Energy measurement of 241Am-9Be neutrons by tagged neutron time-of-flight

Neutron energy spectrum of a ²⁴¹Am-⁹Be source was measured in the energy range of 0.3 to ∼ 6.5 MeV using γ-ray tagged neutron time-of-flight method. BC501A type organic liquid scintillator detector was used at a flight path of 175 cm to detect neutrons with good energy resolution. The de-excitation γ-ray emitted in coincidence with neutrons was detected using a fast BaF₂ detector. The measured data has been compared with the ISO 8529-2 standard neutron reference spectrum and found good agreement in the overlapping energy region. Present measurement applied efficiency correction to the data and extended up to 0.3 MeV in the lower energy region compared to earlier reported measurement using similar technique.

OGAS: Omni-directional Glider Assisted Scheme for autonomous deployment of sensor nodes in open area wireless sensor network

Wireless Sensor Network (WSN) is built with the wireless interconnection of Sensor Nodes (SNs) generally deployed to monitor the changes within the environment of hostile, rugged, and unreachable target regions. The optimal placement of SNs is very important for the efficient and effective operation of any WSN. Unlike small and reachable regions, the deployment of the SNs in large-scale regions (e.g., forest regions, nuclear radiation affected regions, international border regions, natural calamity affected regions, etc.) is substantially challenging. Present paper deals with an autonomous air-bone scheme for the precise placement of SNs in such large-scale regions. It uses an Omni-directional Circular Glider (OCG) per SN. After being aerially dropped, SN pilots the OCG to glide itself to the predetermined locations (PL) within a target region. The major advantage of using OCG is its capability to quickly update the direction, during the flight (with turning radius = 0) toward its PL. The proposed uses a recursive path correction model to maintain the orientation of the gliding SN towards the PL. The simulation results, and the hardware implementation, indicate that the proposed model is effectively operational in the environmental winds. It is time-efficient and more accurate in the deployment of the SNs in comparison to existing state of art SN deployment models.

Molar Incisor Hypomineralization: Prevalence, Associated Risk Factors, Its Relation with Dental Caries and Various Enamel Surface Defects in 8–16-year-old Schoolchildren of Lucknow District

Introduction

Aim

Methodology

Results

Conclusion

Clinical significance

How to cite this article

Comparative Microleakage Evaluation through the Interfaces between the Tooth and Cement after Stainless Steel Crown Cementation in Primary Molars: An In Vitro Study

Introduction

The longevity of stainless steel crowns is related to perfect adaptation and long-term union between restoration and teeth. In this respect, evaluation of marginal leakage of luting cement is essential.

Aim and objective

To compare and evaluate the ability of new adhesive cement to prevent microleakage under stainless steel crowns on primary teeth.

Materials and methods

Forty-five specimens were embedded, standardized preparations were made onto selected extracted primary molars, and stainless steel crowns were adapted. Samples were assigned randomly to cement groups: Glass ionomer (GI), resin-modified glass-ionomer (RMGI), and Adhesive resin (AR) cement, followed by storage in water, artificially aging, staining, sectioning, and the linear dye penetration and proportion of microleakage evaluation.

Results

AR showed the lowest microleakage, followed in increasing order by RMGIC and GIC showed the greatest microleakage (p-value < 0.0001).

Clinical Significance

There are many kinds of luting agents that vary considerably from the viewpoint of solubility, strength, and ability to adhere to the tooth structure. Lack of adhesion of the luting cement to the tooth structure is one of the reasons for microleakage related to different types of crowns. Cement breakdown may result in the entrance of fluids and microorganisms along with the tooth restoration interface. In this study, attempts were made to simulate standard clinical procedures, although this is not a substitute for the complex oral environment, the results provide useful information to choosing the best cement materials.

Conclusion

Adhesive resin cement can be recommended for cementation of Stainless Steel Crowns because of added advantages over others.

How to cite this article

Gundewar MS, Saha S, Arora D, et al. Comparative Microleakage Evaluation through the Interfaces between the Tooth and Cement after Stainless Steel Crown Cementation in Primary Molars: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(2):159-163.

