Antisialogogues Commonly Prescribed In Children Undergoing Dental Treatment Under General Anaesthesia- A Retrospective Study

Introduction: Antisialogogue are drugs that reduce the production of saliva and produce opposite effects to sialogogues. These drugs are considered in procedures as they produce a good field for surgeries and help in reducing the salivary flow rate of the child in order to treat the patient effectively. These drugs are available as both natural and synthetic. Most commonly they are used in cases of RCT and extraction. Commonly used anti-sialogogue drugs include glycopyrrolate and atropine. Aim: Aim of the study is to find out the commonly prescribed antisialogogue in children undergoing dental treatment under General anaesthesia. Materials and Methods: This is a retrospective study. Data of the patients were collected from the dental hospital management system. Total of 88 samples were collected according to the inclusion criteria. The collected data was tabulated based on the age and type of antisialagogue used for the patients. The tabulated data were converted to variables and the data was imported to SPSS. The data were statically analysed and results were obtained accordingly. Results: In the present study, 1-3yrs (59.09%) of age have been the highest percentage of the children treated under antisialogogues and glycopyrrolate (70.45%) is the commonly used antisialagogue drug for treating patients under general anaesthesia. Conclusion: Under the limitation of the study it is concluded that the most commonly used anti-sialogogue in dental treatment under general anaesthesia is glycopyrrolate

Anti-Cancer Activity of Siddha Drug Ashta Bairava Chenduram against Oral Squamous Cell Carcinoma [OSCC] through In-Vitro Model

Traditional medicinal systems are gaining more importance when compared with conventional medicinal systems of the world. One such is the Siddha system. The Siddha system of medicine was introduced by the ancient scientists “Siddhars’’ who were the spiritual adepts, super human beings with high culture and intellectual abilities.The evaluation of therapeutic efficacy of the trial drug is “AshtaBairavaChenduram” from the Siddha literature “Pranarakshamirthasinthu” against Oral Carcinoma (kannaputtru) is dealt with in the entire study. Introduction of the study comprises about the prevalence of Carcinoma worldwide, which is found to be the major cause of the death in human. It is the right time to explore the therapeutic values of classic preparation against life threating malignancies to the society. In the Drug Review,details about the therapeutic efficacy, active principles of Arsenic compounds and other ingredients and their role in the Siddha formulations indicated for Cancer are discussed

ANTIFOULING EFFECTS OF GRACILARIA EDULIS TO SCREEN THE BIOCHEMICAL AND CYTOTOXICITY ASSAY IN MALLIPATTINAM HARBOUR

Ship operators have faced the problem of biofouling, or the adhesion and growth of organisms on submerged, man-made surfaces, for at least two millennia. Barnacles and other sessile marine invertebrates contribute to biofouling, which raises the frictional resistance of a ship's hull and increases the power and fuel needed to maintain speed. More than a century ago, scientists and engineers realized that a deeper understanding of the biology of the organisms involved particularly with regard to larval settlement and metamorphosis as well as adhesives and adhesion would be necessary to solve the biofouling problem. Using barnacles has been a valuable tool for this research. One strategy for studying innovative non-toxic anti-fouling materials used in this study is to take advantage of some marine organisms' intrinsic ability to manufacture chemical defense compounds in order to maintain an epibiont-free surface. In this study Gracilaria edulis was intensely analyzed for its biochemical constituents like protein and lipid content along with the cytotoxicity analysis. These newly developed materials can be helpful probes to further our understanding of these processes, even though basic research on topics like the nature of the interaction between organismal adhesives and the substrate or the ability of settling larvae to perceive surface cues has not had a significant impact on the development of most current biofouling control technologies

Influence of dissipation on extreme oscillations of a forced anharmonic oscillator

Dynamics of a periodically forced anharmonic oscillator (AO) with cubic nonlinearity, linear damping, and nonlinear damping, is studied. To begin with, the authors examine the dynamics of an AO. Due to this symmetric nature, the system has two neutrally stable elliptic equilibrium points in positive and negative potential-wells. Hence, the unforced system can exhibit both single-well and double-well periodic oscillations depending on the initial conditions. Next, the authors include nonlinear damping into the system. Then, the symmetry of the system is broken instantly and the stability of the two elliptic points is altered to result in stable focus and unstable focus in the positive and negative potential-wells, respectively. Consequently, the system is dual-natured and is either non-dissipative or dissipative, depending on location in the phase space. Furthermore, when one includes a periodic external forcing with suitable parameter values into the nonlinearly damped AO system and starts to increase the damping strength, the symmetry of the system is not broken right away, but it occurs after the damping reaches a threshold value. As a result, the system undergoes a transition from double-well chaotic oscillations to single-well chaos mediated through extreme events (EEs). Furthermore, it is found that the large-amplitude oscillations developed in the system are completely eliminated if one incorporates linear damping into the system. The numerically calculated results are in good agreement with the theoretically obtained results on the basis of Melnikov's function. Further, it is demonstrated that when one includes linear damping into the system, this system has a dissipative nature throughout the entire phase space of the system. This is believed to be the key to the elimination of EEs.Comment: 15 pages, 9 figures. Accepted for publications in International Journal of Non-Linear Mechanic

