Comparison of efficacy and safety of thiocolchicoside and pregabalin in the treatment of acute non-specific low back pain: an open label randomized prospective study

Background: The present study was undertaken to study the efficacy and safety of thiocolchicoside, a centrally acting skeletal muscle relaxant, GABA mimetic drug and pregabalin, an anti-epileptic, GABA mimetic drug in the treatment of acute non-specific low back pain.Methods: The study was carried out at the orthopaedic outpatient department of our hospital. 80 patients were included during the study period of two months. Out of the 80, 40 were given pregabalin 75 mg 1hs and the rest were given thiocolchicoside 8 mg bd by the prescribing doctor. Patients, aged between 18-60 years having non-radiating low back pain for less than 7 days were selected. The data was collected in a proforma which included the patient’s details and the prescribed drugs. The patients were also given notepads to record adverse effects. On day 1, the pain was measured on visual analogue scale. After a week, follow up was done and decrease in pain was measured on the visual analogue scale.Results: There was significant difference between pre and post visual analogue scale score in both the groups with a p-value of less than 0.0001. But the difference between the two groups was not statistically significant (p-value 0.0664). In both the groups, patients did not report any adverse effects. Pregabalin has a slower onset than thiocolchicoside however has better efficacy. In India, where the drug abuse risk is higher, pregabalin is a safer choice as skeletal muscle relaxants (thiocolchicoside) should not be given for more than a week.Conclusions: Pregabalin has better efficacy in treatment of acute non-specific low back pain as compared to thiocolchicoside

Crystal structure, Hirshfeld surface analysis and computational study of bis(2-{[(2,6-dichlorobenzylidene)hydrazinylidene]methyl}phenolato)cobalt(II) and of the copper(II) analogue

The title homoleptic Schiff base complexes, [M(C14H9Cl2N2O)2], for M = CoII,(I), and CuII, (II), present distinct coordination geometries despite the Schiff base dianion coordinating via the phenolato-O and imine-N atoms in each case. For (I), the coordination geometry is based on a trigonal bipyramid whereas for (II), a square-planar geometry is found (Cu site symmetry 1). In the crystal of (I), discernible supramolecular layers in the ac plane are sustained by chlorobenzene-C—HO(coordinated), chlorobenzene-C—H(fusedbenzene ring) as well as (fused-benzene, chlorobenzene)–(chlorobenzene) interactions [inter-centroid separations = 3.6460 (17) and 3.6580 (16) A˚ , respectively]. The layers inter-digitate along the b-axis direction and are linked by dichlorobenzene-C—H(fused-benzene ring) and – interactions between fused-benzene rings and between chlorobenzene rings [inter-centroid separations = 3.6916 (16) and 3.7968 (19) A˚ , respectively] . Flat, supramolecular layers are also found in the crystal of (II), being stabilized by – interactions formed between fused-benzene rings and between chlorobenzene rings [intercentroid separations = 3.8889 (15) and 3.8889 (15) A˚ , respectively]; these stack parallel to [101] without directional interactions between them. The analysis of the respective calculated Hirshfeld surfaces indicate diminished roles for HH contacts [26.2% (I) and 30.5% (II)] owing to significant contributions by ClH/HCl contacts [25.8% (I) and 24.9% (II)]. Minor contributions by ClCl [2.2%] and CuCl [1.9%] contacts are indicated in the crystals of (I) and (II), respectively. The interaction energies largely arise from dispersion terms; the aforementioned CuCl contact in (II) gives rise to the most stabilizing interaction in the crystal of (II)

Lessons from the first ecancer symposium on angiogenesis in gastric cancer

In March 2015, ecancer hosted a symposium at the European Institute of Oncology in Milan, Italy on the topic of angiogenesis in gastric cancer. During this meeting, leaders in the field focused on the latest research on the topic of angiogenesis in gastric cancer, delivering lectures combined with interactive question and answer (Q & A) sessions and a roundtable discussion with the meeting's chairs. Topics covered included biomarkers, imaging, and the current state of antiangiogenic drugs in gastric cancer. This report will provide an understanding of the relevance of angiogenesis in gastric cancer research, and clinical experiences from diverse perspectives

ESSENS dyslipidemia: A placebo-controlled, randomized study of a nutritional supplement containing red yeast rice in subjects with newly diagnosed dyslipidemia

