Comparative study of anaphylaxis incidence in patients receiving anti-snake venom with or without prophylactic adrenaline: a prospective, randomized, blinded study

Background: Anti-snake venom serum (ASV) administered for snake-bite patients is the most specific treatment available. Unfortunately, it can cause severe anaphylaxis which can be fatal sometimes.Methods: Fifty patients were included in the study and randomly divided into group A, who received sub-cutaneous adrenaline before administration of anti-venom serum and group B who did not. Each group comprised of twenty-five patients. The incidences as well as the severity of anaphylaxis in both groups and also the effects of subcutaneous adrenaline on the hemodynamic were analysed.Results: Anaphylactic reactions were significantly less in group A than group B population (p0.05) implying that administration of sub-cutaneous adrenaline is safe.Conclusions: Prophylactic subcutaneous adrenaline before anti snake venom administration is highly efficacious and safe in reducing the incidence as well as severity of anaphylactic reactions

Anesthetic Management of a Patient with Ebstein's Anomaly for Obstructed Inguinal Hernia

Ebstein’s anomaly is a rare congenital heart disease constituting less than 1% of patients with congenital heart diseases.  It has diverse presentations, severity, and consequently, the management too. These patients are at increased risk of developing ventricular and supraventricular tachycardias, congestive heart failure, and even death. Here, we report a case of a 32-year old man with Ebstein’s anomaly, who had successfully undergone emergency open inguinal hernioplasty under nerve blocks

COMPARISON OF ORAL CLONIDINE WITH ORAL MIDAZOLAM IN MANAGING AGITATION FOLLOWING SEVOFLURANE ANESTHESIA – A PROSPECTIVE, RANDOMIZED, DOUBLE BLINDED STUDY

ABSTRACT:Objective: Emergence agitation is a major problem during recovery from anesthetic agents like sevoflurane, particularly in children. This study had compared the effects of oral clonidine with oral midazolam in reducing the incidence of emergence agitation following sevoflurane anesthesia.Methods: 50 children of ASA status I and II aged between 3-8 years were randomly allotted to one of the two groups, each group comprising 25 children. Group I children were given oral Midazolam 0.5 mg/kg and Group II children were given oral Clonidine 4 mcg/kg 30 min before the induction of anesthesia. Emergence reaction was analyzed using modified objective pain scale in all children following sevoflurane administration.Results: The total agitation score was significantly less in clonidine group in comparison to midazolam group during the first hour of post operative period (P<0.05).No remarkable change in the hemodynamics or oxygen saturation was observed in both groups.Conclusion: Premedication of oral clonidine 4 microgram per kg is superior to oral midazolam 0.5 mg per kg in reducing the incidence of emergence agitation following sevoflurane anesthesia.Keywords: sevoflurane, recovery, emergence agitation, clonidine, midazolam

Free energy barrier for melittin reorientation from a membrane-bound state to a transmembrane state

An important step in a phospholipid membrane pore formation by melittin antimicrobial peptide is a reorientation of the peptide from a surface into a transmembrane conformation. In this work we perform umbrella sampling simulations to calculate the potential of mean force (PMF) for the reorientation of melittin from a surface-bound state to a transmembrane state and provide a molecular level insight into understanding peptide and lipid properties that influence the existence of the free energy barrier. The PMFs were calculated for a peptide to lipid (P/L) ratio of 1/128 and 4/128. We observe that the free energy barrier is reduced when the P/L ratio increased. In addition, we study the cooperative effect; specifically we investigate if the barrier is smaller for a second melittin reorientation, given that another neighboring melittin was already in the transmembrane state. We observe that indeed the barrier of the PMF curve is reduced in this case, thus confirming the presence of a cooperative effect

