Abhava pratinidhi dravya: A Comparative Phytochemical Study of Bharangi and Kantakari

Abhava pratinidhi dravya excites the scientific curiosity concerning the Ayurvedic principles behind selection of the substitute drug. Present study had reported a comparative phytochemical study of one such Ayurvedic substitution pair: Solanum surattense Burm.f., a substitute for Clerodendrum serratum L. The study was conducted to understand the logic behind the Abhava pratinidhi dravya (Drug substitution). The strategy was to scrutinize and compare their Ayurvedic properties by literary studies and test the phytochemical profile of these two herbs for biochemical similiarties and differences. On analyzing their Ayurvedic pharmacology (Dravyaguna properties), findings show that both the drugs possess katu and tikta rasa, but Bharangi is katu rasa dominant and Kantakari is tikta rasa dominant drug. Along with this, both drug possess laghu, ruksha and ushna guna in common. Kantakari which contain different properties i.e. sara and tikshna guna. Both drug possess katu vipaka and ushna veerya. Both drugs had been stated to treat majority of respiratory ailments. Phytochemical observations suggest that in Bharangi root extract alkaloids and tannins was present whereas Kantakari root extract was rich in flavonoids content. Saponins was present in maximum amount in both the plant extracts. Despite taxonomically unrelated and morphologically dissimiliar, Bharangi has been substituted by Kantakari drug. In Ayurveda, more importance was given to pharmacological properties of raw drug rather than its botanical classification. Further comparative pre-clinical studies and bio-equivalence clinical studies has been needed to explore the different pharmacological properties.

Conformations and interactions comparison between R- and S-methadone in wild type CYP2B6, 2D6 and 3A4

Methadone is a morphine-substitute drug in methadone maintenance treatment (MMT) program to treat patients with opioid dependency. However, the methadone clinical effects are depending on the methadone metabolism rates that vary among the patients with genetic polymorphism of cytochrome P450s (CYPs). Our previous study showed methadone has different binding affinity due to the polymorphisms in CYP2B6, CYP2D6 and CYP3A4 that could contribute to the methadone metabolism rate. In this work, the conformation and interactions of R- and S-methadone in wild type CYP2B6, CYP2D6 and CYP3A4 were further studied in order to understand behaviour of R- and S-methadone at the CYP binding site. Clustering analysis showed that the conformation of R- and S-methadone in CYP2B6 are most stable, thus could lead to a higher efficiency of methadone metabolism. The conformation fluctuation of methadone in CYP2D6 could due to relatively smaller binding pocket compared with CYP2B6 and CYP3A4. The binding sites volumes of the studied CYPs were also found to be increased upon the binding with methadone. Therefore, this might contributed to the interactions of both R- and S-methadone in CYPs were mainly by hydrophobic contacts, van der Waals and electrostatic interactions. In the future, should an inhibitor for CYP is to be designed to prolong the prolonged opioid effect, the inhibitor should cater for single CYP isozyme as this study observed the behavioural differences of methadone in CYP isozymes. Graphical Abstract:

What does the general population think about chemotherapy shortages?

6530 Background: Chemotherapy shortages have been increasingly recognized, and most oncologists report their patients have been at least intermittently affected. Despite their potential impact, little is known about the perspectives of the general population regarding shortages. Methods: In October 2016, we conducted a survey using the GfK KnowledgePanel, an online probability-based sample representative of adults in the United States. We assessed awareness of shortages, and provided vignettes in which a substitute chemotherapy drug had either a major or minor difference in side effects or effectiveness. We asked respondents whether they would want to be informed of a substitution, and, if the original drug were available elsewhere, would transfer care to receive it. We also asked if cancer centers were to publish drugs in shortage at their center, if such data would affect decisions about where to seek care. Analyses applied post-stratification sampling weights to draw national inferences. Results: Of 737 potential participants, 420 (57%) responded; 16% had heard of chemotherapy shortages. Respondents with a personal history of cancer were more likely to have heard of shortages (31% vs 14%, p = 0.03), as were those with greater education (p = 0.01) and those who reported more sources of health information (p = 0.01). Most desired to be informed about a chemotherapy substitution in the setting of both major (87%) and minor (83%) differences in side effects, as well as both major (87%) and minor (82%) differences in effectiveness. In contrast, only 61% reported they would transfer care if a substitute drug had major differences in side effects, and even fewer (40%) for minor differences. Similarly, 72% and 46% reported they would transfer care if a substitute had major or minor differences in effectiveness respectively. Finally, 57% reported that publically-reported shortage data would be a “big factor” in deciding where to be treated. Conclusions: Our data suggest that the general population is largely unaware of chemotherapy shortages. Moreover, in the setting of even minor changes in effectiveness or side effects, respondents wanted to be made aware of substitutions. With major differences, many would seek care elsewhere.

Membrane Separation Assisted One-Pot Synthesis of Hydroxyapatite Nanorods

In the current paper, hydroxyapatite (HAP) nanorods have been synthesized via a precipitation method with membrane separation technique assisted. The reactants were Ca(NO3)2 ·4H2O, NH4H2PO4 and ammonia water. The synthesized HAP nanocrystals were characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM) measurements. Patterns of XRD exhibit that the products are indexed high-quality hexagonal crystal system nanocrystals. Though the TEM pictures, large quantities of HAP nanorods could be observed with a length of about 50-80nm and a diameter of about 10-20 nm. Preliminary study on the membrane based purifing process is also discussed by comparion the membrane of molecular weight cut-off 6000 to 10000. The resulting HAP nanorods have extensive use in biomedical area such as the bone graft substitute, drug delivery system, carrier for gene transfection, and etc.

Management of a Type I Hypersensitivity Reaction to IV Etoposide in a Woman with a Yolk Sac Tumor: A Case Report

Type I hypersensitivity reactions to intravenous administration of etoposide are extremely rare. Etoposide is an essential component of several chemotherapy regimens used in gynecologic oncology, and discontinuation of this drug during a course of treatment should only be due to severe patient intolerance. We report the successful use of intravenous etoposide phosphate as a substitute drug in a patient with a yolk sac tumor who manifested a Type I hypersensitivity to intravenous etoposide. The patient ultimately completed all 4 cycles of bleomycin, etoposide, cisplatin (BEP) using etoposide phosphate as a substitute drug.