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Psoriasis is a multi-factorial skin disease with a complex pathogenesis. Various factors which have been suggested to play a key role in the pathogenesis are T cells, antigen presenting cells (APC′s), keratinocytes, Langerhans′ cells, macrophages, natural killer cells, an array of Th1 type cytokines, certain growth factors like vascular endothelial growth factor (VEGF), keratinocyte growth factor (KGF), and others. It has been hypothesized that the disease starts with the activation of T cell by an unknown antigen, which leads to secretion of an array of cytokines by activated T cells, inflammatory cells, and keratinocytes. The characteristic lesion of psoriasis is due to the hyper-proliferation of the keratinocyte. Activated Langerhans′ cells migrate from skin to lymph nodes presenting the antigen to nodal naοve T cells (cells that have not been activated by antigen previously). The T cells activated by non-antigen-dependent mechanism may, however, become antigen-specific memory cells that react with a cross-reactive auto-antigen such as keratin (molecular mimicry). The genetic background of the disease may be suggested from the fact that concordance rate is 63-73% in monozygotic twins, as compared to 17-20% in dizygotic twins. Several disease susceptibility loci have been suggested as predisposing factors, PSORS1-PSORS9.

Background: Post-operative sore throat (POST) is highly common with the incidence rate as high as 21%-71.8%. The present study was conducted to assess compare the effects of inhaled budesonide suspension, administered using a metered dose inhaler, on occurrence of POST in surgical patients following endotracheal intubation. Materials & Methods: 90 patients of either gender with American society of Anaesthesiologists (ASA) physical status I-II scheduled for short elective laparoscopic surgeries under general anaesthesia with endotracheal intubation were divided 2 groups of 45 each. Group I received 200 µg budesonide inhalation suspension, using a metered dose inhaler, 10 min before intubation, and repeated 6 hours after extubation. In group II, no such intervention was performed. The incidence and severity of POST was recorded. Results: There were 28 males and 17 females in group I and 25 males and 20 females in group II. ASA grade I was 30 in group I and 31 in group II and grade II in 15 in group I and 14 in group II. Mallampatti score 1 was seen in 35 and 32 and 2 in 10 and 13 in group I and II respectively. Number of attempts at intubation was 1 in 36 and 37 and 2 seen among 9 and 8. Rescue therapy for POST was seen among 8 and 25 in group I and II respectively. The difference was significant (P< 0.05). POST at 2 hours, 6 hours, 12 hours and 24 hours was seen in 25% and 70%, 12% and 65%, 6% and 62% and 2% and 58% in group I and II respectively. The difference was significant (P< 0.05). Conclusion: Inhaled budesonide suspension is effective and efficient in reducing the incidence and severity of POST significantly. [ABSTRACT FROM AUTHOR]

Background: Upper limb surgeries can be performed under various regional blocks such as supraclavicular, infraclavicular, interscalene, axillary etc. The present study was conducted to assess effectiveness of bupivacaine versus levobupivacaine in supraclavicular brachial plexus block. Materials & Methods: 80 patients were given brachial plexus block by supraclavicular approach for various upper limb surgeries of both genders were divided into 2 groups of 40 each. Group I patients received bupivacaine and group B received levobupivacaine. Onset and duration of sensory and motor block was recorded. Results: Group I had 23 males and 17 females and group II had 22 males and 18 females. The mean onset of sensory block was 11.8 minutes in group I and 9.1 minutes in group II, onset of motor block was 13.9 minutes in group I and 10.3 minutes in group II, duration of sensory block was 810.8 minutes in group I and 1020.6 minutes in group II, duration of motor block was 924.2 minutes in group I and 1154.4 minutes in group II and duration of analgesia was 908.2 minutes in group I and 1050.0 minutes in group II. The difference was significant (P< 0.05). Conclusion: It was found that levobupivacaine has a faster onset of both sensory and motor blockade as compared to bupivacaine. [ABSTRACT FROM AUTHOR]

