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Introduction: Ureteric colic in pregnancy is one of the common non-obstetric reasons for emergency department visits. Ureteric calculi present a significant threat to maternal and fetal health and definitive management often becomes necessary. Our aim is to assess the safety and efficacy of ureteroscopic laser lithotripsy in the management of ureteric stones in pregnancy. Material and methods: This is a prospective observational study of 3 years carried at a tertiary referral center. It includes all pregnant patients who underwent ureteroscopic laser lithotripsy for ureteric stones. Results: A total of 29 pregnant patients underwent ureteroscopic laser lithotripsy at our center in 3 years. The mean age of patients was 33.5 ± 6.2 years, and the mean gestation age at the time of ureteroscopy was 23.34 ± 5.9 weeks. The average stone size was 8.3 ± 3.6 mm and was predominantly found in upper ureter (62%). The mean operative time was 31 ± 8.9 min, and the average laser energy spent was 4.3 ± 1.1 kJ/case. There was no major Intraoperative complication, and the average hospital stay was 2.5 ± 1.5 days. Complete stone clearance was achieved in 93.1% of cases. Conclusion: Ureteroscopic laser lithotripsy is safe and effective treatment of ureteric stones in terms of obstetric outcome and stone clearance in pregnancy. [ABSTRACT FROM AUTHOR]

Terbutaline is used for the management of bronchospasm associated with asthma, bronchitis, emphysema, and chronic obstructive pulmonary disease. A systematic review would be beneficial to assess the impact of routes of administration, stereoisomerism, disease states, smoking, age, exercise, and chronobiology on pharmacokinetics (PK) of terbutaline in humans. PubMed and Google Scholar databases were searched to screen all the relevant articles consisting of at least one of the PK parameters after administration of oral, inhaled, and intravenous (IV) terbutaline in humans. Oral studies of terbutaline depicted a linear relationship between plasma concentration (Cp) and the administered dose. The IV studies demonstrated multi-exponential behavior for disposition and renal clearance. Higher systemic availability was observed with inhaled as compared to oral route, and chrono-pharmacokinetic behavior was notable. Time to reach maximum plasma concentration (Tmax) was prolonged, and maximum plasma concentration (Cmax) was lowered after exercise. The primary route of excretion in chronic kidney disease (CKD) patients is reported to be nonrenal. In pregnant women, the Cp of terbutaline is lowered and clearance is increased. The addition of theophylline to terbutaline did not affect the PK of terbutaline; hence, both can be used without dose adjustment. This review summarizes all the available PK parameters of terbutaline, and it may be helpful for researchers in the development and evaluation of PK models as well as in designing optimal dosage regimens in different clinical conditions. [ABSTRACT FROM AUTHOR]

Background: Metoprolol is recommended for therapeutic use in multiple cardiovascular conditions, thyroid crisis, and circumscribed choroidal hemangioma. A detailed systematic review on the metoprolol literature would be beneficial to assess all pharmacokinetic parameters in humans and their respective effects on patients with hepatic, renal, and cardiovascular diseases. This review combines all the pharmacokinetic data on metoprolol from various accessible studies, which may assist in clinical decision making.Methodology: The Google Scholar and PubMed databases were searched to screen articles associated with the clinical pharmacokinetics of metoprolol. The comprehensive literature search retrieved 41 articles including data on plasma concentration-time profiles after intravenous and oral (immediate-release, controlled-release, slow-release, or extended-release) routes of administration, and at least one pharmacokinetic parameter was reported in all studies included.Results: Out of 41 retrieved articles, six were after intravenous and 12 were after oral administration in healthy individuals. The oral studies depict a dose-dependent increase in maximum plasma concentration (Cmax), time to reach maximum plasma concentration (Tmax), and area under the concentration-time curve (AUC). Two studies were conducted in R- and S-enantiomers, in which one study reported the gender differences, depicting greater Cmax and AUC among women, whereas in another study S-metoprolol was found to have higher values of Cmax, Tmax, and AUC in comparison with R-metoprolol. Results in different diseases depicted that after IV administration of 20 mg, patients with renal impairment showed an increase in clearance (CL) (60 L/h vs 48 L/h) compared with healthy subjects, whereas a decrease in CL (36.6 ± 7.8 L/h vs 48 ± 6.6 L/h) was seen in patients with hepatic cirrhosis at a similar dose. In comparison with a single oral dose following administration of 15 mg IV in three divided doses, patients having an acute myocardial infarction (AMI) showed an increase in Cmax (823 nmol/L vs 248 nmol/L) at a steady state. Twenty different studies have reported significant changes in CL, Cmax, and AUC of metoprolol when it is co-administered with other drugs. One study has reported a drug-food interaction for metoprolol but no significant changes were seen in the Cmax and AUC.Conclusion: This review summarizes all the pharmacokinetic parameters of metoprolol after pooling up-to-date data from all the studies available. The summarized pharmacokinetic data presented in this review can assist in developing and evaluating pharmacokinetic models of metoprolol. Moreover, this data can provide practitioners with an insight into dosage adjustments among the diseased populations and can assist in preventing potential adverse drug reactions. This review can also help avoid side effects and drug-drug interactions. [ABSTRACT FROM AUTHOR]

