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With a vision to meet the changing trends and recent developments in the field of pharmacology and therapeutics, the postgraduate medical education board of the national medical commission has put forth amendments to the existing guidelines for the MD pharmacology course. Major changes include introducing a district residency-based program for 3 months apart from the clinical postings and more focus is given to the areas of rational prescribing, pharmacovigilance, and ethical aspects of research. These amendments come as a new ray of hope in developing the postgraduate student as a complete professional equipped to meet the increasing standards in the workplace be it a hospital or a research arena. Including the simulation-based approaches for training as a lesson learned from the pandemic and adopting patient-oriented learning during the course are some of the key changes in the new guidelines. This review focuses on highlighting these amendments and correlating the same with the current scenario and discusses the future areas that can be improved for comprehensive development in the pharmacology curriculum.
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Monkeypox is a self-limiting zoonotic disease caused by the monkeypox virus belonging to the genus of orthopox viruses. Initially considered an ‘African disease’, this infection has crossed the boundaries to affect other continents and it has raised tremendous concerns among the general public as well as the medical fraternity all over the world, particularly because of the lack of specific vaccinations and drugs for the management of the illness. Epidemiological evaluation of the current infection has reported that it is mainly transmitted through sexual contact in bisexual men, mostly whites, and in those with pre-existing human immunodeficiency virus infection. The most common presentations were skin rash, anogenital lesions, or mucosal lesions along with systemic symptoms. It has been established that the vaccines and drugs approved for the management of smallpox could be used for the management of the current monkeypox outbreak. Vaccinia Immune Globulin (VIG) and vaccines like JYNNEOS and ACAM2000 and antiviral drugs like tecovirimat, cidofovir (CDV), and brincidofovir are being considered for those patients with serious diseases. It is imperative for physicians to understand the pharmacological aspects of these drugs for delivering better care to patients with monkeypox, which is eventually essential for the containment of this infection. This review covers updates on vaccines as well as drugs for the prevention and management of monkeypox.
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Tapinarof is a novel topical formulation approved recently, in May 2022, by the United States Food and Drug Administration to treat plaque psoriasis. Existing topical therapies for psoriasis are limited by systemic and local adverse effects, medication cost and repeated administration, thus significantly hampering the compliance of patients to therapy. These limitations can be resolved by tapinarof owing to its better efficacy and favourable safety profile in psoriasis management. Tapinarof was developed with a unique mechanism targeting the aryl hydrocarbon receptor (AhR) involved in inflammation and modulation of skin barrier integrity in inflammatory dermatological disorders such as psoriasis and atopic dermatitis. The efficacy and safety outcomes of tapinarof in psoriasis were justified through the two pivotal clinical trials, namely, PSOARING 1 and PSOARING 2. The common adverse effects observed with tapinarof are folliculitis, contact dermatitis and headache. The literature search was conducted for efficacy and safety of tapinarof in the electronic databases of PubMed and Cochrane using a combination of keywords such as tapinarof, psoriasis and AhR. This review will delineate the molecular mechanisms underlying the action of tapinarof and also summarise the trial data supporting the claim that tapinarof is replacing the existing standard of care in psoriasis management.
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Objective: To determine total phenolic and flavonoids contents and also quantify vindoline and rutin in different morphotypes of Catharanthus roseus using High-performance liquid chromatography (HPLC) method. Methods: Total flavonoids content (TFC) was determined by Aluminium chloride colorimetric and total phenolic content (TPC) was estimated by Folin-Ciocalteu reagent assay. The chromatographic separation was done by using a C18 column at room temperature and eluted with a mobile phase consisting of a mixture of phosphate buffer (pH=5.8) and acetonitrile at a flow rate of 1.0 ml/minute and detection was carried out at 254 nm. Results: TPC and TFC content was found highest in Cr00DP and lowest in Cr00WFSRE. Results also showed that the purple morphotypes Cr00DP gives more vindoline (0.3 mg/g) and rutin (18.57 mg/g) concentration compared to the pink morphotype Cr00PFRE contained 18.3 mg/g rutin and 0.2 mg/g vindoline. White morphotypes contained 0.383 mg/g rutin and 0.004 mg/g vindoline which was significantly less as compared to purple and pink morphotypes. Conclusion: The plant has significant number of alkaloids and flavonoids. The obtained outcomes from different morphotypes are thus significant for the purpose of vindoline and rutin isolation from Catharanthus roseus plant. These isolated bioactive phytoconstituents are a good candidate for further pharmacological and clinical study.
