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BMC Psychiatry Mar 2021Poisoning and deaths by organo-phosphorous (OP) compounds are one of the major causes of death in developing and poor countries, and a common admission in the emergency...
BACKGROUND
Poisoning and deaths by organo-phosphorous (OP) compounds are one of the major causes of death in developing and poor countries, and a common admission in the emergency ward and the ICU. OP compounds act by irreversibly binding to pseudocholinesterase enzyme and hence prolong the apnea in patients being given suxamethonium. We present a unusual case of OP poisoning (OPP) in which prolonged apnea ensued in a patient of severe depression following MECT (modified electroconvulsive therapy) in which suxamethonium was used as muscle relaxant, in whom we were cautious of the side-effect of prior organophosphorus poisoning. Since the cases of OPP are very high worldwide, a thorough knowledge of the interaction of the action of the drug and the receptors on which it acts takes pride of place. This article highlights the nuances in the field of psychiatry and anaesthesia in diagnosis and management of prolonged apnea after ECT.
CASE PRESENTATION
A 53/F patient consumed OP 38 days prior to MECT. Since existing literature recommend a delay of 4 weeks and a subminimal dose of suxamethonium to prevent prolonged apnea, both these points were taken into consideration. Despite 38 days post exposure to OP, and a dose of succinylcholine of < 0.3 mg/kg, the patient remained apneic for 3 h. Suxamethionum apnea was managed with elective ventilation. After recovery, patient had no residual effect. Subsequently her pseudocholinesterase levels were done which were found to be very low.
CONCLUSION
This case is being presented to emphasize that behaviour of post synaptic receptors cannot be relied upon after OP poisoning and pseudocholinesterase levels needs to be mandatorily checked, irrespective of duration post-exposure. In strong suspects dibucaine number and fluoride number also needs to be estimated.
Topics: Apnea; Electroconvulsive Therapy; Female; Humans; Neuromuscular Depolarizing Agents; Organophosphate Poisoning; Poisoning; Succinylcholine
PubMed: 33691646
DOI: 10.1186/s12888-021-03150-0 -
Spectrochimica Acta. Part A, Molecular... Jul 2021For the treatment of internal and external hemorrhoids, policresulen (POL) and cinchocaine hydrochloride (CIN) are used in combination. Using a new, simple, fast, and...
For the treatment of internal and external hemorrhoids, policresulen (POL) and cinchocaine hydrochloride (CIN) are used in combination. Using a new, simple, fast, and economical first-derivative synchronous fluorescence spectroscopic process, both drugs were simultaneously determined and validated. At Δλ60 nm and with a scanning rate of 600 nm/min, methanol was used as the solvent for both products. In the concentration ranges of 5.0-21.0 μg mL and 0.5-6.0 μg mL for POL and CIN, the amplitude-concentration plots were rectilinear. The detection limits were found to be 0.770 μg mL and 0.118 μg mL and the quantitation limits for POL and CIN were 2.541 μg mL and 0.391 μg mL. To evaluate all compounds in synthetic mixtures and medicinal dosage types, the proposed method has been successfully applied. These findings were in line with the results obtained using high-performance thin layer chromatography, the comparison process.
Topics: Cresols; Dibucaine; Drug Combinations; Formaldehyde; Ointments; Spectrometry, Fluorescence; Suppositories
PubMed: 33744839
DOI: 10.1016/j.saa.2021.119648 -
Dermatitis : Contact, Atopic,...Topical medications may lead to allergic contact dermatitis. This study characterized positive patch test reactions associated with medications in patients evaluated by...
BACKGROUND/OBJECTIVES
Topical medications may lead to allergic contact dermatitis. This study characterized positive patch test reactions associated with medications in patients evaluated by the North American Contact Dermatitis Group (NACDG).
METHODS
This study is a retrospective analysis of the NACDG data (2001-2018). Patients with at least 1 positive patch test reaction associated with a medication source were included. Allergens, reaction characteristics, clinical relevance, and source details were tabulated.
