Background Lopinavir-ritonavir is a repurposed drug for coronavirus disease-2019 (COVID-19). In this study, a pooled effect of lopinavir-ritonavir on mortality, virological cure, radiological improvement and safety profile in COVID-19 patients has been evaluated. Methods The databases were searched for comparative randomized controlled studies evaluating the efficacy and/or safety of lopinavir-ritonavir in COVID-19 patients. The mortality outcome was pooled as a risk difference (RD) with 95% CI. The virological cure, radiological improvement and adverse events were pooled as risk ratio (RR) with 95% CI. All outcomes were pooled using the Mantle-Hanzle method random effect model. The heterogeneity was assessed using the I 2 test. Results Out of 82 full text assessed, seven studies were included in the analysis. The included studies had five different control interventions: supportive care (n = 4), umifenovir (arbidol) (n = 2), navaferon (recombinant anti-tumour and anti-virus protein) (n = 1), lopinavir-ritonavir + novaferon (n = 1) and lopinavir-ritonavir + interferon beta 1b + ribavirin (n = 1). Lopinavir-ritonavir group did not show significant difference in mortality [RD: 0.00 (95% CI: -0.01, 0.02), I 2 = 0], virological cure [RR: 1.06 (95% CI: 0.85, 1.31), I 2 = 0%], radiological improvement [RR: 0.81 (95% CI: 0.62, 1.05)] and adverse events [RR: 2.59 (95% CI: 0.17, 38.90), I 2 = 75%] than supportive care. Similarly, no difference was observed for any efficacy outcomes between lopinavir-ritonavir and other control interventions. We observed significantly high risk of adverse events with lopinavir-ritonavir as compared to umifenovir [RR: 2.96 (95% CI: 1.42-6.18); I 2 = 0%]. Conclusion There is no benefit of the addition of lopinavir-ritonavir to the standard care in COVID-19 patients.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Markers of inflammation are being investigated as predictors of coronary ischaemic events. All major statins have shown almost similar and significant efficacy in reducing C-reactive protein (CRP) concentrations in acute coronary syndrome (ACS), but atorvastatin was used in a high dose (80 mg).• This study was designed to evaluate the effect of a lower dose (20 mg) of atorvastatin on hs-CRP concentrations in patients with ACS. WHAT THIS STUDY ADDS• A lower dose of atorvastatin (20 mg) was effective in decreasing hs-CRP and LDL concentrations in as short a duration as 4 weeks. The use of a lower dose of atorvastatin in patients of ACS can offer an attractive approach for early treatment of ACS patients. AIMSTo evaluate the effect of a lower dose (20 mg) of atorvastatin on hs-CRP concentrations in patients with ACS. METHODSGroup A (n = 50) patients received atorvastatin 20 mg day -1 for 4 weeks in addition to standard anti-anginal treatment. Group B (n = 50) patients received standard anti-anginal treatment without atorvastatin. RESULTShs-CRP concentrations decreased in both groups, but the decrease was greater in group A. The decrease in hs-CRP was also significantly greater in the subgroups of smoking, hypertension and past history of cardiovascular disease with atorvastatin. CONCLUSIONSThe use of a lower dose (20 mg) of atorvastatin can offer an attractive approach for early treatment of patients with ACS.

Citalopram had shown better efficacy, earlier onset of action and more number of responders and remitters as compared to sertraline in MDD in Indian patients.

