Local anaesthesia for carotid endarterectomy: Pro: protect the brain

No abstract available

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The effects of intraoperative lung protective ventilation with positive end-expiratory pressure on blood loss during hepatic resection surgery: A secondary analysis of data from a published randomised control trial (IMPROVE)

BACKGROUND: During high-risk abdominal surgery the use of a multi-faceted lung protective ventilation strategy composed of low tidal volumes, positive end-expiratory pressure (PEEP) and recruitment manoeuvres, has been shown to improve clinical outcomes. It has been speculated, however, that mechanical ventilation using PEEP might increase intraoperative bleeding during liver resection. OBJECTIVE: To study the impact of mechanical ventilation with PEEP on bleeding during hepatectomy. DESIGN: Post-hoc analysis of a randomised controlled trial. SETTING: Seven French university teaching hospitals from January 2011 to August 2012. PARTICIPANTS: Patients scheduled for liver resection surgery. INTERVENTION: In the Intraoperative Protective Ventilation trial, patients scheduled for major abdominal surgery were randomly assigned to mechanical ventilation using low tidal volume, PEEP between 6 and 8 cmH2O and recruitment manoeuvres (lung protective ventilation strategy) or higher tidal volume, zero PEEP and no recruitment manoeuvres (non-protective ventilation strategy). MAIN OUTCOME AND MEASURE: The primary endpoint was intraoperative blood loss volume. RESULTS: A total of 79 (19.8%) patients underwent liver resections (41 in the lung protective and 38 in the non-protective group). The median (interquartile range) amount of intraoperative blood loss was 500 (200 to 800) ml and 275 (125 to 800) ml in the non-protective and lung protective ventilation groups, respectively (P = 0.47). Fourteen (35.0%) and eight (21.5%) patients were transfused in the non-protective and lung protective groups, respectively (P = 0.17), without a statistically significant difference in the median (interquartile range) number of red blood cells units transfused [2.5 (2 to 4) units and 3 (2 to 6) units in the two groups, respectively; P = 0.54]. CONCLUSION: During hepatic surgery, mechanical ventilation using PEEP within a multi-faceted lung protective strategy was not associated with increased bleeding compared with non-protective ventilation using zero PEEP. TRIAL REGISTRATION: The current study was not registered. The original Intraoperative Protective Ventilation study was registered on clinicaltrials.gov; number NCT01282996.

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Local anaesthesia for carotid endarterectomy: Con: decrease the stress for all

No abstract available

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Regional or general anaesthesia for carotid endarterectomy: Does it matter?

No abstract available

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Reply to: how to minimise ventilator-induced lung injury in transplanted lungs

No abstract available

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Neck circumference as a predictor of difficult intubation and difficult mask ventilation in morbidly obese patients: A prospective observational study

BACKGROUND: There is conflicting evidence as to whether obesity and neck circumference are predictors of difficult intubation in the surgical population. In addition, the cut-off neck circumference related to difficult intubation has not been clearly identified. OBJECTIVES: The primary study objective was to determine whether neck circumference and obesity were predictors of difficult intubation in morbidly obese surgical patients. Secondary outcomes included difficult mask ventilation. DESIGN: A prospective, noninterventional study. SETTING: Canadian tertiary care surgical centre between October 2012 and August 2013. PATIENTS: A total of 104 morbidly obese surgical patients (BMI ≥40 kg m−2) were included in the study. Eighty-eight patients were women and 16 were men. Exclusions were known difficult airway and emergency surgery. MAIN OUTCOME MEASURES: The primary outcome of the study was difficult tracheal intubation. An Intubation Difficulty Scale (IDS) was derived using seven parameters and difficult intubation was defined as IDS of at least 5. The secondary outcome was difficult mask ventilation; mask ventilation was graded as easy or difficult (inadequate, desaturation, two-handed or impossible). RESULTS: Univariate analyses showed that difficult intubation was associated with neck circumference, males, BMI more than 50 kg m−2, American Society of Anesthesiologists (ASA) status and waist circumference, and difficult mask ventilation with neck circumference, males, BMI more than 50 kg m−2 and thyromental distance. Multiple logistic regression analysis showed that neck circumference more than 42 cm (P = 0.044) and BMI more than 50 kg m−2 (P = 0.017) were independent predictors of difficult intubation. Male sex (P = 0.004) and BMI more than 50 kg m−2 (P = 0.031) were independent predictors of difficult mask ventilation.

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Reply to: preventing hypoxia

No abstract available

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Efficacy of coaxial ventilation with a novel endotracheal catheter equipped with a functional cuff: A swine model study

BACKGROUND: We have developed an endotracheal catheter with a functional cuff (ECFC) that inflates during inspiration and deflates during expiration. This catheter, together with a regular ICU ventilator, can provide coaxial ventilation. OBJECTIVE: The aim of this study was to determine the efficacy of ventilation in adult human-sized swine using an ECFC and a regular ICU ventilator. DESIGN: A prospective animal study. SETTING: Experimental, Trauma Transplant Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA. ANIMALS: Eight adult Yorkshire swine, weighing 45 to 50 kg, were studied. INTERVENTIONS: To create the ECFC, a 5 cm long latex cuff was placed over the distal side ports of either a 14 or 19-Fr gauge endotracheal catheter and a 1 cm long piece of plastic tube was inserted into the tip of the endotracheal catheter to create an internal resistance. The ECFC was placed into the trachea and the proximal end of the ECFC was connected to an ICU ventilator in pressure-control mode, with peak pressures set at either 25, 50 or 70 cmH2O. MAIN OUTCOME MEASURES: Tidal volume was calculated using plethysmography. RESULTS: During pressure control ventilation with the 14-Fr gauge ECFC at set inspiratory pressures of 25, 50 and 75 cmH2O, the tidal volumes generated were 209 ± 36, 309 ± 61 and 367 ± 85 ml, respectively, and with the 19-Fr gauge ECFC these were 277 ± 51, 442 ± 91 and 538 ± 123 ml, respectively. No complications were observed. CONCLUSION: An ECFC combined with a regular pressure-controlled ICU ventilator can produce adequate tidal volumes in adult human-sized swine. Our results establish the feasibility of ventilation with this new alternative technique. The safety and advantages of such a technique remain to be determined in humans.

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EEG response varies with lesion location in patients with chronic stroke

Brain activation differs according to lesion location in functional magnetic resonance imaging (fMRI) studies, but lesion location-dependent electroencephalographic (EEG) alterations are unclear. Because of th...

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The dynamics of electric powered wheelchair sideways tips and falls: experimental and computational analysis of impact forces and injury

To reduce the occurrence of wheelchair falls and to develop effective protection systems, we aimed to quantify sideways tip and fall dynamics of electric power wheelchairs (EPWs). We hypothesized that driving ...

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Anatomical location of the vocal cords in relation to cervical vertebrae: A new predictor of difficult laryngoscopy?

