Can low dose spinal anesthesia combined with ultrasound guided bilateral ilioinguinal-iliohypogastric nerve blocks avoid use of additional epidural catheter in high risk obstetric cases? Our experience from two cases

Critical obstetric cases associated with cardiac pathology may pose real challenge for anaesthesiologist during Caesarean section. Meticulous perioperative care and suitable selection of anaesthesia technique are the key to successful outcome. Single shot spinal anaesthesia is not used any more because of serious haemodynamic consequence. Progressive and controlled epidural local anaesthetic injection is mostly used in such cases. But recently combined spinal epidural anaesthesia and continuous spinal anaesthesia are suggested due to better precise control of haemodynamics and quicker onset. However, institution of such complex technique may require time which may not be feasible in emergency situations. Use of bilateral ilioinguinal-iliohypogastric nerve block along with low dose spinal anaesthesia may obviate the need of additional epidural catheter in such complicated cases. We hereby present our experience from two cases.

Role of serotonin in seasonal affective disorder

This review was prepared with an aim to show role of serotonin in seasonal affective disorder. Seasonal affective disorder, which is also called as winter depression or winter blues, is mood disorder in which persons with normal mental health throughout most of the year will show depressive symptoms in the winter or, less commonly, in the summer. Serotonin is an important endogenous neurotransmitter which also acts as neuromodulator. The least invasive, natural, and researched treatment of seasonal affective disorder is natural or otherwise is light therapy. Negative air ionization, which acts by liberating charged particles on the sleep environment, has also become effective in treatment of seasonal affective disorder.  

Retracted Article: Doping, strain, defects and magneto-optical properties of Zn1−xMnxO nanocrystals

High resolution transmission electron microscopic images of ZnO:Mn²⁺ nanoparticles, for (a) 10% Mn doping, showing defect free regular atomic arrangement, and (b) 20% Mn doping, irregular lattice planes with significant defects. (c) Digital photograph of liquid suspension of ZnO:Mn²⁺ nanocrystals under UV lamp. (d) MH loop of ZnO:Mn²⁺ nanoparticles.

Development, characterization and solubility study of solid dispersions of Cefuroxime Axetil by the solvent evaporation method

Cefuroxime Axetil (Poorly water soluble drug), when prepared as solid dispersion showed improved solubility and dissolution. Therefore, the main purpose of this investigation was to increase the solubility and dissolution rate of Cefuroxime Axetil by the preparation of its solid dispersion with urea, using the solvent evaporation method. Physical mixtures and solid dispersions of Cefuroxime Axetil were prepared by using urea as a water-soluble carrier in various proportions (1:1, 1:2, 1:3, 1:4, 1:5, 1:6, and 1:7 by weight), by employing the solvent evaporation method. The drug release profile was studied and it was found that the dissolution rate and the dissolution parameters of the drug from the physical mixture as well as solid dispersion were higher than those of the intact drug. The Fourier Transform Infrared (FTIR) spectra revealed no chemical incompatibility between the drug and urea. Drug-polymer interactions were investigated using differential scanning calorimetry (DSC) and Powder X-Ray Diffraction (PXRD).

Functional characterization of βC1 gene of Cotton leaf curl Multan betasatellite

Whitefly-transmitted Begomoviruses having circular single stranded DNA genome cause severe leaf curl diseases in the tropical and subtropical region. The majority of Old World monopartite begomoviruses with DNA A component is associated with a satellite DNA of 1.3 kb length referred to as betasatellites. The presence of betasatellite is required to express typical symptoms in the primary hosts. Increased symptom expression in betasatellite's presence is attributed to a 13-15 kDa βC1 protein encoded by the βC1 gene on complementary sense strand. The exact mechanism by which the βC1 protein contributes to the symptoms' severity and helper viral DNA's accumulation is not yet understood. Here, we studied the βC1 protein of Cotton leaf curl Multan betasatellite, associated with mono and bipartite begomoviruses. The βC1 protein was expressed in prokaryotic system as 6XHis-βC1 fusion protein and recombinant protein showed size- and sequence-specific DNA binding activity. The host proteins which may interact with βC1 were identified by binding βC1 recombinant protein with heptapeptide in phage display library. The βC1-interacting host proteins predicted belong to metabolic and defense pathways, indicating that βC1 protein has a pivotal role in viral pathogenicity.

