"The Role of Topical Anesthesia in Flexible Nasofibrolaryngoscopy" Is It Necessary?

 "The Role of Topical Anesthesia in Flexible Nasofibrolaryngoscopy" Is It Necessary? | Ommega Online Publishers


The development of Otolaryngology in recent decades has been facilitated by the emergence of flexible nasofibrolaryngoscopy, which has become an essential diagnostic tool for the otolaryngologist. However, their use is not without discomfort to the patient, which is why various topical anesthesia options have been proposed for the development of the technique. Cocaine paste, Co-Phenylcaine forte, lidocaine, and others have been part of preparations proposed to decrease the degree of discomfort when making such exploration. However existing results in the literature differ on the need for its use. That is why in this article we attempt to review the existing scientific evidence at present regarding the use of topical anesthesia during flexible nasofibrolaryngoscopy.



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Simple and Sensitive Method for the Simultaneous Estimation of Drotaverine HCL and Aceclofenac Using RP-HPLC

 Simple and Sensitive Method for the Simultaneous Estimation of Drotaverine HCL and Aceclofenac Using RP-HPLC  | Ommega Online Publishers



To develop a simple and sensitive method for the simultaneous estimation of drotaverine HCL (DRH) and aceclofenac (AF) using RP-HPLC. The HPLC separation was achieved on a thermo column (250 mm × 4.6 mm, 5μ) with an isocratic mixture of acetonitrile and 5 mM of ammonium acetate in the ratio of 65:35, pH adjusted to 4.5 at a flow rate of 1.0 ml/min and the detection at 285nm. The method was validated as per ICH guidelines. The retention time for DRH and AF was 3.9 and 5.0 minutes, respectively. The optimized method was linear in the range of 50 - 120 ng/ml and 100 - 700 ng/ml for DRH and AF respectively. The overall recovery of DRH and AF were 99.8 and 99.5 % respectively. The developed sensitive, robust and rugged method as proven reproducibility of the result obtained as an outcome of small deliberate variation in the analytical parameter and the change the operator. 


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Obesity-Related Hormones and Metabolic Risk Factors: A Randomized Trial of Diet plus Either Strength or Aerobic Training versus Diet Alone in Overweight Participants

 Obesity-Related Hormones and Metabolic Risk Factors | Ommega Online Publishers


There is debate about the additive effects of exercise in conjunction with diet to treat obesity, and not much is known about the differential effects of strength versus aerobic training. This randomized controlled trial examined the effects of diet plus strength training, diet plus aerobic training, or diet only on metabolic risk factors associated with obesity. Eighty-one overweight and obese participants completed the 8-week intervention. All participants received an energy-restrictive formula diet with an energy content based on 70% of measured resting metabolic rate (RMR). Participants assigned to an exercise group trained 3 days/week under supervision. Anthropometrics and fasting hormones were assessed pre- and post-intervention. Mean weight loss (8.5± 4.3kg SD) did not differ between groups nor did reductions in BMI or body fat, although the diet plus strength training group showed marginally greater lean mass retention. There were significant improvements in the values and number of metabolic syndrome risk factors, and decreases in insulin concentrations and insulin resistance, which did not vary between groups. For men, testosterone increased significantly more in the diet plus aerobic training as compared to the other groups. As compared to diet alone, the addition of strength or aerobic training did not improve changes in BMI, body fat or metabolic risk factors although the diet plus strength training group showed a trend toward preservation of lean mass, and the diet plus aerobic group in men resulted in increased testosterone concentrations. 