BACKGROUND: Several anatomical factors, such as prognathism, sex, short thyromental distance and others are known to make direct laryngoscopy difficult. OBJECTIVE: We investigated the hypothesis that the anatomical position of the vocal cords in relation to the cervical vertebrae correlates with difficult laryngoscopy. Existing MRI was used to identify the position of the vocal cords relative to the cervical spine in patients with and without difficult laryngoscopy. DESIGN: Observational study with adaptive enrichment. SETTING: University hospital. PATIENTS: A total of 142 adult patients, 91 with easy (Cormack-Lehane class 1 or 2) and 51 with difficult (Cormack-Lehane class 3 or 4) laryngoscopy. MAIN OUTCOME MEASURES: Position of the vocal cords relative to cervical vertebrae in patients with easy vs. difficult laryngoscopy. RESULTS: In patients with difficult laryngoscopy, we found a higher incidence of cranial position of the vocal cords in relation to the cervical spine compared with patients with easy laryngoscopy (P 

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How to minimise ventilator-induced lung injury in transplanted lungs

No abstract available

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McGRATH MAC video laryngoscope for insertion of a transoesophageal echocardiography probe: A randomised controlled trial

BACKGROUND: Transoesophageal echocardiography (TOE) probe insertion in anaesthetised patients can cause pharyngeal and oesophageal injuries. Kim et al. have shown that insertion assisted by a Macintosh laryngoscope can reduce such complications but it may sometimes be difficult to observe the passage of a TOE probe. The McGRATH MAC (McGRATH) has been shown to provide a better view of the glottis, piriform fossa and oesophageal inlet during tracheal intubation than the Macintosh. OBJECTIVE: We hypothesised that the McGRATH provided better visualisation of the oesophageal inlet and was useful as an aid to TOE probe placement, possibly reducing the incidence of pharyngeal injury related to insertion, compared with the Macintosh. DESIGN: A randomised controlled trial. SETTING: The study was conducted in a university hospital from February to December 2014. PATIENTS: One hundred patients undergoing elective surgery under intraoperative TOE monitoring were randomised to either a Macintosh group or a McGRATH group. INTERVENTIONS: Macintosh and McGRATH were used to visualise the passage of the TOE probe and guide its insertion. MAIN OUTCOME MEASURES: Visibility of the oesophageal inlet, the number of TOE insertion attempts and incidence of pharyngeal mucosal injury after the TOE probe had been removed were assessed. RESULTS: The percentage of patients in whom the oesophageal inlet was visible was higher in the McGRATH group (88%) than in the Macintosh group (41%) (P 

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Blind intubation through Air-Q SP laryngeal mask in morbidly obese patients

No abstract available

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Low-positive pressure ventilation improves non-hypoxaemic apnoea tolerance during ear, nose and throat pan-endoscopy: A randomised controlled trial

BACKGROUND: It has been suggested that oxygenation using pressure support ventilation (PSV) before general anaesthesia can reduce the duration of non-hypoxaemic apnoea. OBJECTIVE: The objective was to determine whether or not pre-oxygenation with PSV increases the duration of non-hypoxaemic apnoea in non-obese patients during pan-endoscopy. DESIGN: A randomised, controlled trial. SETTING: Amiens University Hospital, France. PATIENTS: Fifty patients scheduled for ENT pan-endoscopy with a BMI lower than 35 kg m−2. INTERVENTION: Patients scheduled for pan-endoscopy were enrolled to receive either 100% oxygen at neutral pressure (the control group) or 100% oxygen with positive-pressure ventilation (a positive inspiratory pressure of 4 cmH2O and a positive end-expiratory pressure of 4 cmH2O; the PSV group) during spontaneous ventilation with a face mask. The goal of pre-oxygenation was to obtain an end-tidal oxygen concentration of more than 90% prior to induction of anaesthesia. MAIN OUTCOME MEASURES: The primary efficacy criterion was the duration of non-hypoxaemic apnoea (i.e. before the peripheral capillary oxygen saturation fell to 90%). Secondary outcomes were duration of pre-oxygenation, pre-oxygenation failure and tolerance. RESULTS: The mean (interquartile range) duration of non-hypoxaemic apnoea was longer in the PSV group [598 (447 to 717) s] than in the control group [310 (217 to 451) s] (P 

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Preventing hypoxia

No abstract available

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Effects of dexmedetomidine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery: A randomised double-blinded trial

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a risk factor that increases the incidence of postoperative cardiopulmonary morbidity and mortality after lung resection. Dexmedetomidine, a selective α2-adrenoreceptor agonist, has been reported previously to attenuate intrapulmonary shunt during one-lung ventilation (OLV) and to alleviate bronchoconstriction. OBJECTIVE: The objective is to determine whether dexmedetomidine improves oxygenation and lung mechanics in patients with moderate COPD during lung cancer surgery. DESIGN: A randomised, double-blinded, placebo-controlled study. SETTING: Single university hospital. PARTICIPANTS: Fifty patients scheduled for video-assisted thoracoscopic surgery who had moderate COPD. Patients were randomly allocated to a control group or a Dex group (n = 25 each). INTERVENTIONS: In the Dex group, dexmedetomidine was given as an initial loading dose of 1.0 μg kg−1 over 10 min followed by a maintenance dose of 0.5 μg kg−1 h−1 during OLV while the control group was administered a comparable volume of 0.9% saline. Data were measured at 30 min (DEX-30) and 60 min (DEX-60) after dexmedetomidine or saline administration during OLV. MAIN OUTCOME MEASURES: The primary outcome was the effect of dexmedetomidine on oxygenation. The secondary outcome was the effect of dexmedetomidine administration on postoperative pulmonary complications. RESULTS: Patients in the Dex group had a significantly higher PaO2/FIO2 ratio (27.9 ± 5.8 vs. 22.5 ± 8.4 and 28.6 ± 5.9 vs. 21.0 ± 9.9 kPa, P 

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The VivaSight-DL double-lumen tube with integrated camera

No abstract available

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Introduction to the Special Section on Implementing Feedback from Outcome Measures in Child and Adult Mental Health Services

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Evaluation of the effect of vitamin D on sodium fluoride–induced toxicity in reproductive functions of male rabbits

2016-03-02T14-34-17Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Basem H Elesawy, Abd Al N Rahman Alghamdy, Ahmad El-Askary, Magdi M Salih.
Background: Fluorosis is an endemic problem in many countries of the world. Aims and Objectives: To see the effect of fluoride on the reproductive system and to see the role, if any, of vitamin D analog paricalcitol on it. Materials and Methods: Sixty rabbits were divided into four equal groups. Group I was fed on standard diet, Group II vehicle-treated control, Group III on sodium fluoride (NaF) 20 mg/kg body weight, and Group IV on NaF + paricalcitol. Result: In Group III (fed on NaF) significant decrease in sperm count (P

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Intraocular pressure changes in smokers and nonsmokers

