Sedation and renal impairment in critically ill patients: a <Emphasis Type="Italic">post hoc</Emphasis> analysis of a randomized trial

Introduction  

Not sedating critically ill patients reduces the time patients receive mechanical ventilation, decreases the time in the intensive care department and reduces the total hospital length of stay. We hypothesized that no sedation improves hemodynamic stability, decreases the need for vasoactive drugs, diminishes the need for extra fluids and lowers the risk of acute kidney injury.     

Not <Emphasis Type="Italic">if</Emphasis> but <Emphasis Type="Italic">when</Emphasis>; no longer <Emphasis Type="Italic">why</Emphasis> but <Emphasis Type="Italic">how</Emphasis>

There is accruing evidence that information technology can improve patient health care, with several trials of technology showing smaller numbers of medication errors, or can provide earlier detection of adverse events. Critics of this type of research point out that better resolution of events is of no value unless their direct management influences clinical outcome. Nevertheless, indirect evidence is available, such as reports indicating the importance of providing specialist neuro-critical care in the management of patients with traumatic brain injury. These studies do not indicate which aspects of critical care management are crucial, but management aimed at the earlier detection and treatment of adverse events must be partly responsible. We continue to hope for definitive controlled trial evidence that information technology-led management yields improved patient outcome, but our experience so far of funding and conducting such studies has been poor. There is no question that we need better monitoring and event detection technology for health care and that we need more research into optimising that technology, but should their adoption depend on large-scale clinical trials? Perhaps now the questions we need to focus upon are no longer if but when, and no longer why but how.     

Rizatriptan <Emphasis Type="Italic">vs.</Emphasis> ibuprofen in migraine: a randomised placebo-controlled trial

The objective of this study was to compare the efficacy of rizatriptan and ibuprofen in migraine. The study was a randomised placebo-controlled trial in a tertiary care teaching hospital. Migraine patients with <8 attacks/months were included. One hundred and fifty-five migraine patients were randomised to rizatriptan 10 mg (53), ibuprofen 400 mg (52) and placebo (50). Efficacy was assessed by headache relief, and headache freedom at 2 h and 24 h. Two-hour headache relief, was noted in 73% in rizatriptan, 53.8% in ibuprofen and 8% in placebo groups. Headache freedom was achieved in 37.7% in rizatriptan, 30.8% in ibuprofen and 2% in placebo groups. Rizatriptan was superior to ibuprofen and placebo in relieving headache at 2 h but not at 24 h. Side effects were noted in 9 patients in rizatriptan, 8 in ibuprofen and 3 in placebo, all of which were nonsignificant. Rizatriptan and ibuprofen are superior to placebo. Rizatriptan is superior to ibuprofen in relieving headache, associated symptoms and functional disability.     

Oral probiotic and prevention of <Emphasis Type="Italic">Pseudomonas aeruginosa</Emphasis> infections: a randomized,double-blind,placebo-controlled pilot study in intensive care unit patients

Introduction  

Preventing carriage of potentially pathogenic micro-organisms from the aerodigestive tract is an infection control strategy used to reduce the occurrence of ventilator-associated pneumonia in intensive care units. However, antibiotic use in selective decontamination protocols is controversial. The purpose of this study was to investigate the effect of oral administration of a probiotic, namely Lactobacillus, on gastric and respiratory tract colonization/infection with Pseudomonas aeruginosa strains. Our hypothesis was that an indigenous flora should exhibit a protective effect against secondary colonization.     

