Implications of different analgesic models on inflammatory markers after laparoscopic cholecystectomy

BACKGROUND

Despite its advantages, laparoscopic surgery causes significant shoulder and abdominal pain in 35%-80% of patients. The cause of post-laparoscopy pain is not fully understood, but it is assumed to be a multifactorial referred pain.

AIM OF THE STUDY

To evaluate the effect of different analgesia techniques on post-laparoscopic pain and inflammatory markers.

METHODS

Patients scheduled for elective laparoscopic cholecystectomy were randomly assigned to receive local hepatic and right subdiaphragmatic infiltration of one of the 4 study drug combinations: Group 1 (G1) received 20 ml bupivacaine 0.25%; Group 2 (G2) received 20 ml bupivacaine 0.25% +3 mg morphine sulphate; Group 3 (G3) received 20 ml bupivacaine 0.25% + 3 mg morphine sulphate +200 µg/kg ketamine; and Group 4 (G4) received 20 ml isotonic saline as the control group.

RESULTS

In G3, both shoulder pain on the verbal numerical rating scale and inflammatory marker levels were lower compared with the other groups. The highest levels of inflammatory markers were observed in the control group; this difference was statistically significant. No side effects or complications were observed in the study groups.

CONCLUSION

The addition of ketamine and morphine to bupivacaine for hepatic and subdiaphragmatic infiltration produced good analgesia and reduced inflammatory marker levels after laparoscopic cholecystectomy.

The anticorrosive performance of cost saving zeolites

Purpose

In recent years, zeolites have been highlighted as a new component in many industrial applications owing to their unique properties. The purpose of this study is to apply three prepared types of zeolites Na-X, Na-Y and hydroxysodalite (Na-HS) in anticorrosive paint formulations to be evaluated as a partial replacement to zinc phosphate in anticorrosive paint formulations to protect carbon steel.

Design/methodology/approach

The three types of zeolites were characterized using different instrumental analysis such as X-ray diffraction, scanning electron microscopy and X-ray fluorescence. Evaluation of zeolites was done using American society for material and testing. Then, they were incorporated in paint formulations based on medium oil-modified soya-bean dehydrated castor oil alkyd resin in the presence and absence of zinc phosphate. Their corrosion behavior was estimated using both immersion test and electrochemical impedance measurements in 3.5% NaCl.

Findings

Generally, the prepared zeolites exhibited good corrosion protection performance, but in presence of zinc phosphate the performance was better. This proves that, zeolites by themselves can resist corrosion but not efficiently, while in presence of zinc phosphate and owing to a synergistic effect between them, the performance was better. This opens the way to partial replacement of zinc phosphate with another safer and cheaper ingredient, which is zeolite.

Practical implications

The three zeolites can be applied in many industries besides the paint industry, such as reinforcing filler in rubber, plastics and ceramic composites, also can be applied in paper filling, paper coatings and electrical insulation.

Originality/value

The three zeolites are environmentally friendly materials that can partially replace other expensive anticorrosive pigments (e.g. zinc phosphate).

Elastic moduli of untreated, demineralized and deproteinized cortical bone: validation of a theoretical model of bone as an interpenetrating composite material

A theoretical experimentally based multi-scale model of the elastic response of cortical bone is presented. It portrays the hierarchical structure of bone as a composite with interpenetrating biopolymers (collagen and non-collagenous proteins) and minerals (hydroxyapatite), together with void spaces (porosity). The model involves a bottom-up approach and employs micromechanics and classical lamination theories of composite materials. Experiments on cortical bone samples from bovine femur include completely demineralized and deproteinized bones as well as untreated bone samples. Porosity and microstructure are characterized using optical and scanning electron microscopy, and micro-computed tomography. Compression testing is used to measure longitudinal and transverse elastic moduli of all three bone types. The characterization of structure and properties of these three bone states provides a deeper understanding of the contributions of the individual components of bone to its elastic response and allows fine tuning of modeling assumptions. Very good agreement is found between theoretical modeling and compression testing results, confirming the validity of the interpretation of bone as an interpenetrating composite material.

