In vivo effects of nonionic and ionic contrast media on beta-thromboglobulin and fibrinopeptide levels

AbstractNonionic contrast media are suggested to cause increased thromboembolism (in vivo), platelet aggregation and procoagulant effect (in vitro) as compared with ionic contrast media. To study these effects in vivo, 30 consecutive patients undergoing routine angiography were prospectively randomized to three groups of 10 patients each. Group A received diatrizoate (ionic, high osmolality), Group B ioxaglate (ionic, low osmolality) and Group C iohexol (nonionic, low osmolality). In vivo platelet alpha-granule release and fibrin-1 formation were measured by radioimmunoassay of beta-thromboglobulin and fibrinopeptide A in peripheral venous samples.Levels were estimated at three stages daring the procedure: before and after left ventriculography and after coronary angiography. No differences were noted (p = NS) when the ratios of beta-thromboglobulin and fibrinopeptide A were compared among the three groups. These data suggest that the newer nonionic contrast media do not demonstrate enhanced systemic platelet activation or fibrin formation as compared with standard ionic contrast media. However, larger randomized clinical studies are necessary to conclusively establish the suggested thromboembolic potential of nonionic contrast media

Development and Validation of UPLC-MS/MS Method for Rapid Simultaneous Determination of Levothyroxine and Liothyronine in Human Serum

A simple ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) method was developed and fully validated to simultaneously determine levothyroxine (LT4) and liothyronine (LT3) in human serum. Sample preparation was done through protein precipitation with acetonitrile. HyPURITY C18 column was selected to achieve rapid separation for LT4 and LT3 within 4 min. Electrospray ionization (ESI) under multiple reaction monitoring (MRM) was used to monitor the ion transitions for LT4 (m/z 777.54→731.52), LT3 (m/z 651.64→ 605.65) and internal standard LT4-D3 (m/z 780.53 →734.19), operating in the positive ion mode. The method was proved to be accurate (82.35% to 113.56%) and precise (0.73% to 8.28%) over concentration range of 50.37 ng/ml – 300.13 ng/ml for LT4 and 0.5 ng/ml – 50.37 ng/ml for LT3. The validated method could be applied for pharmacokinetic study or bioequivalence testing of combination products of LT4 and LT3. Keywords: Levothyroxine; Liothyronine; Ultra Performance Liquid Chromatographic; Mass Spectrometry; Human Seru

A comparative study of the fracture union between long and short proximal femoral intramedullary nails antirotation in the treatment of intertrochanteric femur fractures in the elderly: a multicentric analysis

Background: The objective of the study was to compare the fracture union of long vs. short proximal femoral intramedullary nail antirotation (PFNA) in the treatment of intertrochanteric fractures in elderly patients who was more than 60 years old.Methods: A retrospective analysis of 170 cases of intertrochanteric fractures of the femur (AO type A1 and A2) in the elderly was conducted. There were 64 males (37.6%) and 106 females (62.3%) with the age of 60–90 (mean age 75) years. The general demographic data of patients, operation time, intraoperative blood loss, length of hospital stay, blood transfusion rate, anterior thigh pain, postoperative complications like periprosthetic fractures, infections were recorded.Results: The short nail group also had a significantly shorter operation time (41.5±15.3 minutes vs. 62.5±25.3 minutes, p=0.002) and lower rate of postoperative transfusion (31.3% vs. 58.7%, p=0.041). However the length of hospital stay showed no significant differences. After surgery in short group there were 03 cases of periprosthetic fracture with a total incidence of 03%, however there were none in long nail group. At the end of the follow-up, all patients achieved bony union. The average fracture union time of the long nail group was (8.5±3.2) months, and the short nail group was (7.8±4.7) months, revealing no significant differences (p=0.09).Conclusions: Both the proximal femoral intramedullary long and short nail fixation has a good result in the form of fracture union in treating intertrochanteric femur fractures in the elderly. They showed no significant difference in terms of fracture union, hospital stay, and postoperative complications. The incidence of periprosthetic fractures and anterior thigh pain was slightly high in short nail group. In short intramedullary nailing group there was obvious decrease in the intraoperative blood loss, operation time and postoperative blood transfusion