First Attempt of Complete Rearing of Tea Looper, <Emphasis Type="Italic">Biston</Emphasis> (=<Emphasis Type="Italic">Buzura</Emphasis>)<Emphasis Type="Italic"> suppressaria</Emphasis>, on Artificial and Natural Diet

Complete rearing of the looper pest, Biston (=Buzura) suppressaria (Guen.) (Lepidoptera: Geometridae) through generations has been attempted for the first time on artificial diet as an alternative to tea-leaf diet. A comparative study on performance of the pest on its natural host, tea (Camellia sinensis, O’Kuntz), and on the newly formulated artificial diet revealed adequacy and superiority of the latter diet. The development period of B. suppressaria was shorter (48 days) on artificial diet, with a better survival rate than that on tea. On artificial diet the species showed a greater effective rearing rate with production of heavier pupae and adults. Nutritional indices determined for advanced looper stage tilted in favour of artificial diet as compared to that on tea with significantly higher relative growth rate, efficiency of conversion of ingested food, efficiency of conversion of digested food, approximate digestibility, production index and significantly lower maintenance cost.     

Larvicidal Activity of <Emphasis Type="Italic">Colocasia esculenta,Eclipta prostrata</Emphasis> and <Emphasis Type="Italic">Wrightia tinctoria</Emphasis> Leaf Extract Against <Emphasis Type="Italic">Culex quinquefasciatus</Emphasis>

Control of mosquitoes by using chemical insecticides creates several problems including development of resistance. This leads to find out alternative methods via plant products. Viewing this in mind, methanolic extracts of Colocasia esculenta, Eclipta prostrata and Wrightia tinctoria leaves were tested against II, III, IV instars and pupa of filarial vector Culex quinquefasciatus. The LC₅₀ value obtained for IV instar larvae of Cx. quinquefasciatus is 165.697 ppm for C. esculenta while it is 114.257 ppm for E. prostrata and 210.298 ppm for W. tinctoria. Of the three plants studied E. prostrata is most effective in controlling mosquito larvae than the others.     

DNA Barcodes Distinguish <Emphasis Type="Italic">Withania somnifera</Emphasis> and <Emphasis Type="Italic">Withania ashwagandha</Emphasis>

On the basis of morphology, chemical profiling, crossing ability, amplified fragment length polymorphism and comparison of nucleotide sequences of nuclear ribosomal internal transcribed spacer (ITS), the cultivated form of Withania somnifera, a species of therapeutic value, has been circumscribed as a new species, Withania ashwagandha. The present study was undertaken to ascertain whether the two species can be distinguished on the basis of DNA barcoding. Six barcode loci, ITS, ITS2, matK (maturase K), rbcL (ribulose-bisphosphate carboxylase/oxygenase, large subunit), rpoC1 (RNA polymerase-β′ subunit, main catalytic subunit) and trnH-psbA spacer (transfer RNA for histidine-photosystem II protein D1 spacer) from W. somnifera, W. ashwagandha, their hybrid, and ‘ashwagandha’ market samples were amplified, sequenced, and compared. ITS, ITS2 and matK distinguished two species on the basis of phylogenetic tree method. Likewise, BLAST 1 analysis based on ITS, ITS2, matK, and rbcL individually discriminated two species. However, on the basis of Kimura 2 Parameter distances, two species could not be distinguished as the requirement of a distinct barcode gap—the highest intraspecific distance being lower than the lowest interspecific distance—was not met by any of the loci. If compared by character-based method, ITS, ITS2 and matK sequences of the two species had distinct diagnostic nucleotides (pure character attributes) at nine, four and one positions, respectively. Interestingly, all market samples co-segregated and shared character attributes with W. ashwagandha.     

Evaluation of Cultivated and Wild <Emphasis Type="Italic">Allium</Emphasis> Accessions for Resistance to <Emphasis Type="Italic">Fusarium oxysporum</Emphasis> f. sp. <Emphasis Type="Italic">cepae</Emphasis>

