Can adding Ephedrine to Admixture of Propofol & Lidocaine Overcome Propofol Associated Hemodynamic Changes and Injection Pain?

Purpose: There are numerous studies researching ways to alleviate propofol injection pain. In this study, we evaluated and compared the use of propofol-lidocaine admixture vs propofol-lidocaine combined with ephedrine, on vascular pain and hemodynamic changes associated propofol. Methods: This double-blinded, prospective, randomised study was performed on 100 patients with ASA I-II who were divided into two group. The first received admixture consisting of 20 mg of lidocaine and propofol 1% 20 ml (Group L), and the other received admixture consisting of 20 mcg ephedrine, 20 mg lidocaine and propofol 1% 20 ml (Group LE). Baseline and after induction heart rate, mean arterial pressure and rate pressure product (RPP) were recorded per minute. Vascular pain were evaluated with verbal rating scale. Results: Data of 40 patients in group L and 39 patients in Group LE were evaluated in the study. The incidence of pain in group L was 90%, it was 38.4% for Group LE. Mild pain was observed significantly more in Group L when compared to Group LE (p<0.05). Average blood pressure and RPP immediately after induction and 1 min after intubation were significantly higher in group LE compared to group L (p<0.05). Heart rate was higher in Group LE immediately after induction and at initially 4 minutes after intubation. Conclusion: Our study has demonstrated significant decrease in rate of vascular pain and increased hemodynamic stability in patients receiving 20 mg ephedrine added to 20 ml % 1 propofol and 20 mg lidocaine admixture when compared to those who only received the lidocaine-propofol admixtur

Using criticalities as a heuristic for Answer Set Programming

Answer Set Programming is a new paradigm based on logic programming. The main component of answer set programming is a system that finds the answer sets of logic programs. Generally, systems utilize some heuristics to choose new literals at the choice points. The heuristic used in this process is one of the key factors for the performance of the system. A new heuristic for answer set programming has been developed. This heuristic is inspired by hierarchical planning. The notion of criticality, which was introduced for generating abstraction hierarchies in hierarchical planning, is used in this heuristic. The resulting system (CSMODELS) uses this new heuristic and is based on the system SMODELS. The experimental results show that this new heuristic is promising for answer set programming. CSMODELS generally takes less time than SMODELS to find an answer set

Microfluidic Impedance Spectroscopy as a Tool for Quantitative Biology and Biotechnology

A microfluidic device that is able to perform dielectric spectroscopy is developed. The device consists of a measurement chamber that is 250 μm thick and 750 μm radius. Around 1000 cells fit inside the chamber assuming average quantities for cell radius and volume fraction. This number is about 1000 folds lower than the capacity of conventional fixtures. A T-cell leukemia cell line Jurkat is tested using the microfluidic device. Measurements of deionized water and salt solutions are utilized to determine parasitic effects and geometric capacitance of the device. Physical models, including Maxwell-Wagner mixture and double shell models, are used to derive quantities for sub-cellular units. Clausius-Mossotti factor of Jurkat cells is extracted from the impedance spectrum. Effects of cellular heterogeneity are discussed and parameterized. Jurkat cells are also tested with a time domain reflectometry system for verification of the microfluidic device. Results indicate good agreement of values obtained with both techniques. The device can be used as a unique cell diagnostic tool to yield information on sub-cellular units. (C) 2012 American Institute of Physics

Trends in antibiotic use among outpatients in New Delhi, India

<p>Abstract</p> <p>Background</p> <p>The overall volume of antibiotic consumption in the community is one of the foremost causes of antimicrobial resistance. There is much ad-hoc information about the inappropriate consumption of antibiotics, over-the-counter availability, and inadequate dosage but there is very little actual evidence of community practices.</p> <p>Methods</p> <p>This study surveyed antibiotic use in the community (December 2007-November 2008) using the established methodology of patient exit interviews at three types of facilities: 20 private retail pharmacies, 10 public sector facilities, and 20 private clinics to obtain a complete picture of community antibiotic use over a year. The Anatomical Therapeutic Chemical (ATC) classification and the Defined Daily Dose (DDD) measurement units were assigned to the data. Antibiotic use was measured as DDD/1000 patients visiting the facility and also as percent of patients receiving an antibiotic.</p> <p>Results</p> <p>During the data collection period, 17995, 9205, and 5922 patients visiting private retail pharmacies, public facilities and private clinics, respectively, were included in our study. 39% of the patients attending private retail pharmacies and public facilities and 43% of patients visiting private clinics were prescribed at least one antibiotic. Consumption patterns of antibiotics were similar at private retail pharmacies and private clinics where fluoroquinolones, cephalosporins, and extended spectrum penicillins were the three most commonly prescribed groups of antibiotics. At public facilities, there was a more even use of all the major antibiotic groups including penicillins, fluoroquinolones, macrolides, cephalosporins, tetracyclines, and cotrimoxazole. Newer members from each class of antibiotics were prescribed. Not much seasonal variation was seen although slightly higher consumption of some antibiotics in winter and slightly higher consumption of fluoroquinolones during the rainy season were observed.</p> <p>Conclusions</p> <p>A very high consumption of antibiotics was observed in both public and private sector outpatients. There was a high use of broad spectrum and newer antibiotics in the community. Suitable and sustainable interventions should be implemented to promote rational use of antibiotics that will help in decreasing the menace of antibiotic resistance.</p