2016-03-02T14-19-52Z
Source: International Journal of Medical Science and Public Health
Ganesh Kamble, Joya Rani D, Madhuri Taranikanti, Ratna Jyothi Meka.
Background: Smoking is a known risk factor for several diseases and is a modifiable risk factor for several ocular diseases. Cigarette smoke contains toxic chemicals such as polycyclic aromatic hydrocarbons, tar, carbon monoxide, and heavy metals. Nicotine is a psychoactive component of tobacco that can affect the eye causing cataracts and macular degeneration leading to loss of vision. Objectives: To see the effects of tobacco smoke on the intraocular pressure and systemic blood pressure and to assess the visual acuity of smokers. Materials and Methods: A total of 100 male participants between 40 and 60 years were included in the study of which 50 were controls who were nonsmokers and 50 participants grouped as cases had variable smoking history. A questionnaire was given to all participants to obtain information about smoking in terms of number of cigarettes smoked and duration (number of years). Anthropometric measurements were taken to determine their weight in Kg and height in cm. Blood pressure was measured using a sphygmomanometer to obtain both systolic and diastolic pressures. Normal blood pressure was considered as systolic blood pressure between 100 and 140 mmHg and diastolic blood pressure between 60 and 90 mmHg. Pulse rate and respiratory rate were also recorded. Examination of the eye was done to measure their visual acuity using a Snellens chart and intraocular pressure was measured using Schiotz tonometer. Results: There was a statistically significant fall in visual acuity and a rise in intraocular pressure with p

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Cannabis Abuse Is Increasing and Associated with Increased Emergency Department Utilization in Gastroenterology Patients

Abstract

Background

The role of cannabinoids in gastrointestinal diseases is controversial and of great interest, yet their use in patients has not been critically examined.

Aim

To determine the prevalence and effects of cannabis abuse on healthcare utilization, as measured by emergency department (ED) visits, in a large, tertiary gastroenterology practice.

Methods

All patients seen in the gastroenterology clinic at a tertiary care center during a 27-year period (1986–2013) were included in our study to determine the overall prevalence of cannabis abuse. We matched cannabis abusers 1:2 with non-abusing controls to determine the effect of cannabis on ED utilization, our primary outcome. We used multivariate linear regression to adjust for confounders and define the independent effect of cannabis abuse on ED utilization.

Results

Our prevalence study cohort included 190,303 GI clinic patients with an overall cannabis abuse prevalence of 0.80 % (1520 patients). From 1986 to 2012, the prevalence of cannabis abuse in this clinic increased by 0.73 % (0.03 %/year) (p < 0.0001). From the 1520 cannabis abusers identified, 467 patients were randomly selected as cases and were matched to 934 controls. From this retrospective cohort, the median ED visits/year for cannabis abusers was 1.88 versus 0.89 for non-abusers (p < 0.0001). After multivariate adjustment, cannabis abuse was associated with a 1.47-fold increase (95 % CI 1.23–1.76, p < 0.0001) in median ED visits/year.

Conclusions

Reported cannabis abuse in GI clinic patients is less prevalent than in the adult US population, but is increasing. Cannabis abuse among gastroenterology patients is associated with increased ED visits.

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The valley system of the Jihlava river and Mohelno reservoir with enhanced tritium activities

Publication date: Available online 2 March 2016
Source:Journal of Environmental Radioactivity
Author(s): P. Simek, T. Kořínková, I. Svetlik, P.P. Povinec, M. Fejgl, I. Malátová, L. Tomaskova, V. Stepan
The Dukovany nuclear power plant (NPP Dukovany) releases liquid effluents, including HTO, to the Mohelno reservoir, located in a deep valley. Significantly enhanced tritium activities were observed in the form of non-exchangeable organically bound tritium in the surrounding biota which lacks direct contact with the water body. This indicates a tritium uptake by plants from air moisture and haze, which is, besides the uptake by roots from soil, one of the most important mechanisms of tritium transfer from environment to plants. Results of a pilot study based on four sampling campaigns in 2011–2015 are presented and discussed, with the aim to provide new information on tritium transport in the Mohelno reservoir - Jihlava River – plants ecosystems.



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Alteration of natural 37Ar activity concentration in the subsurface by gas transport and water infiltration

Publication date: May 2016
Source:Journal of Environmental Radioactivity, Volumes 155–156
Author(s): Sophie Guillon, Yunwei Sun, Roland Purtschert, Lauren Raghoo, Eric Pili, Charles R. Carrigan
High ³⁷Ar activity concentration in soil gas is proposed as a key evidence for the detection of underground nuclear explosion by the Comprehensive Nuclear Test-Ban Treaty. However, such a detection is challenged by the natural background of ³⁷Ar in the subsurface, mainly due to Ca activation by cosmic rays. A better understanding and improved capability to predict ³⁷Ar activity concentration in the subsurface and its spatial and temporal variability is thus required. A numerical model integrating ³⁷Ar production and transport in the subsurface is developed, including variable soil water content and water infiltration at the surface. A parameterized equation for ³⁷Ar production in the first 15 m below the surface is studied, taking into account the major production reactions and the moderation effect of soil water content. Using sensitivity analysis and uncertainty quantification, a realistic and comprehensive probability distribution of natural ³⁷Ar activity concentrations in soil gas is proposed, including the effects of water infiltration. Site location and soil composition are identified as the parameters allowing for a most effective reduction of the possible range of ³⁷Ar activity concentrations. The influence of soil water content on ³⁷Ar production is shown to be negligible to first order, while ³⁷Ar activity concentration in soil gas and its temporal variability appear to be strongly influenced by transient water infiltration events. These results will be used as a basis for practical CTBTO concepts of operation during an OSI.



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Frequency-specific disruptions of neuronal oscillations reveal aberrant auditory processing in schizophrenia

Abstract

Individuals with schizophrenia exhibit abnormalities in evoked brain responses in oddball paradigms. These could result from (a) insufficient salience-related cortical signaling (P300), (b) insufficient suppression of irrelevant aspects of the auditory environment, or (c) excessive neural noise. We tested whether disruption of ongoing auditory steady-state responses at predetermined frequencies informed which of these issues contribute to auditory stimulus relevance processing abnormalities in schizophrenia. Magnetoencephalography data were collected for 15 schizophrenia and 15 healthy subjects during an auditory oddball paradigm (25% targets; 1-s interstimulus interval). Auditory stimuli (pure tones: 1 kHz standards, 2 kHz targets) were administered during four continuous background (auditory steady-state) stimulation conditions: (1) no stimulation, (2) 24 Hz, (3) 40 Hz, and (4) 88 Hz. The modulation of the auditory steady-state response (aSSR) and the evoked responses to the transient stimuli were quantified and compared across groups. In comparison to healthy participants, the schizophrenia group showed greater disruption of the ongoing aSSR by targets regardless of steady-state frequency, and reduced amplitude of both M100 and M300 event-related field components. During the no-stimulation condition, schizophrenia patients showed accentuation of left hemisphere 40 Hz response to both standard and target stimuli, indicating an effort to enhance local stimulus processing. Together, these findings suggest abnormalities in auditory stimulus relevance processing in schizophrenia patients stem from insufficient amplification of salient stimuli.

