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Background: Advanced age is associated with the physiologic process of aging and decreased functional reserve of organs. These patients are often frail and have several comorbid conditions. The physiological changes in the aging cardiovascular system affect the arterial and venous vasculature, myocardium, and autonomic nervous system, making the older person more prone to cardiovascular instability. In addition to the physiological changes, the cardiovascular status of the older person tends to be compromised by associated pathological conditions that are more common with increasing age. This study aimed to analyze cardiovascular challenges in geriatric anesthesia after induction of GA. Material Methods: This prospective study was conducted at the Department of Anesthesia, Combined Military Hospital (CMH), Dhaka, Bangladesh. The study was carried out from April 2016 to September 2016. A total of 60 subjects were selected as per inclusion criteria. Subjects were divided into 2 groups to compare the parameters among the non-elderly and elderly respondents, Group A (age ≤60 years) and Group B (age >60 years). Statistical analysis of the results was obtained by using Statistical Packages for Social Sciences (SPSS-17) software. Results: In this study, 30 (50%) patients belonged to group A with ≤60 years of age and 30 (50%) patients belonged to group B with >60 years of age. Among the respondents 20 were male and 10 were female in group A, and 23 were male and 7 were female in group B. Regarding pre-existing cardiovascular co-morbid conditions, most patients (5, 16.67%) suffered from hypertension, followed by atherosclerosis (2, 6.67%) and 1 patient (3.33%) had cardiac arrhythmias in group A. Most of the patients (7, 23.33%) suffered from hypertension followed by congestive heart failure (6, 20.0%), 5 patients (16.67%) had atherosclerosis, 5 patients (16.67%) had coronary artery disease, 4 patients (13.33%) went through cardiac arrhythmias and the rest 3 (10.0%) patients suffered from aortic stenosis. The mean difference of SBP between the groups 20 minutes before and after induction of general anesthesia showed a statistically significant difference at 5,10,15 and 20th-minute follow-ups. (P=

Pharmacogenomic (PGx) testing has emerged as a compelling strategy that clinicians can use to inform antidepressant medication selection and dosing, but the clinical efficacy of this strategy has been questioned. We systematically reviewed and meta-analyzed clinical trials for an association between the use of PGx-guided antidepressant therapy and depressive symptom remission in patients with major depressive disorder (MDD). We included prospective, controlled clinical trials published in English up to July 12, 2022. Data extraction and synthesis adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Each trial was assessed for risk of bias and a random-effects model was used to estimate pooled risk ratios. Thirteen trials comprising 4,767 patients were analyzed, including 10 randomized controlled trials, and three open label trials. Across all included trials, those that received PGx-guided antidepressant therapy (n = 2,395) were 1.41 (95% confidence interval (CI) = 1.15-1.74, P = 0.001) more likely to achieve remission compared with those that received unguided antidepressant therapy (n = 2,372). Pooled risk ratios for randomized controlled trials and open label trials were 1.46 (95% CI: 1.13-1.88) and 1.26 (95% CI = 0.84-1.88), respectively. These results suggest that PGx-guided antidepressant therapy is associated with a modest but significant increase in depressive symptom remission in adults with MDD. Efforts to address the heterogeneity in PGx test composition (i.e., genes and alleles tested) and accompanying prescribing recommendations across trials will likely reduce the uncertainty about the efficacy of PGx-guided antidepressant therapy in the literature.

Pharmacogenetics (PGx)-guided prescribing is an evidence-based precision medicine strategy. Although the past two decades have reported significant advancements in both the quality and quantity of PGx research studies, they are seldom done in developing countries like Bangladesh. This review identified and summarized PGx studies conducted in the Bangladeshi population by searching PubMed and Google Scholar. Additionally, a quality evaluation of the identified studies was also carried out. Eleven PGx studies were identified that looked at the effects of genetic variants on blood thinners (CYP2C9, VKORC1, and ITGB3), cancer drugs (TPMT, MTHFR, DPYD, ERCC1, GSTP1, XPC, XRCC1, TP53, XPD, and ABCC4), statins (COQ2, CYP2D6, and CYP3A5), and prednisolone (ABCB1, CYP3A5, and NR3C1) in the Bangladeshi population. Most studies were of low to moderate quality. Although the identified studies demonstrated the potential for PGx testing, the limited PGx literature in the Bangladeshi population poses a significant challenge in the widespread implementation of PGx testing in Bangladesh.

