Two Cases of Ipsilateral Posterior Hip Dislocation and Shaft Femur Fracture and Management.

Introduction: The incidence of ipsilateral fracture of the shaft of the femur and dislocation of the hip are extremely rare injuries. However, the incidence of complex fractures is increasing day by day due to an increasing variety of traumatic mechanisms. This type of injury constitutes various diagnostic and treatment difficulties for the surgeon. Such injuries should be managed on an urgent basis for better functional outcomes. Case Report: We hereby describe two such cases: First case hip was reduced using external fixator pins, stabilization of the shaft femur fracture was done with an external fixator and the second case hip was reduced with bone holding clamps and the shaft femur fracture was fixed with interlocking nail. Conclusion: Fixator-assisted closed reductions are the first line of treatment in the management of posterior dislocation hip complicated with ipsilateral femoral shaft fractures. If closed reduction fails, fracture site can be opened and direct forces can be applied to the proximal femur to aid hip reduction with minimum complications.

Data analytics and modelling in context to determination of moisture susceptibility of reclaimed asphalt foamed bituminous mix.

The presence of water badly affects the moisture susceptibility of the reclaimed asphalt Foamed Bituminous Mix (FBM). The present study is mainly emphasized to assess the moisture susceptibility of reclaimed asphalt FBM, Where RAP is being incorporated as a replacement of fresh aggregates. Moisture susceptibility of the mix is evaluated in terms of tensile strength ratio (TSR) and resilient modulus ratio, subjected to different conditioning procedures namely AASHTO T283, modified IDOT, TG-2 guidelines, and MIST. Further data analytics and regression modeling are also carried out to determine the moisture susceptibility of the mix and to check the statistics among the variables. The findings show that the incorporation of RAP in the FBM improves moisture resistance. Further, FBM containing 100% RAP shows the least moisture susceptibility in terms of TSR and Mr ratio irrespective of any conditioning type. Moreover, MIST conditioning may be preferred to assess the moisture sensitivity as it simulates the field pore pressure effects. Further, mathematical analysis is carried out to predict the moisture susceptibility of mix. Adjusted R square coefficient indicates a better fit of the prediction model developed. Overall, the study may be helpful to highway professionals in analyzing the conditioning procedures and determining the moisture sensitivity of the reclaimed asphalt Foamed Bituminous Mix.

Ipsilateral Knee Dislocation and Ankle Fracture Dislocation.

Introduction: A dislocated knee is a potential limb-threatening injury. Simultaneous dislocation of knee and ankle joint in an ipsilateral limb is a very rare pattern of injury. A few cases of ipsilateral hip and knee dislocation were described in literature. Rare injury such as posterior dislocation knee with ipsilateral ankle fracture dislocation cases was also presented. However, lateral dislocation of knee along with the same side ankle fracture dislocation is a rare scenario. To the best of our knowledge, these two simultaneous lesions do not seem to have been reported previously. Immediate management of such injury is to reduce both joint and stabilization with external fixator and definitive surgery in the second stage when soft-tissue condition allows. Case Report: We describe a rare case of a 37-year-old farmer having injury to his right leg with tiller machine. Lateral right knee dislocation and right ankle fracture dislocation reduced in the emergency department. In emergency OT, external fixator applied for knee and ankle stabilization. When swelling subsides in ankle, fracture fixation is done with plates and screws. Knee fixator is kept for 6 weeks then knee physiotherapy started. Conclusion: Dislocation of any joint is treated as an orthopedic emergency. Simultaneous dislocation of knee and ankle joints in an ipsilateral limb is a challenging situation for even the experienced surgeon. The outcome of such patients varies with associated injuries and time took for relocation and meticulous physical examination, with a high index of clinical suspicion is needed in diagnosing and management of such cases.

Development and standardization of a COVID-19 Vaccination Anxiety scale for Adult Urban Indian Population (CVAS-A).

