Gabapentin pre-treatment for pressor response to direct laryngoscopy and tracheal intubation: a randomized, double-blind, placebo controlled study.

Background: Laryngoscopy and endotracheal intubation are associated with an increase in blood pressure (BP) and heart rate (HR). The present study was conducted to evaluate the role of gabapentin in attenuation of these hemodynamic changes. Methods: Forty patients undergoing elective laparoscopic cholecystectomy under general anesthesia with standardized premedication and anesthetics were randomized to receive gabapentin or a matching placebo. The patients of Group I received gabapentin 600 mg orally 2 hrs before surgery and patients in Group II received a matching placebo. Patient’s HR, systolic BP (SBP), diastolic BP (DBP), mean BP (MBP), were monitored before and after 1, 2, 5, and 10 mins of endotracheal intubation. Results: Comparison of SBP, DBP, and MBP at 1, 2, 5 and 10 mins after endotracheal intubation showed statistically significant attenuation in the gabapentin group when compared to placebo. Changes in the HR were not significant. Conclusion: Gabapentin 600 mg, given 2 hrs before induction is effective in attenuating the pressor response to laryngoscopy and tracheal intubation.

Gabapentin for post-operative nausea and vomiting: a pilot study.

Background: Gabapentin has been used in perioperative setting for the management of post-operative pain for surgery performed under general anaesthesia. Post-operative nausea and vomiting (PONV) even with the use of newer agents remains a major problem. The primary aim of this study was to see if gabapentin use decreased PONV. Methods: A total of 40 patients undergoing elective laparoscopic cholecystectomy under general anesthesia with standardized premedication and anesthetics were randomized to receive gabapentin or a matching placebo. The patients in Group I received gabapentin 600 mg orally 2 hrs before surgery and 12 hrs after the first dose. The patients in Group II received a matching placebo orally 2 hrs before surgery and 12hrs after the first dose. Patients in both groups received diclofenac sodium 75 mg i.m b.i.d for pain and ondensetron 4 mg i.v for PONV. Additional doses were given on demand and recorded. The treatment was double blinded. Results: The present study did not find significant reduction in PONV score and antiemetic consumption in gabapentin group when compared to a placebo for a period of 24 hrs. Conclusions: Gabapentin in the doses used was found to ineffective in post-operative nausea and vomiting in patients undergoing planned laparoscopic cholecystectomy with standardized pre-anaesthetic and anaesthetic medication.

Antidiabetic and antiulcer effects of extract of eugenia jambolana seed in mild diabetic Rats : Study on gastric mucosal offensive acid-pepsin secretion.

Diabetes has been reported to increase propensity to peptic ulceration through its effect both on offensive and defensive mucosal factors. Seeds of Eugenia jambolana (EJ) have been reported to have both antidiabetic as well as ulcer protective effects. The present study evaluates the antidiabetic effects of ethanolic extract of dried seed kernel of Eugenia jambolana (EJE) and its comparative effect on gastric ulceration and acidpepsin secretion with standard antisecretory FL-blocker. Ranitidine and antidiabetic glibenclamide with a premise that Eugenia jambolana may show better ulcer healing effects by promoting defensive or reducing offensive mucosal factors in mild diabetes (MD) rats. MD was produced in adult rats by administration of streptozotocin (45 mg/kg, ip). EJE was given orally in the doses of 100–400 mg/kg for 10 days and in the dose of 200 mg/kg for 30 days respectively to study its dose- and time-dependent effects on various diabetic parameters like blood glucose, serum cholesterol and triglycerides, insulin level and glycosylated hemoglobin. For ulcer protective and gastric secretion studies, EJE (200 mg/kg) was given orally for 10 days against 2 h cold restraint stress (CRS)-, 4 h pylorus ligation (PL), aspirin (ASP, 200 mg/kg, 4 h) – and 95% ethanol (EtOH, 1 ml/200 g, 1 h)-induced gastric ulcers and offensive acid-pepsin secretion after 4 h PL with cooccurring MD in rats. EJE showed dose-dependent decrease in blood glucose level in MD rats. Blood glucose level remained stable in mild diabetic rats from 3rd day onwards after streptozotocin administration (taken as 1st day for treatment) and EJE (200 mg/kg) showed anti-hyperglycemic effect on 10th day of its administration. Further, EJE in the above dose also decreased cholesterol level with little or no effect on triglycerides level and reversed the decrease and increase in insulin and glycosylated hemoglobin level near to the normal level as observed alter 30 days treatment in MD rats. MD rats exhibited an increased propensity to gastric ulceration induced by CRS, ASP, EtOH and PL and caused increase in acid-pepsin secretion. EJE was not only effective in reversing the increased propensity to ulceration in diabetic rats but also decreased the acid-pepsin output better than glibenclamide. The ulcer protective effect of Eugenia Jambolana seems to be due to its antidiabetic and gastric antisecretory effects.

Ulcer healing properties of ethanolic extract of eugenia jambolana seed in diabetic rats : Study on gastric mucosal defensive factors.

Diabetes has been reported to cause an increase in offensive and decrease in defensive gastric mucosal factors, the imbalance of which can cause ulceration and delay the ulcer healing. Eugenia jambolana has been documented to have both antidiabetic and antiulcer activities. The present study evaluates the effects of ethanolic extract of E. jambolana on gastric ulcer healing and on rat gastric mucosal defensive factors in gastric ulcer with co-occurring diabetes. E. jambolana extract was administered orally in the dose of 200 mg/kg once daily for 10 days. E. jambolana extract increased mucin secretion, mucosal glycoprotein and glutathione levels and decreased the lipid peroxidation in gastric mucosa of diabetic rats. Its treatment also reversed the decrease in life span of gastric mucosal cells as indicated by decreased cell shedding in the gastric juice but found to have no effect on cell proliferation, indicating enhanced defensive status. E. jambolana extract was effective in reversing the delayed healing of gastric ulcer in diabetic rats near to the normal level. E. jambolana showed better ulcer healing effect than glibenclamide, because of its both antihyperglycemic and mucosal defensive actions. It could thus, be a better choice for treating gastric ulcers co-occurring with diabetes.

