Comparison of I-gel and laryngeal mask airway classic in terms of ease of insertion and hemodynamic response: a randomised observational study

Background: The gold standard technique for preserving a patent airway throughout anaesthesia is tracheal intubation. I-gel is a relatively new addition to the SADs. I-gel has combined the concept of the non-cuffed SADs like the SLIPA and gastric tube of the proseal LMA yet retaining the shape of laryngeal mask. Hence, we have compared ease of insertion, number and duration of insertion attempts among the two devices. Methods: This study was conducted on patients undergoing elective surgery under GA in Pacific Medical College and Hospital, Udaipur. Patients were divided into two groups: group A= LMA classic, a variant of supraglottic airway device and group B= I-gel, a variant of supraglottic airway device. The two devices were than compared with respect to success rate of insertion, time taken for insertion and ease of gastric tube placement (number of attempts) and post-operative airway morbidity. Results: Mean insertion time was 8.66±3.21 seconds in C-LMA and 6.49±1.92 seconds in I-gel (p<0.001). 97.14% was the success rate of single time attempt insertion with I-gel as compared to 88.57% in C-LMA. There was a failure rate of 11.43% in single attempt insertion with CLMA as compared to 2.86% with I-gel (p>0.05). Conclusions: We hereby concluded with our study that successful and shorter duration of insertion, with less hemodynamic response, makes I-gel™ a suitable alternative to LMA classic™ during general anesthesia

Effect of a dietary essential oil mixture on performance of laying hens in the summer season

The experiment was conducted to evaluate the effects of dietary supplements of either an essential oil mixture (EOM) or a mannan oligosaccharide (MOS) as alternatives to an antibiotic feed additive (avilamycin) for layers kept under hot summer conditions. Four hundred and eighty 54-week old Nick-Brown hens were assigned to four dietary treatments. Each treatment consisted of four replications of 10 cages (three hens per cage). The treatment groups were: 1) Control: Basal diet without additive; 2) Basal diet plus antibiotic (10 mg avilamycin/kg feed); 3) Basal diet plus 1 g MOS/kg feed; 4) Basal diet plus 24 mg EOM/kg feed. Performance of laying hens was affected by dietary treatments. Dietary supplementation of EOM and MOS significantly increased egg production compared with control and antibiotic groups. There were no significant differences in feed consumption between treatments. The EOM significantly improved feed conversion ratio above that of the control group. Egg weights were significantly different between treatments. Laying hens consuming MOS produced significantly lower egg weights than the other groups, while egg weights in the EOM, antibiotic and control groups did not differ significantly. Cracked-broken egg rate was decreased by dietary addition of EOM, MOS and antibiotic compared with the control. Number of deaths among hens was significantly affected by dietary treatments with the number of deaths in the MOS treatment being significantly lower than in the other treatments. The performance of laying hens during the summer season could be maintained with inclusions of EOM and MOS in the diet. Keywords: Essential oils, mannan oligosaccharide, antibiotic, egg production, laying hen, summer seasonSouth African Journal of Animal Science Vol. 36 (4) 2006: pp. 215-22

Impact of Initiating Insulin Glargine Disposable Pen Versus Vial/Syringe on Real-World Glycemic Outcomes and Persistence Among Patients with Type 2 Diabetes Mellitus in a Large Managed Care Plan: A Claims Database Analysis

Background: Diabetes accounts for almost 15% of all direct healthcare expenditures. Managed care organizations try to reduce costs and improve patient outcomes. Increasing patient persistence with antidiabetes treatment could help achieve these goals. Subjects and Methods: A retrospective study was conducted using the Optum Research Database (Optum, Eden Prairie, MN) to analyze clinical and economic outcomes associated with initiation of insulin glargine via a disposable pen (GLA-P) or vial and syringe (GLA-V) among adult, insulin-naive patients with type 2 diabetes mellitus (T2DM). Propensity-matched patient cohorts were assessed for persistence with insulin therapy, glycated hemoglobin (A1C), hypoglycemic events (based on diagnosis codes), and healthcare costs (total paid amount of adjudicated claims) after follow-up at 1 year. Results: In 1,308 matched patients, persistence was significantly higher (P=0.011) and longer (P=0.001) with GLA-P. Follow-up A1C values were significantly lower (P=0.038), and decreases in A1C from baseline significantly larger (P=0.043), in GLA-P than in GLA-V. Significantly fewer hypoglycemic events (P=0.042) were experienced, and a lower rate of diabetes-related inpatient admissions (P=0.008) was reported in GLA-P than GLA-V. Despite higher study drug costs with GLA-P than GLA-V, all-cause and diabetes-related healthcare costs were similar. Conclusions: In insulin-naive patients with T2DM, initiation of insulin glargine using the disposable pen rather than the vial and syringe is associated with higher persistence, better A1C control, and lower rates of hypoglycemia. The higher study drug costs associated with pen use do not increase total all-cause or diabetes-related healthcare costs. This may help treatment selection for patients with T2DM in a managed care setting.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140354/1/dia.2013.0312.pd