Given the ongoing COVID-19 vaccination drive across the globe, a significant amount of confusion, mistrust, misunderstanding, and hesitancy had surfaced regarding the vaccine. A standardized tool to understand the possible reasons of COVID-19 vaccination anxiety and hesitancy would be valuable in this context. The current study aimed at developing a standardized tool to measure COVID-19 Vaccination Anxiety among Urban Indian adults. A 19-item scale was administered to an Urban adult Indian population (N = 760) between the period of February 2021- May 2021 to obtain factors associated with COVID-19 Vaccination Anxiety and establish reliability estimates of the scale. Infection-related anxiety, information-related anxiety and vaccine side-effect-related anxiety were the three factors determined through Factor Analysis. The scale was validated with Convergent and Discriminant Validity by finding correlation between the three factors of the scale and five factors of the Brief version of the Big-Five personality Inventory (extraversion, agreeableness, openness to experience, conscientiousness, and neuroticism). It is expected that a tool such as CVAS-A would help in understanding and managing COVID-19-related vaccination hesitancy.

Cobalt(III)-Catalyzed C-6 Alkenylation of 2-Pyridones by Using Terminal Alkyne with High Regioselectivity.

Co(III)-catalyzed alkenylation of 2-pyridones by using terminal alkyne as a reaction partner with high regioselectivity has been demonstrated for the first time. The reaction conditions are mild and compatible with a wide range of substrate combinations. It also shows good functional group tolerance. It proceeds through cyclometalation followed by alkyne insertion and protodemetalation steps. The formation of five- and seven-membered cobaltacycle intermediates was also detected through high-resolution mass spectrometry.

Chitosan Engineered PAMAM Dendrimers as Nanoconstructs for the Enhanced Anti-Cancer Potential and Improved In vivo Brain Pharmacokinetics of Temozolomide.

PURPOSE: To establish a platform for the possibility of effective and safe delivery of Temozolomide (TMZ) to brain via surface engineered (polyamidoamine) PAMAM dendrimer for the treatment of glioblastoma. METHODS: The present study aims to investigate the efficacy of PAMAM-chitosan conjugate based TMZ nanoformulation (PCT) against gliomas in vitro as well as in vivo. The prepared nanoconjugated formulation was characterized by 1H NMR, FT-IR spectroscopy and for surface morphological parameters. The reported approach was also designed in such a way to ensure toxicity before in vivo delivery through conducting the hemolytic study. RESULT: Surface morphology was found as per nanoformulation via size, pdi and zeta potential measurement. PCT was more efficacious in terms of IC50 values compared to pure TMZ against U-251 and T-98G glioma cell lines. The in vivo pharmacokinetic parameters proved sustained release fashion such as half-life (t1/2) of 22.74 h (PCT) rather than15.35 h (TMZ) only. Higher concentration was found in heart than brain in bio-distribution studies. This study exhibits the potential applicability of dendrimer and CS in improving the anticancer activity and delivery of TMZ to brain. CONCLUSION: The attractive ex vivo cytotoxicity against two glioma cell lines; U-251 and T-98G and phase solubility studies of TMZ revealed remarkable results. In vivo studies of prepared nanoformulation were significant and promising that explored the double concentration of TMZ in brain due to surface functionality of dendrimer. The reported work is novel and non- obvious as none of such approaches using chitosan anchored dendrimer for TMZ delivery has been reported earlier.

Impact of Dendrimers on Solubility of Hydrophobic Drug Molecules.

