The number of new and continuing drug shortages has continued to be on the rise for last ten years. Drug shortages not only reduces the quality of patient care but also contributes to the indirect costs on the healthcare systems by requiring additional time and money to be spent finding alternatives, rescheduling procedures, or modifying drug usage protocols. In order to better understand the dilemma of this crisis, this review article will focus on the specific causes, impact, and most importantly, management strategies of the drug shortage crisis.

Aim: To investigate the influence of genetic polymorphisms of Multidrug Resistant Gene (MDR1), Reduced Folate Carrier (RFC1), Folylpolyglutamyl Synthase (FPGS), Gamma Glutamyl Hydrolase (GGH), and Methylenetetrahydrofolate Reductase (MTHFR) on Methotrexate (MTX) efficacy and toxicity in Chinese patients with Rheumatoid Arthritis (RA).

Methods: One hundred and thirteen Rheumatoid Arthritis (RA) patients defined by the American College of Rheumatology (ACR) 1987 classification criteria were recruited in this study. All patients were treated with low-dose MTX (10-20 mg/week) without concomitant uses of other DMARDs for at least six months. RFC1 80G>A, MDR1 3435C>T, FPGS rs1544105 G>A, GGH - 401C>T, MTHFR 677C>T and MTHFR 1298A>C were genotyped by Polymerase Chain Reaction–Restriction Fragment Length Polymorphism (PCR–RFLP) methods. The MTX toxicity assessment was categorized according to the common toxicity criteria of the National Cancer Institute.

Result: The remission of RA symptoms was achieved in all the MDR1 3435TT genotype carriers (16/16), in 73.1% of subjects with 3435CT genotype (38/52), and in 75.6% of patients with 3435CC genotype (34/45) (P=0.046), respectively. Interaction between SNPs in RFC1 80 and MTHFR 1298 seemed to affect the efficacy of MTX with the best overall performances (accuracy of 0.67) and a CVC of 10/10 (P=0.002). MTHFR 677T allele carriers were more susceptible to MTX toxicity (P=0.007, OR:1.897, 95%CI: 1.725-2.087), compared to those with CC genotype. Of four diplotypes, patients with MTHFR CA-TA diplotype were more easy to experience toxicity (P=0.007, OR: 2.273, 95%CI: 1.303-3.964) when compared to patients without CA-TA diplotype.

Conclusion: MDR1 3435C>T might influence efficacy of RA therapy with MTX. Interaction between RFC1 80 and MTHFR 1298 seemed to impact MTX efficacy. Polymorphisms in the MTHFR gene were associated with toxicity of MTX. Further studies are warranted.

Objective: The main object of present study is to clinically evaluate the efficacy of an Ayurvedic compound formulation Phalatrikadi Kvatha (PTK) on Hepatitis B patients.

Method: Total 59 Hepatitis B positive patients were selected from OPD and IPD of S.S. Hospital, Institute of Medical Sciences, B.H.U. PKT was given in a dose of 80 ml/day in two divided doses for 6 months and follow up was done on every third month. In each follow up Routine Hematological examinations- Hb%, TLC, DLC and ESR; Biochemical investigations- LFT, Serological test- HBsAg (for HBV) and HBV DNA and Radiological tests- USG whole abdomen were done.

Result: Result showed significant effect of Phalatrikadi Kvatha (PTK) on sign and symptoms of Hepatitis which was evidenced by laboratory investigations i.e. LFT (p<0.05), negative HBsAg in 8 patients and HBV DNA (Chi-square =45.9 and P<0.01).Thus present results showed efficacy of PKT on Hepatitis.

Conclusion: Present findings suggest that Phalatrikadi Kvatha (PTK) is an effective and beneficial formulation for management of Hepatitis B patients.

The present study was designed to investigate the anti-stress activity of Aqueous Extract of Asparagus (AEA) in a laboratory setting by the Trier Social Stress Test. Twenty four subjects were randomly divided into three groups: aqueous extract of asparagus, placebo and control treatment. The experimental sessions were performed by single-blinded, and the order of them was counterbalanced. The experiment protocol began with a 30 min rest period (baseline), followed by the Trier Social Stress Test task for 20 min and two rest periods. The saliva samples and psychological measure (state anxiety scores) were obtained at the end of each period. Heart Rates (HR), Systolic and Diastolic Blood Pressure (SBP, DBP) were measured using an Omron electronic blood pressure monitor. The results showed that aqueous extract of asparagus intake resulted in a significant reduction of state anxiety score, HR and SBP responses to an acute stress task relative to the placebo control condition. Moreover, analyses of saliva cortisol level indicated that the reductions in saliva cortisol level was likely attributable to an attenuation of sympathetic nervous activation. Thus, it was suggested that the oral intake of aqueous extract of asparagus could cause anti-stress effects via the inhibition of cortical neuron excitation. These results might suggest AEA consumption as an innovative and effective approach to reduce psychological and physiological stress responses.

Objective: The experiment intended to analyze chemical components of volatile oil from Curcuma kwangsiensis by GC-MS, and to explore its inhibitory action on the growth of human lung cancer cells.

Methods: Extracted with the steam distillation, chemical compositions of volatile oil from Curcuma kwangsiensis were isolated and identified by GC-MS and computer similarity retrieval. Relative percentage contents of each ingredient were determined with peak area normalization. And active ingredients of Curcuma kwangsiensis were determined its inhibitory action on the growth of human lung cancer cells.

Results: Twenty compounds were identified from volatile oil from Curcuma kwangsiensis. They were almost sesquiterpenes and monoterpenes. The relative percentage content of curzerenone was highest, 4.94 %, followed by eucalyptol, 3.03 %, γ-gurjunenepoxide-(1), 2.03 %, germacrone, 1.8 %, camphor, 1.57 %. The IC50 value of volatile oil from Curcuma kwangsiensis acting on H446 cells was 7.55±0.38 μg/mL.

Conclusion: Compounds of volatile oil from Curcuma kwangsiensis were almost sesquiterpenes and monoterpenes, and volatile oil from Curcuma kwangsiensis had an inhibitory action on the growth of human lung cancer cells, H446 cells.

Several current publications have been collected to present in this paper. Taiwan local projects have also provided. Integrated phytoremediation can be defined using plant such as hyper accumulating plant as well as energy plant to remove heavy metals. Chelating agents, phytohormones, and calcium peroxide can be employed to enhance phytoremediation. Energy plants can be extract oil from energy plant to provide biogas and biofuel.

Human sacrifice has been practiced on a number of occasions and in many cultures. The various rationales behind human sacrifice are the same that motivate religious sacrifice in general