Role of structure and glycosylation of adsorbed protein films in biolubrication

Water forms the basis of lubrication in the human body, but is unable to provide sufficient lubrication without additives. The importance of biolubrication becomes evident upon aging and disease, particularly under conditions that affect secretion or composition of body fluids. Insufficient biolubrication, may impede proper speech, mastication and swallowing, underlie excessive friction and wear of articulating cartilage surfaces in hips and knees, cause vaginal dryness, and result in dry, irritated eyes. Currently, our understanding of biolubrication is insufficient to design effective therapeutics to restore biolubrication. Aim of this study was to establish the role of structure and glycosylation of adsorbed protein films in biolubrication, taking the oral cavity as a model and making use of its dynamics with daily perturbations due to different glandular secretions, speech, drinking and eating, and tooth brushing. Using different surface analytical techniques (a quartz crystal microbalance with dissipation monitoring, colloidal probe atomic force microscopy, contact angle measurements and X-ray photo-electron spectroscopy), we demonstrated that adsorbed salivary conditioning films in vitro are more lubricious when their hydrophilicity and degree of glycosylation increase, meanwhile decreasing their structural softness. High-molecular-weight, glycosylated proteins adsorbing in loops and trains, are described as necessary scaffolds impeding removal of water during loading of articulating surfaces. Comparing in vitro and in vivo water contact angles measured intra-orally, these findings were extrapolated to the in vivo situation. Accordingly, lubricating properties of teeth, as perceived in 20 volunteers comprising of equal numbers of male and female subjects, could be related with structural softness and glycosylation of adsorbed protein films on tooth surfaces. Summarizing, biolubrication is due to a combination of structure and glycosylation of adsorbed protein films, providing an important clue to design effective therapeutics to restore biolubrication in patients with insufficient biolubrication.

Rheological evaluation of thermoreversible and mucoadhesive nasal gels of Zolmitriptan

BACKGROUND AND OBJECTIVES

Rheological evaluation of thermoreversible mucoadhesive nasal gel of zolmitriptan is done to determine the steady shear behaviour and gelation temperature. The thermoreversible mucoadhesive polymers are sucessesfully used to increase the contact time of the therapeutic compound in the nasal cavity as well as they cause enhancement in permeation of drug through the nasal mucosa.

MATERIAL AND METHODS

Pluronic (F127) and Pluronic (F 68) were used as thermoreversible polymers in combination with a mucoadhesive polymer obtained from natural resource Zolmiriptan anti migraine drug obtained from Cipla Ltd. Rheometer Brookfield R/S- CPS- PI having cone-and-plate geometry was used for steady shear behaviour study and the gelation temperature was determined by Brookfield R/S plus Rheometer (Brookfield viscometer Ltd, Harlow, Essex, UK) fitted with spindle and Eurotherm cone/plate geometry.

RESULTS

Steady shear behaviour study concludes as content of mucoadhesive polymer starts increasing subsequently the viscosity of the solution starts increasing in the same manner. Gelation temperature study suggests that as the mucoadhesive content was increased in formulation the gelation temperature of the formulation was decreased subsequently. So it was concluded from the study that gelation temperature of the formulation was influenced by the mucoadhesive content. Temperature increases the gelation time of the formulation.

CONCLUSIONS

Above studies indicate that even small difference in the composition of the thermoreversible mucoadhesives gel formulations may cause major change in the rheological behaviour. Although the gelation temperatures of all the three formulations L1, L2 and L3 were below the human nasal temperature, they show different responses to the varied shear rates at different temperatures below and above the temperature of nasal cavity.

