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Background Hemodynamic stability is crucial during coronary artery bypass grafting (CABG) surgery to reduce perioperative complications. Dexmedetomidine, an alpha-2 adrenergic agonist, has been increasingly used for its sedative, analgesic, and sympatholytic properties. This study aims to evaluate the effects of intraoperative dexmedetomidine administration on hemodynamic parameters during CABG surgery. Materials and Methods A randomized controlled trial was conducted on 120 patients undergoing elective CABG surgery. Patients were randomly assigned into two groups: Group D (dexmedetomidine, n=60) and Group C (control, n=60). Group D received a loading dose of dexmedetomidine (0.5 μg/kg) followed by a maintenance infusion of 0.4 μg/kg/h until the end of surgery. Group C received an equivalent volume of saline as placebo. Hemodynamic parameters, including heart rate (HR), mean arterial pressure (MAP), and cardiac output (CO), were recorded at baseline, after induction, during cardiopulmonary bypass, and postoperatively. Statistical analysis was performed using ANOVA and t-tests. Results The administration of dexmedetomidine significantly reduced HR and MAP compared to the control group. At the end of surgery, Group D showed a 15% reduction in HR (p<0.001) and a 20% decrease in MAP (p<0.001) compared to baseline. Additionally, CO was better maintained in Group D, with an average CO of 5.5 L/min compared to 4.8 L/min in Group C (p=0.03). The incidence of intraoperative hypotension was lower in Group D (10%) compared to Group C (25%) (p=0.02). Postoperative recovery was also smoother in Group D, with a lower requirement for vasoactive drugs. Conclusion Intraoperative administration of dexmedetomidine during CABG surgery significantly improves hemodynamic stability, reducing the incidence of intraoperative hypotension and maintaining cardiac output. Dexmedetomidine may be a valuable adjunct in managing patients undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]

Background Cardiac surgery often requires the use of inhalational anesthetics to maintain anesthesia. Isoflurane and sevoflurane are commonly used due to their cardioprotective properties. However, differences in hemodynamic stability, recovery profile, and myocardial protection between these two agents remain a subject of interest. This study aims to compare the effects of isoflurane and sevoflurane in patients undergoing cardiac surgery, focusing on hemodynamic parameters, recovery time, and postoperative complications. Materials and Methods A total of 100 patients scheduled for elective cardiac surgery were randomized into two groups: Group I (n=50) received isoflurane, and Group S (n=50) received sevoflurane as the primary anesthetic agent. Hemodynamic parameters (heart rate, mean arterial pressure), time to extubation, and incidence of postoperative complications (e.g., myocardial infarction, arrhythmias) were recorded. Data were analyzed using appropriate statistical tests, with a significance level set at p<0.05. Results Group S (sevoflurane) exhibited significantly more stable hemodynamic parameters compared to Group I (isoflurane), with an average mean arterial pressure of 75 mmHg versus 70 mmHg in Group I (p=0.03). The time to extubation was shorter in Group S (8.5 ± 2.1 hours) compared to Group I (10.2 ± 2.5 hours) (p=0.01). Additionally, the incidence of postoperative myocardial infarction was lower in Group S (4%) compared to Group I (10%) (p=0.04). No significant differences were observed in the occurrence of arrhythmias between the two groups. Conclusion Sevoflurane demonstrated superior hemodynamic stability, faster recovery times, and a lower incidence of postoperative myocardial infarction compared to isoflurane in patients undergoing cardiac surgery. Sevoflurane may be preferred for its enhanced myocardial protection and quicker recovery profile. [ABSTRACT FROM AUTHOR]

A 49-year-old female patient presented at the hospital with a history of herpetic blisters, frequent episodes of vomiting and loose stools, bilateral upper and lower limb weakness, and diminishing sensorium. She was diagnosed with hyponatraemia and respiratory failure and later became unconscious with absent brainstem reflexes. The patient was initially treated for herpetic encephalitis, a chronic obstructive pulmonary disease with acute exacerbation, hyponatraemia and neuroparalytic snake bite. Further evaluation, however, identified the uncommon Guillain Barre syndrome presentation with overlap of Bickerstaff brainstem encephalitis. This is an uncommon disorder characterised by the involvement of higher mental functions, fixed dilated pupils, absent brainstem reflexes and quadriplegia that resembles a neuroparalytic snake bite and brain death. After receiving intravenous immunoglobulins for treatment, the patient completely recovered. [ABSTRACT FROM AUTHOR]

