Role of pre-operative dexamethasone as prophylaxis for postoperative nausea and vomiting in laparoscopic surgery

INTRODUCTION

Laparoscopic surgery provides tremendous benefits to patients, including faster recovery, shorter hospital stay and prompt return to normal activities. Despite the minimally invasive nature of laparoscopy, high incidence of postoperative nausea and vomiting remains a major cause for morbidity. The aim of the present study was to investigate whether preoperative Dexamethasone can reduce PONV in patients undergoing laparoscopic Surgery.

MATERIALS AND METHODS

The study included 200 patients undergoing laparoscopic cholecystectomy. We divided the patients into two groups; one group received preoperative Dexamethasone (group 1) and the other group received Ondansetron (group 2). After surgery, patients were observed for any episode of nausea or vomiting, or whether the patient required any anti-emetic drug in the postoperative period.

RESULTS

The two groups, (Dexamethasone and Ondansetron) were comparable in outcome, in terms of post-operative nausea and vomiting, in patients undergoing laparoscopic cholecystectomy. In group I, 24% of patients had nausea, as compared to 30% in group II (P=0.2481). Similarly, 12% of patients in group I and 18% of patients in group II had vomiting (P=0.3574).

CONCLUSION

We conclude that, preoperative intravenous low dose Dexamethasone reduces the incidence of PONV and is comparable to intravenous Ondansetron.

Hydrophobic interactions are the prevalent force in bromelain:Fab’ complex

Antibromelain polyclonal antibodies against stem bromelain were raised in male albino rabbits and the Fab monomers isolated from the IgG of the immune sera as reported in our earlier communication (Gupta, P., Khan, R. H., and Saleemuddin, M. (2003) Biochim. Biophys. Acta, 1646, 131-135). Further, as evident from that communication bromelain:Fab complex has 1 : 1 stoichiometry. The stability of bromelain:Fab complex (1 : 1 stoichiometry) was investigated by far and near-UV CD and fluorescence measurements. Addition of up to 1.8 M NaCl caused no significant changes in fluorescence signals and near-UV CD peak pattern. However, the spectral studies together with gel filtration studies suggest dissociation of the complex beyond 5% (v/v) methanol. These results show that hydrophobic interactions play a pronounced role in the binding of Fab to bromelain while electrostatic interactions may be less crucial.

Antiviral profile of Nyctanthes arbortristis L. against encephalitis causing viruses

The ethanolic extracts, various fractions and two pure compounds isolated from the plant N. arbortris were tested against Encephalomyocarditis Virus (EMCV) and Semliki Forest Virus (SFV). Pronounced in vitro virus inhibitory activity was observed with the ethanolic and n-butanol fractions as well as with the pure compounds arbortristoside A and arbortristoside C. In addition, ethanolic extracts and n-butanol fraction protected EMCV infected mice to the extent of 40 and 60% respectively against SFV at a daily dose of 125 mg/kg body weight.

Ternary amorphous composites of celecoxib, poly(vinyl pyrrolidone) and meglumine with enhanced solubility

The present study highlights the development of ternary amorphous composites to enhance the solubility of a poorly soluble crystalline drug, celecoxib (CEL). These systems comprised of an 'amorphous drug,' and its 'stabilizer' and 'solubilizer.' The ternary amorphous system of CEL, poly(vinyl pyrrolidone) (PVP) and meglumine (MEG) (7:2:1 w/w) enhanced CEL solubility by approximately equal to 10.2-fold over that for the crystalline drug, and maintained the thermodynamic stability of the amorphous drug. However, MEG alone was unable to stabilize the amorphous CEL against thermally-induced crystallization, and so gave no solubility advantage. The PVP-MEG combination provided a 'synergistic' enhancement of CEL solubility, as compared to their use alone in the amorphous systems. Phase-solubility studies provided greater insight into molecular mechanisms underlying stability and solubility of these amorphous systems. MEG exhibited phase-specific interaction with CEL molecules, when stabilized by PVP in the amorphous state. The higher solubility of CEL from ternary amorphous systems was also thermodynamically favored, as analyzed by van't Hoff plots. A possible molecular level interaction of MEG with PVP-stabilized amorphous CEL seems to be responsible for the solubility advantage of the CEL-PVP-MEG ternary amorphous system.

