Best Patient Compliance

Ginlac-V ensures best patients compliance compared to any other Vaginal Preparation due to

1.Shorter duration of Therapy

2.Faster disintegration of Tablet in Vagina ensures that patient can perform her usual work early.

3.Retention of drug at site of infection minimizes need of repetition.

4.Poor class of population due to poor sanitation & poor living standards are most affected & repeatedly complains vaginal infection hence Lesser Cost of Treatment ensures affordability to poor class of population.

5.Polycarbophil ensures moisturization hence relives irritation & itching which may be a cause of Social Embarrassment.

6.Easy to carry Pack prevents Social Embarrassment.

Lactic Acid Bacillus

•The human vagina has several effective mechanisms of defense against exogenous microbes. Among these mechanisms, the presence of nonpathogenic commensal microorganisms, mainly Lactobacillus acidophilus, which produces antimicrobial bacteriocins, peroxides, and lactic acid from glycogen, is of primary importance.

•Thanks to the presence of lactobacilli, the pH of the vaginal fluid in healthy women is maintained between 4 and 5. The natural resistance to the colonization of pyogenic organisms is therefore mediated by lactic acid, low pH, and antimicrobial polypeptides.1,2

•A strict coincidence has been observed between an increase in vaginal pH and a higher incidence of bacterial vaginosis and of trichomoniasis also resulting in the destruction of the natural flora of lactobacilli.3

•The increase of the vaginal pH (to as much as pH 7) may also occur in postmenopausal women with consequent possible colonization of the vaginal mucosa by pathogenic microorganisms and, therefore, increased risk of local infections. Irritation of the mucosa, with consequent itching, tenderness, and unpleasant smell are the main consequences of these pathological situations

CLICK AT CARTOON TO SEE WHAT THEY MEAN

Highest Individual Scorer

By now , If you have visited Rapross Mont Cricket League on net , You must have seen that Highest Individual Score has been 500 Runs.

Hence if wish to be Man of the series you must plan at least 600+ Runs both in June & July to become Man of the Series.

I am confident you will start hitting hard in slog overs now to become honwred Man of The Series.

Best of Luck

Lornasafe-Plus has been launched by Mankind

Mr.Jwalant Shukla has informed about the launch of Lornsafe-Plus (Lornoxicam 8 mg + Paracetamol 500 mg) by Mankind @ Rs.4.99/- Tab.

You are suggested to become more aggresive & must details that we are Pioneer & also take adavantage of 20% Bonus offer on Topcam-P.

Belive me it Persistant efforts & strong demand is more imortant than the MRP. Hence be more demanding & persuasive during the visit to Drs.

Montelukast in the Treatment of Children with Moderate-To-Severe Atopic Dermatitis: A Pilot Study

Tamara Perry, MD and Robert A. Wood, MD
Baltimore, MD
Purpose to the Study. The role of leukotrienes in the pathogenesis of atopic dermatitis (AD) is uncertain. This double-blind, placebo-controlled crossover study addressed the efficacy of the leukotriene receptor antagonist montelukast in moderate to severe AD.
Study Population. Fifteen patients (ages 6–16) with moderate to severe AD despite conventional therapy consisting of at least a class II steroid, soap substitutes, and emollients.
Methods. Disease severity was evaluated by grading 8 areas of the body (head/neck, front of the trunk, the back, genitalia, and 4 limbs) on a scale of 0 to 3. A score of at least 40 was required to be enrolled in the study. The extent of disease was calculated by estimating the percentage of the body surface involvement. Patients were examined by the same physician on a biweekly basis and completed questionnaires to assess the impact of AD on daily life, as well as the effect of disease on relationships with family members and social life. There was a 2-week run-in period during which standardized topical treatment was initiated. Patients were randomized to receive either 5 mg montelukast or placebo daily for 4 weeks. There was a 2-week washout period before crossover for the second phase.
Results. Eleven patients completed the study with 6 in group A (placebo first) and 5 in group B (drug first). Despite randomization, the baseline median disease severity score between groups was significantly different, group A 52 and group B 78 (P = .018). Group B had a significant decrease in the disease severity (P = .05) during the drug phase. There was also an increase in disease severity during the placebo phase, however, severity scores did not return to baseline. Group A had improvement during both the placebo and drug phase (P = .075 and .029, respectively). Patient index scores and extent of disease did not change significantly for either group.
Conclusion. This pilot study shows that leukotrienes may be important mediators in AD and leukotriene receptor antagonists (LRAs) may be suitable adjuvant therapy in those patients with severe disease.
Reviewers’ Comments. Although leukotrienes are important chemical mediators in asthma and allergic rhinitis, their role in the pathogenesis of AD is not as clear. This study suggests that they may have a role in AD and that LRAs may provide some clinical benefit. In practice, some patients do seem to improve although the responses have not been overwhelming, which is consistent with the results of this study. It may be worth a try in patients with severe disease and, in addition, patients who are started on an LRA for their asthma may experience some improvement in their AD.