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High Blood Pressures

 High Blood Pressures | Ommega Online Publishers


Case Stem (one to two paragraphs on pertinent patient and scenario information-this should be the stem for the learner and should include location, physician/help availability, family present, etc.)
60 year old male with no past medical or surgical history presented to the Emergency Room with sudden onset dyspnea and palpitations^[1,2]. For the past 2 weeks, he had been experiencing include intermittent headaches, palpitations, anxiety, and occasional shortness of breath on exertion, which is what brought him to the hospital. This morning, his wife noted increased anxiety leading to “he can’t catch his breath.” Work up includes an Electrocardiogram, cardiac enzymes, chest x-ray, stress test, and transthoracic echocardiography, all of which were normal. Incidentally, a abdominal Computerized tomography (CT) scan was performed, and an acute appendicitis could not be ruled out, so he was sent to the Operating Room to do a diagnostic laparoscopy and appendectomy. Background and briefing information for Facilitator/coordinator's eyes only In the ER, his blood pressure ranged from noninvasive systolic 140-280 millimeters mercury over diastolic 30-150 millimeters mercury, so a CT (computerized tomography) abdomen showed a 6-centimeter round mass retroperitoneally on the right adrenal gland suggesting pheochromocytoma[4,5], but this was missed initially as it only showed a possible acute appendicitis. Serum epinephrine was 18.6 nanogram/milliliter (normal: 0.01-0.18 nanogram/milliliter), norepinephrine 24.2 nanogram/milliliter (normal: 0.06-0.45 nanogram/milliliter), and dopamine 4.8 nanogram/milliliter (normal 0-0.09 nanogram/milliliter). No metaiodobenzylguanidine (MIGB) scan performed because of acute renal failure. 


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Fructose Intake and Circulating Triglycerides: An Examination of the Role of APOC 3

 Fructose Intake and Circulating Triglycerides: An Examination of the Role of APOC 3  | Ommega Online Publishers




Fructose consumption can lead to marked increases in plasma triglycerides in both humans and laboratory animals. We have observed that overnight access to a 16% fructose solution can promote hypertriglyceridemia in rats. Several investigators have suggested that APOC 3 may be implicated in promoting fructose-induced hypertriglyceridemia. We have examined the role of APOC 3 in liver and blood taken from rats that had been given access to a fructose solution overnight as a supplement to standard laboratory chow. Hepatic APOC3 mRNA expression from fructose alone resulted in a 14 % reduction compared to control. Interestingly, hepatic APOC3 expression was increased by about 250% in sucrose, high fructose corn syrup and glucose groups. The serum protein levels of APOC3 did not differ across groups. Contrary to our hypothesis, these results indicate that glucose containing sugars increased hepatic APOC3 mRNA expression but no sugar was capable of increasing the serum protein level.



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Formulation and Evaluation of Self-Nanoemulsifying Powder of Ezetimibe

 Formulation and Evaluation of Self-Nanoemulsifying Powder of Ezetimibe | ommega online publishers



Ezetimibe (EZT) is the selective cholesterol absorption inhibitor. It is indicated for the treatment of primary hypercholesterolemia. The current investigation was aimed to formulation and evaluation of self nanoemulsifying powder (SNEP) for EZT to enhance solubility and dissolution rate and this will leads to minimize the variability in absorption. Solubility of drug was determined in different vehicles. Pseudo ternary phase diagram generated using Acrysol EL 135, Tween 80 and Trancutol P. The SNEP was prepared by adsorbing the optimized liquid SNEDDS on to Fujicalin as carrier. The SNEP characterized by micromeritic properties, differential scanning studies, percentage transmittance, emulsification time and zeta potential. The optimized formulation had shown the smallest particle size, less emulsification time, good % transmittance and good in vitro release. The in vitro dissolution rate and Ex vivo   permeation rate of the drug from the SNEP was significantly higher than that of the plain drug and its suspension respectively. 


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Fasting C-Peptide Index May be the Strongest Predictor for Detecting Effectiveness of Glycemic Control by GLP-1 Analogue, Liraglutide Therapy for Japanese Type 2 Diabetic Patients

 Strongest Predictor for Detecting Effectiveness of Glycemic Control by GLP-1 Analogue | Ommega Online Publishers