Assessment of materno-foetal transmission of SARS-CoV-2: A prospective pilot study

BACKGROUND

The issue of vertical transmission of SARS-CoV-2 infection to the foetus has not yet been resolved. Its main reason is lack of a bigger study to analyse this question. The evidence of the affection of the foetus during antenatal or intrapartum period is limited to some anecdotal reports. To look for the possibility of vertical transmission of Severe Acute Respiratory Syndrome - Corona Virus-2 (SARS-CoV-2) infection to the foetus, this prospective pilot study was conducted at a tertiary health care COVID-19 designated centre of Armed Forces.

METHODS

This study was conducted during 01 June 2020 and 15 October 2020 and included 54 covid-positive pregnant mothers. During delivery, amniotic fluid and cord blood samples were collected in a sterile manner. Amniotic fluid samples were not collected during vaginal deliveries as chances of contamination was very high. These samples were tested for the presence of SARS-CoV-2 gene by Reverse Transcriptasee Polymerase Chain Reaction (RT-PCR) test, and the results were analysed. Newborns were allowed to room in with mother, and they underwent throat and nasal swab RT-PCR testing of covid within 24-48 h of delivery.

RESULTS

A total of 1520 pregnant mothers underwent RT-PCR test during the study period. Total positivity rate among our pregnant women was 2.8%. Out of 54 covid-positive women during the study period, amniotic fluid RT-PCR tests were carried out for 43 women, and cord blood was tested for 45 women.

CONCLUSION

RT-PCR test of amniotic fluid, cord blood and nasal and throat swab of all newborns delivered by SARS-CoV-2-positive pregnant women were negative. Based on our study, the possibility of intrauterine vertical transmission of SARS-CoV-2 infection appears to be unlikely.

511 A Case Report of A 16-Year-Old Girl with Peritoneal Tuberculosis

Peritoneal Tuberculosis (PTB) is a rare extra-pulmonary manifestation of Mycobacterium tuberculosis infection. It usually presents with non-specific symptoms that can mimic other intra-abdominal pathology. Therefore, a high index of suspicion is needed for diagnosis and early treatment of PTB. Some of the intra-abdominal conditions in young patients that may have similar presentations to PTB include Crohns’ disease, ovarian pathology and acute appendicitis. Diagnosing PTB in the paediatric population tends to be even more challenging as an obvious history of exposure may be difficult to obtain. Diagnostic laparoscopic biopsy and histopathology provides definitive diagnosis. Most studies recommend a 6-month course of anti-TB therapy for abdominal tuberculosis with a planned regimen using Isoniazid, Rifampicin, Pyrazinamide and Ethambutol.

This case report presents the case of a 16-year-old girl who presented with a history of recurrent abdominal pain, vomiting and pyrexia. Radiological, laparoscopic, and histopathological findings were used for final diagnosis of this condition. The patient was treated using the anti-tuberculosis therapy for 6 months following which, she was able to make a full recovery.

An In-Vitro evaluation of resin infiltration system and conventional pit and fissure sealant on enamel properties in white spot lesions

BACKGROUND

Clinically appearing early caries are referred to as white spot lesions (WSLs). These lesions compromise esthetics and precede cavitation; therefore, they must be halted by effective materials.

AIM

To evaluate and compare the depth of penetration and effect of resin infiltration system (Icon) and other conventional pit and fissure sealants (Clinpro and Embrace) on enamel surface properties of WSLs.

METHODOLOGY

Freshly extracted premolars were obtained. Enamel surfaces were treated with resin infiltrant and fissure sealant. Depth of penetration and surface roughness of specimens were measured with an optical profilometer. Microhardness was determined by a Vickers' hardness tester.

STATISTICAL ANALYSIS

Normality of the data was checked by Shapiro-Wilk test. Inferential statistics were performed using one-way analysis of variance. Post hoc pairwise comparison was done using post hoc Tukey's test.

RESULTS

Icon resin infiltrant showed the highest depth of penetration and microhardness followed in descending order by Embrace and Clinpro whereas Clinpro was found to cause maximum surface roughness followed in descending order by Embrace and Icon.

