Innovare Academic Sciences: E-Journals
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COMPARISON OF 0.75% HYPERBARIC ROPIVACAINE WITH FENTANYL AND 0.75% HYPERBARIC ROPIVACAINE WITH DEXMEDETOMIDINE FOR SPINAL ANAESTHESIA IN ELECTIVE LOWER LIMB SURGERIES
No full textObjective: Spinal anaesthesia is a preferred technique for lower limb surgeries due to its reliability and safety. Adjuvants like fentanyl and dexmedetomidine are commonly added to local anaesthetics to enhance block characteristics. To compare the sensory and motor block characteristics, haemodynamic profile, sedation, duration of analgesia, and complications of intrathecal 0.75% hyperbaric ropivacaine with fentanyl versus dexmedetomidine in elective lower limb surgeries.
Methods: After institutional ethics committee approval, 60 ASA I–II patients aged 18–60 y scheduled for elective lower limb surgeries were randomised into two groups (n=30 each). Group I received 2 ml of 0.75% hyperbaric ropivacaine+25 µg fentanyl, and Group ii received 2 ml of 0.75% hyperbaric ropivacaine+10 µg dexmedetomidine intrathecally. Onset and duration of sensory and motor block, haemodynamics, sedation (Ramsay score), postoperative pain (VAS), and side effects were recorded. Data were analysed using Student’s t-test and chi-square test; p<0.05 was considered significant.
Results: Onset of sensory (Group I: 2.76±0.08 min vs Group ii: 2.72±0.08 min; p=0.134) and motor block (Group i: 1.58±0.40 min vs Group ii: 1.38±0.37 min; p=0.053) was comparable. Duration of sensory block (Group I: 275.10±16.46 min vs Group ii: 310.13±14.94 min; p<0.001), motor block (Group I: 113.77±13.01 min vs Group ii: 124.30±6.91 min; p<0.001), and analgesia (Group I: 226.40±18.09 min vs Group ii: 280.60±13.90 min; p<0.001) was significantly longer in Group ii. Haemodynamic parameters and sedation scores remained stable and comparable. Incidence of side effects was similar.
Conclusion: Intrathecal dexmedetomidine as an adjuvant to 0.75% hyperbaric ropivacaine provides significantly longer sensory and motor blockade and postoperative analgesia compared to fentanyl, with similar haemodynamic stability and side-effect profile
ACCURACY AND TEACHABILITY OF ARTIFICIAL INTELLIGENCE CHATBOTS IN SOLVING PHARMACEUTICAL CALCULATIONS: A DESCRIPTIVE STUDY
No full textObjectives: This study evaluated the accuracy and teachability of widely available AI chatbots in performing pharmaceutical calculations, including adult and paediatric dosing, IV infusion rates, and dilution/concentration problems.
Methods: A descriptive study was conducted in the Department of Pharmacology, Sri Venkateswara Medical College, Tirupati. Five free-access AI chatbots (A–E) were given 35 questions each. Responses were compared with gold standard answers. Incorrect answers were corrected through feedback, and performance was reassessed. Data were analysed descriptively using Microsoft Excel.
Results: Accuracy varied across chatbots, with Chatbot A performing best (89%) and Chatbot D close behind (86%). All chatbots performed well in simpler tasks such as percentage and ratio calculations (86%), whereas paediatric dosing, IV infusion, and dilution/concentration problems were more error-prone. Following feedback, teachability was high: Chatbots A, B, and D corrected all errors (100%), while C and E improved to 91% and 82%, respectively.
Conclusion: AI chatbots show potential as educational and clinical support tools for pharmaceutical calculations. They handle simpler tasks reliably and can improve performance after feedback. Nevertheless, supervision remains crucial for complex calculations to ensure patient safety. When integrated carefully, AI chatbots can complement traditional learning and clinical practice
RISK FACTORS, MICROBIOLOGICAL SPECTRUM, ANTIBIOTIC SENSITIVITY AND OUTCOMES OF VENITILATOR ASSOCIATED PNEUMONIA IN NEONATES: A STUDY FROM A TERTIARY CARE HOSPITAL IN SOUTHERN ASSAM
No full textObjective: To determine the incidence, microbiological profile, antibiotic sensitivity, risk factors, and outcomes of VAP in neonates.
