Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients With Hypertension

Background

There are conflicting data regarding the relative effectiveness of renal sympathetic denervation (RSD) in patients with hypertension.

A Review on the History of Tympanoplasty

The history of myringoplasty and tympanoplasty is one of the most interesting in the history of ear surgery. The aims and ambitions of otologists have evolved along with time and experience. The objective of this article is to give an idea about the evolution of tympanoplasty, thus giving inspiration to future surgeons in their quest for a perfect technique which would be as good as a normal ear and its hearing. The history of otology starts from the early Egyptian healers. Hippocrates in his time observed that ear infections may be cause of death especially in young children. Early surgeries were performed mainly for drainage in order to save the life of the child having the ear disease. With time and scientific developments newer methods of treatment started to evolve. The invention of antimicrobials and their usage threw a new light into the treatment of otology infections. Then after the advent of microscope and with better understanding of the anatomy and physiology of ear and its diseases treatment strategies and surgical planning kept on advancing. Surgeons with time have become more interested in returning back the hearing along with curing infection from ear. But the quest is on for the perfect surgical technique which would give best results with minimal maneuvering. History of tympanoplasty nearly sums up the history of evolution of otology as a whole. The quest is still on to devise a way so as to give maximum post-operative hearing using minimal instrumentation.     

Meta-analysis of cardiovascular outcomes with dronedarone in patients with atrial fibrillation or heart failure

Dronedarone is a benzofuran derivative approved by the Food and Drug Administration to decrease the risk of cardiovascular hospitalization in patients with paroxysmal or persistent atrial fibrillation (AF) and associated cardiovascular risk factors who are in sinus rhythm or will undergo cardioversion. There has been recent evidence to suggest that dronedarone may not have a favorable safety profile. We decided to evaluate all available evidence on the cardiovascular safety of this drug. A systematic search was made of the PubMed, CENTRAL, and EMBASE databases for randomized controlled trials from 1966 through 2011 comparing dronedarone to comparators in AF/heart failure. Intervention was dronedarone for AF for some studies and heart failure for others. Comparators included standard medical therapy and/or placebo and amiodarone for 1 study. Outcomes assessed were all-cause mortality, cardiovascular mortality, ventricular arrhythmias, embolic events, acute coronary syndrome, heart failure exacerbations, and hospitalization rates in the intervention versus comparator group at the end of ≥ 3 months of follow up with abstraction of data by 1 author. Seven randomized controlled trials were included in our analysis. Dronedarone use was associated with a trend toward worse all-cause and cardiovascular mortalities and increased heart failure exacerbations. It also showed numerically higher event rates for all other outcome events except acute coronary syndrome. Our pooled analysis showed increased all-cause and cardiovascular mortalities and increased heart failure exacerbations with use of dronedarone across a wide spectrum of populations. In conclusion, we recommend exercising caution using dronedarone, especially in patients with cardiovascular risk factors.     

Increase in Temperature Induces the Malathion Toxicity in <Emphasis Type="Italic">Pangasianodon hypophthalmus</Emphasis>: A Short Term Acute Test

The study was conducted to evaluate the effect of higher temperature beyond optimum range on acute toxicity for malathion (effective concentration 50 %) in Pangasianodon hypophthalmus. A 2 days renewal bioassay system for 96 h was used to determine LC₅₀ value of malathion at three different regimes of temperature that is 30, 32 and 34 °C considering as T1, T2 and T3, respectively. The physico-chemical parameters of water of different treatment groups were estimated during pre and post-exposure of test chemical, following standard methods. The result of short term acute toxicity test at 96 h LC₅₀ values through probit analysis was found to be 7.76, 6.45 and 4.46 µL L^?1 for T1, T2, and T3, respectively. The 96 h LC₅₀ of malathion at 34 °C was found to be significantly (p < 0.01) lower as compared with estimated LC₅₀ for malathion at 30 and 32 °C. High temperature and free carbon dioxide coupled with low dissolved oxygen were significantly noticed in T3 group when compared to T1 and T2 groups. Lower LC₅₀ of malathion at 34 °C as compared to 30 and 32 °C showed that at a higher temperature, the toxicity of malathion increased, signifying diminished fish protective response to malathion toxicity. The current study reflects the impact of increased temperature on pesticide toxicity in the aquatic ecosystem, alarming the aqua farmers to judiciously use malathion in ponds.