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Sickle cell disease (SCD) is a significant public health concern in India, with one of the highest disability burdens worldwide. For the success of the disease prevention and control program that aims to reduce prevalence through health promotion and screening, the public's prior knowledge of the disease is important. Hence, this study was conducted to assess baseline knowledge of the disease and effects of health education and community mobilization program in the SCD endemic tribal community of Gujarat. This quasi-experimental study was conducted in three phases at Chhotaudepur district of Gujarat, India. Knowledge of the community was assessed through the administration of pretested quantitative questionnaire in 1646 and 1631 individuals respectively during formative and evaluation phases. Differences between the proportions of two phases were statistically assessed by chi-square tests. Despite 75.3% of respondents having heard of SCD before, only 20% could perceive the correct cause. It was improved by 42% post-intervention. During the evaluation, 83% respondents recognized the most common symptom of extreme pain, whereas 86.8% identified the correct diagnostic method. Seventy-seven percent respondents reported modern medicine as a treatment for SCD at endline. Knowledge and awareness about SCD were found inadequate in the community. However, health education intervention strategies effectively improved knowledge related to the disease and its causes, diagnosis, and treatment. Hence, urgent action is required to incorporate community mobilization and awareness generation strategies to mitigate the disease burden., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Pesticide deposits post-treatment and before diffusing inside the plants are exposed to sunlight. Many of them degrade into a variety of photoproducts that may be harmful to living beings through accidental ingestion. The addition of ultraviolet light absorbers to the pesticide formulations is an attractive strategy to prevent photodegradation of the pesticides. Water-soluble quaternary ammonium ultraviolet light absorbers (QAUVAs) were synthesized from 2,4-dihydroxy benzophenones (BP-1) and their structures were confirmed by 1 H NMR, 13 C NMR, UV, and FTIR. A cost-saving approach for the photoprotection of disulfoton insecticide using these QAUVAs is presented. All the four QAUVAs exhibit excellent UV screening effect. The insecticide disulfoton was recovered in much higher amounts (22.27 ~ 25.64% higher than control) when it was irradiated in the presence of QAUVAs in comparison with the amount of recovery of pesticide exposed in absence of them., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Regardless of many extensive studies, hormonal-based breast cancer is the most common cause of cancer-related mortality of females worldwide. Indeed, estrogen receptor-positive (ER +) is the communal subtype in breast cancer. To treat this, three types of medications are typically used: selective estrogen receptor modulators (SERMs), selective estrogen receptor down modulators (SERDMs), and aromatase inhibitors (AIs), all of which directly interact with the activation of the estrogen signaling pathway and its formation. Despite their effectiveness, the development of new treatments is required since clinical efficacy is restricted owing to resistance. As a result, in silico studies for drug discovery are booming over the decades because of their affordability and less time-consuming features. Here, 25 deketene curcumin derivatives have been selected for docking studies through MVD software over the positive type of breast cancer through both the treatment hosts Erα + receptor and aromatase. DKC compounds are used because they have several pharmacological uses, including anti-cancer, anti-diabetic, anti-viral, anti-fungal, and anti-bacterial properties. Moreover, an ADME study was carried out for DKC derivatives that reveal the optimum drug-likeness profile. From 25 derivatives, the results showed a better MolDock score, hydrogen bonding, and steric interaction between compounds DKC-10, DKC-20, and DKC-21 with Erα + and aromatase. Although the study was done on both the treatable path hosts, better results were obtained with Erα + as an antagonist. Therefore, it is proposed that three selected DKC derivatives would be better therapeutic agents against breast cancer., Supplementary Information: The online version contains supplementary material available at 10.1007/s11224-021-01871-2., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.)

The prevalence of electronic cigarette use is increasing at an astonishing pace, particularly in the teenage population. While at school, a healthy 13-year-old male experienced a sudden cardiac arrest after vaping multiple times throughout the day. Workup revealed an anomalous left coronary artery originating from the right sinus of Valsalva. Given this patient's underlying anomalous left coronary artery, we suspect that sympathoexcitatory and arrhythmogenic effects of high dose nicotine from vaping led to his cardiovascular collapse. This is the first published case report of a vaping associated cardiac arrest in a patient of this age., (Copyright 2021 by the Missouri State Medical Association.)

