Drug utilization study of antihypertensive drugs used in the treatment of second and third trimester of pregnancy in tertiary care hospital

Background: Hypertensive disorders are major cause of the perinatal and maternal mortality and morbidity worldwide. Aim of study was to evaluate current trend of antihypertensive drugs and to assess frequency and distribution of antihypertensive drugs in pregnancy.Methods: A retrospective observational study was conducted in a tertiary care hospital for period of six months in collaboration with department of obstetrics and gynaecology. Patients data recorded in case report form and analysed to study prescription pattern and related information.Results: Total of 104 cases were enrolled in this study. Prescribed antihypertensive drugs in pregnancy were Labetalol, Nifedipine, MgSO4 and furosemide. Most commonly prescribed drug was labetalol. In this study, Gestational hypertension was most common diagnosis in hypertensive disorder. Majority of drug prescribed from category C and A. In present study, Single drug therapy was most commonly prescribed for hypertension in pregnancy was 64.42% whereas multiple drug therapy was 35.57%. Most common maternal complication was anaemia i.e. 54.05% followed by placental abruption in 24.3%. Neonatal outcome was low birth weight i.e.36% followed by preterm birth i.e.24%.Conclusions: Labetalol found to be most common prescribed drug. Single drug therapy prescription was high as compared to multiple drug therapy prescription in hypertensive disorders in pregnancy. Gestational hypertension was most common cause of hypertensive disorder. Anaemia was found to be most common maternal complication encountered in hypertensive disorders in pregnancy. Most common adverse neonatal outcome was low birth weight

Oscillator strength measurements of the 5s6s 1S0→5snp 1P1 Rydberg transitions of strontium

We report the experimentally determined oscillator strengths for the 5s6s 1S0→5snp 1P1 Rydberg transitions of strontium using two-step excitation in conjunction with a thermionic diode ion detector. The absolute photoionization cross section from the 5s6s 1S0 excited state has been determined by adjusting the polarization vector of the ionizing laser beam parallel, perpendicular, and at the magic angle with respect to that of the exciting dye laser. The measured absolute value of the photoionization cross section 0.9±0.2 Mb at the 5s threshold is used to extract the f values of the 5s6s 1S0→5snp 1P1 (26≤n≤73) Rydberg transitions. The oscillator strength in the discrete region merges smoothly to the oscillator strength density at the ionization threshold

Real Time Wireless Air Pollution Monitoring system

Air pollution has significant influence on the concentration of constituents in the atmosphere leading to effects like global warming and acid rains. To avoid such adverse imbalances in the nature, an air pollution monitoring system is utmost important. This paper attempts to develop an effective solution for pollution monitoring using wireless sensor networks (WSN) on a real time basis namely real time wireless air pollution monitoring system. Commercially available discrete gas sensors for sensing concentration of gases l ike CO 2 , NO 2, CO and O 2 are calibrated using appropriate calibration technologies. These pre - calibrated gas sensors are then integrated with the wireless sensor motes for field deployment at the campus and the Hyderabad city using multi hop data aggregatio n algorithm. A light weight middleware and a web interface to view the live pollution data in the form of numbers and charts from the test beds was developed and made available from anywhere on the internet. Other parameters like temperature and humidity w ere also sensed along with gas concentrations to enable data analysis through data fusion techniques. Experimentation carried out using the developed wireless air pollution monitoring system under different physical conditions show that the system collects reliable source of real time fine - grain pollution data