The sexual and reproductive health in men with generalized epilepsy: a multidisciplinary evaluation

This study was specifically aimed to evaluate the sexual and reproductive health in a group of men with generalized epilepsy. In total, 44 men with generalized epilepsy were included in this study, their ages between 18 and 48 years (29.2+/-9.9) and duration of illness between 2 and 35 years (11.2+/-7.4); 34 patients were treated with conventional antiepileptic drugs (AEDs). Sexological and psychological interviews together with serum total testosterone, E(2), FSH, LH and prolactin were determined. Hyposexuality was diagnosed in 61.4%. Erectile dysfunction (ED) and premature ejaculation represented 70.4 and 66.7%, respectively. Variables such as hyposexuality, seizure duration and its poor control on AEDs were significantly associated with depressive symptoms. Compared to the normal control group, all patients reported elevated E(2) levels (P<0.001), 10 had FSH (n=4) and LH (n=6) levels exceeding that of the normal range for controls and two had hyperprolactinemia. Although the patients' mean value of total testosterone remained within the normal range, but it was significantly lower in hyposexual men compared to nonhyposexual (P<0.002), only two epileptic patients had markedly reduced level of total testosterone beyond normal control levels. This study strongly supports that: (1) The risk of hyposexuality and reproductive disturbances is high in epileptic patients with GTC convulsions despite the AEDs utilized. The risk for SD is further increased by poor seizure control and the frequently accompanied depressive manifestations. (2) It is possible that elevated E2 could increase the risk of SD by reducing active testosterone through negative feedback and the reduction of active testosterone could increase seizure intractability to antiepileptic medications.

Effect of drug proportion and mixing time on the content uniformity of a low dose drug in a high shear mixer

The purpose of this study was to investigate the effect of reducing drug proportion and mixing time on the content uniformity of a low dose drug. Buspirone hydrochloride was used as a model drug and was mixed with other ingredients in two different concentrations (0.5% w/w and 5% w/w) in a T. K. Fielder high shear mixer at a high impeller speed (522 rpm) and a high chopper speed (3600 rpm) up to 32 min. Samples were withdrawn from nine locations in the mixer at specific time points using a side-sampling thief probe. The final blends at 32 min were compressed using an instrumented tablet press. Tablets were sampled at the beginning, middle, and end of the compression run. The statistical results indicated that the drug proportion had a significant effect on the content uniformity of the powder blend and the corresponding tablets. For this study, the optimum time to mix the 0.5% w/w formulation was after 8 min while it was only 1 min for the 5% w/w formulation. The RSD of buspirone hydrochloride contents of tablets decreased as the compression run was toward its end. Uniformly mixed blends produced tablets that met the USP XXIV content uniformity requirements.

Application of multiple response optimization technique to extended release formulations design

The purpose of the present study was to apply response surface methodology and multiple response optimization utilizing superimposed contour diagrams to design extended release formulations with a preplanned release profile. Bumetanide solution was layered on sugar pellets followed by coating with various coating formulations according to a central composite statistical design using a Glatt GPCG 1 Wurster Fluid Bed. The coated pellets were tested for their release profiles and the percent of drug released after 1, 4 and 8 h were used to describe and optimize the release process. Statistical models describing the percent bumetanide released after 1, 4 and 8 h were developed and the corresponding contour diagrams were superimposed to predict the coating formulation parameters expected to produce target release profile. The pellets coated with the designed coating formulation were tested for their release profiles in comparison to the target profile. According to the model-independent approach using similarity factor (F2), the dissolution profile of the designed formulation and the expected target profile were found to be similar. It was concluded that response surface methodology and multiple response optimization could be successfully used to design and optimize extended release formulations with desired preplanned release profile.