Introduction: The impact of online medical education using videoconferencing platforms on the education environment during the present COVID-19 pandemic is not known. The objectives were to evaluate the impact of online teaching using videoconferencing platforms on the education environment, satisfaction, and perception of the medical undergraduate students to online teaching., Methods: This prospective observational survey undertaken at a medical college included voluntarily participating medical undergraduate students from first (2 nd semester), second (4 th semester), and third year MBBS (6 th and 8 th semesters). The education environment was evaluated using the validated Dundee Ready Education Environment Measure (DREEM). The perception of the students was evaluated using questionnaire with five point Likert scale response., Results: The response rate in our survey was 77.5% (465 out of 600 students). The mean DREEM score of medical undergraduate students was 132.3 ± 19.8. Domains of DREEM evaluated were students' perception of learning (30.1 ± 6.3), students' perception of teachers (29.7 ± 4.6), students' academic self-perception (21.3 ± 4.9), students' perception of atmosphere (32.5 ± 6.2), and students' social self-perception (18.7 ± 3.5). Two hundred and fifty five students (54.8%) were extremely satisfied and quite satisfied with the online teaching-learning modalities. Two hundred and fifty eight students (55.5%) rated online learning methods to be very useful and quite useful during the lockdown period., Conclusion: The educational environment at our medical college was positive and students had a positive perception and attitude toward the role of the videoconferencing platforms for learning (telemedicine) during the COVID-19 pandemic lockdown., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Background: Videoconferencing has been used as a modality of online medical teaching by various institutes. There is a paucity of studies reporting the perception of medical teachers toward teaching using teleconferencing platforms. The objective of this survey was to evaluate the perception of medical teachers toward teaching using videoconferencing platforms such as Zoom meet, Google meet, and Google classroom during the COVID-19 pandemic. Our hypothesis was teaching faculty would have a positive perception and experience toward web-based teaching modalities., Materials and Methods: Medical teachers of a medical college were invited to participate in a prospective observational cross-sectional online survey. The faculty demographic information, perception, experience, and satisfaction were noted. Perception data were presented as proportion and percentage., Results: 104 out of 160 faculty members participated in the study (response rate = 65%). 61 male (58.7%) and 43 female (41.3%) faculty members participated in the study. The mean age of the faculty members was 39.3 years ± 13 (range: 27-69 years). Laptop ( n = 73 [70.2%]) was the most commonly used electronic device by the faculty members for conducting e-teaching sessions followed by smartphone ( n = 25 [24%]). Google meet was the most preferred videoconference tool for online teaching. Ninety-six faculties (92.2%) were satisfied with the e-teaching method adopted by the institute. Eighty-three faculty (79.8%) perceived the e-teaching method to be very useful and quite useful as a modality for teaching during the lockdown period., Conclusions: The teaching faculties had a positive perception toward digital education methods adopted for teaching of undergraduate medical students at our institute., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Objectives: Presently, the pandemic of COVID-19 has worsened the situation worldwide and received global attention. The United States of America have the highest numbers of a patient infected by this disease followed by Brazil, Russia, India and many other countries. Moreover, lots of research is going on to find out effective vaccines or medicine, but still, no potent vaccine or drug is discovered to cure COVID-19. As a consequence, many types of research have designated that computer-based studies, such as protein-ligand interactions, structural dynamics, and chembio modeling are the finest choice due to its low cost and time-saving features. Here, oxindole derivatives have been chosen for docking because of their immense pharmacological applications like antiviral, antidiabetic, anti-inflammatory, and so on. Molecular docking of 30 oxindole derivatives done on the crystallized structure of the protein (COVID-19 Mpro)., Methods: The process of docking, interaction, and binding the structure of ligand with protein has executed using Molegro Virtual Docker v.7.0.0 (MVD) and visualized the usage by Molegro Molecular Viewer v.7.0.0 (MMV)., Results: Among the 30 derivatives, the outcomes depicted better steric interaction and hydrogen bonding amongst OD-22 ligand, OD-16 ligand, OD-4 ligand, and OD-9 ligand (oxindole derivatives) with COVID-19. In addition to this, the comparative study of these four compounds with existing drugs that are under clinical trials shows comparatively good results in terms of its MolDock scores, H-bonding and steric interactions., Conclusions: Hence, It is proposed that these four oxindole derivatives have good potential as a new drug against coronavirus as possible therapeutic agents., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Coronavirus disease-2019 (COVID-1) 9 pandemic is spreading like a wildfire across the globe. For its containment, measures such as isolation and quarantine are followed. The patients tested positive for COVID-19 disease are kept in isolation with no interaction with the family members leading to negative mental health consequences. To address this, Parul Sevashram Hospital adapted to a more holistic approach to treatment., Methodology: A process documentation of the best practices was undertaken. Key Informant Interviews (KIIs) were used to gather responses of the project implementers ( n = 2), physiotherapists ( n = 2), dietician ( n = 1), Ayurveda practitioners ( n = 2), and staff nurses ( n = 2) who were mainly involved in tailoring the package of services to be offered as well as their implementation. In addition, KIIs were also conducted with the patients ( n = 10) their views on the additional package of services offered to them and the overall level of satisfaction with the care., Findings: The holistic care services involved diet therapy, physiotherapy and yoga, AYUSH medicines for boosting immunity, music therapy and books and indoor games. Few implementation challenges include convincing healthcare workers for providing care to COVID patients, availing raw materials for preparing AYUSH medicines during lockdown. Trainings were also provided to HCW on infection control practices, provided monetary incentive and mobilised the existing resources for addressing the challenges., Conclusion: The holistic care has potential influence on patient's mental health, recovery rate, and satisfaction of COVID-19 patients. These approaches can be up-scaled with a minimum investment and has a potential to benefit patients both in public and private hospitals., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Background: National family health survey-4 data suggests alarmingly high prevalence of anemia among adult population. Hemoglobinopathies such as thalassemias and structural hemoglobin (Hb) variants are the commonly seen autosomal, recessively inherited, monogenic disorders of Hb production, and pose a significant health burden in India. Premarriage screening for thalassemia would help to prevent such marriage, reduce health and financial burdens., Objectives: To assess the burden of anemia and hemoglobinopathies, among newly admitted college students through a University-level screening program., Methodology: A cross-sectional study was conducted among college students of the University. The study was part of regular health check-up of all new admissions. Sample frame included all the 4197 students who appeared for health screening and were screened for anemia and hemoglobinopathies., Results: Out of 4197 students, 73.2% were male and a total of 19.5%were anemic. Gender-wise prevalence among males and females was 13.6% and 35.7%, respectively. Among anemic, the proportion of mild, moderate, and severe anemia was 69%, 29%, and 2%. Prevalence of typical beta thal minor and sickle cell trait was found to be 2.6% and 1.4%., Conclusions: Anemia and hemoglobinopathies are significant public health challenges. University setup offers a unique opportunity for modeling and pilot testing integrated interventions for screening and management., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Community Medicine.)