RESULTS
Of 43,722 patients, 6374 (14.6%) had positive allergic patch test reactions associated with 1 or more topical medication sources. Patients with versus without allergic reactions to medications were more likely to be older than 40 years (P < 0.0001) and/or have primary sites of dermatitis on the legs, anal/genital region, or trunk (P < 0.0001). There were 8787 reactions to NACDG allergens; the most common were neomycin (29.4%), bacitracin (29.1%), propylene glycol 100% (10.6%), tixocortol-17-pivalate (10.0%), lidocaine (7.9%), budesonide (4.9%), and dibucaine (4.4%). Propylene glycol 100% was the most common inactive ingredient (10.6%). Current relevance was present in 61.0%. A total of 6.5% of the individuals with medication allergy would have had 1 or more positive patch test reactions missed if only tested to the NACDG screening series.
CONCLUSIONS
Positive patch test reactions associated with topical medications were common (14.6%), and most were clinically relevant. Patients with topical medication allergy were twice as likely to have anal/genital involvement. Active ingredients, especially neomycin, bacitracin, and tixocortol-17-pivalate, were frequent culprits.
Topics: Allergens; Dermatitis, Allergic Contact; Humans; North America; Patch Tests; Retrospective Studies
PubMed: 34405832
DOI: 10.1097/DER.0000000000000777 -
Evidence-based Complementary and... 2022Alzheimer's disease (AD) is the most common type of dementia, and the abnormal hyperphosphorylation of the tau protein is the main component of its pathogenesis. Calpain...
Alzheimer's disease (AD) is the most common type of dementia, and the abnormal hyperphosphorylation of the tau protein is the main component of its pathogenesis. Calpain was found to be abnormally activated in neurofibrillary tangles (NFTs) in a previous report. Cornel iridoid glycosides (CIG) have been reported to reduce the hyperphosphorylation of tau protein. Nevertheless, the role of calpain in the reduction tau hyperphosphorylation by CIG remains unclear. In the present study, we investigated the effect of CIG on calpain activity through in vitro and in vivo experiments. Western blotting results suggested that CIG decreased the phosphorylation of tau at Ser 404 and Ser 262 sites in P301S mice. Moreover, CIG inhibited the activity of calpain and glycogen synthase kinase 3 (GSK-3) and enhanced the activity of protein phosphatase 2A (PP2A) both in vivo and in vitro. CIG also inhibited the activation of PP2A and reduced the GSK-3 activity caused by the calpain activator dibucaine. In addition, the main components of CIG, morroniside and loganin, play an equivalent role in reducing calpain activity, as the effect of their combined use is equivalent to that of CIG. The abovementioned findings revealed that CIG improved PP2A activity and reduced GSK-3 activity by adjusting the activity of calpain 1, leading to a reduction in the phosphorylation of tau. This study highlights the remarkable therapeutic potential of CIG for managing AD.
PubMed: 35096120
DOI: 10.1155/2022/9213046 -
Chemico-biological Interactions Oct 2020Two types of cholinesterases (ChEs) are present in mammalian blood and tissues: acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). While AChE regulates...
Two types of cholinesterases (ChEs) are present in mammalian blood and tissues: acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). While AChE regulates neurotransmission by hydrolyzing acetylcholine at the postsynaptic membranes and neuromuscular junctions, BChE in plasma has been suggested to be involved in detoxifying toxic compounds. This study was undertaken to establish the identity of circulating ChE activity in plasmas from domestic animals (bovine, ovine, caprine, porcine and equine) by assessing sensitivity to AChE-specific inhibitors (BW284c51 and edrophonium) and BChE-specific inhibitors (dibucaine, ethopropazine and Iso-OMPA) as well as binding to anti-FBS AChE monoclonal antibodies (MAbs). Based on the inhibition of ChE activity by ChE-specific inhibitors, it was determined that bovine, ovine and caprine plasma predominantly contain AChE, while porcine and equine plasma contain BChE. Three of the anti-FBS AChE MAbs, 4E5, 5E8 and 6H9, inhibited 85-98% of enzyme activity in bovine, ovine and caprine plasma, confirming that the esterase in these plasmas was AChE. These MAbs did not bind to purified recombinant human or mouse AChE, demonstrating that these MAbs were specific for AChEs from ruminant species. These MAbs did not inhibit the activity of purified human BChE, or ChE activity in porcine and equine plasma, confirming that the ChE in these plasmas was BChE. Taken together, these results demonstrate that anti-FBS AChE MAbs can serve as useful tools for distinguishing between AChEs from ruminant and non-ruminant species and BChEs.
