A Comparative Study of Two Different Intravenous Bolus Doses of Phenylephrine Used Prophylactically for Preventing Hypotension after Subarachnoid Block in Cesarean Sections.

BACKGROUND AND AIMS: Hypotension occurs in most of the cases following subarachnoid block in for cesarean sections. Studies comparing different bolus doses of phenylephrine for preventing hypotension induced by subarachnoid block in cesarean sections are sparse. SETTINGS AND DESIGN: This study was conducted to compare the efficacy of two different bolus doses of phenylephrine for preventing subarachnoid block-induced hypotension in cesarean sections. MATERIALS AND METHODS: Sixty parturients undergoing cesarean section were allocated into two groups. Group A (n = 30) received 150 mcg phenylephrine intravenously (IV) and Group B (n = 30) received 200 mcg phenylephrine IV prophylactically immediately after subarachnoid block. Then, for every 2 min, systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and heart rate (HR) were measured for 20 min, and APGAR scores were measured. STATISTICAL ANALYSIS: The observations are expressed as mean ± standard deviation and were compared using unpaired t-test. The statistical significance of difference between groups was based on P value. P < 0.05 was considered statistically significant. RESULTS: There was no difference in preventing hypotension in both the groups, the incidence in Group A being 16.6% and Group B also 16.6%. However, the rise in systolic pressure in Group B was higher than Group A in the first 2-6 min. The incidence of bradycardia was higher in Group B (43.3%) than Group A (20%). CONCLUSIONS: Both the doses of phenylephrine were equally efficient in prevention of hypotension after subarachnoid block. Lower prophylactic bolus phenylephrine 150 mcg IV is better in the prevention of hypotension after subarachnoid block in cesarean sections as the incidence of bradycardia is higher with phenylephrine 200 mcg.

Attenuation of Hemodynamic Response to Tracheal Extubation: A Comparative Study between Esmolol and Labetalol.

BACKGROUND AND AIMS: Cardiovascular stress response to extubation can result in elevated heart rate (HR) and mean arterial blood pressures which can be detrimental in high-risk patients. SETTINGS AND DESIGN: The objective of this study is to compare the esmolol and labetalol efficacy in attenuating hemodynamic response to tracheal extubation. MATERIALS AND METHODS: Sixty patients scheduled for elective surgical procedures were selected randomly and divided into two groups of thirty each. Group I - esmolol 1.5 mg/kg and Group II - labetalol 0.25 mg/kg were administered 2 min before extubation after following a standard perioperative anesthetic management. Hemodynamic parameters recorded include HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) at baseline, reversal, study drug, 1 min after study drug, extubation, and at 1, 2, 3, 4, 5, and 15 min postextubation. STATISTICAL ANALYSIS: Student's t-test and analysis of variance have been used to find the significance of study parameters between groups of patients. P <0.05 was considered statistically significant. RESULTS: Both esmolol and labetalol obtunded extubation response throughout the extubation and postextubation period. At extubation and immediately postextubation at 1st and 2nd min, there was statistical significance (P < 0.05) in SBP, DBP, and MAP which showed esmolol was better than labetalol. Whereas labetalol was more efficient in controlling HR at 5th and 15th min postextubation having statistical significance. CONCLUSIONS: Both esmolol and labetalol attenuated hemodynamic response. Esmolol was more efficient than labetalol at extubation and immediately postextubation. If patient has tachycardia at extubation, labetalol is preferred. If patient has raised blood pressure, then esmolol is a good option in blunting the response.

Noninvasive assessment of cutaneous alterations in mice exposed to whole body gamma irradiation using optical imaging techniques.

We report the results of a study carried out to investigate the potential of optical techniques such as optical coherence tomography, Mueller matrix spectroscopy, and cross-polarization imaging for noninvasive monitoring of the ionizing radiation exposure-induced alterations in cutaneous tissue of mice. Radiation dose-dependent changes were observed in tissue microvasculature and tissue optical parameters like retardance and depolarization as early as 1 h post radiation exposure. Results suggest that these optical techniques may allow early detection of radiation dose-dependent alterations which could help in screening of population exposed to radiation.

Chronic exposure to neonicotinoids reduces honey bee health near corn crops.

Experiments linking neonicotinoids and declining bee health have been criticized for not simulating realistic exposure. Here we quantified the duration and magnitude of neonicotinoid exposure in Canada's corn-growing regions and used these data to design realistic experiments to investigate the effect of such insecticides on honey bees. Colonies near corn were naturally exposed to neonicotinoids for up to 4 months-the majority of the honey bee's active season. Realistic experiments showed that neonicotinoids increased worker mortality and were associated with declines in social immunity and increased queenlessness over time. We also discovered that the acute toxicity of neonicotinoids to honey bees doubles in the presence of a commonly encountered fungicide. Our work demonstrates that field-realistic exposure to neonicotinoids can reduce honey bee health in corn-growing regions.

