Flunarizine is one the cerebroselective calcium channel blocker, commonly prescribed for migraine prophylaxis in neurology clinic. It is considered as non inferior to propranolol and amytriptyline to reduce the frequency of migraine attacks. Here we report a case flunarizine induced extrapyramidal syndrome and depression. A 37 year old female on tablet flunarzine 15 mg daily for her migraine signs of depression and restlessness, propensity to bend, slow reactions and mask face. Depression was rated using patient health questionnaire and extrapyramidal syndrome was diagnosed by modified simpson agnus scale and Barnes akathisia rating scale. Considering nil organic lesion and improvment of all symptoms with the cessation of flunrarizine, case was diagnosed as flunarizine induced depression and extrapyramidal disorder.

Introduction: Qualitative and quantitative analysis of single cells treated with immunomodulators can be done by FACS. T cells, B cells and NK cells, designated as CD cells, are the immunological biomarkers of various haematological conditions which are attributed to prognosis and diagnosis of related disorders. Azathioprine and Cyclophosphamide are immunosuppressive agents, having different mode of action and classification which are been used clinically. Here, we have compared the dose of Azathioprine and Cyclophosphamide in CD-1 ® mice through lymhocytes’ enumeration by FACS to compare the potency of immunosuppression. Methods: Randomly divided male and female mice were treated with AZA 20, AZA 50 and CPM 20 for four days, Body weight and feed consumption was taken on day 1 and 5. Collected blood samples were mixed with antibodies. Samples were lysed by lysing solution. Repeated washing and centrifugation yields leucocytes in each tube for estimation. Lymhocytes’ enumeration was performed for CD3, CD4, CD7, CD8, CD16, CD19 and CD45 and percent population of CD markers were evaluated. Results and Conclusion: All the animals were normal throughout treatment. No significant change in body weight, percent body weight change and food consumption was observed. No gross lesions were observed. Total lymhocytes’ counts were decreased. Double negative tregs of CD4- and CD8- in female mice showed potent immunosuppressive effects and sensitivity towards female gender. Azathioprine was less immunosuppressive than Cyclophosphamide at 20 mg/ kg body weight.

Background: Menstrual disorders are one of the major problems faced by women all around the world and may have considerable psychological and physical consequences in student community and contribute to absenteeism. Objective: This study was conducted to investigate student’s experience of and their response to menstrual symptoms and also to understand the impact of the respondents’ study background on the treatment preferred for the menstrual discomforts. Methods: The survey was carried out using a pre-validated questionnaire consisting 29 questions, organized into two sections viz., the first section includes 10 items on the demographic details; second section includes 19 questions related to menstrual problems and the treatment preferred. Results: A total of 592 questionnaires were returned by the participants giving a response rate of 70% and only 569 questionnaires were completely filled. Among the participants, 34.97% of students responded to have irregular menstrual cycle. The participants responded that menstrual discomforts was a reason for them to avoid physical exercise (64.0%), feel depressed (54.8%), absent from classes (20.0%) and also that it affected work ability (44.1%), academic activities (32.3%), social relationship (30.2%). Conclusion: In this study, the most common discomfort experienced by the students was pain cramps leading to usage of pain killers as their main choice. Among alternative medicines, Chinese medicine was their most preferred choice of treatment, whereas in home remedies, raw ginger was their choice. An educational intervention regarding menstrual problems and the importance to seek medical advice can help these students to be concerned on their health.

Our gut is home to over a trillion of microbes existing in a symbiotic relationship with its host organ. The enzymes synthesized by gut Microflora have been long known to influence our health, but their role in the metabolism of drugs has not been studied to that extent. Similar to drug metabolizing enzymes in liver and intestine, gut Microbiota can modulate the metabolism of drugs in a number of ways including but not limited to hydrolysis, reduction, or degradation of a drug molecule. The role of liver and intestine has been extensively studied during early drug discovery for its influence on drug metabolism but very less emphasis is given to metabolism of drugs by gut Microbiota . This review paper discusses the role of gut Microflora and its role to alter drug metabolism and advocate the inclusion of microbial metabolism screening during drug development.

Isoniazid (INH) is a crucial drug in the prevention and treatment of tuberculosis. INH is commonly known to cause derangements in liver function tests and peripheral neuropathy due to pyridoxine deficiency in slow acetylators. However, in toxic doses it is known to cause severe neurologic manifestations and acute metabolic acidosis. INH toxicity is characterized by the clinical triad of repetitive seizures unresponsive to the usual anticonvulsants, metabolic acidosis with a high anion gap and coma. Hence, the diagnosis of INH overdose should be considered in any patient who presents to Emergency medical services (EMS) with the triad. Though accidental overdose of anti-tuberculosis drugs have been reported in children and adults, acute toxicity is rare. When recognized, intravenous pyridoxine and correction of acidosis with sodium bicarbonate and supportive treatment is effective. The condition is easily treated with intravenous pyridoxine but if not treated in time could prove fatal. Unlike other poisonings, serum INH levels do not co-relate with either symptomatology or liver injury.