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Radioactivity of cigarettes and the importance of 210Po and thorium isotopes for radiation dose assessment due to smoking

Publication date: May 2016
Source:Journal of Environmental Radioactivity, Volumes 155–156
Author(s): Davor Kubalek, Gregor Serša, Marko Štrok, Ljudmila Benedik, Zvonka Jeran
Tobacco and tobacco smoke are very complex mixtures. In addition to various chemical and organic compounds they also contain natural radioactive elements (radionuclides). In this work, the natural radionuclide activity concentrations (²³⁴U, ²³⁸U, ²²⁸Th, ²³⁰Th, ²³²Th, ²²⁶Ra, ²¹⁰Pb and ²¹⁰Po) of nine different cigarette samples available on the Slovenian market are reported. In addition to ²¹⁰Po, the transfer of thorium isotopes from a cigarette to a smoker's body and lungs have been determined for the first time. Cigarette smoke and exhaled air from smokers' lungs were collected from volunteer smokers (C-4 brand) to determinate what quantity of ²¹⁰Po and thorium isotopes is transferred from the tobacco to the smoker's lungs. Cigarette ash and smoked filters were also collected and analysed. Among the determined isotopes, ²¹⁰Pb and ²¹⁰Po showed the highest activity concentrations. During the smoking of one cigarette approximately 22% of ²¹⁰Po (and presumably its predecessor ²¹⁰Pb), 0.6% of ²²⁸Th, 24% of ²³⁰Th, and 31% of ²³²Th are transferred from the cigarette and retained in the smoker's body. The estimated annual effective dose for smokers is 61 μSv/year from ²¹⁰Po; 9 μSv/year from ²¹⁰Pb; 6 μSv/year from ²²⁸Th; 47 μSv/year from ²³⁰Th, and 37 μSv/year from ²³²Th. These results show the importance of thorium isotopes in contributing to the annual effective dose for smoking.

Graphical abstract

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Naturally occurring radioactivity in some Swedish concretes and their constituents – Assessment by using I-index and dose-model

Publication date: May 2016
Source:Journal of Environmental Radioactivity, Volumes 155–156
Author(s): M. Döse, J. Silfwerbrand, C. Jelinek, J. Trägårdh, M. Isaksson
The reference level for effective dose due to gamma radiation from building materials and construction products used for dwellings is set to 1 mSv per year (EC, 1996, 1999), (CE, 2014). Given the specific conditions presented by the EC in report 112 (1999) considering building and construction materials, an I-index of 1 may generate an effective dose of 1 mSv per year. This paper presents a comparison of the activity concentrations of ⁴⁰K, ²²⁶Ra and ²³²Th of aggregates and when these aggregates constitute a part of concrete. The activity concentration assessment tool for building and construction materials, the I-index, introduced by the EC in 1996, is used in the comparison. A comparison of the I-indices values are also made with a recently presented dose model by Hoffman (2014), where density variations of the construction material and thickness of the construction walls within the building are considered. There was a ∼16–19% lower activity index in concretes than in the corresponding aggregates. The model by Hoffman further implies that the differences between the I-indices of aggregates and the concretes' final effective doses are even larger. The difference is due, mainly to a dilution effect of the added cement with low levels of natural radioisotopes, but also to a different and slightly higher subtracted background value (terrestrial value) used in the modeled calculation of the revised I-index by Hoffman (2014). Only very minimal contributions to the annual dose could be related to the water and additives used, due to their very low content of radionuclides reported.



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Movement Patterns of the Knee During Gait Following ACL Reconstruction: A Systematic Review and Meta-Analysis

Abstract

Background

Altered gait patterns follow ing anterior cruciate ligament reconstruction (ACLR) may be associated with long-term impairments and post-traumatic osteoarthritis.

Objective

This systematic review and meta-analysis compared lower limb kinematics and kinetics of the ACL reconstructed knee with (1) the contralateral limb and (2) healthy age-matched participants during walking, stair climbing, and running. The secondary aim was to describe the differences over time following ACLR for these biomechanical variables.

Method

Database searches were conducted from inception to July 2014 and updated in August 2015 for studies exploring peak knee angles and moments following ACLR during walking, stair negotiation, and running. Risk of bias was assessed with a modified Downs and Black quality index for all included studies, and meta-analyses were performed. Forest plots were explored qualitatively for recovery of gait variables over time after surgery.

Results

A total of 40 studies were included in the review; 26 of these were rated as low risk and 14 as high risk of bias. The meta-analysis included 27 studies. Strong to moderate evidence indicated no significant difference in peak flexion angles between ACLR and control groups during walking and stair ascent. Strong evidence was found for lower peak flexion moments in participants with ACLR compared with control groups and contralateral limb during walking and stair activities. Strong to moderate evidence was found for lower peak adduction moment in ACLR participants for the injured compared with the contralateral limbs during walking and stair descent. The qualitative assessment for recovery over time indicated a pattern towards restoration of peak knee flexion angle with increasing time from post-surgery. Peak knee adduction moments were lower within the first year following surgery and higher than controls during later phases (5 years).

Conclusion

Joint kinematics are restored, on average, 6 years following reconstruction, while knee external flexion moments remain lower than controls. Knee adduction moments are lower during early phases following reconstruction, but are higher than controls, on average, 5 years post-surgery. Findings indicate that knee function is not fully restored following reconstruction, and long-term maintenance programs may be needed.

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Rehabilitation needs of stroke survivors after discharge from hospital in India

Publication date: Available online 2 March 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): K. Sureshkumar, G.V.S. Murthy, Audrey Prost, N. Subbulakshmy, Hira Pant, C. Naveen, Shifalika Goenka, Hannah Kuper
ObjectiveThe primary objective of this study was to assess the rehabilitation needs of stroke survivors in Chennai, India, after discharge from hospital.DesignMixed Methods research designSettingHome-based: Participantsa. Quantitative survey: Stroke survivors (N=50; mean age, 58.9 ±10.5yrs) and Primary caregivers of these stroke survivors (N=50; mean age, 43.1 ±11.8 yrs.)b. Qualitative in-depth interviews: A sub-sample of 12 stroke survivors, 10 primary caregivers and eight health care professionals.InterventionsNot applicableMain Outcome MeasureRehabilitation needs following hospital dischargeResultsAbout 82% of the needs expressed by stroke survivors and 92 % of the needs expressed by caregivers indicated that they had a substantial need for information. The proportion of financial needs reported by the stroke survivors and the caregivers was 70% and 75% respectively. The qualitative data revealed major gaps in access to stroke rehabilitation services. Service providers identified availability, affordability of services as key problems. Stroke survivors and their caregivers identified lack of information about stroke as major barriers to accessibility of stroke rehabilitation services. Caregivers expressed a tremendous need for support to manage family dynamics.ConclusionThe study highlights considerable unmet need for post-stroke rehabilitation services. Given the lack of rehabilitation resources in India, developing an accessible, innovative, patient-centred, culturally sensitive rehabilitation intervention is of public health importance. It is crucial for Low and Middle Income Countries like India to develop technology-driven stroke rehabilitation strategies to meet the growing rehabilitation needs of stroke survivors.