The visual and instantaneous detection of trace levels of toxic lead ions (Pb2+) in water is still challenging. In this study, a perovskite precursor-based fluorescent sensor for visual and instantaneous...

Refereed/Peer-reviewed Background: Genetic polymorphism exerts an undeniable impact on schizophrenia (SCZ) pathogenesis. Two polymorphisms, including rs1344806 of ZNF804A and rs12807809 of NRGN gene have been identified as susceptible candidates bearing the risk of SCZ. The target of this experimental study is to investigate the role of these polymorphisms with SCZ in native Bangladeshi people. Methods: For this study, 220 schizophrenic patients and 204 non-schizophrenic controls were recruited to perform this investigation. For genotyping, tetra-primer ARMS-PCR technique was applied. The Agarose gel electrophoresis system visualized the final genomic products of the desired size. Results: From the genotypic analysis of ZNF804A rs1344706 polymorphism, it was revealed that the minor allele frequency was noticeably increased in the patients than in the healthy population (42.27% vs. 29.17%). Five genetic models showed significantly increased risk of SCZ, including codominant model 1 (1.56-times), codominant model 2 (3.02-times), dominant model (1.86-times), recessive model (2.43-times), and allele model (1.78-times) (p < 0.05). The over-dominant model also had 1.18 times higher risk for SCZ, although the result could not meet the significance level (p > 0.05). Genotyping of rs12807809 unveiled the presence of a comparatively higher genotypic frequency of the minor allele among the patients than in controls (39.09% vs. 17.65%). Every genetic model under investigation showed significantly increased risk for SCZ– codominant model 1 (2.85-times), codominant model 2 (6.45-times), dominant model (3.44-times), recessive model (4.31-times), over-dominant model (2.10-times), and allele model (3.00-times) (p < 0.05). Conclusion: This experimental study concluded that rs1344806 of ZNF804A and rs12807809 of NRGN SNPs are significantly associated with SCZ in the Bangladeshi population.

Poor design choices, bad coding practices, or the need to produce software quickly can stand behind technical debt. Unfortunately, manually identifying and managing technical debt gets more difficult as the software matures. Recent research offers various techniques to automate the process of detecting and managing technical debt to address these challenges. This manuscript presents a mapping study of the many aspects of technical debt that have been discovered in this field of study. This includes looking at the various forms of technical debt, as well as detection methods, the financial implications, and mitigation strategies. The findings and outcomes of this study are applicable to a wide range of software development life-cycle decisions.

Objectives Partial response to pharmacotherapy is common in major depressive disorder (MDD) and many patients require alternative pharmacotherapy or augmentation, including adjunctive L-methylfolate. Given that L-methylfolate augmentation is rarely included in major clinical practice guidelines, we sought to systematically review evidence for L-methylfolate augmentation in adults with MDD and to examine its efficacy meta-analytically. Methods We systematically searched PubMed for articles up to December 31, 2020, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Included studies were published in peer-reviewed, English-language journals and examined L-methylfolate adjunctive therapy in depressive disorders or its effect on antidepressant response. A fixed- and random-effects meta-analysis and risk of bias assessment using the Cochrane Risk of Bias Tool were conducted. Results Qualitative assessment of nine articles (N=6,707 patients) suggests that adjunctive L-methylfolate improved antidepressant response. In the meta-analysis of categorical Hamilton Rating Scale for Depression-17 response, (three studies, N=483) adjunctive L-methylfolate was associated with a small effect versus antidepressant monotherapy (relative risk: 1.25, 95% confidence interval [CI]=1.08 to 1.46, p=0.004). A meta-analysis of four studies (N=507) using a continuous measure of depressive symptoms showed a similar effect of adjunctive L-methylfolate (standardized mean difference=− 0.38, 95% CI=− 0.59 to−0.17, p=0.0003). Conclusion Adjunctive L-methylfolate may have modest efficacy in antidepressant-treated adults with MDD.