Fusarium basal rot (FBR) caused by Fusarium oxysporum f. sp. cepae (FOC) is a highly destructive soil borne disease incurring heavy damage in pre and post harvest onion and garlic crops worldwide. Only a few onion lines exhibit partial resistance against the pathogen and there is a need for identification of more effective resistance sources for use in breeding programmes. Selected sets of wild onion and garlic accession and seven related Allium species were screened for resistance to Fusarium basal rot using three FOC isolates. FOC infection revealed significant variation among the evaluated Allium species (at P = 0.001). A. sativum accession ‘CBT-As153’ showed high level of resistance to each isolate while A. cepa accession ‘CBT-Ac77’ exhibited intermediate resistance. Among related Allium species, A. fistulosum, A. roylei and A. schoenoprasum were highly resistant, A. tuberosum had mixed response while A. griffithianum was susceptible. Further, the root density of Allium species negatively correlated with disease incidence for different FOC isolates. Thus, the present study suggests that besides related Allium species, A. sativum ‘CBT-As153’ can be used as a potential donor of FBR resistance for genetic improvement of onion and garlic in India.     

Bioefficacy of <Emphasis Type="Italic">Beauveria bassiana</Emphasis> (Balsamo) Vuillemin and <Emphasis Type="Italic">Lecanicillium lecanii</Emphasis> Zimmerman against <Emphasis Type="Italic">Thrips tabaci</Emphasis> Lindeman

Bioefficacy of Beauveria bassiana (Balsamo) Vuillemin and Lecanicillium lecanii Zimmerman in comparison with their commercial formulations along with standard check insecticide, Fenvalerate 20 EC were evaluated against onion thrips, Thrips tabaci Lindeman under greenhouse as well as field conditions. The results revealed that the standard check fenvalerate 20 EC @ 0.0075 % showed significantly the highest cumulative corrected mortality of 97.84 % followed by commercial formulation of B. bassiana, Myco-Jaal @ 1 × 10⁸ spores/mL which showed 80.90 % mortality. The laboratory cultured B. bassiana showed percent mortalities of 74.11, 71.69 and 78.48 % for the concentrations of 1.23 × 10⁷, 1.23 × 10⁶ and 1.23 × 10⁸ spores/mL, respectively. However, these concentrations were statistically at par on all the days of observation. Thrips mortality gradually increased with the increase in concentrations of fungal preparations and days of observations. Similar trend was also observed in L. lecanii experiment. Under field conditions, Fenvalerate 20 EC @ 0.0075 % recorded highest mortality of T. tabaci (90.10 %) followed by commercial formulation of V. lecanii (Phule Bugicide @ 2 × 108 cfu/g) with 74.90 % mortality. All the concentrations of fungal concentrations gave low mortality ranging from 9.40 to 10.10 % and 7.10 to 7.40 % at 2 days after treatment (DAT) of B. bassiana and L. lecanii, respectively. The standard check of Fenvalerate 20 EC @ 0.0075 % was highly toxic and showed significantly maximum percent reduction (90.50 %) of T. tabaci population in both the experiments. The present study clearly shows that these entomopathogens may be integrated with existing integrated pest management (IPM) practices for management of T. tabaci.     

Nutritional Requirements to Improve Delta-Endotoxins Production of <Emphasis Type="Italic">Bacillus</Emphasis><Emphasis Type="Italic">thuringiensis</Emphasis> var. <Emphasis Type="Italic">kurstaki</Emphasis> Using Mixed Designs Modelling

Bacillus thuringiensis kurstaki is a soil bacterium that produces insecticidal toxins called delta-endotoxins. In order to increase the toxic crystal concentrations in a low-cost culture medium and thus improve the biopesticide quality to control insect pests, the Plackett–Burman screening method was applied. It was shown a tool to evaluate the significance of the selected seven factors (KH₂PO₄, K₂HPO₄, MgSO₄, MnSO₄, FeSO₄, soybean meal, starch) which are necessary to the production of the delta-endotoxins. This was performed into two different shake flasks (250 and 500 ml). The main factors that affected the production of delta-endotoxins are shown to be soybean meal, starch, and FeSO₄ in 250 ml culture flasks. In 500 ml culture flasks, soybean meal and FeSO₄ are the principal factors influencing the delta-endotoxin production. The multiple linear regression, a method applied as the merging dataset of the two Plackett–Burman designs, established that soybean meal and starch are the factors positively affecting the production of delta-endotoxins, in contrast to FeSO₄. Furthermore, the available oxygen in culture flasks showed no significant negative effect on delta-endotoxin production. This study revealed that mixed method designs were useful to identify the significance and the effect of hidden culture parameters.     

