Pharmacological management is an important pillar in the treatment of substance use disorders. Decades back, researchers were struggling to find specific pharmacological agents for management of different substance use disorders. However, in the past two decades many effective pharmacological interventions have been discovered, approved, and recommended by several international management guidelines. In recent years, many novel pharmacological agents have been introduced or are in different phases of trial. This review focuses on the current understanding about different pharmacotherapeutic options and recent advances in the management of substance use disorders.

Pain processes are regulated by voltage-gated calcium channels (VDCC) and Ca²⁺. Many mediators of pain increase Ca²⁺ influx through calcium channels, leading to a significant increase in intracellular calcium ([Ca²⁺]_i). Calcium channels act as integrators of G-protein-mediated signalling in neurons. Phosphorylation of calcium channels primary subunits by kinases such as protein kinase C (PKC) and tyrosine kinases have been shown to inhibit/enhance Ca_vchannels. Increased/decreased Ca_vcurrents and PKC activations observed in in vivo pain investigations, and a Xenopus oocytes model may serve as an in vitro model for some cellular mechanisms of pain. In this review, we focus on anesthetic and PKC regulations on ion channels and their properties.

Rave drugs are a class of synthetic drugs that are becoming increasingly popular among the adolescents and youths, especially those who participate in parties where the use of these drugs is rampant. Because of the wrong perception regarding their ability to increase sociability, energy, and safety, they are being extensively abused and are making alarming inroads in the Indian social scenario too. Anesthesiologists can expect to come across rave drug users in their clinical practice. Considering the settings in which rave parties are held, it is likely that anesthesiologists will have to deal with rave drug users in emergency situations. However, it is possible for anesthesiologists to come across such patients who are posted for elective surgeries too. This review attempts to increase awareness among anesthesiologists about the emerging societal menace of rave drugs and their pharmacological characteristics, their effects on various organ systems, and their associated anesthetic interactions.

Neurodegenerative diseases, particularly mediated through increased nitroxidative stress and inflammatory cytokines, are considered to be a greatest medical challenge even for the poorly-developed world. The un-predictable onset of neurodegeneration can lead to devastating illnesses, such as Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic Lateral Sclerosis (ALS) and other types of dementia. Extensive research has shown that inflammatory cytokines and mitochondrial dysfunction can promote neurodegeneration, resulting in accumulation of Ab peptides in the case of Alzheimer's disease or progressive loss of dopaminergic neurons by a-synuclein mutation in the nigrostrial system in Parkinson's disease. In addition, cardiovascular disorders are among the leading causes of death and disability in the world. For instance, hypertension is a major risk factor for cardiovascular and cerebrovascular disease, end stage renal disease, type 2 diabetes, and metabolic syndrome. Similarly, cancers in many tissues including lung, breast, prostate and blood are leading causes of mortality all over the world. In addition to changes in gene expression and genetic mutations, environmental factors, drugs and dietary habits of individuals may play an important role in the onset of these neurological conditions. In the search for effective treatment and cure, the focus has recently shifted from allopathic western medicine to alternative and complementary medicine in many countries (including the United States of America). In fact, some dietary supplements including herbs, vegetables, nuts and fruits, have demonstrated promising outcomes in improving human health. Among them, pomegranate; is one of the exotic fruits that has been known for its valuable effects from the time immemorial.

Objective: Mimosa pudica (M. pudica) Linn. (family: Mimosaceae) is a traditionally used folk medicine to treat various ailments including convulsion, alopecia, diarrhea, dysentery, insomnia, tumor, wound, snake bite, etc., Here, the study was aimed to evaluate the potential on antiepileptic, analgesic, and motor activities of M. pudica leaves on rodents. Materials and Methods: In an acute toxicity study, the extracts were administered in doses of 50-2,000 mg/kg/p.o. and behavioral changes were observed for up to 24 h. For a pharmacological study, the ethyl acetate extract of M. pudica (EAMP) leaves in doses of 100 mg/kg/day, 200 mg/kg/day, and 400 mg/kg/day were orally administered for consecutive 7 days to animals. The antiepileptic study was evaluated by inducing electric shock, pentylenetetrazole (PTZ), and isoniazid (INH) in mice, whereas the motor activity test was performed by using an actophotometer, rotarod test, and traction test in mice. The analgesic activity was done by hot-plate, tail flick, and acetic acid-induced writhing in rats. Statistical analysis was carried out by one-way analysis of variance (ANOVA) followed by Dunnett's test. Results: The EAMP showed dose-dependent analgesic activity by increasing the reaction time as compared to the vehicle control. Similarly, the motor performance was improved in dose-dependent manner as compared to standard. The doses (100 mg/kg/day, 200 mg/kg/day, 400 mg/kg/day) of the extract significantly (P < 0.01 and P < 0.001) reduced the duration of seizures induced by maximal electro shock (MES) and delayed the onset of tonic-clonic seizures produced by PTZ and INH. All the tested doses significantly prevented the latency and duration of convulsion against seizure inducers as compared to the vehicle controls. Conclusion: These results revealed that the EAMP possesses potent analgesic, antiepileptic, and motor activities on animals. This could be an effective treatment option for various motor or seizure disorders.

