Survival of tuberculosis patients treated under DOTS in a rural tuberculosis unit (TU), south India.

Objective: To estimate survival probabilities and identify risk factors for death of tuberculosis (TB) patients during treatment period. Methods: TB patients registered during May 1999 to December 2004 from a rural TB unit (TU) with a population of 580 000 in Tiruvallur district, South India, formed study population. Life table and Cox’s regression methods were used. Results: Of the 3818 TB patients who were initiated on treatment, 96, 94 and 97% of category – I, II and III respectively, were surviving after completion of treatment. Higher death rates were independently associated with patient’s age (45 years), previous history of treatment, alcoholism and initial body weight (<35 kgs). Conclusion: The survival probability was found to be similar in all patients irrespective of categorization. Necessary actions need to be initiated in the programme to improve body weight and abstain from alcoholism

Weight gain in patients with tuberculosis treated under directly observed treatment short-course (DOTS)

Set up: One Tuberculosis Unit (TU) in Tiruvallur district, Tamil Nadu, India where Tuberculosis (TB) patients treated under Directly Observed Treatment Short Course (DOTS) programme. Objective: To identify the effects of weight gain among TB patients at the end of treatment on different factors such as socio-economic and demographic characteristics, smoking and drinking habits, treatment under supervision, the type of DOTS centres and problems in taking drugs. Methods: TB patients registered between May 1999 and December 2004 formed the study population. Multiple regression method was used for the analysis. Results: Among 1557 smear-positive TB patients registered under DOTS programme, the changes in weight ranged from a loss of 4 kgs to a gain of 20 kgs at the end of TB treatment; the average change in weight was 3.22 kgs. The gain in weight at the end of treatment was associated with age (<45 years), DOT at government centres, no problems in taking drugs as reported by patients and cure rate. Conclusion: The findings showed that there is an association between gain in weight with DOT at government centres and cure of patients

In vivo investigation of hyperpolarized [1,3-13C2]acetoacetate as a metabolic probe in normal brain and in glioma.

Dysregulation in NAD+/NADH levels is associated with increased cell division and elevated levels of reactive oxygen species in rapidly proliferating cancer cells. Conversion of the ketone body acetoacetate (AcAc) to β-hydroxybutyrate (β-HB) by the mitochondrial enzyme β-hydroxybutyrate dehydrogenase (BDH) depends upon NADH availability. The β-HB-to-AcAc ratio is therefore expected to reflect mitochondrial redox. Previous studies reported the potential of hyperpolarized 13C-AcAc to monitor mitochondrial redox in cells, perfused organs and in vivo. However, the ability of hyperpolarized 13C-AcAc to cross the blood brain barrier (BBB) and its potential to monitor brain metabolism remained unknown. Our goal was to assess the value of hyperpolarized [1,3-13C2]AcAc in healthy and tumor-bearing mice in vivo. Following hyperpolarized [1,3-13C2]AcAc injection, production of [1,3-13C2]β-HB was detected in normal and tumor-bearing mice. Significantly higher levels of [1-13C]AcAc and lower [1-13C]β-HB-to-[1-13C]AcAc ratios were observed in tumor-bearing mice. These results were consistent with decreased BDH activity in tumors and associated with increased total cellular NAD+/NADH. Our study confirmed that AcAc crosses the BBB and can be used for monitoring metabolism in the brain. It highlights the potential of AcAc for future clinical translation and its potential utility for monitoring metabolic changes associated with glioma, and other neurological disorders

Quality of symptom elicitation in an epidemiological survey on tuberculosis

The quality of symptom elicited by health workers in an epidemiological survey on tuberculosis was assessed by again subjecting a 10% random sample of the persons interviewed, by the supervisory staff, independently. Three thousand four hundred and forty nine persons were thus interviewed twice. The overall estimates for overdiagnosis and under-diagnosis in the elicitation of symptoms by health workers were to the extent of 16% and 8% respectively, with minimal yield of sputum positivity from the discordant groups of persons. The additional load of 16% for sputum examination can thus be considerably reduced if health workers are well trained in symptom-elicitationscreening of the population and their work is monitored through spot supervisory checks

Formulation and Evaluation of Nebivolol Immediate Release Tablets with Improved Dissolution Using Solid Dispersion Technique

