Acute coronary syndrome (ACS) is principally driven by platelet aggregation. Dual antiplatelet therapy (DAPT) has demonstrated a reduction in recurrent ischemic events. The newer antiplatelets ticagrelor and prasugrel have demonstrated superiority over clopidogrel. While prasugrel demonstrated benefit in patients scheduled for percutaneous intervention (PCI), benefits of ticagrelor were seen irrespective of the treatment strategy. Current guidelines recommend the use of DAPT for 1 year in all patients with ACS. Ticagrelor 60 mg is recommended for up to 3 years in high-risk patients. DAPT and Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE DAPT) scores are tools to support decision-making in deciding duration of dual antiplatelet therapy. Electronic supplementary material The online version of this article (10.1007/s40119-020-00197-0) contains supplementary material, which is available to authorized users.

Fulvestrant is an oestrogen-receptor antagonist that exerts selective oestrogen receptor downregulation, antiproliferative activity and induction of apoptosis. It is indicated for the treatment of postmenopausal women with locally advanced or metastatic breast cancer for disease relapse or progression on or after adjuvant anti-oestrogen therapy. Fulvestrant was initially approved at a dose of 250 mg, however, the results of the CONFIRM trial led to approval of 500 mg dose (i.e. 500 mg on days 0, 14 and 28, then 500 mg every 28 days).Fulvestrant has also shown superiority over anastrozole as first-line therapy in the phase II trial. There are contrasting data for its efficacy when used in combination with anastrozole. It is well tolerated, with no significant difference with respect to the toxicity profile of other hormonal therapies. Treatment with fulvestrant is not associated with any clinically significant effects on sex hormone levels, bone-specific turnover markers or endometrial thickening. 4 Both anastrozole and letrozole have proven superior to tamoxifen as five years' primary adjuvant therapy in early breast cancer, in addition to providing a number of tolerability benefits compared with the tamoxifen. 5 The selective oestrogen receptor modulator (SERM) tamoxifen is also used widely to treat both premenopausal and postmenopausal patients with advanced breast cancer as firstline treatment. 6 Other endocrine therapies include the progestins, such as megestrol acetate, high-dose oestrogens and androgens. However, these treatment options are being used less frequently as newer, more effective and better-tolerated therapies become available. Although adjuvant endocrine therapy is an effective treatment for breast cancer, most patients with advanced disease will eventually exhibit resistance to individual therapies. Nonetheless, an initial response to endocrine treatment is generally indicative of a positive response to further alternative endocrine agents.

Objectives:1. To evaluate and compare the pattern and rationality of prophylactic antimicrobial therapy in elective surgeries. 2.To evaluate and compare the adherence of hospitals to the standard guidelines on prophylactic antimicrobial therapy.

Introduction: Vanillin is one of the primary chemical components of the vanilla bean (Vanilla planifolia). An aphrodisiac is defined as any food or drug that arouses the sexual instinct, induces venereal desire and increases sexual pleasure and performance. Unpublished data claim that vanillin, taken under proper guidance, can help relieve problems of impotence, erectile dysfunction, frigidity, loss of libido and promotes arousal. Hence this study was conducted to study the potential aphrodisiac effects of vanillin in rats. Methods: Twenty four male rats were divided into four groups which received vehicle, vanillin 100 mg/kg/day, 200 mg/kg/day and 400 mg/kg/day orally, respectively. Female rats were brought to oestrous cycle by the sequential administration of estrogen (10 μg/100 g) and progesterone (0.5 mg/100 g) through intraperitoneal injections, 48 hours and 4 hours (respectively) prior to pairing with the male on day 1 to study the acute effects and on day10 to study the sub-chronic effects. Sexual behaviors were observed for three hours. Serum testosterone levels were estimated. The data was analyzed using one way ANOVA followed by posthoc tests. Results: There was a statistically significant increase in the mount frequency and intromission frequency compared to control following both acute and chronic treatment with vanillin (200 mg/kg). The mount latency, intromission latency, ejaculation latency and post-ejaculatory interval decreased in the vanillin treated groups especially at 200 mg/kg. There was no significant difference in the serum testosterone levels among the groups. Conclusion: Vanillin in the dose of 200 mg/kg demonstrated aphrodisiac properties in male wistar rats.