CONCLUSION

The resin infiltration technique for treating WSLs seems adjusted to the philosophy of minimally invasive dentistry in a single appointment, making it beneficial for the patients, especially children.

Bacillus amyloliquefaciens induces production of a novel blennolide K in coculture of Setophoma terrestris

AIMS

The discovery of known bioactive chemical leads from microbial monocultures hinders the efficiency of drug discovery programmes. Therefore, in recent years, the use of fungal-bacterial coculture experiments has gained considerable attention due to their ability to generate new bioactive leads. In this work, fungal strain Setophoma terrestris was cocultured with Bacillus amyloliquifaciens to discover novel bioactive compounds.

MATERIALS AND METHODS

The bioactive methanolic coculture extract was chosen for the isolation of compounds by chromatographic methods. The isolated compounds were characterized by NMR and mass spectrometric techniques.

CONCLUSION

Coculture extract has resulted in the production of five blennolides. The novel compound, blennolide K was found active against PC-3 (prostate) and MCF-7 (breast) cell lines with an IC₅₀ value of 3·7 ± 0·6 and 4·8 ± 0·4 μmol l^-1 respectively. Furthermore, the nuclear morphology study in PC-3 cells after treatment with blennolide K, demonstrated chromatin condensation, formation of apoptotic bodies and shrinkage of cells.

SIGNIFICANCE AND IMPACT OF THE STUDY

To our knowledge, only few studies have reported the induction of bioactive compounds by coculture having long-distance inhibition morphology. This is principally due to the low occurrences of such morphology. Our study demonstrates the impact of coculture on production of new chemical leads in drug discovery programmes.

A comparative evaluation of dental caries status and salivary properties of children aged 5-14 years undergoing treatment for acute lymphoblastic leukemia, type I diabetes mellitus, and asthma - In vivo

BACKGROUND

The subjective sensation of dry mouth, xerostomia, is a well-recognized problem in adults, however, relatively little attention has been paid to this issue in children. Xerostomia commonly occurs as an adverse effect of drugs in asthma and leukemia, which alter the composition and flow of saliva and systemic diseases, including diabetes. It decreases the oral pH and significantly increases the development of plaque and dental caries.

AIM

This study aims to evaluate and compare the dental caries status and salivary properties of children aged 5-14 years undergoing treatment for acute lymphoblastic leukemia, type 1 diabetes mellitus, and asthma - in vivo.

MATERIALS AND METHODS

The study was divided into two parts: Part I: Oral examination was performed and dental caries status Decayed, Missing, Filled Teeth/ decayed, extraction, filled teeth (DMFT/deft) was noted and Part II: Salivary analysis was performed by GC Saliva-Check BUFFER kit to check for hydration, viscosity, pH of saliva, salivary flow, and buffering capacity.

STATISTICAL ANALYSIS

All statistical analysis was performed using the SPSS 21 statistical software version. Inferential statistics were performed using Chi-square test and ANOVA. Post hoc pairwise comparison was done using Post hoc Tukey's test.

RESULTS

The prevalence of mean DMFT/deft with regard to salivary properties was highest in leukemic patients followed in descending order by diabetic and asthmatic patients.

CONCLUSIONS

Leukemic patients had significantly higher caries and decreased salivary properties while asthmatic patients showed the least caries prevalence and best salivary properties.

New cytochalasin from Rosellinia sanctae-cruciana, an endophytic fungus of Albizia lebbeck

AIM

To explore the potential of Rosellinia sanctae-cruciana an endophytic fungus associated with Albizia lebbeck for pharmaceutically important cytotoxic compounds.