Treating of ankle injuries is challenging due to swelling, risk of infection and skin necrosis in the postoperative period. After subside of swelling closed displaced bi-malleolar fracture in adult. Above the age of 18 years are treating with a one-third tubular plate for lateral malleolus and distal threated cancellous screw or tension band wiring for medial malleolar fracture, which can be evaluated clinically and radiologically. This multicenter, nonrandomized, experimental comparative study has been carried out in Rajshahi Medical College Hospital, Rajshahi and Sador Hospitals Joypurhat in Bangladesh. From June 2017 to December 2020 in this study. Total 30 patients were split into two groups: 'A,' consists of a one-third tubular plate and distal threaded cancellous screw and another group 'B' ORIF with Small DCP or one-third tubular plat with tension band wiring for medial malleolus. The mean surgery injury interval was 11.6 days. The mean hospital stay was 4.2 days. We have an assessed all patients with The Olerud C and Molander H functional score system. There were excellent practical results in 11 cases in the partially threaded vice with one-third tubular plate (73.3 percent), In 3 cases good (20%), in one case fair (6,7%) good. There were also very good functional results in 6 cases (40%), good (5%), fair in 4 cases in tension bowing wiring with one-third tubular plate (26.7 percent). The p-values were >0.05. We have classified all patients with the Danis-Weber classification system, operated Type A, B, and C categorized patients. We have used a syndesmotic screw in10 patients that have been removed at the end of 12 weeks. All implants were removed within 2.5 years in both groups. Both the operational techniques used in the study produce excellent union rates and functional results. The study was limited in samples small and lacked long-term follow-ups in both groups.

Background: The BPTB graft and quadruple graft of semitendinosus and gracilis are the two most popular options for anterior cruciate ligament reconstruction. Objective: To assess the efficacy of arthroscopic ACL reconstruction with semitendinosus and gracilis tendon grafts and biodegradable screw fixation in ACL injury. Methodology: This prospective interventional study was carried out at Dhaka Medical College Hospital and a private hospital in Dhaka from July 2014 to May 2016. Thirty-one (31) patients with ACL injuries were treated with arthroscopic reconstruction of the ACL using a quadrupled hamstring autograft of semitendinosus and gracilis tendon, as well as a rehabilitation protocol. Patients were routinely followed up on and an outcome evaluation was performed at 24 weeks. Subjective and objective evaluations were performed using the IKDC and Lysholm knee scoring scales to compare preoperative and postoperative outcomes. Results: All patients had either a grade II or a grade III positive Lachman test before surgery. There was a statistically significant improvement after surgery, with 87 percent (27 patients) having a negative Lachman test and only 13 percent (4 patients) having a positive Lachman test. The pre-operative Lysholm knee score was 53, and the postoperative Lysholm knee score was 90, indicating a significant improvement (p0.05). Excellent results (>94–100 points) were obtained in 12 (38.7 percent) patients, good results (>84–94 points) in 15 (48.4 percent) patients, fair results (>64–84 points) in 2 (6.5 percent) patients, and poor results (64 points) in 2 (6.5 percent) patients, according to the Lysholm knee scoring scale. Conclusion: Quadrupled Arthroscopic ACL Reconstruction ACL injury patients can benefit from a hamstring graft of semitendinosus and gracilis tendon and fixation with a biodegradable.

