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Background: Second lumbrical interosseous (2L-I) median-ulnar motor conduction study across wrist is pivotal in electrodiagnosis of carpal tunnel syndrome (CTS) in different grades of severity. 2L-I Median versus ulnar distal motor latency (DML) difference more than 0.5 milliseconds is used to diagnose median neuropathy at wrist. Other variables of study, namely, 2L DML, compound muscle action potential (CMAP) amplitude, CMAP duration, and conduction velocity (CV) remain less explored with few studies pressing for its role to substantiate CTS diagnosis. Aims and Objectives: Current cross-sectional study aimed to explore role of 2L-I DML, amplitude, duration, and CV in diagnosis of median neuropathy at wrist. Materials and Methods: Total 70, 37 clinically suspected CTS hands and 33 age, height, and weight matched non-CTS hands underwent 2L-I Median Ulnar motor conduction study. Results: Statistically significant difference (P < 0.05) in 2L median DML, CMAP amplitude, duration and CV between CTS and non-CTS hands along with 2L-I Median versus Ulnar DML difference. 2L DML and 2L-I DML difference variables showed better specificity and sensitivity: 83.78 and 93.91, respectively, in diagnosing CTS. Conclusion: We concluded that apart from 2L-I DML difference other variables such as DML, amplitude, duration, and CV may also play substantial role in evaluation of CTS and may be included as part of electrodiagnostic protocol.
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Background: Bacterial multidrug resistance (MDR) is particularly common in Gram-negative bacilli (GNB), with important clinical consequences regarding their spread and treatment options. The prevalence of drug-resistant cases is increasing globally. MDR has become a major problem for the treatment of bacterial infections and is becoming greatest challenge to public health. Quantification of the prevalence and the common antimicrobial coresistance patterns of MDR GNB (MDRGNB) isolates would have important implications for patient care. Aim and Objective: The aim of this study was to know the prevalence of multidrug resistant Gram-negative bacteria. Materials and Methods: This retrospective study was done from January 2021 to December 2021 at the Department of Microbiology, GMERS Medical College and Hospital, sola, Ahmedabad, Gujarat. Species identification was done by bacterial growth and standard biochemical reaction. Drug susceptibility testing of isolates was done by Kirby–Bauer disk diffusion method following Clinical Laboratory Standards Institute guidelines. MDR was defined as acquired resistance to at least one agent in three or more antimicrobial categories. Stool samples were not included in this study. Results: The 1-year records of a total of pathogens were studied. The highest number of pathogens were isolated from blood cultures (19%), followed by wound swabs (19%) then urine (10.3%) then sputum and pleural fluid (8.5%). The most frequently isolated pathogens were Klebsiella spp. (32.8%), Escherichia coli (28.8%), Acinetobactor spp. (20.8%), and Pseudomonas spp. (9.6%). Gram-negative isolates exhibited high overall resistance to all used antibiotic classes. All isolates showed 100% susceptibility to colistin. Conclusion: The results of the study showed that the most common MDR-GNB isolate is Klebsiella Pneumonii in intensive care units department in blood, pus, and sputum sample. The study findings will be part of a strict antibiotic stewardship (AMS) program and also indicate that AMS should begin at primary and secondary health-care centers to prevent antimicrobial resistance.
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The purpose of this research was to prepare and evaluate monolithic drug-in-adhesive type patches of Rasagiline Mesylate (RM) containing penetration enhancer and having seven day wear property. Preformulation studies like solubility in permeation enhancers, compatibility study, transmission study, uptake study and crystallization study of Rasagiline Mesylate in various pressure sensitive adhesive polymers were performed. Transdermal system was prepared by solvent casting method. The effects of various permeation enhancers (Propylene Glycol, Oleic Acid, Isopropyl Palmitate, and lauryl lactate) on the ex-vivo transcutaneous absorption of Rasagiline Mesylate through human cadaver skin were evaluated by modified Franz diffusion cell system. Ex-vivo transcutaneous absorption of prepared transdermal patch was performed using different concentration of Lauryl lactate (3%, 5%, and 7%). In-vitro Adhesion testing (Peel, tack shear etc.) was performed on different dry GSM (Grams per Square Meter) of patch like 80GSM, 100 GSM and 150 GSM. The final transdermal patches were tested for appearance, weight of matrix, thickness, % assay of drug content, in-vitro adhesion testing, cold flow study and ex-vivo skin permeation studies. Based on crystallization study and adhesion testing, Durotak-4098 (14% drug concentration) was selected as pressure sensitive adhesive. Patch containing Lauryl lactate showed highest cumulative permeation compared to other permeation enhancers. The patch containing 5% laurel lactate showed greater transdermal flux (2.36 µg/cm2 /hr). Patch with 150 dry GSM showing promising adhesion properties. Backing film Scotchpak 9723 and release liner Saint Gobain 8310 was selected based on transmission and uptake study of Rasagiline Mesylate. Stability study indicates that developed formulation remains stable. In conclusion, the present research confirms the practicability of developing Rasagiline Mesylate transdermal system.
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Properties of a mutant at the LLD (LEAF-LET DEVELOPMENT) locus in pea Pisum sativum L. are reported in this paper. Plants homozygous for the Mendelian recessive mutation lld bear leaves in which a few to many leaflets are incompletely developed. Opposite pinnae of rachis nodes often formed fused incompletely developed leaflets. The lld mutation was observed to abort pinna development at almost all morphogenetic stages. The lld mutation demonstrated high penetrance and low expressivity. The phenotypes of lld plants in tl, tac, tl tac, tl af and tl af tac backgrounds suggested that LLD function is involved in the separation of lateral adjacent blastozones differentiated on primary, secondary and tertiary rachides and lamina development in leaflets. The aborted development of tendrils and leaflets in lld mutants was related to deficiency in vascular tissue growth. The morphological and anatomical features of the leaflets formed on a tl lld double mutant permitted a model of basipetal leaflet development. The key steps of leaflet morphogenesis include origin of the lamina by splitting of a radially symmetrical growing pinna having abaxial outer surface, opposite to the vascular cylinder, through an invaginational groove, differentiation of adaxial surface along the outer boundary of split tissue in the groove and expansion of the lamina ridges so formed into lamina spans.