Task-Optimal Registration Cost Functions

In this paper, we propose a framework for learning the parameters of registration cost functions – such as the tradeoff between the regularization and image similiarity term – with respect to a specific task. Assuming the existence of labeled training data, we specialize the framework for the task of localizing hidden labels via image registration. We learn the parameters of the weighted sum of squared differences (wSSD) image similarity term that are optimal for the localization of Brodmann areas (BAs) in a new subject based on cortical geometry. We demonstrate state-of-the-art localization of V1, V2, BA44 and BA45

Measurement of the total antioxidant response using a novel automated method in subjects with nonalcoholic steatohepatitis

BACKGROUND: Oxidative stress, an increase in oxidants and/or a decrease in antioxidant capacity, is one of the potential biochemical mechanisms involved in the pathogenesis of nonalcoholic steatohepatitis. We aimed to investigate the total antioxidant response using a novel automated method in nonalcoholic steatohepatitis subjects. As a reciprocal measure, we also aimed to determine total peroxide level in the same plasma samples. METHODS: Twenty-two subjects with biopsy proven nonalcoholic steatohepatitis and 22 healthy controls were enrolled. Total antioxidant response and total peroxide level measurements were done in all participants. The ratio percentage of total peroxide level to total antioxidant response was regarded as oxidative stress index. RESULTS: Total antioxidant response of subjects with nonalcoholic steatohepatitis was significantly lower than controls (p < 0.05), while mean total peroxide level and mean oxidative stress index were higher (all p < 0.05). In subjects with nonalcoholic steatohepatitis, fibrosis score was significantly correlated with total peroxide level, total antioxidant response and oxidative stress index (p < 0.05, r = 0.607; p < 0.05, r = -0.506; p < 0.05, r = 0.728, respectively). However, no correlation was observed between necroimflamatory grade and those oxidative status parameters (all p > 0.05). CONCLUSION: Nonalcoholic steatohepatitis is associated with increased oxidant capacity, especially in the presence of liver fibrosis. The novel automated assay is a reliable and easily applicable method for total plasma antioxidant response measurement in nonalcoholic steatohepatitis

Changes in Hepatic Gene Expression upon Oral Administration of Taurine-Conjugated Ursodeoxycholic Acid in ob/ob Mice

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent and associated with considerable morbidities. Unfortunately, there is no currently available drug established to treat NAFLD. It was recently reported that intraperitoneal administration of taurine-conjugated ursodeoxycholic acid (TUDCA) improved hepatic steatosis in ob/ob mice. We hereby examined the effect of oral TUDCA treatment on hepatic steatosis and associated changes in hepatic gene expression in ob/ob mice. We administered TUDCA to ob/ob mice at a dose of 500 mg/kg twice a day by gastric gavage for 3 weeks. Body weight, glucose homeostasis, endoplasmic reticulum (ER) stress, and hepatic gene expression were examined in comparison with control ob/ob mice and normal littermate C57BL/6J mice. Compared to the control ob/ob mice, TUDCA treated ob/ob mice revealed markedly reduced liver fat stained by oil red O (44.2±5.8% vs. 21.1±10.4%, P<0.05), whereas there was no difference in body weight, oral glucose tolerance, insulin sensitivity, and ER stress. Microarray analysis of hepatic gene expression demonstrated that oral TUDCA treatment mainly decreased the expression of genes involved in de novo lipogenesis among the components of lipid homeostasis. At pathway levels, oral TUDCA altered the genes regulating amino acid, carbohydrate, and drug metabolism in addition to lipid metabolism. In summary, oral TUDCA treatment decreased hepatic steatosis in ob/ob mice by cooperative regulation of multiple metabolic pathways, particularly by reducing the expression of genes known to regulate de novo lipogenesis

Significant Reduction of Antibiotic Use in the Community after a Nationwide Campaign in France, 2002–2007

Didier Guillemot and colleagues describe the evaluation of a nationwide programme in France aimed at decreasing unnecessary outpatient prescriptions for antibiotics. The campaign was successful, particularly in reducing prescriptions for children