Radio-isotopic determination of hydrogen peroxide in aqueous humor and urine

The concentrations of hydrogen peroxide in the aqueous humor and urine of several animal species and humans have been determined. The determinations are based on peroxide-dependent decarboxylation of I-[14C]-alpha-ketoglutaric acid and measurement of the resulting 14CO2 by quantitating the radioactive disintegration. The levels of H2O2 in most animals varied between 5.0 and 41 microM for aqueous, and 115 and 187 microM for urine. The levels of peroxide in the urine of steer, cat and baboon were lower and fell out of the above range. In the aqueous of humans with cataracts, the levels ranged from 33 to 324 microM, the overall average being 189 +/- 88 microM. The source of such high levels in the aqueous of cataract patients is currently being studied.     

lontophoretic Devices for Drug Delivery

Transdermal drug delivery of ionized drugs can be enhanced by iontophoresis. Drug in the ionic form, contained in some reservoir, can be phoresed through the skin with a small current across two electrodes, one above the reservoir and one at a distal skin location. Positive ions can be introduced from the positive pole, or negative ions from the negative pole. The design and development of iontophoretic devices are rather simple. Some of the principles of operation and the advantages/disadvantages and clinical implications associated with these devices are outlined in this review.     

A Correlative study of sinusitis versus headache

Headache is a very annoying condition for patients and also for those trying to tread it.Head aches can be of sinugenic origin, even if this cause may not be suspected from the case history:Average age of onset for sinugenic headache is 25 to 30 years. Sinugenic headache occurs equaliy in both saxes. Diagnosis of sinugenic headache is done by the clinical history,examition of nuse and paranasal sinuses and relevant investigatins besides excluding the headaches of nonsinugenic and pyschogenic cause. Surgical treatment is helpful in curing the patients of sinugenic headaches in most of the cases. Only two patients could benefit with medical treatment. Recurrences are common in patients of headaches of multiple etiology and more if not treated specfically.     

Bleeding complications after dual antiplatelet therapy with ticagrelor versus dual antiplatelet therapy with clopidogrel—a propensity-matched comparative study of two antiplatelet regimes in off-pump coronary artery bypass grafting

PurposeTicagrelor combined with aspirin had shown better saphenous vein graft patency than aspirin with clopidogrel after off-pump coronary artery bypass grafting. However, the safety of this drug in regard to bleeding complications remains unknown. The aim of our study was to assess the bleeding complications of dual antiplatelet therapy with aspirin and ticagrelor compared with aspirin and clopidogrel within the first 3 months after off-pump surgery.MethodsThree hundred eighty-two consecutive patients who were prescribed aspirin with ticagrelor (ticagrelor group) were compared with 660 patients who received aspirin and clopidogrel (clopidogrel group). After propensity matching, 144 patients in each group were compared for bleeding events and major adverse cardiac and cerebral events. Major bleeding was defined as composite outcome of re-exploration for bleeding, any fatal bleeding, intracranial bleeding, and any bleeding requiring hospitalization.ResultsPatients in the ticagrelor group had more incidence of re-exploration for bleeding (p = 0.042), pericardial effusion requiring drainage (p = 0.007), readmissions (p < 0.01), gastrointestinal bleeding (p = 0.01), and major bleeding (5.8% vs. 2.1%, p < 0.01, OR 2.8 (1.43–5.58)). After propensity analysis, gastrointestinal bleed (p = 0.024), major bleeding (7.6% vs.1.4%, p < 0.001, OR 5.8 (1.28–26.97)), length of ICU stay (p = 0.039), and readmissions (p = 0.003, OR 11.83 (1.51–92.86)) were more in the ticagrelor group. Major adverse cardiac and cerebral events were similar between the groups.ConclusionDual antiplatelet therapy with aspirin and ticagrelor increased gastrointestinal bleeding events, major bleeding events, and readmission rates compared with aspirin and clopidogrel after off-pump coronary artery bypass grafting.     

Incidental Detection of Parathyroid Adenoma on Somatostatin Receptor PET/CT and Incremental Role of <Superscript>18</Superscript>F-Fluorocholine PET/CT in MEN1 Syndrome

Multiple endocrine neoplasia type 1 (MEN1) syndrome is characterized by combined occurrence of tumors of endocrine glands including the parathyroid, the pancreatic islet cells, and the anterior pituitary gland. Parathyroid involvement is the most common manifestation and usually the first clinical involvement in MEN1 syndrome, followed by gastroentero-pancreatic neuroendocrine tumors (NETs). Here we present a case where the patient initially presented with metastatic gastric NET and a single parathyroid adenoma was detected incidentally on ⁶⁸Ga-DOTANOC PET/CT done as part of post ¹⁷⁷Lu-DOTATATE therapy (PRRT) follow-up. Further ¹⁸F-fluorocholine PET/CT showed four adenomas for which the patient subsequently underwent subtotal parathyroidectomy.     

Bacterial meningitis in India: An IJP survey

Conclusions It can be concluded that bacterial meningitis is an important cause of childhood morbidity and mortality. Isolation of causative pathogenes is poor in our country. A routine gram staining of CSF and use of rapid diagnostic kits with better culture facilities would be helpful in improving the outcome. In first 3 months of life, therapy should include one of the 3rd generation cephalosporins with an aminoglycoside. For meningitis in age groups between 3 months to 12 years, chloramphenicol and ampicillin should be the first line empirical therapy. If gram-ve organisms are suspected or isolated, one of the 3rd generation cephalosporins with or without an aminoglycoside is good alternative. The treatment can be stopped in uncomplicated case after 7–10 days (5 days of afebride period) in meningitis caused by meningococcus, pneumococcus andH. infuenzae. For BM caused by gram-ve bacilli treatment for 21 days is recommended. There is no need to perform CSF examination at the conclusion of therapy in cases of bacterial meningitis beyond neonatal period. There is a need to further evaluate therapeutic regimens like chloramphenicol alone, ceftriaxone home therapy, especially for rural areas etc. to decrease the cost of hospitalisation in referral hospitals.