Comparing lignocaine-adrenaline-tetracaine gel with lignocaine infiltration for anesthesia during repair of lacerations: A randomized trial

BACKGROUND:

This study aimed to compare the topical anesthetic lignocaine, adrenaline, and tetracaine (LAT) (4% lignocaine, 1:2 000 adrenaline, 1% tetracaine) with the conventional lignocaine infiltration(LI) for repair of minor lacerations, for the comfort of anesthetic administration, efficacy, adverse effects and cost.

METHODS:

This was a prospective randomized clinical trial. Forty Asian patients who required toilet and suture for minor lacerations in the emergency department of the Singapore General Hospital over a 4-month period. The patients were assigned randomly to 2 arms of treatment. The first was the LAT gel group who had LAT gel applied to the laceration prior to suturing. The second was the control group in whom the anesthetic administered was lignocaine infiltration (LI) via a syringe. The pain of the process of administering anesthetic and efficacy of anesthesia were scored using the visual pain scale included within. The efficacy of LAT vs. lignocaine infiltration as an anesthetic prior to the toilet and suture of minor lacerations and complications of therapy.

RESULTS:

Twenty patients were randomized to LAT gel and 16 to LI on an intention to treat analysis. The mean pain score by patients in the LAT gel group was 2.5 (0.52 SE), and 2.5 (0.58 SE) in the LI group. The pain score for pain during application of the anesthetic was 1.5 (0.40) in the LAT gel group, and 3.5 (0.46) in the LI group. There was no difference in complications between the LAT and LI groups

CONCLUSION:

LAT gel prior to the toilet and suture of minor lacerations is proven to be as efficacious as LI in terms of patient comfort and effectiveness of anesthesia. The complications are also comparable to those treated with LI.KEY WORDS: Lignocaine infiltration, Lacerations, Emergency department, Pain score     

魔芋精粉的降血糖作用

目的：研究魔芋精粉的降糖作用。方法：以不同剂量魔芋精粉ｉｇ正常小鼠和四氧嘧啶糖尿病小鼠,连续１０ｄ后,葡萄糖氧化酶法测定正常小鼠的空腹血糖、糖耐量试验以及四氧嘧 啶糖尿病小鼠的血糖尿病小鼠的血糖,以放射免疫法测定血清胰岛素。结果：魔芋精粉有降低正常小鼠血糖作用,呈一定量效关系趋势;且具有改善小鼠糖耐量作用,能明显降低四氧嘧啶糖尿病小鼠血糖,但因清胰岛素水平无明显影响。结论：魔芋精粉可能是通过影响糖代     

N-(1-乙氧羰基-3-苯氨甲酰基丙基)甘氨酰甘氨酸衍生物的合成

报道4个N-(1-[1-乙氧羰基-3-(对甲)苯氨甲酰基]丙基甘氨酰｝-N-取代甘氨酸(XI_1～4)和5个1-[1-乙(或甲)氧羰基-3-(对甲)苯氨甲酰基]丙基-4-取代-1,4-哌嗪-2,5-二酮(XII_1～5)共9个估计有血管紧张素转化酶抑制活性化合物的合成和鉴定。所有这些化合物及9个相应的酯(X_1～9)均未见文献报道。药理初试结果,化合物XII₂,XII₅,XI₄和XII₁均有较强降压活性。     

Gastric antisecretory and antiulcer/cytoprotective effects of 2-cyano-3-(ethylthio-3-methylthio)-2-propenoic acid methyl ester

AY-28,200 (2-cyano-3-(ethylthio-3-methylthio)-2-propenoic acid methyl ester), a new gastric antisecretory/antiulcer agent, inhibited basal and pentagastrin-stimulated gastric acid secretion in the conscious rat (ED50 = 7.6 and 1.9 mg/kg i.g., respectively). For inhibition of basal secretion, peak activity was attained in 5 to 6 h after dosing and was maintained for more than 10 h, with no gastric antisecretory activity occurring at 24 h. The K+ stimulated H+-K+ ATPase activity from rabbit gastric microsomes was inhibited by AY-28,200 (IC50 = 22 mumol/l). AY-28,200 inhibited ethanol-induced gastric lesions, at 3 mg/kg p.o. AY-28,200's cytoprotective effects against ethanol lasted for more than 4 h. AY-28,200 blocked acetylsalicylic acid and stress-induced gastric ulcers but was inactive against indomethacin-induced gastric ulcers. These results suggest that AY-28,200 is a parietal cell proton pump inhibitor with cytoprotective properties, and may produce its cytoprotective effect by stimulating the formation of endogenous prostaglandins.     

Evaluation of retinal nerve fiber layer,ganglion cell layer,and optic nerve head morphological parameters in patients with obstructive sleep apnea and comparison with normal population

Purpose:To compare the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and optic nerve head (ONH) morphological parameters between obstructive sleep apnea (OSA) patients and age-matched controls using spectral domain optical coherence tomography (SD-OCT).Methods:This case control study was conducted in a multi-specialty tertiary care hospital from 2014 to 2016. Patients diagnosed to have OSA by overnight polysomnography were included in the study. Fifty eyes of 25 OSA patients with clinically normal optic disc were compared with 50 eyes of age-matched controls. The study population underwent detailed ophthalmological evaluation including SD-OCT.Results:There was significant thinning of the superior, inferior, and average RNFL in the OSA group when compared to controls. GCL analysis also showed a significant thinning of the six sectors as well as average and minimum ganglion cell layer + inner plexiform layer in OSA patients. The optic nerve head rim area was significantly decreased in OSA patients when compared to controls.Conclusion:OSA patients even with clinically normal optic disc showed significant decrease in the RNFL thickness, GCL thickness, and rim area when compared to age-matched controls. Hence, these patients constitute a high-risk population who need to be regularly screened and followed up for ocular co-morbidities.     