Molecular Authentication of Medicinal Plant, <Emphasis Type="Italic">Swertia</Emphasis><Emphasis Type="Italic">chirayita</Emphasis> and its Adulterant Species

Swertia is ethno-medicinally an important genus belonging to family Gentianaceae. Swertia chirayita is used as imperative medicinal plant in Indian system of medicine. However, this species has been frequently adulterated due to its high demand and scarcity. Authentication of this species was needed to protect consumers and conservation measures and to find out the alternative source. Deoxyribose nucleic acid (DNA) extracted from fifteen samples of six species belonging to different localities, were used as templates. Four candidate barcodes were amplified by polymerase chain reaction and sequence analysis was executed by Z-Big Dye Terminator Cycle Sequencing v.3. Sequenced products were analyzed on automated applied biosystems 3730XI analyzer. Identification was performed by using molecular evolutionary genetics analysis 5 software (version 5.1). The amplification efficiency of all DNA barcodes [megakaryocyte-associated tyrosine kinase (matK), ribulose-bisphosphate carboxylase (rbcL), photosystem II protein D1- stuctural RNA- His tRNA (psbA-trnH) and internal transcribed spacer region (ITS)] was 100 %. Here, the highest interspecific divergence provided by ITS is 11.87 % and intraspecific by psbA-trnH being 10.22 % as compared to matK (5.04 %) and rbcL (0.99 %). ITS region proves robust molecular marker for differing the S. chirayita from its related adulterant species. All barcoding regions indicate that S. chirayita and S. minor both are more closely related than other Swertia species. Findings showed that DNA barcoding is an efficient tool for identification and authentication of S. chirayita. Use of S. minor as substitute to S. chirayita can be advocated.     

<Emphasis Type="Italic">Stachys</Emphasis> <Emphasis Type="Italic">gaziantepensis</Emphasis> (Lamiaceae), a New Species from South Anatolia,Turkey

Stachysgaziantepensis species nova is described and illustrated. It exhibits general features of the section Infrarosularis. However, it differs from the other species of the section from Turkey by its slender appearance. In addition, while the other species of the section grow on limestone or serpentine rocks, the new species grows on marble rocks. Diagnostic characters of S.gaziantepensis from sect. Infrarosularis species, especially from its closest relative S. pumila and S. choruhensis with extreme distribution, are discussed. In addition to its more slender appearance, it differs from S. pumila by its indumentum, leaf shape, inflorescence, calyx size and shape, corolla size and colour; from S. choruhensis by its indumentum, stem ramification, leaf shape, inflorescence and corolla colour according to the observations. The accompanying taxa within its habitat are given. The conservation status of the new species is also evaluated based on population density and possible threats within presently known locality.     

Motion-Artifact-Free <Emphasis Type="Italic">In Vivo</Emphasis> Imaging Utilizing Narcotized Avian Embryos <Emphasis Type="Italic">In Ovo</Emphasis>

Purpose  

The chick embryo in ovo is a well-accessible and economical in vivo model, but its use in molecular imaging has been limited because of motion artifacts on resulting images. The purpose of this study was to develop a method using narcotics to inhibit motility and to perform motion-artifact-free imaging of living chick embryos in ovo.     