Potential triazole derivatives having significant antiepileptic effect- A Review

Triazole is a five membered heterocyclic moiety of two carbon and three nitrogen atom, triazole are present in two isomeric forms, 1,2,4-triazole and 1,2,3-triazole. Alprazolam, Triazolam and Midazolam are established drugs used in epilepsy which have triazole moiety. Epilepsy is the most frequent neurological disorder characterized by excessive temporary neuronal discharge. The overall prevalence of the disease is 1% of the population and up to 50 million people worldwide. The literature shows that different substitution on triazole moiety exhibit potent antiepileptic activity and less/no neurotoxicity. The maximal electroshock seziures test is most widely used in- vivo models among the various screening models of epilepsy. The present article focused on the previous researches on triazole, which include synthesis, spectral characterization and antiepileptic activity of the synthesized triazole derivatives, and we also go for the development of structure activity relationship of the earlier synthesized triazole derivatives with reference to their pharmacological effect.

Structural, electrochemical characterization and SOD mimic activities of 1D chain or 3D network encouraged by unique μ₂-bridging by adipate ion in mixed ligand complexes containing α-diimine as auxiliary ligand

The present ternary complexes [Cu(ada)(phen)(H(2)O)]·2H(2)O (1), [Co(2)(ada)(2)(phen)(2)(H(2)O)(2)] (2) and [{Cu(ada)(3)(bipy)}(n)·3nH(2)O] (3) (H(2)ada=adipic acid, phen=1,10-phenanthroline and bipy=2,2'-bipyridine) obtained under varying experimental conditions were characterized by spectral, electrochemical and thermal studies. The bonding modes and the spatial arrangements of the carboxylate dianion around the metal ions have been investigated employing FTIR, EPR and X-ray crystallographic studies. Present data revealed a six coordinate distorted octahedral geometry for 2 with a=8.068, b=9.788, c=11.788Å, α=70.464, β=75.109, γ=72.063° and a five coordinate square pyramidal geometry for 3 with a=9.509, b=9.912, c=12.656Å, α=70.486, β=73.604, γ=75.162°. The superoxide dismutase (SOD) mimic activities of the complexes are in the order 1>3>2.

A review on an update of NS5B polymerase hepatitis C virus inhibitors

BACKGROUND

Hepatitis C virus (HCV) infection is widespread, abhorrently under-diagnosed, and radically under-treated. Globally, infection with HCV is a major cause of acute hepatitis and chronic liver disease. Therefore, novel HCV inhibitors are required for the treatment of the HCV infected patients.

OBJECTIVE AND PERSPECTIVES

This review gives the detailed knowledge of upcoming therapy such as NS5B polymerase inhibitors that are urgently needed.

CONCLUSION

In the past decade, intensive hard work has focused on the discovery of both structural and nonstructural inhibitors of the HCV NS5B polymerase. These demanding efforts have resulted in various promising agents advancing in clinical development with emphasis on clinical efficacy and impact for future combination studies.

Managing urethral injuries in suburban India-general surgeon's perspective

Although, urethral injuries are relatively uncommon, their incidence has been increasing due to increasing incidence of road traffic accidents. Initial management of urethral injury depends upon the degree and location of the injury, patients' haemodynamic status, and any associated injuries. Besides these factors, availability of clinical infrastructure and clinical expertise also play a significant role in making appropriate management decisions at the time of injury.

Synthesis and characterization of self-assembled nanofiber-bundles of V2O5: their electrochemical and field emission properties

High-quality self-assembled V(2)O(5) nanofiber-bundles (NBs) are synthesized by a simple and direct hydrothermal method using a vanadium(v) hydroxylamido complex as a vanadium source in the presence of HNO(3). The possible reaction pathway for the formation of V(2)O(5) NBs is discussed and demonstrated that HNO(3) functions both as an oxidizing and as an acidification agent. V(2)O(5) NBs are single-crystals of an orthorhombic phase that have grown along the [010] direction. A bundle is made of indefinite numbers of homogeneous V(2)O(5) nanofibers where nanofibers have lengths up to several micrometres and widths ranging between 20 and 50 nm. As-prepared V(2)O(5) NBs display a high electrochemical performance in a non-aqueous electrolyte as a cathode material for lithium ion batteries. Field emission properties are also investigated which shows that a low turn-on field of ∼1.84 V μm(-1) is required to draw the emission current density of 10 μA cm(-2).