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BACKGROUND: Vascular endothelial growth factor (VEGF), a major mediator of vascular permeability and angiogenesis, may play a pivotal role in mediating the development and progression of breast cancer. In the present study, we examined the genetic variations of the VEGF gene to assess its possible relation to breast cancer. MATERIALS AND METHODS: A total of 200 patients with histologically confirmed cases of breast cancer and 200 healthy women were genotyped for VEGF single nucleotide polymorphisms (405G > C and −1154G > A) by polymerase chain reaction‑restriction fragment length polymorphism analysis. Pre‑operative plasma VEGF levels were determined by enzyme‑linked immunosorbent assay in 200 women with breast cancer and in 200 normal female controls. RESULTS: The genotype frequencies of the +405G > C, −1154G > A polymorphisms did not show a significant deviation from the Hardy‑Weinberg expectation. The minor allele frequencies of the +405G > C and −1154G > A polymorphisms among cases and controls were 33.5% (C allele), 31.5% (A allele) and 35% (C allele), 34.5% (A allele) respectively. +405GG and −1154GG genotypes were associated with higher levels of VEGF among breast cancer cases and controls. Increased plasma VEGF levels were significantly associated with, clinical stage of the disease (P = 0.035). CONCLUSION: Although none of the polymorphisms were significantly associated with breast cancer, some of the VEGF genotypes may influence tumor growth through an altered expression of VEGF and tumor angiogenesis.
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Child maltreatment happens in all countries and in families of all racial and religious groups. There are four major types of abuse: physical abuse, sexual abuse, emotional abuse and neglect. Cutaneous injury is the most common injury caused by abuse. Cutaneous manifestations of physical abuse include bruises, lacerations, abrasions, burns, oral trauma, bite marks and traumatic alopecia. Abuse by burning comprises approximately 6% to 20% of all child abuse cases. Proper evaluation is necessary, because the use of cultural practices does not exclude the potential for child abuse. A 3 year old boy reported with extra oral swelling over the right side of the submandibular region. On clinical examination the boy had well demarcated burn marks at right and left side of submandibular regions. Treatment for lymhadenitis and burnt region was carried out and case reported to psychiatry department for counseling. It is recommonded that the offering of community child abuse educational progrmmes for all professionals including dental professionals, psychiatry, medicine, allied health,nursing, social workers and schools of education by providing literature, posters and handouts
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An investigation was made on total heterotrophic bacterial (THB) load in relation with hydrographical features of Pazhayakayal estuary, Tuticorin, from July 2009 to June 2010. The water temperature (25 to 32oC), pH (7 to 10), and salinity (0‰ to 35.7‰) were maximum during summer season (April - June) and minimum during monsoon season (October - December). The dissolved oxygen (do) varied from 0.2 to 9.95 mg l-1. The THB load was high (42.0?0-7cfu ml-1) during monsoon season and low (1.2?0-7cfu ml-1) during summer. The correlation was insignificant between temperature, pH and THB load, however THB load was negatively correlated with salinity. Almost in all the stations (I-VI), THB load were found to be maximum (40.0?0-7,36.0?0-7, 30.0?0-7,36?0-7, 42.0?0?0-7 and 29.6?0-7 cfu ml-1) during monsoon season might be due to the bulk rainfall and freshwater input.
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Background: Oral squamous cell carcinoma is the most common neoplasm and comprises of approximately 80% of the cancers occurring in the oral cavity. The role of the host response to this neoplasm has been recognized, and for many years the regional lymph node in tumor-bearing hosts has been considered as an anatomic barrier to the systematic dissemination of tumor cells. Morphological evaluation of the regional nodes has aided in understanding the immune response. Aim: The current study was carried out to observe the morphological changes occurring in the regional lymph nodes and to evaluate whether these features could be helpful in assessing the immunological status of the patient, and thereby, the prognosis of the patient. Materials and Methods: The study was based on lymph nodes from 63 patients with oral squamous cell carcinoma, who underwent radical neck dissection or modified neck dissection. In the lymph node, four morphological patterns were observed that included lymphocyte predominance, germinal center predominance, mixed pattern (sinus Histiocytosis), and an unstimulated pattern. The cases were then divided into four groups according to the predominant immunoreactivity pattern based on the World Health Organization (WHO) standardized system for reporting human lymph node morphology. Results: Revealed that risk of metastases to cervical lymph nodes in patients with lymphocyte predominance was less (28.6%) when compared to the high risk of metastases with germinal center predominance (68%), and these results were statistically significant (P < 0.05). Patients with a mixed pattern showed less risk of metastases (45.4%), while those with an unstimulated pattern had increased risk of metastases (66.6%), but the results were not statistically significant. It was also found that in the positive nodes, germinal center hyperplasia (50.2%) was the predominant pattern. Conclusion: The present study revealed that patients with lymphocyte predominance had less risk of metastases and patients with germinal center predominance had a high risk of metastases to the lymph node.