Supercritical water-cooled nuclear reactors: thermodynamic-cycles options

Paper presented at the 6th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, South Africa, 30 June - 2 July, 2008.Currently there are a number of Generation IV SuperCritical Water-cooled nuclear Reactor (SCWR) concepts under development worldwide. The main objectives for developing and utilizing SCWRs are: 1) Increase gross thermal efficiency of current Nuclear Power Plants (NPPs) from 33 – 35% to approximately 45 – 50%, and 2) Decrease the capital and operational costs and, in doing so, decrease electrical-energy costs (~$1000 US/kW or even less). SCW NPPs will have much higher operating parameters compared to current NPPs (i.e., pressures of about 25 MPa and outlet temperatures up to 625°C). Additionally, SCWRs will have a simplified flow circuit in which steam generators, steam dryers, steam separators, etc. will be eliminated. Furthermore, SCWRs operating at higher temperatures can facilitate an economical co-generation of hydrogen through thermo-chemical cycles (particularly, the copper-chlorine cycle) or direct high-temperature electrolysis. To decrease significantly the development costs of a SCW NPP, to increase its reliability, and to achieve similar high thermal efficiencies as the advanced fossil steam cycles it should be determined whether SCW NPPs can be designed with a steam-cycle arrangement that closely matches that of mature SuperCritical (SC) fossil power plants (including their SC turbine technology). The state-of-the-art SC steam cycles in fossil power plants are designed with a single-steam reheat and regenerative feedwater heating and reach thermal steamcycle efficiencies up to 54% (i.e., net plant efficiencies of up to 43% on a Higher Heating Value (HHV) Basis). Therefore, simplified no-reheat, single-reheat, and double-reheat cycles without heat regeneration and a singlereheat cycle with heat regeneration based on the expected steam parameters of future SCW NPPs were analyzed in terms of their thermal efficiencies. On this basis, several conceptual steam-cycle arrangements of pressure-tube SCWRs, their corresponding T–s diagrams and steam-cycle thermal efficiencies (based on constant isentropic turbine and polytropic pump efficiencies) are presented in this paper.vk201

A new test for random number generators: Schwinger-Dyson equations for the Ising model

We use a set of Schwinger-Dyson equations for the Ising Model to check several random number generators. For the model in two and three dimensions, it is shown that the equations are sensitive tests of bias originated by the random numbers. The method is almost costless in computer time when added to any simulation.Comment: 6 pages, 3 figure

Advancement in the pressureless sintering of CP titanium using high-frequency induction heating

High-frequency induction heating is applied as an alternative heating source for pressureless sintering of commercially pure Ti powders, aiming to intensify the sintering process. The effects of the process parameters on the properties of the sintered material are systematically studied. The initial powder compact density is the most influential parameter permitting sintered structures with highly porous to almost fully dense appearance. Short heating time combined with sintering to temperatures just above the β-transus resulted in a strong diffusion bonding between the Ti powder particles, and grain growth is observed at the former boundaries of the neighboring powder particles. The dimpled appearance of the fracture surface at those regions confirmed the strong metallic interparticle bonding. Tensile properties comparable to those of Ti-Grade 3 and Ti-Grade 4 are achieved, which also demonstrates the efficiency of the induction sintering process. A mechanism explaining the fast and efficient sintering is proposed. The process has the added advantage of minimizing the oxygen pickup