Therapeutic action and underlying mechanisms of a combination of two pentacyclic triterpenes, α- and β-amyrin,in a mouse model of colitis

Background and purpose:

α- and β-amyrin are pentacyclic triterpenes found in plants and are known to exhibit pronounced anti-inflammatory effects. Here, we evaluated the effects of a 1:1 mixture of α- and β-amyrin (α,β-amyrin) on an experimental model of colitis in mice.

Experimental approach:

Colitis was induced in Swiss male mice by trinitrobenzene sulphonic acid (TNBS) and followed up to 72 h; animals were treated systemically with α,β-amyrin, dexamethasone or vehicle. Macro- and microscopic damage, myeloperoxidase activity and cytokine levels were assessed in colons. Histological sections were immunostained for cyclooxygenase-2 (COX-2), vascular endothelial growth factor, phospho-p65 nuclear factor-κB (NF-κB) and phospho-cyclic AMP response element-binding protein (CREB)

Key results:

TNBS-induced colitis was associated with tissue damage, neutrophil infiltration and time-dependent increase of inflammatory mediators. Treatment with α,β-amyrin (3 mg·kg⁻¹, i.p.) or dexamethasone (1 mg·kg⁻¹, s.c.) consistently improved tissue damage scores and abolished polymorphonuclear cell infiltration. α,β-Amyrin, like dexamethasone, significantly diminished interleukin (IL)-1β levels and partially restored IL-10 levels in colon tissues 72 h after colitis induction, but only α,β-amyrin reduced vascular endothelial growth factor expression by immunohistochemistry. The colonic expression of COX-2 at 24 h and that of phospho-NF-κB and phospho-CREB (peaking at 6 h) after colitis induction were consistently inhibited by both α,β-amyrin and dexamethasone.

Conclusions and implications:

Systemic administration of α,β-amyrin exerted a marked and rapid inhibition of TNBS-induced colitis, related to the local suppression of inflammatory cytokines and COX-2 levels, possibly via inhibition of NF-κB and CREB-signalling pathways. Taken together, our data suggest a potential use of α,β-amyrin to control inflammatory responses in bowel disease.     

Historical control data on urinary and renal tissue biomarkers in naive male Wistar rats.

Total proteins, angiotensin-converting enzyme, N-acetyl-beta-D-glucosaminidase, glutamine transaminase K and glutamine synthetase were determined in urine collected overnight (14 h: 6:00 p.m.-8:00 a.m.) from naive male Wistar rats; glutamine transaminase K and glutamine synthetase in the kidney 10,000 g supernatant and p-aminohippurate uptake in renal cortical slices also were measured. Urinary parameters were related both to urinary creatinine concentration and urinary flow rate; kidney parameters were related to protein concentration (enzymes) or slice/medium (S/M) ratio (p-aminohippurate uptake). The following reference ranges (1.0 and 99.0 percentiles) were obtained: urine: total urinary proteins (195 samples) 0.03-0.29 g mmol(-1) creatinine and 0.13-1.77 mg h(-1); angiotensin-converting enzyme (115 samples) 8.9-63.7 micromol mmol(-1) creatinine and 59.4-282.7 nmol h(-1); glutamine transaminase K (115 samples) 0-1.7 micromol mmol(-1) creatinine and 0-8.5 nmol h(-1); N-acetyl-beta-D-glucosaminidase (72 samples) 0.7-5.0 micromol mmol(-1) creatinine and 4.9-28.4 nmol h(-1) (naive male rats did not excrete glutamine synthetase); kidney: glutamine transaminase K (36 samples) 14.5-32.8 nmol mg(-1) protein; glutamine synthetase (22 samples) 13.9-48.6 nmol mg(-1) protein and p-aminohippurate (54 samples) 4.77-17.89 S/M. Urinary creatinine (r = -0.780), total urinary proteins (r = -0.521), angiotensin-converting enzyme (r = -0.650) and N-acetyl-beta-D-glucosaminidase (r = -0.796) but not glutamine transaminase K were well correlated with diuresis. In addition, the same parameters, but not glutamine transaminase K, were well correlated with creatinine (r = 0.604,0.701 and 0.747, respectively). Significant correlation also was observed between urinary indices adjusted to creatinine or urinary flow rate (total urinary proteins: r = 0.813; angiotensin-converting enzyme: r = 0.677; glutamine transaminase K: r = 0.939; N-acetyl-beta-D-glucosaminidase: r = 0.657). Finally, a low but significant correlation was found between total urinary proteins and angiotensin-converting enzyme (r = 0.293) and N-acetyl-beta-D-glucosaminidase (r = 0.471).