No abstract

Palmoplantar psoriasis (PPP) is a variant of psoriasis which affects only 5% body surface area, but has a devastating impact on affected individual's quality of life. There are few studies assessing efficacy of individual drugs, and few comparative studies of efficacy of two drugs in the literature, however randomized control trial comparing all three drugs against each other has not been done. A total of 75 patients of PPP were enrolled for study and randomly divided into three groups A, B, C of 25 each and assigned for treatment with cyclosporine (CSA) (2.5‐5 mg/kg/d), methotrexate (MTX)(7.5‐15 mg/week), and acitretin (ACT) (25‐50 mg/d), respectively. Modified psoriasis area and severity index (PASI), psoriasis severity scale, visual analogue scale, physician global assessment, and PPQOL were used for monitoring response to therapy and improvement in quality of life up to end of study, and thereafter monthly follow‐up was done to find duration of remission for next 90 days. Side effects if any were recorded. There was a statistically significant difference in modified PASI for CSA, MTX, and ACT. The mean modified PASI at baseline was 12.8 ± 4.8 for CSA, 12.57 ± 3.8 for MTX, and 11.92 ± 3.28 for ACT (P = .75). Mean modified PASI reduced to 2.91 ± 1.8 for CSA, 6.57 ± 2.2 for MTX, and 4.7 ± 2.2 for ACT at week 5 (P = <.01). Mean modified PASI further reduced to 0.095 ± 0.35 for CSA, 2.12 ± 1.4 for MTX, and 0.78 ± 0.97 for ACT at end of study (P = <.01). However, average duration of remission was 9 weeks for ACT group, followed by 6.47 and 3 weeks for CSA and MTX group, respectively. Adverse events were comparatively more in ACT group as compared to MTX and CSA groups. PPP affects quality of life tremendously and warrants systemic treatment for the same. CSA provides fastest resolution of lesions and have highest efficacy. MTX and ACT have similar efficacy, but ACT provides longer duration of remission.

Gmelina arborea is an important medicinal plant in the traditional system of medicine in India. The present study was designed to evaluate toxicity and analgesic activity of the alcoholic extract (AlcE) of G. arborea stem bark and its various fractions. The AlcE was prepared by the Soxhlet extraction technique. AlcE was fractionated with petroleum ether, chloroform, ethyl acetate, and n-butanol. The acute toxicity of AlcE and its fractions was studied in female Swiss albino mice using the OECD guidelines. In the acute toxicity test, mice were treated with AlcE and its fractions (2000 mg/kg), orally. Animals were observed periodically during the fi rst 24 h after administration and daily thereafter for 14 days. The analgesic activity was studied in Swiss albino mice by using acetic acid-induced writhing method. The AlcE (250 and 500 mg/kg) and its fractions (200 mg/kg) were administered to animals before 45 minutes of administration of acetic acid. The number of muscular contractions was counted over a period of 10 minutes after acetic acid injection. AlcE and its fractions did not produce mortality, changes in behavior or any other physiological activities in mice, at selected dose. The AlcE at 250 and 500 mg/kg showed a signifi cant decrease in writhes -13.4 ± 0.16 and 12.2 ± 0.22, respectively when compared with control (19.2 ± 0.58). The n-butanol fraction showed maximum inhibition of writhes (57.37%) as compared to other fractions. These fi ndings suggested that AlcE and its fractions are safe after oral administration and have signifi cant analgesic activity.