Adequate aqueous solubility has been one of the desired properties while selecting drug molecules and other bio-actives for product development. Often solubility of a drug determines its pharmaceutical and therapeutic performance. Majority of newly synthesized drug molecules fail or are rejected during the early phases of drug discovery and development due to their limited solubility. Sufficient permeability, aqueous solubility and physicochemical stability of the drug are important for achieving adequate bioavailability and therapeutic outcome. A number of different approaches including co-solvency, micellar solubilization, micronization, pH adjustment, chemical modification, and solid dispersion have been explored toward improving the solubility of various poorly aqueous-soluble drugs. Dendrimers, a new class of polymers, possess great potential for drug solubility improvement, by virtue of their unique properties. These hyper-branched, mono-dispersed molecules have the distinct ability to bind the drug molecules on periphery as well as to encapsulate these molecules within the dendritic structure. There are numerous reported studies which have successfully used dendrimers to enhance the solubilization of poorly soluble drugs. These promising outcomes have encouraged the researchers to design, synthesize, and evaluate various dendritic polymers for their use in drug delivery and product development. This review will discuss the aspects and role of dendrimers in the solubility enhancement of poorly soluble drugs. The review will also highlight the important and relevant properties of dendrimers which contribute toward drug solubilization. Finally, hydrophobic drugs which have been explored for dendrimer assisted solubilization, and the current marketing status of dendrimers will be discussed.

Dendrimer encapsulated and conjugated delivery of berberine: A novel approach mitigating toxicity and improving in vivo pharmacokinetics.

Berberine (BBR) is a nitrogenous cyclic natural alkaloid with potential anticancer activity. However it has been less explored due to its poor pharmacokinetic profile. Dendrimers (e.g. PAMAM) have promising potential to deliver anticancer drugs/bio-actives because of their well-defined architecture, monodispersity and tailor-made surface functionality. In the present study it was attempted to deliver berberine through G4 PAMAM dendrimers by conjugation (BPC) as well as encapsulation (BPE) approach. The developed encapsulated and conjugated berberine formulations were found to have size in the approximate range of 100-200nm while zeta potential was almost same as PAMAM G4 dendrimer. The entrapment efficiency in BPE was found to be 29.9%, whereas, the percentage conjugation in BPC was found to be 37.49% indicating high drug payload in conjugation. The developed nano-formulations were characterized through 1H NMR, FT-IR as well as electron microscopy (SEM and TEM). The in vitro release study in different media (water and PBS 7.4) showed sustained release pattern of BBR. Almost 72% and 98% drug was released within 24h respectively; whereas in PBS almost 80% and 98% release was observed within 24h, respectively. The formulations followed Higuchi release and first order release as best fit release kinetic model. MTT assay results showed significantly higher anticancer activity for the PAMAM-BBR (BPC) (p<0.01) against MCF-7 and MDA-MB-468 breast cancer cells. The time dependent ex vivo hemolytic toxicity of the BPC and BPE was significantly less (<5%) even after 24h, which indicated that the formulations can be regarded as significantly safe and biocompatible. Similarly, the in vivo hematological parameters were analyzed through auto-analyzer and the formulations were found to be safer and biocompatible with very least but insignificant (p>0.05) effects. The in vivo pharmacokinetic parameters were found to be impressively improved in albino rat model. The pharmacokinetic parameters such as half-life (t1/2) and AUC of berberine were impressively improved in the plasma level time in vivo studies in albino rat model. The obtained t1/2 was 14.33h for BPC compared to 6.7h for BBR alone. The overall conclusion says that among both the developed formulations the conjugated formulation (BPC) was found to be more prominent than the encapsulated one (BPE). Therefore conclusively conjugation can be a better option for the delivery of natural bio-actives through dendrimers.

PLGA Nanoparticles and Their Versatile Role in Anticancer Drug Delivery.

