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Gabapentin is a new gamma aminobutyric acid (GABA) analogue that has anticonvulsant activity. Preliminary results are promising with gabapentin for the treatment of refractory anxiety disorders. In a supplementary role in several behavioral disorders, especially in acute mania, it has produced significant beneficial results. In this study, the anxiolytic activity of gabapentin was examined in mice. There was a significant decrease in time spent in the central square, an increase in the crossings, and an increase in rearing in the open field with the low-dose gabapentin (10 and 30 mg/kg), implying anxiolysis. Furthermore, potentiation of diazepam with gabapentin was also reported. On screening the gabapentin for learning and memory with passive avoidance response, there was significant prolongation of step-down latency, decrease in step-down error, and decrease in the total time spent by the mice in the shock zone at 10 and 100 mg/kg of gabapentin. Gabapentin was not associated with any adverse effect on the memory of mice.The lack of effect of gabapentin on memory, exhibiting anxiolytic activity at a low dose, the lack of cognition deficits, lack of drug interaction, alleviating the requirement for plasma monitoring, and its freedom from dependence or abuse liability suggest the potential advantage of gabapentin over the exiting anxiolytics. [ABSTRACT FROM AUTHOR]

SUMMARY The authors have assessed the role of computerized three-dimensional (3-D) and traditional (TD) radiotherapy planning and inhomogeneity corrections in improving target volume coverage and normal tissue sparing in carcinoma of the tongue. Coverage of target volumes in 3-D versus TD plans revealed the following. Volume receiving 95% of dose, clinical target volume (CTV): 1-68% versus 0-24%; gross tumour volume-lymph nodes (GTV-I): 0-80% versus 0-20%; gross tumour volume-primary tumour (GTV-II): 0-65% versus 0-26%. Dose to 95% of target volume CTV 77-92% versus 76-87%; GTV-I: 81-90% versus 61-88%; GTV-II: 82-93% versus 68-87%. Minimum dose to 5% of target volume, CTV: 77-93% versus 74-81%; GTV-I: 81-90% versus 61-88%; GTV-II: 76-93% versus 68-87%. Minimum dose to a volume of no less than 5% of the target volume, CTV: 93-98% versus 88-96%; GTV-I: 87-100% versus 88-97%; GTV-II: 86-98% versus 88-96%. A new parameter (inhomogeneity difference) was devised to study target volume dose homogeneity and was found to be very useful. Dose to two-thirds of the parotid glands in 3-D versus TD plans showed a mean of 46 versus 65% for right parotid glands and 44 versus 56% for left parotid glands in all patients. Better tumour dose homogeneity, increased mean tumour dose, avoidance of geographic misses and better parotid sparing was achieved in 3-D plans as compared to TD plans. We could not demonstrate any role for inhomogeneity corrections using currently available computerized dose algorithms. [ABSTRACT FROM AUTHOR]

The hyper-accumulation of chromium in its hexavalent form is treated as a hazardous soil pollutant at industrial and mining sites. Excessive accumulation of Cr 6+ in soil threatens the environmental health and safety of living organisms. Out of two stable forms of chromium, Cr 6+ is highly responsible for ecotoxicity. The expression of the high toxicity of Cr 6+ at low concentrations in the soil environment indicates its lethality. It is usually released into the soil during various socio-economic activities. Sustainable remediation of Cr 6+ contaminated soil is of utmost need and can be carried out by employing suitable plant hyperaccumulators. Alongside the plant's ability to sequester toxic metals like Cr 6+ , the rhizospheric soil parameters play a significant role in this technique and are mostly overlooked. Here we review the application of a cost-effective and eco-friendly remediation technology at hyperaccumulators rhizosphere to minimize the Cr 6+ led soil toxicity. The use of selected plant species along with effective rhizospheric activities has been suggested as a technique to reduce Cr 6+ toxicity on soil and its associated biota. This soil rectification approach may prove to be sustainable and advantageous over other possible techniques. Further, it may open up new solutions for soil Cr 6+ management at polluted sites.

Aim: To determine the correlation between vitamin D levels and gestational diabetes mellitus., Materials and Methods: Cross-sectional observational study, conducted in Gauhati Medical College and Hospital, over a period of 1 year, on 350 antenatal patients, with gestational age beyond 24 weeks, keeping in mind the inclusion and exclusion criteria. Age, obstetric score, religion, BMI were noted for all patients. They underwent screening for gestational diabetes mellitus using DIPSI (Diabetes in Pregnancy Study Group of India) guidelines and were divided into two groups. Vitamin D estimation by CLIA method (chemiluminescence method) was done in both groups and results were compared. Association between vitamin D levels and gestational diabetes mellitus was studied using Chi Square Test., Results: The prevalence of vitamin D deficiency in antenatal patients was found to be 63.7%. 73% of gestational diabetes mellitus patients were deficient in vitamin D. There was a statistically significant association seen between vitamin D level and Gestational diabetes mellitus ( p value-0.046). There was 1.34 times increased risk of developing gestational diabetes mellitus when the vitamin D levels were deficient as compared to when the vitamin levels were within the normal range., Conclusion: There was a high level of vitamin D deficiency in the pregnant women of North East. Due to lack of screening of vitamin D levels, many pregnant women suffer from adverse feto-maternal outcomes. There is a need to identify them early in pregnancy, provide vitamin D supplementation and to decrease the likelihood of them developing complications., Competing Interests: Conflict of interestThe authors declare no conflict of interest., (© Federation of Obstetric & Gynecological Societies of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Multilayer thin film assembly by the layer-by-layer (LbL) technique offers an inexpensive and versatile route for the synthesis of functional nanomaterials. In the case of polymer-clay systems, however, the technique faces the challenges of low clay loading and lack of tunability of the film characteristics. This is addressed in the present work that achieves exponential growth in clay-containing polyelectrolyte films having high clay loading and tailored properties. Our approach involves the incorporation of a weak polyelectrolyte and a clay with relatively high charge density and small particle size. The system of investigation comprises poly(diallyldimethylammonium chloride) (PDDA) as the polycation and laponite clay and poly(acrylic acid) (PAA) or poly(sodium-4-styrene sulfonate) (PSS) as polyanions that are used alternately to create multilayers. Successful high clay loading and exponential growth were achieved by two different approaches of polyanion incorporation in the multilayers. A progressive increase in the degree of ionization of PAA was shown to contribute to the exponential growth. Our findings also include novel pathways to manipulate thickness, surface topography, and clay content. The strategy presented here can lead to novel approaches to fabricate tailor-made nanomaterials for distinct applications.

