Nitric Oxide Bioavailability and Its Potential Relevance to the Variation in Susceptibility to the Renal and Vascular Complications in Patients With Type 2 Diabetes

OBJECTIVE—We compared the renal and systemic vascular (renovascular) response to a reduction of bioavailable nitric oxide (NO) in type 2 diabetic patients without nephropathy and of African and Caucasian heritage. RESEARCH DESIGN AND METHODS—Under euglycemic conditions, renal blood flow was determined by a constant infusion of paraminohippurate and changes in blood pressure and renal vascular resistance estimated before and after an infusion of l-Ng-monomethyl-l-arginine. RESULTS—In the African-heritage group, there was a significant fall in renal blood flow (Δ−46.0 ml/min per 1.73 m(2); P < 0.05) and rise in systolic blood pressure (Δ10.0 mmHg [95% CI 2.3–17.9]; P = 0.017), which correlated with an increase in renal vascular resistance (r(2) = 0.77; P = 0.004). CONCLUSIONS—The renal vasoconstrictive response associated with NO synthase inhibition in this study may be of relevance to the observed vulnerability to renal injury in patients of African heritage

Microbiological surveillance of operation theatres, intensive care units and labor room of a teaching hospital in Telangana, India

Background: Hospital-associated infections are the major cause of patient morbidity and mortality. Environmental monitoring by the microbiological testing of surfaces and equipments is useful to detect changing trends of types and counts of microbial flora. The aims of the study were to count CFU (colony forming unit) rate of indoor air, to identify bacterial colonization of surface and equipments isolated from Operation theatres, ICUs and Labor room of a teaching hospital in Telangana, India.Methods: Air sampling of 10 OT’s, 4 ICU’s and 1 LR were done by settle plate method. Swabs were taken from different sites and equipments and bacterial species were isolated and identified from them.Results: Gynaecology OT-2 and 3 showed less bacterial CFU rate of air (6 CFU/m3) followed by Opthamology OT (16 CFU/m3) and highest in Orthopaedics minor OT (72 CFU/m3) and Dental OT (42 CFU/m3 with 1 fungal CFU/m3). Pediatric ICU showed less bacterial CFU rate (28 CFU/m3) followed by Surgery ICU (40 CFU/m3) and highest in Medical ICU (100 CFU/m3 and 5 fungal CFU/m3). Labor room showed 65 CFU/m3. Bacterial species were isolated from 48 (43%) out of total 111 swab samples taken from all OTs and ICUs. The most common isolate was Bacillus species 36 (75%) followed by micrococcus (54%). Pathogenic organisms isolated were 12 Gram negative bacilli and 6 gram positive cocci, the common isolate was Klebsiella spp (7 of 12).Conclusions: The study shows that OTs were having bacterial CFU rate of air varying from 6-72 CFU/m3 and colonized by contaminants like Bacillus sp and pathogens like Klebsiella sp. ICUs were having bacterial CFU rate of air varying from 28-100 CFU/m3 and colonized with contaminant like Bacillus sp., as well as potential pathogens like Klebsiella, Pseudomonas etc. Fungal CFU were also seen both in OTs and ICUs. High level of microbial contamination indicates the needs for periodic surveillance aimed at early detection of bacterial contamination levels and prevention of hospital acquired infections

SYNTHESIS, ANTIOXIDANT AND ANTI-INFLAMMATORY ACTIVITIES OF ETHYL 2-(2-CYANO-3- (SUBSTITUTED PHENYL)ACRYLAMIDO)-4,5-DIMETHYLTHIOPHENE-3-CARBOXYLATES

Objective: Objective of the study was to synthesize and evaluate a series of novel compounds, ethyl 2-(2-cyano-3-(substituted phenyl)acrylamido)- 4,5-dimethylthiophene-3-carboxylates, for in vitro antioxidant and in vivo anti-inflammatory activities.Methods: Ethyl 2-(2-cyano-3-(substituted phenyl)acrylamido)-4,5-dimethylthiophene-3-carboxylates were synthesized by knoevenagel condensation of active methylene group of ethyl 2-(2-cyanoacetamido)-4,5-dimethylthiophene-3-carboxylate with substituted benzaldehydes. The synthesized compounds were evaluated for their in vitro antioxidant properties in three different models, viz., reduction of 1,1-diphenyl-2-pycrylhydrazyl free radical, scavenging of nitric oxide free radical, and ferric ion-induced lipid peroxidation using rat brain homogenate. Few selected compounds with good antioxidant properties were pharmacologically evaluated for anti-inflammatory activity by carrageenan-induced rat paw edema model.Results: Clean and efficient synthetic procedure was used for the preparation of series of compounds. The structures of synthesized compounds were confirmed by infrared, 1H nuclear magnetic resonance and mass spectra. The antioxidant activity data revealed that the compounds of ethyl 2-(2-cyano-3-(substituted phenyl)acrylamido)-4,5-dimethylthiophene-3-carboxylate containing phenolic substitution showed greater antioxidant activity. Hence, the active compounds were evaluated for anti-inflammatory activity and found to possess good activity. The percentage inhibition of rat paw edema obtained for the evaluated compounds was in the range of 70.2-83.1, comparable to the standard drug diclofenac (85.0%).Conclusion: The use of inexpensive, eco-friendly and readily available reagents, easy work-up and high purity of products makes the procedure a convenient and robust method for the synthesis of title compounds. The compounds of ethyl 2-(2-cyano-3-(substituted phenyl)acrylamido)-4,5- dimethylthiophene-3-carboxylate containing phenolic substitution showed greater antioxidant and anti-inflammatory activities