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Validity of The Timed Up and Go as A Measure of Functional Mobility in Persons with Multiple Sclerosis

Publication date: Available online 2 March 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Emerson Sebastião, Brian M. Sandroff, Yvonne C. Learmonth, Robert W. Motl
ObjectiveTo examine the validity of the TUG as measure of functional mobility in persons with multiple sclerosis (MS) using a comprehensive framework based on construct validity (i.e., convergent and divergent validity).DesignCross-sectional studySettingHospital settingParticipantsCommunity-residing persons with MS (n = 47)InterventionNot applicable.Main Outcome MeasuresMain outcome measures included the Timed Up and Go Test (TUG), 25-foot walk (T25FW), six-minute walk (6MW), Multiple Sclerosis Walking Scale-12 (MSWS-12), Late Life Function and Disability Inventory, posturography evaluation, Activities-specific Balance Confidence (ABC), Symbol Digits Modalities Test (SDMT), Expanded Disability Status Scale (EDSS), and the number of steps taken per day.ResultsTUG performance was strongly-associated with other valid measures of ambulatory mobility (rs=.71-.90) and disability status (rs=.80); moderately-to-strongly associated with balance confidence (rs=.66), and weakly-associated with postural control (i.e., balance) (rs=.31). TUG performance was moderately-associated with cognitive processing speed (rs=.59), but not associated with other non-ambulatory measurement (i.e., LLFDI-UEF scores).ConclusionsOur findings support the validity of the TUG as a measure of functional mobility. This warrants its inclusion in patients' assessment alongside other valid measures of functional mobility in both clinical and research practice in persons with MS.



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Detection and interpretation of impossible and improbable Coma Recovery Scale-Revised scores

Publication date: Available online 2 March 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): C. Chatelle, Y.G. Bodien, C. Carlowicz, S. Wannez, V. Charland-Verville, O. Gosseries, S. Laureys, R.T. Seel, J.T. Giacino
ObjectivesTo determine the frequency with which specific Coma Recovery Scale-Revised (CRS-R) subscale scores co-occur as a means of providing clinicians and researchers with an empirical method of assessing CRS-R data quality.DesignWe retrospectively analyzed CRS-R subscale scores in hospital inpatients diagnosed with DoC to identify impossible and improbable subscore combinations as a means of detecting inaccurate and unusual scores. Impossible subscore combinations were based on violations of CRS-R scoring guidelines. To determine improbable subscore combinations, we relied on the Mahalanobis distance which detects outliers within a distribution of scores. Subscore pairs that were not observed at all in the database (i.e., frequency of occurrence = 0%) were also considered improbable.SettingSpecialized DOC program and University hospital. Participants: 1190 patients diagnosed with DoC (coma= 76, VS= 464, MCS= 586, EMCS= 64; 794 males; mean age= 43±20 years; traumatic etiology= 747; time post injury= 162±568 days). Interventions: Not applicable.Main Outcome Measure(s)Impossible and improbable CRS-R subscore combinations.ResultsOf the 1190 CRS-R profiles analyzed, 4.7% were excluded because they met scoring criteria for impossible co-occurrence. Among the 1137 remaining profiles, 12.2% (41/336) of possible subscore combinations were classified as improbable. Conclusions: Clinicians and researchers should take steps to ensure the accuracy of CRS-R scores. To minimize the risk of diagnostic error and erroneous research findings, we have identified 9 impossible and 36 improbable CRS-R subscore combinations. The presence of any one of these subscore combinations should trigger additional data quality review. Key words: Assessment, disorders of consciousness, vegetative state, minimally conscious state, data quality.



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Antioxidant, analgesic and anti-inflammatory activities of the leafy stems of Waltheria indica L. (Sterculiaceae)

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Mouhibatou Nadège YOUGBARE-ZIEBROU, Marius LOMPO, Noufou OUEDRAOGO, Boubacar YARO, Innocent Pierre GUISSOUN.
Abstract Aim of the study: The existence of numerous side effects following the use of anti inflammatory drugs has led to the present study about Waltheria indica (Sterculiaceae), prescribed in the treatment of many inflammatory diseases component to discover phytomedicines secondary effects mitigated. Materials and methods: The chemical principles have been demonstrated by test characterization in liquid medium according the method of Ciulei (1949). In vivo, the model of edema induced by carrageenan to cause inflammation and the model of acetic acid induced pain were used to assess the anti-inflammatory and analgesic activities of the extract. In vitro, the effects of the aqueous extract on the DPPH°°radical, the lipoxygenase and lipid peroxidation has been demonstrated. Results: Phytochemical study of leafy stems of the plant showed the presence of tannins, flavonoids, sterols, triterpenes, saponins, reducing compounds, coumarins etc. In vivo, the results showed the aqueous extract and anti- edematous effects of the analgesic of the plant. In vitro, the results revealed the aqueous extract of W. indica inhibited the radical of DPPH°°, the lipoxygenase and the lipid peroxidation. Conclusion: The presence of chemical compounds and biological properties obtained justify the contribution of the plant in traditional medicine for the treatment of diseases with inflammatory component. Keywords: Medicinal plants, Waltheriaindica L., Inflammation, Analgesia, Anti -oxidants


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Improving Dye ability and antimicrobial properties of Cotton Fabric

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Fatma A. Mohamed, Hassan M. Ibrahim, Elham A. El-Kharadly, Ekhlas A. El-Alfy.
To improve the dyability and antimicrobial activity of cotton, we treatment the cotton, Firstly, Carboxymethylation was carried out in the cotton fibers to form alkali cellulose. Due to carboxymethylation, the alkali cellulose modifies the crystalline structure of cellulose and increases the accessibility of fibres to chemicals by swelling. Secondly, it padded in a solution content ( 5 % nano zinc oxide,, 4% citric acid) or( 6 % titanium isopropoxid, 4% citric acid) or in a solution of ( 5 % nano zinc oxide, 6 % titanium isopropoxid, 4% citric acid) at wet pick up of ca 100%, then dried at 85 °C for 5 min., and cured at 100 °C for 3 min ,the latter ,we use these fabric in dyeing with synthesized acid dye and commercial basic dye finally, we measure antimicrobial activity for these fabric toward grame negative and grame positive .


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Hepcidin TH1-5 Induces Apoptosis and Activate Caspase-9 in MCF-7 Cells

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Mohammed Al-kassim Hassan, Wan-Atirah Azemin, Saravanan Dharmaraj, Khamsah Suryati Mohd.
Breast cancer is the most commonly diagnosed and leading cause of cancer deaths among women globally. In continuation of our investigation into the cytotoxicity of the antimicrobial peptide, hepcidin TH1-5, on human breast adenocarcinoma cell line (MCF-7), we further affirm the apoptosis induction effect of the cysteine-rich antimicrobial peptide in the present study. Annexin V-fluorescein isothiocyanate and propidium iodide (annexin V-FITC/PI) apoptosis assay was carried out after treatment of the cells. In the determination of caspase activity and pathway of apoptosis, luminescence assay was also performed where caspase-3/7, caspase-8 and caspase-9 were evaluated at time 12, 24 and 48 hours. Results of annexin V-FITC/PI staining showed that 44.33%, 34.33%, 9.67% of the cell were in the early apoptosis, late apoptosis and necrotic stages respectively after 72 hours of treatment. Based on the data from the luminescence test, hepcidin TH1-5 activates caspases-3/7 and -9 which suggests that the apoptosis induced may be due to the peptide treatment. Hepcidin TH1-5 may have induced apoptosis in MCF-7 cells via the activation of caspase-9 of the intrinsic pathway. These results support our previous findings of the cytotoxicity of hepcidin TH1-5 and indicated that the peptide may be a potential agent for breast cancer therapy.


