Isoniazid urine spectrophotometry for prediction of serum pharmacokinetics in adults with TB

BACKGROUND

Isoniazid (INH) is an important drug in many TB regimens, and unfavorable treatment outcomes can be caused by suboptimal pharmacokinetics. Dose adjustment can be personalized by measuring peak serum concentrations; however, the process involves cold-chain preservation and laboratory techniques such as liquid chromatography (LC)/mass spectrometry (MS), which are unavailable in many high-burden settings. Urine spectrophotometry could provide a low-cost alternative with simple sampling and quantification methods.

METHODS

We enrolled 56 adult patients on treatment for active TB. Serum was collected at 0, 1, 2, 4, 6, and 8 h for measurement of INH concentrations using validated LC-MS/MS methods. Urine was collected at 0-4, 4-8, and 8-24 h intervals, with INH concentrations measured using colorimetric methods.

RESULTS

The median peak serum concentration and total serum exposure over 24 h were 4.8 mg/L and 16.4 mg*hour/L, respectively. Area under the receiver operator characteristic curves for urine values predicting a subtherapeutic serum concentration (peak <3.0 mg/L) were as follows: 0-4 h interval (AUC 0.85, 95% CI 0.7-0.96), 0-8 h interval (AUC 0.85, 95% CI 0.71-0.96), and 0-24 h urine collection interval (AUC 0.84, 95% CI 0.68-0.96).

CONCLUSION

Urine spectrophotometry may improve feasibility of personalized dosing in high TB burden regions but requires further study of target attainment following dose adjustment based on a urine threshold.

Correlates of Defaulting from MDT among Leprosy Patients

In order to analyse the factors of demographic as well as disease related variables and their correlation with Rate of Defaulting (ROD) from Multi Drug Therapy (MDT) among leprosy patients, secondary data have been collected from 3,579 new cases registered for MDT, during a period of 4 years from 2007 to 2010 in four leprosy hospitals/ treatment centers across the four high endemic states viz. Uttar Pradesh, Chhattisgarh; Maharashtra and Andhra Pradesh. Year wise percentage of patients defaulted was calculated on aggregate as well as with reference to each centre and cross tabulated with demographic and disease related factors. Findings show that out of the total 3,579 new cases, 1944,(54.3%) defaulted with variation across centers ranged from 44 to 66 percent. Comparison of ROD against type of leprosy indicated that MB types defaulted (55.7%) more than PB (50.6%) types, (statistically significant difference, (p=0,04). ROD of male patients across the centers ranged from 45% to 67.7% in comparison with 42.4% to 61.5% of female patients. A-statistically significant difference (p=6.04) was found between the overall ROD of males (56.35%) and females (51.47%). The ROD among those with more severe disabilities (WHO Gr-2) ranged between 44% to 67.5% across the centers, while the same among those'with less severe disabilities (Gr-0&1) ranged from 42.6 to 72.7 percent. Comparison of ROD against severity of disability was found statistically significant only across 2 centers. No statistically significant variation was found when ROD of adult patients with refeince to each centr ranged between (43.6% to 65.4%) was compared with the same of children ranged beeIen (36.2% to 69.3%). Across each of these categories and centers,'the ROD remained consistent over the ,4 years. Based on the above findings'this may be concluded that male sex and MB types are significant correlates of default from treatment. Severity of disabilities plays significant role only in certain areas, probably due to other interfering factors, which needs to be further investiged.

Exploring stable thermoluminescence signal in natural Barite (BaSO4) for retrospective dosimetry

We explore the possible use of Barite (BaSO4) for radiation dosimetry and geochronology using thermoluminescence technique. Natural Barite with Mn as an impurity has a glow peak at 608K with a minimum detectable dose of 1.45±0.12mGy. This peak shows ~35% fading on 30 days of storage time and is photo-bleachable with excellent reproducibility on repeated read-out. The sensitivity changes with dose and evidence of athermal fading is also seen. We infer that the signal can be used for both retrospective dosimetry and geochronology of young deposits extending to 20ka.

