Haemodynamic effects of intrathecal dexmedetomidine added to ropivacaine intraoperatively and for postoperative analgesia

Background: For lower abdomen and lower limb surgery, spinal anaesthesia is most common modality used in routine. This study was conducted on 50 ASA 1 and 2 planned for lower limb and lower abdomen surgery.Methods: 50 patients of ASA 1 and 2 scheduled for lower limb and lower abdominal surgery were selected. Each patient received 4 milliliter volume of 0.75% isobaric ropivacaine + 5 microgram dexmedetomidine. At the intervals of 1 minute, 2 minute, 5 minute, 10 minute, 20 minute, 30 minute and 1 hour, 2 hour and 3 hour reading of pulse rate and blood pressure were recorded. Postoperatively, pain scores were recorded by using Visual Analogue Scale.Results: There were no significant changes in systolic and diastolic blood pressure after induction. The combination of ropivacaine and dexmedetomidine provided better postoperative analgesia and reduced requirement of diclofenac injection in first 24 hour.Conclusions: The patients showed excellent hemodynamic stability and postoperative analgesia to ropivacaine + dexmedetomidine. Thus it is a safe modality for lower limb and lower abdomen surgery as far as haemodynamic effects and postoperative analgesia is concerned

The prevalence of thyroid disorder in pregnancy

Background: The development of maternal thyroid disorders during early pregnancy can influence the pregnancy outcome and fetal development. The present study was conducted to know the prevalence of thyroid disorders in the Indian pregnant population and the obstetric outcomes of those women suffering from thyroid disorders. Methods: The present study was conducted on 100 women who came for an antenatal check-up in the first trimester, with Singleton Pregnancy. A detailed history was taken followed by a thorough general physical examination. Patients were sent for TSH (Thyroid Stimulating Hormone) testing. Patients were sent for TSH (Thyroid Stimulating Hormone) testing. If TSH (Thyroid Stimulating Hormone) was deranged, then FT3 and FT4 levels were checked. Depending upon the FT3 and FT4 values they are grouped as subclinical/overt hypothyroidism or hyperthyroidism. Results: Most of the patients in the present study were from the age group 21 to 30 years. The prevalence of thyroid disorders in the present study was 38%, including hypo and hyperthyroidism. 28% of patients were found to be hypothyroid; 10% of patients were hyperthyroid. Conclusions: The prevalence of thyroid disorders, especially hypothyroidism (28%) was high. Further studies are needed to assess adverse effects on maternal and fetal outcomes. Routine antenatal thyroid screening should be done.

PHARMA SCIENCE MONITOR AN INTERNATIONAL JOURNAL OF PHARMACEUTICAL SCIENCES DEVELOPMENT AND OPTIMIZATION OF AN ECONOMIC METHOD FOR QUANTITATION OF AZITHROMYCIN IN HUMAN PLASMA BY TANDEM MASS SPECTROSCOPY (LCMS/MS) FOR CLINICAL TRIALS

ABSTRACT The present study deals with development and optimization of an economic method for quantitation of Azithromycin in human plasma by Tandem Mass Spectroscopy (LCMS/MS) for Clinical studies. Enalapril (stable and economic) was used as an internal standard. Azithromycin was extracted from plasma using an Oasis HLB solid-phase extraction cartridge (Waters Corporation, USA). The elution was carried out with degassed 0.1% formic acid buffer in methanol (5:95, v/v, economic as compare to commonly used acetonitrile). After elution the elute was evaporated to dryness in nitrogen, and was reconstituted in 100 µl mobile phase (same as elution buffer) and 10 µl of the sample was injected into an HPLC system containing Chromolith RP C18, 100*4.6 mm column connected to LCMS/MS system. The lower limit of quantitation (LLOQ) was 0.95ng/ml, without interfering peaks. The calibration curve was linear (R=0.9979) over a concentration range 0.95ng/ml to 951.63 ng/ml. Retention time for Azithromycin and its internal standard was 1.26 minutes and 1.45 minutes. The accuracy (85%-115%) and precision (CV ≤ 15%) were acceptable. The mean recoveries for Azithromycin at 3, 425 and 875 ng/ml were: 75.44±2.86%, 79.23±4.475% and 74.84±2.86% (n=6), respectively. Azithromycin was stable in plasma for at least 6 hours at room temperature and for at least four freeze and thaw cycles (% change = 3.73 at LOQ and 4.46 at ULQ). It was observed that the method is selective for Azithromycin as no peak interference was observed from plasma matrix while blank plasma or plasma with the drugs was run at RT of internal standard and analyte. The developed method has adequate sensitivity, specificity, accuracy and precision to measure Azithromycin in human plasma and, it can be considered as a cost effective, fast and with the acceptable range of recovery (80% -90%) for BE studies/clinical trials

Rothmund–Thomson syndrome: anaesthesia considerations

Rothmund–Thomson syndrome (RTS) or poikiloderma congenitale is a rare autosomal recessive disorder. Approximately 300 cases of this syndrome have been reported in the scientific literature worldwide. This study reports the case of an 11-yearold female child with RTS undergoing diagnostic oesophago-gastro-duodeno (OGD) scopy as a result of dysphagia to solids. Adequate knowledge of the condition is needed when planning anaesthesia in such a case as associated anomalies can interfere with anaesthesia management.Keywords: anaesthesia management, Rothmund–Thomson syndrom

Association between prediabetes diagnosis and body mass index trajectory of overweight and obese adolescents