Methods: This prospective observational study, conducted for one year in a tertiary care NICU in Southern Assam, included 101 neonates ventilated for over 48 h. VAP was defined using CDC criteria, integrating clinical, Laboratory, radiological, and microbiological findings. Data on patient characteristics, VAP occurrence, microbiology, and antibiotic susceptibility were collected and analysed.
Results: Thirty-seven (36.7%) neonates developed VAP, resulting in an incidence of 41.11 per 1,000 ventilator days. Key risk factors significantly associated with VAP included prematurity, low birth weight, bronchopulmonary dysplasia, and asphyxia. Common clinical signs were new onset tachypnoea and increased respiratory secretions. VAP led to significantly longer hospital stays (38.1±17.82 vs. 21.4±14.3 d, p=0.0001) and mechanical ventilation durations (13.42±8.74 vs. 5.89±3.56 d, p=0.0001), alongside increased antibiotic use. Gram-negative organisms predominated (68.9% of 45 isolates), notably multi-drug resistant (MDR) Acinetobacter spp. and ESBL-producing Klebsiella pneumoniae/oxytoca. Pseudomonas isolates showed high resistance to Amikacin, Meropenem, and Piperacillin+Tazobactam. MRSA exhibited good Linezolid susceptibility. VAP is associated with increased morbidity and mortality.
Conclusion: Neonatal VAP imposes a substantial burden, driven by prematurity, severe underlying conditions, and a high prevalence of MDR Gram-negative pathogens. Our findings highlight the urgent need for robust infection control, vigilant surveillance, and culture-guided antibiotic therapy to optimize outcomes and combat antimicrobial resistance. Larger, multi-center studies are essential
COMBINED BCL-2–KI-67 SCORE AND ITS CORRELATION WITH TUMOUR INFILTRATING LYMPHOCYTES IN ENDOMETRIAL CARCINOMA – A NOVEL STUDY
No full textObjective: This study aimed to evaluate a combined Bcl-2–Ki-67 score and assess its correlation with TILs in endometrioid endometrial carcinoma.
Methods: A retrospective analysis was performed on 40 cases of endometrioid endometrial carcinoma, from January 2017 to June 2018. Immunohistochemically staining for Bcl-2 and Ki-67 was performed, and a combined score was generated by inverting the Bcl-2 score and summing with the Ki-67 score. TILs were evaluated as low (<10%), moderate (20–40%), and high (>50%). Correlation between the combined score and TILs was analyzed using Fisher’s exact test, and interobserver agreement for TIL assessment was calculated using the Kappa coefficient.
Results: Combined Bcl-2–Ki-67 scores ranged from 0–6. A significant inverse correlation was observed between the combined score and TILs (p=0.00105, Fisher’s exact test). Interobserver agreement for TIL scoring was high (κ = 0.82).
Conclusion: The combined Bcl-2–Ki-67 score inversely correlates with TIL levels in endometrioid endometrial carcinoma, highlighting its potential use as a prognostic marker. Further studies with larger cohorts are warranted to validate these findings
DICHLORODIPHENYLTRICHLOROETHANE (DDT) POISONING: A CASE REPORT
No full textObjective: Dichlorodiphenyltrichloroethane (DDT) is a highly lipophilic organochlorine pesticide known for its environmental persistence and neurotoxicity. Although banned or restricted in many countries, sporadic cases of poisoning continue to occur due to illegal use and accidental exposure. Acute toxicity primarily affects the nervous system.
Methods: We report a case of acute DDT poisoning in a 34 y old male who presented with gastrointestinal and neurological symptoms following accidental ingestion. The patient initially had stable vital parameters but subsequently developed respiratory failure and hypotension requiring mechanical ventilation and vasopressor support. Management was entirely supportive, as no specific antidote exists for DDT toxicity.
Results: The patient showed progressive clinical improvement and was successfully extubated on the third day, with complete recovery.
Conclusion: DDT poisoning, though uncommon, should be considered in patients presenting with unexplained neurological manifestations and a relevant exposure history. Early recognition and aggressive supportive management are crucial for favorable outcomes
GREEN SYNTHESIS OF SILVER NANOPARTICLES FROM NEEM BARK FOR THE REMEDIATION OF WATERBORNE PATHOGENS
No full textObjective: The objective of the study was to develop an eco-friendly method for synthesizing silver nanoparticles (AgNPs) using neem (Azadirachta indica) bark extract as a reducing and stabilizing agent, and to evaluate their antibacterial, antipathogenic, and larvicidal activities for water purification and vector control.