Nearest neighbor bosons possessing only on-site interactions do not form on-site bound pairs in their quantum walk due to fermionization. We obtain signatures of nontrivial on-site pairing in the quantum walk of strongly interacting two component bosons in a one dimensional lattice. By considering an initial state with particles from different components located at the nearest-neighbor sites in the central region of the lattice, we show that in the dynamical evolution of the system, competing intra- and intercomponent on-site repulsion leads to the formation of on-site intercomponent bound states. We find that when the total number of particles is three, an intercomponent pair is favored in the limit of equal intra- and intercomponent interaction strengths. However, when two bosons from each species are considered, intercomponent pairs and trimer are favored depending on the ratios of the intra- and intercomponent interactions. In both cases, we find that the quantum walks exhibit a reentrant behavior as a function of intercomponent interaction.

We investigate the two-component quantum walk in one-dimensional lattice. We show that the inter-component interaction strength together with the hopping imbalance between the components exhibit distinct features in the quantum walk for different initial states. When the walkers are initially on the same site, both the slow and fast particles perform independent particle quantum walks when the interaction between them is weak. However, stronger inter-particle interactions result in quantum walks by the repulsively bound pair formed between the two particles. For different initial states when the walkers are on different sites initially, the quantum walk performed by the slow particle is almost independent of that of the fast particle, which exhibits reflected and transmitted components across the particle with large hopping strength for weak interactions. Beyond a critical value of the interaction strength, the wave function of the fast particle ceases to penetrate through the slow particle signalling a spatial phase separation. However, when the two particles are initially at the two opposite edges of the lattice, then the interaction facilitates the complete reflection of both of them from each other. We analyze the above mentioned features by examining various physical quantities such as the on-site density evolution, two-particle correlation functions and transmission coefficients., (© 2021. The Author(s).)

Background: It has been more than a year since the whole world is struggling with COVID-19 pandemic and may experience resurgences in the near future. Along with severe pneumonia, this disease is notorious for extensive thromboembolic manifestations. That is why experts advocated aggressive anticoagulation as a part of the therapy since the beginning. However, from May 2020 onwards, cases of heparin-induced thrombocytopenia (HIT) are being reported. HIT in itself is an autoimmune entity leading to life-threatening thrombosis in the setting of thrombocytopenia. Continuation of heparin can have disastrous consequences in case of unrecognized HIT. Hence, timely recognition of HIT is of utmost value to modify the anticoagulation strategy and salvaging lives. We performed a systemic review trying to find all reported cases of HIT in COVID-19., Methods: It involved extensive search of the databases including PubMed, Google Scholar, Scopus, and Embase in an attempt to find all reported literature in the last 1 year (November 1, 2019-December 25, 2020) using keywords in various combinations. Literature search resulted in a total of 27 articles and 12 articles were finally selected based on the study design and their relevance pertaining to the intervention done and the outcome of interest., Results: A total of 35 patients were included (mean age 56.7 ± 12.8 years, male-to-female ratio = 2:1). The most frequent comorbidity was hypertension. Fifty-seven percent of cases were with low-molecular weight heparin and the rest with unfractionated heparin. Confirmatory functional assay was done in 85.7% of cases (67% by serotonin-release assay [SRA] and 33% by heparin-induced platelet aggregation [HIPA]). All cases tested with HIPA were positive, while with SRA, only 30% were positive. The most common alternate anticoagulation used was argatroban infusion. The new arterial thrombotic event was seen in only 5.7% of cases as repeat myocardial infarction, stroke, and splenic infarction, while clinically significant bleeding was seen in 17.1% of cases. Fifty percent of bleeding episodes were seen where conventional doses of argatroban were used, while no mortality was seen with low-dose argatroban infusion. However, only 45.7% of patients were discharged, 31.4% of patients died, while the outcome was pending for 23% of patients., Conclusion: Severe endotheliitis and immune dysregulation giving rise to HIT antibodies and antiphospholipid antibodies have been demonstrated in COVID-19 and modifying our therapy becomes indispensable when it is pathogenic with potentially fatal consequences. In the light of interim results of REMAP-CAP study in severe COVID-19 cases where heparin does not improve the outcome, the present anticoagulation strategy needs re-evaluation. Unrecognized HIT can be catastrophic and close clinical monitoring is required for patients on heparin therapy., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Anesthesia: Essays and Researches.)