METHODS AND RESULTS

One novel cytochalasin, named jammosporin A (1) and four known analogues (2-5) were isolated from the culture of the endophytic fungus R. sanctae-cruciana, harboured from the leaves of the medicinal plant A. lebbeck. Their structures were elucidated by extensive spectroscopic analyses including one-dimensional and two-dimensional nuclear magnetic resonance data along with MS data and by comparison with literature reports. In preliminary screening the ethyl acetate extract of the fungal culture was tested for cytotoxic activity against a panel of four cancer cell lines (MOLT-4, A549, MIA PaCa-2 and MDA-MB-231), and found to be active against MOLT-4 with an IC₅₀ value of 10 μg ml^-1 . Owing to the remarkable cytotoxic activity of the extract the isolated compounds (1-5) were evaluated for their cytototoxicity against the MOLT-4 cell line by MTT assay. Interestingly, compounds 1-2, 4 and 5 showed considerable cytotoxic potential against the human leukaemia cancer cell line (MOLT-4) with IC₅₀ values of 20·0, 10·0, 8·0 and 6·0 μmol l^-1 , respectively, while compound 3 showed an IC₅₀ value of 25 μmol l^-1 . This is the first report of the existence of this class of secondary metabolites in R. sanctae-cruciana fungus.

CONCLUSION

This study discovered a novel compound, named jammosporin A, isolated for the first time from R. sanctae-cruciana, an endophytic fungus of A. lebbeck with anticancer activity against the MOLT-4 cell line.

SIGNIFICANCE AND IMPACT OF THE STUDY

Rosellinia sanctae-cruciana represents an interesting source of a new compound with bioactive potential as a therapeutic agent against a human leukaemia cancer cell line (MOLT-4).

An insight into the role of cyclooxygenase and lipooxygenase pathway in renal ischemia

OBJECTIVE

Renal ischemia (RI) is a clinical condition that occurs due to marked decrease in renal blood flow. The pathophysiology of RI is interlinked with atherosclerotic renal artery stenosis, infarction, organ transplantation and sepsis. The mechanism of RI injury depends on various factors such as inflammatory response, oxidative stress and apoptosis. In this review, we evaluate the role of cyclooxygenase and lipoxygenase in modulating the process of ischemic renal injury.

MATERIALS AND METHODS

This is a literature review of articles published on PubMed and Web of Science in English.

RESULTS

RI is characterized by an inflammatory response and oxidative stress, which are further worsened by the metabolites of the arachidonic acid pathway.

CONCLUSIONS

RI results from a vigorous process involving inflammation and some mediators in a multifaceted interaction. Indulgence of oxidative stress and lipid peroxidation seems to be major factors which promote the inflammation process during RI.

Successful Renal Transplantation Across HLA Barrier: Report from India

Organ donors are sometimes found “unsuitable” due to the presence of donor-specific anti-HLA antibodies in the recipient. In recent years, improved desensitization protocols have successfully helped to overcome HLA incompatibility hurdle. We present three cases where optimum desensitization was achieved in patients with the donor-specific anti-HLA antibody (DSA) leading to successful renal transplantation. All patient–donor pair underwent HLA typing, complement dependent cytotoxicity crossmatch (CDC-XM), flow cytometry XM (FC-XM), and panel reactive antibody. If any of the three tests was positive, single antigen bead assay was performed to determine the specificity of the anti-HLA antibody (s). Patients with DSA were offered organ-swap or anti-HLA antibody desensitization followed by transplantation. Desensitization protocol consisted of single dose rituximab and cascade plasmapheresis (CP) along with standard triple immunosuppression. The target DSA mean fluorescence index (MFI) was <500, along with negative CDC-XM and FC-XM for both T- and B-cells. Three patients with anti-HLA DSA, who did not find a suitable match in organ swap program, consented to anti-HLA antibody desensitization, followed by transplantation. Mean pre-desensitization antibody MFI was 1740 (1422–2280). Mean number of CP required to achieve the target MFI was 2.3 (2–3). All the three patients are on regular follow-up and have normal renal function test at a mean follow-up of 8 months. This report underlines successful application of desensitization protocol leading to successful HLA-antibody incompatible renal transplants and their continued normal renal functions.

Renal infarct following varicella infection

Renal infarction usually occurs against a background of heart disease or a thromboembolic tendency and rarely is associated with infections. Here we present a case of a young boy who reported with painless gross hematuria following primary Varicella infection and was found to have an isolated renal infarct.

