Patients with type II diabetes mellitus are usually dyslipidemic, even when under relatively good glycaemic control. Furthermore type 2 diabetes is an important risk ABSTRACT Background: Statins are the first choice in the treatment of dyslipidemia, commonly atorvastatin. Pitavastatin is a newer statin with more potency, less drug interactions and many added advantages considering the longevity of treatment required for dyslipidemia. The objective of this study was to evaluate the efficacy and safety of pitavastatin versus atorvastatin in dyslipidemic patients associated with hypertension, diabetes and/or coronary artery disease. Methods: A prospective, comparative, randomized, controlled, double blind, clinical trial was designed. Total 100 eligible subjects were randomised into 1:1 ratio to receive pitavastatin 4 mg once daily and atorvastatin 20 mg once daily for period of 8 weeks. Evaluation was scheduled at 4 week and 8 week. The efficacy assessment included percentage change from baseline in various lipid parameters like low density lipoprotein cholesterol (LDLC), total cholesterol (TC), high density lipoprotein cholesterol (HDLC), triglycerides (TG), and LDLC/HDLC ratio. Results: Analysis of data showed a significant improvement in all lipid parameters within both therapeutic groups. The difference in LDLC, TC and TG levels was not statistically significant between the two treatment groups after 8 weeks of therapy. However, significant improvement was seen in HDLC and LDLC/HDLC ratio with pitavastatin as compared to atorvastatin at the end of the study. Both were well tolerated. Conclusions: With better HDLC levels, in addition to comparable efficacy and good tolerability of pitavastatin, as compared to atorvastatin, could be considered as good alternative for treatment of dyslipidemia.
Aim:To review the biosynthesis, mechanism, and important effects of neurosteroids on brain functions and brain disease by modulating synaptic and extrasynaptic transmission. Materials and Methods: This article is based on a comprehensive database search on the internet. Full-text articles in English, published between 2001 and 2012, were searched for, using the terms 'neuroactive steroids', 'neurotransmitter agents', 'molecular mechanism', 'depression', 'anxiety' 'neuropsychopharmacology', 'interactions with receptors', 'neuroprotection', and 'neuroendocrinology' to identify potential therapeutic targets. The reference lists of leading review articles identifi ed during this search were checked for additional publications. Results: Neurosteroids regulate physiological functions of the central nervous system (CNS) and help in the neurodevelopmental functions relating to their neuroprotective effects in brain injury and possible therapeutic potential in brain lesions and other diseases of the nervous system. Neurosteroids have been shown to affect neuronal excitability via their interaction with the ligand-gated ion channel family, such as the GABA A and 5-HT 3 receptors, by acting genomically as well as nongenomically. By virtue of these properties, neurosteroids appear to be relevant to pathophysiology and pharmacological treatment of many psychiatric disorders, including not only the notable mood and anxiety disorders, but also psychotic disorders, childhood dementia and stress disorders. They have also been found to be involved in the pathophysiology and treatment of epilepsy, alcohol and substance abuse. Conclusion: Neurosteroids may become potential targets for pharmacological intervention in the future, with further research at the basic science level as well as in the context of large double-blinded placebo-controlled investigations to elicit their role fully in the understanding and management of various psychiatric conditions.
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