One of the most significant impediments to the long-term maintainability of software applications is code smells. Keeping up with the best coding practices can be difficult for software developers, which might lead to performance throttling or code maintenance concerns. As a result, it is imperative that large applications be regularly monitored for performance issues and code smells, so that these issues can be corrected promptly. Resolving code smells in software systems can be done in a variety of ways, but doing so all at once would be prohibitively expensive and can be out of budget. Prioritizing these solutions are therefore critical. The majority of current research prioritizes code smells according to the type of smell they cause. This method, however, is not sufficient because of a lack of knowledge regarding the frequency of code usage and code changeability behavior. Even the most complex programs have some components that are more important than others. Maintaining the functionality of certain parts is essential since they are often used. Identifying and correcting code smells in places that are frequently utilized and subject to rapid change should take precedence over other code smells. A novel strategy is proposed for finding frequently used and change-prone areas in a codebase by combining business logic, heat map information, and commit history analysis in this study. It examines the codebase, commits, and log files of Java applications to identify business processes, heat map graphs, and severity levels of various types of code smells and their commit history. This is done in order to present a comprehensive, efficient, and resource-friendly technique for identifying and prioritizing performance throttling with also handling code maintenance concerns.

Objective: To systematically review the impact of CYP2D6 genetic variation on antipsychotic pharmacokinetics, efficacy, and adverse drug reactions among children and youth. Method: The published li...

Introduction: Diabetes mellitus (DM), particularly Type 2 DM is now recognized as a major chronic public health problem throughout the world. Different anti-diabetic agents, oral or injectable are used to regulate patients’ glycemic status as monotherapy or in combination. Objectives: To observe the prescribingpattern ofanti-diabetic agents and to collect demographic and disease details of type 2 DM patients. Materials and Methods: This descriptive cross-sectional study was conducted from January to August 2017 in the outpatient department of Border Guard Hospital, Pilkhana; a tertiary level hospital in Dhaka. The study enrolled 172 type 2 diabetic patients purposively on specified criteria. Demographic data,drug prescribing pattern, disease pattern were collected by an interview and from patients’ prescriptions. Results: Among 172 respondents,70 (40.70%) were male and 102 (59.30%) were female. The mean age of patients was 54.21±10.09 years. Eighty seven (50.58%) patients were either overweight or obese. Eighty two (47.67%) patients had family history of DM. Majority of patients (84.89%) had duration of diabetes >5 years and 84 (48.84%) patients had co-morbidities. Majority of the patients 135(78.49%) were prescribed oral drugs either alone or in combination. Among them 83 (63.48%) patients were prescribed oral monotherapy and 52(38.52%) patients were prescribed oral combination therapy. Metformin was the most prescribed oral anti-diabetic drug as monothearpy (71.08%). Among combined anti-diabetic drugsbased on class, metformin+Dipeptidyl peptidase 4 inhibitors(DPP4i) (36.11%), combination was the most commonly prescribed combination. The findings can lead to select the formulation and combination of anti-diabetic drugs in this part of the world for developing & marketing a new anti-diabetic drug. Conclusion: Metformin was the most commonly prescribed drug both as monotherapy as well as combination therapy and monotherapy was predominant over combination therapy. Journal of Armed Forces Medical College Bangladesh Vol.14 (2) 2018: 139-143

Vascularised periosteum can used for reconstructing bony defects due to its intrinsic osteogenic properties. This osteogenic potential can be harnessed as a vascularised flap to induce bone growth of complex constructs in-vivo. The authors aimed to use a novel pedicled periosteal flap from the scapula to induce bone growth in a critical sized construct.Eight sheep were used as live animal models. A novel periosteal flap was raised from the infraspinous fossa of each animal and wrapped around non-vascularised autologous bone graft. The constructs were allowed to incubate between 1 and 84 days before harvest. Analysis of the flap was done via histopathology using haematoxylin and eosin staining.All flaps were viable at the conclusion of surgery. Seven flaps showed variable thickening with matrix deposition. One flap was devitalised at time of harvest.The novel periosteal scapular flap described is a promising technique to induce bone growth in complex constructs.

