Psychotropic Drug and Oxidative Stress in Acute Poisoning

Psychotropic drug poisoning is an important cause of mortality and morbidity in many countries. It has been estimated that there are 3 million cases of severe poisoning occur in developing countries. Amitriptyline is the most common suicidal poison with high morbidity and mortality and account for a large proportion of patients admitted to intensive care units. It is noted that acute amitriptyline poisoning accounted for 15-20% out of total admission to the medical intensive care units of Government Hospitals. Though routine standard treatment (RST) is being given to all acute amitriplyline poisoning (AP) cases, the exact mechanism of toxicity still remain elusive. Studies on acute amitriptylene poisoning patients indicate that besides their inhibiting effect on acetylcholinesterase, acute amitriptyline poisoning may induce oxidative stress in humans. The main objective of this study was to find out the antioxidant status, enzyme variations in acute amitriptyline poisoning cases. Vitamin C or ascorbic acid is a monosaccharide antioxidant found in both animals and plants. As it cannot be synthesized in humans and must be obtained from the diet, it is a vitamin.9 It is a water -soluble antioxidant that protects organic and biological molecules against oxidative degradation. It also works along with glutathione peroxidase (a major free radical - fighting enzyme) to revitalize alpha lipoic acid a fat-soluble antioxidant. Due to its versatile properties it is decided to supplement to acute amitriptyline poisoning cases. Alpha lipoic acid initially classified as a vitamin possessed potent antioxidant properties. It dissolves in both water and fat and thus claimed to be an "Universal antioxidant" it can reach tissues composed of fat such as the nervous systems as well as those made mainly of water such as heart. Alpha lipoic acid is seen to be very effective in various neurological disorders like Parkinson's diseases, Alzhmeir's diseases. Since acute amitriptyline poisoning causes considerable neurotoxicity, we have dicided to supplement alpha lipoic acid to acute amitriptyline poisoning cases and study its effect before and after supplementation. During the course of this study, observed elevated LDH and CPK activity in all acute amitriptyline poisoning cases, we were interested in knowing the exact fraction of isoenzyme elevation so as to find out the maximum tissue or organ damage in acute amitriptyline poisoning cases. A total of 132 acute amitriptyline cases were selected for study from IMCU and poison centre, Government General Hospital between September 2004 to March 2008, informed consent was obtained from the attendants of the patients. This study was approved by the ethical committee of Madras Medical College, Chennai - 3. The severity of poisoning was graded according to the method of Edinburgh Scale. Venous blood was drawn from each experimental subjects, antioxidant levels, enzymes and isoenzyme patterns of CPK and LDH were carried out for patients. 50ml of gastric aspirate was collected from all patients and this is taken for identification of amitriptyline drugs by TLC. Blood investigations were carried out by standard procedures by semi autoanalyzer, spectrophotometer, chromatographic techniques and semiautomated electrophoresis system. Statistical evaluation was carried out using SPSS (Version 14.0). Data obtained from the study groups were compared with variable by student `t' test, standard deviation, mean, ANOVA and percentage of benefit with and without supplementation of Vitamin C, alpha lipoic acid and in combination. Multiple comparison of each group with normal and without antixoidants was carried out using Bonferroni t-test. Standard tables and charts are depicted whenever required. Results were discussed in detail for all parameters with the literature available and observations were recorded. Based on the study the conclusions are arrived as follows. 1. Supplementation of Vitamin C, alpha lipoic acid and their combination decrease the oxidative stress and increase total antioxidant status of acute amitriptyline poisoning cases. 2. The effect of supplementation of Vitamin C and alpha lipoic acid combination was maximum in Group V acute amitriptyline poisoning cases. The longer supplementation of antioxidant combination will help the recovery of acute amitriptyline poisoning cases and also to reduce their long term side effects such as amitriptyline induced delayed neuropathy (AIDN). I.V. form of supplementation will be more beneficial for acute amitriptyline poisoning cases, also supplementation of these antioxidants to chronic amitriptyline poisoning cases will reduce their long term side effects. 3. The recovery and regeneration of plasma cholinesterase was more rapid than RBC cholinesterase. 4. Significant decrease in catalase activity was noticed in all groups of acute amitriptyline poisoning cases on supplementation with antioxidants. 5. The study shows only lower values of RBC Glutathione reductase activity on admission and increase in values on discharge for Group III and Group IV acute amitriptyline poison cases. 6. The average age of acute amitriptyline poisoning cases was 33 for male and 32 for female, and this study shows that the amitriptyline poisoning is seen more in male (55.3%) than female (44.7%). 7. The isoenzyme studies show that the increased LDH in Group A (ten cases were selected randomly among the groups only on admission for LDH and CPK study) and Group B (ten cases were selected randomly among the groups only on admission for LDH and CPK study) cases may be due to pulmonary infarction and may be moderately due to hepatic cell damage. 8. The increase of CK in acute amitriptyline poisoning cases in Group A and Group B are primarily due to pulmonary infarction not due to cardiac or skeletal muscle involvement