Emergency Obstetric Hysterectomy: A Retrospective Study from a Teaching Hospital in North India over Eight Years

OBJECTIVES

We sought to determine the frequency, demographic characteristics, indications, and feto-maternal outcomes associated with emergency peripartum hysterectomy in an easily accessible urban center.

METHODS

We conducted a retrospective, observational, and analytical study over a period of eight years, from August 2006 to July 2014. A total of 56 cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynecology, Kasturba Hospital, New Delhi.

RESULTS

The incidence of EOH in our study was 30 per 100,000 following vaginal delivery and 270 per 100,000 following cesarean section. The overall incidence was 83 per 100,000 deliveries. Atonic postpartum hemorrhage (25%) was the most common indication followed by placenta accreta (21%) and uterine rupture (17.5%). The most frequent sequelae were febrile morbidity (19.2%) and disseminated intravascular coagulation (13.5%). Maternal mortality was 17.7% whereas perinatal mortality was 37.5%.

CONCLUSIONS

A balanced approach to EOH can prove to be lifesaving at times when conservative surgical modalities fail and interventional radiology is not immediately available. Our study highlights the place of extirpative surgery in modern obstetrics in the face of rising rates of cesarean section and multiple pregnancies particularly in urban settings in developing countries.

Life threatening tension pneumothorax during cardiac surgery. A case report

Tension pneumothorax is a life threatening condition that occurs when the intrapleural pressure exceeds atmospheric pressure. It requires prompt diagnosis and immediate treatment. Tension pneumothorax developing postoperatively after cardiac surgery is not uncommon but occurrence in the operating room during cardiac surgery is rare. We report a case of tension pneumothorax intraoperatively during off pump coronary artery bypass grafting.

Allele characterization of genes required for rpg4-mediated wheat stem rust resistance identifies Rpg5 as the R gene

A highly virulent form of the wheat stem rust pathogen Puccinia graminis f. sp. tritici race TTKSK is virulent on both wheat and barley, presenting a major threat to world food security. The recessive and temperature-sensitive rpg4 gene is the only effective source of resistance identified in barley (Hordeum vulgare) against P. graminis f. sp. tritici race TTKSK. Efforts to position clone rpg4 localized resistance to a small interval on barley chromosome 5HL, tightly linked to the rye stem rust (P. graminis f. sp. secalis) resistance (R) gene Rpg5. High-resolution genetic analysis and post-transcriptional gene silencing of the genes at the rpg4/Rpg5 locus determined that three tightly linked genes (Rpg5, HvRga1, and HvAdf3) are required together for rpg4-mediated wheat stem rust resistance. Alleles of the three genes were analyzed from a diverse set of 14 domesticated barley lines (H. vulgare) and 8 wild barley accessions (H. vulgare subsp. spontaneum) to characterize diversity that may determine incompatibility (resistance). The analysis determined that HvAdf3 and HvRga1 code for predicted functional proteins that do not appear to contain polymorphisms determining the compatible (susceptible) interactions with the wheat stem rust pathogen and were expressed at the transcriptional level from both resistant and susceptible barley lines. The HvAdf3 alleles shared 100% amino acid identity among all 22 genotypes examined. The P. graminis f. sp. tritici race QCCJ-susceptible barley lines with HvRga1 alleles containing the limited amino acid substitutions unique to the susceptible varieties also contained predicted nonfunctional rpg5 alleles. Thus, susceptibility in these lines is likely due to the nonfunctional RPG5 proteins. The Rpg5 allele analysis determined that 9 of the 13 P. graminis f. sp. tritici race QCCJ-susceptible barley lines contain alleles that either code for predicted truncated proteins as the result of a single nucleotide substitution, resulting in a stop codon at amino acid 161, a single cytosine indel causing a frame shift, and a stop codon at amino acid 217, or an indel that deleted the entire STPK domain. The three P. graminis f. sp. tritici race QCCJ-susceptible lines (Swiss landraces Hv489, Hv492, and Hv611) and the wild barley accession WBDC160 contain rpg5 alleles predicted to encode full-length proteins containing a nonsynonomous nucleotide substitution that results in the amino acid substitution E1287A. This amino acid substitution present in the uncharacterized C-terminal domain is not found in any resistant line and may be important to elicit the resistance reaction. These data suggest that rpg4-mediated resistance against many wheat stem rust pathogen races, including P. graminis f. sp. tritici race TTKSK, rely on the Rpg5 R gene; thus, rpg4- and Rpg5-mediated resistance rely on a common R gene and should not be considered completely distinct. The data also determined that Rpg5 gene-specific molecular markers could be used to detect rpg4-mediated wheat stem rust resistance for marker-assisted selection.