Antidepressants are used to treat several psychiatric disorders; however, a large proportion of patients do not respond to their first antidepressant therapy and often experience adverse drug reactions (ADR). A common insertion–deletion polymorphism in the promoter region (5-HTTLPR) of the serotonin transporter (SLC6A4) gene has been frequently investigated for its association with antidepressant outcomes. Here, we performed a systematic review and meta-analysis to assess 5-HTTLPR associations with antidepressants: (1) response in psychiatric disorders other than major depressive disorder (MDD) and (2) tolerability across all psychiatric disorders. Literature searches were performed up to January 2021, yielding 82 studies that met inclusion criteria, and 16 of these studies were included in the meta-analyses. Carriers of the 5-HTTLPR LL or LS genotypes were more likely to respond to antidepressant therapy, compared to the SS carriers in the total and European ancestry-only study populations. Long (L) allele carriers taking selective serotonin reuptake inhibitors (SSRIs) reported fewer ADRs relative to short/short (SS) carriers. European L carriers taking SSRIs had lower ADR rates than S carriers. These results suggest the 5-HTTLPR polymorphism may serve as a marker for antidepressant outcomes in psychiatric disorders and may be particularly relevant to SSRI treatment among individuals of European descent.

The main objective of this paper is to measure the level of household resilience to cyclone and storm surges in the coastal area of Bangladesh. We draw on four general disaster frameworks in terms of addressing household-level resilience to cyclones and storm surges. We use a composite indicator approach organized around four components: (1) household infrastructure (HI), (2) household economic capacity (HEC), (3) household self-organization and learning (HSoL), and, (4) social safety nets (SSN). Drawing on a household survey (N = 1188) in nine coastal union parishads in coastal Bangladesh purposively selected as among the most vulnerable places in the world, we use principal components analysis applied to a standardized form of the survey data that identifies key household resilience features. These household index scores can be used for the assessment and monitoring of household capacities, training, and other efforts to improve household cyclone resilience. Our innovative methodological approach allows us to (a) identify patterns and reveal the underlying factors that accurately describe the variation in the data, (b) reduce a large number of variables to a much smaller number of core dimensions of household resilience, and (c) to detect spatial variations in resilience among communities. Aggregated to the community level, our new index reveals significant differences in community cyclone resilience in different areas of the coastal region. In this way, we can show that shoreline and island communities, in particular, have significant deficits in terms of household resilience, which seem to be mutually reinforcing one another and making for lower resilience.

The design of local state-feedback control systems to prevent controllability at remote network nodes is studied. An algorithm based on a joint eigenvalue-right eigenvector assignment method is developed, which under broad conditions maintains all the eigenvalues of the open-loop system while blocking controllability from selected remote nodes. Additionally, the graph structure of the network is exploited to enable controllability-blocking based on regional feedback, where only state measurements in a network partition are required. The design based on regional feedback does not preserve eigenvalue locations, however a modification of the design based on timescale separation is presented which guarantees stability. The results are illustrated with a numerical example.

Recombination hotspots in a genome are unevenly distributed. Hotspots are regions in a genome that show higher rates of meiotic recombinations. Computational methods for recombination hotspot prediction often use sophisticated features that are derived from physico-chemical or structure based properties of nucleotides. In this paper, we propose iRSpot-SF that uses sequence based features which are computationally cheap to generate. Four feature groups are used in our method: k-mer composition, gapped k-mer composition, TF-IDF of k-mers and reverse complement k-mer composition. We have used recursive feature elimination to select 17 top features for hotspot prediction. Our analysis shows the superiority of gapped k-mer composition and reverse complement k-mer composition features over others. We have used SVM with RBF kernel as a classification algorithm. We have tested our algorithm on standard benchmark datasets. Compared to other methods iRSpot-SF is able to produce significantly better results in terms of accuracy, Mathew's Correlation Coefficient and sensitivity which are 84.58%, 0.6941 and 84.57%. We have made our method readily available to use as a python based tool and made the datasets and source codes available at: https://github.com/abdlmaruf/iRSpot-SF . An web application is developed based on iRSpot-SF and freely available to use at: http://irspot.pythonanywhere.com/server.html .

