A comparative study of validated spectrophotometric and TLC- spectrodensitometric methods for the determination of sodium cromoglicate and fluorometholone in ophthalmic solution

The determination of sodium cromoglicate (SCG) and fluorometholone (FLU) in ophthalmic solution was developed by simple, sensitive and precise methods. Three spectrophotometric methods were applied: absorptivity factor (a-Factor method), absorption factor (AFM) and mean centering of ratio spectra (MCR). The linearity ranges of SCG were found to be (2.5–35 μg/mL) for (a-Factor method) and (MCR); while for (AFM), it was found to be (7.5–50 μg/mL). The linearity ranges of FLU were found to be (4–16 μg/mL) for (a-Factor method) and (AFM); while for (MCR), it was found to be (2–16 μg/mL). The mean percentage recoveries/RSD for SCG were found to be 100.31/0.90, 100.23/0.57 and 100.43/1.21; while for FLU, they were found to be 100.11/0.56, 99.97/0.35 and 99.94/0.88 using (a-Factor method), (AFM) and (MCR), respectively. A TLC-spectrodensitometric method was developed by separation of SCG and FLU on silica gel 60 F₂₅₄ using chloroform:methanol:toluene:triethylamine in the ratio of (5:2:4:1 v/v/v/v) as developing system, followed by spectrodensitometric measurement of the bands at 241 nm. The linearity ranges and the mean percentage recoveries/RSD were found to be (0.4–4.4 μg/band), 100.24/1.44 and (0.2–1.6 μg/band), 99.95/1.50 for SCG and FLU, respectively. A comparative study was conducted between the proposed methods to discuss the advantage of each method. The suggested methods were validated in compliance with the ICH guidelines and were successfully applied for the determination of SCG and FLU in their laboratory prepared mixtures and commercial ophthalmic solution in the presence of benzalkonium chloride as a preservative. These methods could be an alternative to different HPLC techniques in quality control laboratories lacking the required facilities for those expensive techniques.     

Hip fracture discrimination study: QUS of the radius and the calcaneum.

As an emerging alternative to current radiation-based bone densitometry techniques, there is a growing interest in the use of quantitative ultrasound (QUS) measurements for the noninvasive assessment of fracture risk in the management of osteoporosis. However, there are also a multiplicity of technologically different QUS devices available on the market and, so far, no study has compared heel and radius QUS device for the discrimination of subjects with hip fractures. Our study evaluated the ability of three QUS devices (one calcaneal gel-coupled system, one calcaneal water-coupled system, and one radius system) to discriminate osteoporotic from controls subjects, using the same population. We also checked if the combination of two different skeletal sites (i.e., calcaneum and radius) improve the discriminatory ability of the QUS devices. Forty-five women aged 79.1+/-7.1 yr with hip fractures within the last 4 d were used as the hip-fracture group and compared to 40 healthy controls from 65-87 yr. In addition, 47 young controls, aged 20-40 yr, were used as reference population to express some of the results as T-scores. QUS measurements were performed with the Hologic Sahara, Ge-Lunar Achilles+, and Sunlight Omnisense devices according to the manufacturer's recommendations. Adjusted odds ratio results showed that a decrease in Omnisense SOS of 1 standard deviation (SD) was associated with a significant increase in fracture risk (OR adj.=2.83) comparable with Sahara BUA (OR adj.=2.42) and Achilles BUA (OR adj.=3.29). However, given the large overlap between the 95% intervals of each odds ratio, no significant difference was found between the devices. Similarly, comparison between the areas under ROC curves did not show any significant difference between all the parameters. Considering the parameters provided per default by each QUS device, the Sahara, Achilles, and Omnisense devices classified correctly 70, 67.5, and 62.5% of the subjects, respectively. Although the OR of the combination of radius and calcaneum is improved (3.62 to 4.74) compared with either one of the single skeletal site, the large confidence intervals do not allow to claim a significant difference. The three QUS technologies tested against hip fractures seem to show the same discriminatory ability. However, there is some differences in the definition of the diagnostic threshold underlying the nonusability of the World Health Organization (WHO) osteoporosis definition. Finally the combination of several site using two different devices is not clinically relevant. Potential interest could be seen in combining several sites using the same device, supposing that such device would measure differently active bone.     