Stroke Volume variation as a predictor for fluid responsiveness in patients undergoing elective major abdominal surgeries

INTRODUCTION: Stroke volume variation may be used as a continuous preload variable and in combination with the continuously measured cardiac output, the most important characteristics of cardiac function, allowing for optimal fluid management. In patients undergoing major abdominal surgery, preoperative fasting, induction of general anesthesia, epidural analgesia and intraoperative bleeding may decrease intravascular volume, blood pressure, as a result leads to compromise perfusion of organs. Conventional hemodynamic variables, such as blood pressure, heart rate (HR), central venous pressure (CVP), and even pulmonary artery occlusion pressure (PAOP), are insensitive and sometimes misleading in the assessment of circulating blood volume. Measuring left ventricular (LV) end-diastolic area by transesophageal echocardiography (TEE), although considered to be the clinical “gold standard” for the estimation of preload, is limited to a small number of patients and is not routinely used in most operating rooms. As an alternative to these static variables, assessment of stroke volume variation (SVV) has been used as a dynamic index to guide fluid therapy in patients receiving mechanical ventilation. The SVV are more pronounced during hypovolemia and the variation decreases if intravascular volume is restored, and it has shown to reliably predict changes in cardiac output. AIM OF THE STUDY: 1. To assess whether Stroke volume Variation (SVV) can serve as a predictor of fluid responsiveness in patients undergoing elective major abdominal surgery. 2. To compare Stroke volume variation (SVV) with Central venous pressure (CVP) for fluid responsiveness. METHODS: Study Design: This study was a prospective observational study conducted in Government Stanley Medical College and Hospital, Chennai. Study Setting and Population: The Institutional Ethical committee approval was obtained before commencement of the study. Written informed consent was obtained from all the patients. Twenty five adult patients of ASA Physical status 1& 2 of either sex undergoing elective abdominal surgical procedures under general anaesthesia were enrolled in the study. The study was conducted at the Surgical gastroenterology theatre complex, Stanley Medical College and Hospital, Chennai. The study was conducted from May 2011 to August 2011.All major abdominal surgeries within this period who fit into the inclusion criteria were included in the study. PATIENT SELECTION: Inclusion criteria: 1. Elective major abdominal surgery (intestine resection, gastric resection, Whipple procedure, frey procedure), 2. Both genders, 3. Age 18-60 YRS, 4. ASA PS I/II. Exclusion criteria: 1. Patients under 18 years, 2. Patient > 60 yrs, 3. ASA PS III/IV, 4. Patients with severe aortic regurgitation, 5. Patients with renal impairment, 6. Permanent cardiac arrhythmias, 7. Intra-aortic balloon pump, 8. Patients undergoing emergency surgery were excluded from the study. Study Materials: The materials need for the study included 1. Intravenous Cannula, 2. Drugs for general anesthesia, 3. Inj. Fentanyl, 4. Inj. Propofol, 5. Inj. Atracurium, 6. Appropriate size endotracheal tubes and laryngoscopes, 7. Standard Monitors – pulse oximeter, ECG, NIBP, ETCO2, 8. All emergency drugs, 9. Anesthesia Ventilator, 10. Arterial Catheter 20 G, 11. Central venous catheter 7 Fr, 12.Vigileo Flotrac monitor with transducer. Study Methods: After obtaining ethical committee clearance Twenty five patients of similar age group, weight and equal sex distribution were included in the study. Informed written consent was obtained. Detailed history of past medical/surgical were obtained. Statistical Analysis: Twenty five patients of either sex belonging to ASA PS 1 & 2, undergoing elective abdominal procedures under general anaesthesia were studied. Each patient underwent six volume loading steps. A total of 150 volume loading steps were performed. 1. All hemodynamic variables were analyzed as continuous variables and expressed as the mean ± SD. 2. To determine whether hemodynamic variables changed in relation to volume loading, differences between values before and after each VLS were compared between responsive and nonresponsive VLSs by using a Paired sample t-test. 3. The correlation between changes in SV and changes in hemodynamic variables was assessed by using Pearson’s correlation test. 4. Receptor operation characteristic curves29 were drawn for each hemodynamic variables and the area under the curve was obtained. All data analysed using SPSS 16.0 version (SPSS Inc., Chicago, IL). SUMMARY: The Vigileo™/FloTrac™ system (Edwards Life sciences, Irvine, CA) is based on the analysis of the systemic arterial pressure wave without external calibration to continuously monitor cardiac output (CO) and SVV. It has been shown that SVV-FloTrac is a good indicator of fluid responsiveness by various studies conducted in cardiac patients18,abdominal procedures and in critically ill patients on mechanical ventilator. The aim of this study was to assess whether SVV can serve as a predictor of fluid responsiveness in patients undergoing elective abdominal surgery and to compare its predictive value to the CVP and to commonly measured hemodynamic variables like heart rate, MAP, Systolic, diastolic blood pressure. Twenty five patients of ASA PS 1/II who underwent elective abdominal surgeries were included in the study. A total of 150 volume loading steps (VLS) were performed of which 75 was volume responsive and 75 was nonresponsive. Comparison of the various hemodynamic variables before and after fluid loading were statistically analysed. Our observations were, 1. There was correlation between the change in SV and the values of SVV. No correlation was found between the changes in SV and the values of the CVP. 2. The change in SVV was pronounced in responders in comparison to non responders. But the change in CVP were not statistically significant in responders and non responders. 3. Hemodynamic variable Before fluid loading, SVV (>13%) were significantly higher and CVP were significantly lower in Responders than in Non Responders. 4. The area under the curve for SVV was Statistically more than those for CVP. 5. MAP,DBP,SBP were also found to be predictors with less area under the curve in ROC curves when compared to SVV. 6. The optimal threshold values given by ROC for SVV was 10.5%. Thus if a patient had a SVV value of more than 10.5% he was very likely to be responsive to a subsequent volume load by increasing his stroke volume by 5% with a sensitivity of 92 % and specificity of 64%. CONCLUSIONS: This prospective study demonstrates that Stroke volume variation is a reliable predictor of fluid responsiveness in the setting of major abdominal surgery when compared to the central venous pressure, though central venous pressure is used for current intraoperative fluid management