REFERENCES
Pei A, Chan H, Leung T. Pediatr Allergy Immunol.2001; 12 :154 –158[CrossRef][ISI][Medline]
PEDIATRICS (ISSN 1098-4275). ©2002 by the American Academy of Pediatrics

Montelukast is efffective in Atopic Dermatitis ?

Montelukast treatment of moderate to severe atopic dermatitis in adults: a randomized, double-blind, placebo-controlled trial

Journal of Drugs in Dermatology , Sept-Oct, 2005

The authors present a two-center, randomized, double-blind, placebo-controlled trial to evaluate the efficacy of montelukast in the treatment of moderate to severe atopic dermatitis. Fifty-nine patients were recruited for the study and randomly assigned to 1 of 2 treatment arms: 10 mg of montelukast once daily or placebo for 4 weeks. No statistically significant differences in disease activity were noted in the 2 groups at baseline. Patients were required to undergo a wash-out period of 2 weeks and no systemic or topical treatment, with the exception of emollients, was allowed during the study. The primary outcome was the modified eczema area and severity index (EASI) score. This score is the sum of a score for pruritus and the EASI score. A secondary outcome was the pruritus score alone. Patients were assessed at baseline, after the wash-out period, and at weeks 1, 2, and 4 of treatment. Six patients dropped out of the study before beginning treatment. Drop-out occurred in 6 patients during the study secondary to either worsening of their atopic dermatitis or not returning for follow-up visits. As the intention-to-treat analysis was used, these latter 6 patients were included in the analysis giving a total of 53 patients. No statistically significant difference was noted between the montelukast and placebo groups. No adverse events were reported.
Comment
The authors present a well-designed study to evaluate the efficacy of montelukast in the treatment of moderate to severe atopic dermatitis. Rationale for the use of montelukast in atopic dermatitis is based on anecdotal reports as well as prior studies. As leukotrienes are important in the pathogenesis of atopic disorders such as asthma and allergic rhinitis, it is possible they also play a role in atopic dermatitis. Synthesis of leukotrienes, determined by urinary excretion of leukotriene E4, was studied in 8 patients with atopic dermatitis compared with 8 healthy controls. (1) Patients with atopic dermatitis were found to have a statistically significant increase (4.5-fold) in leukotriene E4 excretion in comparison to controls. Hence it is theoretically possible that a leukotriene antagonist such as montelukast would improve atopic dermatitis. This study fails to demonstrate such efficacy. One reason may be that the investigators considered a 60% reduction in scoring as significant. Prior studies have shown efficacy. (2,3) These studies involved fewer patients and considered smaller reductions as significant. For example in Yanase et al, a 30% reduction in scoring was considered significant. This study confirms that the efficacy of montelukast in the treatment of atopic dermatitis is in no way dramatic. It may improve atopic dermatitis modestly at best and is certainly not suitable as a monotherapy. However, it may be useful in combination with a topical or systemic agent in a subset of patients.
References
1. Fauler J, et al. Enhanced synthesis of cysteinyl leukotrienes in atopic dermatitis. British Journal of Dermatology. 1993;128(6):627-630.
2. Eustachio N, et al. Efficacy and tolerability of montelukast as a therapeutic agent for severe atopic dermatitis in adults. Acta Derm Venereol. 2002; 82:297-320.
3. Yanase DJ, et al. The leukotriene antagonist montelukast as a therapeutic agent for atopic dermatitis. Journal of the American Academy of Dermatology. 2001; 44(1):89-93.
Washington Whispers provides a summary and critical evaluation of the latest drug trials, studies, and reactions available to the medical community, as collated from a wealth of industry sources.