Bangladesh is struggling with an increasing trend of environmental degradation due to the adverse shocks of climate change. Rajshahi, a northwestern city of Bangladesh, is mostly vulnerable to drought, heat waves, air and water pollution, etc. Although various earlier studies regarding environmental governance are mostly focused on mega cities such as Dhaka, studies on medium-sized cities are less frequently highlighted. Thus, achieving sustainable government through environmental governance in the medium-sized city is an urgent issue for academia and policy makers alike. Local environmental governance plays a significant role in attaining local sustainable development. In Bangladesh, the local government authorities perform a wide range of development activities in the cities. To understand local sustainable development, the environmental impact of these development activities must be explored. The main purpose of this chapter is to investigate the overall status of environmental governance for promoting sustainable development considering environmental issues in development programs. This investigation is empirical research mainly based on primary data as collected from the government officials and field staff of the Rajshahi City Cooperation, and various stakeholders of the city, e.g., residents and civil society, through questionnaire surveys and key informant interviews, including a case study. The central finding indicates that the state of environmental governance for sustainable development at the Rajshahi City Cooperation is functionally poor. Despite having a policy framework for prioritizing environmental issues in the development activities of the city, a huge gap still remains between policies and practices. The findings of the study may assist the policy makers and concerned authorities in formulating policies and taking initiatives to ensure environmental governance to strengthen sustainable development in the urban areas of Bangladesh.

Matching individuals to tolerable and efficacious pharmacotherapies in mental health has proven challenging. As such, efforts to personalize psychotropic prescribing in mental health has received considerable attention over the past decade. This attention has been fueled by technological advances in genomics, specifically, pharmacogenomics, and, more recently, epigenomics, transcriptomics, proteomics, and metabolomics that have facilitated the identification of clinically useful biological markers to guide medication selection and dosing. The convergence of these omic technologies is arguably the future of personalized psychotropic prescribing. This chapter provides an overview of the current genomic, epigenomic, transcriptomic, proteomic, and metabolomic knowledgebase as it relates to psychotropic drug response in an effort to identify promising linkages between and facilitate convergence across these approaches to guide safe and effective pharmacotherapy relevant to psychiatry.

Objective: To identify and assess pharmacogenetic testing options relevant to psychiatry in Canada. Method: Searches of published literature, websites, and Standard Council of Canada’s Laboratory Directory were conducted to identify pharmacogenetic tests available in Canada. Identified tests were assessed on 8 key questions related to analytical validity, accessibility, test ordering, delivery of test results, turnaround time, cost, clinical trial evidence, and gene/allele content. Results: A total of 13 pharmacogenetic tests relevant to psychiatry in Canada were identified. All tests were highly accessible, and most were conducted in accredited laboratories. Both direct-to-consumer and clinician-gated testing were identified, with turnaround times and cost ranging from 2 to 40 days and CAD$199 to CAD$2310, respectively. Two tests were supported by randomized controlled trials. All tests met minimum gene and allele panel recommendations for psychiatry, but no 2 panels were identical. No test was unequivocally superior to all other tests. Conclusions: Pharmacogenetic testing in Canada is readily available but highly variable in terms of ordering procedures, delivery of results, turnaround times, cost, and gene/allele content. As such, it is important for psychiatrists and other health-care providers to understand the differences between the available tests to ensure appropriate selection and implementation within their practice.

