Chemically cross-linked poly(acrylic-co-vinylsulfonic) acid hydrogel for the delivery of isosorbide mononitrate.

We report synthesis, characterization, and drug release attributes of a series of novel pH-sensitive poly(acrylic-co-vinylsulfonic) acid hydrogels. These hydrogels were prepared by employing free radical polymerization using ethylene glycol dimethacrylate (EGDMA) and benzyl peroxide (BPO) as cross-linker and initiator, respectively. Effect of acrylic acid (AA), polyvinylsulfonic acid (PVSA), and EGDMA on prepared hydrogels was investigated. All formulations showed higher swelling at high pHs and vice versa. Formulations containing higher content of AA and EGDMA show reduced swelling, but one with higher content of PVSA showed increased swelling. Hydrogel network was characterized by determining structural parameters and loaded with isosorbide mononitrate. FTIR confirmed absence of drug polymer interaction while DSC and TGA demonstrated molecular dispersion of drug in a thermally stable polymeric network. All the hydrogel formulations exhibited a pH dependent release of isosorbide mononitrate which was found to be directly proportional to pH of the medium and PVSA content and inversely proportional to the AA contents. Drug release data were fitted to various kinetics models. Results indicated that release of isosorbide mononitrate from poly(AA-co-VSA) hydrogels was non-Fickian and that the mechanism was diffusion-controlled

A prospective randomized controlled trial comparing the effects of dexmedetomidine and fentanyl on attenuation of pressor response during laryngoscopy and intubation in neurosurgical patients

Background: Laryngoscopy is associated with a sympathetic response that results in a rapid increase in blood pressure and heart rate in these patients. The mechanisms underlying these hemodynamic changes are incompletely understood. They may be caused by a reflex sympathetic discharge due to stimulation of the upper respiratory tract. It has been observed that hemodynamic responses to tracheal intubation are associated with an increase in plasma catecholamine concentrations and are attenuated by β-adrenergic blockade. These hemodynamic changes may be undesirable particularly in neurosurgical patients. Aim of the study is the present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy and intubation in neurosurgical patients undergoing lumbar spine surgeries.Methods: A total of 60 patients of 18–65 years, American Society of Anaesthesiologists Class I/II of undergoing elective neurosurgical procedures were included in the study. The patients were divided into two groups of 30 patients each. Group D received dexmedetomidine and Group F received Fentanyl. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) were recorded preoperatively (baseline), at 5 and 8 minutes after infusion of study drug, before induction, 1 minute after induction, 2 minute after intubation, 5 minute after intubation, 10 minute after intubation  and 15 minute after intubation.Results: There was a better control of Heart rate, systolic blood pressure, diastolic blood pressure   and mean arterial pressure in Group D when compared to Group F during laryngoscopy and after intubation.Conclusions: The present study shows that dexmedetomidine suppresses hemodynamic responses effectively than fentanyl

Camel Milk as Adjuvant to Treat Alloxan Diabetes: Effect of Heat Treatment on this Property

Diabetes is one of the most frequent and serious chronic diseases in humans all over the world. The aim of our study was to evaluate the effect of heat treatment on antidiabetic activity of camel milk on serum glucose and lipid profile of alloxan-induced diabetic rats. Diabetes was induced in Wistar albino rats by intraperitoneal injection of alloxan (120 mg/kg BW once). Albino rats each weighing 180-230g were divided into 3 equal groups (n=4) as following: G1- normal rats fed on normal diet, G2 - diabetic rats fed on normal diet, and G3 - diabetic rats were fed with raw camel milk. Fasting blood glucose was measured lipid profile was assessed. Results: Our study showed a significant effect of raw camel milk on blood glucose and lipid profile parameters in alloxan induced diabetic rats, there was a significant reduction in lipid profile of T. Cholesterol, Triglycerides, LDL-C in (Diabetic+ Raw camel milk) comparing to (Diabetic+ Pasteurized camel milk) and Positive control group with values 121.4 mg/dl, 80.4 mg/dl, 17.9 mg/dl and 141.5 mg/dl, 90.7 mg/dl, 28.7 mg/dl and 181.6 mg/dl, 113.8 mg/dl, 48.9 mg/dl respectively. Diabetic+ Boiled camel milk group died at the end of experiment. Conclusion: Raw camel milk improved the glycemic and lipid profile in diabetic rats but not in Diabetic+ Boiled camel milk group. These findings indicate that boiling of raw camel milk may have reducing potential benefits in the treatment of diabetes. Future studies will be needed to establish its safety and mechanism of action

