A rare case of heterotopic pregnancy: case report

Heterotopic pregnancy is defined as the coexistence of intrauterine and extrauterine gestation. The incidence is low and estimated to be 1 in 30,000 of spontaneous pregnancies though it is becoming commoner with assisted reproductive technique. It can be a life-threatening condition and can be easily missed with the diagnosis being overlooked. We present a rare case of spontaneous heterotopic pregnancy with intrauterine gestation without cardiac activity and unruptured tubal ectopic

EFFECT OF HPMC/CARBOPOL ON THE RELEASE OF CHLORPHENIRAMINE MALEATE FROM MATRIX TABLETS

Chlorpheniramine maleate is widely used in treatment for allergic disorder and cold. The controlled release matrix tablets of chlorpheniramine maleate were prepared using HPMC K15M, HPMC K100M and carbopol and studied their effect on drug release. Prepared tablets were evaluated for various physical parameters. In vitro drug release study shows that slow release in HPMC K100M than other two polymers. If concentration of polymer increases than the drug release is decreases due to formation of polymeric matrix. Zero order, first order, Higuchi’s and Korsmeyer’s equations applied to know the mechanism of drug release from prepared tablets. The similarity and dissimilarity factor found to be 77.88 and 4.14, respectively for drug release in stability study which shows there was no significant difference in drug release.Key words: Chlorpheniramine maleate, matrix tablet, HPMC K15M, HPMC K100M, carbopol and swelling inde

Low dose oral hydroxyurea prophylaxis improves all clinico: haematological parameters among sickle cell disease patients

Background: Sickle cell disease (SCD) an inheritable disorder of haemoglobin structure resulting from substitution of valine for glutamic acid at 6th position of β-globin chain of haemoglobin(HbS), which polymerizes on deoxygenation and undergoes to sickle shaped RBC causing vaso-occlusive painful crisis, chronic haemolysis, anaemia, frequent blood transfusions, frequent hospitalizations with increased morbidity and acute chest syndrome leading to mortalities. Presence of foetal haemoglobin (HbF) prevent sickling and use of drugs like Hydroxyurea (HU) results in increased production of HbF to prevent complications of SCD. Aims and objectives was to know the various effect of low dose HU on clinical and haematological parameters among SCD patients.Methods: Total 100 S HbSS patients were consecutively selected, with indication for HU in 10mg/kg + 5mg folic acid/day. Baseline haemoglobin, HbF, HbS, haematocrit (HCT), TRBC, MCV, MCH, MCHC, and HbS, TPC, TWBCs, ANCs and other relevant tests as needed. Follow up haematological tests were done at 1 month and then every 3 month up to 24 months with monitoring of clinical status, hepatic, renal, and myelotoxicities. Data were collected and analyzed.Results: There were 31 paediatric cases with mean age of 8.47±4.1 years and 69 adults with mean age of 25.9±8.2 years presented with or history of various complications. HU improves all clinical and haematological parameters significantly (Hb, HCT, HbF, MCV, MCH, MCHC,) with mild myelotoxicities (decreased ANC, TPC, WBCs).Conclusions: HU improves all clinical and haematological parameters with mild myelotoxicities among SCD patients

A comparative study of the effect of dexmedetomidine and lignocaine on hemodynamic responses and recovery following tracheal extubation in patients undergoing intracranial surgery

Background: Recovery from general anesthesia and extubation is a period of intense physiological stress for patients. The most feared complications after intracranial surgery are development of an intracranial hematoma and major cerebral edema. Both may result in cerebral hypoperfusion and brain injury. Thus, the anesthetic emergence of a neurosurgical patient should include maintenance of stable respiratory and cardiovascular parameters. Minimal reaction to the endotracheal tube removal prevents sympathetic stimulation and increases in venous pressure. In our study, we compared dexmedetomidine HCl, lignocaine HCl and placebo to blunt stress response and providing a smooth transition from extubation phase.Methods: 75 ASA Grade I and II patients aged 18-60 years scheduled for elective intracranial surgery for intracranial space occupying lesions were randomly divided into three groups of 25 each. Balanced general anesthesia was given. Inhalation anesthetic was discontinued and after return of spontaneous respiration patient in Group D received injection dexmedetomidine 0.5 µg/kg intravenous (IV), Group X received injection lignocaine 1.5 mg/kg IV and Group P received 10 ml normal saline IV over 60 sec. Heart rate (HR), mean arterial pressure (MAP), quality of extubation were measured at 1, 3, 5, 10, 15 mins interval after extubation. Emergence time and extubation time were noted and quality of extubation was evaluated on cough grading.Results: There was a significant decrease in MAPs and HR in Group D as compared to Group L and Group P (p<0.05) at all-time interval after extubation. Extubation quality score of the majority of patients was 1 in Group D, 2 in Group X, and 3 in Group P (p<0.001). The duration of emergence and extubation were comparable in all three groups. Sedation score of the most patient was 3 (44%) in Group D and 2 (56%) in Group X. Six patients in Group D and 1 patient in Group X had bradycardia.Conclusion: Single bolus dose of IV dexmedetomidine HCl 0.5 mg/kg given before tracheal extubation effectively attenuates hemodynamic response to extubation as compared to 1.5 mg/kg lignocaine HCl

