, 5 and 7 mg/kg) and escitalopram (2.5, 5 and 10 mg/kg) were administered subcutaneously to obtain their subanalgesic doses using tail flick analgesiometer. Tail flick latencies were obtained at 15, 30, 60 and 120 min. after drug administration. Naloxone (1 mg/kg) was administered 10 minutes prior to test drug for testing antagonism. Observations : fluoxetine (5 and 10 mg/kg), mirtazapine (5 and 7 mg/kg) and venlafaxine (40 and 50 mg/kg) were found to have antinociceptive activity but not at lower doses. Escitalopram failed to show any antinociceptive activity at any of the doses used. The antinociceptive effect of all the drugs was antagonized by naloxone (1 mg/kg). Further, subanalgesic doses of fluoxetine, mirtazapine and venlafaxine showed analgesic activity with suboptimal dose of morphine (0.5 mg/kg). Result and conclusion : fluoxetine, mirtazapine and venlafaxine have antinociceptive activity whereas escitalopram doesn′t; their site of action seems to be the same as that of opioid analgesics (′mue′ receptors). However, other pathways (cholinergic, histaminic, noradrenergic, GABAergic) may be involved in mediation of their analgesic activity, deserving further elucidation. Results apparently show that these drugs may be useful in the management of pain as monotherapy or in combination with other opioids. Source

Sikka P.,LLRM Medical College | Bindra V.K.,IDST | Kapoor S.,ITS CDSR | Jain V.,Lokpriya Hospital | Saxena K.K.,LLRM Medical College
Journal of Pharmacy and Bioallied Sciences

Methemoglobinemia is a disorder characterized by the presence of >1% methemoglobin (metHb) in the blood. Spontaneous formation of methemoglobin is normally counteracted by protective enzyme systems, for example, nicotinamide adenine dinucleotide phosphate (NADPH) methemoglobin reductase. Methemoglobinemia is treated with supplemental oxygen and methylene blue (1-2 mg/kg) administered slow intravenously, which acts by providing an artificial electron acceptor for NADPH methemoglobin reductase. But known or suspected glucose-6-phosphate dehydrogenase (G6PD) deficiency is a relative contraindication to the use of methylene blue because G6PD is the key enzyme in the formation of NADPH through pentose phosphate pathway and G6PD-deficient individuals generate insufficient NADPH to efficiently reduce methylene blue to leukomethylene blue, which is necessary for the activation of the NADPH-dependent methemoglobin reductase system. So, we should be careful using methylene blue in methemoglobinemia patient before G6PD levels. Source

Sikka P.,ITS CDSR | Bindra V.K.,IDST
Indian Journal of Critical Care Medicine

Thromboembolic disorders are one of the disorders for which we are still on the look out for a safe and efficient drug. Despite the widespread use of antithrombotic drugs for the prevention and treatment of arterial and venous thrombosis, thromboembolic diseases continue to be a major cause of death and disability worldwide. This shows our inefficiency in searching efficacious and safe antithrombotic drugs. We have reached the basic mechanism of thrombus formation and by interrupting various steps of this mechanism, we can prevent as well as treat thromboembolic disorders. In continuation of Aspirin, now, we are using Clopidogrel, Ticlopidine and GpIIb/IIIa inhibitors (Abciximab, Tirofiban and Eptifibatide). Warfarin is an old antithrombotic drug which is still being used; but due to various side effects and drug interactions, we are bound to use newer drugs. Newer antiplatelet drugs include Prasugrel, Ticagrelor and Cangrelor, whereas newer thrombin inhibitors are Ximelgatran and Dabigatran. Apixaban is also a newer entry in this category as factor Xa inhibitor. Idrabiotaparinux is an indirect inhibitor of Xa as it accelerates the activity of antithrombin. Moreover, researches and trials for better and safe drugs are ongoing. Source

Lymphangioma are uncommon hamartomatous congenital malformations of the lymphatic system that involve skin and subcutaneous tissue. They have marked predilection for head and neck region in 75% of cases. Around 50% of lesions are noticed at birth and 90% by 2 years of age. Oral lymphangioma may be present in tongue, palate, buccal mucosa, gingiva and lip. Lymphangioma are of 3 types-simplex, cavernous and cystic lymphangioma. Cavernous lymphangioma is usually seen in fairly dense tissue such as the tongue.We report two unusual cases of cavernous lymphangioma in 24-26 years age group with the site of involvement being floor of the mouth extending into the submandibular triangle in the first case, and the second manifesting as a bluish red swelling on the labial mucosa. Source

Tyagi N.,IDST Dental College | Shetty D.C.,ITS CDSR | Urs A.B.,Maulana Azad Medical College
Journal of Oral and Maxillofacial Pathology

Background: Oral lichen planus (OLP), a well-known mucocutaneous lesion has been the center of debate regarding its obscure etiopathogenesis. Recent highlight has been placed on the role of autoimmunity and a sect of constitutional molecules, the native chaperones HSP70, proposed to be important in the onset and progress of disease. Aim: To substantiate a potential role of HSP70 in the pathogenesis of oral lichen planus. Settings and Design: The study involved immunohistochemical (IHC) analyses in a laboratory under monitored conditions. It was a retrospective study on clinically and histopathologically confirmed specimens. Materials and Methods: 30 samples of confirmed cases of OLP were selected and grouped on the basis of the thickness of the epithelial layer into atrophic, normal (classical) and acanthotic. An immunohistochemical analysis of the expression of HSP70 protein was done, followed by a quantitative and qualitative analysis of the stained layers. Statistical Analyses: A Z test was performed to estimate the difference observed between two sample proportions. The statistics was given at 1% level of significance i.e. P<0.01. Results: An increased expression of HSP70 was noted in the basal and suprabasal cells of the epithelium of OLP. A higher count and intensity of HSP70 expression was seen in the basal layer of the epithelium. Greater expression was noted in the epithelium of the atrophic group. Conclusion: The expression pattern of HSP70 positively implicates it in the pathogenesis of OLP. Source

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