AbstractObjectiveEvidence suggests prolonged exposure to lower levels of low-density lipoprotein cholesterol (LDL-C), starting at a younger age, substantially lowers cardiovascular (CV) risk. Accordingly, the CV pandemic affecting younger population in low- to low-middle-income countries, where statin usage is poor even in secondary prevention, may benefit from lipid-lowering nutritional products, as nutritional intervention is generally preferred in these cultures. However, the safety and efficacy of such preparations have not been systematically tested.MethodsIn this multicenter, double-blind study, 191 statin-free subjects with newly-diagnosed hyperlipidemia (LDL-C >120 mg/dL, 3.11 mmol/L) and no evidence of CV disease were randomized to one capsule of a proprietary bioactive phytonutrient formulation containing red yeast rice, grape-seed, niacinamide, and folic acid (RYR-NS) or matched placebo twice daily, along with lifestyle modification, for 12 wk.ResultsMean baseline LDL-C levels were 148.5 ± 24.0 mg/dL (3.85 ± 0.62 mmol/L) and 148.6 ± 21.9 mg/dL (3.85 ± 0.57 mmol/L) in the RYR-NS and placebo groups respectively. Compared with placebo, RYR-NS resulted in a significant reduction in LDL-C (−29.4% versus −3.5%, P < 0.0001) and non–high-density lipoprotein cholesterol (non-HDL-C; −29.8% versus −10.3%, P < 0.0001) at 12 wk. With RYR-NS, 43.4% individuals attained desirable LDL-C levels and 55.4% desirable non-HDL-C levels by week 12, compared to only 0% and 1.1%, respectively, at baseline. No safety issues were observed.ConclusionThis study demonstrates the efficacy and safety of RYR-NS in lowering LDL-C and non-HDL-C after 12 wk, with magnitude of LDL-C reduction being comparable to that seen with moderate-intensity statin therapy. Further long-term studies are required to determine the impact of RYR-NS on treatment adherence and clinical outcomes

2-{(1E)-[(E)-2-(2,6-Dichlorobenzylidene)hydrazin-1-ylidene]methyl}phenol: crystal structure, Hirshfeld surface analysis and computational study

The title Schiff base compound, C14H10Cl2N2O, features an E configuration about each of the C N imine bonds. Overall, the molecule is approximately planar with the dihedral angle between the central C2N2 residue (r.m.s. deviation = 0.0371 A˚ ) and the peripheral hydroxybenzene and chlorobenzene rings being 4.9 (3) and 7.5 (3), respectively. Nevertheless, a small twist is evident about the central N—N bond [the C—N—N—C torsion angle = 172.7 (2)]. An intramolecular hydroxy-O—H���N(imine) hydrogen bond closes an S(6) loop. In the crystal, – stacking interactions between hydroxy- and chlorobenzene rings [inter-centroid separation = 3.6939 (13) A˚ ] lead to a helical supramolecular chain propagating along the b-axis direction; the chains pack without directional interactions between them. The calculated Hirshfeld surfaces point to the importance of H���H and Cl...H/H...Cl contacts to the overall surface, each contributing approximately 29% of all contacts. However, of these only Cl...H contacts occur at separations less than the sum of the van der Waals radii. The aforementioned – stacking interactions contribute 12.0% to the overall surface contacts. The calculation of the interaction energies in the crystal indicates significant contributions from the dispersion term

Strategies to improve spinal cord ischemia in endovascular thoracic aortic repair: Outcomes of a prospective cerebrospinal fluid drainage protocol

PurposeAlthough endovascular repair of thoracic aortic aneurysm has been shown to reduce the morbidity and mortality rates, spinal cord ischemia remains a persistent problem. We evaluated our experience with spinal cord protective measures using a standardized cerebrospinal fluid (CSF) drainage protocol in patients undergoing endovascular thoracic aortic repair.MethodsFrom 2004 to 2006, 121 patients underwent elective (n = 52, 43%) and emergent (n = 69, 57%) endovascular thoracic aortic stent graft placement for thoracic aortic aneurysm (TAA) (n = 94, 78%), symptomatic penetrating ulceration (n = 11, 9%), pseudoaneurysms (n = 5, 4%) and traumatic aortic transactions (n = 11, 9%). In 2005, routine use of a CSF drainage protocol was established to minimize the risks of spinal cord ischemia. The CSF was actively drained to maintain pressures <15 mm Hg and the mean arterial blood pressures were maintained at ≥90 mm Hg. Data was prospectively collected in our vascular registry for elective and emergent endovascular thoracic aortic repair and the patients were divided into 2 groups (+CSF drainage protocol, −CSF drainage protocol). A χ2 statistical analysis was performed and significance was assumed for P < .05.ResultsOf the 121 patients with thoracic stent graft placement, the mean age was 72 years, 62 (51%) were male, and 56 (46%) underwent preoperative placement of a CSF drain, while 65 (54%) did not. Both groups had similar comorbidities of coronary artery disease (24 [43%] vs 27 [41%]), hypertension (44 [79%] vs 50 [77%]), chronic obstructive pulmonary disease (18 [32%] vs 22 [34%]), and chronic renal insufficiency (10 [17%] vs 12 [18%]). None of the patients with CSF drainage developed spinal cord ischemia (SCI), and 5 (8%) of the patients without CSF drainage developed SCI within 24 hours of endovascular repair (P< .05). All patients with clinical symptoms of SCI had CSF drain placement and augmentation of systemic blood pressures to ≥90 mm Hg, and 60% (3 of 5 patients) demonstrated marked clinical improvement.ConclusionPerioperative CSF drainage with augmentation of systemic blood pressures may have a beneficial role in reducing the risk of paraplegia in patients undergoing endovascular thoracic aortic stent graft placement. However, selective CSF drainage may offer the same benefit as mandatory drainage