Effect of Cisatracurium, Rocuronium pretreatment on Succinylcholine-Induced Fasciculations and Myalgia: A Comparison with Placebo, Double blind randomised control study

OBJECTIVE: To study the effect of pretreatment of Cisatracurium, Rocuronium on succinylcholine induced muscle fasciculation and post operative myalgia in patients undergoing ambulatory surgery. DESIGN: Randomised double blind, placebo controlled trial SETTING: Teaching Hospital. SUBJECTS: 150 ASA Physical status I and II Patients scheduled for elective g surgery under general anesthesia INTERVENTION: A standardized balanced anaesthetic technique was used for all patients. MEASUREMENTS AND MAIN RESULTS; Patients were randomised to receive cisatracurium 0.01mg/kg, rocuronium 0.06mg/kg, or saline 3 minutes prior to intravenous succinyl choline 1.5 mg/kg. The intensity of fasciculation was assessed using a four point rating scale. In addition the severity of myalgia was assessed using a four point rating scale in the post anaesthesia care unit and at 24 hrs post operatively. No patient complained of any side effects after the administration of the study drug. Fasciculations were observed less frequently (P < 0.05) in the rocuronium group compared with cisatracurium and saline. Although fasciculation occurred less frequently in the cisatracurium group than in the placebo group, this difference did not reach statistical significance. Incidence of Post operative myalgia were observed less frequently in the rocuronium group compared with that of cis atracurium and placebo group. CONCLUSION: Pretreatment with rocuronium was superior to cisatracurium in preventing succinyl choline induced muscle fasciculation and also the incidence of post operative myalgia

Inhibition of corrosion of carbon steel in well water by arginine-Zn2+ system

The environmental friendly inhibitor system arginine-Zn2+, has been investigated by weight-loss method. A synergistic effect exists between arginine and Zn2+ system. The formulation consisting of 250 ppm of arginine and 5 ppm of Zn2+ offers good inhibition efficiency of 98 %. Polarization study reveals that this formulation functions as an anodic inhibitor. AC impedance spectra reveal that a protective film is formed on the metal sur­face. The FTIR spectral study leads to the conclusion that the Fe2+- DL-arginine complex, formed on anodic sites of the metal surface, controls the anodic reaction. Zn(OH)2 formed on the cathodic sites of the metal surface controls the cathodic reaction. The surface morphology and the roughness of the metal surface were analyzed with Atomic Force Microscope. A suitable mechanism of corrosion inhibition is proposed based on the results obtained from weight loss study and surface analysis technique

A mental health training program for community health workers in India: impact on knowledge and attitudes

<p>Abstract</p> <p>Background</p> <p>Unmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities. This study aims to provide a mental health training intervention to community health workers in Bangalore Rural District, Karnataka, India, and to evaluate the impact of this training on mental health literacy.</p> <p>Methods</p> <p>A pre-test post-test study design was undertaken with assessment of mental health literacy at three time points; baseline, completion of the training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a four day course based on a facilitator's manual developed specifically for community health workers in India.</p> <p>Results</p> <p>70 community health workers from Doddaballapur, Bangalore Rural District were recuited for the study. The training course improved participants' ability to recognize a mental disorder in a vignette, and reduced participants' faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants' faith in recovery following treatment.</p> <p>Conclusion</p> <p>The findings from this study indicate that the training course demonstrated potential to be an effective way to improve some aspects of mental health literacy, and highlights strategies for strengthening the training course.</p

Entanglement swapping between independent and asynchronous integrated photon-pair sources

Integrated photonics represents a technology that could greatly improve quantum communication networks in terms of cost, size, scaling, and robustness. A key benchmark for this is to demonstrate their performance in complex quantum networking protocols, such as entanglement swapping between independent photon-pair sources. Here, using time-resolved detection, and two independent and integrated Si$_3$N$_4$ microring resonator photon-pair sources, operating in the CW regime at telecom wavelengths, we obtained spectral purities up to $0.97 \pm 0.02$ and a HOM interference visibility between the two sources of $V_{\rm HOM}=93.2 \pm 1.6\,\%$. This results in entanglement swapping visibility as high as $91.2 \pm 3.4\,\%

The antimicrobial efficacy of hypoxia mimicking cobalt oxide doped phosphate-based glasses against clinically relevant Gram positive, Gram negative bacteria and a fungal strain