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An evaluation of Metered-Dose Inhaler Administration Technique in Patients of Asthma and Chronic Obstructive Pulmonary Disease

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Alpesh Chauhan, Prakruti Patel, Anuradha Gandhi, Mira Desai.
Only few patients followed all the essential steps of inhalation technique of MDI. This can be improved by proper education of the patients by means of actual demonstration, showing pictures, performing in front of physician and repeated training for the proper inhalation technique which can improve efficacy, compliance and quality of life in asthma and COPD patients.


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Nano-Crystalline Cellulose as a Novel Tablet Excipient for Improving Solubility and Dissolution of Meloxicam

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Laila H. Emara, Ahmed A. El-Ashmawy, Nesrin F. Taha, Khaled A. El-Shaffei, El-Sayed M. Mahdey, Heba K. El-kholly.
This study explored the effect of nano-crystalline cellulose (NCC) on Meloxicam (MX) solid dispersion (SD) prepared by co-grinding technique compared to micro-crystalline cellulose (MCC) in presence of lactose. MX-tablets were prepared by direct compression of different co-ground SDs or physical mixtures. The solubility, dissolution, SEM and DSC of different preparations were studied. Flow-through cell apparatus (FTC) was used to study the dissolution of MX from tablets at pH 7.4. Generally, the results revealed that increasing NCC loadings showed a direct increase in both the solubility and dissolution of MX. MCC did not improve either the solubility or the dissolution of MX in the physical mixture, while, co-grinding dramatically decreased the dissolution rate of MX. It was interesting to find that grinding of MX-powder alone or in a mixture with lactose highly increased MX solubility and dissolution. SEM as well as DSC were found to be very good tools, without a single exception, to describe the observed solubility and dissolution of MX in these proposed preparations. SEM-images showed the particle size reduction upon grinding or co-grinding techniques. While DSC-data proved that the crystalline structure of MX has been changed to an amorphous state.


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A comparative study of the effect of amikacin administered through autoinjector and manual injection on biochemical parameters in rats

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Anitha Roy, R. Vijayaraghavan, R. V. Geetha, Anitha Magesh, S. Vishnu Priya, Anusha Ramasamy, U Vidyalakshimi, K RaagaNamrata, S. Krishna Mohan, Madhan Chakkaravarthy.
Objective: The objective was to compare the biochemical changes of amikacin by autoinjector delivery and manual injection in rats. Materials and Methods: Amikacin drug cartridge (500 mg/2 mL) for autoinjectors was diluted to 63 mg/mL and rats were administered 1 mL, i.p. One group was given 3 and a second group 7 injection on consecutive days. 3 and 7 days manual injection of same dose of amikacin (about 500 mg/kg, i.p.) and a control group (saline) were also included (total 5 groups). On day 4 or 8 biochemical parameters were studied. Results: Significant increase in urea, creatinine and aspartate aminotransferase were observed in 7 day administration in both autoinjector and manual injection groups compared to control group. All other parameters viz., glucose, cholesterol, total triglycerides, bilirubin, uric acid, total protein, albumin, alanine aminotransferase and alkaline phosphatase did not show any significant change. No significant change was observed in 3 day administration groups. Conclusion: High dose of amikacin for longer duration is known for its nephrotoxicity which is evidenced by the increase in urea and creatinine in both autoinjector and manual injection groups. This study shows that autoinjector device for amikacin which is new can be considered for further research work.


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Sildenafil reduces ischemia/reperfusion testicular injury after torsion/detorsion in rats

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Marwa M. Abdel-Rahman, Ayman M. Mahmoud, Nevien M. Mostafa, Mohamed E. Saleh, Hassan M. Eissa.
This study was conducted to investigate the protective effects of sildenafil citrate on testicular injury after testis torsion/detorsion (T/D) in rats. Forty adult male Wistar rats were randomly allocated into four equal groups of ten rats each. Group 1 (Sham-operated); Group 2 (torsion for 2 hours and detorsion for 2 hours); Group 3, (torsion for 2 hours, sildenafil injection and detorsion for 2 hours), and Group 4 (sildenafil injection, torsion for 2 hours and detorsion for 2 hours). The levels of lipid peroxidation (P


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Antimicrobial and Anticancer Activities of Ethyl Acetate Extract of Co-culture of Streptomyces sp. ANAM-5 and AIAH-10 Isolated From Mangrove Forest of Sundarbans, Bangladesh

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Md. Uzzal Haque, Md. Ajijur Rahman, Md. Anwarul Haque, Ashish Kumar Sarker, Md. Anwar Ul Islam.
In this study we investigated the antimicrobial and anticancer activities of ethyl acetate extract of co-culture of Streptomyces sp. ANAM-5 and AIAH-10 isolated from soil of mangrove forest Sundarbans, Bangladesh. The antimicrobial activity of ethyl acetate extract was determined using broth-dilution method against Candida albicans, Saccharromyces cerevaceae and Aspergillus niger whereas anticancer activity was evaluated against Ehrlich Ascites Carcinoma (EAC) cells in Swiss albino mice with the dose of 50 mg/kg and 100 mg/kg body weight (i. p). The Minimum Inhibitory Concentrations (MIC) of ethyl acetate extract was found 32 μg/ml against Candida albicans while 64 μg/ml against Saccharromyces cerevaceae and Aspergillus niger. The antineoplastic activity of the crude extract was increased in dose dependent manner with a significant value (p


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Free radical scavenging ability of Ximenia americana L. stem bark and leaf extracts

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Valdiléia Teixeira Uchôa, Cleyton Marcos Melo Sousa, Adonias Almeida Carvalho, Antônio Euzébio Goulard SantAna, Mariana Helena Chaves.
Phytochemical investigation of the ethanol extract of stem bark and leaves of Ximenia americana L. revealed the presence of epicatechin and quercetin, respectively. This is the first report of the occurrence of epicatechin in this genus. The extracts, fractions and isolated compounds of X. americana were subjected to an in vitro antioxidant activity assay by the DPPH method (2,2-diphenyl-1-picrylhydrazyl). The EC50 values were calculated and the results indicate that the ethyl acetate fractions of the stem bark and leaves have high antioxidant activity and a high content of total phenols. The high antioxidant activity of these fractions is justified by the presence of epicatechin and quercetin.