Oro-facial aspects of leprosy : report of two cases with literature review

Leprosy is a chronic infectious disease affecting primarily the skin, peripheral nerves, respiratory system and the eyes. Leprosy induces various types of clinical presentation affecting the patient´s immune response. Cellmediated immunity is considered to be the crucial defence against the disease and the magnitude of this immunity defines the extent of the disease. The article presents two case reports of manifestations of leprosy in the oro-facial region, with a brief review of various other important oro-facial manifestations of leprosy. The first report deals with granulomatous nodules in the palate while the second report presents bilateral facial palsy in leprosy patients. Both the reports gain importance due to rare oral manifestation in a borderline leprosy patient in the first case, while the second case presents a rare bilateral Bell´s sign. The role of the dental profession and especially the Oral Medicine specialist is of great importance in early diagnosis of oral lesions

Investigation of Hazardous Materials in Firecrackers using LIBS Coupled with a Chemometric Method and FTIR Spectroscopy

This article reports the detection and quantification of toxic constituents in firecrackers using LIBS coupled with PCA and FTIR. Spectral signatures of lethal elements along with other elements and electronic bands of Cyanide, AlO, BaO, and CaO are seen in their LIBS spectra which confirms the presence of inorganic and organic compound in the fireworks. The concentration of each constituent/element is determined using the CF-LIBS method and results are compared with ICP-OES results. The concentration of Al is in adequate amount except S4 (b). Li and Ba are present in all samples with maximum amount in S4 (b) and S3 respectively. Molecular stretching of SO4-, C4 H8 - , CuCl- , CO3 - , and NO3 - are observed in the FTIR spectra of the samples. The combined results of LIBS and FTIR recommends the presence of BaNO3 , LiCO3 , SrCO3 , Al-chip, and charcoal in the firecrackers. To discriminate various firecrackers, PCA of the LIBS data is performed. The results show that S3 and S4 (b) are more harmful as they contain higher concentration the compounds of Al, Ba, Li, Sr i.e BaNO3 , LiCO3 , SrCO3 , (Cu3 As2 O3 Cu(C2 H3 O2 )2 )

Acute limb ischemia in COVID-19 patients and its rehabilitation: a case series from a tertiary care hospital in Central India

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible and infectious virus. It belongs to the family coronavirus and it is a single strand positive sense virus. There are many theories which relate to the origin and transmission of this virus and hence the virus has been tagged with many names according to various taxonomical guidelines. The conventional clinical spectrum of this infection includes cough, fever, dyspnea, anorexia and gastrointestinal symptoms. It has been seen during the course of this disease that there are also some properties relating this virus to the hypercoagulability in the disease spectrum. The cases involving arterial and venous thromboembolism are not rare. This case series is a collection on three such cases from the red zone (zone separated for COVID-19 infected patients) of a tertiary care hospital in central India which showcase acute limb ischemia in patients infected with SARS-CoV-2

Spontaneous pneumothorax as a complication in COVID‐19 recovered male patient: a case report from a tertiary care centre in Central India

As the number of COVID-19 cases emerge new complications associated with the disease are recognised. This report records a case of pneumothorax in a COVID-19 patient. Our report justifies that pneumothorax can occur during different phases of disease in patients without any history of pulmonary comorbidity and is not necessarily associated to positive pressure ventilation or a severity of COVID-19. However debatable might be the exact mechanism of the process be, this observation might imply that extensive alveolar destruction due to COVID-19 may lead to bulla formation resulting in subsequent pneumothorax

Application of Handheld Tele-ECG for Health Care Delivery in Rural India

Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. The purpose of our study was to use handheld tele-electrocardiogram (ECG) developed by Bhabha Atomic Research Center (BARC) to identify heart conditions in the rural underserved population where the doctor-patient ratio is low and access to health care is difficult. The objective of our study was clinical validation of handheld tele-ECG as a screening tool for evaluation of cardiac diseases in the rural population. ECG was obtained in 450 individuals (mean age 31.49 ± 20.058) residing in the periphery of Chandigarh, India, from April 2011 to March 2013, using the handheld tele-ECG machine. The data were then transmitted to physicians in Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, for their expert opinion. ECG was interpreted as normal in 70% individuals. Left ventricular hypertrophy (9.3%) was the commonest abnormality followed closely by old myocardial infarction (5.3%). Patient satisfaction was reported to be ~95%. Thus, it can be safely concluded that tele-ECG is a portable, cost-effective, and convenient tool for diagnosis and monitoring of heart diseases and thus improves quality and accessibility, especially in rural areas