Intralenticular bimanual irrigation: aspiration for subluxated lens in Marfan's syndrome

We describe a new technique of aspiration of subluxated lens in young patients with Marfan's syndrome. Two small circular anterior capsulorhexis (1.5 mm to 2.0 mm) openings were created, and bimanual irrigation/aspiration was performed by introducing the irrigation cannula through 1 capsular opening and the aspiration cannula through the other. The irrigation cannula served the dual purpose of hydrating the lens matter and holding the lens in central position to ensure complete aspiration of the lens matter. The lens capsule was later removed and anterior vitrectomy performed by a vitrectomy cutter. This new technique of intralenticular irrigation/aspiration is effective and safe in performing lens aspiration in extensively dislocated crystalline lens in Marfan's syndrome.     

Activated clotting time during cardiopulmonary bypass: is repetition necessary during open heart surgery?

We evaluated the need of activated clotting time monitoring and efficacy of heparinization protocol in 100 patients undergoing open heart surgery. Patients were anticoagulated with 300 or 400 units.kg(-1) heparin, based on their heparin sensitivity assessed at 5 min by activated clotting time. One-third of the initial dose was repeated at 90 min and thereafter hourly until completion of cardiopulmonary bypass. Patients who attained an activated clotting time of > 350 seconds at 5 min were included. Activated clotting time was repeated every 30 min. A time of < 350 seconds or presence of clot in the surgical field/extracorporeal circuit was considered failure of the protocol. Cardiopulmonary bypass was performed using a membrane oxygenator, non-pulsatile flow, hypothermia and crystalloid/blood priming solution. At 5 min, 94 patients had activated clotting time of > 350 seconds, 6 were < 350 seconds. At predetermined time intervals of 30 min, up to 210 min, 406 activated clotting time measurements were above 400 seconds and 40 were between 350 and 400 seconds. No clot was observed in the surgical field or extracorporeal circuit. This anticoagulation protocol ensures adequate anticoagulation during hypothermic cardiopulmonary bypass. With this protocol, only one activated clotting time at 5 min after heparin administration is required and essential; subsequent monitoring is not necessary.     

Evaluation of Race by Cranial Index of Adult Human Skull in Maharastra Population

Biologists and physical anthropologists attempted to classify human being into races according to phenotypic variations. The latter are based either on one or two phenotypic characters therefore the outcome is unable to givq clear distinction among different races. Cranial index seems to be an important,tool, which may be used to identify the races in different geographical regions. 75 dried skulls collected from different part of Maharashtra were measured to determine the cranial index. Skulls were classified by the method of Montagu (1960)2 Average maximum cranial length and breadth were found to be 17.11 cm and 12.98 cm respectively and maximum & minimum cranial lengths were observed to be 18.50 and 16.60 cm and cranial breadths were noted to be 14.50 and 12.10 cm respectively. Average cranial index (mean ± SD) was 75.49 ± 3.95. In our study most of the skulls were grouped under the Mesocranial (46.66%) and Dolichocranial (42.66%) categorises when based on Montagu and Dolichocranial categorises when 56% based Comas'. As per the conclusion Maharashtrian population belongs to Indo-Dravidian race.     

Post-kala-azar dermal leishmaniasis in a patient treated with injectable paromomycin for visceral leishmaniasis in India

Post kala-azar dermal leishmaniasis (PKDL) is a skin manifestation that usually develops after treatment of visceral leishmaniasis (VL), a major public health problem in India. The diagnosis and management of PKDL is complex. This is the first case report from India in which PKDL occurred after paromomycin treatment for VL in an Indian patient.     

Utility of an oxidation reaction for the spectrophotometric determination of acarbose in controlled release tablets at various simulated gastrointestinal media

A sensitive kinetic method for spectrophotometric determination of acarbose is developed and validated for the determination of the drug in bulk and pharmaceutical formulations. The drug was estimated in simulated gastrointestinal media i.e., 0.1 M HCl (pH 1.2) and phosphate buffer (pH 6.8). The method involves the oxidation of acarbose by treating it with a strong oxidizing agent (potassium permanganate (1 x 10(-2) M)) in alkaline media. The reaction kinetics was determined for 20 min at room temperature. The reaction followed first order kinetics and the absorbance of the corresponding manganate ions produced was determined at 610 nm. The absorbance-concentration plot was found to be rectilinear over the concentration range of 2-20 microg/mL. The proposed method was used for estimation of the drug in a novel controlled release dosage form. Thus, the method developed was simple, reproducible and can be successfully applied for the determination of the drug in simulated gastrointestinal fluid.