BackgroundCurrent therapy for the treatment of neuropathic pain is often unsatisfactory. Considerable variation in treatment pattern still exists in spite of availability of sufficient literature from various guidelines. Recent Indian market data suggested that the utilization (sale) of drugs such as amitriptyline, pregabalin, and gabapentin was more for low-dose unit packs than that of the high-dose unit packs, raising the belief that these drugs are prescribed at a lower dose than is actually recommended in the guidelines. To test this hypothesis, a survey was conducted across speciality throughout the country to observe the prescription pattern of these drugs amongst the health care providers in India.MethodsThree hundred fifty survey forms were distributed of which 281 forms were included for analysis.ResultsIt was observed that the commonly used initiation and maintenance dose for amitriptyline, pregabalin, and gabapentin was 5–10 mg/day, 50–75 mg/day, and 100–300 mg/day, respectively. The reason to select the lower dosages was to have a balancing effect to achieve good efficacy with minimum side effects. Care-givers reported no side effects/not many side effects as a reason in 22.2%, 16.88%, and 23.86% patients with amitriptyline, pregabalin, and gabapentin, respectively. Sedation and giddiness were commonly reported with all three drugs.ConclusionsCommonly prescribed drugs for management of neuropathic pain, such as amitriptyline, pregabalin, and gabapentin are preferred at lower doses in Indian clinical settings. Acceptable efficacy and low tolerance to the standard dosage is believed to be the reason behind the prescribed dose.

<p class="abstract"><strong>Background:</strong> Osteoarthritis (OA) is the most common musculoskeletal conditions affecting the quality of life. Undenatured collagen type II has emerged as one of the promising treatment options in treatment of OA. Despite being available in India, clinical safety and efficacy have not been evaluated. We performed a non-interventional, real-life study to determine its safety and efficacy in Indian population.</p><p class="abstract"><strong>Methods:</strong> A non-interventional,<strong> </strong>real-life study was performed in patients with OA of knee by 18 orthopaedicians in India. Patients enrolled were followed-up at day 30 (visit 2), day 60 (visit 3) and day 90 (visit 4). Efficacy was assessed by Western Ontario McMaster Osteoarthritis Index (WOMAC) and Visual Analogue scale (VAS) on each visit. Safety was assessed by incidence of suspected adverse events (AEs), and abnormal laboratory parameters.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 291 enrolled patients 226 patients completed the study. Mean age of the population was 56.2±8.7 years and 53.3% of them were females. In 291 patients included in safety analysis, at least one treatment emergent adverse event (TEAE) was seen in 4.47% patients. None of the AEs were serious or resulted in termination of patient from the study. Nausea (1.37%) and headache (1.03%) were the common AEs. Treatment with undenatured collagen type II was associated with significant reduction in WOMC score (p&lt;0.0001) and VAS scores (p&lt;0.0001) from baseline to day 90.</p><p class="abstract"><strong>Conclusions:</strong> Undenatured collagen type II is safe and efficacious in Indian patients with OA. This can be considered early in the initial management of OA.</p>

ABSTRACT-The objective of our study is to determine its anti-inflammatory potential of protein extracted from the stings of honey bee (Apis mellifera). In this study, protein extracted from the stings of Apis mellifera using Tris HCl/ice cold acetone and determined through Nano drop method and then determined its Da protein using SDS-PAGE. In addition, indirect ELISA was performed using rubella vaccine as coating antigen and determined its antibody titre using variable concentration of sting protein (15.62-250 µg) and also determined its activity on human whole blood for determining total cellular content and proliferation against rubella vaccine antigen. The results showed that protein from stings of Apis mellifera showed drastic declined in antibody titre at higher doses but there is slightly enhancement in antibody titre, total cellular content and proliferations at lower concentration as compared to control and rubella vaccine (standard).Overall, this study suggest that stings protein of Apis mellifera showed anti-inflammatory potential against rubella vaccine antigen.

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