High yield synthesis of electrolyte heating assisted electrochemically exfoliated graphene for electromagnetic interference shielding applications

Herein, we demonstrate a facile one pot synthesis of graphene nanosheets by electrochemical exfoliation of graphite. In the present study, we report a significant increase in the yield of graphene by electrolyte heating assisted electrochemical exfoliation method. The obtained results of heating assisted electrochemically exfoliated graphene (utilizing H2SO4 + KOH + DW) synthesis clearly exhibit that the yield increases similar to 4.5 times i.e. from similar to 17% (room temperature) to similar to 77% (at 80 degrees C). A plausible mechanism for the enhanced yield based on lattice expansion and vibration of intercalated ions has been put forward and discussed in details. The quality of graphene was examined by Raman, XPS, FTIR, AFM, SEM, TEM/HRTEM and TGA techniques. The Raman as well as morphogenesis results confirm the quality of the graphene nanosheets. We have used this graphene as electromagnetic interference shielding material where a comparatively large quantity of graphene is required. This graphene exhibits enhanced shielding effectiveness (46 dB at 1 mm thickness of stacked graphene sheets in frequency region 12.4 to 18 GHz) as compared to conventional electromagnetic interference shielding materials, which is greater than the recommended limit (similar to 30 dB) for techno-commercial applications. Thus the present work is suggestive for future studies on enhancement of yield of high quality graphene by proposed method and the use of synthesized graphene in electromagnetic interference shielding and other possible applications

Association between the choice of the conditioning regimen and outcomes of allogeneic hematopoietic cell transplantation for myelofibrosis

Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only curative treatment for myelofibrosis. However, the optimal conditioning regimen either with reduced intensity conditioning (RIC) or myeloablative conditioning (MAC) is not well known. Using the Center for International Blood and Marrow Transplant Research database, we identified adults aged ≥18 years with myelofibrosis undergoing allo-HCT between 2008-2019 and analyzed the outcomes separately in the RIC and MAC cohorts based on the conditioning regimens used. Among 872 eligible patients, 493 underwent allo-HCT using RIC (Fludarabine/busulfan=166, Fludarabine/melphalan=327) and 379 using MAC (Fludarabine/busulfan=247, Busulfan/cyclophosphamide=132). In multivariable analysis with RIC, Fludarabine/melphalan was associated with inferior overall survival (HR 1.80, 95% CI 1.15-2.81, p=0.009), higher early non-relapse mortality (HR 1.81, 95% CI 1.12-2.91, p=0.01) and higher acute graft versus host disease (GVHD) (grade II-IV- HR 1.45, 95% CI 1.03-2.03, p=0.03; grade III-IV HR 2.21, 95%CI 1.28-3.83, p=0.004) compared to Fludarabine/busulfan. In the MAC setting, Busulfan/cyclophosphamide was associated with a higher acute GVHD (grade II-IV HR 2.33, 95% CI 1.67-3.25, p\u3c0.001; grade III-IV HR 2.31, 95% CI 1.52-3.52, p\u3c0.001) and inferior GVHD-free relapse-free survival (GRFS) (HR 1.94, 95% CI 1.49-2.53, p\u3c0.001) as compared to Fludarabine/busulfan. Hence, our study suggests that Fludarabine/busulfan is associated with better outcomes in RIC (better overall survival, lower early non-relapse mortality, lower acute GVHD) and MAC (lower acute GVHD and better GRFS) in myelofibrosis

Structure of a double ubiquitin-like domain in the talin head: a role in integrin activation

Talin is a 270-kDa protein that activates integrins and couples them to cytoskeletal actin. Talin contains an N-terminal FERM domain comprised of F1, F2 and F3 domains, but it is atypical in that F1 contains a large insert and is preceded by an extra domain F0. Although F3 contains the binding site for β-integrin tails, F0 and F1 are also required for activation of β1-integrins. Here, we report the solution structures of F0, F1 and of the F0F1 double domain. Both F0 and F1 have ubiquitin-like folds joined in a novel fixed orientation by an extensive charged interface. The F1 insert forms a loop with helical propensity, and basic residues predicted to reside on one surface of the helix are required for binding to acidic phospholipids and for talin-mediated activation of β1-integrins. This and the fact that basic residues on F2 and F3 are also essential for integrin activation suggest that extensive interactions between the talin FERM domain and acidic membrane phospholipids are required to orientate the FERM domain such that it can activate integrins