Haemodynamic effects of intrathecal dexmedetomidine added to ropivacaine intraoperatively and for postoperative analgesia

Background: For lower abdomen and lower limb surgery, spinal anaesthesia is most common modality used in routine. This study was conducted on 50 ASA 1 and 2 planned for lower limb and lower abdomen surgery.Methods: 50 patients of ASA 1 and 2 scheduled for lower limb and lower abdominal surgery were selected. Each patient received 4 milliliter volume of 0.75% isobaric ropivacaine + 5 microgram dexmedetomidine. At the intervals of 1 minute, 2 minute, 5 minute, 10 minute, 20 minute, 30 minute and 1 hour, 2 hour and 3 hour reading of pulse rate and blood pressure were recorded. Postoperatively, pain scores were recorded by using Visual Analogue Scale.Results: There were no significant changes in systolic and diastolic blood pressure after induction. The combination of ropivacaine and dexmedetomidine provided better postoperative analgesia and reduced requirement of diclofenac injection in first 24 hour.Conclusions: The patients showed excellent hemodynamic stability and postoperative analgesia to ropivacaine + dexmedetomidine. Thus it is a safe modality for lower limb and lower abdomen surgery as far as haemodynamic effects and postoperative analgesia is concerned

Fluctuations in Overseas Travel by Americans, 1820 to 2000

There were substantial fluctuations in the numbers of American overseas travelers, especially before World War II. These fluctuations in travel around the robust, long term upward trend are the focus of this paper. We first identify those fluctuations in the raw data and then try to explain the pattern of overseas travel in a quantitative way. As we show, despite the impact of a myriad of episodic events, the fluctuations in travel can be explained to a large extent by changes in the direct price of travel, changes in per capita GDP in the U.S., the extent of travel in the preceding year, and by periods of armed conflict in Europe. We attempt to explain some of the remaining variation for specific episodes in which the actual level of travel differed substantially from the predicted.

The American Invasion of Europe: The Long Term Rise in Overseas Travel, 1820-2000

Tourism today is an activity of substantial economic importance worldwide, and has been for some time. Tourism is also of substantial economic importance in the United States, sufficient to warrant the Bureau of Economic Analysis's establishing special accounts on travel and tourism. In this paper we investigate the long term rise in overseas travel by Americans. Over the course of the nineteenth and twentieth centuries the number of Americans going abroad rose from less than 2,000 travelers to over 26 million. The industry went from one confined to the elite of American society to what some have described as mass tourism. We document this rise by compiling a long term series on overseas travel, and describe the changes in the composition of the travelers, their destinations, and their mode of travel. We use an Error Correction Model to explain how the increase came about.

Diabetic retinopathy awareness and associations with multiple comorbidities: Insights from DIAMOND Study

Background: Diabetic retinopathy (DR) is leading cause of visual impairment in working-age adults. Macular edema can occur with or without other signs of retinopathy. Methods: This was a single-center, retrospective study conducted over 2 years in patients (>40 years of age) having type 2 diabetes mellitus (T2DM). Outcome measures were to analyze awareness and prevalence of DR and association of DR with identified risk factors. Results: Overall 6000 T2DM patients over 2 years were retrospectively evaluated. Almost 63% (n = 3780) of patients were unaware that diabetes affects the retina. Almost 65% (n = 3894) of patients were reported to have DR. Total 78.98% of males, and 69.50% of females had DR. There was a significant increase in the incidence of DR with age (P 9% (P < 0.00001). Overall 52.02% (n = 1820) of smokers were reported of DR (P < 0.00001). With the increase in total cholesterol and triglycerides, there was a significant increase in DR incidence (P < 0.00001). A strong association was observed between hypertension and DR, with 42.6% (n = 2556) of patients having coexistence of hypertension and DR (P < 0.00001). Patients having diabetic kidney disease (DKD) also reported DR. A high proportion of patients (49.11%, n = 2947) had co-existence of cardiac morbidity and DR. Almost 47% (n = 2845) of patients having DR were also reported anemia. Totally 43.85% (n = 2631) of patients with microalbuminuria had two times more risk of developing proliferative DR (P < 0.00001). The statistical significance for the association of DR with risk factors, calculated by Pearson Chi-Square method of analysis was found statistically significant (P < 0.00001). Conclusion: The study reported the high prevalence and significantly high unawareness for DR in T2DM patients. All the risk factors are independently and significantly associated with DR (P < 0.00001)

Pharmacological aspects of Co(II), Ni(II) and Cu(II) schiff base complexes: An insight

Schiff bases are versatile chemical compounds that are frequently utilized and manufactured by reacting various amines with carbonyl compounds (aldehydes/ketones), resulting in the formation of the azomethine/imine (–CN–) group by condensation reaction. Medical science is driven to generate novel drugs with revolutionary bioactivities and functionalities to cure diseases that are rapidly evolving. Schiff base (SB) is a dynamic pharmacophore that, through chelation, can create complexes with metals of various oxidation states. SB metal complexes have already been recognized as an effective branch of investigation in coordination science. In the recent years, scientists have paid close attention to SBs and the metal complexes owing to versatile potential in the pharmaceutics sector, such as antifungal, antibacterial, antiviral and antimalarial, anti-HIV, anti-cancer, anti-tuberculosis, and many others. These compounds have also been identified as potent oxidants, with applications in sensing and nanotechnology. The ligand environment, metal ion complexation, and lipophilic nature have an impact on the biological activity of transition metal complexes. SB metal complexes are the attractive targets for the development of broad-spectrum medicines due to their combination of pharmacological properties. The review focuses on the synthesis, spectroscopic characterization and in-vitro biomedical applications (antimicrobial, anticancer, antitumor, DNA binding and cleavage, antioxidant) of SBs as well as their Co(II), Ni(II) and Cu(II) transition metal complexes

Nonsuicidal self-injury and identity formation in Indian clinical and nonclinical samples: A comparative study

Background: Nonsuicidal self-injury (NSSI) is being increasingly identified as an important emerging mental health issue in the West. Yet, NSSI has not been adequately studied in clinical and nonclinical contexts in countries like India. Aim: The aim of this study was to compare different features of NSSI between clinical and nonclinical samples in India. We also explored if the strength of the association between NSSI and disturbances in identity formation – a risk factor that can increase vulnerability to NSSI – was similar in the two samples mentioned above. Method: For the clinical sample, data regarding NSSI and identity formation were collected from 100 psychiatric patients (47.0% females, mean age = 34.76 years, SD = 12.76, 17–70 years) from an outpatient/inpatient psychiatric department of a large tertiary hospital in Mumbai, India. Nonclinical data were collected from 120 young adults studying in a medical college in Mumbai, India (51.7% females, mean age = 19.7 years, SD = 2.16, 17–28 years). Information regarding NSSI and identity were collected using self-report questionnaires. Results: Lifetime prevalence of NSSI in the clinical and nonclinical samples was found to be around 17% and 21%, respectively. Although the prevalence of NSSI did not significantly differ between the two samples, some features of NSSI did differ between the two groups. Finally, multigroup Bayesian structural equation modeling indicated that irrespective of the type of the sample (i.e. clinical or nonclinical), consolidated and disturbed identity significantly (negative and positive, respectively) predicted lifetime NSSI. Additionally, the association between the aforementioned identity variables and NSSI did not significantly differ between the two samples. Conclusion: The findings of these studies highlight the need for exploring issues related to identity formation in individuals who engage in NSSI irrespective of whether they suffer from a psychiatric disorder or not.status: Published onlin