AIM AND OBJECTIVE:The aim of the present work is to investigate the possibility of obtaining immediate release tablet of nebivolol with improved dissolution using solid dispersion technique. Basic goals in the development of immediate dissolving tablet are to increase patient compliance, ease of administration, safety and appropriate dosing. Orally disintegrating formulations also provide benefits for pharmaceutical companies like lifecycle management, line extension, market expansion, cost effective drug development programs. According to BCS classification nebivolol coming under class 2 category which has low solubility and high permeability. Nebivolol is a white powder, relatively insoluble in water. Solubility and dissolution was improved by formulating solid dispersion. Keeping in view the advantages of this delivery system, in the present study, attempts were made to formulate immediate dissolving tablet nebivolol, which is useful to reduce blood pressure level in the treatment of antihypertensive agents. The direct compression was used to compress the tablets as it is the easiest way to manufacture tablets. Conventional equipments, commonly available excipients and limited number of processing steps are involved in direct compression and so manufacturing cost is low. Tablets produced by direct compression are relatively strong in hardness and have less friability.Super disintegrants are the major components of immediate release tablets.Based on their origin they can be grouped in to two category, synthetic super disintegrants (micro crystalline cellulose, cross povidone, cros carmellose sodium, starch glycolate) and natural super disintegrants. Natural origin is preferred over semi synthetic and synthetic substances because they are comparatively cheper, abundantly, non irritating non toxic in nature. The formulation of immediate release using natural super disintegrants is an excellent example for the application of natural agents in the formulative field. And this proved that the natural agents have almost equivalent properties to synthetic agents, which can be widely used for formulation of dosage forms. Nebivolol used to improve the solubility, stability of drug and also to mask its bitter taste.SUMMARY:In the present study immediate release drug delivery system of nebivolol were successfully developed in the form of mouth dissolving tablets with improved dissolution characteristic by forming solid dispersion with PEG 6000, which offers a suitable and practical approach in serving desired objective of faster disintegration and dissolution characteristics with increase bioavailability. Immediate release tablets of nebivolol were prepared by using natural superintegrants like microcrystalline cellulose, croscarmellose sodium, crospovidone, sodium starch glycolate and their combination as superdisintegrants. Superdisintegrants work as an auxiliary or as a facilitator of the flowability and compressibility of the mixture and contribute to the fast dispersion of the tablet, due to its high solubility in water. For the nebivolol formulation, batch No. 2 was chosen as it has disintegration time around 5-35 seconds and hardness3.5 Kg/Cm2. IR spectra of drug with other excipients has not shown any interaction and also selected formulation was stable after stability studies.CONCLUSION:The solubility and dissolution rate of nebivolol can be enhanced by formulating SDs of nebivolol with PEG 6000.The solubilization effect of PEG 6000, reduction of particle aggregation of the drug, formation of microcrystalline or amorphous drug, increased wettability and dispersibility, and alteration of the surface properties of the drug particles might be responsible for the enhanced solubility and dissolution rate of nebivolol from its SD and to some extent in PMs. No endothermic peak of nebivolol was present in of SDs with PEG 6000 suggesting the absence of crystalline nebivolol. From FTIR spectroscopy, it was concluded that there was no well defined chemical interaction between nebivolol and PEG 6000 in SDs and in PMs, as no important new peaks could be observed. The identical composition of Superdisintegrants showed that a substantial shorter time require for disintegration can be obtained and immediate release tablet were prepared. The nebivolol immediate release tablet (F2) showed 68.30% drug release within first 5 min. and 99.93% drug release with in 30 min. The results showed that the formulation satisfied the objective of fast disintegration, dissolution, % friability, hardness, wetting time, water absorption ratio, ease of administration and safety. Success of the present study recommends a detailed investigation in to invivo studies for its effective use in clinical practice

Experimental Investigation, ANN Modelling and TOPSIS Optimization of a Gasoline Premixed HCCI-DI Engine with Direct Injection of FeCl3 Nanodditive Blended WCO