Beware of Symkast-LC

You must have observed that Symkast-LC is main competitors of our LCZ-Mont.
Have A look on Symkast-LC
>MRP- Rs.10.00 Per Tab
>Single Tab Formulation unlike our Double Layers Tab for Optimum Absorption.
>Hit on Double Layerd Technology & Price Advantage.
Hit them hard & meet your targetted Doctors atleast 6-8 Times in month so that you get advantage over them.
Best of Luck.

Top Uplifter till now

Mr.Pankaj has scored 175 Runs till now in June-09.
He is leading batsman of Uplifters
Come on become man of the match
Match is still on but only 7 Ball are left.

COMPOSITION

Each uncoated tablet contains:
Montelukast sodium equivalent to Montelukast .........................................................10 mg Levocetirizine dihydrochloride I.P. ……………..5 mg Colour-Ponceau-4R

DESCRIPTION

Montelukast is a leukotriene receptor antagonist (LTRA) used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergies. It is usually administered orally.

Levocetirizine is the R-enantiomer of cetirizine. Levocetirizine is an orally active, potent, selective and long acting H1-histamine receptor antagonist with no anticholinergic activity.

It has been demonstrated by recent studies that the treatment of AR with concomitant administration of an antileukotriene (montelukast) and an antihistamine (levocetrizine), shows significantly better symptom relief compared with the modest improvement of rhinitis symptomatology with each of the treatments alone.

Montelukast was approved by FDA in 1998

PHARMACOLOGY

PHARMACODYNAMICS

Montelukast:
Montelukast is a CysLT1 antagonist; that is it blocks the action of leukotriene D4 on the cysteinyl leukotriene receptor CysLT1 in the lungs and bronchial tubes by binding to it. This reduces the bronchoconstriction otherwise caused by the leukotriene, and results in less inflammation

Because of its method of operation, it is not useful for the treatment of acute asthma attacks. Again because of its very specific focus of operation, it does not interact with other allergy medications such as theophylline.

The Mont in Montelukast stands for Montreal, the place where Merck developed the drug (Singulair)

Leukotrienes are chemical substances that are responsible for an inflammatory response in the lower respiratory pathway, in bronchus and lung. Leukotrienes are produced in the body from arachidonic acid by the enzyme 5-lipoxygenase. Their production by the body is part of a complex response that usually includes the production of histamine therefore anti-histaminics are also needed to inhibit the trigger

Levocetirizine,

the (R) enantiomer of cetirizine, is a potent and selective antagonist of peripheral H 1 -receptors

Benefit of combination
Levocetirizine is highly effective in relieving the symptoms of seasonal & perennial allergic rhinitis including sneezing ,pruritus & rhinorrhoea
Montelukast has shown particular benefit in improving night time symptoms of allergic rhinitis: including difficult in going to sleep ,nasal congestion & night time awakening.
Pharmacokinetics