Topics: Acetylcholinesterase; Animals; Animals, Domestic; Antibodies, Monoclonal; Butyrylcholinesterase; Cattle; Cholinesterase Inhibitors; Fetal Blood; Humans; Mice; Ruminants
PubMed: 32795450
DOI: 10.1016/j.cbi.2020.109225 -
Environmental Toxicology and Chemistry Feb 2022In spite of recent reports about the presence of pharmaceuticals in African water bodies, their prevalence has still not been sufficiently quantified. The few available...
Target and Suspect Screening of Pharmaceuticals and their Transformation Products in the Klip River, South Africa, using Ultra-High-Performance Liquid Chromatography-Mass Spectrometry.
In spite of recent reports about the presence of pharmaceuticals in African water bodies, their prevalence has still not been sufficiently quantified. The few available studies have mostly focused on a limited number of pharmaceuticals. In the present study, a suspect screening of 92 compounds (mainly pharmaceuticals and their transformation products) along the Klip River, South Africa was conducted, followed by target monitoring of 21 of the detected pharmaceuticals. The experimental approach was based on solid-phase extraction followed by analysis with ultra-high-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry (UHPLC-QTOF-MS). The results revealed 47 pharmaceuticals, 31 of which were detected for the first time in South African waters. Seven detected pharmaceuticals (propyphenazole, sulfamerazine, levamisole, tryptophan, dibucaine, albuterol, and fenpropimorph) are not approved medications in South Africa. Six pharmaceutical metabolites were detected for the first time in South Africa. Pharmaceuticals with the highest concentrations in river water were flumequine (0.257 µg L ), oxolinic acid (0.355 µg L ), and acetaminophen (0.432 µg L ). Oxolinic acid presented the highest hazard quotient, 48.6, indicating a risk of toxicity to aquatic organisms. Hazard quotients for other pharmaceuticals were below 1, except that of flumequine, which reached 1.285. These results suggest a need for further research into the fate of pharmaceuticals in surface waters, and a quantification of the risks associated with the identified drugs because they are likely to accumulate in the tissues of fish/aquatic organisms, thus affecting humans. Environ Toxicol Chem 2022;41:437-447. © 2021 SETAC.
Topics: Animals; Aquatic Organisms; Chromatography, High Pressure Liquid; Environmental Monitoring; Mass Spectrometry; Oxolinic Acid; Pharmaceutical Preparations; Rivers; South Africa; Water; Water Pollutants, Chemical
PubMed: 34888926
DOI: 10.1002/etc.5265 -
Korean Journal of Family Medicine Sep 2019It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine...
BACKGROUND
It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine hydrochloride help patients with such cancer pain. This study evaluated the efficacy of trigger point injections for alleviating pain in patients with advanced cancer.
METHODS
Twenty patients with advanced cancer who had a life expectancy of 6 months or less and had been diagnosed with myofascial pain syndrome were treated with trigger point injections. Prior to treatment, a Visual Analog Scale (VAS) was used to measure the resting pain level and discomfort upon application of pressure on the site of pain. These values were compared with last treatment measurements.
RESULTS
The mean pre-treatment VAS scores for pain at rest and upon application of pressure on the pain site were 7.3 and 9.0, respectively. These scores decreased significantly to 1.95 and 3.2, respectively, after the treatment (P<0.05).
CONCLUSION
Trigger point injection is an alternative and effective pain control modality for advanced cancer patients with myofascial pain syndrome.
PubMed: 31487973
DOI: 10.4082/kjfm.18.0065 -
Methods in Molecular Biology (Clifton,... 2020Caveolins are integral membrane proteins that are the principal structural component of caveolae. Newly synthesized caveolin self-associates into oligomers that further...
Caveolins are integral membrane proteins that are the principal structural component of caveolae. Newly synthesized caveolin self-associates into oligomers that further assemble into higher-order structures. Imaging fluorescently labeled caveolin at the plasma membrane with total internal reflection fluorescence (TIRF) microscopy reveals a spatially heterogeneous distribution with aggregates of various sizes. In this chapter, we present a set of image-processing tools to quantify the spatial organization and mobility of caveolin aggregates seen in TIRF images. We apply a spot detection algorithm to identify punctate features on multiple length scales, and computationally estimate the area and integrated fluorescence signal of each detected feature. We then partition the original image into two disjoint sets: one containing pixels within punctae, and the other containing pixels on the rest of the plasma membrane. From these partitions, we estimate the relative fraction of caveolin that is punctate versus diffuse. Finally, we analyze the mobility of caveolin aggregates by tracking them and classify individual trajectories as diffusive or subdiffusive using a moment scaling spectrum analysis. Together, these analyses capture multiple facets of caveolin organization and dynamics. To demonstrate their utility, we quantify the distribution of fluorescent Caveolin 1 stably transfected in HeLa cells. We analyze cells at baseline and after being exposed to the anesthetic Dibucaine that is known to scramble membrane phospholipids. Our analysis shows how this perturbation dramatically alters caveolin aggregation and mobility.