Background: Despite the advances in medical sciences, the morbidity and mortality due to sepsis in critically ill medical or surgical patients remains high, hence the need for an early and accurate diagnosis. In the current armamentarium, we have various biomarkers such as procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), CRP, and band cell percentage for an early clue., Aims: This study explores the accuracy of these markers in distinguishing sepsis from systemic inflammatory response syndrome (SIRS) and their correlation with sequential organ failure assessment (SOFA) scoring in critically ill patients., Materials and Methods: After ethical committee approval and written informed consent from guardians, 180 consecutive patients, with clinically suspected infection from any source fulfilling at least two criteria of SIRS, were enrolled and 150 eligible patients were investigated and analyzed prospectively in one cohort, which was later subdivided into two different groups (Group A and Group B) based on microbiology reports, as having SIRS or sepsis, respectively. Samples for cultures (blood, tracheal, or urine as required), biomarkers such as PCT, hs-CRP, and CRP, and band cell percentage were sent from each patient on days 1, 2, 3, and 5 and whenever there were fever spikes. Clinical follow-up was done for 28 days, and demographics, ventilator days, duration of intensive care unit (ICU) stay, and the survival rates were noted., Statistical Analysis: Receiver operating characteristics, area under curve (AUC-ROC) was used for each of the biomarker variables to decide the cutoff values and performance. Correlation coefficient was also seen for each of the biomarkers with SOFA scoring., Results: Attributes of performance for all the biomarkers were satisfactory but was best for PCT (AUC-ROC of 0.987) followed by band cell percentage (0.881). SOFA scoring could also be used with good diagnostic accuracy (AUC-ROC of 0.920). SOFA score correlated best with PCT among the four biomarkers in diagnosing sepsis (Spearman's coefficient of + 0.734). Band cell percentage was significantly higher in the expired group of sepsis patients than survived patients ( P = 0.02) and correlated well with ICU stay and 28-day mortality than rest (Spearman's coefficient of - 0.54)., Conclusions: The addition of PCT to the standard workup of critically ill patients with suspected sepsis increases diagnostic certainty and generates improved patient management. Band cell percentage also provides a cost-effective alternative to PCT with an analogous diagnostic performance., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Anesthesia: Essays and Researches.)

Background: There is paucity of literature on the prognostic value of tissue oxygen saturation (StO2) and regional cerebral oxygen saturation (rSO2) in neurological patients with sepsis. In this preliminary study, we investigated the prognostic value of StO2 and rSO2 in a group of neurological patients and correlated StO2 and rSO2 with hemodynamic and metabolic parameters., Materials and Methods: This preliminary, prospective observational study was conducted in 45 adult neurological patients admitted to intensive care unit. Once a diagnosis of sepsis or septic shock was established, parameters of oxygenation (StO2, rSO2, central venous oxygen saturation [ScvO2]), serum lactate, illness severity scores (Acute Physiology and Chronic Health Evaluation score, Sequential Organ Failure Assessment score, Glasgow Coma Scale) were recorded at 0, 6, 12, 24, 36, and 48 hours, and once daily thereafter. Outcomes were in-hospital mortality attributable to sepsis and the Glasgow outcome score at hospital discharge., Results: There was a moderately positive correlation between StO2 and rSO2 at baseline (r=0.599; P=0.001). StO2, illness severity scores and serum lactate, but not rSO2, were significantly different between survivors (n=29) and nonsurvivors (n=16) at baseline and during the first 48 hours. An rSO2 of 62.5% had a sensitivity of 83% and specificity of 67% to differentiate survivors and nonsurvivors of septic shock at 48 hours. StO2 had a higher correlation with ScvO2 and serum lactate than rSO2., Conclusions: StO2 prognosticates survival and favorable/unfavorable outcomes in neurological patients with sepsis. The role of rSO2 in predicting survival in milder form of sepsis is doubtful.

Introduction: Multiple myeloma (MM) is a neoplastic clonal plasma cell disorder. Approximately 30% of newly diagnosed MM present with baseline renal dysfunction adversely affecting prognosis and survival. But its outcome has improved with the advent of novel agents., Methods: We undertook this clinicopathological study to assess the profile of renal involvement, evaluate hematological response, renal reversibility and renal response of 34 newly diagnosed cases of MM with renal impairment receiving 4-6 cycles of Bortezomib, Thalidomide and Dexamethasone (BTD)., Results: Bone pain (67.64%) and pallor (88.23%) were the most common clinical symptom and sign respectively. Mean serum creatinine before and after treatment was 3.5 mg/dl and 1.59 mg/dl respectively. After treatment 15 cases achieved renal reversibility, 8 patients had improved renal function and 3 patients became dialysis independent. The median time to renal reversal was 22weeks (2-28 weeks) and overall myeloma response rate was 78.78%. All patients showed renal response. The median time to renal response was 2.4weeks. We found 38.23% pure cast nephropathy, 14.7% myeloma immunoglobulin deposition disease (MIDD), 5.88% amylodosis apart from other lesions., Conclusion: BTD is safe, effective in reversing renal impairment and improves survival in newly diagnosed cases of MM with renal impairment., (© Journal of the Association of Physicians of India 2011.)

Delay in diagnosis of falciparum may result in complicated, life-threatening conditions. Though haematological abnormalities and coagulopathy are common complications that occur in malaria but complications with rare manifestations like overt bleeding do pose challenges for the clinicians worldwide. This study reports the incidence and prognosis of overt bleeding from the east coast of India and makes an attempt to relate it with the pathogenesis of the disease in severe Plasmodium falciparum malaria patients. This study was conducted in Sriram Chandra Bhanj Medical College Hospital, Cuttack, Odisha, India. A total of 120 complicated (multi organ dysfunction) malaria cases were included in this study. Amongst them 54 (45.0%) showed signs of overt bleeding and clinically the bleeding was either from one or multiple sites. Out of the total overt bleeding cases, 79.6% had elongated prothrombin time (PT), activated partial prothrombin time (aPTT) and elevated D-dimer with thrombocytopenia indicating disseminated intravascular coagulopathy (DIC). It was observed that case fatality rate was very high in coagulopathy group than the non coagulopathy group. Our observations highlight that awareness of overt bleeding in P. falcipatum infection is necessary for general practitioners in endemic areas for malaria like in Odisha for effective and timely management of complicated patients.Timely diagnosis and treatment of DIC with appropriate prescribed drugs can prevent and cure the complications of severe falciparum malaria with anti-malarial treatment.