Liraglutide (Victoza, Novo Nordisk Pharma Ltd.), a GLP-1 analogue preparation for diabetes mellitus has been reported to potently reduce the blood sugar level and decrease the body weight when injected once a day. As the risk of hypoglycemia is low, it has been used as an epoch-making drug in a rapidly increasing number of patients. In this study, we investigated the effects of liraglutide subcutaneously injected once a day in 48 patients with type 2 diabetes who had been treated at the outpatient clinic of the Diabetes Center in Yokohama Rosai hospital without admission. After 3 - month administration, the mean HbA1c value was significantly decreased (from 8.61 to 8.04%), and the mean body weight was also significantly reduced (from 71.0 to 69.2 kg). However, there were marked individual differences in the effects. We compared background factors between groups with and without improvement. The results showed that liraglutide was particularly effective in patients with a short duration of diabetes in whom endogenous insulin secretion, which was evaluated by examining fasting C-peptide with fasting sugar level, was well maintained. Furthermore, we examined the characteristics of eating behavior before and after administration using a questionnaire. In patients with a significant decrease in the blood sugar level, there was a marked improvement in the eating behavior pattern. Therefore, not only a decrease in the blood sugar level related to improved ability of endogenous insulin secretion but also the improvement of a patient’s eating behavior was closely associated with a decrease in the blood sugar level after liraglutide administration.



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Factors Associated with Metabolic Syndrome in Patients with Mental Disorders in Mexico

 Factors Associated with Metabolic Syndrome in Patients with Mental Disorders in Mexico | ommega Online Publishers


Metabolic Syndrome (MS) is defined by the presence of biochemical, physiological, and anthropometric abnormalities linked to insulin resistance, which increase the risk of diabetes mellitus and/or cardiovascular disease, as well as alterations such as abdominal obesity, glucose intolerance or diabetes mellitus, hypertension and dyslipidemia ^[1] .
According to the International Diabetes Federation (IDF), abdominal obesity is not currently a prerequisite for MS, but it is important criterions within those five that classify the syndrome.^[1,2] They recommend that the threshold for waist circumference that would define abdominal obesity should be established according to the country and population type, considering factors such as ethnicity.


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Discovery of Adiponectin and its Future Prospect

 Discovery of Adiponectin and its Future Prospect | ommega online publishers



Adiponectin is an adipocyte-specific protein abundantly present in the plasma. Since its discovery, numerous experimental and clinical studies have demonstrated that adiponectin has anti-atherogenic, antidiabetic and anti-inflammatory properties. Hypoadiponectinemia plays a key role in the pathogenesis of metabolic syndrome. In this manuscript, we review the discovery and establishment of adiponectin and discuss future prospects of this molecule. 

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Contralateral Prophylactic Mastectomy: Characteristics Influencing Utilization

 
 Contralateral Prophylactic Mastectomy: Characteristics Influencing Utilization | ommega online publishers

Breast conservation has been shown to have similar mortality rates as compared to mastectomy. We hypothesized that variables involving the patient, tumor and surgeon influence the treatment a patient may choose. Methods: Retrospective review of a prospectively maintained database of all patients who underwent surgical treatment for breast cancer between 2000 and 2009 was performed. Multivariate logistic regression models were used to compare characteristics associated with breast conservation therapy (BCT) and contralateral prophylactic mastectomy (CPM)


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Asymmetry of Symptoms and Signs in Multiple System Atrophy

  Asymmetry of Symptoms and Signs in Multiple System Atroph | Ommega Online Publishers

It has been widely recognized that some of the symptoms and signs of multiple system atrophy (MSA) emerge with laterality, but only a few studies have evaluated this issue comprehensively. Small-scale case reports that have been published thus far suggest that laterality in MSA is a rather rare finding.
In order to examine the prevalence and characteristics of laterality in symptoms and signs in MSA, we retrospectively investigated the records of 155 MSA patients. Among all the patients, 39% had episodes that suggested the presence of laterality in their illness history.
The MSA with predominant parkinsonism (MSA-P) patients presented with more episodes of laterality than the MSA with cerebellar features (MSA-C) patients. Among the episodes, laterality was more frequent in parkinsonism than for the cerebellar symptoms.Interestingly, these symptoms were more prevalent at the left side of the body. Laterality in the cerebellar signs was present in 63% of the MSA-C patients and laterality in parkinsonism was exhibited by 64% of the MSA-P patients. Interestingly, cerebellar signs, parkinsonism, and Horner's sign were all observed predominantly at the left side.
Thus, we concluded that a significant number of MSA patients present with laterality in both symptoms and signs and that more interestingly, these are predominantly observed at the left side.


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