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Background-Euphorbia prostrata possesses many actions one of which is wound healing. Skin wound healing is a significant health care problem which clinician faces still. Hence this study was planned to evaluate effect of euphorbia prostrata on skin wound healing. Material and methods-This study was conducted among randomly selected wistar rats (n=6 per group). Group A and Group B had Cream and 1% euphorbia prostrate cream applied topically on the excisional wound respectively. Wound healing and epithelisation was assessed on Days 4,8,12,16,20. Results: Group A showed an average wound size of 348±13.0 on day 4, 278±10.5 on day 8, 119±9.8 on day 12, 86±9.2 on day 16 and 100% wound healing was observed day 20 onwards. Group B showed an average wound size of 296±11.0 on day 4, 147±9.5 on day 8 and complete wound healing was observed day 12 onwards in the test group. Conclusion: Euphorbia prostrata holds promise as effective drug therapy for wound healing.

Proton pump inhibitors [PPI] are acid activated pro drugs which convert in to sulfenic acid and then in to tetracycline sulfenamide in the acidic pH of parietal cell canaliculi. They block H+K+ATPase proton pumps and reduce gastric acid secretion. They are used to treat acid peptic disorders and NSAID induced gastric mucosal injury. Activity of PPI against Helicobactor pylori [H.pylori] is proved undisputably. Lansoprazole is the most effective PPI against H.pylori due to its unique chemical structure.PPI inhibit urease activity of H. pylori. They affect respiration and energy metabolism of these organisms as result of decreased ATP synthesis. Structural similarity of benzimidazole PPI with imidazole like metronidazole and tinidazole may contribute for their antibacterial property. Omeprazole and lansoprazole have been found to have anti fungal activity by inhibition of fungal H+K+ATPase-vacuolar ATPase which are essential for fungal survival and to carry out essential physiological functions, the inhibition of which leads to fungicidal action. Recently anti tubercular action of lansoprazole was highlighted which is attributed to its intra mycobacterial sulfoxide reduction to lansoprazole sulfide. This acts on mycobacterial cytochrome bc1 complex and inhibits ATP synthesis and compromises energy metabolism threatening its survival. Cytochrome bc1 of plasmodium also forms a drug target for lansoprazole. Thus, lansoprazole can emerge as a potential drug to treat MDR tuberculosis and malaria. Antiviral action of lansoprazole was noted against rhinovirus. Gram positive and negative organisms other than H.pylori were found to be inhibited by omeprazole in vitro. But this is not supported by in vivo studies.

Thrombotic events in diabetics contribute for almost 65-80% of cardiovascular events. Diabetes affects the platelet, the coagulation factors and fibrinolytic system leading to a state of hypercoagulation and hypofibrinolysis resulting in to thrombosis. Oral drugs commonly used in management of type II diabetes mellitus are antidiabetics like metformin, PPAR- γ agonist and DPP-4 inhibitor. They rarely produce hypoglycemia. Metformin has been proved to prevent release of mtDNA from arachidonic acid stimulated platelets, reduce membrane damage and mitochondrial ROS production in the platelets. Similarly processes like platelet adhesion, activation and aggregation on collagen coated surfaces which initiate thrombosis are prevented by metformin. PPAR- γ agonists like pioglitazone and rosiglitazone have anti atherogenic effect. They decrease the expression of inflammatory markers and affect the coagulation markers like factor VII: C and inhibit platelet activation. Pioglitazone also reduces the VLDL, triglycerides and increases HDL which further contributes in attenuation of atherosclerosis. DPP-4 inhibitors, which are relatively newer class of antidiabetics, having minimum potential for hypoglycemia induction, due to their novel mechanism of action. Studies have proved that long term use of DPP-4 inhibitors have reduced cardiac mortality by their lipid lowering action, increased release of NO from endothelium and inhibition of TNF- α, PAI-1 and VCAM expression. Increased levels of stromal cell derived factor - 1α helps to maintain endothelial homeostasis and vascular repair. Decreased oxidative stress, inhibition of inflammatory genes like IL- 6, IL-12, TNF- α provide additional benefit. Destabilization of vasculo-atherosclerotic plaque is prevented by DPP-4 inhibitors. Thus these oral antidiabetics drugs offer many benefits beyond blood glucose control which prevent atherosclerosis, inhibits hypercoagulable state and enhances fibrinolysis which translates into decreased cardiac complications in diabetes

Proton pump inhibitors [PPIs] are extensively used drugs for various indications. They are not approved for long term use by regulatory authorities. PPIs are also available as over the counter drugs which can lead to their inappropriate use. Amongst the adverse drug reactions [ADRs] of PPIs, dementia and Alzheimers disease [AD] are the recent ones. Inappropriate long term use of PPIs can lead to serious ADRs like myocardial infarction, nephropathy along with dementia. The possible mechanisms for PPIs induced dementia and AD are endothelial dysfunction, its aging and senescence. Effect on lysosomal function and proteostasis, shortening of telomere length, and inhibition of vacuolar ATPases [V-ATPases] of microglial lysosomal membrane also contribute for this pathology. Increased generation of beta amyloid [Aβ] peptide by inverse gama secretase modulation and augmentation of beta secretase are responsible for the generation and accumulation of Aβ along with its decreased degradation as a result of inhibition of V-ATPases in the microglia. Vitamin B 12 absorption is decreased due to long term use of PPIs. This also contributes for nerve damage as a result of impaired DNA synthesis, methylation and homocysteine neurotoxicity along with cognition impairment. Seizure like condition can be the result of hypomagnesemia induced by long term PPIs use. Thus long term, inappropriate use of PPIs invite serious and life threatening conditions which need to be kept in mind by the clinician before prescribing them.