Recent relativistic coupled-cluster (RCC) calculations of electric dipole moments (EDMs) of diamagnetic atoms due to parity and time-reversal violating (P,T-odd) interactions, which are essential ingredients for probing new physics beyond the standard model of particle interactions, differ substantially from the previous theoretical results. It is therefore necessary to perform an independent test of the validity of these results. In view of this, the normal coupled-cluster method has been extended to the relativistic regime [relativistic normal coupled-cluster (RNCC) method] to calculate the EDMs of atoms by simultaneously incorporating the electrostatic and P,T-odd interactions in order to overcome the shortcomings of the ordinary RCC method. This new relativistic method has been applied to ^{199}Hg, which currently has a lower EDM limit than that of any other system. The results of our RNCC and self-consistent RCC calculations of the EDM of this atom are found to be close. The discrepancies between these two results on the one hand and those of previous calculations on the other are elucidated. Furthermore, the electric dipole polarizability of this atom, which has computational similarities with the EDM, is evaluated and it is in very good agreement with its measured value.

Polyelectrolyte complexes (PECs) are three-dimensional macromolecular structures formed by association of oppositely charged polyelectrolytes in solution. Polyelectrolyte multilayers (PEMs) can be considered a special case of PECs prepared by layer-by-layer (LbL) assembly that involves sequential deposition of molecular-thick polyelectrolyte layers with nanoscale control over the size, shape, composition and internal organization. Although many functional PEMs with novel physical and chemical characteristics have been developed, the current practical applications of PEMs are limited to those that require only a few bilayers and are relatively easy to prepare. The viability of such engineered materials can be realized only after overcoming the scientific and engineering challenges of understanding the kinetics and transport phenomena involved in the multilayer growth and the factors governing their final structure, composition, and response to external stimuli. There is a great need to model PEMs and to connect PEM behavior with the characteristics of the PEC counterparts to allow for prediction of performance and better design of multilayered materials. This review focuses on the relationship between PEMs and PECs. The constitutive interactions, the thermodynamics and kinetics of polyelectrolyte complexation and PEM formation, PEC phase behavior, PEM growth, the internal structure and stability in PEMs and PECs, and their response to external stimuli are presented. Knowledge of such interactions and behavior can guide rapid fabrication of PEMs and can aid their applications as nanocomposites, coatings, nano-sized reactors, capsules, drug delivery systems, and in electrochemical and sensing devices. The challenges and opportunities in future research directions are also discussed., (Copyright © 2016. Published by Elsevier B.V.)

Refinery wastewater (RW) treatment in microbial fuel cell (MFC) was studied in batch mode operation followed by continuous mode operation with 8h and 16h hydraulic retention time (HRT). The MFC performance was evaluated in terms of power density, organics removal, specific contaminants (oil & grease, phenol and sulfide) removal and energy conversion efficiency with respect to operation mode. Higher power density of 225±1.4mW/m 2 was observed during continuous mode operation with 16h HRT along with a substrate degradation of 84.4±0.8% including the 95±0.6 of oil content. The columbic efficiency during this operation was about 2±0.8% and the projected power yield was 340±20kWh/kg COD R /day. Batch mode operation also showed good substrate degradation (81±1.8%) but took longer HRT which resulted in significantly low substrate degradation rate (0.036±0.002kgCOD R /m 3 -day) over continuous mode operation (1.05±0.01kgCOD R /m 3 -day). Overall, current study depicted the possibility of utilizing RW as substrate in MFC for power generation along with its treatment., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Heavy polar diatomic molecules are the primary tools for searching for the T-violating permanent electric dipole moment of the electron (eEDM). Valence electrons in some molecules experience extremely large effective electric fields due to relativistic interactions. These large effective electric fields are crucial to the success of polar-molecule-based eEDM search experiments. Here we report on the results of relativistic ab initio calculations of the effective electric fields in a series of molecules that are highly sensitive to an eEDM, the mercury monohalides (HgF, HgCl, HgBr, and HgI). We study the influence of the halide anions on E_{eff}, and identify HgBr and HgI as attractive candidates for future electric dipole moment search experiments.

The human race is afflicted with more than 100 types of cancer with diversified underlying genetic events. Still, altered metabolism (known as 'Warburg effect') and unrestrained cellular proliferation are precise traits of all cancers, being governed by the expression of genes. The obligatory energy for the proliferating neoplastic cells is endowed through the glycolytic pathway, albeit, lesser ATP is generated in this metabolic process. So, some perceptible cancer cell specific signalling is at the base of the transformed metabolism. Concurrently, the regulators of gene expression, transcription factors, have been observed to be one of the driving forces for tumourigenesis through transcriptional activation of genes involved not only in proliferation, growth and survival signalling, but also in glycolysis. This may be exemplified by the extensively studied metabolic functions of the transcriptional regulator, hypoxia inducible factor 1 (HIF1), which transactivates genes of the major enzymes of glycolysis. Preliminary investigation of a vital group of transcription factors, homeodomain transcription factors, revealed association with the process of development of an organism. The homeodomain transcription factors are, however, also found to be involved in the tumourigenesis process, with little or no information on their involvement in cancer cell metabolism. So, this is a review of the existing knowledge on homeodomain transcription factor/s for deciphering their involvement in neoplastic metabolism and it emerges that homeodomain transcription factors influence the transformed metabolic pathway in a circuitous manner., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: Irrational use of drugs as well as inappropriate and over drug prescribing leads to unnecessary expenditures and emergence of resistant bacterial strains. Feedback intervention on drug prescribing habits and face to face educational intervention of prescription audit would be effective in rationalizing prescribing practices., Objective: To measure the impact of educational feedback intervention on the prescribing behavior of dental surgeons., Methods: Prospective audit of twelve hundred outpatients prescriptions in dental OPD at BPKIHS of those dental surgeon who attended the educational intervention session was collected randomly by trained persons on customized data collection sheet before and after educational intervention., Results: A total 1200 prescription were collected, 300 before and 300 after intervention period at the internal of one month, three months and six months. Majority of the prescriptions (39.33%) contained four drugs but after intervention, prescriptions contained mostly one drug, 73% in first month, 78.67% in third month and 65.34% in six month. Mean number of drugs per prescription after intervention were decreased. There was increased number of generic names of drugs after intervention. Amoxicillin, Metronidazole, Chlorhexidine, Povidone iodine gargle, Nimesulide, Ibuprofen, Ibuprofen + paracetamol, and Paracetamol were most commonly prescribed by dental prescribers before and after intervention. Selection of antimicrobial was done on empirical basis which was correct because Amoxicillin concentration reaches effectively in gingival crevicular fluid and Metronidazole covered effectively against anaerobic bacteria were found in orodental infection. The uses of topical anti-infective preparation as irrigants of choice that can kill majority of micro-organisms found is root canal and dental tubules and minimize systemic use of antimicrobials. Nimesulide prescribing needs to be rationalized., Conclusion: Feedback educational intervention of prescription audit is effective to improve their prescribing behaviors and rationalize drug utilization pattern for the benefit of the patients.