A sequential compression mechanical pump to prevent hypotension during elective cesarean section under spinal anesthesia

BACKGROUND

Spinal anesthesia is a standard technique for cesarean section but can cause hypotension which may be related to venous pooling secondary to progesterone-induced decreases in vascular tone. This study investigated the use of a sequential compression mechanical pump with thigh-high sleeves with compression cycles timed to venous refilling. We hypothesized that this would recruit pooled venous blood from the lower limbs, maintain the central blood volume and thus decrease the incidence of hypotension.

METHODS

One hundred parturients scheduled for elective cesarean section under spinal anesthesia were recruited and randomly assigned to use of either a mechanical pump (Group M) or control (Group C). A standardized protocol for co-hydration and anesthesia was followed. Hypotension, defined as a decrease in systolic blood pressure by >20% from baseline, was treated with 6-mg boluses of intravenous ephedrine. The incidence of hypotension was defined as the primary outcome. Median ephedrine requirement was taken as a measure of the severity of hypotension.

RESULTS

Hypotension occurred in 12 of 47 (25.5%) patients in Group M compared to 27 of 45 (60%) in Group C (P=0.001). The median [range] ephedrine dose was greater in Group C (12 [0-24]mg) compared to Group M (0 [0-12]mg) (P<0.001). There was no difference between groups in the time to onset of hypotension.

CONCLUSION

The use of a sequential compression mechanical pump that detects venous refilling and cycles accordingly, reduced the incidence and severity of hypotension after spinal anesthesia for cesarean section.

Epidural analgesia in high risk cardiac surgical patients

Cardiac surgery is associated with high morbidity and mortality in patients with renal, hepatic or pulmonary dysfunction, advanced age and morbid obesity. Thoracic epidural analgesia is associated with decreased morbidity in these patients. Thoracic epidural analgesia in cardiac surgery is associated with haemodynamic stability, decreased catecholamine response, good pulmonary function, early extubation and discharge from intensive care unit. It is an important component of fast tracking in cardiac surgery as well. Its use has significantly increased over the years and has been used as an adjuvant to general anaesthesia as well as the sole anaesthetic technique in selected groups of patients. Proper selection of patients for thoracic epidural analgesia is mandatory. Timing of epidural catheter insertion and removal should be judiciously selected. The risk of epidural hematoma secondary to anticoagulation or residual effects of antiplatelet drug that can be reduced by taking standard precautions. In conclusion thoracic epidural analgesia in high risk cardiac surgery might decrease pulmonary, cardiovascular or renal complications, provide excellent analgesia and allow early extubation.

Genesis of dihydropyrimidinone(psi) calcium channel blockers: recent progress in structure-activity relationships and other effects

In the armamentarium of calcium channel blockers appropriately functionalized 3,4-dihydropyrimidin-2(1H)-ones have received considerable attention in recent past owing to their structural similarity with 1,4-dihydropyridine based drugs. In this review, we highlight detailed investigations in the calcium channel blocking and other activities of this category of compounds as well as trace their genesis from 1,4-dihydropyridine based drugs.

Management of Rh-isoimmunised Pregnancies : Our Experience

BACKGROUND

The aim of this study was to assess the role of middle cerebral artery peak systolic velocity (MCA-PSV), as measured by doppler ultrasound, in detecting foetal anaemia in Rh- isoimmunised pregnancies. Intra-uterine foetal blood transfusion was performed in such anaemic foetuses to tide over the crisis of foetal immaturity till considered fit for extra-uterine survival.