Antiprotozoal Activity of Turkish Origanum onites Essential Oil and Its Components

Essential oil of Origanum species is well known for antimicrobial activity, but only a few have been evaluated in narrow spectrum antiprotozoal assays. Herein, we assessed the antiprotozoal potential of Turkish Origanum onites L. oil and its major constituents against a panel of parasitic protozoa. The essential oil was obtained by hydrodistillation from the dried herbal parts of O. onites and analyzed by Gas Chromatography-Flame Ionization Detector (GC-FID) and Gas Chromatography coupled with Mass Spectrometry (GC-MS). The in vitro activity of the oil and its major components were evaluated against Trypanosoma brucei rhodesiense, T. cruzi, Leishmania donovani, and Plasmodium falciparum. The main component of the oil was identified as carvacrol (70.6%), followed by linalool (9.7%), p-cymene (7%), γ-terpinene (2.1%), and thymol (1.8%). The oil showed significant in vitro activity against T. b. rhodesiense (IC50 180 ng/mL), and moderate antileishmanial and antiplasmodial effects, without toxicity to mammalian cells. Carvacrol, thymol, and 10 additional abundant oil constituents were tested against the same panel; carvacrol and thymol retained the oil's in vitro antiparasitic potency. In the T. b. brucei mouse model, thymol, but not carvacrol, extended the mean survival of animals. This study indicates the potential of the essential oil of O. onites and its constituents in the treatment of protozoal infections

Analysis of the volatile components of five Turkish Rhododendron species by headspace solid-phase microextraction and GC-MS (HS-SPME-GC-MS)

Volatile constituents of various solvent extracts (n-hexane, CH2Cl2, H2O) of 15 different organs (leaves, flowers, fruits) of five Rhododendron species (Ericaceae) growing in Turkey were trapped with headspace solid-phase microextraction (HS-SPME) technique and analyzed by GC-MS. A total of 200 compounds were detected and identified from organic extracts, while the water extracts contained only traces of few volatiles. The CH2Cl2 extract of the R. luteum flowers was found to exhibit the most diverse composition: 34 compounds were identified, with benzyl alcohol (16.6%), limonene (14.6%) and p-cymene (8.4%) being the major compounds. The CH2Cl2-solubles of R. x sochadzeae leaves contained only phenyl ethyl alcohol. This study indicated appreciable intra-specific variations in volatile compositions within the genus. Different anatomical parts also showed altered volatile profiles. This is the first application of HS-SPME-GC-MS on the volatiles of Rhododendron species

Insecticidal and biting deterrent activities of magnolia grandiflora essential oils and selected pure compounds against aedes aegypti

© 2020 by the authors. In our natural products screening program for mosquitoes, we tested essential oils extracted from different plant parts of Magnolia grandiflora L. for their insecticidal and biting deterrent activities against Aedes aegypti. Biting deterrence of seeds essential oil with biting deterrence index value of 0.89 was similar to N,N-diethyl-3-methylbenzamide (DEET). All the other oils were active above the solvent control but the activity was significantly lower than DEET. Based on GC-MS analysis, three pure compounds that were only present in the essential oil of seed were further investigated to identify the compounds responsible for biting deterrent activity. 1-Decanol with PNB value of 0.8 was similar to DEET (PNB = 0.8), whereas 1-octanol with PNB value of 0.64 showed biting deterrence lower than 1-decanol and DEET. The activity of 1-heptanol with PNB value of 0.36 was similar to the negative control. Since 1-decanol, which was 3.3% of the seed essential oil, showed biting deterrence similar to DEET as a pure compound, this compound might be responsible for the activity of this oil. In in vitro A & K bioassay, 1-decanol with MED value of 6.25 showed higher repellency than DEET (MED = 12.5). Essential oils of immature and mature fruit showed high toxicity whereas leaf, flower, and seeds essential oils gave only 20%, 0%, and 50% mortality, respectively, at the highest dose of 125 ppm. 1-Decanol with LC50 of 4.8 ppm was the most toxic compound