Well-defined double-brush copolymers with each graft site carrying a polystyrene (PSt) graft and a polylactide (PLA) graft were synthesized by simultaneous reversible addition-fragmentation chain transfer (RAFT) and ring-opening polymerization (ROP) processes, followed by ring-opening metathesis polymerization (ROMP) "grafting through" of the resulting diblock macromonomer (MM). Their Janus-type morphologies were detected by transmission electron microscopy (TEM) imaging after thermal annealing to facilitate the intramolecular self-assembly of PSt and PLA grafts. This finding provides critical evidence to verify double-brush copolymers as Janus nanomaterials.

Polyelectrolyte nanocages were synthesized by interfacial cross-linking of monolayers of vinyl-functionalized surfactant molecules adsorbed by crystallized miniemulsion droplets. The monolayer-thick shell of these nanocages was confirmed by AFM analysis., (This journal is © The Royal Society of Chemistry 2011)

Introduction: Newer anticonvulsants have a neuromodulatory effect on pain perception mechanisms in a hyperexcitable and damaged nervous system., Aim: This study was designed to study the analgesic effects of gabapentin alone and in combination with lamotrigine and topiramate in experimental pain models., Materials and Methods: Adult albino mice (n=490) weighing 20-30 g and rats (n=130) weighing 100-200 g were injected intraperitoneally with gabapentin, lamotrigine, and topiramate alone and in different dose combinations. The hot-plate method, tail-flick method, capsaicin-induced mechanical hyperalgesia, and formalin assay were used to assess the antinociceptive effects., Results: Of the three antiepileptic drugs, when given separately, gabapentin was more efficacious than either topiramate or lamotrigine in all the pain models. Combination of 25 mg/kg gabapentin with 25 mg/kg topiramate was more efficacious (P<.05) than 50 mg/kg gabapentin alone in the capsaicin-induced mechanical hyperalgesia test. Similarly, 50 mg/kg gabapentin with 50 mg/kg topiramate or 5 mg/kg lamotrigine was more efficacious (P<.05) than 50 or 100 mg/kg gabapentin alone in late-phase formalin-induced behaviors., Conclusions: Combination of gabapentin with either lamotrigine or topiramate produced better results than gabapentin alone in capsaicin-induced mechanical hyperalgesia test and in late-phase formalin-induced behaviors.

An observational follow up study conducted for one year at a tertiary care centre in 154 newly diagnosed diabetes mellitus patients is presented. The aims of the study were to determine the demographics, prescribing patterns, drug cost and analyze effectiveness of different therapies. Effectiveness of therapies were analyzed in patients achieving glycemic control by Wilcoxon signed- rank test. Majority of patients (n = 114) fell into the middle age strata of 35-64 years and 97% were type 2 diabetics. A total of 282 prescriptions were screened that included antidiabetics and other drug categories. Mean number of drugs per prescription sheet was 1.83 +/- 1.31. Oral hypoglycemic agents were advised to 64% of the patients. The prescribing frequency of biguanides (24.5%) was more than sulphonylureas (19.9%). Only 67 patients followed up for 3 months +/- 15 days, of which 46 achieved glycemic control. The biguanides only group (p = 0.002) and combination therapy of biguanides and sulphonylureas group (p = 0.005) were the highly effective therapies, as their p values of fasting blood glucose levels on follow up were the lowest. Nearly 90% of patients on combination therapy achieved glycemic control. In conclusion, this study reflects the therapeutic approach followed in diabetes mellitus as optimal. Future research on a larger patient population is warranted to evaluate existing patterns of therapy for sound practice and quality of care.

The electric dipole moment (EDM) enhancement factor of atomic Tl is of considerable interest as it has been used in determining the most accurate limit on the electron EDM to date. However, its value varies from -179 to -1041 in different approximations. In view of the large uncertainties associated with many of these calculations, we perform an accurate calculation employing the relativistic coupled-cluster theory and obtain -466, which in combination with the most accurate measurement of Tl EDM [Phys. Rev. Lett. 88, 071805 (2002)] yields a new limit for the electron EDM: |d(e)| < 2.0 × 10⁻²⁷e cm.