Title predictors of difficult subarachnoid block

Background: The aim of this prospective randomised study was to evaluate the association of four patient variables with difficulty in subarachnoid block. These variables are age, BMI, quality of bony landmarks and anatomical abnormality of spine. An attempt was made to prepare a difficulty score to predict this difficulty and assess it’s predictive value.Methods: 498 patients scheduled for surgical procedures under subarachnoid block were included. Each patient was assigned a difficulty score according to gradation of four variables. The difficulty was assessed in terms of number of levels, number of  attempts, and completeness of  anaesthesia. Since all these variables operated simultaneously and randomly in each patient, multivariate analysis was used with SPSS version 11.5. ROC curves were used to evaluate the sensitivity and specificity of the score. ROC curves were plotted at scores of 2, 3, 4 and 5 and AUC was compared.Results: This study was successful in preparing a score to predict difficulty in subarachnoid block. A score of 4 or more is indicative of difficulty as far as number of attempts and levels is concerned. However, completeness of anaesthesia could not be predicted with this score.Conclusions: This difficulty score can enable the anaesthetist to predict a difficult spinal puncture. This is a distinct advantage as multiple attempts are not without hazards

FORMULATION AND IN VITRO CHARACTERIZATION SOLID SELF EMULSIFYING DRUG DELIVERY SYSTEM OF RAMIPRIL PREPARED BY ADSORPTION TECHNIQUE

Objective: The primary goal of the present work was to formulate solid self-emulsifying drug delivery systems (S-SEDDS) in order to improve the solubility of the highly lipophilic antihypertensive drug, ramipril. Methods: SEDDS are generally liquid form preparations obtained by homogeneously mixing oils, surfactants and co-surfactants along with drug component. Based on solubility studies Capmul PG8 NF, Gelucire 44/14 and Transcutol P were selected as oil, surfactant, co-surfactant respectively in order to prepare liquid SEDDS (L-SEDDS). Nine different liquid SEDDS were prepared and subjected to various evaluation tests in order to obtain optimized L-SEDDS. Finally, the optimized formulation was converted to S-SEDDS by physical adsorption technique using an inert carrier. Further, S-SEDDS were also subjected to solid state characterization. Results: Out of 9 different L-SEDDS, S9 formulation was optimized as it formed thermodynamically stable emulsion without any drug precipitation and phase separation on storage and also showed least globule size (22.56 nm). The optimized formulation was loaded onto inert carrier (Sylysia FCP 350) to obtain S-SEDDS. S-SEDDS showed acceptable flow properties. They were further processed for solid state characterization such as XRD, DSC and SEM and the results confirmed the transformation of native crystalline nature of drug to an amorphous state. FTIR analysis also confirmed no drug-excipient interaction. S-SEDDS showed improved in vitro dissolution behaviour of ramipril over that of pure drug. Conclusion: Ramipril S-SEDDS retained emulsification characteristics of L-SEDDS. Further, S-SEDDS was encapsulated in hard gelatin capsules and this formulation proved to have improved solubility for ramipril

Cardiovascular Disease Risk among Rural Population of South India

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Convolutional recurrent neural network with template based representation for complex question answering

Complex Question answering system is developed to answer different types of questions accurately. Initially the question from the natural language is transformed to an internal representation which captures the semantics and intent of the question. In the proposed work, internal representation is provided with templates instead of using synonyms or keywords. Then for each internal representation, it is mapped to relevant query against the knowledge base. In present work, the Template representation based Convolutional Recurrent Neural Network (T-CRNN) is proposed for selecting answer in Complex Question Answering (CQA) framework. Recurrent neural network is used to obtain the exact correlation between answers and questions and the semantic matching among the collection of answers. Initially, the process of learning is accomplished through Convolutional Neural Network (CNN) which represents the questions and answers separately. Then the representation with fixed length is produced for each question with the help of fully connected neural network. In order to design the semantic matching between the answers, the representation of Question Answer (QA) pair is given into the Recurrent Neural Network (RNN). Finally, for the given question, the correctly correlated answers are identified with the softmax classifier