Aim of present work was to apply quality by design (QbD) principles for the development of proliposome of poorly soluble lopinavir (LPV). The patient-centric quality target product profile (QTPP) was defined and critical quality attributes (CQAs) earmarked. Risk assessment studies were carried out to identify the probable risks affecting the CQAs of the product. On the basis of preliminary study, lipid:drug ratio and amount of carrier were selected as critical material attributes (CMAs) and were optimized by face centered central composite design. Liposome vesicle size, drug entrapment efficiency and % drug release after 60min were selected as CQAs and mathematical relationship between CQAs and CMAs was derived using multiple linear regression analysis. Optimum composition of CMAs, identified using numerical optimization and desirability function, demonstrated excellent entrapment efficiency (>90%), drug release characteristics (>95% in 60min) and had vesicle size of 659.7±23.1nm. Solid state characterization studies (Differential Scanning Calorimetry, scanning electron microscopy and X-ray diffraction) were performed for optimized proliposome, suggested transformation of crystalline to amorphous form. Oral bioavailability study in Wistar rats revealed that LPV proliposome exhibited 2.24 and 1.16 fold higher bioavailability than pure LPV and available commercial formulation of LPV/RTV (lopinavir+ritonavir), respectively. Stability study of the optimized LPV loaded proliposome was performed as per ICH guideline and was found to be stable for period of 6months. Overall results of the study indicate that the proliposome offers advantages of enhanced oral bioavailability for poorly soluble LPV., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Clostridium difficile infection (CDI) is the leading cause of antibiotic-associated and nosocomial infectious diarrhea. Presenting as clostridium difficile colitis, it is a significant cause of morbidity and mortality. Metronidazole is regarded as the agent of choice for CDl therapy and also for the first recurrence in most patients with mild to moderate CDI. Vancomycin is recommended as an initial therapy for patients with severe CDI. With recent Food and Drug Administration-approval fidaxomicin is available for clinical use and is as effective as vancomycin with lower relapse rates. Rifaximin and fecal bacteriotherapy are alternative approaches in patients with severe or refractory CDI, before surgical intervention. Antibiotic research is ongoing to add potential new drugs such as teicoplanin, ramoplanin, fusidic acid, nitazoxanide, rifampin, bacitracin to our armamentarium. Role of toxin-binding agents is still questionable. Monoclonal antibody and intravenous immunoglobulin are still investigational therapies that could be promising options. The ongoing challenges in the treatment of CDI include management of recurrence and presence of resistance strains such as NAP1/BI/027, but early recognition of surgical candidates can potentially decrease mortality in CDI.

