Drug discovery begins in the laboratory with target identification and validation followed by pre-clinical and clinical development. The entire process takes around 10 to 15 years. It is associated with high costs and a high rate of failure. The probability of a drug going beyond Phase I testing is quite low. The quest for discovering anti-cancer agents has shifted from non-specific chemotherapeutic agents to a specific molecular target-based approach. Drug development processes for various drugs need to be re-evaluated. Phase 0 clinical trials act as a novel tool to hasten and improve the drug development from laboratory to clinic. Phase 0 studies enable go versus no-go decisions for a new drug early in its development process. The administration of a single sub-therapeutic dose provides preliminary data on the pharmacokinetics of the drug. It helps in confirming whether the drug behaves in humans as was predicted by pre-clinical studies. Notwithstanding, Phase 0 clinical studies are associated with some disadvantages. This article describes about Phase 0- its rationale, conduct, potential benefits and limitations.

Introduction: Psychological stress worsens glycemic control and increases oxidative stress in Type 2 DM patients. The practice of yoga, along with physical exercise reduces psychological stress and improves glycemic control in diabetic individuals, thereby preventing its progression to complications. This study evaluated the impact of two combined yogic interventions in the management of Type 2 DM. Methodology: Around 20 Type 2 diabetic subjects were randomly recruited to participate in the study. A pre- and post- test methodology with yogic intervention for 5 weeks was employed in the study. A student's paired t-test on the overall mean scores and mean scores, stratified by gender, age and duration of diabetes, was conducted to evaluate the hypothesis. Results: A significant decrease in plasma glucose, serum cortisol and serum malone-di-aldehyde (MDA) levels and a significant increase in serum super oxide dismutase (SOD) activity were noted. Also, the effect of yogic intervention was found to be more pronounced in subjects with poor glycemic control. Conclusion: This study emphasizes the role of two yogic practices (Nadishodhana Pranayama and the Sun Salutation) as adjuvant therapy in patients with Type 2 diabetes.

Obsessive compulsive disorder (OCD) is characterized by unwanted, persistent, and intrusive thoughts and has lifetime prevalence estimated at 1 to 3%. OCD is often associated with a high degree of psychiatric comorbidities (like depression), disability, and relatively poor long-term outcome. Cognitive-behavior therapy (CBT) has proven to be an effective treatment regiment for OCD. Yet, it is being underused used in acute care facilities for the treatment of patients with OCD and associated psychiatric comorbidities. We present a challenging case highlighting the benefit of CBT alongside medication adjustments in a mental health unit. A 20-year-old male patient presented to our mental health unit with previously diagnosed OCD and severe depression. In addition, he also had social anxiety, insomnia, and suicidal ideation. Patient history revealed that he had been prescribed fluvoxamine, 200 mg per day, five months back but his symptoms had gotten worse. He has had one previous hospitalization. His Global Assessment of Functioning (GAF) at admission was in the range of 21-30. The fluvoxamine that had been previously prescribed was kept at 200 mg per day. In addition, he was also prescribed lorazepam 1 mg every four hours (anxiety), and zolpidem 10 mg per day (insomnia). During his inpatient stay, the patient also underwent CBT with counselors and a social worker. At discharge which was 6 days post admission, the fluvoxamine was increased to 250 mg per day. He had mild depression; GAF had improved; was very sociable; slept 8 hours a day; and had no suicidal ideation. CBT that focuses primarily on exposure and response prevention may be better at treating co-occurring depression. This case illustrates the importance of considering CBT alongside proper pharmacotherapy in the treatment of OCD with depression in acute care facilities.

During ongoing morphological study of adult human larynx, we found a rare variant of thyroid cartilage anatomy. Absence of superior cornua of thyroid cartilage was seen on left side in a specimen of larynx. In the same specimen was present a large spindle shaped triticeous cartilage. Very few studies describe this type of variation. We recommend that surgeons, radiologists and autopsy surgeons performing any procedures in the region of the neck, to make a mental note of this anatomical variation. This variation and its clinical significance are reported in the paper.