Asymmetric Impact of Institutional Quality on Tourism Inflows Among Selected Asian Pacific Countries

From an idealistic viewpoint, the existence of the tourism industry in a country/region is a blessing because of its anticipated sustainable economic benefits. To turn this idealistic state into a realistic one, institutions need to play a pivotal role in optimizing the desired incentives. The present study examines the asymmetric role of institutional quality in stimulating tourism inflows (receipts and arrivals) in selected Asia Pacific countries involved in tourism. The previous literature has established that improving institutional quality attracts tourism inflows to a destination. However, the literature fails to identify the specific point (threshold level) above (below) which the relationship turns positive (negative). To the best of our knowledge, this is the first study that estimates the asymmetries in the nexus of institutions and tourism inflows, using robust nonlinear autoregressive distributed lag approach. Our results show that the tourism inflow in Asian Pacific countries responds asymmetrically to any changes in institutional quality, and there is a single threshold of 7.52 points, where the impact of institutional quality reverses. We conclude that our findings are robust to the alternative measures of tourism inflows. The study offers useful policy inputs for devising short and long-run policies for the betterment of the institutional framework in the region by understanding the asymmetric impact of institutional quality on tourism inflow

Encapsulated virgin coconut oil as a nanoscale in vitro solution against multiple drug resistant Staphylococcus aureus

Abstract Niosomes are excellent nanoscale vehicular systems that can carry a variety of drugs and (bioactive) compounds entrapped inside them. Virgin coconut oil (VCO) is the finest grade of coconut oil that is highly enriched with phenolic content, antioxidant activity and also comprises medium chain triglycerides. In this work, niosomes were encapsulated with VCO synthesized by a simple chemical method. The electron microscopy confirmed that spherical nanostructured lipid carrier molecules with a diameter in the range of 180–190 nm were produced. A zeta potential value of −42 mV was a testimony that these nanovehicles were having good stability. The natural oil loaded nanocarrier spheres proved to be potent antibacterial nano‐antibiotics against multiple drug resistant (MDR) bacteria. The antibacterial activity of these magic nano‐spheres was found to be better than ZnO (metallic oxides) nanoparticles. The nano‐antibiotics resulted in 17, 14 and 12 mm zones of inhibition against methicillin‐resistant Staphylococcus aureus (MRSA), vancomycin‐resistant S. aureus (VRSA) and a (general) MDR strain of S. aureus in contrast to nanoparticles that resulted in zones of inhibitions 7, 8 and 6 mm for the same bacterial strains. Niosomes prove to be an excellent nanocarrier system that can encapsulate a number of bio‐active compounds

pH-sensitive polyvinylpyrrolidone-acrylic acid hydrogels: Impact of material parameters on swelling and drug release