Water extract of respirable particulate matter (RPM) was analyzed by Ion chromatography technique to investigate the presence of nitrite (NO2) as secondary aerosol in ambient environment. The nitrite particulates undergo photo hydroxyl radical reaction in environment produce nitrous acid, which reacts with metal and absorbs on RPM as water-soluble metal salt. The mean concentration of nitrite was 20.86 microg m(-3) in ambient environment. Regression analysis showed that the relationship for respirable particulate matter and nitrite (RPM-NO2, R2 = 0.742) was positively significant. We are reporting the presence of nitrite as an aerosol in ambient environment.

The purpose of the present investigation was to produce a quick/slow biphasic delivery system for metoclopramide hydrochloride using the superdisintegrant Ac-di-sol for the fast release layer and hydroxypropyl methylcellulose K100M and Ucarflock 302 to modulate the release of the drug. A dual component tablet made up of a sustained release and an immediate release layer was prepared by direct compression. A 3(2) full factorial design was applied to systematically optimize the drug release profile of the sustained release layer. The results of the full factorial design indicate that a small amount of HPMC K100M and a large amount of Ucarflock 302 favor sustained release of the metoclopramide hydrochloride vaginal dual component system. The ex vivo residence time reveals that the formulation was retained for more than 10 h. The formulation gave an initial burst effect to provide the loading dose of the drug followed by sustained release for 12 h, thus solving the problem of repeated administration, especially in pregnancy.

Exposure to benzene and toluene from the combustion of solid biomass fuels is one of the important causes of morbidity and mortality in developing countries. In this study, we assessed the exposure of cooks to benzene and toluene from biomass fuel combustion in 55 rural homes. The GC-MS was used for quantification while a personnel sampler was used for environmental monitoring. The benzene exposure differed significantly (p < 0.0001) across different types of indoor kitchen fuel combinations. The geometrical mean (GM) of benzene exposure for cooks during cooking hours in an indoor kitchen using mixed fuel was 75.3 microg/m3 (with partition) and 63.206 microg/m3 (without partition), while the exposure was 11.7 microg/m3 for open type. The benzene exposure was significantly higher (p < 0.05) in an indoor kitchen with respect to open type using mixed fuels. Concentration of benzene (114.1 microg/m3) for cooks in an indoor kitchen with partition using dung fuel was significantly higher in comparison to non-cooks (5.1 microg/m3) for open type. Benzene exposure was not significantly different for kitchen with ventilation (31.2 microg/m3) and without ventilation (45.0 microg/m3) using wood fuel. However, this value was significantly (p < 0.05) lower than in indoor kitchens with or without partition. An almost similar trend was observed for toluene but the difference was statistically non-significant. This study may be helpful in developing a regional exposure database and in the facilitation of health risk assessment due to volatile organic pollutants in our day-to-day environment.

