Correlation of Serum Lactate Levels, Perfusion Index and Plethysmography Variability Index With Invasive Blood Pressure in Late Preterm and Term Infants With Shock

Objective: To study the correlation of objective parameters for diagnosing shock viz., perfusion index (PI), plethysmography variability index (PVI) and serum lactate (SL) with invasive blood pressure in late preterm and term infants with shock. Methods: Prospective observational study (diagnostic test) conducted at the neonatal intensive care unit of Kanchi Kamakoti CHILDS Trust Hospital, Chennai between June, 2018 and May, 2020. Term and late preterm neonates with shock were included in the study. PI, PVI, SL, SpO2 and heart rate were monitored. PI, PVI and SLL were recorded at 0,12, 24 and 72 hours of onset of shock. All the babies were followed up till discharge or death. Results: Total 78 neonates were enrolled in the study. At 0 hour, SL and PVI had negative correlation (P =0.002 and P=0.003) while PI had a weak-to-moderate positive correlation (P=0.002) with invasive blood pressure. SL ?4.65 had a sensitivity of 75% and specificity of 75.8%, and PI <0.455 had a sensitivity of 65%, and specificity of 58.6% for predicting invasive hypotension. PVI ?23.5 had a sensitivity of 90% and specificity of 63.8% in predicting invasive hypotension. Conclusion: PI has moderate positive correlation while SL and PVI have moderate negative correlation with invasive blood pressure. The cutoff values of SL ?4.65, PI <0.45 and PVI ?23.5 can predict invasive hypotension with good sensitivity and negative predictive value.

Biochemical evaluation of anti-diabetic phytomolecule through bioactivity guided solvent fractionation and subfractionation from hydromethanolic (2:3) extract of Alligator pear Fruit in streptozotocin induced diabetic rats.

The study was to evaluate the most effective fraction and subfraction having hypoglycemic activity from the hydro-methanolic (2:3) extract of the fruit of Persea americana Mil. through bioactivity guided investigation in streptozotocin induced diabetic rats. Out of different solvent fractions and subfractions, the effective fraction and subfraction of Persea americana Mill. were subjected to antidiabetic study in streptozotocin-induced diabetic rat. Serum insulin, glycosylated hemoglobin, transaminases, carbohydrate metabolic enzymes in liver, kidney, cardiac and skeletal muscle, were also assessed after 8 weeks of treatment and compared to the vehicle control. A significant recovery was noted in the level of serum insulin, glycosylated hemoglobin, activities of carbohydrate metabolic enzymes and serum transaminases after n-hexane fraction treatment in respect with other treated groups. Two sub fractions A and B were obtained using petroleum ether sub fractionation of which sub fraction B was more bioactive considering the above biosensors and was comparable with glibenclamide. HPTLC study focused four and two components (P1 and P2) in sub fraction A and B respectively where P1 is major, confirmed by HPLC study. The dose of sub fraction B was 1/4th of the n-hexane fractions dose. It has been concluded that sub fraction B (P1 and P2) which was obtained from nhexane fraction had the antidiabetic activities in the streptozotocin-induced diabetic model.