Tungsten disulphide (WS2) nanostructures, WS2 nanosheets (WNS) and WS2 nanorods (WNR), were synthesized by varying the surfactant, N-cetyl-N, N,N-trimethyl ammonium bromide (CTAB), concentration using facile hydrothermal technique. Samples were characterized by high-resolution transmission electron microscopy (HRTEM) and field emission scanning electron microscopy (FESEM) for morphology, X-ray diffraction (XRD) to confirm their phase and crystal structure, photoluminescence (PL) and Raman studies for the determination of defect density, Tauc plot for the determination of band gap, Fourier transform infra red (FTIR) spectroscopy for functional groups and bonds, and Brunauer–Emmett–Teller (BET) isotherms for the determination of pore size and surface area. A comparative study using WS2 nanostructures (WNS and WNR) was conducted to observe the photocatalytic degradation efficiency (ƞ) and degradation kinetics on methylene blue (MB) and 4-chlorophenol (4-CP). The superior photocatalytic performance of WNS over WNR is attributed to enhanced pore size and reduced defect density. High-performance liquid chromatography was carried out for the determination of intermediate products during photocatalytic degradation. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infection is the most important problem across the world. It causes acute and chronic liver infection. Different approaches are in use to inhibit HCV infection, including small organic compounds, siRNA, shRNA and peptide inhibitors. This review article summarizes the current and future therapies for HCV infection. PubMed and Google Scholar were searched for articles published in English to give an insight into the current inhibitors against this life-threatening virus. HCV NS3/4A protease inhibitors and nucleoside/nucleotide inhibitors of NS5B polymerase are presently in the most progressive stage of clinical development, but they are linked with the development of resistance and viral breakthrough. Boceprevir and telaprevir are the two most important protease inhibitors that have been approved recently for the treatment of HCV infection. These two drugs are now the part of standard-of-care treatment (SOC). There are also many other drugs in phase III of clinical development. When exploring the various host-cell-targeting compounds, the most hopeful results have been demonstrated by cyclophilin inhibitors. The current SOC treatment of HCV infection is Peg-interferon, ribavirin and protease inhibitors (boceprevir or telaprevir). The future treatment of this life-threatening disease must involve combinations of therapies hitting multiple targets of HCV and host factors. It is strongly expected that the near future, treatment of HCV infection will be a combination of direct-acting agents (DAA) without the involvement of interferon to eliminate its side effects. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) is involved in different liver pathologies worldwide. In contemporary scenario, HCV treatment is lagging behind owing to absence of vaccines against virus. The only consideration for HCV treatment is pegylated interferon-alpha and ribavirin that results in sustained virological response in 50 % of patients. Two feasible hosts for HCV infection are chimpanzee and humans. For decades, chimpanzees are sole host to study HCV pathogenesis, but their use is limited due to ethical issues. The dilemma behind HCV therapy is the need of sustainable animal models that can help simulate in vivo conditions. We have assembled recent advances in animal models to study liver diseases for targeted therapy. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the reliability of reported stool frequency in the diagnosis of constipation. Methods: Our criterion for the diagnosis of idiopathic constipation was ≤3 stools per week for ≥6 months. Subjects who believed that they met this criterion were invited to participate. Daily stool frequency was recorded over a 4-wk study period, and all stools were weighed during the final week. A colon transit study and anorectal manometry were performed at the beginning and at the end of the study. Results: On review of stool diaries from 45 subjects who described chronic constipation and who completed the 4-wk study, only 22 (49%) actually satisfied our criterion for idiopathic constipation. The remaining 23 (51%) subjects, although describing constipation, had, on average, 6 stools/wk. A history of psychiatric illness was 5 times more frequent among those whose bowel symptoms correlated poorly with objective measures. Measures of difficult defecation were similar in the two groups. Mean colon transit time was significantly longer and correlated closely with stool weight only in subjects who truly were constipated (p < 0.05). Anorectal manometry was not helpful in discriminating between those who satisfied our criterion for constipation and those who did not. Conclusions: Defining constipation on the basis of a patient's reported stool frequency may prove misleading; the diagnosis of idiopathic constipation should be supported by the use of stool diaries and a colon transit study. [ABSTRACT FROM AUTHOR]