An overview of tramadol and its usage in pain management and future perspective.

Patients with chronic non-malignant pain report impairment of physical and social life along with psychological state affecting their overall quality of life. The purpose of managing pain is to reduce the trauma and improve the patient comfort with better quality of life. Tramadol is a centrally acting weak µ-opioid receptor analgesic and is a racemic mixture of (+)-tramadol and (-)-tramadol enantiomers. Tramadol is used worldwide and is listed in many medical guidelines for pain management. The (+)-tramadol has greater affinity for µ-opioid receptor and provides additional prevention of 5- hydroxy tryptamine reuptake, while the (-)-tramadol is a successful noradrenaline reuptake inhibitor and intensifies its release by activating the auto receptor. Tramadol is prescribed to relieve moderate to severe pain management in patients. Tramadol does not show much serious adverse effects without any dependency potential in therapeutic doses as seen in other opioids, like morphine. Tramadol metabolite M1 also has µ-opioid receptor agonist activity, but it faces poor blood brain barrier permeability. In this review, we report the complete updated status of Tramadol along with its chemistry, synthesis, pharmacology, medicinal uses, adverse effects and its combinations available in the market. We have also covered Tramadol patents so that a complete overview provides a broader perspective for future designing of its derivatives and increase their potential use for pain management in terminal cancer patients.

Pathophysiology, mechanisms and applications of mesenchymal stem cells for the treatment of spinal cord injury.

Spinal Cord Injury (SCI) is a serious devastating condition associated to the high chances of morbidity and mortality. It involves a primary and a secondary injury, former cause damages to both lower and upper motor neurones and disrupts sensory, motor and autonomic functions while the latter involves various stages of molecular plus cellular incidents which elaborate the original injury. In the treatment of SCI, stem cells possess a good therapeutic potential. Bone marrow, adipose tissue, placenta, amniotic fluid and umbilical cord are the good sources for mesenchymal stem cells. This review article shows the uses of bone marrow derived mesenchymal cells in the treatment of acute and chronic case of SCI and its future scope.