Cerebrospinal fluid findings in adults with acute Lyme neuroborreliosis

Presence of BB-specific antibodies in the cerebrospinal fluid (CSF) with evidence of their intrathecal production in conjunction with the white cell count in the CSF and typical clinical symptoms is the traditional diagnostic gold standard of Lyme neuroborreliosis (LNB). Few data are available on the CSF lactate concentration in European adults with the diagnosis of acute LNB. The objective of the study was to investigate the CSF changes during acute LNB. Routine CSF parameters [leukocyte count, protein, lactate and albumin concentrations, CSF/serum quotients of albumin (QAlb), IgG, IgA and IgM, and oligoclonal IgG bands] and the Borrelia burgdorferi (BB)-specific antibody index were retrospectively studied in relation to the clinical presentation in patients diagnosed with acute LNB. A total of 118 patients with LNB were categorized into the following groups according to their symptoms at presentation; group 1: polyradiculoneuritis (Bannwarth’s syndrome), group 2: isolated facial palsy and group 3: predominantly meningitic course of the disease. In addition to the CSF of patients with acute LNB, CSF of 19 patients with viral meningitis (VM) and 3 with neurolues (NL) were analyzed. There were 97 patients classified with definite LNB, and 21 as probable LNB. Neck stiffness and fever were reported by 15.3% of patients. Most of these patients were younger than 50 years. Polyradiculoneuritis was frequently found in patients older than 50 years. Lymphopleocytosis was found in all patients. Only 5 patients had a CSF lactate ≥3.5 mmol/l, and the mean CSF lactate level was not elevated (2.1 ± 0.6 mmol/l). The patients with definite LNB had significantly higher lactate levels than patients with probable LNB. Elevated lactate levels were accompanied by fever and headache. In the Reiber nomograms, intrathecal immunoglobulin synthesis was found for IgM in 70.2% followed by IgG in 19.5%. Isoelectric focussing detected an intrathecal IgG synthesis in 83 patients (70.3%). Elevated BB AIs in the CSF were found in 97 patients (82.2%). Patients with VM showed lower CSF protein concentration and CSF/serum quotients of albumin than LNB patients. In acute LNB, all patients had elevated cerebrospinal fluid (CSF) leukocyte counts. In contrast to infections by other bacteria, CSF lactate was lower than 3.5 mmol/l in all but 5 patients. The CSF findings did not differ between polyradiculoneuritis, facial palsy, and meningitis. The CSF in LNB patients strongly differed from CSF in VM patients with respect to protein concentration and the CSF/serum albumin quotient

Successful management of multiple permanent pacemaker complications – infection, 13 year old silent lead perforation and exteriorisation following failed percutaneous extraction, superior vena cava obstruction, tricuspid valve endocarditis, pulmonary embolism and prosthetic tricuspid valve thrombosis

A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful. A review of literature of pacemaker endocarditis and tricuspid thrombosis along with the relevant management strategies is presented. We believe this case report is unusual on account of non operative management of right atrial lead perforation following an unsuccessful attempt at percutaneous removal of right sided infected pacemaker leads and the incidental discovery of the perforated lead 13 years later at sternotomy, presentation of pacemaker endocarditis with a massive load of vegetations along the entire pacemaker lead tract in superior vena cava, right atrial endocardium, tricuspid valve and right ventricular endocardium, leading to a functional and structural SVC obstruction, requirement of an unusually large dose of warfarin postoperatively occasioned, in all probability, by antibiotic drug interactions, presentation of tricuspid prosthetic valve thrombosis uniquely as vasovagal syncope and isolated hypoxia and near instantaneous resolution of tricuspid prosthetic valve thrombosis with Alteplase thrombolysis

A randomized controlled trial of metformin on left ventricular hypertrophy in patients with coronary artery disease without diabetes:the MET-REMODEL trial

Aim We tested the hypothesis that metformin may regress left ventricular hypertrophy (LVH) in patients who have coronary artery disease (CAD), with insulin resistance (IR) and/or pre-diabetes. Methods and results We randomly assigned 68 patients (mean age 65 ± 8 years) without diabetes who have CAD with IR and/or pre-diabetes to receive either metformin XL (2000 mg daily dose) or placebo for 12 months. Primary endpoint was change in left ventricular mass indexed to height1.7 (LVMI), assessed by magnetic resonance imaging. In the modified intention-to-treat analysis (n = 63), metformin treatment significantly reduced LVMI compared with placebo group (absolute mean difference −1.37 (95% confidence interval: −2.63 to −0.12, P = 0.033). Metformin also significantly reduced other secondary study endpoints such as: LVM (P = 0.032), body weight (P = 0.001), subcutaneous adipose tissue (P = 0.024), office systolic blood pressure (BP, P = 0.022) and concentration of thiobarbituric acid reactive substances, a biomarker for oxidative stress (P = 0.04). The glycated haemoglobin A1C concentration and fasting IR index did not differ between study groups at the end of the study. Conclusion Metformin treatment significantly reduced LVMI, LVM, office systolic BP, body weight, and oxidative stress. Although LVH is a good surrogate marker of cardiovascular (CV) outcome, conclusive evidence for the cardio-protective role of metformin is required from large CV outcomes trials