Effect of intravenous dexmedetomidine and small dose fentanyl on shoulder tip pain in gynecological laparoscopic surgeries under spinal anaesthesia

Background: Shoulder tip pain and discomfort due to peritoneal stretching is the major limiting factor of spinal anaesthesia in laparoscopic surgeries. Aim of the study was to evaluate the effect of intravenous dexmedetomidine along with small dose fentanyl in abolishing the shoulder tip pain during gynaecological laparoscopic surgery and to assess its respiratory and hemodynamic effects.Methods: 50 ASA grade I and II, with age 18-50 yrs and weight 45-70 kgs, who were undergoing elective gynecological laparoscopic surgeries with estimated pneumoperitoneum time of one hour or less, were included in the study. Injection dexmedetomidine 1 mcg/kg was infused over a period of ten minutes before spinal anaesthesia with 3.5 ml of injection ropivacaine (0.75%) in lateral position. Injection fentanyl 0.5mcg/kg was given intravenously before intraperitoneal insufflation. Shoulder tip pain, peri-operative heart rate, noninvasive blood pressure, end tidal carbon dioxide, respiratory rate and sedation level using Ramsay sedation score were assessed at frequent intervals.Results: 35 patients were comfortable with no complaints, 11 patients had mild and two patients had moderate shoulder tip pain which was relieved by reducing abdominal pressure or/and an additional dose of fentanyl (25 mcg). One patient had severe pain and had to be converted to general anaesthesia. Ready sedation score was 2 or 3 for all the patients except one who was deeply sedated and had to be intubated. The drug combination used reduced the shoulder tip pain in gynaecological laparoscopic surgeries performed under spinal anaesthesia while maintaining the stable intra-operative hemodynamics.Conclusions: This study has provided the preliminary evidence of feasibility of use of dexmedetomidine along with low dose fentanyl to reduce the discomfort and shoulder tip pain during gyanaecological laparoscopic procedures of short duration under spinal anaesthesia in selected patients

Acute hepatitis due to brucellosis: case report

Brucella infection is a systemic disease. It rarely causes local infections like hepatitis in gastrointestinal system. In this article we would like to present an acute hepatitis case related to brucella infection that followed up in our clinic. A male, 30 year-old patient hospitalized due to common muscle pain, high fever and vomiting. During the physical examination the patient’s skin, scleras and mucosal membranes were icteric, the liver was 2-3 cm palpable and tender. Laboratory findings were as follows: AST:1190 U/L; ALT:715 U/L; GGT:961 U/L; ALP:369 U/L; total bilirubin:4.6 mg/dL; direct bilirubin:2.1 mg/dL. Viral markers were found to be negative. We started treatment with streptomicine and doxicycline since, the patient’s standard brucella tube agglutination test was positive (1/60) and brucella spp produced in his blood culture. From the second day of the treatment, we started to get clinical response. On the 17th day of the treatment, he discharged from the hospital because ALT, AST and bilirubine level were found normal and his treatment was completed to the 8 weeks. Brucella is continuing to be an important health problem especially who live in surrounding countryside and have to keep in mind in the differential diagnosis of the acute hepatitis

Protective effect of luteolin on the transgenic Drosophila model of Parkinson’s disease

In the present study we have studied the effect of 25, 50, 75 and 100 µM of luteolin on the transgenic Drosophila expressing human alpha synuclein. The doses of luteolin were established in diet and the PD flies were allowed to feed on it for 24 days. After 24 days of exposure the flies were assayed for climbing assay, oxidative stress markers, caspase-3 & 9 activity and dopamine content. The immunohistochemistry was also performed on the brain sections for the activity of tyrosine hydroxylase. The exposure of luteolin showed a dose dependent delay in the loss of climbing ability and activity, reduction in oxidative stress markers, caspase-3&9 activities and results in an increase in the dopamine content. The results obtained for the immunohistochemistry also supports the protective role of luteolin against the damage of the dopaminergic neurons

QoS improvement in TCP/IP-based wireless sensor networks using cross-layer optimization