We report a series of quantum-chemical calculations for the ground and some of the low-lying excited states of an isolated LiYb molecule by the spin-orbit multistate complete active space second-order perturbation theory (SO-MS-CASPT2). Potential energy curves, spectroscopic constants, and transition dipole moments (TDMs) at both spin-free and spin-orbit levels are obtained. Large spin-orbit effects especially in the TDMs of the molecular states dissociating to Yb((3)P(0,1,2)) excited states are found. To ensure the reliability of our calculations, we test five types of incremental basis sets and study their effect on the equilibrium distance and dissociation energy of the ground state. We also compare CASPT2 and CCSD(T) results for the ground state spectroscopic constants at the spin-free relativistic level. The discrepancies between the CASPT2 and CCSD(T) results are only 0.01 Å in equilibrium bond distance (R(e)) and 200 cm(-1) in dissociation energy (D(e)). Our CASPT2 calculation in the supermolecular state (R=100 a.u.) with the largest basis set reproduces experimental atomic excitation energies within 3% error. Transition dipole moments of the super molecular state (R=100 a.u.) dissociating to Li((2)P) excited states are quite close to experimental atomic TDMs as compared to the Yb((3)P) and Yb((1)P) excited states. The information obtained from this work would be useful for ultracold photoassociation experiments on LiYb.

A relativistic many-body theory for the electric dipole moment (EDM) of paramagnetic atoms arising from the electric dipole moment of the electron is presented and implemented. The relativistic coupled-cluster method with single and double excitations (RCCSD) using the Dirac-Coulomb Hamiltonian and a weak parity and time reversal violating interaction to the first-order of perturbation has been employed to obtain the EDM enhancement factor for the ground state of the Fr atom due to the intrinsic EDM of the electron. The trends of different correlation effects and the leading contributions from different physical states are discussed. Our results in combination with that of the Fr EDM experiment that is currently in progress possess the potential to probe the validity of the standard model (SM) of elementary particle physics.

The electric dipole moment of atomic 199Hg induced by the nuclear Schiff moment and the tensor-pseudotensor electron-nucleus interactions are calculated. For this, we develop and employ a novel method based on the relativistic coupled-cluster theory. The results of our theoretical calculations, combined with the latest experimental result of the 199Hg electric dipole moment, provide new bounds on the T reversal or CP violation parameters thetaQCD, the tensor-pseudotensor coupling constant CT, and (tilde d(u)-tilde d(d)). This is the most accurate calculation of these parameters to date. We highlight the crucial role of electron correlation effects in their interplay with the P, T violating interactions. Our results demonstrate substantial changes in the results of earlier calculations of these parameters which can be attributed to the more accurate inclusion of important correlation effects.

Sequestration of parasitized erythrocytes (PE) in the microvasculature contributes directly to the virulence and severe pathology of Plasmodium falciparum malaria. The scavenger receptor CD36 appears to play an important role in PE adherence. Recently several mutations in the CD36 gene have been found to be associated with variability in susceptibility to P. falciparum infection in different ethnic populations. We investigated the possible association of T188G CD36 gene polymorphism with severe clinical manifestations of malaria in 95 adult patients with severe malaria admitted to SCB Medical College Hospital, Cuttack, Orissa, India ('severe' group) and 95 ethnically matched controls attending outpatient clinics at primary health centres ('mild' group). The frequency of the wild-type (T188T) allele of the CD36 gene was 0.91 in the 'severe' group and 0.78 in the 'mild' group of patients, while mutant (T188G) allele frequency was 0.09 in the severe group and 0.22 in the mild group. The Hardy-Weinberg equation indicates that the mutant allele is under selection pressure and disease association analysis shows that the presence of the heterozygote mutant allele renders protection against severe malaria (chi(2)=10.67, odds ratio=3.51, 95% CI 1.67-7.36).

Objective: To investigate the effect of Ocimum sanctum, ascorbic acid, and verapamil on macrophage function and oxidative stress in experimental animals exposed to cocaine., Materials and Methods: Mice were used in this study and were divided randomly into different groups of six animals each. They were either treated with intraperitoneal injection of saline or cocaine hydrochloride or an oral feeding of oil of Ocimum sanctum, ascorbic acid or verapamil, or both (ascorbic acid and verapamil), and were evaluated for a respiratory burst of macrophages, superoxide and nitric oxide (NO) production, estimation of TNF-alpha in the serum and supernatant of cultured macrophages, estimation of lipid peroxidation (malondialdehyde- MDA) in the serum, and superoxide dismutase activity in the erythrocytes., Results: Unstimulated respiratory burst as well as superoxide production was enhanced on treatment with cocaine and all the three drugs were found to attenuate this enhancement. The bactericidal capacity of macrophages decreased significantly on chronic cocaine exposure, as it was associated with decreased respiratory burst and superoxide production. There was a significant decrease in NO production by macrophages on chronic cocaine exposure and all the test drugs were found to restore nitrite formation to a normal level. There was an increase in the malonylodialdehyde (MDA) level and decrease in the superoxide dismutase level on chronic cocaine exposure, and all the three drugs effectively decreased the MDA level and increased superoxide dismutase level. There was an increase in serum TNF-alpha on chronic cocaine exposure, which was decreased significantly by ascorbic acid and verapamil., Conclusion: O. sanctum, ascorbic acid, and verapamil were equally effective in improving the macrophage function and reducing oxidative stress. These findings suggested that O. sanctum, ascorbic acid, and verapamil attenuated acute and chronic cocaine-mediated effects.

Objective of this prospective study was to assess the acquisition of prescribing skill of preclinical medical and dental undergraduate students. Prescription writing skills of 258 students of both first and second year of MBBS and BDS students were analyzed through an objective structured practical examination. MBBS student of second year scored 85.01% and 92.82% respectively in physician and drug related component whereas first year MBBS students scored 89.9% and 83.4%. BDS student of first year scored 91.96% and 86.33% in physician and drug related components which is better than second year that scored 83.33% and 77.94% respectively. This study revealed that the students of both courses acquire prescribing skills to a limited extent during preclinical phase. Prescribing errors were found both in physician and drug related components. To minimize the different form of prescribing errors vigorous training in the internship period will help to minimize prescribing errors and improve rational prescribing too.