Miniaturizing in chip technology, optics, micro mechanics, medicine, gene and biotechnology requires highly precise positioning techniques. The motivation for the new manipulation technology is the desire to enter the micro- and nanoworld not only by viewing but also acting, altering micro- and nanosized objects. A new era on medicine are expected to happen in the coming years. Due to the advances in the field of nanotechnology, nanodevice manufacturing has been growing gradually. From such achievements in nanotechnology and recent results in biotechnology and genetics, the first operating biological nanorobots are expected to appear in the coming 5 years and more complex diamondoid based nanorobots will become available in about 10 years. In terms of time, it means a very near better future with significant improvements in medicine.

The correlation study of secondary aerosol (nitrate and sulfate) with RPM in ambient air at different traffic junctions of Vadodara city is reported. RPM was analyzed using Ion Chromatography technique and measured the level of nitrate and sulfate in ambient air. The correlation studies of these particulates with RPM have been established. The average concentration of sulfate and nitrate in ambient air was found 35.74 microg/m3 and 24.22 microg/m3, which ranged of 5.33-84.69 and 1.93-77.86 microg/m3 respectively. The correlation of RPM and SO4 (r = 0.813, P<0.01), RPM-NO3 (r = 0.5549, P<0.01) and SO4-NO3 (r = 0.6133, P<0.01) were found significant. The presence of sulfate and nitrate in RPM is 8.25% and 5.60% . The pH of water extract of RPM averaged 6.81, which ranged 6.17-7.28. Regression analysis result showed that the relationship between RPM-SO4 was significantly (R2=0.66215) correlated. This indicate that probably the secondary aerosols such as nitrate and sulfate in excess may cause irritation and increasing lung disease.

A gas chromatography-mass spectroscopic method in electron ionization (EI) mode with MS/MS ion preparation using helium at flow rate 1 ml min(-1) as carrier gas on DB-5 capillary column (30 m x 0.25 mm i.d. film thickness 0.25 microm) has been developed for the determination of benzene in indoor air. The detection limit for benzene was 0.002 microg ml(-1) with S/N: 4 (S: 66, N: 14). The benzene concentration for cooks during cooking time in indoor kitchen using dung fuel was 114.1 microg m(-3) while it was 6.6 microg m(-3) for open type kitchen. The benzene concentration was significantly higher (p < 0.01) in indoor kitchen with respect to open type kitchen using dung fuels. The wood fuel produces 36.5 microg m(-3) of benzene in indoor kitchen. The concentration of benzene in indoor kitchen using wood fuel was significantly (p < 0.01) lower in comparison to dung fuel. This method may be helpful for environmental analytical chemist dealing with GC-MS in confirmation and quantification of benzene in environmental samples with health risk exposure assessment.

Background: We investigated the relationship of stress technetium 99m sestamibi lung uptake with rest thallium 201 lung uptake and with indices of left ventricular (LV) dysfunction and severity of coronary artery disease (CAD) in patients with known or suspected CAD undergoing stress testing and cardiac catheterization. Stress Tc-99m sestamibi lung uptake and both stress and rest Tl-201 lung uptake are associated with LV dysfunction and extent of CAD. Although the mechanism of lung uptake is thought to be similar for the two isotopes, their physiologic characteristics are different. No direct comparison of lung uptake for the two isotopes has been reported., Methods and Results: We evaluated 192 consecutive patients who underwent dual-isotope myocardial perfusion imaging and cardiac catheterization within 30 days. We examined the relationship of stress Tc-99m sestamibi lung-to-heart ratio (LHR) with rest Tl-201 LHR, with indices of myocardial perfusion, and with invasive measures of the severity of LV dysfunction and CAD. Stress Tc-99m sestamibi LHR correlated with rest Tl-201 LHR (r = 0.548, P <.001). Stress Tc-99m sestamibi LHR was positively associated with LV filling pressures and extent of CAD and negatively associated with LV ejection fraction and arterial systolic blood pressure. However, after adjustment for multiple comparisons, stress Tc-99m sestamibi LHR was significantly associated only with LV end-diastolic pressure (r = 0.287, P =.002) and pulmonary capillary wedge pressure (r = 0.337, P <.001)., Conclusions: Increased stress Tc-99m sestamibi LHR correlates with rest Tl-201 LHR in patients with known or suspected CAD. Stress Tc-99m sestamibi lung uptake is also associated with invasively measured LV filling pressures.

