Resistance to ondansetron: Role of pharmacogenetics in post-operative nausea and vomiting

Post-operative nausea and vomiting is the most annoying and at the same time a dangerous side effect of general anaesthesia. Ondansetron is a routinely used anti emetic drug which is being administered by the trial and error principle. Though it did revolutionized the management of this condition but by and large failed to completely eliminate the problem. Recently an important factor possibly elucidating this failure is said to be the differing expression of genes controlling proteins that are involved in transport and receptors related to this drug. Quite surprisingly these transporter and receptor pathways have been found to be polymorphic and at the same time shown to be related to efficacy of the drug. The differentiation between those responding to treatment and those not responding may pave a way to individualize treatment for emesis to a greater extent. This review highlights the pharmacogenetics related to this commonly used anti-emetic drug in anaesthesia. It is visualized as a promising way to achieve the target of individualized therapy. It seems obvious that pharmacogenetics will become an important field of anaesthesia research in the future.Keywords: 5-Hydroxytryptamine type 3 receptor antagonists; Ondansetron; Post-operative nausea and vomiting; Polymorphism; Pharmacogenetic

Solid Waste Supervision System based on Heuristic Algorithmic approach and Internet of Things

This research article emphasises on use of algorithmic approach to activate sensors to optimize waste disposal and internet of things technology to notify the trash collectors when it is time to clean the trash cans. Here, a heuristic algorithmic approach will serve as the universal alarm and an SMS will be sent to the cleaners' registered mobile numbers as the local alert. The registered higher officials will receive an SMS alert if cleaners don't finish cleaning by the deadline. The top and bottom of a trashcan are where the ultrasonic sensors will be placed as part of the research goals. Every second, the value of the sensed ultrasonic sensor will be stored in the cloud. If the trash can is full, the lid will automatically close as a local warning. There will be a global alert sent via SMS to the authorised cleaners and higher officials. The research objectives include placing the ultrasonic at top and bottom of a dustbin. The sensed ultrasonic sensor value will store in a cloud at every second. As a local alert the lid of the garbage will be closed automatically if the dustbin is full. Global alert as a SMS will send to the authorized cleaners and higher officials. To know where the trash can is, attach a GPS sensor there. The existing intelligent dustbin is equipped with a voice controller that is used to classify the garbage but is not connected to the internet. In the existing system, an IoT platform was used with the assistance of a computer terminal, an infrared sensor, and continuous monitoring of the root plan to empty the dustbin. The lead of a dustbin is closed and opened by a vibration switch in smart homes. Whether the trash is full or not, the intelligent trash can will only locally but not worldwide transmit an alarm. The smart waste tank will communicate with smart phones by sending local dustbin values but was not stored in the cloud for every second. In this garbage narrow band IoT module was used but not internet. Accordingly the IoT enabled dustbin by placing the ultrasonic sensors, GPS sensor it is capable to know whether the dustbin is full or empty and the status will be indicated as local alert and global alert. The local alert will be the automatic lid closing of a dustbin and the global alert will be a SMS with the location of a dustbin and the status as full

Minimizing the Localization Error in Wireless Sensor Networks Using Multi-Objective Optimization Techniques

When it comes to remote sensing applications, wireless sensor networks (WSN) are crucial. Because of their small size, low cost, and ability to communicate with one another, sensors are finding more and more applications in a wide range of wireless technologies. The sensor network is the result of the fusion of microelectronic and electromechanical technologies. Through the localization procedure, the precise location of every network node can be determined. When trying to pinpoint the precise location of a node, a mobility anchor can be used in a helpful method known as mobility-assisted localization. In addition to improving route optimization for location-aware mobile nodes, the mobile anchor can do the same for stationary ones. This system proposes a multi-objective approach to minimizing the distance between the source and target nodes by employing the Dijkstra algorithm while avoiding obstacles. Both the Improved Grasshopper Optimization Algorithm (IGOA) and the Butterfly Optimization Algorithm (BOA) have been incorporated into multi-objective models for obstacle avoidance and route planning. Accuracy in localization is enhanced by the proposed system. Further, it decreases both localization errors and computation time when compared to the existing systems

Hybridizing Micro - B4C with Carbon nanotubes to Enhance the Mechanical Properties of Aluminium Matrix Composites