Gene expression patterns of trembling aspen trees following long-term exposure to interacting elevated CO2 and tropospheric O3

Expression of 4600 poplar expressed sequence tags (ESTs) was studied over the 2001-2002 growing seasons using trees of the moderately ozone (O(3))-tolerant trembling aspen (Populus tremuloides) clone 216 exposed to elevated CO(2) and/or O(3) for their entire 5-yr life history. Based on replication of the experiment in years 2001 and 2002, 238 genes showed qualitatively similar expression in at least one treatment and were retained for analysis. Of these 238 genes, 185 were significantly regulated (1.5-fold) from one year to the other in at least one treatment studied. Less than 1% of the genes were regulated 2-fold or more. In the elevated CO(2) treatment, relatively small numbers of genes were up-regulated, whereas in the O(3) treatment, higher expression of many signaling and defense-related genes and lower expression of several photosynthesis and energy-related genes were observed. Senescence-associated genes (SAGs) and genes involved in the flavonoid pathway were also up-regulated under O(3), with or without CO(2) treatment. Interestingly, the combined treatment of CO(2) plus O(3) resulted in the differential expression of genes that were not up-regulated with individual gas treatments. This study represents the first investigation into gene expression following long-term exposure of trees to the interacting effects of elevated CO(2) and O(3) under field conditions. Patterns of gene-specific regulation described in this study correlated with previously published physiological responses of aspen clone 216.

Arthrobacter gangotriensis sp. nov. and Arthrobacter kerguelensis sp. nov. from Antarctica

Two coryneform bacteria were isolated from a penguin rookery soil sample collected in Antarctica, near the Indian station Dakshin Gangotri (strain Lz1y(T)), and from sea water from Kerguelen island, Antarctica (strain KGN15(T)). They have morphological and chemotaxonomic properties (peptidoglycan A4alpha type; major menaquinones MK-8, MK-9 and MK-10; predominant fatty acids anteiso-C(15 : 0) and anteiso-C(17 : 0)) that are characteristic of members of the genus Arthrobacter. The isolates shared 97.8 % 16S rRNA gene sequence similarity to each other and were most closely related to Arthrobacter sulfureus (about 98.5 % sequence similarity). DNA-DNA hybridization experiments revealed 50 % relatedness between the isolates, while the levels of DNA-DNA relatedness between strains Lz1y(T) and KGN15 (T) and their phylogenetic relative, A. sulfureus, were respectively 54 and 12 %. Based on the above data and distinct phenotypic differences between the isolates and A. sulfureus, two novel species are proposed, Arthrobacter gangotriensis sp. nov. (type strain Lz1y(T)=DSM 15796(T)=JCM 12166(T)) and Arthrobacter kerguelensis sp. nov. (type strain KGN15(T)=DSM 15797(T)=JCM 12165(T)).

Clinico bacteriological evaluation of surface and core microflora in chronic tonsillitis

The present study is undertaken on 50 tonsillectomy cases to determine the correlation between surface culture swabs and tonsillar core. Tonsillar disease may stem from the bacteria within the core of the tonsil, rather than the bacteria identified on its surface. Also no consistent pattern of combinations of different pathogenic bacteria was noted. The study proves that surface culture does not reliably predict core pathogens.

Experimental investigation of perturbation Monte-Carlo based derivative estimation for imaging low-scattering tissue

Experimental results for imaging the low-scattering tissue phantoms based on the derivative estimation through perturbation Monte-Carlo (pMC) method are presented. It is proven that pMC-based methods give superior reconstructions compared to diffusion-based reconstruction methods. An easy way to estimate the Jacobian using analytical expression obtained from perturbation Monte-Carlo method is employed. Simulation studies on the same objects, considered in the experiment, are performed and corresponding results are found to be in reasonable agreement with the experimental studies. It is shown that inter-parameter cross talk in diffusion based methods lead to false results for the low-scattering tissue, where as the pMC-based method gives accurate results.

Electron screening and kinetic-energy oscillations in a strongly coupled plasma

We study equilibration of strongly coupled ions in an ultracold neutral plasma produced by photoionizing laser-cooled and trapped atoms. By varying the electron temperature, we show that electron screening modifies the equilibrium ion temperature. Even with few electrons in a Debye sphere, the screening is well described by a model using a Yukawa ion-ion potential. We also observe damped oscillations of the ion kinetic energy that are a unique feature of equilibration of a strongly coupled plasma.

DNA fingerprinting of Mycobacterium tuberculosis isolates from Agra region by IS 6110 probe

DNA fingerprinting using IS 6110 probe has been used all over the world quite successfully to characterize M. tuberculosis strains. The present study has been carried out to study the polymorphism among isolates of M. tuberculosis from Agra region from patients attending the clinics at SN Medical College and TBDTC, Agra. Sputa were collected in sterilized containers and brought to CJIL, Agra. Samples were processed and cultured on Lowenstein Jensen (LJ) slants. M. tuberculosis isolates were identified by standard biochemical tests. DNA from these isolates were purified by a physicochemical procedure, restricted with Pvu II enzyme and hybridized with PCR amplified and DIG labeled 245 bp IS 6110 probe. With a view to study IS 6110 polymorphism, M. tuberculosis isolates obtained from different geographical areas of Agra region were analyzed. Among the 60 isolates taken in study, 5 had no copy of IS 6110, 8 had 1-4 copies and 47 had multiple copies of IS 6110. DNA fingerprinting using this probe was found to be quite discriminating for typing of most of the strains (80%) which had multiple copies. RFLP profiles did not correlate with geographical areas, contacts or the resistance pattern of the strains. While this data shows the potential of IS 6110 based RFLP for strain characterization of M. tuberculosis in Agra, to understand the molecular epidemiology of tuberculosis in this region, a larger number of isolates from defined geographical areas need to be studied.

