Manage Engine
I was recently evluating ServcieDesk Plus from Manage Engine. A superb product in my view. I was especially impressed with their attitude to support. They have a forum where you can suggest improvements or features you'd like to have. I made a suggestion during the evaluation preriod and, about 3 weeks later, received a notification that it had been implemented.
It works extremely well with MS Exchange, uses MS SQl or MySQL, is very easy to set up, is fully ITIL V3 compliant and very easy to customise to meet your needs.
I was evaluating a number of other products at the samer time but have recommended this to my employers. They have a free version but I've gone for the fully featured Enterprise version.