Boundary conditions and symplectic structure in the Chern-Simons formulation of (2+1)-dimensional gravity

We propose a description of open universes in the Chern-Simons formulation of (2+1)-dimensional gravity where spatial infinity is implemented as a puncture. At this puncture, additional variables are introduced which lie in the cotangent bundle of the Poincar\'e group, and coupled minimally to the Chern-Simons gauge field. We apply this description of spatial infinity to open universes of general genus and with an arbitrary number of massive spinning particles. Using results of [9] we give a finite dimensional description of the phase space and determine its symplectic structure. In the special case of a genus zero universe with spinless particles, we compare our result to the symplectic structure computed by Matschull in the metric formulation of (2+1)-dimensional gravity. We comment on the quantisation of the phase space and derive a quantisation condition for the total mass and spin of an open universe.Comment: 44 pages, 3 eps figure

Polygon model from first order gravity

The gauge fixed polygon model of 2+1 gravity with zero cosmological constant and arbitrary number of spinless point particles is reconstructed from the first order formalism of the theory in terms of the triad and the spin connection. The induced symplectic structure is calculated and shown to agree with the canonical one in terms of the variables.Comment: 20 pages, presentation improved, typos correcte

Electrical stimulation alleviates depressive-like behaviors of rats: investigation of brain targets and potential mechanisms

Deep brain stimulation (DBS) is a promising therapy for patients with refractory depression. However, key questions remain with regard to which brain target(s) should be used for stimulation, and which mechanisms underlie the therapeutic effects. Here, we investigated the effect of DBS, with low- and high-frequency stimulation (LFS, HFS), in different brain regions (ventromedial prefrontal cortex, vmPFC; cingulate cortex, Cg; nucleus accumbens (NAc) core or shell; lateral habenula, LHb; and ventral tegmental area) on a variety of depressive-like behaviors using rat models. In the naive animal study, we found that HFS of the Cg, vmPFC, NAc core and LHb reduced anxiety levels and increased motivation for food. In the chronic unpredictable stress model, there was a robust depressive-like behavioral phenotype. Moreover, vmPFC HFS, in a comparison of all stimulated targets, produced the most profound antidepressant effects with enhanced hedonia, reduced anxiety and decreased forced-swim immobility. In the following set of electrophysiological and histochemical experiments designed to unravel some of the underlying mechanisms, we found that vmPFC HFS evoked a specific modulation of the serotonergic neurons in the dorsal raphe nucleus (DRN), which have long been linked to mood. Finally, using a neuronal mapping approach by means of c-Fos expression, we found that vmPFC HFS modulated a brain circuit linked to the DRN and known to be involved in affect. In conclusion, HFS of the vmPFC produced the most potent antidepressant effects in naive rats and rats subjected to stress by mechanisms also including the DRN.postprin

A Fuzzy ANP Based Grey Relational Approach to Evaluate CRM System in Context of Bangladesh