Nanotechnological advancement has become a key standard for the diagnosis and treatment of several complex disorders such as cancer by utilizing the enhanced permeability and retention effect and tumor-specific targeting. Synthesis and designing the formulation of active agents in terms of their efficient delivery is of prime importance for healthcare. The use of nanocarriers has resolved the undesirable characteristics of anticancer drugs such as low solubility and poor permeability in cells. Several types of nanoparticles (NPs) have been designed with the use of various polymers along or devoid of surface engineering for targeting tumor cells. All NPs include polymers in their framework and, of these, polylactide-co-glycolide (PLGA) is biodegradable and Food and Drug Administration approved for human use. PLGA has been used extensively in the development of NPs for anticancer drug delivery. The extensive use of PLGA NPs is promising for cancer therapy, with higher efficiency and less adverse effects. The present review focused on recent developments regarding PLGA NPs, the methods used for their preparation, their characterization, and their utility in the delivery of chemotherapeutic agents.

Spectroscopic characterization and quantitative determination of atorvastatin calcium impurities by novel HPLC method.

Seven process related impurities were identified by LC-MS in the atorvastatin calcium drug substance. These impurities were identified by LC-MS. The structure of impurities was confirmed by modern spectroscopic techniques like (1)H NMR and IR and physicochemical studies conducted by using synthesized authentic reference compounds. The synthesized reference samples of the impurity compounds were used for the quantitative HPLC determination. These impurities were detected by newly developed gradient, reverse phase high performance liquid chromatographic (HPLC) method. The system suitability of HPLC analysis established the validity of the separation. The analytical method was validated according to International Conference of Harmonization (ICH) with respect to specificity, precision, accuracy, linearity, robustness and stability of analytical solutions to demonstrate the power of newly developed HPLC method.

Effect of feeding different proportions of groundnut haulms (Arachis hypogaea) and cluster bean straw (Cyamopsis tetragonoloba) on nutrient utilisation and serum biochemical parameters in dromedary camels.

The effect of feeding different proportions of groundnut haulms (Arachis hypogaea) and cluster bean straw (Cyamopsis tetragonoloba) on nutrient digestibility, nutritive value, nutrient intake and serum biochemical parameters was studied using nine male dromedary camels of Bikaneri breeds (637.5 kg average body weight; 8-9 years of age). Groundnut haulms (GNH) and cluster bean straw (CBS) were fed in one of three ratios, 75:25, 50:50 and 25:75 in treatments T(1), T(2) and T(3), respectively. In all treatments, concentrate mixture was fed as per requirement of the camels. The groundnut haulms were more nutritive as compared to the cluster bean straw. The nutrient digestibility of dry matter, organic matter, crude protein (CP), crude fibre and acid detergent fibre was better in T(1) than T(2) and T(3). Likewise, the CP, digestible crude protein and total digestible nutrient contents were significantly higher in T(1) followed by T(2) and T(3). There was non-significant affect on average daily gain of camels. However, dry matter intake, digestible crude protein intake and total digestible nutrients were better in T(1) as compared to T(2) and T(3). The total water intake per kilogram of dry matter intake (litres) was 2.98, 2.89 and 2.68, respectively, in T(1), T(2) and T(3). The camels in all the treatments were in positive nitrogen, calcium and phosphorus balance. The treatments had a significant effect on serum biochemical parameters like glucose, cholesterol, aspartate transaminase and creatinine. The results may conclude that feeding of higher proportion of groundnut haulms as compared to cluster bean straw has pronounced improvement in nutritional utilisation by the camels.

Ambulatory laparoscopic tubal ligation: a comparison of general anaesthesia with local anaesthesia and sedation.