Experiments have been carried out to compute performance, combustion and emission characteristics of a homogeneous charge compression ignition – direct injection (HCCI-DI) engine in which 20% of the fuel was premixed in the intake manifold and the remaining 80% of the fuel was injected directly. Gasoline was selected as the premixed fuel and three different fuel combinations, namely, diesel, B50 (50% waste cooking oil (WCO) and 50% diesel by volume) and WCO were selected as direct injection (DI) fuels. 100 ppm of FeCl3 nanoadditive was blended with the DI fuels aimed at enhancing favourable fuel properties. The experimental investigations show a reduction of 54.17% and 50% in hydrocarbon (HC) and carbon monoxide (CO) emissions, respectively, in the case of WCO fuelled DI combustion compared with the diesel fuelled combustion. Significant increase in the cylinder pressure (pcyl) and the rate of heat release (ROHR) values was observed when the FeCl3 nanoadditive blended fuel was used. Also, with this type of fuel smoke emissions were reduced by 34.8%. Significant increase in the brake thermal efficiency (ηbth) with reduced nitrogen oxide (NOx) emissions was observed in the HCCI-DI combustion. Artificial neural network (ANN) was used for forecasting the performance of and emissions from the engine in different operating conditions. The technique for order preference by similarity to ideal solution (TOPSIS) was used for optimizing engine input parameters, which can result in maximum efficiency and minimum emissions

Targeting groundwater potential zones using Electrical resistivity and GIS techniques in Kadavanar Sub-basin, South India

Geographical Information System techniques are widely used to determine suitable sites for groundwater recharge through artificial recharge techniques. The present research work is to identify suitable locations for constructing artificial recharge structures in the Kadavanar Sub-basin, South India. People in the Sub-basin mainly depend on the groundwater resources for drinking and irrigation purposes. Groundwater resources are often overexploited in many parts of this Sub-basin to meet the water demand leading to groundwater consumption. A lot of surfaces and sub-surface information and criteria are required for mapping the groundwater recharge zone. This is where the geographic information system [GIS] provides the right impetus besides the groundwater prospective zone to harness multilayered spatial data so that multi-criteria analysis is possible. This analysis integrates historic rainfall data analysis, groundwater level fluctuation, stream network, aquifer thickness, land use/land cover and basin slope. Drainage map, slope map and land use/land cover maps were prepared from satellite imageries. Vertical electrical sounding (VES) geophysical survey with Schlumberger electrode configuration was also conducted in the basin at 50 locations to map the aquifer thickness. Spatial variation maps for groundwater level and aquifer thickness were generated using GIS. Weighted aggregation method was used in this study to obtain groundwater recharge maps. Finally, multi-criteria analysis has been carried out to identify and assess the potential sites for groundwater recharge according to the associated weightages. It is established that GIS is best suited for the mapping of groundwater recharge zones. A similar study can be extended to any other hard-rock region facing water crises

The effect of dental chair light exposure duration on shear bond strength of orthodontic brackets : an in vitro study

The purpose of this study is to determine if the duration of exposure to the halogen overhead dental chair light has an effect on shear bond strength (SBS) of metal orthodontic brackets. One hundred twenty extracted human lower incisor teeth were divided into six groups (n=20/group). Each group was assigned a predetermined duration of exposure to the halogen dental chair light, set at a fixed distance, before being cured. Light exposure times of 0 minutes (Group 1-Control), 1 minute (Group 2), 2.5 minutes (Group 3), 5 minutes (Group 4), 10 minutes (Group 5), and 15 minutes (Group 6) were tested. Each tooth was subjected to an exclusion criteria examination, scrubbed of all debris, and imbedded in a PVC-stone fixture with the crown of the tooth exposed above the stone surface. All groups had orthodontic brackets bonded with the same materials and process, then light cured for 6 seconds using the Valo LED curing unit after their designated light exposure time. Groups were tested using an Instron E-1000 universal testing machine with a shear load test set at a speed of 1mm/min using a knife-edged chisel. Data was analyzed using a one-way ANOVA test. The Adhesive Remnant Index (ARI) was scored under 10x magnification. The ARI data was analyzed using the Chi-square test (p-value < 0.05). All control and experimental groups for each specific tooth type tested resulted in SBS within or above the clinically acceptable range. Statistically significant differences (p<.05) were found between the control and experimental groups for dental chair light exposure times of 5 minutes, 10 minutes and 15 minutes. A chi-square test determined that there was statistical significance when evaluating the frequency of ARI scores when light exposure duration was greater than 5 minutes. It can be concluded that dental chair light exposure in the 5 minute, 10 minute and 15 minute groups produced higher shear bond strength than those of the control, 1 minute and 2.5 minute groups. The dental chair light is capable of initiating polymerization and causing higher bond strengths than the clinical acceptability of 5.8-7.9 MPa, thus continued dental chair light exposure over 5 minutes is not recommended. The ARI analysis revealed that as bond strength increased, the fracture pattern shifted from most remaining adhesive attached to the tooth toward that attached to the bracket