Bilateral adductor vocal cord paresis following endotracheal intubation for general anaesthesia

Recurrent laryngeal nerve palsy is a rare complication of endotracheal intubation. We report a case of bilateral vocal cord palsy following endotracheal intubation for general anaesthesia. The clinical picture was of hoarseness and aspiration suggestingpartialparesis, as complete bilateral recurrent laryngeal nerve palsy usually causes acute airway obstruction due to unopposed vocal cord adduction. Compression of the anterior branch of the recurrent laryngeal nerve between the cuff of the endotracheal tube and the posterior part of the thyroid cartilage was the likely mechanism. Ensuring that the cuff of the endotracheal tube is distal to the cricoid cartilage and that the pressure in the cuff is kept to the minimum required to prevent a gas leak should prevent this complication.

Correlation of mutations detected by INNO-LiPA with levels of rifampicin resistance in Mycobacterium tuberculosis

BACKGROUND & OBJECTIVES

Due to emergence of drug resistance in Mycobacterium tuberculosis, there is a need to have accurate and rapid methods for detection of drug resistance to important drugs like rifampicin. The present study was aimed at evaluation of a commercially available INNO-LiPA assay, for the detection of mutation in rpoB gene region of M. tuberculosis and correlate these mutations with levels of rifampicin resistance for assessing their clinical relevance.

METHODS

Fifty five well-characterized isolates of M. tuberculosis deposited from various regions of India in Mycobacterial Repository Centre at the CJILOMD, Agra were subjected to susceptibility testing for rifampicin at various concentrations of drug viz., 10, 40, 64, 128 microg/ml on Lowenstein- Jensen (LJ) medium. rpoB gene fragment (260 bp) was amplified using Rif-TB amplification kit and after hybridization, detection was done by using INNO-LiPA Rif TB kit.

RESULTS

The rpoB gene could be amplified from DNA extracted from all the 55 culture isolates and showed clear hybridization pattern with M. tuberculosis complex specific probes on LiPA strips. Mutations detected were correlated with degree of rifampicin resistance. All the sensitive isolates (identified by MIC) were identified as rifampicin sensitive (100%) by INNO-LiPA as they exhibit positive for wild type 'S' probes and negative for 'R' probes. Two of the 5 isolates, resistant at 10 microg/ml and 40 microg/ml had either D516V, H526Y mutations or unknown mutations. Thirty (85.71%) isolates resistant at clinically relevant levels (64,128microg/ml) exhibited double, triple or more 'R' type mutations (R(2(D516V)), R(4a(H526Y)), R(4b(H526D)), R(5(S531L))) as well as unknown mutations present at 'S' probes region whereas remaining isolates did not show any mutation by this method. This method could identify with definitiveness 60 per cent ( 21/35) isolates as rifampicin resistant as mutations observed in others were also present in isolates with low levels of resistance.

INTERPRETATION & CONCLUSION

The results indicate that INNO-LiPA Rif TB test is a rapid and easy to use method for detection of mutations associated with rifampicin resistance in M. tuberculosis. However, as some of these mutations are also present in isolates with low degree of resistance which are still microbiologically sensitive to rifampicin, there is a need to improve this assay by exclusion of some of the current probes and inclusion of more probes.

The antifilarial activity of a marine red alga, Botryocladia leptopoda, against experimental infections with animal and human filariae

The antifilarial activity of the marine red alga Botryocladia leptopoda against rodent and human lymphatic filarial parasites is described. The animal filarial species included Litomosoides sigmodontis and Acanthocheilonema viteae maintained in cotton rats and Mastomys coucha, respectively, while a subperiodic strain of the human lymphatic filarial parasite Brugia malayi was maintained in M. coucha. The crude extract and its hexane fraction brought about a marked reduction in the peripheral microfilarial level in both of the rodent filarial parasites L. sigmodontis and A. viteae. The microfilaricidal effect began slowly from day 8 or 15 after initiation of treatment and increased with time with a very high efficacy at the end of the observation period against both rodent filariids. The microfilaricidal efficacy was, however, not as prominent in the case of B. malayi. The antifilarial activity, which occurred in the hexane fraction, exerted action at a much lower dose. The product killed a significant proportion of A. viteae and L. sigmodontis adult parasites. In the case of B. malayi, although the macrofilaricidal efficacy was much less than that of the rodent parasites, it (hexane fraction) caused sterilization of a significant proportion of the surviving female parasites. The present findings indicate the possibility of developing an adulticidal and female sterilizing agent against filarial parasites from a marine red alga.