Synthesis of novel 2-alkyl triazole-3-alkyl substituted quinoline derivatives and their cytotoxic activity

The propargyl alcohol on reaction with alkylazides under Sharpless conditions through click chemistry concept gave exclusively 1,4-disubstituted triazoles 2. The compounds 2 were oxidized to aldehydes 3 followed by reaction with aniline resulted Schiff's bases 4. The compounds 4 was further reacted with various aldehydes having α-hydrogen using molecular iodine as a catalyst and obtained 2-alkyl triazole-3-alkyl substituted quinoline derivatives 5. All the final compounds were screened against four human cancer cell lines (THP-1, Colo205, U937 & HeLa) and promising compounds have been identified.

Spectroscopic investigations of Fe3+ doped poly vinyl alcohol (PVA) capped ZnSe nanoparticles

Fe(3+) doped poly vinyl alcohol (PVA) capped ZnSe nanoparticles have been synthesized by using chemical method at room temperature. The prepared sample is characterized by X-ray diffraction, optical, photoluminescence (PL), electron paramagnetic resonance (EPR) and FT-IR techniques. Different physical parameters are evaluated by using measured values of refractive index and density. From the X-ray diffraction pattern, the average crystallite size is calculated by using Scherrer's formula and it is about 9 nm. Optical absorption spectrum reveals that the Fe(3+) ion enter into the lattice as octahedral symmetry. Crystal field (Dq) and inter-electronic repulsion parameters (B, C) are evaluated for Fe(3+) doped ZnSe nanoparticles as Dq=720, B=720 and C=2500 cm(-1). Photoluminescence spectrum of Fe(3+) doped ZnSe exhibits emission bands in UV and yellow regions. EPR spectrum showed various resonance signals at g=7.3, 3.5 and 2.0. FT-IR spectrum of Fe(3+) doped PVA capped ZnSe indicates the presence of O-H, C-H, C=C and C=O molecular groups.

Utilization of kidneys with similar kidney donor risk index values from standard versus expanded criteria donors

With the shortage of standard criteria donor (SCD) kidneys, efficient expanded criteria donor (ECD) kidney utilization has become more vital. We investigated the effects of the ECD label on kidney recovery, utilization and outcomes. Using data from the Scientific Registry of Transplant Recipients from November 2002 to May 2010, we determined recovery and transplant rates, and modeled discard risk, for kidneys within a range of kidney donor risk index (KDRI) 1.4-2.1 that included both SCD and ECD kidneys. To further compare similar quality kidneys, these kidneys were again divided into three KDRI intervals. Overall, ECD kidneys had higher recovery rates, but lower transplant rates. However, within each KDRI interval, SCD and ECD kidneys were transplanted at similar rates. Overall, there was increased risk for discard for biopsied kidneys. SCD kidneys in the lower two KDRI intervals had the highest risk of discard if biopsied. Pumped kidneys had a lower risk of discard, which was modulated by KDRI for SCD kidneys but not ECD kidneys. Although overall ECD graft survival was worse than SCD, there were no differences within individual KDRI intervals. Thus, ECD designation adversely affects neither utilization nor outcomes beyond that predicted by KDRI.

Mixed alkali effect and optical properties of Ni2+ doped 20ZnO+xLi2O+(30-x)Na2O+50B2O3 glasses

Optical and physical properties of Ni2+ doped 20ZnO+xLi2O+(30-x)Na2O+50B2O3 (5≤x≤25) glasses are carried out at room temperature. Powder XRD pattern of all the glass samples confirms the amorphous nature. Several physical parameters are evaluated for all the glasses with respect to the composition. The optical absorption spectra confirm the site symmetry of the Ni2+ doped glasses are near octahedral. Crystal field and inter-electronic repulsion parameters are also evaluated. It is interesting to observe that the optical band gap and Urbach energies exhibit the mixed alkali effect. The FT-IR spectral investigations of Ni2+ doped glasses exhibit characteristic vibrations of BO3 and BO4 units.

