Multiple myeloma represents a malignant proliferation of plasma cells derived from a single clone. The tumor, its products and the host response to it result in a number of organ dysfunctions and symptoms of bone pain, fracture, anemia, hypercalcemia, susceptibility to infection, neurologic symptoms, clotting abnormalities and manifestations of hyperviscosity. The cause of myeloma remains unexplained but it is associated with few occupations, inflammatory conditions, autoimmune illnesses, viral infections and genetic heterogeneity. Direct interaction between multiple myeloma cells and bone marrow cells activates pleiotropic signalling pathways that mediate growth, survival, migration of multiple myeloma cells and also resistance to chemotherapy. Although myeloma remains incurable, but the use of novel drugs like thalidomide, lenalidomide and bortezomib have resulted in a paradigm change in the therapy of myeloma. Their inclusion in current multiple myeloma treatment regimens have extended median overall survival especially in younger patient population. Recent advances in the molecular genetics have provided opportunities to design highly specific inhibitors of signal transduction pathways that may enhance the efficacy of standard chemotherapy drugs by reducing or altering the pathways associated with cell survival. Despite therapeutic advances, multiple myeloma ultimately relapses and remains an incurable disease. Current research goals are to further increase our knowledge, to identify additional targeted therapies, and to reduce adverse effects and improve response rate. This review focuses on recent clinical advancement in ant myeloma strategies with additional discussion dedicated to emerging drugs that may prove beneficial to patients with this disease. [Int J Basic Clin Pharmacol 2013; 2(2.000): 103-121

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Background: Pharmacology as a medical subject undergoes constant update and thus is ever expanding. Periodic review of the teaching-learning tools along with the evaluation methods and then improvisation of the same to make the curriculum effective as well as student friendly can help in making the medical student grasp the difficult subject easily. The present study was undertaken to get the students' feedback regarding the various teaching methodologies used in the Department of Pharmacology and the evaluation techniques to assess them. Methods: A prevalidated and anonymous questionnaire was given to the second professional MBBS students at the end of their session. The questionnaire had both closed ended and open ended questions. The data were compiled and evaluated as counts and percentages. Approval was taken from Institutional Ethics Committee. Results: About 57.9% students found the subject useful and interesting and the most common topics of interest among the students were general pharmacology (29.5%), cardiovascular system (17.9%), and autonomic nervous system (15.8%). Interactive lectures, audiovisual aids with demonstrations and tutorials were considered the most interesting method of learning pharmacology (42.1%, 31.6%, and 31.6%, respectively). The majority of the students (61%) wanted clinical case studies to be incorporated in the routine teaching of pharmacology for better understanding and better correlation of drugs used in diseases. The best method of evaluation according to the students was a combination of written and viva exam (51.6%), followed by written class test only (33.7%), and tutorials (22.1%). The suggestions about improvement in pharmacology teaching which were highlighted by the students were inclusion of clinical case studies with drug management, incorporation of multiple choice questions, and computer simulations. Conclusion: It is important to take regular feedbacks from the students to make the teaching more useful and interesting so that synchronization between teachinglearning, evaluation and assessment can be achieved for improved outcome.

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Background: Type 2 Diabetes mellitus (DM) is a heterogeneous group of disorders associated with both microvascular and macrovascular complications. Due to progressive nature of type 2 DM, dual / triple drug therapy produce additive effects, less side effects and allows the use of submaximal doses of individual agents. Therefore, the present study was designed to study the effect of voglibose in comparison to pioglitazone on glycaemic and lipid profile as an add-on drug in patients with DM whose glycaemic status was uncontrolled with glimepiride and metformin. Methods: The present study was open, randomized parallel group comparison of two active treatment groups over a six months period. Sixty patients of either sex in the age group of 30-75 years, suffering from type 2 DM, with FBG> 126 mg/dl and HbA1c between 7- 10 % were selected at random. The effect of voglibose and pioglitazone were observed on various parameters i.e. FBG, PPBG, HbA1c and lipid profile (Total cholesterol, TG, LDL, VLDL). Results: At the end of 6 months it was observed that though both pioglitazone and voglibose reduced FBG, PPBG and HbA1C significantly but pioglitazone caused a significantly greater percentage change in FBG as well as in PPBG whereas the difference in mean percentage change in HbA1C was not significant. Also, fall in total cholesterol, TG, LDL and VLDL was significantly greater with pioglitazone than voglibose. Few side effects were observed with voglibose and not with pioglitazone. Conclusions: Though pioglitazone and voglibose were equally effective in lowering HbA1C levels yet pioglitazone showed better results in improving FBG, PPBG and lipid profile as compared to voglibose. Pioglitazone had minimal side effects as compared to voglibose. [Int J Basic Clin Pharmacol 2012; 1(3.000): 160-167