Modulation of pain perception by ramipril and losartan in human volunteers.

The angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are a well known entity and have been used in therapeutics for various indications like hypertension, myocardial infarction and CHF. However, there is a renewed interest in these compounds in terms of their effects on pain perception in animals as well as in human beings. They have yielded contradictory results, showing hyperalgesia in some studies but analgesia in others. Hence this study was undertaken to evaluate the effect of Ramipril (an ACE-I) and Losartan (an ARB) on pain perception in human volunteers using cola caps and handcuff of sphygmomanometer. A total of 30 healthy, normotensive individuals with no previous history of intake of analgesics during or 4 weeks prior to the study were selected after an informed consent. The first group received a single dose of placebo, the second group received Ramipril (2.5 mg) & the third group received Losartan (50 mg). Pain perception threshold (the point at which an individual first experiences pain) and the maximum tolerated pain were assessed using the above method. The control group showed no significant changes in pain threshold, but the group receiving either Ramipril or Losartan showed a decline in threshold for maximum tolerated pain. Only Ramipril and not Losartan decreased the pain perception threshold. Our study revealed that single dose treatment of healthy volunteers with Ramipril and Losartan may cause algesia as early as after ingestion of the first dose and further studies are needed to study their long term effects on pain perception.

Effect of ethanolic extract of Eugenia jambolana seeds on gastric ulceration and secretion in rats.

Eugenia jambolana (Jamun) fruit has been reported to give soothing effect on human digestive system. Present study includes the effect of ethanolic extract of seeds of E. jambolana (EJE) against gastric ulcers induced by 2 h cold restraint stress (CRS), aspirin (ASP, 200 mg/kg, 4 h), 95% ethanol (EtOH, 1 ml/200 g, 1 h) and 4 h pylorus ligation (PL) in rats. To ascertain the mechanism of action of EJE, its effect was studied on mucosal offensive acid-pepsin secretion, lipid peroxidation (LPO, free radical) and defensive mucin secretion, cell proliferation, glycoprotein and glutathione (GSH, an antioxidant). Acute and subacute toxicity studies were also conducted for the safety profile of Eugenia jambolana. EJE 200 mg/kg, when administered orally for 10 days in rats was found to reduce the ulcer index in all gastric ulcer models. It tended to decrease acid-pepsin secretion, enhanced mucin and mucosal glycoprotein and decreased cell shedding but had no effect on cell proliferation. It showed antioxidant properties indicated by decrease in LPO and increase in GSH levels in the gastric mucosa of rats. Acute toxicity study indicated LD50 to be more than 10 times (>2000 mg/kg) of the effective ulcer protective dose while subactue toxicity study (>1000 mg/kg) indicated no significant change in the general physiological and haematological parameters, liver and renal function tests. The result of the present study indicates that E. jambolana seed has gastro-protective properties mainly through promotion of mucosal defensive factors and antioxidant status and decreasing lipid peroxidation.

Doping droops.

Drug abuse is a major concern in the athletic world. The misconception among athletes and their coaches is that when an athlete breaks a record it is due to some "magic ingredient" and not because of training, hard work, mental attitude and championship performance. The personal motivation to win in competitive sports has been intensified by national, political, professional and economic incentives. Under this increased pressure athletes have turned to finding this "magic ingredient". Athlete turns to mechanical (exercise, massage), nutritional (vitamins, minerals), pharmacological (medicines) or gene therapies to have an edge over other players. The World Anti-Doping Agency (WADA) has already asked scientists to help find ways to prevent gene therapy from becoming the newest form of doping. The safety of the life of athletes is compromised with all forms of doping techniques, be it a side effect of a drug or a new technique of gene doping.

Effect of aqueous extract of neem (Azadirachta indica) leaves on offensive and diffensive gastric mucosal factors in rats.

Standardized aqueous extract of Neem (Azadirachta indica) leaves (AIE) has been reported to show both ulcer protective and ulcer healing effects in normal as well as in diabetic rats. To study the mechanism of its ulcer protective/healing actions, effects of AIE (500 mg/ kg) was studied on various parameters of offensive acid-pepsin secretion in 4 hr pylorus ligation, pentagastrin (PENTA, 5 microg/kg/hr)-stimulated acid secretion and gastric mucosal proton pump activity and defensive mucin secretion including life span of gastric mucosal cells in rats. AIE was found to inhibit acid-pepsin secretion in 4 hr pylorus ligated rats. Continuous infusion of PENTA significantly increased the acid secretion after 30 to 180 min or in the total 3 hr acid secretion in rat stomach perfusate while, AIE pretreatment significantly decreased them. AIE inhibited the rat gastric mucosal proton pump activity and the effect was comparable with that of omeprazole (OMZ). Further, AIE did not show any effect on mucin secretion though it enhanced life span of mucosal cells as evidenced by a decrease in cell shedding in the gastric juice. Thus, our present data suggest that the ulcer protective activity of AIE may be due to its anti-secretary and proton pump inhibitory activity rather than on defensive mucin secretion. Further, acute as well as sub acute toxicity studies have indicated no mortality with 2.5 g/kg dose of AIE in mice and no significant alterations in body or tissues weight, food and water intake, haematological profile and various liver and kidney function tests in rats when treated for 28 days with 1 g/kg dose of AIE.