Dissertação de Mestrado, Engenharia Informática, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015Internet of Things (IoT) is becoming a reality and new and advanced applications are expected to emerge. For applications with reliability needs to work well in IoT environments, robust data transportation is required. Approaches like TCP are known for not being adequate in sensor network environments, while UDP has been included in the 6LoWPAN stack allowing low-power and limited processing devices to participate in the IoT. However, UDP provides no reliability. One way of providing reliability is to use link-layer acknowledgements but this mechanism may lead to an inefficient use of resources if used unconditionally throughout all the network. Another way is to request the confirmation of messages sent, done at the application layer, but this is an end-to-end process that can only be applied for specific message type transactions. If used for all data then there will be long delays and inefficient use of resources also. Here we address the design of a cross-layer reactive mechanism that improves reliability of data delivery, in order to support applications that require some reliability level when delivering data notifications. This mechanism introduces link layer reliability at specific nodes, gradually and only when needed, having no scaling problems. Results show that this mechanism can improve data delivery and improve the use of network resources.Erasmus Mundus Iran Iraq Yemen (EMIIY

Graded epidural anaesthesia for Caesarean section in a parturient with Shone’s syndrome: a case study

Pregnancy with underlying heart disease is a unique challenge both to the obstetrician and the anesthesiologist. Asymptomatic women with mild to moderate single lesions can successfully carry a pregnancy to term and undergo vaginal delivery. However, pregnancy can result in rapid clinical deterioration, which may lead to maternal and/or foetal mortality in symptomatic patients with complex heart diseases, like Shone’s syndrome. A thorough understanding of the impact of pregnancy on the haemodynamic response to the patient’s cardiac lesion is required for the management of labour and delivery. A meticulous approach is needed when planning anaesthesia for Caesarean section in such a case as the associated haemodynamic effects of both regional and general anaesthesia can have a serious deleterious effect on both the mother and infant.We report on the successful management of a parturient known to have Shone’s syndrome undergoing Caesarean section under graded epidural anaesthesia.Keywords: Caesarean section, epidural anaesthesia, pregnancy, Shone’s syndrom

Evaluation of micronucleus frequency by acridine orange fluorescent staining in bucccal epithelial cells of oral submucosus fibrosis (OSMF) patients

Oral submucosus fibrosis (OSMF) is a collagen-related disorder seen in habitual betel quids and smokers. This is a high risk precancerous condition in which the connective tissue fibers of the lamina propria and deeper parts of the mucosa becomes stiff with restricted mouth opening. Patients with severe cases have symptoms like difficulties in chewing, swallowing and speaking. In the present study 25 individuals were gutkha chewers and 25 were OSMF patients (chewing gutkha along with smoking) and 25 individuals were taken as controls. A significant increase in the frequency of micronuclei was observed in OSMF patients (34.4 ±1.79) as compared to gutkha chewers (14.4± 0.73) and controls (4.36± 0.27). The number of micronucleated cells in OSMF, gutkha chewers and control groups were 19.84± 0.69, 12.6 ± 0.51 and 4.20 ±0.27, respectively and are significantly different at p< 0.05. Acridine orange is used due its fluorescence nature and easier visibility of the micronucleus present in the buccal epithelial cells. It is concluded that chewing gutkha along with smoking is more dangerous for human health as it hastens the incidence of OSMF.Keywords: Oral submucosus fibrosis; Gutkha; Smoking; MicronucleusThe Egyptian Journal of Medical Human Genetics (2013) 14, 189–19

Assessment of DNA damage by panmasala, gutkha chewing and smoking in buccal epithelial cells using alkaline single cell gel electrophoresis (SCGE)

In the present study the comet assay was performed in buccal epithelial cells to evaluate DNA damage among pan masala or gutkha chewers and smokers. The assay is a rapid, suitable and sensitive method for detecting various forms of DNA damage at individual cell level. The study comprises 300 individuals of which 50 individuals were gutkha chewers along with smoking, 50 individuals were pan masala chewers along with smoking, 50 individuals were gutkha chewers, 50 individuals were pan masala chewers, 50 individuals were smokers and 50 individuals were non-users (control) or not having any addiction. Comet tail length was observed to measure the extent of DNA damage. In all groups a significant increase in the tail length was observed as compared to the non-users (control). The highest tail length was observed among gutkha chewers along with smoking (36.9 ± 3.60). The results of the present study suggest that the panmasala and gutkha are genotoxic agents and induce DNA damage.Keywords: Comet assay; DNA damage; Gutkha; Pan masala; Buccal epithelial cell