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Antinociceptive, anti-inflammatory and antipyretic effects of ethanolic root bark extract of Icacina senegalensis in rodents

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Esien David-Oku, Godwin Christian Akuodor, Emmanuel Effiong Edet, Godknows K Ogbuji, Juliet Ifeoma Obiajunwa-Otteh, Daniel Ogbonna John Aja.
To investigate the ethanolic root bark extract of Icacina senegalensis for antinociceptive, anti-inflammatory and antipyretic activities in rats and mice. Acetic acid-induced abdominal constriction and tail immersion tests were used to evaluate the antinociceptive activity of the extract. Egg albumin and carrageenan-induced paw oedema were used to study the anti-inflammatory activity, whereas the anti-pyretic studies were evaluated on yeast and amphetamine-induced pyrexia. The root bark extract (50, 100 and 200 mg/kg) significantly (P


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Cost and Antibiotic Utilization of Pneumonia Patients in Intensive Care Unit

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Ramya Kateel, Prabha Adhikari, Sheetal Rajm.
Objective of this study is to evaluate the cost and antibiotic utilization of pneumonia patients admitted in intensive care unit. It was a retrospective study. Details required for antibiotic utilization and cost analysis were acquired from hospital files. Out of 320 cases evaluated 110 cases were of pneumonia.28.2% of people had pneumonia as their primary diagnosis and 71.8% had hospital acquired/aspiration pneumonia. The mean length of ICU stay was 3.30± 1.91 days. 21.8% patients were put on ventilator. The mortality rate was 34.5%. Betalactum along with betalactamase inhibitor antibiotics were prescribed for 91% patients, Carbapenams for 20%, anti-staphylococcal antibiotic for 51% of patients and macrolides and miscellaneous antibiotics were prescribed in 25.5% and 36.4% patients respectively. Betalactum antibiotic along with betalactamase inhibitor and clindamycin combination was most commonly prescribed antibiotic. Average cost per patient who was not put on ventilator was Rs 27,123 where as ventilated patient per cost was Rs44, 812. This study showed that one third of ICU admissions was due to pneumonia. Highest numbers of pneumonia were hospital acquired/aspiration pneumonia. Cost of ventilator supported pneumonia was two times more than non-ventilated pneumonia. Ventilator support was the most expensive intervention adding to the cost of care followed by cost of antibiotics and investigations.


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Antifungal Properties of Malaysian Tualang Honey and Stingless Bee Propolis against Candida Albicans and Cryptococcus Neoformans

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Aminu Shehu, Salwani Ismail, Mohd Adzim Khalili Rohin, Azian Harun, Aniza Abd Aziz, Mainul Haque.
Candida albicans and Cryptococcus neoformans can cause life-threatening infections, especially in immune-compromised patients. Treatment with currently available antifungal agents may lead to severe side-effects and emergence of resistant strains. The objective of this study was to evaluate the antifungal properties of MTH and SBP against C. albicans and C. neoformans. Broth dilution method was used to assess the antifungal properties of the MTH and propolis. Different concentrations of the MTH and propolis (0.78 mg/mL 50.00 mg/mL) in two-fold dilutions were tested against each fungus to determine the Minimum Inhibitory Concentration (MIC) which was done by visual inspection and spectrophotometric (MIC95) reading at 620 nm. Minimum Fungicidal Concentration (MFC) was obtained by culturing on Sabouraud Dextrose Agar. Total phenolic acids and flavonoids contents were also determined by Folin-Ciocalteu and colorimetric assay respectively. The MICs of the MTH against C. albicans and C. neoformans by visual inspection were 6.25 mg/mL and 1.56 mg/mL respectively, meanwhile 6.25 mg/mL and 3.13 mg/mL by spectrophotometric reading. The MFCs of the MTH against C. albicans and C. neoformans were 12.50 mg/mL and 6.25 mg/mL respectively. The MICs of SBP against C. albicans and C. neoformans by visual inspection were both 1.56 mg/mL whereas spectrophotometric reading recorded MICs of 3.13 mg/mL and 1.56 mg/mL respectively. The MFCs of SBP against C. albicans was 6.25 mg/mL and 3.13 mg/mL for C. neoformans. The total phenolic acids and flavonoids contents of MTH were 275.6 mg gallic acid/kg and 71.8 mg quercetin/kg respectively whereas for SBP, the phenolic acids content was 1754.2 mg gallic acid/kg and the flavonoids content was 82.6 mg quercetin/kg. MTH and SBP exhibited significant antifungal activities against C. albicans and C. neoformans. Their antifungal activities might be attributed to the high phenolic acids and flavonoids. This result suggests that MTH and SBP could potentially be used as alternative therapeutic agents against these fungi.


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Knowledge, Attitude and Practice of Malaysian Public University Students on Risk Factors for Cardiovascular Diseases

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Mardhiah Mahada Ibrahim, Nor Azlina A. Rahman, Nor Iza A. Rahman, Mainul Haque.
Cardiovascular diseases (CVD) account for 30% of all deaths in Malaysia. Major risk factors for CVD include age, gender, heredity, hypertension, cigarette smoking, hypercholesterolemia, diabetes, obesity and physical inactivity. The current study was conducted to understand the knowledge, attitude and practice (KAP) of University students regarding cardiovascular diseases. This is a cross-sectional study using a stratified random sampling method. Students of all faculties of International Islamic University Malaysia (IIUM) in Kuantan Campus were included. The respondents were randomly selected from each faculty. The sample size was 163. KAP questionnaire was developed and distributed to the respondents involved. The data collected was analyzed using SPSS version 17.0. The mean and standard deviation of the knowledge, attitude and practice scores were 42.98±2.46, 57.12±5.73 and 26.7±3.507, respectively. Significant difference on knowledge scores were found between different faculties (p


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The Median Time to Develop Recurrent Tuberculosis at a Tertiary Hospital in Kota Bharu, Kelantan, Malaysia

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Nyi Nyi Naing, Myat Moe Thwe Aung, Abdullah Mohamed Rusli, Mat Jaeb Mat Zuki, Nadiah Wan-Arfah, Mainul Haque.
This study has the intention to determine the median time to develop recurrent tuberculosis [TB] in TB patients attending the Chest Clinic at Hospital Raja Perempuan Zainab II [HRPZ II], Kelantan, Malaysia. Records of 114 recurrent TB patients from 1/1/2003-31/12/2009 were analyzed. Kaplan-Meier analysis was used to examine the median time for recurrence of TB. The overall median time to develop TB recurrence in registered TB recurrent patients was six months [95%CI: 4.58, 7.42] after the previous episode. It was found that recipients of Streptomycin (S), Isoniazid (H) and Rifampicin (R) twice weekly (S2H2R2) drug regimen [p=0.026] or daily HR drug regimen [p=0.049] during the continuation phase took a longer duration to develop recurrent TB than non-recipients of these medicines by Kaplan-Meier analysis. Moreover, there also existed a significant time difference [P = 0.006] between the defaulters and non-defaulters of treatment to develop recurrent TB. Patients should take the complete course of therapy, to reduce recurrent TB infection. The drug regimens must contain the two most potent first line drugs Isoniazid [H] and Rifampicin [R] during the continuation phase.