Environmental and centrifugal factors influencing the visco-elastic properties of oral biofilms in vitro

Centrifugal compaction causes changes in the surface properties of bacterial cells. It has been shown previously that the surface properties of planktonic cells change with increasing centrifugal compaction. This study aimed to analyze the influences of centrifugal compaction and environmental conditions on the visco-elastic properties of oral biofilms. Biofilms were grown out of a layer of initially adhering streptococci, actinomyces or a combination of these. Different uni-axial deformations were induced on the biofilms and the load relaxations were measured over time. Linear-Regression-Analysis demonstrated that both the centrifugation coefficient for streptococci and induced deformation influenced the percentage relaxation. Centrifugal compaction significantly influenced relaxation only upon compression of the outermost 20% of the biofilm (p < 0.05), whereas biofilm composition became influential when 50% deformation was induced, invoking re-arrangement of the bacteria in deeper biofilm structures. In summary, the effects of centrifugal compaction of initially adhering, centrifuged bacteria extend to the visco-elastic properties of biofilms, indicating that the initial bacterial layer influences the structure of the entire biofilm.

Neonatal presentation of familial glucocorticoid deficiency resulting from a novel splice mutation in the melanocortin 2 receptor accessory protein

BACKGROUND

Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive disorder characterised by isolated glucocorticoid deficiency. Mutations in the ACTH receptor/melanocortin 2 receptor (MC2R), the MC2R accessory protein (MRAP) or the STAR protein (STAR) cause FGD types 1, 2 and 3, respectively, accounting for ~50% of all cases.

PATIENT AND METHODS

We report a neonate of Indian origin, who was diagnosed with FGD in the first few days of life. He presented with hypoglycaemic seizures and was noted to have generalised intense hyperpigmentation and normal male genitalia. Biochemical investigations revealed hypocortisolaemia (cortisol 0.223 μg/dl; NR 1-23 μg/dl) and elevated plasma ACTH (170 pg/ml). Serum electrolytes, aldosterone and plasma renin activity were normal. Peak cortisol following a standard synacthen test was 0.018 μg/dl. He responded to hydrocortisone treatment and continues on replacement. Patient DNA was analysed by direct sequencing. The effect of the novel mutation was assessed by an in vitro splicing assay using wild type and mutant heterologous minigenes.

RESULTS

A novel homozygous mutation c.106+2_3dupTA was found in the MRAP gene. Both parents were heterozygous for the mutation. In an in vitro splicing assay, the mutation resulted in the skipping of exon 3.

CONCLUSION

We have identified a novel MRAP mutation where disruption of the intron 3 splice-site results in a prematurely terminated translation product. This protein (if produced) would lack the transmembrane domain that is essential for MC2R interaction. We predict that this would cause complete lack of ACTH response thus explaining the early presentation in this case.

Epidemiological trends of leprosy in an urban leprosy centre of Delhi: a retrospective study of 16 years

This study was done by collecting the retrospective data from 1994 to 2009 of patients attending the urban leprosy centre attached to the department of dermatology, STD & leprosy of PGIMER & Dr. R M L Hospital, New Delhi. The data was analysed according to age, sex, type of leprosy, leprosy reactions, deformities and relapse and compared with the national figures by comparison of proportions after taking the national data per 10,000 population. A total of 3659 patients attended our ULC (Urban Leprosy Centre) among which 2741 were male and 945 females (M:F-3:1). 669 patients (18.2%) were children. The data analysed show a gradual decline in new case detection rate with a marginal rise in 2005 and 2008. Percentage of MB cases was falling consistently till 2005 after which it showed an abrupt rise. The incidence of type 1 reaction varied from 21% in 1994 to 10% in 2009 in PB patients and from 6% in 1994 to 8% in 2009 in MB patients. The trend of type 2 reactions in MB patients showed a slow declining trend. MDT completion rate showed an impressive improvement from 56% in 1994 to 90% in 2009. The number of patients revisiting the ULC with features of relapse also showed a decrease in number. The pattern of visible deformities showed an almost constant trend similar to national figures. Improved MDT completion rate helps in reducing the disease transmission, severity, reactions and disabilities.

