Role Of Fentanyl In Attenuation Of Haemodynamic Changes During Electroconvulsive Therapy

BACKGROUND AND AIMS : The use of Electroconvulsive therapy as a treatment modality has increased over the recent years. Electroconvulsive therapy (ECT) is associated with transient episodes of hypertension and tachycardia.Various agents like Beta-blocking agents, Opioids, Nitroglycerine and Clonidine are usedto prevent cardiovascular response.Aim of our study was to assess the efficacy of Fentanyl on cardiovascular response and seizure duration during ECT. MATERIAL AND METHOD :60 patients aged 18-60 years with ASA Grade I or II undergoing ECT were divided into Group A patients who received Inj.Fentanyl 1 mcg/kg intravenously and Group B patients who did not received Inj. Fentanyl 1 mcg/kg. The haemodynamic changes and seizure duration were recorded and tested by Mean, Standard deviation, Percentage, P value for significance. RESULTS :The haemodynamic changes after giving ECT were less in Fentanyl Group A (P<0.05) as compared to Nonfentanyl Group B and vitals came to baseline value earlier in Fentanyl group than Nonfentanyl group. Seizure duration was not affected by Fentanyl (P>0.05). CONCLUSION : Those patients receiving ECT when given Inj. Fentanyl 1 mcg/kg intravenously wereseen to be more haemodynamicaly stable as compared to those patients who did not received Inj.Fentanyl intravenously.

Tyrosinemia type 1: clinical and biochemical analysis of cases with poor treatment outcome

Tyrosinemia Type I [TT1] is a metabolic disorder with impaired activity of fumarylacetoacetate hydrolase enzyme. The causes of death are liver failure, pseudo porphyric crisis and hepatocarcinoma. The treatment is based on diet restriction, liver transplantation and the NTBC. Aim: To review the clinical presentation, biochemical analysis and expose the causes of failure of treatment in 3 patients with TT1. By studying the clinical and biochemical data of 3 dead patients with TT1 [part of the total 15 patients with the same diagnosis], during [October 2001 to October 2009].The diagnosis was established by high tyrosin in the blood and succinylacetone in the urine. Monitoring was based on the combination of liver imaging, and alpha feto protein as tumor marker. Two patients were treated by NTBC and diet restriction [patients 1 and 2] while the 3rd patient was treated by diet restriction only. Overall survival rate was 80% [85.7% in those treated by NTBC]. The age at onset was respectively 8, 5 and 1.5 months .The age at diagnosis was 40, 6 and 6 months. All three patients were presented with severe liver failure. [PT ranged from 21% to 24%], patient 1 was treated with NTBC for 4 months and died after 2 months of stopping NTBC. The second patient did not respond to NTBC and died after 5 months of treatment. The third patient died after 2 months of treatment. A. Poor prognosis in patient 1 and 2 could be explained by [1] The dose was less than 2mg/kg/d [2] Late diagnosis in patient 1. [3] Difficulty of management and monitoring. B. Poor prognosis in patient 3 was on diet restriction as in the literature. C. Slow decrease of alpha feto protein can explain the possibility of hepatocarcinoma in patient 1 and 2 but the duration of the treatment was short to conclude, the increase in patient 3 is well known as a part of hepatocarcinoma mechanism. [1] Early diagnosis and starting NTBC with diet restriction give good prognosis. [2] Starting neonatal metabolic screening

Psychoda albipennis maggots [Diptera: psychodidae] as a cause of urinary myiasis in an upper Egyptian male, the second World case

A case of urinary myiasis with the manifestations of urinary tract discharge, frequency and burning micturation in a 21 years old Upper Egyptian male was described. Eleven larvae of the Psychodid fly [Psychoda albipennis] were recovered from his urine. The maggots were diagnosed, described and photographed. Psychoda albipennis maggots as a cause of urinary myiasis is here to be the second recorded case in the world

In-vitro and in-vivo evaluation of cinnarizine solid dispersions

To solve the problem of cinnarizine dissolution, its solid dispersions with certain amino acids, aspartame, gentisic acid ethanolamide [GAEA], and Eudragit E100 were prepared in different ratios. The prepared solid dispersions were subjected to dissolution rate studies in comparison to plain cinnarizine as well as the drug treated in the same way without additives. Effect of aging on drug dissolution was also investigated. Selected cinnarizine coprecipitates containing 2: 1 w/w Eudragit E100 [FII], 1: 5 M aspartame [FIII] and 1: 3M Dl-phenylalanine [FIV] were subjected to in vivo bioavailability testing compared to plain cinnarizine [FI]. HPLC method was used to quantitate cinnarizine in rabbits' serum

Qualidade de animais de laboratório: situaçäo internacional e brasileira / Quality of laboratory animals: international and Brazilian situation

É feita uma análise crítica da situaçäo do bioterismo no Brasil - e países em desenvolvimento em geral - em comparaçäo com o que existe nos países desenvolvidos em geral - em comparaçäo com o que existe nos países desenvolvidos. Säo discutidas as causas da situaçäo dos biotérios na grande maioria dos centros de pesquisa e o significado desta situaçäo quanto à qualidade de animais de laboratório e, por extensäo, à validade da investigaçäo biológica, apontando-se, ao mesmo tempo, caminhos para superar os problemas