OBJECTIVES: Chronic constipation (CC), a common functional gastrointestinal disorder, has laxatives as its mainstay of treatment. Refractoriness to laxatives calls for better treatment options. Prucalopride is a novel, well-tolerated enterokinetic with high 5-hydroxytryptamine 4 receptor selectivity. This study was undertaken with the intention to establish the efficacy and safety of prucalopride with placebo in adults with refractory CC. MATERIALS AND METHODS: Patients were screened and 180 patients fulfilling the inclusion criteria were simply randomized into 2 groups either to receive prucalopride 2 mg (n = 90) or placebo (n = 90) once daily for a duration of 12 weeks. The efficacy endpoints (primary) were intended to measure the proportion of patients with three or more spontaneous complete bowel movements (SCBMs) per week over 12 weeks. Secondary endpoints were assessed via the validated questionnaires. Adverse events, electrocardiogram, and other laboratory parameters were monitored at different time intervals. RESULTS: Efficacy and safety were analyzed in 180 patients simply randomized (1:1) into group A (prucalopride arm, n = 90) and group B (placebo arm, n = 90). Patients having three or more SCBMs per week in the prucalopride arm (2 mg) were 41% as against to 12% in the placebo arm (P < 0.001). A significant increase (P < 0.001) in the number of spontaneous bowel movements per week plus an increase of average bowel movement by 1 point per week was seen in the prucalopride arm. Secondary efficacy endpoints which included patients' treatment satisfaction, improvement in the perception of constipation symptoms using the patient assessment of constipation -symptoms and stool consistency score changes were more pronounced in the prucalopride arm than the placebo. The most common adverse events reported from both the groups were headache, nausea, bloating, and diarrhea. No significant cardiovascular changes or laboratory abnormality was detected throughout the study period. CONCLUSION: Prucalopride is effective in laxative refractory CC cases with a good safety profile.

Background: Diacerein has been known as an anti-osteoarthritic agent that is usually given along with other analgesic drugs. Still there is no evidence of the analgesic effect of diacerein alone. So this pilot study was undertaken to assess the analgesic property at supra-spinal level by using the tail-flick method.Methods: Diacerein at doses of 50, 100 and 200 mg/kg was given to Albino wistar rats weighing approximately 100-200 grams along with distilled water as placebo. All drugs were given by oral routes and the analgesic effect was evaluated using analgesiometer at baseline, 15 min, 30 min, 60 min and 120 min. Analgesic activity was measured as change in tail flick latency from baseline in animals.Results: Diacerein showed significant increase in tail flick latency and showed promising analgesic activity compared to placebo starting from 15 mins till 60 mins. However the effect persisted up to one hour only and after which it started decreasing.Conclusions: Diacerein at all the three doses possess dose dependant analgesic activity that is maximally effective up to 60 minutes.

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BACKGROUND: Imatinib mesylate is the cornerstone therapy in the management of chronic myeloid leukemia (CML). Monitoring of adverse drug reactions (ADRs) of imatinib in our patients is very important to ensure their safety. Aims and Objectives: The current study aims to monitor ADRs encountered in CML patients in the chronic phase with imatinib (400 mg/day). MATERIALS AND METHODS: This prospective, observational study was conducted from November 2011 to May 2015 on 310 patients presented to the Departments of Clinical Hematology and Pharmacology of SCB MCH, Cuttack, diagnosed with CML at chronic phase. Collected ADRs were entered in the ADR reporting form (PvPI) and were analyzed for causality and severity. RESULTS: Anemia was the most common hematological ADR, whereas hyperpigmentation and nausea were the most common nonhematological ADRs reported. Maximum ADRs were mild to moderate and required no change in the treatment course. CONCLUSION: The study revealed that imatinib mesylate, a well tolerated drug, has very few cases of severe ADRs in Indian patients at the chronic stable phase of CML.

Introduction: Mental health illness has increased substantially since the COVID-19 pandemic. Estimating anxiety and depression in healthcare providers can clarify the dimensions of this burden. The objectives of the study were to compare the levels of anxiety and depression in the study population (COVID-positive versus COVID-negative) with Hamilton's anxiety (HAM-A) and Hamilton's depression (HAM-D) scales, respectively, and to estimate the relative risk of anxiety and depression in the COVID-positive participant to COVID-negative participant with subgroup analyses as per gender and occupation.Materials and Methods: In this cross-sectional study, we recruited 983 healthcare professionals from SCB Medical College, India, to assess their levels of anxiety and depression during the COVID-19 pandemic. We compared the HAM-A and HAM-D scores of COVID-positive and COVID-negative participants. We also calculated the relative risks of developing anxiety and depression symptoms. We used R software (version 4.1.2) for the statistical analyses and generation of plots. Results: The mean age of the study population was 35.95±11.54 years. Six hundred thirteen participants (62.36%) were positive for COVID infection. 575 (58.49%) persons had anxiety, as suggested by their HAM-A scores. The majority of them were nurses and pharmacists (245, 24.92%), followed by students (236, 24.01%) and clinicians (94, 9.56%). 620 (63.07%) persons had depression. Most of them were medical students (301, 30.62%), followed by nurses and pharmacists (211, 21.46%) and clinicians (108, 10.99%). The COVID-positive individuals were less anxious [relative risk: 0.614; 95% CI: 0.538-0.701] and more depressed [relative risk: 2.541; 95% CI: 2.079-3.106] than the COVID-negative individuals. Subgroup analysis of the HAM-A and HAM-D scores yielded similar results.Conclusion: The majority of the study population had symptoms of anxiety and depression during this pandemic. The COVID-negative individuals were more anxious than the COVID positives. Nevertheless, the symptoms of depression were more common in COVID-positive individuals.