METHODS

Rh-isoimmunised pregnancies reporting to a tertiary institute from 2003 to 2005, were screened by doppler ultrasound to estimate MCA-PSV to detect foetal anaemia. If the foetus developed MCA-PSV of more than 1.5 multiple of median (MoM) for the gestational age, foetal blood sampling through cordocentesis was performed to confirm foetal anaemia, followed by intrauterine foetal blood transfusion to all anaemic foetuses at the same sitting. Neonatal outcome was evaluated by recording gestational age at the time of delivery, duration of gestational time gained and need for blood transfusion in the neonatal period.

RESULTS

A total of thirteen isoimmunised pregnancies were evaluated. Three pregnancies did not require in-utero foetal blood transfusion. Twenty-one intrauterine foetal blood transfusions were performed in the remaining ten patients. Five received blood transfusion in the neonatal period. Intra uterine foetal death occurred in one grossly hydropic foetus and favourable neonatal outcome was recorded in the rest.

CONCLUSION

The clinical outcome of these pregnancies justifies the use of doppler studies of MCA-PSV in detecting foetal anaemia and intra uterine foetal blood transfusion is the only hope of prolonging pregnancy and salvaging such foetuses.

A combination of fentanyl-midazolam-propofol provides better intubating conditions than fentanyl-lignocaine-propofol in the absence of neuromuscular blocking agents

BACKGROUND

The use of propofol and adjuvants such as opioids, benzodiazepines and local anaesthetic agents, may provide adequate conditions for tracheal intubation without the need for neuromuscular blocking agents. In this randomized, double-blind study, intubating conditions after induction of anaesthesia with propofol, midazolam and fentanyl were compared with those after propofol, lignocaine and fentanyl.

METHODS

In 80 ASA I/II adult patients undergoing elective gynaecological surgery, intubating conditions were compared after induction of anaesthesia with a fentanyl 2 microg/kg, midazolam 0.03 mg/kg, propofol 2.5 mg/kg combination (group FMP) vs. a fentanyl 2 microg/kg, lignocaine 1.5 mg/kg, propofol 2.5 mg/kg combination (group FLP). Intubating conditions were assessed using a qualitative scoring system.

RESULTS

Intubation was successful in all patients in group FMP and in 87.5% of patients in group FLP; (P= 0.021). Overall, intubating conditions were clinically acceptable in 77.5% and 55% of patients in group FMP and group FLP, respectively (P= 0.033).

CONCLUSION

We conclude that the fentanyl, midazolam, propofol combination more reliably provides acceptable conditions for intubation than the fentanyl, lignocaine, propofol combination. Intubation was successful in all patients receiving the fentanyl, midazolam, propofol combination.

Management of chronic hepatitis B with New Livfit in end stage renal disease

New Livfit (NLF) is a standardized, poly-herbal formulation that has been found useful in the management of hepatitis. The aim of this placebo-controlled study was to evaluate its usefulness against hepatitis B virus in the patients of end stage renal disease (ESRD). Patients were regularly evaluated at 6, 12, 24 and 36 weeks of therapy. With 36 weeks of treatment of NLF, there was rapid clearing of HBV-DNA in a significant number of patients. Significant seroconversion of the other markers of hepatitis B and restoration of the raised levels of ALT and AST was observed. The study suggests the potential usefulness of NLF in the control of HBV infection in the patients of ESRD prior to renal transplant.

Exact solutions of some urn models of relaxation in glassy dynamics

We consider two simple models, called "urn models," for a general N-ball, M-urn problem. These models find applications in the study of relaxation in glassy dynamics. We obtain exact analytical results in these two cases for the average relaxation time tau to reach the ground state. In model I we also obtain the functional dependence of tau for large N, and in model II we obtain an asymptotic (N-->infinity) dependence of tau as a function of the number of urns M.

