Cardiopulmonary, Sedative, and Drug Disposition Effects of Vatinoxan in Sheep Receiving Dexmedetomidine, Medetomidine, Ketamine and Atipamezole

The impact of the peripherally selective α2-adrenoceptor antagonist, vatinoxan, on selected pharmacodynamic and pharmacokinetic properties of two selective α2-adrenoceptor agonists, medetomidine and dexmedetomidine, were investigated in sheep. Moreover, certain interactions between vatinoxan and atipamezole, a specific α2-adrenoceptor antagonist, were evaluated. The initial objective of this study was to identify a dose of vatinoxan that would best mitigate the undesirable cardiopulmonary changes produced by intramuscular (IM) medetomidine-ketamine in sheep. Specifically, three doses of vatinoxan (150, 300 and 600 µg/kg) or saline were combined in the same syringe with medetomidine (30 µg/kg) and ketamine (1 mg/kg) and given IM. Systemic hemodynamics, arterial blood gas tensions, clinical sedation and plasma drug concentrations were compared, both before and after reversal with IM atipamezole (150 µg/kg). The middle dose of vatinoxan (300 µg/kg), which appeared to be optimal among the other doses, was then added to medetomidine (30 µg/kg) and co-administered IM, followed by atipamezole for reversal. Last, the influence of intravenous pre-treatment with vatinoxan on dexmedetomidine-induced cardiopulmonary alterations was investigated in sevoflurane-anesthetized sheep. Following concomitant IM administration, vatinoxan dose-dependently attenuated some of medetomidine’s cardiopulmonary side effects. Vatinoxan did not significantly affect the level of sedation or the plasma concentrations of drugs when ketamine was included in the same syringe. Conversely, vatinoxan significantly increased the plasma concentrations of medetomidine, and accelerated the onset and intensified the degree of sedation when compared with the agonist alone. Moreover, recoveries after atipamezole-reversal were more complete in the presence of vatinoxan. No deleterious effects were noted between vatinoxan and atipamezole. Pre-treatment with vatinoxan prevented all dexmedetomidine-induced pulmonary alterations in sheep anesthetized with sevoflurane. In conclusion, vatinoxan alleviated or prevented the unwanted cardiopulmonary effects of (dex-) medetomidine by blocking the peripheral α2-adrenoceptors. Presumably, when co-administered IM in the same syringe, vatinoxan accelerated the absorption of medetomidine and increased its concentration in blood, which resulted in a faster and more intense sedation than when the agonist was used alone. Vatinoxan also decreased later exposure to dexmedetomidine, which appeared to improve atipamezole’s efficacy to reverse both the central and peripheral effect of the agonist.Vatinoksaani on keskushermoston ulkopuolella vaikuttava selektiivinen α2-adrenoseptoreiden antagonisti. Tutkimuksessa selvitettiin vatinoksaanin vaikutuksia kahden α2-adrenoseptoriagonistin, medetomidiinin ja dexmedetomidiinin tiettyihin farmakodynaamisiin ja farmakokineettisiin ominaisuuksiin lampailla. Tutkimuksessa arvioitiin myös vatinoksaanin ja α2-adrenoseptoriantagonisti atipametsolin yhteisvaikutuksia. Tutkimuksen lähtökohtainen tarkoitus oli selvittää annos, jolla vatinoksaani parhaiten lievittää lihaksensisäisesti annostellun medetomidiini-ketamiinin haittavaikutuksia verenkierto- ja hengityselimistöön lampailla. Tutkimusksessa testattiin kolmea annosta vatinoksaania, 150, 300 ja 600 µg/kg sekä fysiologista keittosuolaliosta. Vatinoksaani tai keittosuolaliuos annosteltiin samassa ruiskussa medetomidiinin (30 µg/kg) ja ketamiinin (1 mg/kg) kanssa lihaksensisäisesti. Verenkiertoelimistön toimintaa, valtimokaasujen osapaineita, sedaation syvyyttä sekä lääkeaineiden pitoisuuksia plasmassa verrattiin annosten kesken ennen ja jälkeen sedaation kumoamisen lihaksensisäisellä atipametsoli-injektiolla (150 µg/kg). 300 µg/kg osoittautui optimaaliseksi vatinoksaaniannokseksi. Seuraavassa kokeessa vatinoksaani (300 µg/kg) annosteltiin lihaksensisäisesti samassa ruiskussa pelkän medetomidiinin (30 µg/kg) kanssa ja sedaation kumottiin atipametsolilla. Lopuksi tutkittiin suonensisäisesti ennen dexmedetomidiinia annostellun vatinoksaanin vaikutuksia verenkierto- ja hengityselimistön toimintaan lampailla sevoflunaarianestesiassa. Vatinoksaani lievitti joitain medetomidiinin aiheuttamia haittavaikutuksia, kun lääkeaineet annosteltiin lihaksensisäisesti samassa ruiskussa. Vaste oli annosriippuvainen. Ketamiinin läsnä ollessa vatinoksaani ei merkittävästi vaikuttanut sedaatiotasoon tai lääkeaineiden pitoisuuksiin plasmassa. Pelkän medetomidiinin kanssa annosteltuna vatinoksaan nosti medetomidiinin plasmapitoisuutta merkittävästi ja nopeutti sedaation alkamista sekä syvensi sedaation tasoa verrattuna medetomidiiniin ilman vatinoksaania. Lisäksi sedaation kumoutuminen atipametsoli-injektion jälkeen oli varmempaa vatinoksaanin läsnä ollessa. Vatinoksaaniesilääkitys esti dexmedetomidiinin aiheuttamat haittavaikutukset hengityselimistön toimintaan sevofluraanianestesiassa. Lopputuloksena voidaan todeta, että vatinoksaani lievitti tai esti (dex-)medetomidiinin aiheuttamia haittavaikutuksia hengityselimistöön vähentämällä keskushermoston ulkopuolista α2-adrenoseptoriaktivaatiota. Annosteltaessa lihaksensisäisesti samassa ruiskussa vatinoksaani kiihdytti medetomidiinin imeytymistä ja nosti sen pitoisuutta veressä, mikä johti nopeampaan ja syvempään sedaatioon kuin pelkkä medetomidiini. Vatinoksaani vähensi dexmedetomidiinialtistusta sedaation lopussa, mikä näytti parantavan atipametsolin kykyä poistaa agonistin vaikutukset sekä keskushermostossa että sen ulkopuolella