Montelukast

Ø AbsorptionAfter administration of the 10-mg film-coated tablet to fasted adults, the mean peak montelukast plasma concentration (C max ) is achieved in 3 to 4 hours (T max ). The mean oral bioavailability is 64%. The oral bioavailability and C max are not influenced by a standard meal in the morning.
Ø DistributionMontelukast is more than 99% bound to plasma proteins. The steady-state volume of distribution of montelukast averages 8 to 11 litres.
Ø MetabolismMontelukast is extensively metabolized. In studies with therapeutic doses, plasma concentrations of metabolites of montelukast are undetectable at steady state in adults and pediatric patients.
Ø EliminationThe plasma clearance of montelukast averages 45 mL/min in healthy adults. Following an oral dose of radiolabeled montelukast, 86% of the radioactivity was recovered in 5-day fecal collections and <0.2% was recovered in urine. Coupled with estimates of montelukast oral bioavailability, this indicates that montelukast and its metabolites are excreted almost exclusively via the bile.

Levocetirizine
The pharmacokinetics of levocetirizine are linear with dose and time independent with low inter-subject variability.
Ø Absorption: Levocetirizine is rapidly and extensively absorbed following oral administration. Peak plasma concentrations are achieved 0.9 g h after dosing. Steady state is achieved after two days. The extent of absorption is dose-independent and is not altered by food, but the peak concentration is reduced and delayed.
Ø Distribution: No tissue distribution data are available in humans. Levocetirizine is 90% bound to plasma proteins. The distribution of levocetirizine is restrictive, as the volume of distribution is 0.4 l/kg.
Ø Metabolism The extent of metabolism of levocetirizine in humans is less than 14% of the dose and therefore differences resulting from genetic polymorphism or concomitant intake of enzyme inhibitors are expected to be negligible.Due to its low metabolism and absence of metabolic inhibition potential, the interaction of levocetirizine with other substances, or vice-versa, is unlikely. The plasma half-life in adults is 7.9 + 1.9 hours..
Ø Excretion
The major route of excretion of levocetirizine and metabolites is via urine, accounting for a mean of 85.4% of the dose. Excretion via feces accounts for only 12.9% of the dose.



INDICATIONS
Seasonal Allergic Rhinitis.
Perennial Allergic Rhinitis.
Allergic Rhinitis with asthma.
Exercise induced bronchoconstriction.

DOSAGE
Adults 15 yrs & above 1 tablet OD with or without food

Renal impairmentAs levocetirizine is mainly excreted through urine, dosage adjustment may be required in patients with impaired renal function. Hence this combination should be used with caution in such patients.

Hepatic ImpairmentAs montelukast is mainly excreted through bile, caution is to be exercised while prescribing this combination in patients with impaired hepatic function.

PregnancyThere are no adequate and well controlled studies of either montelukast or levocetirizine in pregnant women. Hence this combination should not be used during pregnancy.
LactationSince levocetirizine is excreted in breast-milk the combination is not recommended during lactation
Elderly
No dosage adjustment in the elderly is required.

STORAGE
Store in a cool dry place

PRESENTATION
Strip of 10 Tablets.

Hi !
UP Lifters ,
Meet Mr.Sateesh Chandra Pandey,Basti H.Q., The Man Of The Match for May-09 with highest Score of 420 Runs, Mr.Sateesh Chandra Pandey is really a Hard Hitter & Surprised all players with his ability to Hit Boundaries in Slog overs, Mr. Sateesh , has promised better scoring in June-09 too, We all wish him all the best.
**********************************************************************************
Also Meet...
Mr.Pankaj from Hardoi H.Q.
Mr.Pankaj has been awarded with Fastest Centurian of the Month as he has provided momentum to UP Lifters in early overs & though he could not become Man Of The Match & stood after Mr.Sateesh with a Score of 332 Runs but he is dertermined to become Man Of The Match in June-2009,
We wish him all the Best.

UP Lifters It's all yours

Hi,

UP Lifters ,

It's your own blog wherein you can share , comment your thoughts & comments.

So,

Start now