Rapid chemical analysis and antiprotozoal effect of the solvent extracts and the essential oil of Artemisia indica

Artemisia indica is used as antipyretic in malarial fevers during malaria outbreaks in India [1]. We selected this plant because reports concerning the presence of artemisinin is contradictory, the content of methoxyflavonoids that potentiate the antimalarial efficacy of artemisinin has remained unstudied and the essential oil of the plant from different regions shows great chemical variations. Solvent extracts [petroleum ether, n-hexane, dichloromethane, acetone, MeOH or EtOH (96, 80 or 60% v/v), and hot water] of A. indica leaves originated from the West Bengal region (India) were assessed by HPLC-DAD and HPLC-MS for the content of artemisinin and the characteristic Artemisia methoxyflavonoids, eupatin, casticin, chrysoplenetin, cirsilineol, chrysosphenol-D and artemetin. None of the extracts contained artemisinin or the methoxyflavonoids chrysosphenol-D and artemetin, while all extracts contained chrysoplenetin. Eupatin, casticin and cirsilineol were found in all extracts except for the p. ether, n-hexane and hot water infusion. The acetone and EtOH extracts contained the highest levels of polymethoxyflavonoids (1.15 – 1.17%), whereas the infusion was devoid of them. The essential oil of the plant was obtained by hydrodistillation and analyzed by GC and GC-MS simultaneously. Of the 92 compounds detected in the oil, camphor (13.0%) and caryophyllene oxide (10.87%) were the major components. All solvent extracts and the volatile oil showed in vitro antimalarial activity (1.8 – 20 µg/mL). Except for the infusion, all extracts were also active against other parasitic protozoa (Trypanosoma b. rhodesiense, T. cruzi, Leishmania donovani). This is the first study investigating both artemisinin and polymethoxyflavonoid content and detailed in vitro antiprotozoal potential of A. indica extracts and the essential oil

Analysis of Episodes of Care in Medicare Beneficiaries Newly Diagnosed with Alzheimer’s Disease

OBJECTIVES: To study transitions between healthcare settings and quantify the cost burdens associated with different combinations of transitions during a 6-month period before initial Alzheimer’s disease (AD) diagnosis so as to investigate how using an episode-of-care approach to payment for specific disease states might apply in AD. DESIGN: A retrospective observational cohort study. SETTING: United States. PARTICIPANTS: A random sample of 8,995 individuals aged 65 to 100 with a diagnosis of AD (International Classification of Diseases, Ninth Revision, Clinical Modification code 331.0) were identified from the Medicare database between January 1, 2011, and June 30, 2014. This analysis identified individuals with AD diagnosed in inpatient (18%), skilled nursing facility (SNF) (1%), hospice (4%), and home and outpatient (77%) settings and analyzed episodes that began in the index setting (defined as the care setting in which the individual was first diagnosed with AD). MEASUREMENTS: Study outcomes included number of transitions between settings, primary discharge diagnoses, and total all-cause healthcare costs during the 6 months after the AD diagnosis. RESULTS: The average numbers of transitions between care settings were 2.8 originating from an inpatient setting, 2.4 from a SNF, 0.3 from a hospice setting and 0.7 from a home or outpatient setting during 6 months post-AD diagnosis. The overall cost burden during the 6 months after AD diagnosis (including costs incurred at the index setting) was high for individuals diagnosed in a nonambulatory setting (mean $41,468). Individuals diagnosed in an ambulatory setting incurred only$12,597 in costs during the same period. CONCLUSION: Episodes of care can be defined and studied in individuals with AD. An episode-of-care approach to payment could encourage providers to use the continuum of care needed for quality medical management in AD more efficiently