Water Demand Management in Some Arab Countries Using GIS

The alarming increase in the scarcity of water in various parts of the world. Water is a main issue in many countries especially in those Arab countries, it has focused a global attention on the need for a stronger and more appropriate water resource management and availability solutions. With about 170 million people in 17 countries suffering from water scarcity and about 275 million in 9 countries having "water stresses" conditions, it becomes imperative for nations to come up with more focused and direct measures that would address and stem this resource scarcity. Water sustainability needs a balance between demand and availability. The main objective of this paper is the application of these  concepts to Arabs countries. Water demand management is about achieving a reduction in the use of water resources, normally through increased efficiency of water application. The management of water resources was not explicitly included in the past from thirty-five years in all most of those countries normative system partly because water was believed to be a free good in mind, and was not accepted to have a price to pay to use it. This work contributed to a low efficiency of water use and waste of it, and water prices are often well below levels needed to cover the costs of the system. Moreover, this contributes to a worse quality of water, and, as quality of water decrease, the management of water resources becomes more challenging and the need to integrate water quality into an overall water resources management grows. The main goal of this paper  is showing, how Geographical  Information Systems (GIS ) can be used to support infrastructure planners and analyst  on water demand of a local area in some Arabs countries such as(Egypt,  Sudan, Libya, Algeria, Tunisia, Morocco, Jordan, KSA and UAE).   Keywords: GIS, Water in land, Water area, XML Schema.