Onion dehydration: a review

Onion (Allium cepa), a very commonly used vegetable, ranks third in the world production of major vegetables. Apart from imparting a delicious taste and flavour due to its pungency in many culinary preparations, it serves several medicinal purposes also. Processing and preservation of onion by suitable means is a major thrust area since a long time. The various kinds of treatments followed for dehydration of onion such as convective air drying, solar drying, fluidized bed drying, vacuum microwave drying, infrared drying and osmotic drying are reviewed here. These techniques are mainly used for preservation and value addition of onion. Several researchers have tried for decades to model the drying kinetics and quality parameters, which are also compiled here briefly.

Impact of bacterial biomass on contaminant sorption and transport in a subsurface soil

The objective of this study was to investigate the impact of bacterial biomass on the sorption and transport of three solutes (quinoline, naphthalene, and Ca) in a subsurface soil. Miscible displacement techniques were employed to measure sorption and transport of the above compounds during steady, saturated water flow in sterile and/or bacterium-inoculated soil columns. The soil was inoculated with either a quinoline-degrading bacterium, Pseudomonas sp. 3N3A isolate, or its mutant isolate, B53, which does not degrade quinoline. In soil columns inoculated with the B53 and 3N3A isolates, quinoline sorption was reduced by about 60 and 20%, respectively. In contrast, Ca sorption was minimally reduced, which indicated that biomass did not significantly alter the cation-exchange capacity of the soil. Biomass impacts on sorption were solute specific, even when the sorption mechanism for both quinoline and Ca was similar. Thus, the differential response is attributed to biomass-induced changes in quinoline speciation; an increase in pH at the sorbent-water interface would result in a larger proportion of the neutral species and a decrease in sorption. Sorption of naphthalene was reduced by about 30%, which was attributed to accessibility of hydrophobic regions. Minimal biosorption of all solutes indicated negligible biofacilitated transport. Alteration of the soil surfaces upon addition of bacterial biomass reduced sorption of quinoline and naphthalene, thereby enhancing transport.

Effect of tibial tunnel position on arthroscopically assisted anterior cruciate ligament reconstruction using bone-patellar tendon-bone grafts: a prospective study

INTRODUCTION

The aim of this research was to study the effect of the tibial tunnel position in anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) grafts in ensuring optimal knee functioning.

METHODS

A prospective study was conducted on 41 patients who underwent arthroscopically assisted ACL reconstruction using a BPTB graft and who were followed up for a minimum period of two years. The radiographic position of the tibial tunnel was compared with the clinical outcome using the International Knee Documentation Committee (IKDC) and modified Lysholm knee scores at two years after surgery.

RESULTS

Six out of eight patients with a fair outcome based on the modified Lysholm score and five out of eight patients with an abnormal outcome based on the IKDC score had their tibial tunnel within the 10 percent to 25 percent anteroposterior width of the tibial plateau. The tibial tunnel of patients with a fair Lysholm outcome (mean 22.2 percent) was significantly anterior compared to that of those with an excellent (mean 38.1 percent) and good (mean 34.1 percent) outcome (p is less than 0.01). The analysis using the IKDC score showed a similar trend.

CONCLUSION

Placing the tibial tunnel in the anterior 25 percent of the tibial plateau is associated with a poor knee outcome. More predictable results can be achieved through 35 percent to 46 percent anteroposterior placement of the tibial tunnel.