Use of Probiotics in the Management of Chemotherapy‐Induced Diarrhea: A Case Study

Gastrointestinal disturbances (particularly diarrhea) are often induced in response to cancer treatments such as chemotherapy or radiation. Oral chemotherapeutic agents can induce diarrhea by damaging the intestinal lining. Two common oral drugs used in cancer treatment that are known to have gastrointestinal side effects are capecitabine and lapatinib. In this brief communication, the authors discuss a case study of a stage IV breast cancer patient whose chemotherapy‐induced diarrhea was treated successfully with a multispecies combination of probiotics. This is a unique study in which grade 3 chemotherapy‐induced diarrhea (characterized by 7–9 stools per day and associ ated with incontinence and abdominal cramping) was treated with only a multispecies combination of probiotics. Probiotics have been used to treat diarrhea in patients with irritable bowel syndrome, ulcerative colitis, pouchitis, and Crohn's disease. More recently, probiotics have been used to treat chemotherapy‐induced diarrhea in colon cancer patients. This case study demonstrates that the probiotics can also be used to treat severe cases of chemotherapy‐induced diarrhea in breast cancer patients. The use of different probiotics in gastrointestinal diseases is an increasingly important area of study, and more research into this area is needed. This study demonstrates that probiotics should be considered for advanced breast cancer patients with chemotherapy‐induced diarrhea.     

Combined coronary surgery and aortic valve replacement after previous right pneumonectomy

Cardiac surgery in patients with previous pneumonectomy is infrequently reported. We report a case of combined coronary artery bypass grafting and aortic valve replacement in a patient with left ventricular ejection fraction less then 35% and a previous right pneumonectomy. All steps in operative management of this rare condition are discussed.     

Antinutritional factor content and hydrochloric acid extractability of minerals in pearl millet cultivars as affected by germination

Four pearl millet cultivars of two different species--Kordofani and Ugandi (Pennisetum typhoideum) and Madelkawaya and Shambat (Pennisetum glaucum)--were germinated for 6 days. The germinated grains were dried and milled. Phytic acid and polyphenol contents and hydrochloric acid (HCl) extractability of minerals from the malt flours were determined at intervals of 2 days during germination. Phytic acid and polyphenol contents decreased significantly (P <0.01) with an increase in germination time, with a concomitant increase in HCl extractable minerals. However, the major mineral content was significantly decreased while that of trace minerals was increased with germination time. When the grains were germinated for 6 days, Madelkawaya had higher extractable calcium while Ugandi had higher extractable phosphorus, whereas iron and manganese recorded high levels in Shambat and Madelkawaya, respectively. There was good correlation between antinutritional factors reduction and the increment in extractable minerals with germination time.     

Diaries written for ICU patients

Diaries are written for critically ill patients, to help them understand their intensive care stay and come to terms with their illness. The aim of this content analysis of eight such diaries is to understand the potential benefits for patients and families of this care intervention. A main category emerged: Sharing throughout the ICU time. Four themes were identified: (a) Sharing the story, (b) Sharing the presence, (c) Sharing feelings, and (d) Sharing through support. The first theme reflects the narration of daily events. The second is the perceived presence of health professionals and family at the patient's bedside and the presence of the patient as a person through the diary entries. The third theme describes the expression of feelings as written throughout the text. The last theme refers to the support offered to the patient. The diaries reflect the commitment and care of contributors to the patients' welfare.     

Epidemiology of end-stage renal disease before starting hemodialysis and factors influencing hemodialysis survival

BACKGROUND: The incidence of end-stage renal failure is high and it is responsible for the increase of the rate of morbidity and mortality rates among our patients. AIM:The objective is to study patient characteristics before starting hemodialysis and to evaluate factors influencing their short and long term survival. METHODS: This is a prospective study of 127 patients starting hemodialysis between June and December 2001. On May 31, 2005, their survival was analyzed according to different parameters. RESULTS: Patients were 77 males and 50 females. Their mean age was 51.4 +/- 16.1 years (15 to 78 years). Diabetes was observed in 33.9% of cases. Only 70.9% of patients were covered by a social service. Chronic renal failure was diagnosed at the end stage in 34.6% of cases. Before starting hemodialysis, only 4 patients were vaccinated against B hepatitis and arteriovenous fistula were not made in any patients. Pericarditis was observed in 9.4% of patients. Albuminemia was < 35 g/l in 60.5% of patients. First hemodialysis session was programmed in 53.5% of patients and realized urgently in 46.3% of patients. Patients were hemodialysed 4, 8 and 12 hours per week respectively in 16.5%, 15.8% and 67.7% of cases. On May 31, 2005, 35.4% of patients died. Their actuarial survivals at 3 months, 1 year and 4 years were respectively at 87.5%, 79.5% and 64.4%. Acturial survival was bad in patients with pericarditis, diabetes, hemodialysed less than 12 hours/week and when the first hemodialysis session was started urgently. CONCLUSION: The diagnosis of renal failure was frequently made at end-stage. There are no preparations before starting hemodialysis. We have to reinforce prevention programmes and increase the number of nephrologists and nephrology departments.