Water–Demand Management in the Kingdom of Saudi Arabia for Enhancement Environment

The purpose and the goal of the paper is growing substantially demand for water and waste-water infrastructure and that is being met through the available scarce and dwindling water resources. The kingdom of Saudi Arabia  (KSA) faces an acute water shortage due to arid climate and absence of permanent lakes and rivers. Ever-increasing imbalances are usually met by increasing water supplies, whereas the concepts of water-demand management have not been given due importance and weight age. Meeting the rapidly rising demand with scarce and depleting resources remains the critical issue. The main goal of this paper is showing; how Geographical Information Systems (GIS) can be used to support infrastructure  of demand water and waste-water. This paper places emphasizes on the urgency of adopting conservation and water-demand management initiatives to maintain demand supply relationship and achieve an acceptable balance between water needs and availability. Demand for water and waste-water infrastructure projects has remained  unaffected by the global financial crisis, and it continue to grow exponentially. Waste-water is a rapidly and globally expanding area of infrastructure development, that enables the sustainable re-use of scarce water resources for non-potable purposes in industry, agriculture, and greening. particularly in the agricultural sector-the largest and most inefficient user of water have been suggested. The paper suggests that the water-use-efficiency (WUE) in various sectors can be enhanced and improved in a local area of the kingdom of Saudi Arabia. The objective of this paper is to safeguard and conserve this precious natural resource through environmental enhancement  technologies for the future generations to come. It is presumed that water resources can be managed on sustainable basis by devising and employing environmental technologies including water conservation measures and develop water for sustainability and efficiency. To improve governance and management to the highest level. Provide water service to the Saudi people up to the level of developed countries whilst minimizing the fiscal burden. To develop and introduce technological and institutional innovations. To conserve and improve the environment.  The usefulness of these measures can be supplemented through the vibrant and viable extension and education initiatives and capacity building programs. In this work, three sets applications of GIS models have been produced. The geodatabase of district  areas  in Saudi Arabia including these layers of area, Subarea, cites, water in land, water area, land cover, roads, rail roads, elevations and mountains. Keywords: Water Demand, Water Resources, GIS, Highway Street, XML Schema

Management of Infrastructure For Water and Petroleum Demand in KSA By GIS

The purpose of this paper  is showing, how Geographical  Information Systems (GIS ) can be used to support infrastructure  planners and analyst  on water and petroleum demand of a local area in the Kingdom of Saudi Arabia (KSA). The first part of this work  discusses the issue of analysis, design and creating  the geodatabase system  of KSA land and infrastructure  using Stylus Studio XML editor, describing the components of the whole system of Subareas in Saudi  Arabia  affecting local infrastructure  planning and analyzing which include of specific  area and facilities management. The second part defines the creation of the GIS  application of the discussed field having the GIS  functions of the infrastructure discusses the  geodatabase of the application of GIS  In infrastructure   in Saudi Arabia districts. The third part defines the  results of the statistics analysis populations  in the Subareas, specify the relation between water resources and the elevations of subareas, the data of the layers of roads, railroads existing in Saudi Arabia  specially in the eastern area where most petroleum s wells are found.   Using Google earth to show the elevation of the subareas and the relation with the water resources. Three groups of GIS  forms was produced  they are the geodatabase of the Saudi Arabia (area, subareas and main cities) ,water resources  layers (water  in land , water  area and land cover ) , roads, railroads  and elevations layers. The main contribution in the paper, discussed the infrastructure and the  results of the statistics analysis populations  in the subareas, specify the relation between water resources and the elevations of subareas of the data layers of roads, railroads existing in Saudi Arabia, especially in the eastern area where most petroleum's wells are found production and exploration of  petroleum including the geodatabase of wells of petroleum distributed in Saudi Arabia  finding the locations using Google earth map, satellites to locate the areas of producing petroleum. Keywords: GIS, Water in land , Water area, Railroad, Elevation ,XML Schema

Managing of Urban Water Network using GIS Concept

The paper introduces a framework based on Geographical information systems (GIS) to integrate geographic information of Urban areas taking Khartoum State as an example. One of the main characteristics of such a framework is to support the information integration and data exchange between facilities using the base maps to solve the problem of water distributing networks. Entities in the Khartoum State (KS) infrastructure linked into information sources and leaded to integrate and exchange of associated information. The Methodology used is to study the existing urban systems specially water network using Geodatabase concept which are analyzed by observing and comparing the related earlier work using different criteria. Geodatabase of the system was defined , designed and build ArcGIS  software, an object oriented geodatabase was created using GIS Software. The information was gathered from Water, Sewage, Transportation Corporations in Khartoum States. The tools and software used are the Style Studio 2009 XML. Enterprise Suite Editor for driving KS Infrastructure geodatabase and KS Digital Base map was obtained from Khartoum State Surveying Corporation for Khartoum city center. Visual Basic for Application (VBA) was used to develop the Search Engine program. The main result obtained by the research is the development of a framework based on Geodatabase concept for the integration of geographic information of Khartoum State infrastructure network facilities. The geodatabase of Khartoum State base map and facilities networks were completed by creating Multitask object oriented geodatabase using ArCatalog. A search engine code was written and tested successfully. The integration of information was available to exchange information between different Corporations to solve any problem that may damage the network facilities and to help in managing and adding any new services on the site. The paper recommends the Building of multi-user unified geodatabase connected to a wide area network to service the concerned enterprise. Keywords: GIS; Geodatabse , Water Network ,ArcGIS , KS ,GM