Bioactive phosphate glasses are of considerable interest for a range of soft and hard tissue engineering applications. The glasses are degradable and can release biologically important ions in a controlled manner. The glasses can also potentially be used as an antimicrobial delivery system. In the given study, novel cobalt-doped phosphate-based glasses, (P 2O 5) 50(Na 2O) 20(CaO) 30-x(CoO) x where 0 ≤ x (mol %) ≤ 10, were manufactured and characterized. As the cobalt oxide concentration increased, the rate of dissolution was observed to decrease. The antimicrobial potential of the glasses was studied using direct and indirect contact methods against both Escherichia coli (NCTC 10538) Staphylococcus aureus (ATCC 6538) and Candida albicans (ATCC 76615). The results showed strong, time dependent, and strain specific antimicrobial activity of the glasses against microorganisms when in direct contact. Antimicrobial activity (R) ≥ 2 was observed within 2 h against Escherichia coli, whereas a similar effect was achieved in 6 h against Staphylococcus aureus and Candida albicans. However, when in indirect contact, the dissolution products from the bioactive glasses failed to show an antimicrobial effect. Following direct exposure to the glasses for 7 days, osteoblast-like SAOS-2 cells showed a 5-fold increase in VEGF mRNA while THP-1 monocytic cells showed a 4-fold increase in VEGF mRNA expression when exposed to 10% CoO-doped glass compared with the cobalt free control glass. Endothelial cells stimulated with conditioned medium taken from cell cultures of THP-1 monocytes exposed to 10% CoO doped glass showed clear tubelike structure (blood vessel) formation after 4 h

Burosumab therapy in children with x-linked hypophosphatemia

BACKGROUND X-linked hypophosphatemia is characterized by increased secretion of fibroblast growth factor 23 (FGF-23), which leads to hypophosphatemia and consequently rickets, osteomalacia, and skeletal deformities. We investigated burosumab, a monoclonal antibody that targets FGF-23, in patients with X-linked hypophosphatemia. METHODS In an open-label, phase 2 trial, we randomly assigned 52 children with X-linked hypophosphatemia, in a 1:1 ratio, to receive subcutaneous burosumab either every 2 weeks or every 4 weeks; the dose was adjusted to achieve a serum phosphorus level at the low end of the normal range. The primary end point was the change from baseline to weeks 40 and 64 in the Thacher rickets severity total score (ranging from 0 to 10, with higher scores indicating greater disease severity). In addition, the Radiographic Global Impression of Change was used to evaluate rachitic changes from baseline to week 40 and to week 64. Additional end points were changes in pharmacodynamic markers, linear growth, physical ability, and patient-reported outcomes and the incidence of adverse events. RESULTS The mean Thacher rickets severity total score decreased from 1.9 at baseline to 0.8 at week 40 with every-2-week dosing and from 1.7 at baseline to 1.1 at week 40 with every-4-week dosing (P<0.001 for both comparisons); these improvements persisted at week 64. The mean serum phosphorus level increased after the first dose in both groups, and more than half the patients in both groups had levels within the normal range (3.2 to 6.1 mg per deciliter [1.0 to 2.0 mmol per liter]) by week 6. Stable serum phosphorus levels were maintained through week 64 with every-2-week dosing. Renal tubular phosphate reabsorption increased from baseline in both groups, with an overall mean increase of 0.98 mg per deciliter (0.32 mmol per liter). The mean dose of burosumab at week 40 was 0.98 mg per kilogram of body weight with every-2-week dosing and 1.50 mg per kilogram with every-4-week dosing. Across both groups, the mean serum alkaline phosphatase level decreased from 459 U per liter at baseline to 369 U per liter at week 64. The mean standing-height z score increased in both groups, with greater improvement seen at all time points with every-2-week dosing (an increase from baseline of 0.19 at week 64) than with every-4-week dosing (an increase from baseline of 0.12 at week 64). Physical ability improved and pain decreased. Nearly all the adverse events were mild or moderate in severity. CONCLUSIONS In children with X-linked hypophosphatemia, treatment with burosumab improved renal tubular phosphate reabsorption, serum phosphorus levels, linear growth, and physical function and reduced pain and the severity of rickets

A 5-Enolpyruvylshikimate 3-Phosphate Synthase Functions as a Transcriptional Repressor in Populus.

Long-lived perennial plants, with distinctive habits of inter-annual growth, defense, and physiology, are of great economic and ecological importance. However, some biological mechanisms resulting from genome duplication and functional divergence of genes in these systems remain poorly studied. Here, we discovered an association between a poplar (Populus trichocarpa) 5-enolpyruvylshikimate 3-phosphate synthase gene (PtrEPSP) and lignin biosynthesis. Functional characterization of PtrEPSP revealed that this isoform possesses a helix-turn-helix motif in the N terminus and can function as a transcriptional repressor that regulates expression of genes in the phenylpropanoid pathway in addition to performing its canonical biosynthesis function in the shikimate pathway. We demonstrated that this isoform can localize in the nucleus and specifically binds to the promoter and represses the expression of a SLEEPER-like transcriptional regulator, which itself specifically binds to the promoter and represses the expression of PtrMYB021 (known as MYB46 in Arabidopsis thaliana), a master regulator of the phenylpropanoid pathway and lignin biosynthesis. Analyses of overexpression and RNAi lines targeting PtrEPSP confirmed the predicted changes in PtrMYB021 expression patterns. These results demonstrate that PtrEPSP in its regulatory form and PtrhAT form a transcriptional hierarchy regulating phenylpropanoid pathway and lignin biosynthesis in Populus