Oligo-glycerol based non-ionic amphiphilic nanocarriers for lipase mediated controlled drug release

A new class of non-ionic amphiphiles is synthesized using a diaryl derivative of diglycerol as a central core and functionalizing it with long alkyl chains (C-12/C-15) and monomethoxy PEG moiety (M_n: 350/550) by following a chemo-enzymatic approach. The aggregation behavior of the amphiphiles in aqueous medium is studied by using dynamic light scattering (DLS) and fluorescence spectroscopy, whereas the size and morphology of the aggregates are studied by transmission electron microscopy (TEM). A hydrophobic dye, Nile red and a hydrophobic drug, nimodipine, are used to demonstrate the nano-carrier capability of these non-ionic amphiphilic systems and the results are compared with amphiphilic analogues obtained from the triaryl derivatives of triglycerol. The in vitro controlled release of the encapsulated dye is successfully carried out in the presence of immobilized Candida antarctica lipase (Novozym 435). Furthermore, cytotoxicity data is also collected which suggests that the amphiphiles are suitable for biomedical applications.

A new series of oligo-glycerol based amphiphiles have been synthesized for drug delivery.     

Reversible renal medullary hyperechogenicity in neonatal hypernatremic dehydration

Three exclusively breastfed term neonates were admitted with lethargy, poor feeding, and oligoanuria. All three babies were severely dehydrated and had a weight loss ranging from 18% to 40%. Serum sodium of more than 180 mEq/l and renal failure were observed in all three. Two had very high creatinine levels of 9.5 mg/dl and 6.7 mg/dl. Both these babies also had multiple seizures. One baby required mechanical ventilation. All three babies showed markedly hyperechoic renal medullary pyramids with speckled foci suggestive of crystal deposition that reversed completely on therapy. Urine showed abundant urate crystals in two and an elevated calcium/creatinine ratio of 1.6 in one. There was no evidence of distal renal tubular acidosis, Bartter syndrome, or high serum calcium. Supersaturation of the ions in a markedly hypertonic renal medulla may have led to crystallization, with resolubilization with hydration and restoration of good urine output. The hypernatremic dehydration was primarily due to lactation failure leading to inadequate fluid intake in the face of ongoing insensible losses. High breast milk sodium may have been a contributory factor in one patient.     

Role of coping strategies and attitudes in mediating distress due to hallucinations in schizophrenia

The purpose of the present study was to determine the role of coping strategies and attitudes in predicting distress due to hallucinations in schizophrenia. Seventy-five chronic stable schizophrenia patients were assessed with respect to sociodemographic profile, clinical variables, general psychopathology, phenomenology (severity) of hallucinations, attitude towards hallucinations, distress due to hallucinations (determined by two measures) and coping strategies used to deal with hallucinations. On multiple stepwise regression analysis, 'severity of hallucinations' and 'problem-solving coping strategies' contributed significantly to both measures of distress. It can be concluded that distress due to hallucinations in schizophrenia is determined by severity of hallucinations (stressor) and problem-solving coping strategies. Attitudes do not seem to play any role in this respect.     

Is antegrade ureteroscopy better than retrograde ureteroscopy for impacted large upper ureteral calculi?

OBJECTIVE: This study was planned to compare the risks and advantages of antegrade and retrograde ureteroscopy for impacted large upper ureteral calculi. PATIENTS AND METHODS: From September 1996 to February 1998, ureteroscopy was offered to 43 patients. Of these, retrograde ureteroscopy was done in 20 patients, while antegrade ureteroscopy was performed in 23 patients. All these patients were followed up to evaluate the immediate and long-term success of the procedure. The incidence and nature of complications were also noted. RESULTS: During retrograde ureteroscopy, complete stone clearance was achieved in 11 patients (55%), while pushback of the whole or fragmented calculus was seen in the rest. These patients with residual calculi were later treated by extracorporeal shockwave lithotripsy (SWL). The stone-free rate at the end of 3 months was 85%. Three patients developed minor ureteroscopy-related complications. Complete stone clearance was achieved in all patients with antegrade ureteroscopy. No intraoperative or postoperative complications were encountered. CONCLUSION: In this series, antegrade ureteroscopy was found to be a safe and effective option for impacted upper ureteral calculi and assured better results than retrograde ureteroscopy.     

Congenital dislocation of patella with ipsilateral hip flexion-abduction deformity: a case report

Iliotibial band tightness and its abnormal insertion on patella is one of the contributing factors in congenital dislocation of patella. Although hip flexion-abduction deformity is caused by a tight iliotibial band, as frequently seen in postpolio residual paralysis, an association of hip flexion-abduction deformity with congenital dislocation of patella has never been reported previously. Such a case was presented to us, and surgical repositioning of the patella was carried out by means of release of the tight iliotibial band from the patella besides other tight lateral structures along with medial augmentation and distal realignment of the quadriceps mechanism. The hip deformity was corrected spontaneously after release of the tight iliotibial band from the knee without need for additional surgery at the hip.