Topics: Algorithms; Caveolins; Cell Membrane; Green Fluorescent Proteins; HeLa Cells; Humans; Image Processing, Computer-Assisted; Microscopy, Fluorescence; Transfection
PubMed: 32548818
DOI: 10.1007/978-1-0716-0732-9_5 -
International Journal of Pharmaceutics Apr 2021Colloidal lipid emulsions are a promising formulation option for poorly water-soluble drugs. Due to their complex composition, they provide different sites for the...
Colloidal lipid emulsions are a promising formulation option for poorly water-soluble drugs. Due to their complex composition, they provide different sites for the localization of drugs. Drug molecules can be situated in the lipid matrix, in the aqueous phase with its structures formed by an excess of emulsifier or at the droplet interface. The interface and the mechanism of stabilization is mainly characterized by the emulsifier. In this study, the main focus was on the influence of drug localization on the stability of emulsions sterically stabilized with poloxamer188. In addition to 5% of this non-ionic emulsifier, the emulsions contained 10% soybean oil. The localization of the drugs fenofibrate, curcumin, betamethasone valerate, cinnarizine, dibucaine and flufenamic acid within the emulsion system at a physiological pH of 7.4 as well as their influence on emulsion stability were examined. The results indicated that the stability of poloxamer 188-stabilized emulsions can be influenced in a positive or negative way by the localization of drug molecules in the interface of emulsion droplets. Applying cinnarizine as model substance at pH 5, 7.4 and 10, no pronounced change in the localization was detected as a result of alterations in the charge of the drug.
Topics: Drug Stability; Emulsifying Agents; Emulsions; Poloxamer; Soybean Oil; Water
PubMed: 33675931
DOI: 10.1016/j.ijpharm.2021.120394 -
Evidence-based Complementary and... 2021Linn. (CQ) is a medicinal plant with good evidence for the treatment of hemorrhoids, listed in the Thai National List of Herbal Products in the oral dosage form. (Wall...
BACKGROUND
Linn. (CQ) is a medicinal plant with good evidence for the treatment of hemorrhoids, listed in the Thai National List of Herbal Products in the oral dosage form. (Wall ex. DC.) R. K. Jansen. (AP) is a medicinal plant with a local anesthetic effect.
OBJECTIVE
To investigate the potential of rectal suppositories containing CQ and AP extracts to alleviate symptoms of hemorrhoids compared with the commercialized rectal suppository containing hydrocortisone and cinchocaine.
MATERIALS AND METHODS
Hemorrhoid outpatients ( = 105) with different severity grades (I, II, or III) from eight hospitals in northern Thailand were included in this study. Hemorrhoid severity was graded by proctoscopy associated with either anal pain or bleeding related to hemorrhoids or both. The patients were randomly allocated to two groups: CQ-AP group ( = 52) or the commercialized rectal suppository group ( = 53). One suppository was rectally administered twice daily in the morning and at bedtime for seven days. Evaluations were performed by physicians on days 1, 4, and 8 of the study. The primary endpoints were bleeding and prolapse size, while the secondary endpoint was anal pain.
RESULTS
Baseline demographics, lifestyle, constipation, number of prolapses, grade of hemorrhoid severity, and duration of experiencing hemorrhoids were comparable in both groups of patients. The effects of CQ-AP and the commercialized rectal suppository on bleeding, prolapse size, and anal pain were comparable. The patients in both groups were satisfied with both products at comparable levels and stated a preference for further use in the case of hemorrhoids recurrence. In terms of safety, the patients in the commercialized rectal suppository group experienced a higher incidence of adverse events, including anal pain and bleeding.
CONCLUSION
Rectal suppositories containing a combined extract of CQ and AP show potential in alleviating hemorrhoidal symptoms with a good safety profile.
PubMed: 34765003
DOI: 10.1155/2021/5605323