In present work, the effects of hybridizing micron sized B4C particles with multi walled carbon nanotubes on the microstructural and mechanical properties of Al - B4C composite were investigated. Microstructure reveals grain refinement ascribed to the presence of uniformly distributed micron sized B4C particles with multi walled carbon nanotubes. The Al - (B4C + MWCNT) hybrid composite indicates the alliance of mechanical properties such as hardness, tensile strength and ductility. The enhanced attribute of Al - (B4C + MWCNT) hybrid composite when compared to Al - B4C is the increased content and uniform distribution of MWCNTs. © Published under licence by IOP Publishing Ltd

Arterial oxygen saturation under hypoxic environment of high-altitude associates with routine physical activities of natives

Per cent oxygen saturation of arterial haemoglobin levels (SaO2), a measure of hypoxemia has been analysed in the permanent residents of Ladakh. The population recognized as high-altitude controls (HAC) and high-altitudemonks (HAM), resided at the same altitude of 3600 m but differed in their routines. SaO2 was measured with a Finger-Pulse Oximeter. The HAM had 3.08% higher SaO2 (P<0.001) compared to the HAC, with mean SaO2 of 91.8°6.1% and 89.0°2.6%, respectively. Furthermore, the younger HAM also revealed an elevation of 4.55% SaO2 than the HAC of identical age (P<0.001). The HAM, who are less hypoxemic than their counterparts are physically more active, which may be a selective advantage in the extreme environment of higher altitudes

Effect of Moringa oleifera (Lam.) pods as feed additive on egg antioxidants, chemical composition and performance of commercial layers

The present study was designed to investigate the influence of Moringa oleifera (Lam.) pod meal (MPM) on production, immunity, and functional food index of chicken eggs. Two hundred HyLine W36 layer birds aged 50 weeks, 1469 ± 46.63 g, were assigned to four treatments in a completely randomized design, with five replicates and ten birds each. Diets A, B, C, and D were formulated with the same caloric and protein levels, but with differing MPM dose levels of 0, 5, 10, and 15g MPM/kg finisher diet, respectively. Data for production performance, quality, and chemical composition of eggs were analysed by one-way ANOVA, and means were compared with Duncan’s multiple range test. As a result of this study, feed conversion ratio (FCR) and egg mass (EM) were significantly decreased and recorded lowest in Group B, which was offered 5 g/kg above the basal diet. Bioactives such as β-carotene, quercetin, and selenium levels were increased (540, 121, & 72.21μg/100g of yolk, respectively), whereas cholesterol levels in egg yolk and serum were decreased significantly, that is, 201.87 mg/100g and 8.47 mg/dl, respectively. Serum biochemical indicators, including serum glutamic-pyruvic transaminase (SGPT), glucose, creatinine and cholesterol levels, were lowered significantly. Proximate analysis of egg yolk showed that moisture and ether extract were decreased, whereas crude protein (CP), ash and minerals, sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), and phosphorus (P) contents were increased. The outcomes of this study showed that MPM supplementation affects EM, serum biochemistry and bioactive compounds of the egg yolk positively. Keywords: Antibody titers, β-carotene, cholesterol, egg quality, quercetin, seleniu

Variations in angiotensin-converting enzyme gene insertion/deletion polymorphism in Indian populations of different ethnic origins

The pattern of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in the Indian population is poorly known. In order to determine the status of the polymorphism, young unrelated male army recruits were screened. The population had cultural and linguistic differences and lived in an environment that varied significantly from one region to another. Analysis of the genotype, showed higher frequency of the insertion allele in four of the five groups i.e. I allele frequency was significantly higher (P<005) in Dogras, Assamese and Kumaonese. The deletion allele frequency was comparatively higher in the fifth group that belonged to Punjab. A correlation was observed between the genotype and enzyme activity. Involvement of a single D allele in the genotype enhanced the activity up to 37.56 ± 313%. The results suggested ethnic heterogeneity with a significant gene cline with higher insertion allele frequency. Such population-based data on various polymorphisms can ultimately be exploited in pharmacogenomics

Angiotensin converting enzyme insertion allele in relation to high altitude adaptation