Tissue Culture Independent <Emphasis Type="Italic">Agrobacterium tumefaciens</Emphasis> Mediated <Emphasis Type="Italic">In Planta</Emphasis> Transformation Method for Tropical Maize (<Emphasis Type="Italic">Zea mays.L</Emphasis>)

Tropical maize is recalcitrant to tissue culture regeneration because of its poor response to in vitro regeneration after transformation. In this context, the present study has developed the tissue culture independent in planta transformation protocol for tropical maize by transferring plumular meristem cells of germinating seeds of tropical maize genotype through Agrobacteriumtumefaciens infection. The protocol was developed by using Agrobacterium strain EHA105 containing vector pCAMBIA3301 carrying cry1Ab, gus and bar genes. The expression of transgene gus in T₀ plants was confirmed by measuring the hydrolysis rate of the fluorescent substrate 4-methylumbelliferyl-beta-D-glucuronide (MUG) assay whereas the presence of cry1Ab gene was confirmed by polymerase chain reaction and T₀ plants were allowed to grow in glass house into whole plant until maturity and were selfed to produce seeds of T₁ generation. The presence of transgene and its segregation was studied in T₁ generation through Southern and enzyme-linked immunosorbent assay confirming the presence of transgene and its expression respectively. The developed protocol is cost-effective, efficient and genotype independent without involvement of any tissue culture procedure and can generate a relatively large number of transgenic plants in approximately 75–90 days.     

Recurrent <Emphasis Type="Italic">Clostridium difficile</Emphasis> colitis

Clostridium difficile is the most common cause of nosocomial infectious diarrhea that is usually treated adequately with standard treatment of metronidazole or vancomycin. Relapse or recurrent infection can occur in certain patients and this can be very difficult to treat. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Impact of quetiapine on resolution of individual delirium symptoms in critically ill patients with delirium: a <Emphasis Type="Italic">post-hoc</Emphasis> analysis of a double-blind,randomized, placebo-controlled study

Introduction  

We hypothesized that delirium symptoms may respond differently to antipsychotic therapy. The purpose of this paper was to retrospectively compare duration and time to first resolution of individual delirium symptoms from the database of a randomized, double-blind, placebo-controlled study comparing quetiapine (Q) or placebo (P), both with haloperidol rescue, for critically ill patients with delirium.     

Feeding Deterrence Effects of Defatted Jojoba (<Emphasis Type="Italic">Simmondisa chinensis</Emphasis>) Meal Against Indian Gerbil, <Emphasis Type="Italic">Tatera indica</Emphasis> (Hardwicke<Emphasis Type="Bold">)</Emphasis>

In search for safe and eco-friendly management of rodent pests a number of phyto-chemicals have been evaluated as repellent, antifertility agent, antifeedant and toxicant etc. Protein rich residue of seed of Jojoba (Simmondisa chinensis) known as defatted jojoba meal is reported to possess marked suppressive effect on food intake in a variety of animal species. In present study the defatted jojoba meal at a concentration of 5, 10, 15, 20, 25 and 30 % in pearl millet bait (w/w basis) was evaluated for its anti-rodent properties against Tatera indica, a predominant rodent pest of Indian subcontinent. Under no-choice condition the bait consumption during treatment period of 7 days was significantly reduced (3.01 ± 0.40–4.76 ± 0.14 g/100 g bwt/day) in comparison to pre-treatment plain bait consumption (9.33 ± 0.73–10.37 ± 0.29 g/100 g bwt/day). At higher dosages 50 % gerbils died. Besides, weight reduction in the range of 10.63–16.67 % was also observed. In choice test mean consumption of treated food was also significantly reduced (0.64 ± 0.28–1.44 ± 0.20 g/100 g bwt/day) in comparison to plain bait (5.80 ± 0.18–8.80 ± 0.29 g/100 g bwt/day) during 7 days of treatment period. Jojoba treated pearl millet bait when offered with plain sorghum bait, after an exposure period of 5 days left an imprinting effect on Indian gerbil which led to aversion towards plain pearl millet bait for 10–11 days. The findings showed that jojoba defatted meal exert strong dose dependant deterrence in Indian gerbils and also induces condition aversion learning behavior in the gerbils.