The electric dipole moment (EDM) of paramagnetic atoms is sensitive to the intrinsic EDM contribution from that of its constituent electrons and a scalar-pseudoscalar (S-PS) electron-nucleus interaction. The electron EDM and the S-PS contributions to the EDMs of these atoms scale as approximately Z;{3}. Thus, the heavy paramagnetic atoms will exhibit large EDM enhancement factors. However, the sizes of the couplings are so small that they are of interest of high precision atomic experiments. In this work we have computed the EDM enhancement factors of the ground states of Rb and Cs due to both the electron EDM and the S-PS EDM using the relativistic coupled-cluster theory. The importance of determining precise ab initio enhancement factors and experimental results of atomic EDMs in deducing a reliable limit on the electron EDM is emphasized.

Use of antimicrobial agents (AMAs) is associated with significant reduction in morbidity and mortality. However, indiscriminate and injudicious use of AMAs leads to the ineffective treatment, increased adverse effects, exacerbation or prolongation of illness, emergence of bacterial resistance and an additional burden of an expensive medical cost to the patients. So controlled use of AMAs at right dose, right interval and right duration is of utmost importance. In this retrospective study, prevalence and prescription patterns, and cost of the prescribed AMAs in the hospitalized patients in the department of internal medicine in a tertiary care center were analyzed. A total of 428 hospitalized patients were included in the study. Out of 428 patients, 274 (64.0%, P < 0.01) patients received AMAs for therapeutic (66.4%) and prophylactic (24.1%) purposes. In 9.5% patients AMA prescription was inappropriate. Use of intravenous route was significantly higher (55.48, P < 0.01) than the oral route. COPD with acute exacerbation was most frequent condition for AMA prescription. Majority (90.42%) of AMA prescriptions were based on empirical basis. Mean number of AMA per patient was 2.12 (minimum 1 and maximum 8). Most frequently prescribed AMA was Ceftriaxone (30.2%) from cephalosporin group (33.9%, P < 0.05). Patients received AMAs for the duration of 1-31 days and total cost of single AMA dosage regimen was as high as $ 482.3. As most of the hospitalized patients were prescribed AMA empirically, strategic AMA prescription guidelines and AMA prescription monitoring systems are extremely necessary in the hospitals to prevent emergence of microbial resistance and to expedite the cost effectiveness of medical treatment.

Ease of drug administration, safety, affordability and efficacy are the major concerns in pharmacotherapy leading to exploration of better drug delivery systems. Liposomes are lyotropic liquid crystals composed mainly of amphiphilic bilayers and these are more frequently used as drug carriers. Liposomes help reduce the toxicity and deliver the drug to the target tissue. So far, liposomes have been the most intensively studied lipid-based delivery system. In liposomes, a hydrophilic drug can be trapped in aqueous interior or channels between successive phospholipids bilayers whereas a hydrophobic drug can reside with the bilayer itself. The non-toxic and nonimmunogenic bilayers dissipate allowing the diffusion of the drug into the tissues. Attachment of polyethyl glycol to the surface of liposome (known as stealth liposome) aids in the better targeting of the drug to the tissues. Pegylated proteins and polymers of lactic and glycolic acids have been well studied as drug carriers and found to be resistant to phagocytosis and complement activation. Newer DNA based strategies including DNA vaccination and antisense oligonucleotides and immunomodulation show good results for new therapeutic systems. Though the DNA based therapeutic systems have high selectivity and specificity with few adverse effects, these systems are so far restricted to animal models and clinical trials.

Type 2 diabetes affects 100 million people throughout the world. Among the various factors implicated in the causation of this disease, the role of leptin, an obesity gene product, is increasingly being investigated. This especially assumes importance in the light of knowledge that obesity confers a minimum of 3-10 fold higher risk of diabetes. This study was planned to investigate the relationship between leptin and insulin levels in type 2 diabetic patients before and after treatment with glibenclamide or glimepiride. 60 type 2 diabetic patients were recruited for the study and were divided into 2 groups-one receiving glimepiride and the other group receiving glibenclamide for duration of 10 weeks. This study demonstrated a highly positive correlation of plasma leptin levels with BMI, plasma insulin and insulin resistance. No gender specific differences were observed in leptin concentrations. The study, however, failed to demonstrate any possible relationship between glycemic control as assessed by blood sugars/ glycosylated hemoglobin (HbAlc) and plasma leptin. The administration of glibenclamide or glimepiride significantly lowered blood glucose levels coupled with a decrease in (HbAlc). Both the drugs increased insulin concentrations. Glibenclamide increased leptin levels but they remained unaltered with glimepiride. Glibenclamide and glimepiride were found to be equally effective in their glucose lowering action. However, the patients receiving glibenclamide experienced higher episode of hypoglycaemic spells than those receiving glimepiride.