Kidney and pancreas transplantation in the United States, 1999-2008: the changing face of living donation

The waiting list for kidney transplantation continued to grow between 1999 and 2008, from 41 177 to 76 089 candidates. However, active candidates represented the minority of this increase (36 951-50 624, a 37% change), while inactive candidates increased over 500% (4226-25 465). There were 5966 living donor (LD) and 10 551 deceased donor (DD) kidney transplants performed in 2008. The total number of pancreas transplants peaked at 1484 in 2004 and has declined to 1273. Although the number of LD transplants increased by 26% from 1999 to 2008, the total number peaked in 2004 at 6647 before declining 10% by 2008. The rate of LD transplantation continues to vary significantly as a function of demographic and geographic factors, including waiting time for DD transplant. Posttransplant survival remains excellent, and there appears to be greater use of induction agents and reduced use of corticosteroids in LD recipients. Significant changes occurred in the pediatric population, with a dramatic reduction in the use of LD organs after passage of the Share 35 rule. Many strategies have been adopted to reverse the decline in LD transplant rates for all age groups, including expansion of kidney paired donation, adoption of laparoscopic donor nephrectomy and use of incompatible LD.

Optical absorption and EPR studies on tenorite mineral

Optical absorption and EPR studies of the mineral tenorite, a cupric oxide which originated from Mexico and contains 54.40 wt% of CuO. EPR spectral results indicate two Cu(II) closely interacting ions to give a d(2) type structure. The calculated spin Hamiltonian at room temperature and liquid nitrogen temperature is g=2.160 and D=125 G. The intensity of resonance line is not the same in low and high field regions. The optical absorption spectrum is due to Cu(II) in which three sets of energies indicating Cu(II) in two independent tetragonal C(4v) symmetry, in addition to d(2) structure of octahedral coordination. The octahedral and tetragonal field parameters are compared with those reported for several other copper containing minerals.

Design, synthesis, structure-activity relationship and antibacterial activity series of novel imidazo fused quinolone carboxamides

A series of novel 7,8 and 1,8 imidazo fused quinolone carboxamides are synthesized and evaluated against antibacterial activity. 1,8 Imidazo fused quinolones exhibit moderate antibacterial activity. Molecular modeling studies were carried out to optimize the pharmacophore.

Monocular blindness due to central retinal artery occlusion in bipolar hemireplacement arthroplasty of the hip

Though rare, perioperative loss of vision after non-ocular surgeries is a disastrous complication. This has been reported after spine surgery or cardiopulmonary bypass surgery. We present an otherwise healthy 54-year-old man who underwent bipolar hemireplacement for a fractured neck of femur, and developed perioperative monocular visual loss due to central retinal artery occlusion, a complication hitherto unreported in hip replacement surgeries. The possible aetiological factors and the measures to prevent this complication are discussed.

Organ donation and utilization in the United States, 1997-2006

Deceased organ donation has increased rapidly since 2002, coinciding with implementation of the Organ Donation Breakthrough Collaborative. The increase in donors has resulted in a corresponding increase in the numbers of kidney, liver, lung and intestinal transplants. While transplants for most organs have increased, discard and nonrecovery rates have not improved or have increased, resulting in a decrease in organs recovered per donor (ORPD) and organs transplanted per donor (OTPD). Thus, the expansion of the consent and recovery of incremental donors has frequently outpaced utilization. Meaningful increases in multicultural donation have been achieved, but donations continue to be lower than actual rates of transplantation and waiting list registrations for these groups. To counteract the decline in living donation, mechanisms such as paired donation and enhanced incentives to organ donation are being developed. Current efforts of the collaborative have focused on differentiating ORPD and OTPD targets by donor type (standard and expanded criteria donors and donors after cardiac death), utilization of the OPTN regional structure and enlisting centers to increase transplants to match increasing organ availability.

Superficial angiomyxoma of the external ear not associated with Carney's complex: a case report

Superficial angiomyxomas are rare tumours and multiple tumours occurring in the external ear are invariably associated with Carney's complex. In the present study, a solitary superficial angiomyxoma was found in a 20 year old lady; and there was no evidence of any of the components of Carney's complex at the time of presentation or at the end of 2 years of follow-up, after the surgical excision of the tumour.