Improve Of Health Care Systems in Subareas of Saudi Arabia by GIS

This paper shows how Geographical Information Systems (GIS) can be used to support health planners and demands on a micro-scale and explores the possibilities of using GIS for health care services in hospitals at Saudi Arabia subareas. GIS has several useful functions and tools that can be used in health planning field. The first part of this paper explains the issues that affect a local health care planning and monitoring of catchment area and facilities management. Each one of these issues is covered using several GIS functions including network analysis and spatial data analysis. The second part defines GIS and its possible application in the health care field. In this section, the relevant GIS functions have also been explained. The third part of this paper discusses the created and implemented a GIS application models, which is made for a local health care centre in Makkahh region and Taif city in Saudi Arabia. All the produced models can be applied on any private or public hospital in Makkahh region  and Taif city. They can be used to build a spatial decision making support system for hospitals in Taif region and serves five local health services neighborhoods named as Turabah, Al-Khurma, Rania, Zulam and Al-Moya. In this paper; the former is used to produce drive-time hospital service area and the route is applied at the selected hospital to calculate the size of its served demand. Finally; in this work, three sets of GIS models have been produced. These are catchment area; patient profile and patient distribution; and patient flows models. So, the output of creating and implementing a GIS models are produced to help a local health planners in their health care decision making output. Keywords: GIS; Health planners; network analysis; hospital served demand; spatial dat

Managing Water Network using GIS

The purpose and the goal of the paper are to introduce a framework based on onto Geographical information systems (GIS) to integrate geographic information of Urban areas taking Khartoum State as an example. One of the main characteristics of such a framework is to support the information integration and data exchange between facilities using the base maps to solve the problem of distributing water networks. Entities in the Khartoum State (KS) infrastructure link information sources and lead to integration and exchange of associated information. The Methodology used is to study the existing urban systems specially water network using Geodatabase concept which are analyzed by observing and comparing the related earlier work using different criteria.   The Geodatabase of the system was defined , designed and build ArcGIS  software. An object oriented geodatabase was created using GIS Software ,then the  information was gathered from Water, Sewage, Transportation Corporations in Khartoum States. The tools and software used are the Style Studio 2009 XML. Enterprise Suite Editor for driving KS Infrastructure geodatabase and KS Digital Base map was obtained from Khartoum State Surveying Corporation for Khartoum city center. Visual Basic for Application (VBA) was used to develop the Search Engine program. The main result obtained by the research is the development of a framework based on Geodatabase concept for the integration of geographic information of Khartoum State infrastructure network facilities.   The geodatabase of Khartoum State base map and facilities networks were completed by creating Multitask object oriented geodatabase using ArCatalog. A search engine code was written and tested ninety presents successful. The integration of information was available to exchange information between different Corporations to solve any problem that may damage the network facilities and to help managing and adding any new services on the site. The paper recommends the Building of multi-user unified geodatabase connected to a wide area network to service the concerned enterprise. Keywords: GIS; Geodatabse , Water Network ,ArcGIS , KS ,GM