Effective teaching is a concern of all teachers. Therefore, regular teachers' training is emphasized globally. B. P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university situated in eastern region of Nepal has an established Medical Education unit which attempts to improve teaching-learning skills by training faculty members through organizing regular medical education training programs. The aim of the present study was to assess the effectiveness of 3-day training workshop on "Teaching-learning methodology and Evaluation" held in four different medical colleges of Nepal. The workshop was targeted at middle and entry level of health profession teachers who had not been previously exposed to any teacher's training program. The various components, such as teaching-learning principles, writing educational objectives, organizing and sequencing education materials, teaching-learning methods, microteaching and assessment techniques, were incorporated in the workshop. A team of resource persons from BPKIHS were involved in all the four medical institutions. The collection data had two categories of responses: (1) a questionnaire survey of participants at the beginning and end of the workshop to determine their gain in knowledge and (2) a semi-structured questionnaire survey of participants at the end of workshop to evaluate their perception on usefulness of the workshop. The later category had items with three-point likert scale (very useful, useful and not useful) and responses to open-ended questions/ statements to document participants general views. The response was entered into a spreadsheet and analyzed using SPSS. The result showed that all participants (n = 92) improved their scores after attending the workshop (p < 0.001). Majority of respondents expressed that the teaching-learning methods, media, microteaching and evaluation techniques were useful in teaching-learning. The workshop was perceived as an acceptable way of acquiring teaching-learning skills but 39.4% participants expressed that the duration of the workshop was too short. The overall impression about trainers was very positive. Therefore, regular organization of such workshops with addition of new advances in medical education would be highly beneficial to improve teaching learning skill of medical teachers.

Tricyclic antidepressant drugs induce antinociceptive effect and suggest that their analgesic action could be related to the monoaminergic activity of the drugs. The analgesic activity of amitriptyline was observed in mouse models of acute pain. Mice were divided into different groups and were given amitriptyline in different doses alone and in combination with morphine. Reaction time in Hot-Plate and Tail-Flick tests was observed. Results showed that amitriptyline had antinociceptive effect in acute pain state in experimental models. Amitriptyline in combination with morphine had better analgesic effect than the morphine alone in Hot-Plate test.

Infection is an important cause of morbidity and mortality in diabetic patients. Chronic hyperglycaemia impairs host defense mechanism such as cell mediated immunity, polymorphonuclear leukocyte (PMNL) function, antibody formation etc. PMNL serves as bodies first line of defense against various infections. The present study was undertaken to establish a correlation between impaired PMNL function, blood glucose levels and its improvement with good glycaemic control with glibenclamide and glimepiride, with special reference to parameters such as respiratory burst and O2(-) and H2O2 production by diabetic neutrophils.

In order to understand the brain function and to treat various neuropsychiatric illnesses including epilepsy, continued search and discovery of newer antiepileptic drugs has failed to revolutionize the approach in the management of this complex disorder. Moreover, in close to 30% of epilepsy patients, the seizure control is either not satisfactory or it is intractable to pharmacotherapy. Amongst the non-pharmacological treatment options for refractory epilepsy, vagus nerve stimulation occupies a unique position as an adjunctive treatment in prevention and control of partial-onset seizures in adults and adolescents older than 12 years. Though the precise mode of action of VNS is still debatable an honest attempt has been mode here to review all possible literatures available on VNS to establish its role in the management of this complex disorder.

Health care costs, and those for inpatient care in particular, pose a barrier to seeking health care, and cost be a major cause of indebtedness and impoverishment, particularly among the poor. The Ministry of Health in Nepal intends to initiate alternative financing schemes such as community and social health insurance schemes as a means to supplement the government health sector financing source. Social Health Insurance (SHI) is a mechanism for financing and purchasing / delivering health care to workers in the formal sector regulated by the government. Considering all these facts BP Koirala Institute of Health Sciences (BPKIHS) has introduced SHI scheme in 2000 as an alternative health care financing mechanism to the community people of Sunsari and Morang districts. In the beginning small area was elected as a pilot project to launch the scheme. A major objective of SHI is to reduce poverty caused by paying for health care and to prevent already vulnerable families from falling into deeper poverty when facing health problems. A total of 26 organizations with 19799 populations are at present in SHI scheme. Sixteen rural based organizations with 14,047 populations and 10 urban based organizations with 5752 people are the beneficiaries in this scheme. BPKIHS SHI Scheme is the outcome of the visionary thinking on social solidarity and as an alternative health care financing mechanism to the community. BPKIHS is mobilizing people's organizations and is offering health services through its health insurance scheme at subsidized expenses. This has helped people to avail with health facilities who otherwise would have been left vulnerable because of their penetrating health needs. There is huge gap between premium collection and expenditures. The expenditures are more and this may be due to knowledge - do gap in the program. If conditions are unsuitable, SHI can lead to higher costs of care, inefficient allocation of health care resources, inequitable provision and dissatisfied patients. It can also be more difficult to realize the potential advantages of SHI in future. The future challenges confronting the scheme are to give the continuity and sustainability of the program to its catchments areas. This might entail a shift in its program operation mechanism. People's active involvement is required, which will further provide a sense of ownership in the scheme amongst the people.

This prospective randomized case controlled study was conducted to determine the efficacy of antihistamine (azelastine) nasal spray and compare it to steroid (beclomethasone) nasal spray on the symptoms of allergic rhinitis. Seventy five symptomatic patients of allergic rhinitis were included in this study. Diagnosis was made on the basis of history and physical examination. The patients were divided into three groups randomly. Group A was treated with Azelastine nasal spray, Group B was treated with Beclomethasone nasal spray and Group C was control group and only treated with steam inhalation. Efficacy of the treatment was assessed in the terms of Total Rhinitis Symptom Complex (TSC) scores and individual symptom score which was calculated on the basis of Okuda's grading system. Base line total symptom complex (TSC) scores were reduced in group A and group B by 84.0% after 4 week treatment whereas in group C it was reduced by only 38.0%. Decrease in mean score for sneezing was 95.0% in group A and group B whereas it was only 28.3% in group C. Similarly decrease in mean score for rhinorrhoea in azelastine group was 94.4% and in beclomethasone group was 95.3% in comparison to steam inhalation group where it was 25.0%. Only the beclomethasone reduced nasal stuffiness score significantly by 95.0%. No significant adverse effects of the drugs were observed. The present study establishes the relative efficacy and tolerability ofazelastine nasal spray as compared to beclomethasone nasal spray in symptomatic patients of allergic rhinitis.