Omega-3 Fatty Acid Based Nanolipid Formulation of Atorvastatin for Treating Hyperlipidemia.

Purpose: In the current study, attempts have been made to formulate an omega-3 fatty acid based nanostructured lipid carriers of atorvastatin (AT), for treating hyperlipidemia; and to evaluate their antihyperlipidemic activity using in vitro and in vivo studies. Methods: Omega-3 fatty acid based AT-loaded nanolipid carriers (NLC) were formulated by the melt emulsification ultrasonication technology. The prepared NLC consist of stearic acid (as solid lipid), omega-3 fatty acid (as liquid lipid), Tween 80, poloxamer 188 (surfactants) and soya-lecithin (co-surfactant). Results: AT loaded NLCs have a particle size of 74.76 ± 4.266 nm, a zeta potential value of -36.03 ± 1.504 mV and a high drug entrapment efficiency (EE) of 86.70 % ± 0.155. The release of AT from NLCs exhibited a sustained behaviour, which made it an ideal vehicle for drug delivery. MTT assay results indicated that NLCs are compatible with L929 (mouse fibroblast) cell lines. Anti-hyperlipidemic study showed a significant reduction in LDL and TG levels in serum with the orally administered Omega-3 fatty acid based AT loaded NLCs when compared to marketed formulation. Conclusion: The results demonstrated that the omega-3 fatty acid based NLC has the potential to be a promising nanomedicine for the treatment of hyperlipidemia.

Intention toward optimal breastfeeding among expecting mothers in Angul district of Odisha, India.

This paper aims to assess the prenatal breastfeeding intention and its predictors in Odisha, a state in India. Data were collected from 218 rural pregnant women of Angul district of Odisha, India in 2012. About 33% of the women lacked the intention to exclusively breastfeed their babies for 6 months. Prelacteal feeding was intended by one-third of the women while 61.5% of the women intended to feed water during the first 6 months of birth. Women of an older age [odds ratio (OR) = 1.30; 95% confidence interval (CI) = 1.09-1.55], with more education (OR = 1.14; 95% CI = 1.08-1.32), belonging to lower castes [other backward caste (OBC)-OR = 21.33; 95% CI = 4.29-106.0, scheduled caste (SC)-OR = 22.77; 95% CI = 2.47-199.1, scheduled tribe (ST)-OR = 26.16; 95% CI = 4.10-174.8), and lesser number of living sons (OR = 0.59; 95% CI = 0.22-0.94) were more likely to have a higher intention for optimal breastfeeding than those of a lower age, with less education, belonging to a higher caste, and with more number of living sons. Awareness generation programs need to be strengthened to educate pregnant women with appropriate and recommended breastfeeding guidelines to establish optimal breastfeeding practices.

Comparative Evaluation of Two Venous Sampling Techniques for the Assessment of Pancreatic Insulin and Zinc Release upon Glucose Challenge.

Advances in noninvasive imaging modalities have provided opportunities to study ß cell function through imaging zinc release from insulin secreting ß cells. Understanding the temporal secretory pattern of insulin and zinc corelease after a glucose challenge is essential for proper timing of administration of zinc sensing probes. Portal venous sampling is an essential part of pharmacological and nutritional studies in animal models. The purpose of this study was to compare two different percutaneous image-guided techniques: transhepatic ultrasound guided portal vein access and transsplenic fluoroscopy guided splenic vein access for ease of access, safety, and evaluation of temporal kinetics of insulin and zinc release into the venous effluent from the pancreas. Both techniques were safe, reproducible, and easy to perform. The mean time required to obtain desired catheter position for venous sampling was 15 minutes shorter using the transsplenic technique. A clear biphasic insulin release profile was observed in both techniques. Statistically higher insulin concentration but similar zinc release after a glucose challenge was observed from splenic vein samples, as compared to the ones from the portal vein. To our knowledge, this is the first report of percutaneous methods to assess zinc release kinetics from the porcine pancreas.

Ureteroarterial fistula: diagnosis and management.

OBJECTIVE: Ureteroarterial fistula (UAF) is an uncommon condition with only approximately 150 cases reported in the literature. Patients typically present with hematuria in the setting of prolonged ureteral stenting, prior pelvic surgery, malignancy, or radiation. Presentation can vary from intermittent hematuria to life-threatening hemorrhagic shock. CONCLUSION: Recognizing this condition in a prototypical patient is essential for accurate diagnosis and management. Angiography yields the highest diagnostic benefit, and arterial stent-graft placement is the treatment of choice.

Segmental arterial mediolysis.

Segmental arterial mediolysis (SAM) is an uncommon, nonatherosclerotic, noninflammatory, large- to medium-sized arteriopathy first described in 1976. It is characterized histologically by vacuolization and lysis of the outer arterial media leading to dissecting aneurysms and vessel rupture presenting clinically with self-limiting abdominal pain or catastrophic hemorrhages in the abdomen. Patients of all ages are affected with a greater incidence at the fifth and sixth decades. There is a slight male predominance. Imaging findings overlap with inflammatory vasculitis, collagen vascular disease, and fibromuscular dysplasia. The presence of segmental dissections involving the celiac, mesenteric, and/or renal arteries is the key distinguishing features of SAM. Inflammatory markers, genetic tests for collagen vascular disorders, and hypercoagulable studies are negative. Anti-inflammatory agents and immunosuppressants are not effective. A mortality rate of 50 % has been attributed to the acute presentation with aneurysmal rupture necessitating urgent surgical or endovascular treatments; in the absence of the acute presentation, SAM is a self-limiting disease and is treated conservatively. There are no established guidelines on medical therapy, although optimal control of blood pressure is considered the main cornerstone of medical therapy. The long-term prognosis is not known.

Median nerve injury as a result of medial brachial fascial compartment syndrome.

A case of brachial plexus injury after brachial arteriography is reported. Percutaneous catheterization of the brachial artery for angiography and intervention is performed when contraindications for the femoral approach exist. Access-related complications include injuries to the infraclavicular brachial plexus. This is often a result of a hematoma within the medial brachial fascial compartment leading to a compartment syndrome. Early recognition and prompt surgical management is vital to prevent permanent nerve damage.