A Novel Framework For User Customizable Privacy Preserving Search

The objective of the Personalized web search (PWS) is to provide an effective and efficient search results, which are tailor mode for individual user needs. we build user profiles based on user preference and these profiles are then used to re-rank the search results and rank the order of user-examined results.User privacy can be protected without affecting the personalized search quality. However, users are troubled, with exposing personal preference information to search engines has become a major limitation for profile based personalized web search.The Privacy-preserving personalized web search framework is called UPS framework which can generalize profiles for each query according to user-specific privacy requirements. .In general, there is a tradeoff between the search quality and the level of privacy protection achieved from generalization. Effective generalization algorithms namely GreedyDP and GreedyIL are used to support the runtime profiling. Experiments are conducted on real web search data show that the algorithms are effective in enhancing the stability of the search quality and avoids the unnecessary exposure of the user profile. DOI: 10.17762/ijritcc2321-8169.150313

Analysis of voluntary reported adverse drug reactions in a tertiary care hospital

Background: Adverse drug reactions are the major cause for increased hospital stay and it increases the economic burden of the patients. Reporting of ADR helps in signal generation and to ensure safe use of a drug. Present study was conducted to analyse the ADR reporting pattern and completeness of the ADR forms. Methods: This was a retrospective study conducted for 6 months in a tertiary care hospital. A total of 330 ADR forms were analysed and completeness of ADR forms were assessed. Results: A total of 330 ADRs were reported. 46% ADRs were reported in 2018, 23% in 2019, 11% in 2020, 8.9% in 2021 and 10.7% in 2022. 177 (53%) were males and 153 (47%) were females. Most occurred reaction was Hyponatremia 22 (6%), followed by Hypokalaemia 18 (5%). Neuropsychiatry cases were 62 (18.78%), Urinary system cases were 45 (13.63%). 122 (88%) patients were taking concomitant drugs whereas only 17 (12%) patients were not taking. Above 80% completeness were seen in 155 (46.96%) forms. Above 70% completeness in 292 (88.68%) forms. Conclusions: ADRs occurrence was high in male compared to female. Most of the ADRs affected Neuropsychiatry followed by Urinary system. Antimicrobials are responsible for majorly reported ADRs followed by cephalosporins (17.6%) and Penicillin (11.76%). Overall completeness of reported ADR form was 80%, 67.87% of forms were not adequately filled with mandatory fields.

CASE STUDY ON BETA BLOCKERS INDUCED PSORIASIS

Drug-induced Psoriasis is one among the common etiological factors of Psoriasis reported worldwide. Familiar drugs known to cause psoriasiform eruptions include Anti-malarials, Beta blockers, NSAIDs, Lithium. etc. Certain antihypertensives like ACE inhibitors, diuretics are also documented to have caused psoriatic episodes. A 57 y old South-Indian male patient with a history of Hypertension, Diabetes Mellitus, Atrial Fibrillation for 4 y; was on antihypertensive therapy for Hypertension and Atrial Fibrillation with proponolol for past 2 y and metoprolol initially. He was presented to the hospital two weeks after switching on to Metoprolol therapy for chief complaints of erythematous scaly lesions especially over both the extremities and paronydrial appearance of nails. Initially, he was on Propranolol therapy which was then shifted to Metoprolol due to an appearance of oral lesions in the mouth. Metoprolol was now discontinued and switched on to Atenolol. After 1-2 w of therapy with Atenolol, the lesions were found to disappear and no recurrence of psoriatic conditions were found. Proper reviewing of medical history for any allergic reactions and the optimization of drug therapy through Therapeutic Drug Monitoring could be initiated by Clinical Pharmacist in order to avoid such drug-induced flares