The health-care sector has undergone remarkable progress along with experiencing challenges such as escalating antimicrobial resistance. Here, we report the successful management of Sphingomonas paucimobilis bloodstream infection in a postliver transplant patient. The objective of sharing this case report is to create the awareness regarding the possibility of this novel bug implicated in infections in the posttransplant setting. Further, it emphasizes on the utility of breakpoint to Minimum Inhibitory Concentration quotient in tailoring appropriate antibiotic therapy. [ABSTRACT FROM AUTHOR]

Excessive heat and humidity causes reduction in appetite of postpartum buffaloes which directly leads negative energy balance (NEBAL) and increases oxidative stress in animals. Betaine is a growth promoting nutritional additive used in livestock. Betaine contains three methyl groups and thus acts as a methyl donor for metabolic reactions. Betaine acts as molecular chaperone, as it repairs heat shock proteins. The present study was aimed to investigate the effect of dietary betaine on heat and metabolic stress during lactation in Murrah buffaloes (Bubalus bubalis). For this purpose, a total of 18 postpartum Murrah buffaloes were randomly divided into control, low betaine and high betaine groups supplemented with betaine @ 50 g/animal/day and 100 g/animal/day respectively from day 5 postpartum and was continued up to 4 months postpartum. 5ml of blood sample was collected from animal for analysis of superoxide dismutase, total antioxidant capacity, HSP70, albumin/globulin ratio and immunoglobin G. The overall mean values of plasma superoxide dismutase, total antioxidant capacity and immunoglobin G of high betaine group was numerically higher than other groups which differed (p<0.05) significantly between groups. The overall mean value of plasma HSP70 of high betaine group was minimum followed by low betaine group and control group had maximum mean value which differed (p<0.05) significantly between groups. The overall mean values of albumin/globulin ratio of control group were higher than the betaine groups which differed (p<0.05) significantly between groups. [ABSTRACT FROM AUTHOR]

Poor bioavailability by the oral route can be due to poor solubility, degradation in GI lumen, poor membrane permeation and presystemic elimination. Any of the approaches, which can alter these characteristics, should help in improving the bioavailability of the drugs. Atorvastatin is one of the most important hypolipidemic drug available today and circumventing the major problem of its poor bioavailability remains a bigger challenge of pharmaceutical scientists.The objective of the present study was to develop and characterize an optimal stable nanoemulsion formulation of atorvastatin (AT) with an aim to increase its bioavailability. The components selected for the nanoemulsion were of GRAS category as the safety is the major determining factor for the excipient selection. Thus, Safsol 218 and Oleic acid mixture was selected as the oil phase, surfactants namely Tween 20 and the cosurfactants, Carbitol were selected. Pseudo ternary phase diagrams were constructed using aqueous titration method. From phase diagram different concentrations of oil and surfactant, which formed nanoemulsions were selected based on the thermodynamic stability and dispersibility test. Optimized formulation was selected for in vivo study on the basis of higher drug release, optimum globule size, minimum polydispersity value, lower viscosity, and overall lower surfactant concentration and co-surfactant. The difference in tmax of nanoemulsion formulation was found to be significant (p<0.05) when compared to API drug suspension whereas the difference was insignificant (p>0.05) when compared to tablet. The difference in Cmax of nanoemulsion was very significant (p<0.01) when compared with the tablet suspensions and API drug suspension. The relative bioavailability of nanoemulsion to that of conventional tablet suspensions was 356.32% whereas to that of API drug suspension was 559.86% respectively. Thus nanoemulsions could be used effectively to improve the bioavailability of poorly water soluble drugs to improve their bioavailability. [ABSTRACT FROM AUTHOR]