BACKGROUND: To compare the anaesthetic techniques for laparoscopic tubal ligation using either general anaesthesia with LMA or a combination of local anaesthetic and intravenous sedation, this study was conducted on 60 ASA-1/2 patients in the age group of 20-40 years. PATIENTS #ENTITYSTARTX00026; METHODS: 60 ASA grade I & II female patients undergoing laparoscopic tubal ligation on a day care basis were randomly divided in two groups- group I (GA using LMA, n=30), group II (Local anaesthesia, n=30). Both groups received similar premedication. General anaesthesia in group I was induced with propofol 2-3 mg kg(-1) and following LMA insertion, the anaesthesia was maintained with 0.5-1.5% halothane. In group II the incision site was infiltrated with 10 ml of 1.5% lidocaine with adrenaline and patients were sedated with intravenous midazolam 0.07mg kg(-1) and ketamine 0.5 mg kg(-1). A rescue dose of 0.15 mg kg(-1) of ketamine was given in group II if the patient complained of pain or discomfort during the procedure. Diclofenac sodium 1 mg kg(-1) was used for postoperative analgesia in both the groups. All patients were observed in the PACU until they met the discharge criteria. RESULTS: The demographic profile was similar in both the groups. The induction to skin incision time was significantly more in group I (5.13 ±0.93 min vs 3.01 ±1.86 min in group II). The decrease in pulse rate and blood pressure (systolic and diastolic) was also significant in group I. The incidence of intraoperative bradycardia was 16.7% and 10% in group I & group II respectively. The changes in SpO(2) during the procedure, recovery time and time to meet discharge criteria were comparable in both the groups. The incidence of PONV was 20% & 3.3% in group I and 10% & 6.6% in group II respectively. All patients in both the groups required postoperative analgesics. CONCLUSIONS: Both the techniques were found to be comparable for laparoscopic sterilization, however a longer induction to skin incision time and higher incidence of PONV and shivering in GA group makes LA with sedation a better choice.

Atypical rabies with MRI findings: clue to the diagnosis.

Rabies is known for most as a fatal infectious disease, mainly transmitted to both humans and animals through bites by rabid animals. In its classical form, rabies is well recognised, but when it presents atypically in paralytic form, it may become difficult to distinguish from Guillain-Barré syndrome (GBS) or myelitis, particularly where history is not forthcoming or concealed. The authors report here an atypical case of paralytic rabies presenting with descending paralysis followed by furious form where clue to suspicion was MRI findings. Imaging in rabies is seldom done. MRI findings of rabies encephalitis are well known, but in myelitis these need to be further characterised. The authors present MRI findings in a confirmed case of rabies myelitis. The differential diagnosis of the imaging findings as well as the role and the relevance of imaging in the diagnosis of this disease are discussed.

An unusual case of DRESS syndrome due to leflunomide.

The DRESS (drug rash, eosinophilia and systemic symptoms) syndrome, is a type of drug hypersensitivity syndrome, is a severe idiosyncratic reaction to several drugs, mainly antiepileptics and antibiotics, which can occasionally produce acute hepatic failure. In this article, the authors report a case of DRESS syndrome with severe exfoliative dermatitis with acute hepatitis associated with intake of leflunomide. Rapid diagnosis with withdrawal of offending agent is crucial for survival of these cases.

Spectroscopy: the study of DNA cleavage by newly synthesized polydentate macrocyclic ligand and its copper(II) complexes.

A novel hexadentate nitrogen donor [N6] macrocyclic ligand, i.e. 2,6,12,16,21,22-hexaaza-3,5,13,15-tetramethyl-4,14-diethyl-tricyclo-[15.3.1.1(7-11)]docosane-1(21),2,5,7(22),8,10,12,15,17,19-decaene (L), has been synthesized. Copper(II) complexes with this ligand have been prepared and subjected to elemental analyses, molar conductance measurements, magnetic susceptibility measurements, mass, 1H NMR (ligand), IR, electronic, and EPR spectral studies. On the basis of molar conductance the complexes may be formulated as [Cu(L)X2] [X = Cl(-), Br(-), NO3(-) and CH3COO(-)] due to their nonelectrolytic nature in N,N'-dimethylformamide (DMF). All the complexes are of the high spin type and are six coordinated. On the basis of IR, electronic and EPR spectral studies tetragonal geometry has been assigned to the Cu(II) complexes. The interaction of these complexes with calf thymus DNA has been explored by using absorption, emission, viscosity measurements, electrochemical studies and DNA cleavage. All the experimental results suggest that the complexes bind to DNA and also promote the cleavage plasmid pBR 322, in the presence of H2O2 and ascorbic acid.