Effect of gold nanoparticles on depolarization characteristics of Intralipid tissue phantom.

We report results of studies on the effect of different shapes and sizes of gold nanoparticles (GNPs) on the depolarization characteristics of Intralipid tissue phantoms. For a given extinction coefficient, the absorption characteristics of the GNPs contributed more to the depolarization of the turbid medium, and the contribution of scattering was significant only for the larger-sized particles. For rod-shaped GNPs, their depolarization plays an important role in the low scattering regime in which the depolarization properties of the nanoparticles (NPs) dominate in the turbid medium even if the contribution of the scattering from the NPs is about an order of magnitude less. For highly scattering samples, GNP absorption significantly modulates the depolarization spectra of the turbid medium.

Human papillomavirus infection and anal dysplasia in renal transplant recipients.

BACKGROUND: Immunosuppression is a known risk factor for anal human papillomavirus (HPV) disease, including anal squamous cell carcinoma. Additional risk factors for HPV-related disease have not been studied in the renal transplant population. The demographics of anal HPV and associated risk factors were investigated in this population. METHODS: Anal cytology and polymerase chain reaction were used to assess anal HPV disease in a cohort of transplant recipients at the Royal London Hospital. Risk factors associated with increased immunosuppression and HPV exposure were collated to determine any association with anal disease. RESULTS: Anal dysplasia was associated with anal oncogenic HPV infection (P < 0.001), duration of immunosuppression (P = 0.050), previous genital warts (P = 0.018) and receptive anal intercourse (P = 0.013). CONCLUSION: Anal dysplasia was related to immunosuppression and patient factors in this cohort.

Novel Fe (III) heterochelates: synthesis, structural features and fluorescence studies.

Fluorescence properties of five 4-acyl pyrazolone based hydrazides (H(2)SB(n)) and their Fe (III) heterochelates of the type [Fe(SB(n))(L)(H(2)O)].mH(2)O [H(2)SB(n)=nicotinic acid [1-(3-methyl-5-oxo-1-phenyl-4,5-di hydro-1H-pyrazol-4yl)-acylidene]-hydrazide; where acyl=-CH(3), m=4 (H(2)SB(1)); -C(6)H(5), m=2 (H(2)SB(2)); -CH(2)-CH(3), m=3 (H(2)SB(3)); -CH(2)-CH(2)-CH(3), m=1.5 (H(2)SB(4)); -CH(2)-C(6)H(5), m=1.5 (H(2)SB(5)) and HL=1-cyclopropyl-6-fluoro-4-oxo-7-(piperazin-1-yl)-1,4-dihydroquinoline-3-carboxylic acid] were studied at room temperature. The fluorescence spectra of heterochelates show red shift, which may be due to the chelation by the ligands to the metal ion. It enhances ligand ability to accept electrons and decreases the electron transition energy. The kinetic parameters such as order of reaction (n), energy of activation (E(a)), entropy (S*), pre-exponential factor (A), enthalpy (H*) and Gibbs free energy (G*) have been reported.

Hydrogen bonding properties of Coumarin 151, 500, and 35: the effect of substitution at the 7-amino position.

The steady-state spectral properties (absorption and emission) of three structurally similar Coumarin dyes, C151, C500, and C35 were investigated in 13 different solvents. A Kamlet-Taft (KT) analysis of the spectral peak frequencies reveals that, in addition to polarity, hydrogen bonding between the carbonyl oxygen and a protic solvent in the excited state imparts maximum stabilization for C151 and minimum for C35, while that for C500 lies in between. The spectral properties of the three dyes in two solvents, chloroform and THF, which have similar polarity in the KT scale but have only hydrogen-bond donor (chloroform) and hydrogen-bond acceptor (THF) properties, are seen to be sensitive to the substitution pattern at the 7-amino position. In addition, a slow emission spectral relaxation is observed for C151 and C500 having a time constant of approximately 500 ps in chloroform. For C35 this was too fast to be detected by the time resolution of our setup. The exact reason for this slow spectral relaxation in chloroform is unclear at present, and further studies are needed to understand clearly the structural effects on the hydrogen bonding dynamics of these dyes.

Depth-resolved fluorescence measurement in a layered turbid medium by polarized fluorescence spectroscopy.

