Propofol in an emulsion of long chain triglyceride and medium-long chain triglyceride: the effect on pain during injection

Pain on injection is major disadvantage of standard propofol formulated with long chain triglycerides [LCT] during induction of anesthesia and sedation in critically ill patients. It is found that concentration of free propofol in aqueous phase of emulsion is responsible for pain on injection and that reducing amount of free propofol would also reduced frequency and intensity of pain on injection. The study was design to investigate whether pain on injection can be reduced by new formulation of propofol which consist of medium chain and long chain triglycerides [MCT/LCT] which is now available in market, and claimed reduced concentration of free propofol in aqueous phase. We devised a prospective, analytical; double blind randomized study to compare the pain on injection of two formulation of propofol for induction of general anesthesia. The present study included 200, non premeditated ASA I, II - adult patients scheduled for elective surgery under general anesthesia at Abbasi shaheed hospital. Patients were allocated randomly in two groups to receive either propofol - MCT/LCT [group I] or propofol - LCT [group II]. The study solution injected at speed of 1ml/sec in a dose of 2.5 mg /kg for induction of general anesthesia and patients graded any associated pain on injection using four point scale: 0= no pain, 1= mild pain, 2= moderate pain, 3= severe pain. There was a significantly less incidence and intensity of injection pain in group-I compared with group-II. The author concluded that propofol MCT/LCT significantly reduced the incidence and severity of pain on injection

In vitro availability of atorvastatin in presence of losartan

Hydroxymethylglutaryl-coenzyme A reductase inhibitors [statins] are a group of cholesterol lowering agents that have become the largest selling drugs in the world. They are of proven clinical benefit in coronary heart disease, at least in those patients who do not have overt chronic heart failure [CHF]. Co-administration of statins with angiotensin II receptor blockers [ARBs] is most common, since there is strong synergy between hypertension and hypercholesterolemia in terms of risk factors for the development of cardiovascular diseases. In present paper, we describe the in vitro availability of atorvastatin, a potent HMG-CoA reductase inhibitor, in presence of losartan potassium, which is a non-peptide angiotensin II receptor antagonist. These studies were carried out at 37, 48 and 60

Comparative study pin and plaster and AO monoplane external fixator in treatment of gustilo type I and II open fracture of tibia

To evaluate effectiveness of pin and plaster as against AO external fixator in open fractures of tibia and fibula in developing countries. Design: It was a prospective, randomised comparative study. Place and Duration of Study: The study was conducted at Jinnah Postgraduate Medical Centre, Karachi, Pakistan from February, 1998 to January, 2000. Materials and A total of 96 patients were included in the study with tibial shaft fracture AO type A and B and Gustilo Grade I and II. More severe fractures were excluded from the study as those required more versatile fixator. Patients were divided into two groups using randomisation. Group I patients were treated with the AO monoplane external fixator and Group II patients with pin in plaster. Formal debridement was done in both the cases. No significant differences in treatment outcomes in both groups were noted as far as soft tissue management, healing time and complications are concerned. It was felt that pin and plaster is equally effective treatment for Gustilo Grade I and II open fractures of tibial shaft more so in our country for economic reasons