Type of milk consumed can influence plasma concentrations of fatty acids and minerals and body composition in infant and weanling pigs

Two experiments using 42 crossbred neonatal pigs to compare the effects of caprine and bovine milk on growth, apparent nutrient digestibility and body composition were conducted. At age 72 h, pigs were removed from their dams and randomly divided into two groups, housed separately in stainless steel metabolism cages and were fed a predetermined amount (300 mL/kg body weight) of pasteurized, nonfortified whole, caprine or bovine milk. Body composition was determined using dual energy X-ray absorptiometry (DXA). In Experiment 1, 22 intact male pigs were used for a 31-d experimental period. There was no significant (P > 0.05) dietary effect on growth, apparent nutrient digestibility or body composition. Significant differences (P < 0.05), however, were observed in plasma of C 8:0, C 10:0 and C 12:0 concentrations. In Experiment 2, 20 pigs (10 intact males and 10 females) were used in a 2 x 2 factorial experiment for 52 d. Pigs fed caprine milk had higher (P < 0.05) plasma concentrations of C10:0 and C12:0 as well as Na, Mg and Zn than those fed bovine milk. At Day 52, pigs fed caprine milk had less body fat (P < 0.001) and higher (P < 0.06) bone mineral density than those fed bovine milk. Drymatter, N and total mineral intake of male pigs was higher (P < 0.05) than female pigs. Also, male pigs had higher (P < 0.05) plasma concentrations of C12:0 than females. This study demonstrates that the type of milk consumed can influence plasma concentrations of fatty acids, minerals and body composition in pigs.

Method for increasing the yield of properly folded recombinant human gamma interferon from inclusion bodies

A strategy is described for improved refolding and purification of recombinant human gamma interferon (rh-IFN gamma), which could warrant a higher yield and specific activity than reported previously. The optimal conditions of refolding are obtained by addition of a labilizing agent, L-arginine, in the refolding buffer. A 10-fold increase in the yield was observed with 0.5 M L-arginine, compared with renaturation in its absence. By varying renaturation parameters, the conditions that allow functional refolding of approximately 25-30% of the recombinant protein have been standardized. A simple process is also described for the purification of rh-IFN gamma. The purification involves a single-column chromatography on S-Sepharose, after refolding of rh-IFN gamma in arginine containing buffer. This procedure has consistently produced rh-IFN gamma having a purity of at least 97%, the rest being the aggregated form of gamma interferon. The purified protein is a dimer under non-denaturing conditions and has a specific activity of 2 x 10(8) IU mg-1 protein, as measured by viral cytopathic assay.

A controlled study of the effect of balanced general anaesthesia on cognitive functions in hypertensives on propranolol

The aim of this study was to observe the effect of general anaesthesia (GA) on multiple dimensions of cognitive functioning in hypertensives on propranolol therapy (group A) in comparison to a control group (group B). Ten subjects in each group were administered a battery of six psychological cognitive tests pre- and post-intervention under GA. Both groups showed a significant decrement in memory scores on the 4th postoperative day which showed signs of recovery on seventh day (P < 0.05 for both groups). The group A patients were further compromised in one of the intelligence test scores (Standard progressive matrices) from the beginning (P < 0.05). Although this intergroup deficit persisted even on the 7th postoperative day (P < 0.05), no added effects of GA on this parameter was observed in group A (P > 0.05). In conclusion, GA induced transient memory deficit in both groups. This should be kept in mind while considering 'street fitness' following general anaesthesia.

Antibody response against tetanus toxoid is enhanced by lipopolysaccharide or tumor necrosis factor-alpha in vitamin A-sufficient and deficient rats

Reduced antibody response to tetanus toxoid (TT) was previously demonstrated during vitamin A deficiency but the response to bacterial lipopolysaccharide (LPS) was normal. We addressed whether anti-TT IgG responses are enhanced in vitamin A-sufficient and deficient rats by immunization with LPS plus TT. Antibody responses in vitamin A-sufficient and deficient rats increased significantly after coimmunization (LPS + TT) compared with the response of rats immunized with TT alone. In additional studies, recombinant tumor necrosis factor-alpha (TNF-alpha) also significantly increased the anti-TT IgG concentrations. Because pretreatment with anti-TNF before coimmunization or immunization with TT alone markedly reduced the anti-TT IgG responses, we infer TNF to be a mediator of both the adjuvanticity of LPS and the unstimulated response to TT. In conclusion, vitamin A-deficient rats can be stimulated to respond to TT by coimmunization with LPS or by treatment with TNF.