Objective: The main purpose of this study was to adverse drug reaction monitoring of psychopharmacological agents. Materials and method: The study was cross sectional and was carried out in Departments of Psychiatry in Chhatrapati Shivaji Subharti Hospital and Pharmacology Department, Subharti Medical College, Meerut the duration of this study was approx 6 months (24 weeks). Institutional ethics committee approval was obtained before the start of the study. Results: A total of 110 patients enrolled in the study, and it occurs 148 adverse events. Among which the male patients were 65 (59%). and female were 45(31%). The most common age group whereas 44.5% were from a higher age group. 40 % patients were in the age group from 36 years up to 55 years. In this study most common adverse effect is found in metabolic syndrome such as these were weight gain 15.45%, change in blood glucose 18.18% and change in cholesterol 9.09%. Antipsychotics were given to 35. % patients, antidepressants to 24.5 %, sedatives and hypnotics were given to 20.9 %, anti epileptic to 10.9%, anti maniac drugs to 5.5% and other drugs 3.0% patients. More patients suffering of 25.45% from anti depressant. This study severity of adverse effects. 70(63.6%) had mild adverse effects where as 40(36.4%) had moderate adverse effects and none had severe adverse effects.38% were definitely preventable, 35% were probably preventable, and 27% were not preventable as per clinical evaluations and application of scale Conclusion: the study results strongly suggests the need for professional healthcare team to focus on assessing and reporting suspect adverse effect to increase the quality of monitoring and managing ADRs. Pharmacovigilance improvement the recognition of ADRs and helps the medical health care professional to have safe practice.

Background: This randomized prospective double-blind study was designed to evaluate the efficacy and side effects of low doses clonidine for perioperative haemodynamic stability and postoperative recovery.Methods: Patient’s with ASA grade I–II undergoing laparoscopic cholecystectomy were randomized into three groups of 30 patients each. All patients received either normal saline 10 ml (Group I) or 0.8 µg/kg (Group II) or 1 µg/kg (Group III) over duration of 180 seconds, 10 min prior to laryngoscopy and intubation. Anaesthesia was induced with 1% propofol (2 mg/kg) and maintained with nitrous oxide 60% in oxygen and isoflurane. The parameters assessed at various time intervals were heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and sedation score.Results: Both doses of clonidine proved to be effective in perioperative haemodynamic stability. Clonidine 0.8 mcg/kg was as effectve and safer to Clonidine 1 mcg/kg for attenuatíon of the hemodynamíc responses to laparoscopy. There were no significant differences in the parameters of recovery between groups.Conclusions: Significant hemodynamic derangements can occur during laproscopic cholecystectomy at intubation, pneumoperitoneum and extubation. These were effectively attenuated by premedication with 0.8 mcg/kg and 1 mcg/kg of intravenous clonidine. Dose of 1 mcg/kg though found to be effective but produced adverse effects in form of hypotension and bradycardia.

Abstract-A wide range of drugs from different pharmacological groups have been tried in premenstrual syndrome by various investigators, with contradictory reports. Pyridoxine is reported to relieve autonomic and behavioural symptoms and NSAIDs to relieve physical symptoms. The present study evaluated and compared with placebo, the clinical efficacy of Pyridoxine and Mefenamic acid alone & in combination in relieving symptoms of pre-menstrual syndrome( PMS) Material/ Methods-80 female patients between 18-45 years of age, diagnosed to be suffering from PMS were randomly divided into 4 groups (A,B,C,D) of 20 patients each. They received Placebo tablets, Pyridoxine HCl 100 mg OD, Mefenamic acid 250 mg TDS and a combination of Pyridoxine and Mefenamic acid respectively for 7 days preceeding menstruation. Patients filled 36 item PMTS self rating scale and 22 item daily diary for 2 months before treatment to record baseline symptoms and during treatment cycle. 22 symptoms were divided into 4 subsets of physical, anxiety related, depression related and fluid-electrolyte related symptoms to study effect of drugs. Results-Statistically significant improvement from baseline symptoms occurred in patients receiving Pyridoxine, Mefenamic acid and their combination (group B,C, D), but mean %age improvement in all the 3 groups was not significantly different from Placebo (p>0.05). Significant (p<0.05) improvement in subset of physical symptoms occurred with mefenamic acid alone, but not with combination of pyridoxine and mefenamic acid. Conclusion-Placebo controll group must always be included in Premensrual syndrome trials. Mefenamic acid 250 mg TDS for 7 days preceeding menses relieved physical symptoms of PMS. However the beneficial effect was lost on combining pyridoxine