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An Empirical Study Towards Status of Pharmaceutical Care Education in Asian and African Schools of Pharmacy

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Nehad J. Ahmed, Ramadan I. Al-Shdefat, Mohammad R. Ain.
Abstract Pharmacy profession changes dramatically in all over the world during the previous decades of years. To provide pharmaceutical care, pharmacists should have the knowledge of clinical pharmacy and good communication skills This study aims to look into the status of pharmaceutical care education in Asian and African universities. Methodology: A questionnaire was designed to collect information from pharmacy colleges in Asia and Africa regards the status of pharmaceutical care education. The questionnaire was a mail-delivered to many universities in Asia and Africa. We used Wikipedia for searching for pharmacy colleges. Results: The survey elucidates that all the universities participated in the survey provide pharmaceutical care courses and in 95.94 % of these universities the course is considered as a required course. The main resources and references used in preparing pharmaceutical care lectures were Textbooks (100 % either alone or with other resources) followed by internet (81.81 %) Conclusion: There are favorable attitudes for universities included in the survey toward pharmaceutical care education. The curriculum of pharmacy should include theoretical and practical part to provide the required knowledge and skills.


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Validated, Ultra High Efficiency RP-HPLC and Stability Indicating Method for Determination of Tranylcypromines Sulphate in Bulk and in Tablet Dosage Forms

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Gamal H. Ragab, Hanaa M. Saleh, Magda M. EL-Henawee, Omnia F. Elsayed.
Simple, sensitive, rapid and stability indicating ultra high efficiency RP-HPLC method was developed and validated for analysis of Tranylcypromine sulphate in bulk drug and in tablet dosage forms. Well-resolved peaks of the target analyte and its degradation products were achieved on a Kinetex® column (75 mm x 4.6 mm ID) 2.6 µm at 30 0C, using simple isocratic mobile phase of acetonitrile - orthophosphoric acid 0.1 % (10: 90, v/v). The flow rate was 1.0 mL/min and the detection was performed at 220 nm. The retention time of the drug was 2 min while for the reported method was 6.7 min. The method was validated according to International Conference on Harmonization (ICH) guidelines. Tranylcypromine was subjected to the stress conditions of hydrolytic acidic, basic, oxidative, and photolytic degradation. The assay was linear over the concentration range of 3-150 µg mL-1 and the correlation coefficient was 1. The RSD% of inter and intraday precision was less than 1 %. The % recoveries were found to be 100.58 % proved that the proposed method is sufficiently accurate and precise. The method distinctly separates the drug from its degradation products within 2 min and total run time of 8 min.


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Development and Validation of a Stability Indicating HPLC Method for the Simultaneous Analysis of Esomeprazole and Itopride in Bulk and In Capsules

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
M. Nageswara Rao, K. B. M. Krishna, B. Hari Babu.
A rapid, simple, selective, precise, and accurate stability indicating HPLC method has been developed and validated for the simultaneous analysis of esomeprazole and itopride in bulk and in capsule form. An isocratic separation was achieved using a Hypersil C4 (250 x 4.6 mm), 5 μm particle size column with a flow rate of 1 mL/min and photodiode array detector at 272 nm. The mobile phase consisted of 0.1M dipotassium hydrogen phosphate: acetonitrile (40:60 v/v). The method was validated for selectivity, specificity, linearity, precision, accuracy and robustness. The selectivity of the method was determined by assessing interference from the placebo, components of mobile phase and common excipients in pharmaceutical formulations. Whereas, specificity was established by stress degradation studies. The method was linear over the concentration range 40120 μg/mL (R2 = 0.9999) and 150-450 μg/mL (R2 = 0.9999) for esomeprazole and itopride, respectively. Limit of detection is 0.207 and 0.724 μg/mL & Limit of quantitation is 0.691 and 2.415 μg/mL for esomeprazole and itopride, respectively. The precision and accuracy of the method was found to be acceptable. The method was found to be robust and suitable for the simultaneous analysis of esomeprazole and itopride in a capsule formulation. Degradation products resulting from the stress studies did not interfere with the detection and quantification of esomeprazole and itopride. The proposed HPLC method is thus stability-indicating.


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Quantitative HPLC analysis of phenolic acids, flavonoids and ascorbic acid in four different solvent extracts of two wild edible leaves, Sonchus arvensis and Oenanthe linearis of North-Eastern region in India

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Tapan Seal.
A reversed-phase high-performance liquid chromatographic method using photodiode array detector with gradient elution has been developed and validated for the simultaneous estimation of ascorbic acid , free phenolic acids and flavonoids (catechin, rutin , quercetin, myrecetin, apigenin and Kaempferol) in four different solvent extracts of two wild edible leaves of viz. Sonchus arvensis and Oenanthe linearis, collected from North-eastern region in India . The chromatographic separation was carried out on Acclaim C 18 column (5 μm particle size, 250 x 4.6 mm) , Dionex Ultimate 3000 liquid chromatograph and detection was carried out at three different wave lengths (272 , 280 and 310 nm) using a mobile phase of acetonitrile and 1% aqueous acetic acid solution with gradient elution . The experimental results showed high amount of ascorbic acid in S. arvensis and O. linearis (1.2% and 2.3 % respectively) and gallic acid ( 0.02% and 0.06% respectively) in 1% aq. acetic acid extract of these two plants. The high percentage of recovery (96-103%), low coefficient of variation ( R2 > 0.99) and low limit of detection (LOD) and limit of quantitation (LOQ) confirm the suitability of the method for simultaneous quantification of ascorbic acid and all phenolic compounds in the two plants under investigation.


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Prophylactic effects of thymoquinone against carbon tetrachloride-induced hepatic damage in Sprague-Dawley rats

2016-03-02T05-40-04Z
Source: Journal of Applied Pharmaceutical Science
Khaled M. A. Hassanein, Ahmed Al-Emam, Khaled Radad.
This study is conducted to investigate the prophylactic effect of thymoquinone (TQ), the major active ingredient of Nigella sativa seeds, against carbon tetrachloride (CCl4)-induced hepatic damage in Sprague-Dawley (SD) rats. Forty rats were divided into four even groups. The first group served as control. The second, third and fourth groups received CCl4, CCl4 and TQ, and TQ only, respectively for 5 weeks. CCl4 (2 ml/kg b.w.) was given orally by gastric tube twice a week on Sunday and Thursday. TQ (20 mg/kg b.w.) was given daily in corn oil by gastric tube. At the end of the experiment, rats were sacrificed, and blood samples and liver specimens were obtained for biochemical analysis and morphological examination, respectively. Control and TQ-treated rats showed normal serum activity for alanine (ALT) and aspartate (AST) aminotransferases, and normal liver histology. Treatment of rats with CCl4 significantly increased serum activity of ALT and AST aminotransferases compared to control rats. Histopathologically, livers from CCl4-treated rats showed dilatation of blood sinusoids and portal blood vessels, Kupffer cell activation, vacuolar degeneration of hepatocytes, focal areas of necrosis and mild hepatic fibrosis. Using transmission electron microscopy (TEM), CCl4 caused clear lesions in the liver including dilatation of endoplasmic reticula, increased extracellular matrix and formation of abundant fatty globules and numerous autophagosomes in hepatocytes. On the other hand, co-administration of TQ with CCl4 significantly decreased serum ALT and AST activities, and attenuated most of CCl4-induced hepatic pathological changes. The present study indicates that TQ has the potential to attenuate CCl4-induced hepatic damage in SD rats.


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