In this study, we fabricated pH-sensitive polyvinylpyrrolidone/acrylic acid (PVP/AA) hydrogels by a free-radical polymerisation method with variation in the content of monomer, polymer and cross-linking agent. Swelling was performed in USP phosphate buffer solutions of pH 1.2, 5.5, 6.5 and 7.5 with constant ionic strength. Network structure was evaluated by different parameters and FTIR confirmed the formation of cross-linked hydrogels. X-ray crystallography showed molecular dispersion of tramadol HCl. A drug release study was carried out in phosphate buffer solutions of pH 1.2, 5.5 and 7.5 for selected samples. It was observed that swelling and drug release from hydrogels can be modified by changing composition and degree of cross-linking of the hydrogels under investigation. Swelling coefficient was high at higher pH values except for the one containing high PVP content. Drug release increased by increasing the pH of the medium and AA contents in hydrogels while increasing the concentration of cross-linking agent had the opposite effect. Analysis of the drug release mechanism revealed non-Fickian transport of tramadol from the hydrogels.Nesse estudo, preparamos hidrogéis de polivinilpirrolidona/ácido acrílico(PVP/AA), sensíveis ao pH, por meio de método de polimerização de radical livre, com variações no conteúdo de monômero, de polímero e de agente de ligação cruzada. O inchamento foi realizado em soluções tampão fosfato USP pH 1,2, 5,5, 6,5 e 7,5, com força iônica constante. A estrutura reticular foi avaliada por diferentes parâmetros e o FTIR confirmou a formação de hidrogéis de ligação cruzada. A cristalografia de raios X mostrou dispersão molecular do cloridrato de tramadol. Realizou-se estudo de liberação do fármaco em soluções tampão fosfato pH 1,2, 5,5 e 7,5 para amostras selecionadas. Observou-se que o inchamento e a liberação do fármaco dos hidrogéis podem ser modificados mudando-se a composição e o grau de ligação cruzada dos hidrogéis em estudo. O coeficiente de inchamento foi alto em pH mais altos, exceto para um deles com alto conteúdo de PVP. A liberação do fármaco aumentou com o aumento do pH do meio e do conteúdo em AA nos hidrogéis, enquanto que o aumento na concentração do agente de ligação cruzada apresentou efeito oposto. A análise do mecanismo de liberação do fármaco revelou transporte não Fickiano do tramadol dos hidrogéis

A review of the blood transfusion practices in neuroanesthesia in the perioperative period in a tertiary care hospital

Background: Blood transfusion involves the administration of blood and blood components. Neurosurgical procedures are associated with significant blood loss with the need for blood transfusion in the preoperative, intraoperative and postoperative period to maintain optimal hemodynamic and cerebral oxygenation. Various neurosurgical procedures as traumatic brain injury, complex spinal surgeries, and endovascular neurosurgical procedures may need blood transfusions to maintain the optimal physiology.Methods: This study was performed prospectively at a tertiary care hospital in northern India with about a work load of 800 to 1000 elective neurosurgical surgical procedures being done per year. This data was collected prospectively over a period of one year from the patients being operated for elective neurosurgical procedures and later on shifted to the neurosurgical intensive care unit and the neurosurgical wards. The patients operated for emergency procedures for traumatic brain surgery were not included in the study.Results: A total of 455 elective neurosurgical procedures were done during the study period. Out of these 455 patients there were 95 patients who were in the paediatric age group with age less than 12 years. Out of 360 adult patients 85 patients were in need of blood transfusion which constituted 23.6 percent of the operated patients.   Out of these 85 patients 45 patients needed two transfusions in the form of whole blood or packed cells, 40 patients needed a single transfusion.42 units of fresh frozen plasma were transfused to 17 patients with 15 patients receiving platelet transfusions.Conclusions: In conclusion, neurosurgical population is associated with significant blood loss and a requirement of blood transfusion. About 47 percent of paediatric population needed blood transfusion in our study with around 24 percent of adult population. The transfusion requirement was mainly seen in patients with craniostenosis, meningiomas, cerebello pontine tumours and meningiomas

Improving a Dental School\u27s Clinic Operations Using Lean Process Improvement

The term lean production, also known as Lean, describes a process of operations management pioneered at the Toyota Motor Company that contributed significantly to the success of the company. Although developed by Toyota, the Lean process has been implemented at many other organizations, including those in health care, and should be considered by dental schools in evaluating their clinical operations. Lean combines engineering principles with operations management and improvement tools to optimize business and operating processes. One of the core concepts is relentless elimination of waste (non-value-added components of a process). Another key concept is utilization of individuals closest to the actual work to analyze and improve the process. When the medical center of the University of Kentucky adopted the Lean process for improving clinical operations, members of the College of Dentistry trained in the process applied the techniques to improve inefficient operations at the Walk-In Dental Clinic. The purpose of this project was to reduce patients\u27 average in-the-door-to-out-the-door time from over four hours to three hours within 90 days. Achievement of this goal was realized by streamlining patient flow and strategically relocating key phases of the process. This initiative resulted in patient benefits such as shortening average in-the-door-to-out-the-door time by over an hour, improving satisfaction by 21%, and reducing negative comments by 24%, as well as providing opportunity to implement the electronic health record, improving teamwork, and enhancing educational experiences for students. These benefits were achieved while maintaining high-quality patient care with zero adverse outcomes during and two years following the process improvement project