A comparative study on the viscoelastic properties of human and animal lenses

A new method of compression between two parallel plates is used to measure the viscoelastic properties of whole and decapsulated human lenses and compare them with other animal species. Compressive load relaxation was performed by deforming the lens by 10% and measuring the force relaxation response for 100 s to obtain thickness, stiffness and relaxation of the induced loading force and Maxwell parameters for human, monkey, porcine and leporine whole and decapsulated lenses. Thickness and percentage loading force relaxation increased linearly with lens age, whereas stiffness and induced loading force increased exponentially. Human and monkey lenses aged at different rates. Loading force relaxation in a generalized Maxwell model was described by three time constants ranging from 1 to 1000 s. Compressive load relaxation is a very versatile method to study the viscoelastic properties of whole and decapsulated lenses and potentially also artificial accommodating lenses. The data presented in the study will help researchers choose the most suitable animal lenses based on the desired properties and age to be mimicked from the human lenses.

Role of eDNA on the adhesion forces between Streptococcus mutans and substratum surfaces: influence of ionic strength and substratum hydrophobicity

The aim of this study was to investigate the role of extracellular DNA (eDNA) on the adhesion strength of Streptococcus mutans LT11 on substrata with different hydrophobicities at high and low ionic strengths. AFM adhesion forces to a hydrophilic and hydrophobic substratum increased with increasing surface-delay times and ionic strength and were stronger on a hydrophobic than on a hydrophilic substratum. The presence of eDNA on the streptococcal cell surface enhanced its adhesion force to a hydrophobic substratum significantly more than to a hydrophilic substratum, especially after bond maturation. Bond maturation on a hydrophilic substratum was accompanied by an increasing number of minor adhesion peaks, indicating the involvement of acid-base interactions, whereas on the hydrophobic substratum surface the number of minor adhesion peaks remained low. More minor adhesion peaks developed on the hydrophilic substratum at low ionic strength than at high ionic strength. The final rupture distance in retraction force-distance curves was independent of ionic strength on a hydrophilic substratum and increased with increasing surface delay time. On the hydrophobic surface, the final rupture distance did not increase with surface delay time but was significantly smaller at low than at high ionic strength. Final rupture distances were different in presence and absence of eDNA, and the lower values of this difference coincided with the decrease in hydrodynamic radius of the streptococci upon increasing ionic strength, measured using dynamic light scattering. AFM also yielded higher values for the ionic strength induced difference in final rupture distance because in AFM rupture is forced, while in dynamic light scattering differences in radius are only induced by ionic strength differences.

CXCL13 mediates prostate cancer cell proliferation through JNK signalling and invasion through ERK activation

OBJECTIVES

  The focus of this study was to determine the dedicator of cytokinesis 2 (DOCK2), extracellular signal-regulated kinase 1/2 (ERK1/2), c-Jun N-terminal kinase-1 (JNK) and Akt signals involved in CXCL13-mediated prostate cancer (PCa) cell invasion and proliferation.

MATERIALS AND METHODS

  Androgen-sensitive (LNCaP), hormone-refractory (PC3) cells and normal cells (RWPE-1) were used to determine CXCL13-mediated PCa cell invasion and proliferation. Immuno-blotting, fast activated cell-based (FACE) ELISA, caspase activity, cell invasion and proliferation assays were performed to ascertain some of the signalling events involved in PCa cell proliferation and invasion.

RESULTS

  Unlike androgen-sensitive LNCaP cells, we report for the first time that the hormone-refractory cell line, PC3, expresses DOCK2. CXCL13-mediated LNCaP and PC3 cell invasion was regulated by Akt and ERK1/2 activation in a DOCK2-independent fashion. CXCL13 also promoted LNCaP cell proliferation in a JNK-dependent fashion even in the absence of DOCK2. In contrast, CXCL13 induced PC3 cell proliferation through JNK activation, which required DOCK2.

CONCLUSIONS

  Our results show CXCL13-mediated PCa cell invasion requires Akt and ERK1/2 activation and suggests a new role for DOCK2 in proliferation of hormone-refractory CXCR5-positive PCa cells.