Purpose: To determine whether corneal epithelial healing differs after the use of topical ciprofloxacin alone, topical ofloxacin alone, or topical ofloxacin with artificial tears in patients having photorefractive keratectomy (PRK)., Setting: Department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston, Houston, Texas, USA., Methods: Eighteen patients (6 women, 12 men) with moderate myopia (-1.50 to -6.00 diopters [D]) had standardized PRK. Patient age ranged from 25 to 62 years. The 28 eyes (16 right, 12 left) were randomized into 3 treatment groups: ofloxacin alone, n = 9 eyes; ciprofloxacin, n = 9 eyes; and ofloxacin with Refresh Plus, n = 10 eyes. The drugs were administered immediately after surgery and then every 6 hours. Video recordings of the corneal wounds stained with fluorescein were performed at 8:00 AM and 4:00 PM using a video slitlamp camera with a cobalt-blue light until the wound completely healed. The videotaped images were recorded and analyzed by a computer planimetry program. Wound areas were recorded and compared among the 3 drugs. The square-root transformation was applied to the wound area to obtain a constant healing rate. Statistical comparisons were analyzed using an analysis of variance test., Results: Mean recovery time was 82.67 hours +/- 14.42 (SD) in the ofloxacin eyes, 120.89 +/- 34.05 hours in the ciprofloxacin eyes, and 76.80 +/- 19.30 hours in the ofloxacin with Refresh Plus eyes. Mean healing rate was 0.66 +/- 0.17 hours, 0.54 +/- 0.16 hours, and 0.67 +/- 0.15 hours, respectively. The healing rate was significantly higher in the ofloxacin with Refresh Plus eyes than in the ciprofloxacin eyes (P < .0001). There was no significant difference between the ofloxacin eyes and the ofloxacin with Refresh Plus eyes (P = .42)., Conclusion: Ofloxacin with Refresh Plus and ofloxacin alone had a more positive effect on epithelial healing than ciprofloxacin. The ciprofloxacin eyes were significantly more prone to impaired or delayed wound healing and to the development of corneal haze.

Background: Nitric oxide (NO) is present in medullary structures and can modulate respiratory rhythm. The authors determined if spontaneous ventilation at rest and in response to increased carbon dioxide is altered by selective neuronal NO synthase (NOS; 7-nitro-indazole, 7-NI) or nonselective (neuronal plus endothelial) NOS (NG-L-arginine methyl ester [L-NAME] and NG-monomethyl L-arginine [L-NMMA]) inhibitors in rats anesthetized with isoflurane., Methods: Fifty-four rats received either L-NAME or L-NMMA (1, 10, and 30 mg/kg) or 7-NI (20, 80, and 400 mg/kg) and were compared with time controls (isoflurane = 1.4%), with isoflurane concentrations (1.6%, 1.8%, and 2%) increased consistent with the increased anesthetic depth caused by NOS inhibitors, or with L-arginine (300 mg/kg). Tidal volume (VT), respiratory frequency (f), minute ventilation (VE), and ventilatory responses to increasing carbon dioxide were determined., Results: L-NAME and L-NMMA decreased resting VT and VE, whereas 7-NI had no effect. Increasing concentrations of isoflurane decreased resting f, VT, and VE. L-NAME and L-NMMA decreased VT and VE, whereas 7-NI had no effect at 8%, 9%, and 10% end-tidal carbon dioxide (ETCO2). Increasing concentrations of isoflurane decreased f, VT, and VE at 8%, 9%, and 10% ETCO2. The slope of VE versus ETCO2 was decreased by isoflurane but was unaffected by L-NAME, L-NMMA, or 7-NI. L-arginine alone had no effect on ventilation., Conclusions: Nonselective NOS inhibitors decreased VT and VE at rest and at increased carbon dioxide levels but did not alter the slope of the carbon dioxide response. Selective neuronal NOS inhibition had no effect, suggesting that endothelial NOS may be the isoform responsible for altering ventilation. Finally, the cause of the decreased ventilation is not a result of the enhanced anesthetic depth caused by NOS inhibitors.