Background:Atorvastatin has a longer duration of action than other hydroxymethylglutaryl coenzyme A reductase inhibitors.Objectives:The objective was to evaluate the efficacy of alternate day vs. daily dosing of atorvastatin for the treatment of hyperlipidemia.Materials and Methods:In this prospective, open label, crossover study, 40 patients with plasma low-density cholesterol (LDL-C) of more than 130 mg/dl and total cholesterol (TC) more than 200 mg/dl were recruited. After baseline tests, they were randomly allocated to two groups. Group A received 20 mg atorvastatin on alternate days and group B received 20 mg atorvastatin daily for 12 weeks. After 4 weeks of washout period, the groups were crossed over to the other treatment regimen for another 12 weeks. Fasting plasma lipid profile and serum alanine transaminase (ALT) and aspartate transaminase (AST) were measured for both groups at 6th, 12th, 16th, 22nd, and 28th weeks. Results were pooled across the periods and data between the two groups were compared using unpaired t-test.Results:Among the 40 enrolled subjects, 38 completed the study. Both treatment regimens significantly reduced LDL-C and TC compared to baseline. There was no statistically significant difference between the two groups in terms of reduction of plasma LDL-C and TC at 6 and 12 weeks of treatment. Both the regimens were well tolerated.Conclusion:Alternate-day treatment with atorvastatin is comparable in efficacy and safety to the established daily treatment regimen, thus being a cost effective alternative.

Background: Pain is a very well-known symptom of many diseases and analgesics are used to relieve pain. The main problem with these drugs remains that of side effects. Herbal medicines are better in view of their cultural acceptability, better compatibility with human body systems and lesser incidence of side effects. Extract of Tinospora cordifolia (Guduchi) plant have been traditionally used to treat pain in traditional medicine.Methods: Commercially available preparation of T. cordifolia plant has been used as test drug (aqueous extract). Healthy albino rats of either sex, weighing between 140-200 g were selected for the study, divided into 4 groups of 6 each (control, standard, 100 mg/kg, 300 mg/kg). Central analgesic activity was assessed by tail flick model (morphine as standard drug I.P). Acetic acid 1% 10 ml/kg aqueous solution I.P. was used for abdominal writhing model. Diclofenac 150 mg/kg oral as standard drug for assessment of peripheral analgesic activity. Results were analysed using SPSS version 16 and Microsoft office excel 2007.Results: T. cordifolia extract significantly increased the tail flick latency time (sec) (mean tail flick latency control, T100, T300 6.833±0.25 sec, 8.65±017 sec, 10.01±0.14 respectively) (p value control vs T100, T300 at 90 min, 120 min, 0.0573, 0.0198, 0.0198 in between group) and decreased number of abdominal writhing in comparison with the control group (p value <0.0001).Conclusions: Extract of T. cordifolia was found to possess analgesic activity and also exhibited dose and time dependant increase involving central and peripheral mechanisms. The analgesic activity of T. cordifolia found to be comparable to standard drug used.

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Objective: Oral sildenafil, a phosphodiesterase 5 inhibitor,is now accepted mode of therapy for symptomatic Pulmonary arterial hypertension(PAH).As the pathobiologic mechanisms are different in primary and secondary PAH, we undertook this study to find out any significant difference in efficacy of oral sildenafil therapy in primary versus secondary PAH. Methods: It was an unicentric parallel group longitudinal study. After selection and baseline investigations,all the patients of primary and secondary PAH were given sildenafil in fixed doses (50 mg thrice daily). Study parameters: 1. Distance covered in 6 minute walk test (6MWT), 2.Pulmonary arterial pressure (PAP) by trans-thoracic Doppler echocardiography, 3.quality of life (QOL) score assessed by Minnesota living with heart disease questionnaire. At the end of 6 weeks, 6 MWT, PAP, QOL were compared to the baseline value. Results: 42 subjects completed the study.20 subjects had primary PAH and 22 had secondary PAH. Sildenafil therapy was effective in both groups in reducing PAP, increase in distance covered in 6 minute walk and reducing QOL score. Reduction of PAP is significantly more in primary PAH than secondary PAH but no such difference was found in 6 MWT and QOL score. Conclusion: Though lowering of pulmonary arterial pressure in primary PAH is significantly lower than secondary PAH, this is not translated in better symptomatic relief.