BackgroundPrediabetes awareness in adults has been associated with improved weight management. Whether youth with prediabetes diagnosis experience similar improvements is unknown.ObjectiveTo investigate the association between prediabetes identification and body mass index (BMI) trajectory in overweight and obese adolescents.SubjectsYouth who were followed longitudinally in a large academic‐affiliated primary care network and who were overweight/obese while 10 to 18 years old.MethodsRetrospective cohort study. Subjects were categorized as “screened” if at least 1 hemoglobin A1c (HbA1c) result was available. Time series analysis was used to determine the difference in difference (DID) in BMI Z‐score (BMI‐Z) slope before and after HbA1c between: (a) screened youth found to have prediabetes‐range HbA1c (5.7%‐6.4%, 39‐46 mmol/mol) versus normal HbA1c and (b) screened versus age‐matched unscreened obese youth.ResultsA total of 4184 (55.6% female) screened subjects (median follow‐up 9.7 years) were included. In which, 637 (15.2%) had prediabetes‐range HbA1c. Prediabetes was associated with a greater decrease in BMI‐Z slope than normal HbA1c (DID: −0.023/year [95% CI: −0.042 to −0.004]). When compared to age‐matched unscreened subjects (n = 2087), screened subjects (n = 2815) experienced a greater decrease in BMI‐Z slope after HbA1c than unscreened subjects at a matched age (DID: −0.031/y [95% CI ‐0.042 to −0.021]).ConclusionsBMI‐Z trajectory improved more among youth with prediabetes‐range HbA1c but also stabilized in screened youth overall. Prospective studies are needed to identify provider‐ and patient‐level drivers of this observation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156184/2/pedi13028.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156184/1/pedi13028_am.pd

An auto-scaling framework for analyzing big data in the cloud environment

Processing big data on traditional computing infrastructure is a challenge as the volume of data is large and thus high computational complexity. Recently, Apache Hadoop has emerged as a distributed computing infrastructure to deal with big data. Adopting Hadoop to dynamically adjust its computing resources based on real-time workload is itself a demanding task, thus conventionally a pre-configuration with adequate resources to compute the peak data load is set up. However, this may cause a considerable wastage of computing resources when the usage levels are much lower than the preset load. In consideration of this, this paper investigates an auto-scaling framework on cloud environment aiming to minimise the cost of resource use by automatically adjusting the virtual nodes depending on the real-time data load. A cost-effective auto-scaling (CEAS) framework is first proposed for an Amazon Web Services (AWS) Cloud environment. The proposed CEAS framework allows us to scale the computing resources of Hadoop cluster so as to either reduce the computing resource use when the workload is low or scale-up the computing resources to speed up the data processing and analysis within an adequate time. To validate the effectiveness of the proposed framework, a case study with real-time sentiment analysis on the universities’ tweets is provided to analyse the reviews/tweets of the people posted on social media. Such a dynamic scaling method offers a reference to improving the Twitter data analysis in a more cost-effective and flexible way

Enhancement of Solubility of Artemisinin and Curcumin by Co-Solvency Approach for Application in Parenteral Drug Delivery System

The aim of present study was to enhance solubility of poorly soluble antimalarial drugs, Artemisinin and Curcumin by adopting  Co-solvency approach and to develop parenteral aqueous injectable solution. Solubility enhancement of both drugs was achieved using co-solvency approach. The parenteral injection was prepared by using a ternary co-solvent system which comprised of benzyl alcohol, PEG 400 and tween 80 (as surfactant). Solubility of Artemisinin and Curcumin was found to be higher in benzyl alcohol and PEG 400. Co-solvent system comprising of  benzyl alcohol, PEG 400 and tween 80 in volume fraction of 0.3, 0.9 and 0.2 respectively showed the minimum required solubility of Artemisinin (90 mg per ml) and Curcumin (180 mg per ml). The parenteral injectable formulation was characterized for pH, clarity, viscosity, osmolarity and sterility and the stated parameters were found in acceptable range.  In-vitro erythrocyte toxicity study showed that intravenous administration of optimized formulation will be safe. In-vitro antimalarial assay indicated that efficacy of artemisinin and curcumin parenteral formulation was greater than quinine and combination of Artemether and Lumefantrine. Stability study of the optimized batch showed no change in physical and chemical characteristics. Based on study, one can conclude that Artemisinin and Curcumin can be successfully formulated as parenteral injectable formulation by co-solvency approach for the effective treatment of malarial infectio

Multi-Omic Analysis of the Microbiome and Metabolome in Healthy Subjects Reveals Microbiome-Dependent Relationships Between Diet and Metabolites

The human microbiome has been associated with health status, and risk of disease development. While the etiology of microbiome-mediated disease remains to be fully elucidated, one mechanism may be through microbial metabolism. Metabolites produced by commensal organisms, including in response to host diet, may affect host metabolic processes, with potentially protective or pathogenic consequences. We conducted multi-omic phenotyping of healthy subjects (N = 136), in order to investigate the interaction between diet, the microbiome, and the metabolome in a cross-sectional sample. We analyzed the nutrient composition of self-reported diet (3-day food records and food frequency questionnaires). We profiled the gut and oral microbiome (16S rRNA) from stool and saliva, and applied metabolomic profiling to plasma and stool samples in a subset of individuals (N = 75). We analyzed these multi-omic data to investigate the relationship between diet, the microbiome, and the gut and circulating metabolome. On a global level, we observed significant relationships, particularly between long-term diet, the gut microbiome and the metabolome. Intake of plant-derived nutrients as well as consumption of artificial sweeteners were associated with significant differences in circulating metabolites, particularly bile acids, which were dependent on gut enterotype, indicating that microbiome composition mediates the effect of diet on host physiology. Our analysis identifies dietary compounds and phytochemicals that may modulate bacterial abundance within the gut and interact with microbiome composition to alter host metabolism