Neurodevelopment assessment of small for gestational age children in a community-based cohort from Pakistan

Background: Children born small for gestational age (SGA) may experience more long-term neurodevelopmental issues than those born appropriate for gestational age (AGA). This study aimed to assess differences in the neurodevelopment of children born SGA or AGA within a periurban community in Pakistan.Methods: This was a prospective cohort study in which study participants were followed from the pilot Doppler cohort study conducted in 2018. This pilot study aimed to develop a pregnancy risk stratification model using machine learning on fetal Dopplers. This project identified 119 newborns who were born SGA (2.4±0.4 kg) based on International Fetal and Newborn Growth Consortium standards. We assessed 180 children (90 SGA and 90 AGA) between 2 and 4 years of age (76% of follow-up rate) using the Malawi Developmental Assessment Tool (MDAT).Findings: Multivariable linear regression analysis comparing the absolute scores of MDAT showed significantly lower fine motor scores (β: -0.98; 95% CI -1.90 to -0.06) among SGAs, whereas comparing the z-scores using multivariable logistic regression, SGA children had three times higher odds of overall z-scores ≤-2 (OR: 3.78; 95% CI 1.20 to 11.89) as compared with AGA children.Interpretation: SGA exposure is associated with poor performance on overall MDAT, mainly due to changes in the fine motor domain in young children. The scores on the other domains (gross motor, language and social) were also lower among SGAs; however, none of these reached statistical significance. There is a need to design follow-up studies to assess the impact of SGA on child\u27s neurodevelopmental trajectory and school performance

Formulation design and evaluation of Cefuroxime axetil 125 mg immediate release tablets using different concentration of sodium lauryl sulphate as solubility enhancer

Formularam-se comprimidos de liberação imediata à base de cefuroxima axetil, pelo método de compressão direta, com diferentes percentagens de lauril sulfato de sódio (LSS), tais como 0,5, 1,0, 1,5, e também sem SLS. Os lotes resultantes dos comprimidos foram avaliados por ambos os métodos da farmacopeia e não farmacopeicos para determinar as propriedades físico-mecânicas. O teste de dissolução foi realizado em meios diferentes, como HCl 0,07 M, água destilada, HCl 0,1 M com pH 1,2 e os tampões fosfato (pH 4,5 e 6,8) para observar a liberação do fármaco contra a correspondente concentração de LSS utilizado. Em seguida, as formulações de teste foram comparadas por fatores f1 (dissimilaridade) e f2 (similaridade), utilizando uma marca de referência de cefuroxima axetil. Diferenças significativas (pCefuroxime axetil immediate release tablets were formulated by direct compression method with different percentages of sodium lauryl sulphate (SLS) such as 0.5, 1.0, 1.5 and also without SLS. Resulting batches of tablets were evaluated by both pharmacopeial and non-pharmacopeial methods to ascertain the physico-mechanical properties. Dissolution test were carried out in different medium like 0.07 M HCl, distilled water, 0.1M HCl of pH 1.2 and phosphate buffers at pH 4.5 and 6.8 to observe the drug release against the respective concentration of SLS used. Later, test formulations were compared by f1 (dissimilarity) and f2 (similarity) factors using a reference brand of cefuroxime axetil. Significant differences (

Effect of myricetin on cognitive impairments in the transgenic Drosophila model of Parkinson’s Disease

27-33Parkinson’s Disease (PD) is a progressive neurodegenerative disorder involving the loss of dopaminergic neurons. Despite the availability of many drugs to ease the life of PD patients, there is no permanent cure until now. Now-a-days, there has been a considerable attention towards the use of herbal products to treat PD patients worldwide due to less side effects. In this context, here we investigated myricetin, a common plant derived flavonoid, on the cognitive impairments exhibited by the transgenic Drosophila expressing human -synuclein in the neurons. The PD flies were allowed to feed on the diet having 10, 20 and 40 μM of myricetin for 24 days and then assayed for cognitive impairments. The exposure of myricetin showed a dose dependent significant delay in the cognitive impairments. Molecular docking studies showed the positive interaction between myricetin and -synuclein. The results suggest a protective effect of myricetin against the cognitive impairments