Background: Hip replacement surgery (HRS) is one of the most successful and cost effective interventions in medicine. Choices of anesthesia include central neuraxial blocks (CNB), peripheral nerve blocks (PNB), general anesthesia (GA) or a combination of any two. Hence; the present study was undertaken to assess complications associated with various anesthetic techniques in patients undergoing hip replacement surgeries. Materials & methods:The present study included retrospective assessment of complications associated with various anesthetic techniques in patients undergoing HRS. Data records of a total of 100 patients were assessed. Complete demographic and clinical details of all the subjects were obtained. We also recorded the biochemical and hematological findings of all the patients from their record files. In relation to the surgical procedures, occurrence of complications was recorded. All the data was compiled in Microsoft excel sheet and were analyzed by SPSS software. Results:All the patients included in the present study were divided into four study groups on the basis of type of anesthesia technique; General anesthesia (GA) group, combined spinal epidural anesthesia (CSEA) group, Spinal anesthesia (SP) group and Lumbar plexus block (LPB) group. Men age of the subjects of the GA, CSEA, SP and LPB group was 64.3, 65.8, 64.8 and 65.9 years respectively. There were 50, 25, 15 and 10 subjects in the GA, CSEA, SP and LPB group respectively. Non- significant results were obtained while comparing the complications occurring in patients undergoing HRS by different anesthetic techniques. Conclusion:In patients undergoing HRS, in terms of complications, different anesthetic techniques can be used with equal efficacy. [ABSTRACT FROM AUTHOR]

Background: Spinal anesthesia has a popular technique for caesarean delivery. This study was conducted to assessment of efficacy of spinal anesthesia with bupivacaine alone and bupivacaine with fentanyl. Materials & methods: This study was conducted in department of anaesthesia on 60 women of ASA grade I and II posted for lower caesarean section. Patients were divided into 2 groups. Group I consisted of 30 women who received 1.5cc of 0.5% of heavy bupivacaine and 0.5cc of normal saline. Group II consisted of 50 women who received 1.5cc of 0.5% of heavy bupivacaine and 0.5cc of fenatyl. 2.0 cc of intrathecal drug was used in both the groups. Results: Out of 100 patients, 50 were in group I and 50 were in group II. The mean time required to reach peak sensory level was earlier in Group BF than Group B and this was statistically significant (P<0.05).Time to onset of sensory blockade, peak level of sensory analgesia, degree of analgesia and onset of motor blockade were comparable in both the groups. Conclusion: Author concluded that low dose fentanyl helps in reduction of the dose of bupivacaine for spinal anesthesia, and used as an adjuvant to intrathecal 0.5% hyperbaric bupivacaine. [ABSTRACT FROM AUTHOR]

Parasite lipids can serve as signaling molecules, important membrane components, energy suppliers, and pathogenesis factors critical for survival. Functional roles of lipid changes in response to drug-generated stress in parasite survival remains unclear. To investigate this, Leishmania donovani parasites, the causative agents of kala-azar, were exposed to the antileishmanial agent potassium antimony tartrate (PAT) (half-maximal inhibitory concentration ~ 284 µg/ml). Analysis of cell extracts using gas chromatography-mass spectrometry showed significant increases in very long-chain fatty acids (VLCFAs) prior to an increase in ergosterol in PAT-treated parasites as compared with vehicle-treated controls. Ergosterol biosynthesis inhibition during PAT treatment decreased cell viability. VLCFA inhibition with specific inhibitors completely abrogated ergosterol upsurge followed by a reduction in cell viability. Following PAT-induced VLCFA increase, an upsurge in reactive oxygen species (ROS) occurred and inhibition of this ROS with antioxidants abrogated ergosterol increase. Genetically engineered parasites expressing low constitutive ergosterol levels showed more susceptibility to PAT as compared with wild-type control cells but ergosterol supplementation during PAT treatment increased cell viability. In conclusion, we propose that during antimony treatment, the susceptibility of parasites is determined by the levels of cellular ergosterol that are regulated by oxidative stress generated by VLCFAs. [ABSTRACT FROM AUTHOR]