Background : Local anaesthetics alone for supraclavicular brachial plexus block provide good operative conditions but have shorter duration of postoperative analgesia. Numerous adjuncts have been added to enhance the efficacy of the block. Steroids have anti-inflammatory as well as analgesic effects. Objectives: This study has been undertaken with a view to find out the efficacy of dexamethasone to increase the duration of analgesia when used as an adjuvant to bupivacaine in supraclavicular brachial plexus block in upper extremity surgery. Methods: Total 60 patients of ASA I and II undergoing upper extremity surgery under brachial plexus block were randomly divided into two equal groups of 30 each; Bupivacaine group-‘’A’’ received 0.5% bupivacaine 2 mg/kg with distilled water 15 ml and Dexamethasone group-‘’B’’ received 0.5% bupivacaine 2 mg/kg with dexamethasone (0.2mg/kg) with distilled water 15 ml. The duration of analgesia in the two groups were compared. Results: There was markedly prolonged duration of analgesia in dexamethasone group. The mean duration of analgesia in bupivacaine group was 455 ± 17.09 minutes, whereas in dexamethasone group it was 864.50 ± 25.19 minutes. The results were statistically highly significant . Conclusion : Dexamethasone when added to bupivacaine in brachial plexus block it results significantly prolonged duration of post-operative analgesia, which was significantly higher in comparison to bupivacaine when it is used alone. Bangladesh Journal of Medical Science Vol.17(2) 2018 p.296-301

Introduction: Dilatation and curettage (D&C) is a common procedure that generally causes considerable pain and usually done under procedural sedation and analgesia. Propofol is an ideal intravenous anaesthtic agent for short interventional procedure like D&C but lack of analgesia remains it’s main shortcoming therefore it is always combined with an analgesic. Ketamine and fentanyl are the popular analgesic in this context. Objectives: This prospective clinical study was designed to evaluate to compare propofol ketamine combination versus propofol fentanyl combination in respect of hemodynamics and recovery time for procedural sedation and analgesia in patients undergoing D&C. Methods: This prospective randomized study was performed on 100 patients who underwent elective D&C procedure. Patients were randomly allocated into two groups of fifty each: group PK received propofol 2mg/kg + ketamine 1mg/kg for induction and propofol 4mg/kg/hr + ketamine 1 mg/kg/hr for maintenance anesthesia, group PF received propofol 2 mg/kg + fentanyl 2 ìg/kg for induction and propofol 4 mg/kg/hr + fentanyl 1ìg/kg/hr for maintenance of anesthesia. The pulse rate, systolic and diastolic arterial blood pressures and peripheral oxygen saturation were recorded. Recovery times, side effects of sedation were also recorded. Results: Demographic data were found similar in two groups. There were no significant differences in heart rate, systolic and diastolic arterial blood pressure in all time intervals among groups except there was statistically significant fall in systolic blood pressure after induction in PF group (P=0.005). Recovery time was statistically significant increase in Group PK compared to Group PF (p=0.004). There were no significant differences among groups in regard to side effects. Conclusion: Propofol ketamine and propofol fentanyl had similar hemodynamic stability without any important side effects for procedural sedation and analgesia in patients underwent D&C but propofol ketamine had longer recovery time. JBSA 2017; 30(1): 14-20

To identify and assess pharmacogenetic testing options relevant to psychiatry in Canada.Searches of published literature, websites, and Standard Council of Canada's Laboratory Directory were conducted to identify pharmacogenetic tests available in Canada. Identified tests were assessed on 8 key questions related to analytical validity, accessibility, test ordering, delivery of test results, turnaround time, cost, clinical trial evidence, and gene/allele content.A total of 13 pharmacogenetic tests relevant to psychiatry in Canada were identified. All tests were highly accessible, and most were conducted in accredited laboratories. Both direct-to-consumer and clinician-gated testing were identified, with turnaround times and cost ranging from 2 to 40 days and CAD$199 to CAD$2310, respectively. Two tests were supported by randomized controlled trials. All tests met minimum gene and allele panel recommendations for psychiatry, but no 2 panels were identical. No test was unequivocally superior to all other tests.Pharmacogenetic testing in Canada is readily available but highly variable in terms of ordering procedures, delivery of results, turnaround times, cost, and gene/allele content. As such, it is important for psychiatrists and other health-care providers to understand the differences between the available tests to ensure appropriate selection and implementation within their practice.