Influence of fluoride-detergent combinations on the visco-elasticity of adsorbed salivary protein films

The visco-elasticity of salivary-protein films is related to mouthfeel, lubrication, biofilm formation, and protection against erosion and is influenced by the adsorption of toothpaste components. The thickness and the visco-elasticity of hydrated films (determined using a quartz crystal microbalance) of 2-h-old in vitro-adsorbed salivary-protein films were 43.5 nm and 9.4 MHz, respectively, whereas the dehydrated thickness, measured using X-ray photoelectron spectroscopy, was 2.4 nm. Treatment with toothpaste slurries decreased the thickness of the film, depending on the fluoride-detergent combination involved. Secondary exposure to saliva resulted in a regained thickness of the film to a level similar to its original thickness; however, no association was found between the thickness of hydrated and dehydrated films, indicating differences in film structure. Treatment with stannous fluoride/sodium lauryl sulphate (SnF(2)/SLS)-containing toothpaste slurries yielded a strong, immediate two-fold increase in characteristic film frequency (f(c)) with respect to untreated films, indicating cross-linking in adsorbed salivary-protein films by Sn(2+) that was absent when SLS was replaced with sodium hexametaphosphate (NaHMP). Secondary exposure to saliva of films treated with SnF(2) caused a strong, six-fold increase in f(c) compared with primary salivary-protein films, regardless of whether SLS or NaHMP was the detergent. This suggests that ionized stannous is not directly available for cross-linking in combination with highly negatively charged NaHMP, but becomes slowly available after initial treatment to cause cross-linking during secondary exposure to saliva.

Analysis of carriers of hepatitis B virus from a tertiary referral hospital: does the viral load change during the natural course of infection?

This study was designed to determine the prevalence, forms of transmission, mutational profile and viral load at baseline of hepatitis B virus (HBV) carriers in Delhi. HBV surface antigen (HBsAg)-positive patients were enrolled and evaluated clinically for liver function, serological markers for hepatitis B and HBV DNA quantitation. Tests were carried out again 1 year later and the results were compared. Liver biopsy was carried out on all carriers with active viral replication. HBV DNA-positive samples were subjected to polymerase chain reaction single-stranded conformation polymorphism (PCR-SSCP) to screen mutations in the Precore, core, and the X-gene prior to sequencing analysis. Among the 100 patients examined, HBeAg was detected in 23% and 40% were HBV DNA-positive. Of the 40 HBV DNA-positive cases, 8 had precore/core mutations, [G1896A (10%), T2066A (12.5%), T2050C (10%), and G1888A (7.5%)]. No X gene mutants were detected. Reduction in viral load was higher in HBeAg-positive patients, as compared to HBeAg-negative patients, over 1 year. At follow-up, 2/8 HBV mutants corresponded with altered liver function and morphological changes suggestive of chronic hepatitis. One patient was re-designated as DNA-negative on follow-up and had wild-type virus infection with a relatively low viral load. The predominant route for HBV transmission was determined to be parenteral. Twenty percent of the HBV carriers were infected with precore and core mutant HBV. Although the clinical and biochemical profiles of these HBV carriers remained largely stable on follow-up, there was evidence of spontaneous reduction in the mean viral load over the 1-year study period.

Acoustic sensing of the bacterium-substratum interface using QCM-D and the influence of extracellular polymeric substances

It is commonly assumed that bacterial presence on a QCM sensor-surface is associated with a negative frequency shift according to conventional mass-loading theory. Here, we demonstrate that bacteria adhering to QCM sensor-surface may yield positive frequency shifts up to 1.9×10(-6) Hz per bacterium according to a coupled-oscillator theory. Furthermore, it is demonstrated that the excretion of extracellular polymeric substances (EPS) by adhering bacteria can change the frequency shift in the negative direction by 1.7×10(-6) Hz per bacterium, according to conventional mass-loading theory. The difference in frequency shifts between an EPS-producing and a non-EPS producing staphylococcal strain correlated with the excretion of 3×10(-14) g EPS per bacterium, representing only a few percent of the weight of a bacterium. Thus an adsorbed molecular mass as low as a few percent of the mass of an adhering bacterium significantly alters the QCM-signal. Since adhesion of many different bacterial strains is accompanied by molecular adsorption of EPS, with potentially opposite effects on the QCM-signal, a combination of the coupled-oscillator and normal mass-loading theory has to be applied for proper interpretation of QCM-frequency shifts in bacterial detection.