Methods: AgNPs were synthesized by green chemistry using neem bark (NB) extract, avoiding hazardous chemicals. Synthesis parameters – pH, temperature, and reaction time – were optimized. Characterization included ultraviolet (UV)-Visible spectroscopy (Shimadzu UV-1800), Fourier transform infrared (Perkin Elmer Spectrum-One, USA), X-ray diffraction (Cu Kα radiation, λ = 1.5406 Å), SEM (Hitachi S-3400N), TEM (JEOL-JEM- 2100F, 200 kV), particle size analysis, and zeta potential measurement. Antibacterial activity against Staphylococcus aureus and Escherichia coli was tested by the well diffusion method. Antipathogenic activity was assessed using pathogenic sewer water, and larvicidal activity was evaluated against mosquito larvae (n=10/concentration).
Results: Spherical NB AgNPs (40–150 nm) with a characteristic SPR peak at 425 nm were obtained. X-ray diffraction confirmed a face-centered cubic crystalline structure with an average crystallite size of 7.66 nm. Zeta potential values (–26.7 to –33.2 mV) indicated good colloidal stability. Antibacterial testing showed maximum inhibition zones of 47 mm for S. aureus and 37 mm for E. coli at 25 μg/mL. In pathogenic water, smaller particles exhibited higher inhibition efficiency. Larvicidal assays achieved 100% mortality at 2.5 μg/mL within 3 h (p<0.05), with no mortality in controls.
Conclusion: NB -mediated AgNPs demonstrate strong antibacterial, antipathogenic, and larvicidal properties, making them a low-cost, sustainable option for water purification and mosquito control. Further studies should focus on in vivo performance, environmental safety, and large-scale application
EFFECTS OF LIGNOCAINE NEBULIZATION VERSUS DEXMEDETOMIDINE NEBULIZATION IN BLUNTING HEMODYNAMIC RESPONSE IN PATIENTS UNDERGOING NASOTRACHEAL INTUBATION IN HEAD AND NECK SURGERIES
No full textObjective: The objective of this study was to compare the efficacy of nebulized lignocaine and dexmedetomidine in attenuating the hemodynamic response to nasotracheal intubation in patients undergoing head and neck surgeries.
Methods: This prospective interventional comparative study included 192 ASA I–II patients aged 18–60 years scheduled for head and neck surgeries under general anesthesia. Patients were allocated to receive nebulization with lignocaine 1.5 mg/kg, dexmedetomidine 2 μg/kg, or normal saline (control) 15 min before intubation. Hemodynamic parameters – heart rate (HR), systolic, diastolic, and mean arterial pressures – were recorded at baseline, pre-intubation, and at 1, 5, 10, and 15 min post-intubation. Statistical analysis was performed using analysis of variance and Chi-square tests, with p<0.05 considered significant.
Results: Baseline characteristics were comparable among the groups. Dexmedetomidine nebulization produced significantly greater attenuation of increases in HR and blood pressure at all post-intubation time points compared with lignocaine and control (p<0.001). Lignocaine provided partial attenuation, whereas the control group displayed marked hemodynamic surges. Adverse events were minimal, with only mild, self-limiting bradycardia in the dexmedetomidine group.
