Introduction: Over the past few years, the demographic profile of lung cancer has changed. However, most reports are limited by small numbers, short follow-up period, and show an inconsistent pattern. A comprehensive evaluation of changing trends over a long period has not been done. Materials and Methods: Consecutive lung cancer patients were studied over a 10-year period from January 2008 to March 2018 at the All India Institute of Medical Sciences, New Delhi, and relevant clinical information, and survival outcomes were analyzed. Results: A total of 1862 patients were evaluated, with mean (SD) age of 59 (11.1) years, and comprising 82.9% males. Majority were smokers (76.2%) with median smoking index of 500 (interquartile range [IQR]: 300–800). Adenocarcinoma (ADC) was the most common type (34%), followed by squamous cell carcinoma (SCC – 28.6%) and small cell lung cancer (SCLC) (16.1%). Over the 10-year period, ADC increased from 9.5% to 35.9%, SCC from 25.4% to 30.6%, and non-small cell lung cancer -not otherwise specified (NSCLC-NOS) decreased from 49.2% to 21.4%. The proportion of females with lung cancer increased although smoking rates remained similar. Majority of NSCLC (95%) continued to be diagnosed at an advanced stage (3 or 4). Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements were present in 25.3% and 11.5% ADC patients, respectively. The median overall survival was 8.8 months (IQR 3.7–19) for all patients and 12.57 (IQR 6.2–28.7) months among the 1013 patients who were initiated on specific treatment (chemotherapy, targeted therapy, radiotherapy, or surgery). Never-smokers were younger, more likely to be female and educated, had a higher prevalence of ADC and EGFR/ALK mutations, and had better survival. Conclusion: Among this large cohort, our center seems to follow the global trend with increasing incidence of ADC. EGFR mutation positivity was similar to existing reports, while higher ALK positivity was detected. A characteristic phenotype of never-smokers with lung cancer was elucidated which demonstrated better survival.

These findings suggest that HRV is reduced in subjects with newly diagnosed essential hypertension and the parasympathetic dysregulation is present in the early stage of essential hypertension.

Fibromyalgia is a musculoskeletal pain of different parts of the body, which is also associated with fatigue, lack of sleep, cognition deficits, family history, gender bias, and other disorders such as osteoarthritis and rheumatoid arthritis. It is generally initiated after trauma, surgery, infection, or stress. Fibromyalgia often coexists with several other conditions or disorders such as temporomandibular joint disorders, bowel and bladder syndrome, anxiety, depression, headaches, and interstitial cystitis. While there is no permanent cure for fibromyalgia, some interventions are available with multiple side effects. rTMS (repetitive transcranial magnetic stimulation), a noninvasive management strategy is used widely for various pain-related etiologies including fibromyalgia in both the laboratory and clinical settings. In this Review, we discuss the role and mechanism of action of rTMS in fibromyalgia patients and on associated comorbidities including anxiety, pain, depression, neurotransmitter alterations, sleep disorders, and overall quality of life of the patients suffering from this chronic problem. We also provide an update on the rTMS application in the clinical trials of fibromyalgia patients and prospective management therapy for multiple problems that these patients suffer.

Background:Quality control of Unani polyherbal formulations is the need of the day for better acceptance of Unani medicine. Qurse Tabasheer (QT) is a Unani polyherbal formulation containing six ingredients, Tabasheer (Siliceous concretions) (Bambosa arundinaceae Retz.), Gule Surkh (Rosa damascena Mill. flower), Gulnar (Punica granatum Linn. flower), Tukhme kahu (Lactuca sativa Linn. seed), Tukhme khurfa (Portulaca oleraceae Linn. seed), and Gile Armani (bole) widely used in treatment of diabetes. The present study was taken up to scientifically evaluate the various physicochemical parameters to standardize the formulation.Objective:To evaluate various physicochemical parameters including ash values, moisture content, extractive values, thin layer chromatography (TLC) and high-performance TLC (HPTLC), friability, disintegration, uniformity, and weight variation for standardization of QT.Materials and Methods:Ingredients were identified by the experts. The method mentioned in national formulary of Unani Medicine with modification was followed for preparation of the tablets. Physicochemical standards were established for ideal batch of tablets on the basis of set parameters regarding friability, hardness, and disintegration. Various parameters such as organoleptic characters, extractive values for the extract and HPTLC fingerprinting postcompression were carried out for evaluation of QT.Results:Parameters for loss of weight on drying, pH, ash values, extractive values documented. Qualitative chemical tests indicated the presence of alkaloid, glycoside, tannins, and steroids. TLC and HPTLC fingerprinting studies showing the presence of major peaks were documented. Friability, hardness, and disintegration time of ideal batch was 0.09 ± 0.0057, 4.03 ± 0.087, and 25.57 ± 0.4860 min, respectively, and it was found to be within the set limit. Weight variation was <5%. Total fungal and bacterial counts were found to be within the limit.Conclusion:Standards were established for poly herbal formulation QT, which may be used as reference for preparation and standardization of QT.SUMMARY In this work Standardization of anti-diabetic tablet Qurse Tabasheer with diverse ingredients including herbal and mineral origin drugs has been attempted with identification of its ingredients, formulation, physicochemical evaluation and HPTLC finger printing, which may help in preparing consistent and better efficacious formulations. Abbreviations Used: QT: Qurse Tabasheer TLC: thin layer chromatography HPTLC: high-performance thin layer chromatography WHO: World health organization FRLHT: Foundation for Revitalization of Local Health Traditions Fe2O3: Iron oxide Sio2: Silica CaCo3: Calcium carbonate, Tio2: Titanium Oxide NIUM: National Institute of Unani Medicine #: Mesh size LOD: Loss of weight on drying USP: United state Pharmacopeia UV: Ultra Violet λ: Lambda θ: theta CFU: Colony-forming unit

Arecacatechu, commonly known as supari, consists of dried ripe nuts that came under Arecaceae family, which is cultivated in the tropical region of India and Southeast Asia. It is a prevalent traditional herbal medicine that is chewed to separate collected fluid in the alimentary canal and for killing worms. Areca catechu seed contains alkaloids (arecoline, arecaine, arecaidine, guvacoline, guvacine, and choline), tannin, gallic acid, gum, and various minerals such as copper, calcium, phosphorus, and iron. The chemical constituents of this plant have been used as antidiabetic, stomatitis, bleeding gums, gingivitis, conjunctivitis, glaucoma, leucorrhoea, urinary disorders, anorexia, diarrhea, blood pressure regulating activity, antiulcerogenic, antioxidant activity, anticonvulsant activity, central nervous system stimulant activity, antifertility, oxytocic activity, antiviral activity, anthelmintic, and foul breath. It showed a dose‐dependent toxicity profile, and various research has been done regarding its safety analysis and it would be considered safe when administered in the prescribed dose. The purpose of the present paper is to make available an up‐to‐date review on the ethnic, traditional description, morphology, phytochemistry, and the pharmacological and toxicological profile of this plant. Furthermore, the possible advances, trends, and a perspective for forthcoming research of this plant have also conversed.