Spectroscopic studies on chromium(III), manganese(II), cobalt(II), nickel(II) and copper(II) complexes with hexadentate nitrogen-sulfur donor [N(2)S(4)] macrocyclic ligand.

Complexes of transition metals have been synthesized with hexadentate ligand (2,6-bis(((2-mercaptophenyl)thio)methyl)pyridinato)metal(II). These complexes have been synthesized via the two step template reaction by using the benzene dithiol, 2,6-bis(chloro)methyl pyridine and corresponding metal salt as key raw materials. The structures of the complexes have been elucidated on the basis of elemental analysis, molar conductance measurements, magnetic susceptibility measurements, IR, electronic and EPR spectral studies. All of the complexes were found to possess six-coordinated geometry and are of high spin type.

The Spectroscopy: a modern technology in the characterization of novel macrocyclic ligand and its homo-bi-nuclear cobalt (II) complexes.

A novel hexadentate nitrogen-sulphur donor [N(4)S(2)] macrocyclic ligand, i.e. 3,13-dithio-6,10,16,20-tetraoxo-8,18-dithia-1,2,4,5,11,12,14,15-octaazacyclocosane (L), has been synthesized. Cobalt (II) complexes of this ligand have been prepared and subjected to elemental analyses, molar conductance measurements, magnetic moment susceptibility measurements, mass, (1)H NMR (Ligand), IR, electronic, and EPR spectral studies. On the basis of molar conductance, complexes may be formulated as [Co(2)(L)X(2)]X(2) [where X=Cl(-), Br(-), NO(3)(-) and NCS(-)] due to their 1:2 electrolytic nature in dimethylformamide (DMF). All the complexes are of the high spin type and are four coordinated. On the basis of IR, electronic and EPR spectral studies tetrahedral geometry has been assigned to all the complexes. The antimicrobial activities of the ligand and its complexes, as growth inhibiting agents, have been screened in vitro against several species of bacteria and plant pathogenic fungi.

Spectroscopic and physicochemical studies on nickel(II) complexes of isatin-3,2'-quinolyl-hydrazones and their adducts.

Nickel(II) complexes of isatin-3,2'-quinolyl-hydrazones of the type [Ni(L)X] (where X=Cl-, Br-, NO3-, CH3COO- and ClO4-] and their adducts Ni(L)X.2Y [where Y=pyridine or dioxane and X=Cl-, Br-, NO3- and ClO4-] have been synthesized under controlled experimental conditions and characterized by using the modern spectroscopic and physicochemical techniques viz. mass, 1H NMR, IR, electronic, elemental analysis, magnetic moment susceptibility measurements and molar conductance, etc. On the basis of spectral studies a four coordinated tetrahedral geometry is assigned for Ni(L)X type complexes whereas the adducts (Ni(L)X.2Y) were found to have a six coordinated distorted octahedral geometry.

Spectroscopic approach in the characterization of the copper(II) complexes of isatin-3,2'-quinolyl-hydrazones and their adducts.

Copper(II) complexes of isatin-3,2'-quinolyl-hydrazones of the type [Cu(L)X] (where X=Cl(-), Br(-), NO(3)(-), CH(3)COO(-) and ClO(4)(-)] and their adducts Cu(L)X.2Y [where Y=pyridine or dioxane and X=Cl(-), Br(-), NO(3)(-) and ClO(4)(-)] have been synthesized under controlled experimental conditions and characterized by using the modern spectroscopic and physicochemical techniques viz. IR, electronic, EPR, elemental analysis, magnetic moment susceptibility measurements and molar conductance, etc. On the basis of spectral studies a four coordinated square planer geometry is assigned for Cu(L)X type complexes whereas the adducts (Cu(L)X.2Y were found to have a six coordinated octahedral geometry.