We show that, when a turbid medium with a layered fluorophore distribution is excited by linearly polarized light, measurement of angle-resolved polarized fluorescence can provide depth-resolved fluorescence measurements.

Increased dermal lymphatic density in the human leg compared with the forearm.

During orthostasis, capillary filtration pressure is higher in the leg than in the arm due to the effect of gravity. We investigated the possibility that the lymphatic network in leg skin might be adapted to cope with a greater fluid load. The dermal lymphatics of the forearm and lower leg were studied in white-skinned and brown-skinned men using fluorescence video microscopy. From video print lymphangiograms the following were determined: lymphatic length density at a series of radii from the centre of the lymphangiogram (LDr); maximum lymphatic density (LDmax); total length of lymphatic vessel (LL); maximum spread of lymphatic vessel; number and size of lymphatic rings (continuous circuits of vessel); and vessel diameter. There were no differences between the two racial types, but clear differences between the arm and leg. In the leg, mean (+/- SD) peak LDr (25.13 +/- 5.65 cm-1), LDmax (32.95 +/- 6.89 cm-1), LL (40.17 +/- 27.42 cm), and spread (1.39 +/- 0.08 cm) were all significantly higher than in the arm (18.03 +/- 5.48 cm-1, 23.91 +/- 7.21 cm-1, 11.76 +/- 5.47 cm, and 1.00 +/- 0.05 cm respectively, P

Multicenter evaluation of ondansetron use in hospitalized oncology patients.

An evaluation of ondansetron use in oncology patients in three hospitals is described. Criteria for the use of ondansetron were developed and approved by each hospital's pharmacy and therapeutics committee or medical staff executive committee. Ondansetron use was concurrently monitored in adult inpatients for four months. Nursing and physician notes were reviewed, and the patients were interviewed. Data were collected on patient demographics, medical history, dosage of ondansetron, outcome, adverse effects, and concurrent medications. The approved criteria were used to evaluate the appropriateness, effectiveness, and safety of ondansetron therapy. A total of 262 oncology patients were evaluated. Of these, 223 (85%) received ondansetron appropriately based on the emetic potential of their antineoplastic drug regimen. Ondansetron was correctly prescribed for acute-phase prophylaxis of nausea and vomiting in 252 patients (96%). Only 117 (45%) of the patients met the criterion for appropriate dosage. The mean +/- S.D. dose of ondansetron was 11.7 +/- 3.22 mg, and the mean +/- S.D. number of doses received per patient was 4.4 +/- 3.23. Of the 135 patients who received an inappropriate dosage, 106 (79%) were given a dose larger than currently recommended by the manufacturer. Positive outcomes, defined as no more than two episodes of vomiting, no more than two episodes of retching, and no more than two p.r.n. doses of antiemetics, were observed in 97%, 99.6%, and 94% of the 248 patients included in the outcome analysis, respectively. Chemotherapy was completed on schedule in all the patients, and there were no complications due to excessive vomiting or retching. Adverse reactions were reported by 21 patients (8%).(ABSTRACT TRUNCATED AT 250 WORDS)

Is there a role for fluconazole in the treatment of vulvovaginal candidiasis?

OBJECTIVE: To review the data describing the use of fluconazole in the treatment of vulvovaginal candidiasis (VVC). DATA IDENTIFICATION: A MEDLINE search of the English-language literature and a bibliographic review of pertinent articles examining the use of fluconazole in the treatment of VVC. STUDY SELECTION AND DATA EXTRACTION: Relevant open and controlled studies reporting on the efficacy, associated adverse effects, or both of fluconazole for the treatment of VVC are reviewed. Appropriate conclusions and/or data are extracted from each article and described. DATA SYNTHESIS: Studies comparing fluconazole with ketoconazole and topical antifungal agents such as clotrimazole and miconazole have shown fluconazole to be equally efficacious with minimal adverse effects. Most of these trials used single-dose fluconazole, which would theoretically lead to a high degree of medication compliance. Fluconazole also has shown promise at diminishing VVC relapse or recurrence, possibly because of more complete vaginal and rectal eradication of Candida species. Pharmacoeconomically, single-dose fluconazole therapy is cost-effective; however, the recent approval of miconazole and clotrimazole by the Food and Drug Administration for over-the-counter use may limit this potential advantage. CONCLUSIONS: Until additional data are available, fluconazole may be considered a treatment alternative for women with VVC who experience frequent relapses or recurrences, or for those who are noncompliant with standard therapy.

An unusual case of rhabdomyosarcoma in a fowl.

A rhabdomyosarcoma is described on the head of a white leghorn which invaded the nasal cavity, intra-orbital septum and the left cerebral hemisphere.