Objectives:To analyze the impact of various drugs used in conservative therapy on renal failure and mortality in hepatorenal syndrome (HRS) at a tertiary care teaching hospital.Materials and Methods:Retrospective review of hospital admission records was conducted for case records with HRS as diagnosis. Demographic and clinical data and drug utilization pattern were collected in a pre-designed patient information sheet. Impact of various drugs especially hepatoprotector antioxidant, silymarin, on survival benefits in terms of number of patients alive, change in mean arterial pressure (MAP) and change in serum creatinine at the end of treatment period were estimated by univariate and followed by multivariate analysis.Results:Of the total 89 case records, 31 met the eligibility criteria and were included in the analysis. On multivariate analysis, a significant correlation between use of intravenous fluids (IVFs) and survival benefits was observed (P < 0.05); wherein patients treated with IVFs had an increase in log odds of survival by 2.42 (95% CI = 1.06 to 121.13) as compared to patient not treated with IVF. However, MAP was not affected by any of the treatment modalities. While change in serum creatinine level was not significantly (P = 0.06, regression correlation = −0.3) correlated with duration of treatment with IVFs.Conclusion:Use of IVFs may be associated with better short-term survival benefits and favor HRS reversal. Use of silymarin as hepatoprotector antioxidant has no beneficial effects on HRS reversal or survival benefits.

Background: Bronchial asthma is one of the commonest chronic inflammatory diseases. The drugs available to treat bronchial asthma such as, beta-2 agonists, though very effective are associated with adverse effects. Therefore, the Ocimum sanctum (Tulsi) which was shown to have antiasthmatic activity in Ayurveda, is evaluated in this study.Objectives: To evaluate the bronchodilator activity of Ocimum sanctum Linn. in mild and moderate asthma and compare its efficacy with the standard bronchodilator drug, Salbutamol.Methods: This is a single-blind cross-over study. Capsules of Ocimum sanctum Linn. (200 mg, twice daily) and Salbutamol sulphate (2 mg, twice daily) were administered in 41 patients. Each drug was administered for a period of one week with a washout period of one week between the two drug schedules. FEV1 and PEFR were recorded in these patients to assess the bronchodilator activity before the drug administration, on 4th and on 7th day of administration of Ocimum sanctum and the parameters obtained were compared with that of the standard drug, Salbutamol.Results: Ocimum sanctum 200mg twice daily produced significant improvement in both FEV1 and PEFR values, on 4th and 7th day and also produced improvement in symptoms of asthma. On comparing the results with that of Salbutamol 2mg twice daily, the bronchodilator activity of Ocimum sanctum was found to be less efficacious, where Salbutamol produced very highly significant improvement in FEV1 and PEFR values on both 4th and 7th day.Conclusions: Our results suggest that Ocimum sanctum Linn. possesses significant bronchodilator activity in mild and moderate bronchial asthma.