A prospective open-label randomized comparative study in Alzheimer’s disease between two commonly used drugs in coastal Indian population

Background: Currently, therapy for Alzheimer’s disease (AD) is only symptomatic. Only two classes of drugs are approved by the United States Food and Drug Administration. Our study aimed at comparing efficacy and safety of memantine and donepezil in moderate to severe AD patients.Methods: Totally, 22 patients with moderate to severe AD were randomized into the 2 arms of the study. The study was divided into an initial 4 weeks for determination of onset of efficacy and subsequent 28 weeks of the treatment phase. Onset of efficacy and response was defined as >20% and >50% reduction in the mean total score of functional dementia scale (FDS) and clinical global impression scale (CGIS) from baseline to the study end, respectively.Results: Onset of efficacy on FDS and CGIS was 16.7% (mean-time 61.25 days) and 80% (mean-time 36 days) with memantine and donepezil, respectively. Response was 89.3% and 40% with memantine and Donepezil, respectively. Total reduction in FDS and CGIS score of from baseline to the study end was 39.50, 40.00, and 25.60, 27.20 with memantine and donepezil, respectively. Tolerability was 86.33% and 20% with memantine and donepezil, respectively. Anorexia, muscle cramps, constipation, headache, and insomnia, were the common side-effects and self-limiting. Safety was 100% in both groups.Conclusions: Onset of efficacy was faster with donepezil seen at 2 weeks. Response, improvement in CGIS, FDS, and tolerability were better seen with memantine at 40 weeks. Thus, in similar clinical settings, memantine can be preferred

Comparative study of quality of life in breast cancer patients receiving two different chemotherapy regimens using European Organization for Research and Treatment of Cancer Quality of Questionnaire-Core 30 questionnaire module; for tolerability and safety

Background: Breast cancer is one of the most frequent occurring cancers in women and burgeoning worldwide. It is the second most common malignancy in India after carcinoma of the uterine cervix. In clinical trials, quality of life (QOL) outcome measurements is an important as endpoints with improving subjects physical, emotional, and social well-being.Methods: In this study, we were evaluated the comparison of the QOL in breast cancer patients on anthracycline-based regimen (six cycles of 5-fluorouracil, adriamycin, and cyclophosphamide [FAC] for a period of 18 weeks) and taxane-containing regimen (four cycles of adriamycin and cyclophosphamide [AC] followed by four cycles of paclitaxel [PTX] for a period of 24 weeks) using European Organization for Research and Treatment of Cancer Quality of Questionnaire-Core 30.Results: During first 3 months of therapy, both treatment groups exhibited a reduction in health-related QOL (HRQOL) with no clinically significant difference between them. The effect on HRQOL was less evident 3 weeks after completing chemotherapy with HRQOL of both groups returning to near baseline scores.Conclusions: Both treatment regimens (FAC and AC → PTX [AC followed by PTX]) were equally tolerated in patients

Human leukocyte Antigen-B*27 allele subtype prevalence and disease association of ankylosing spondylitis among south indian population

Aim: Ankylosing spondylitis (AS) is a chronic inflammatory arthritis mainly affecting articular and extraarticular structures. AS clinical manifestations also involve sacroiliac joints and spine. Genetic factors play a key role in AS susceptibility. AS-associated subtypes of human leukocyte antigen (HLA)-B27 and other HLA-B alleles vary in different ethnic populations. There are no reports of HLA B genotype association to South Indian AS patients. In the current study, we have analyzed the HLA-B genotype association with 105 AS patients and 100 respective controls, we have also verified whether any specific clinical manifestation of AS has any pattern of HLA-B subtype association. Methods: The patients with AS were diagnosed fulfilling ASAS criteria. Before enrolling the patients, the written informed consent was obtained. The peripheral blood DNA genotyping of HLA-B27 was performed in Applied Biotechnologies 3130/3500 sequencer using SeCore HLA B Class I typing high-resolution kit from Invitrogen. Results: HLA B27 allele frequency in AS patients (74%) is significantly higher than healthy controls (3%). Most of the earlier studies associated AS with HLA B27 antigen. The current data illustrate that only 21% of AS patients presented HLA B27 antigen. HLA B27:05 and HLA B27:04 are the predominant subtypes. Early-onset of AS manifestations is seen in HLA B27 phenotypes than non-HLA B27 phenotypes. HLA B27 associated AS patients presented more severe axial manifestations such as bilateral sacroiliitis, erosions, and extra-articular features such as uveitis than non-HLA types. Positivity for HLA B27 allele predicts more severe disease course in South Indian patients with AS, similar to that in other populations. Conclusion: The current study indicates that a majority of South Indian AS patients are associated with HLA-B*27 alleles. In addtion we found that HLA-B*27 associated AS patients presented with more severe axial manifestations