Seasonal variation of toxic benzene emissions in petroleum refinery

Petroleum refineries are largest chemical industries that are responsible for the emission of several pollutants into the atmosphere. Benzene is among the most important air pollutants that are emitted by petroleum refineries, since they are involved in almost every refinery process. Volatile organic compounds (VOCs) are a major group of air pollutants, which play a critical role in atmospheric chemistry. These contribute to toxic oxidants, which are harmful to ecosystem, human health and atmosphere. The variability of pollutants is an important factor in determining human exposure to these chemicals. The ambient air concentrations of benzene were measured in several sites around the Digboi petroleum refinery, near the city of Gowahati in northeast India, during winter and summer 2004. The seasonal and spatial variations of the ambient air concentrations of this benzene were investigated and analyzed. An estimation of the contribution of the refinery to the measured atmospheric levels of benzene was also performed. The ambient air mixing ratios of benzene in a large area outside the refinery was generally low, in ppbv range, much lower than the ambient air quality standards. This article presents the temporal and spatial variation of air pollution in and around petroleum refinery and showed that no health risk due to benzene is present in the areas adjacent to the refinery.

Mortality experience in recipients undergoing repeat transplantation with expanded criteria donor and non-ECD deceased-donor kidneys

Nearly one-quarter of the kidney transplant waiting list is composed of repeat transplantation candidates. Survival following retransplantation using expanded criteria donor (ECD) kidneys has not been adequately studied. Using data from the Scientific Registry of Transplant Recipients, we analyzed mortality after retransplantation with ECD and non-ECD deceased-donor kidneys. Adult patients who experienced graft failure and were relisted for transplantation between 1995 and 2004 were studied (n=9641). Follow-up began at the date of relisting and continued until death or the end of the observation period (December 31, 2004), with censoring at living-donor transplantation. Sequential stratification (an extension of Cox regression) was used to compare mortality between patients receiving an ECD retransplant and those remaining on the waiting list or receiving a non-ECD retransplant (conventional therapy). Of 2908 retransplantations, 292 used ECD kidneys. Survival after ECD retransplantation was approximately equal to that of conventional therapy, with an adjusted hazard ratio of 0.98 (p=0.88). In contrast, non-ECD retransplant recipients experienced a significant reduction in mortality (HR=0.44; p<0.0001). Based on these national data, recipients of ECD retransplantation do not have a survival advantage relative to conventional therapy, whereas non-ECD retransplantation is associated with a significant survival advantage.

Medial collateral ligament avulsion from both tibial and femoral attachments: a case report

The medial collateral ligament (MCL) is the most commonly injured ligament of the knee joint. Proximal MCL tears occur more frequently than do distal ones. We report a 28-year-old man with a valgus injury of his left knee joint after a fall from a motorcycle. Magnetic resonance imaging of the affected knee joint revealed complete avulsion of the superficial MCL from both its femoral and tibial insertions. The meniscofemoral portion of the deep part of the MCL was also torn and the medial meniscus was subluxated. Such a pattern, an MCL tear with subluxation of the medial meniscus, is rare.

Convenient synthesis of novel 4-substitutedamino-5-trifluoromethyl–2,7-disubstituted pyrido[2,3-d] pyrimidines and their antibacterial activity

Novel pyrido[2,3-d]pyrimidines 4 have been synthesised starting from 2-amino-4-trifluoromethyl-6-substituted nicotinonitriles 1 via imine formation, selective amination followed by Dimroth rearrangement. Compounds 4 were screened against Gram +ve and -ve bacteria in vitro. Compounds 4h and 4d showed significant activity against all species of Gram positive bacteria and moderate activity against Gram negative bacteria. N-2,4 difluorophenyl compounds 4l and 4m were the least active among all the compounds. All the compounds were inactive against Pseudomonas aeruginosa at the maximum concentration of 200 microg ml(-1).