Conclusion: Nebulized dexmedetomidine is more effective than lignocaine in blunting the hemodynamic response to nasotracheal intubation and represents a safe, non-invasive strategy for achieving perioperative hemodynamic stability
PHARMACOLOGICAL SIGNIFICANCE AND TOXICITY OVERVIEW OF OLEANOLIC ACID ISOLATED FROM LANTANA CAMARA ROOTS
No full textSeveral therapeutic plants contain oleanolic acid (OA), a pentacyclic triterpenoid. Its drugs protect the liver, reduce inflammation, prevent diabetes, and fight cancer. Lantana camara roots are rich in OA, making them a promising medicine source. From 2000 to Up to present mid-2024, this study includes all published research on L. camara root OA, including phytochemical composition, pharmacological activity, toxicological evaluations, and mutagenicity assessments. We aggregated PubMed, Scopus, ScienceDirect, and Google Scholar data to find therapeutic relevance and safety margins. We thoroughly searched databases using relevant keywords. OA modulates oxidative stress pathways and detoxifying enzymes to protect the liver, and sub-chronic and acute toxicity studies in Wistar rats showed no mortality or adverse histopathological changes up to 2000 mg/kg. Ames tests showed its non-mutagenicity. However, insufficient clinical and chronic exposure investigations, poor water solubility, and bioavailability hinder translational applicability. The review finds that L. camara OA has promising lead phytotherapeutic potential, but more in vivo investigations and formulation improvements are needed to prove its efficacy and safety
GREEN SYNTHESIS OF IRON OXIDE NANOPARTICLES FROM PLECTRANTHUS AMBOINICUS AND THEIR WIDE RANGE OF BIOMEDICAL APPLICATIONS
No full textObjective: Green synthesis of metal nanoparticles provides an environmentally friendly approach in comparison with the chemical method. Iron oxide nanoparticles (FeONPs) have potential biomedical applications such as antimicrobial, antioxidant, and anti-inflammatory activities. The goal of the current study was to synthesize FeONPs using the leaf extract of Plectranthus amboinicus and to assess the biological activities.
Methods: FeONPs were prepared in a green reduction and stabilization method using aqueous extracts of P. amboinicus leaves. The formation of FeONPs was initially qualitatively identified through colorimetry and additionally identified using ultraviolet (UV)-visible spectroscopy, X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). Antimicrobial testing was conducted against Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mutans, Aggregatibacter actinomycetemcomitans, and Candida albicans using minimum inhibitory concentrations (MIC) and time-kill methods. The antioxidant property of the synthesized FeONPs was evaluated using the 2,2-diphenyl-1-picrylhydrazyl radical scavenging assay. The anti-inflammatory property was analyzed by protein denaturation inhibition assays utilizing bovine serum albumin and egg albumin models. The cytotoxicity as well as the toxic properties of FeONPs were analyzed by brine shrimp (Artemia salina) lethality bioassays.
Results: The emergence of a clear color transition from dark brown to light brownish-orange signified nanoparticle development, accompanied by a distinctive UV–Visible Spectroscopy absorption wavelength at 395 nm. XRD pattern verification demonstrated the nanocrystalline and phase-pure quality of FeONPs, measuring 10–12 nm. FTIR pattern matching further demonstrated surface modification by OH, aromatic, and phenolic moieties. The MIC range was 25–100 μg/mL, demonstrating broad-spectrum antibacterial activity, considerable antioxidant activity, and moderate anti-inflammatory activity. Cytotoxicity studies also exhibited moderate cell toxicity with LC50 = 8 μg/mL.
Conclusion: Green-synthesized FeONPs using P. amboinicus demonstrated stability, multifunctional bioactivity, and promising antimicrobial, antioxidant, and anti-inflammatory properties, highlighting their potential for further in vivo biomedical applications
SCREENING OF ANTICHOLINESTERASE AND ANTIOXIDANT ACTIVITIES OF CARISSA CARANDAS L. FRUIT EXTRACT FOR ALZHEIMER’S TREATMENT
No full textObjectives: The aim of this study was to evaluate the acetylcholinesterase (AchE) c inhibitory and antioxidant activity of unripened fruits of Carissa carandas extract to introduce new source for the management of Alzheimer’s disease.
Methods: Preliminary phytochemical screening identified the existence of flavonoids, phenolics, alkaloids, sterols, and saponins. The evaluation of antioxidant activity was led through 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric-reducing antioxidant power (FRAP) capacity, and anti-cholinesterase activity by the Ellman method.
Results: According to the obtained results, the extract contained a valuable source of flavonoids and phenolic compounds and has also shown AchE inhibition activity, which reveals the good inhibition potential with half-maximal inhibitory concentration of 95.92±1.05 μg/mL and significant antioxidant activity in DPPH assay and FRAP assay compared to the respective standards.
Conclusion: The present study revealed that the C. carandas fruit extract showed potential AchE inhibition and antioxidant activity. However, further investigations on the identification of active components in the extracts are needed