Effect of gabapentin pretreatment on propofol consumption,hemodynamic variables,and postoperative pain relief in breast cancer surgery

Study objectiveGabapentin is an inhibitory neurotransmitter of the central nervous system. This prospective randomized double-blind study was conducted to evaluate the effects of gabapentin on intraoperative propofol requirements, hemodynamic variables, and postoperative pain relief in breast cancer patients.Materials and methodsForty adult females of the American Society of Anesthesiologists (ASA) Grade I-II physical status, undergoing total mastectomy for breast cancer were included. Patients were randomly allocated into two groups. Two hours prior to surgery the gabapentin group received gabapentin 600 mg and the control group received placebo. Anesthesia was induced with intravenous fentanyl, propofol, and vecuronium, and maintained with propofol infusion titrated according to the bispectral index. Postoperative analgesia was provided with intramuscular diclofenac sodium and intravenous morphine on demand.ResultsThe intraoperative propofol consumption was significantly less in the gabapentin group as compared with the control group (p = 0.009), whereas there was no difference in fentanyl and vecuronium requirements. Patients in the gabapentin group had lower pain scores at 30 minutes, 1 hour, and 2 hours postoperatively (p < 0.001). The postoperative morphine consumption was also less in the gabapentin group compared with the control group (p = 0.006). No significant adverse effects were noticeable.ConclusionPreoperative administration of gabapentin reduced intraoperative propofol requirements and postoperative analgesic consumption in breast cancer patients undergoing total mastectomy.     

A biomechanical approach to distal radius fractures for the emergency radiologist

Distal radius fractures are the most common upper extremity fracture and account for approximately one sixth of all fractures treated in US emergency departments. These fractures are associated with significant morbidity and have a major economic impact. Radiographic evaluation of distal radius fractures is frequently performed in the emergency department setting, has a profound impact on initial management, and is essential to assessing the quality and relative success of the initial reduction. While the most appropriate definitive management of distal radius fractures remains controversial, overarching treatment principles reflect distal radius injury mechanisms and biomechanics. An intuitive understanding of the biomechanics of the distal radius and of common mechanisms of injury informs and improves the emergency radiologist’s ability to identify key imaging findings with important management implications and to communicate the critical information that emergency physicians and orthopedic surgeons need to best manage distal radius fractures.     

Mucinous eccrine carcinoma of lower eyelid: a case report

A rare case of primary mucinous eccrine carcinoma of the lower eyelid in a 45 year old female is described. The lesion was diagnosed clinically as melanoma. We report this case because of unusual nature of this tumor and rare presentation in a female patient.     

Adaptation of Quality by Design-Based Development of Isradipine Nanostructured–Lipid Carrier and Its Evaluation for In Vitro Gut Permeation and In Vivo Solubilization Fate

The present study demonstrated the systematic adaptation of quality by design-integrated approach for the development of novel nanostructured lipid carrier (NLC) of an anti-hypertensive drug isradipine (ISD) to address the inherent challenges such as low solubility and low oral bioavailability. Plackett-Burman design was used for preliminary screening of significant process and formulation variables (p <0.05), which were further processed using Box-Behnken design for the attainment of optimization goal that is, mean particle size (85.7 ± 7.3 nm), drug entrapment efficiency (87.4 ± 3.29%), and in vitro drug release characteristics (92.89 ± 5.47%). The optimized ISD-NLC formulation also demonstrated well-dispersed uniform-shaped particles (polydispersity index 0.207 ± 0.029), high gastrointestinal fluid stability (zeta potential ?10.17 ± 0.59 mV), and higher in vitro gut permeation (21.69 ± 2.38 μg/cm² of ISD-NLC as compared to 11.23 ± 1.74 μg/cm² in ISD suspension). Furthermore, lipolysis studies were performed for the purpose of in vivo fate, and significantly higher drug content of ISD from ISD-NLC in aqueous phase was found (72.34 ± 4.62%) as compared to drug suspension (3.01 ± 0.91%). Relative bioavailability of ISD-NLC and ISD suspension was increased by 4.2-fold and 1.78-fold in the absence and presence of cycloheximide which is a lymphatic uptake inhibitor revealing lymphatic uptake of ISD-NLC in bioavailability improvement. Hence, systematic adaptation of quality by design integrated approach improved gut permeation and potential solubilizaton fate (dynamic lipolysis) of ISD-NLC, which further improved the lymphatic uptake and biodistribution of drug thereby promisingits in vivo prospect and clinical efficacy.     

Genetic System of Artemisia maritima L.: An Overexploited Medicinal Species Under Stress

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Artemisia maritima L., a potent source of Santonin (a drug used to expel roundworms), forms isolated...     

Functional disconnection of the dentate nucleus in essential tremor

Journal of Neurology - Despite previous functional MRI studies on alterations within the cerebello-thalamo-cortical circuit in patients with essential tremor (ET), the specific role of...     

Persistence of V. cholerae O139 Biofilm Against Physical,Chemical and Antibiotic Lethal Challenges

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Since its emergence, cholera caused by the bacterium Vibrio cholerae remains as a significant threat to human...