Agarose-stabilized gold nanoparticles for surface-enhanced Raman spectroscopic detection of DNA nucleosides

doi:10.1063/1.2192573 http://scitation.aip.org/getpdf/servlet/GetPDFServlet?filetype=pdf&id=APPLAB000088000015153114000001&idtype=cvips&prog=normal&doi=10.1063/1.2192573We present surface-enhanced Raman scattering (SERS) studies of DNA nucleosides using biologically benign agarose-stabilized gold nanoparticles (AAuNP). We compare the SERS activity of nucleosides with AAuNP to that of commercially obtained citrate-stabilized gold nanoparticles and find the SERS activity to be an order of magnitude higher with AAuNP. The higher SERS activity is explained in terms of the agarose matrix, which provides pathways for the gold nanoparticles to have distinct arrangements that result in stronger internal plasmon resonances.This work was supported through the University of Missouri Research Board grants URB04-023 (S.G.) and URB03-080 (M.C. and K.V.K.), NSF under Grant No. DMR-0413601and the NCI under Grant No. IR0ICA119412-01. The gold nanoparticles were produced and supplied by the University of Missouri Nanoparticle Production Core Facility

The Ctf18 RFC-like complex positions yeast telomeres but does not specify their replication time

Peer reviewedPreprin

The effect of Ku on telomere replication time is mediated by telomere length but is independent of histone tail acetylation

Peer reviewedPublisher PD

Asymptotic Safety, Emergence and Minimal Length

There seems to be a common prejudice that asymptotic safety is either incompatible with, or at best unrelated to, the other topics in the title. This is not the case. In fact, we show that 1) the existence of a fixed point with suitable properties is a promising way of deriving emergent properties of gravity, and 2) there is a sense in which asymptotic safety implies a minimal length. In so doing we also discuss possible signatures of asymptotic safety in scattering experiments.Comment: LaTEX, 20 pages, 2 figures; v.2: minor changes, reflecting published versio

Comprehensive characterization of molecular interactions based on nanomechanics

Molecular interaction is a key concept in our understanding of the biological mechanisms of life. Two physical properties change when one molecular partner binds to another. Firstly, the masses combine and secondly, the structure of at least one binding partner is altered, mechanically transducing the binding into subsequent biological reactions. Here we present a nanomechanical micro-array technique for bio-medical research, which not only monitors the binding of effector molecules to their target but also the subsequent effect on a biological system in vitro. This label-free and real-time method directly and simultaneously tracks mass and nanomechanical changes at the sensor interface using micro-cantilever technology. To prove the concept we measured lipid vesicle (approximately 748*10(6) Da) adsorption on the sensor interface followed by subsequent binding of the bee venom peptide melittin (2840 Da) to the vesicles. The results show the high dynamic range of the instrument and that measuring the mass and structural changes simultaneously allow a comprehensive discussion of molecular interactions

Prevention of tracheal cartilage injury with modified Griggs technique during percutaneous tracheostomy - Randomized controlled cadaver study

Introduction: Tracheal stenosis is the most common severe late complication of percutaneous tracheostomy causing significant decrease in quality of life. Applying modified Griggs technique reduced the number of late tracheal stenoses observed in our clinical study. The aim of this study was to investigate the mechanism of this relationship. Materials and methods: Forty-six cadavers were randomized into two groups according to the mode of intervention during 2006-2008. Traditional versus modified Griggs technique was applied in the two groups consequently. Wider incision, surgical preparation, and bidirectional forceps dilation of tracheal wall were applied in modified technique. Injured cartilages were inspected by sight and touch consequently. Age, gender, level of intervention, and number of injured tracheal cartilages were registered. Results: Significantly less frequent tracheal cartilage injury was observed after modified (9%) than original (91%) Griggs technique (p<0.001). A moderate association between cartilage injury and increasing age was observed, whereas the level of intervention (p=0.445) and to gender (p=0.35) was not related to injury. Risk of cartilage injury decreased significantly (OR: 0.0264, 95%, CI: 0.005-0.153) with modified Griggs technique as determined in adjusted logistic regression model. Discussion: Modified Griggs technique decreased the risk of tracheal cartilage injury significantly in our cadaver study. This observation may explain the decreased number of late tracheal stenosis after application of the modified Griggs method. © 2012 Akadémiai Kiadó, Budapes