This study aims to select a suitable CRM (customer relationship management) system among different possible alternatives for organization’s in Bangladesh. Since, evaluating CRM system on the basis of lot of attributes leads us to Multiple-criteria decision analysis (MCDA) problems. In this study, a hybrid MCDA models were used. FuzzyANP (Analytic Network Process) and GRA (Grey Relational Analysis) approaches were adopted to solve the problem. The study explored that the Hubspot CRM was optimal solution in context of Bangladesh. Our research will beneficial to the organizing for better customer support. As far our knowledge goes, this is the first attempt to select CRM softwares in context of Bangladesh. Keywords: Analytic network process; Customer relationship management system; Grey relational analysis; Multiple-criteria decision analysis DOI: 10.7176/IKM/11-4-06 Publication date:June 30th 202

Optimal scheduling of a renewable micro-grid in an isolated load area using mixed-integer linear programming

In the energy management of the isolated operation of small power system, the economic scheduling of the generation units is a crucial problem. Applying right timing can maximize the performance of the supply. The optimal operation of a wind turbine, a solar unit, a fuel cell and a storage battery is searched by a mixed-integer linear programming implemented in General Algebraic Modeling Systems (GAMS). A Virtual Power Producer (VPP) can optimal operate the generation units, assured the good functioning of equipment, including the maintenance, operation cost and the generation measurement and control. A central control at system allows a VPP to manage the optimal generation and their load control. The application of methodology to a real case study in Budapest Tech, demonstrates the effectiveness of this method to solve the optimal isolated dispatch of the DC micro-grid renewable energy park. The problem has been converged in 0.09 s and 30 iterations

Turing Instability in a Boundary-fed System

The formation of localized structures in the chlorine dioxide-idodine-malonic acid (CDIMA) reaction-diffusion system is investigated numerically using a realistic model of this system. We analyze the one-dimensional patterns formed along the gradients imposed by boundary feeds, and study their linear stability to symmetry-breaking perturbations (Turing instability) in the plane transverse to these gradients. We establish that an often-invoked simple local linear analysis which neglects longitudinal diffusion is inappropriate for predicting the linear stability of these patterns. Using a fully nonuniform analysis, we investigate the structure of the patterns formed along the gradients and their stability to transverse Turing pattern formation as a function of the values of two control parameters: the malonic acid feed concentration and the size of the reactor in the dimension along the gradients. The results from this investigation are compared with existing experiments.Comment: 41 pages, 18 figures, to be published in Physical Review

Timelike surfaces in Lorentz covariant loop gravity and spin foam models

We construct a canonical formulation of general relativity for the case of a timelike foliation of spacetime. The formulation possesses explicit covariance with respect to Lorentz transformations in the tangent space. Applying the loop approach to quantize the theory we derive the spectrum of the area operator of a two-dimensional surface. Its different branches are naturally associated to spacelike and timelike surfaces. The results are compared with the predictions of Lorentzian spin foam models. A restriction of the representations labeling spin networks leads to perfect agreement between the states as well as the area spectra in the two approaches.Comment: a wrong sign corrected in equation (65

Port site herniation of the small bowel following laparoscopy-assisted distal gastrectomy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Port-site herniation is a rare but potentially dangerous complication after laparoscopic surgery. Closure of port sites, especially those measuring 10 mm or more, has been recommended to avoid such an event.</p> <p>Case presentation</p> <p>We herein report the only case of a port site hernia among a series 52 consecutive cases of laparoscopy-assisted distal gastrectomy (LADG) carried out by our unit between July 2002 and March 2007. In this case the small bowel herniated and incarcerated through the port site on day 4 after LADG despite closure of the fascia. Initial manifestations experienced by the patient, possibly due to obstruction, and including mild abdominal pain and nausea, occurred on the third day postoperatively. The definitive diagnosis was made on day 4 based on symptoms related to leakage from the duodenal stump, which was considered to have developed after severe obstruction of the bowel. Re-operation for reduction of the incarcerated bowel and tube duodenostomy with peritoneal drainage were required to manage this complication.</p> <p>Conclusion</p> <p>We present this case report and review of literature to discuss further regarding methods of fascial closure after laparoscopic surgery.</p