Improve Of Health Care Systems in Subareas of Saudi Arabia by GIS

This paper shows how Geographical Information Systems (GIS) can be used to support health planners and demands on a micro-scale and explores the possibilities of using GIS for health care services in hospitals at Saudi Arabia subareas. GIS has several useful functions and tools that can be used in health planning field. The first part of this paper explains the issues that affect a local health care planning and monitoring of catchment area and facilities management. Each one of these issues is covered using several GIS functions including network analysis and spatial data analysis. The second part defines GIS and its possible application in the health care field. In this section, the relevant GIS functions have also been explained. The third part of this paper discusses the created and implemented a GIS application models, which is made for a local health care centre in Makkahh region and Taif city in Saudi Arabia. All the produced models can be applied on any private or public hospital in Makkahh region  and Taif city. They can be used to build a spatial decision making support system for hospitals in Taif region and serves five local health services neighborhoods named as Turabah, Al-Khurma, Rania, Zulam and Al-Moya. In this paper; the former is used to produce drive-time hospital service area and the route is applied at the selected hospital to calculate the size of its served demand. Finally; in this work, three sets of GIS models have been produced. These are catchment area; patient profile and patient distribution; and patient flow models. The results of GIS provided by the combined different entities based on their common geographic occurrence makes it a very valuable tool in epidemiological research, disease surveillance and monitoring. Some recent applications of GIS include vector borne diseases, water borne diseases, environmental health and modeling exposure to electromagnetic fields. Also, our results suggest that GIS is highly relevant to meet the demands of outbreak investigation and response, where prompt location of cases, rapid communication of information, and quick mapping of the epidemic’s dynamics are vital. In this work the former is used to produce drive-time hospital service area and the route is applied at the selected hospital to calculate the size of its served demand. It is recommended that more studies should be done in this work; three sets of GIS models have been produced. These are catchment area patient profile and patient distribution and patient flow models. So, we think that such output of creating and implementing a GIS models are produced to help a local health planners in their health care decision making output. Keywords: GIS; Health planners; network analysis; hospital served demand; spatial data

Water–Demand Management in the Kingdom of Saudi Arabia for Enhancement Environment

The purpose and the goal of the paper is growing substantially and that is being met through the available scarce and dwindling water resources. The kingdom of Saudi Arabia (KSA) faces an acute water shortage due to arid climate and absence of permanent lakes and rivers. Ever-increasing imbalances are usually met by increasing water supplies, whereas the concepts of water-demand management have not been given due importance and weight age. Meeting the rapidly rising demand with scarce and depleting resources remains the critical issue. The goal of this paper is showing; how Geographical Information Systems(GIS) can be used to support infrastructure  planners and analyst  on a local area. This paper places emphasizes on the urgency of adopting conservation and water-demand management initiatives to maintain demand supply relationship and achieve an acceptable balance between water needs and availability. The kingdom places emphasis on the shift from supply development to demand management to use of critical and non-renewable water resources efficiently. The paper suggests that the water-use-efficiency (WUE) in various sectors can be enhanced and improved in the kingdom. The paper presents an overview of the country’s water resources and issues related to water. Some possible conservation and remedial measures particularly in the agricultural sector-the largest and most inefficient user of water have been suggested. The objective of this paper is to safeguard and conserve this precious natural resource through environmental friendly technologies for the future generations to come. It is presumed that water resources can be managed on sustainable basis by devising and employing environmental friendly technologies including water conservation measures. The usefulness of these measures can be supplemented through the vibrant and viable extension and education initiatives and capacity building programs. In this work, three sets applications of GIS models have been produced. The geodatabase of district  areas  in Saudi Arabia including these layers of  Area, Subarea, Cites, water in land, water area, land cover, roads, rail roads, elevations. Keywords: Water Demand, Water Resources, GIS, Highway Street, XML Schema

Designing and Developing Electronic Health System Using XML & RDM

An examination of many hospitals that recently implemented in King Saudi Arabia(KSA) a little electronic health record (EHR) system finds that clinical and administrative leaders built EHR adoption into their strategic plans to integrate inpatient and outpatient care and pro­vide a continuum of coordinated services. Using Relational Data Base Management (RDM) and eXtend Marker Language (XML) Systems .Successful implementation depended on: strong leadership, full involvement of clinical staff in design and implementation, mandatory staff training, and strict adherence to timeline and budget. The EHR systems facilitate patient safety and quality improvement through: use of checklists, alerts, and predictive tools; embedded clinical guidelines that promote standardized, evidence-based practices; elec­tronic prescribing and test-ordering that reduces errors and redundancy; and discrete data fields that foster use of performance dashboards and compliance reports. The system will be developed using PHP Hiper Page(PHP) as web based system. Key word: XML, RDM,EHR.EMR,GIS,PH