Using absorption imaging to study ion dynamics in an ultracold neutral plasma

We report optical absorption imaging of ultracold neutral strontium plasmas. The ion absorption spectrum determined from the images is Doppler broadened and thus provides a quantitative measure of the ion kinetic energy. For the particular plasma conditions studied, ions heat rapidly as they equilibrate during the first 250 ns after plasma formation. Equilibration leaves ions on the border between the weakly coupled gaseous and strongly coupled liquid states. On a longer time scale of microseconds, pressure exerted by the trapped electron gas accelerates the ions radially.

Binding and displacement of vascular endothelial growth factor (VEGF) by thrombospondin: effect on human microvascular endothelial cell proliferation and angiogenesis

Vascular endothelial growth factor (VEGF) is a specific angiogenic factor, and thrombospondin (TSP), is a potent inhibitor of angiogenesis. To better understand the role of TSP as an anti-angiogenic agent, we have identified its specific domains that participate in its anti-angiogenic activity and examined the mechanism of its inhibitory effect on VEGF(165) induced angiogenesis. Exogenously added TSP inhibited VEGF(165) induced angiogenesis (proliferation and tube formation of human dermal microvascular endothelial cells [HDMEC] and neovascular outgrowth from human arterial rings). Although both VEGF(165) and TSP are heparin binding proteins, TSP had a higher affinity for (125)I-heparin than VEGF(165) (K(d1) 4 nM and K(d2) 14 nM for TSP; K(d) 91 nM for VEGF(165)). TSP displaced 36% of (125)I-VEGF(165) from HDMEC and this was comparable to the 27% reduction in (125)I-VEGF(165) binding to HDMEC upon cleavage of cell surface heparan sulfate (HS). About 35% of the mitogenic activity of VEGF(165) was attributable to its heparin binding region. These results indicate that a proportion of the mitogenic activity of VEGF(165) is inhibited by TSP via competition for cell surface HS. Further, (125)I-VEGF(165) bound directly to TSP in a saturable, concentration dependent manner, and heparin modulated this binding. The mAbs to the heparin binding domain to the type 1 and type 3 repeats of TSP inhibited the binding of VEGF(165) to TSP, and also blocked the inhibitory effect of TSP on VEGF(165) induced HDMEC proliferation. We conclude that (i) the anti-angiogenic activity of TSP is localized in its heparin binding domain and type 1 and type 3 repeats (ii) TSP inhibits angiogenesis by at least two separate mechanisms, (a) displacement of VEGF(165) from endothelial cell HS and (b) direct binding to VEGF(165).

Depolarization of light in tissue phantoms - effect of a distribution in the size of scatterers

We show that the depolarization behavior of light on propagation through a sample having a mixture of suspension of monodisperse polystyrene microspheres of two different sizes (mean diameter 0.11microm and 1.08 microm) is dominated by the smaller of the two scatterers. In contrast the estimates for the anisotropy parameter (g) for this sample, obtained from goniophotometric measurement, are observed to be closer to the value corresponding to the larger of the two scatterers. These results imply that the depolarization behavior of light in biological tissue (having a distribution of scatterer size) would be different from that of a matched monodisperse scattering sample having the same value of anisotropy parameter (g) and optical thickness (tau = micros x d, micros is scattering coefficient and d being the physical thickness).

2-(2-Naphthyloxy)acetate derivatives. II. A new class of antiamnesic agents

The title compounds, 4-(2-naphthyloxymethylcarbonyl)morpholine, C(16)H(17)NO(3), (I), and 4-methyl-1-(2-naphthyloxymethylcarbonyl)piperazine, C(17)H(20)N(2)O(2), (II), are potential antiamnesics. The morpholine ring in (I) and the piperazine ring in (II) adopt chair conformations. In (I), the molecules are linked by weak intermolecular C-H.O interactions into chains that have a graph-set motif of C(10), while in (II), the molecules are linked by weak intermolecular C-H.O interactions that generate two C(7) graph-set motifs. The dihedral angle between the naphthalene moiety and the best plane through the morpholine ring is 20.62 (4) degrees in (I), while the naphthalene moiety is oriented nearly perpendicular to the mean plane of the piperazine ring in (II).