Angiotensin converting enzyme (ACE) gene I/D polymorphism has been associated with high altitude (HA) disorders as well as physical performance. We, however, envisage that the polymorphism may be associated with adaptation to the hypobaric hypoxia of altitude, thus facilitating physical performance. For this purpose, three unrelated adult male groups, namely (1) the Ladakhis (HLs), who reside at and above a height of 3600 m, (2) lowlanders, who migrated to Ladakh (MLLs), and (3) resident lowlanders (LLs), have been investigated. The HLs had significantly (p<0.001) greater numbers of the II homozygotes and the ID heterozygotes than the DD homozygotes, the genotype distribution being 0.46, 0.43 and 0.11 for II, ID and DD genotypes respectively. The MLLs comprised 60% II homozygotes, which was higher (p<0.001) than the HLs (46%). In the LLs, the heterozygotes were greater (p<0.001) in number than the II and DD homozygotes. The I allele frequency was 0.72 in the MLLs, 0.67 in the HLs and 0.55 in the LLs. Polymorphism study suggested that the II genotype could be associated with altitude adaptation, which might influence physical efficiency

Evaluation of clinical outcomes in neuropathic pain with combinations of anti-neuropathic drugs

Background: Much of the pharmacological treatment modalities especially individual drugs for treating neuropathic pain have unwanted side effects, multiple day to day dosing, modest efficacy of topical treatments, and their local side effects. Combination drug regimen has the advantage of offering relatively better pain relief at lower drug doses and lesser side effects.Methods: The study was conducted in the Department of Neurology at NRI General Hospital, Guntur. The patients who met the inclusion and exclusion criteria were enrolled and assigned into 3 groups of the study drug combinations. The baseline characteristics and post interventional scores of Toronto Clinical Scoring System (TCSS), visual analogue scale (VAS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D) and Medical outcome of sleep scale (MOS) and were analyzed using t test and mean difference.Results: A statistically significant reduction in neuropathic pain in all the three groups was found. The mean difference between the baseline and post interventional scores of TCSS and VAS of group I, II and III were 2.97, 2.75, and 1.97; 2.32, 1.12, and 0.95 respectively. There was a statistically significant improvement of HAM-A in all the three groups, HAM-D and MOS sleep scale were found significant only in group II.Conclusions: The study findings revealed that all the three drug combinations were effective in the management of neuropathic pain with pregabalin and oxcarbazepine combination being better with respect to efficacy and tolerability. Regarding the treatment of depression and sleep disturbances associated with NP pregabalin and duloxetine was more effective

A multicountry randomized controlled trial of comprehensive maternal nutrition supplementation initiated before conception: the Women First trial.

Background: Reported benefits of maternal nutrition supplements commenced during pregnancy in low-resource populations have typically been quite limited. Objectives: This study tested the effects on newborn size, especially length, of commencing nutrition supplements for women in low-resource populations ≥3 mo before conception (Arm 1), compared with the same supplement commenced late in the first trimester of pregnancy (Arm 2) or not at all (control Arm 3). Methods: Women First was a 3-arm individualized randomized controlled trial (RCT). The intervention was a lipid-based micronutrient supplement; a protein-energy supplement was also provided if maternal body mass index (kg/m2) was(DRC), Guatemala, India, and Pakistan. The primary outcome was length-for-age z score (LAZ), with all anthropometry obtainedDRC, outcomes were determined for all 4 sites from WHO newborn standards (non-gestational-age-adjusted, NGAA) as well as INTERGROWTH-21st fetal standards (3 sites, gestational age-adjusted, GAA). Results: A total of 7387 nonpregnant women were randomly assigned, yielding 2451 births with NGAA primary outcomes and 1465 with GAA outcomes. Mean LAZ and other outcomes did not differ between Arm 1 and Arm 2 using either NGAA or GAA. Mean LAZ (NGAA) for Arm 1 was greater than for Arm 3 (effect size: +0.19; 95% CI: 0.08, 0.30, P = 0.0008). For GAA outcomes, rates of stunting and small-for-gestational-age were lower in Arm 1 than in Arm 3 (RR: 0.69; 95% CI: 0.49, 0.98, P = 0.0361 and RR: 0.78; 95% CI: 0.70, 0.88, P \u3c 0.001, respectively). Rates of preterm birth did not differ among arms. Conclusions: In low-resource populations, benefits on fetal growth-related birth outcomes were derived from nutrition supplements commenced before conception or late in the first trimester. This trial was registered at clinicaltrials.gov as NCT01883193