Objective: Although the role of streptozotocin (STZ) in the pathogenesis of diabetes in rats has been well investigated, as evidenced by several citations, to our knowledge no study has been carried out yet to examine the preliminary steps of STZ-mediated oxidative stress in pancreatic rat tissues. This study aimed to evaluate the hypoglycemic and potential antioxidant properties of ginger extract (GE) in diabetic rats. Materials and Methods: Forty-eight male Sprague-Dawley rats weighting 250-300 g were allocated to groups as follows: Nondiabetic control group (n = 12) that received chow diet; nondiabetic control group that received chow diet plus oral feeding of GE (n = 12); diabetic group (n = 12) that received chow diet; and diabetic group (n = 12) that received chow diet plus oral feeding of GE. The drug STZ was used as a diabetogenic agent in a single intraperitoneal injection dose of 60 g/kg body weight, and the blood glucose level for each rat was measured twice a week. After 12 weeks, all animals were overnight fasted and sacrificed; serum was collected for biochemical measurements of glucose, insulin, and oxidative stress indices [advanced oxidation protein products (AOPP), protein carbonyls, and nitrates plus nitrites]. The pancreas tissues were dissected and homogenized for antioxidant measurements [glutathione (GSH) and total antioxidant capacity (TAC)]. Results: Diabetic rats treated with GE showed a significant protective effect against STZ-induced hyperglycemia and oxidative stress as compared with the control group. Conclusion: Our results suggested that GE possesses potential benefits in controlling type 2 diabetes mellitus (T2DM) and that it may also prevent pancreas damage.

Catatonia is a syndrome of specific motor abnormalities, closely associated with disorders of mood, thought, and cognition. The principal symptoms of catatonia are mutism, immobility, negativism, posturing, stereotypy, and echo phenomena. Catatonia occurs in various psychiatric illnesses as well as medical disorders like infections of the central nervous system such as encephalitis, autoimmune disorders, cerebrovascular events, systemic metabolic disturbances, and toxic drug states. Catatonia may often mislead the clinician and the patient may be misdiagnosed as primarily suffering from a psychiatric disorder and be treated accordingly. Encephalitis may present with various psychiatric symptoms including catatonic features as its sequel that may sometimes be misunderstood as a primary psychiatric disorder. We highlight a case of a young female in her postpartum period, who presented with initial aggressive behavior and sleep deprivation followed by features of catatonia accompanied with fever. She initially responded well to benzodiazepines; however, her subsequent response was poor. When she was subjected to neuroimaging, it revealed signal intensity alteration in the bilateral basal ganglia and temporal regions suggestive of encephalitis; cerebrospinal fluid (CSF) viral markers examination revealed immunoglobulin M (IgM) positivity for Japanese encephalitis (JE). This case report highlights the diagnostic dilemma and management issues of a case of JE with catatonic symptoms.

Health anxiety disorder is a very distressing disorder both to the patients and his health care providers. This case of a man who presented with a preoccupation with having human Immunodeficiency virus (HIV) infection that made him pay for repeated tests-approximately more than 100 times. In this case report, we describe a case of a man who presented with preoccupations with having HIV that made him pay for repeated tests more around 100 times.

Obesity is an excess of body fat, resulting in adverse health effects. Obesity has emerged as a major public health problem. A rural mother aged 58 years, a widow for the past 29 years, presented to the chest clinic with complaints of breathlessness, snoring, and excessive sleepiness. Diet and exercise along with counseling for a lifestyle change made her lose 7% of body weight. Obesity is a public health problem with multiple risk factors, and so its management is complex. This sheds light on a nonpharmacological approach for the management of obesity.