Redox behavior of midazolam was studied at a glassy carbon electrode in various buffer systems,supporting electrolytes and pH using differential paise,square-wave and cyclic voltammetry.Based on its reduction behavior,a direct differential pulse voltammetric method has been developed and validated for the determination of midazolam in parenteral dosage.Three welldefined peaks were observed in 0.1％ SLS,Britton-Robinson (BR) buffer of pH 2.5.The effect of surfaetants like sodium lauryl sulfate (SLS),cetyl trimethyl ammonium bromide (CTAB) and Tween 20 was studied.Among these surfactants SLS showed significant enhancement in reduction peak.The cathodic peak currents were directly proportional to the concentration of midazolam with correlation coetfficient of 0.99.

A sensitive electroanalytical method for quantification of pheniramine in pharmaceutical formulation has been investigated on the basis of the enhanced electrochemical response at glassy carbon electrode modified with multi-walled carbon nanotubes in the presence of sodium lauryl sulfate.The experimental results suggest that the phcniramine in anionic surfactant solution exhibits electrocatalytic effect resulting in a marked enhancement of the peak current response.Peak current response is linearly dependent on the concentration of pheniramine in the range 200-1500 μg/mL with correlation coefficient 0.9987.The limit of detection is 58.31 μg/m L.The modified electrode shows good sensitivity and repeatability.

Electrochemical reduction behavior of Adefovir was studied using Hanging Mercury Drop Electrode (HMDE) in Britton-Robinson (BR) buffer solution.Voltammetric study showed one well-defined reduction peak in the potential range -1.2 to -1.4 V (vs.Ag/AgCl) due to reduction of C=N bond of the imidazole ring.Solid-phase extraction and protein-precipitation techniques were employed for extraction of Adefovir from human plasma.The proposed method allows quantification of Adefovir in human plasma over the concentration range 0.50-5.00 μg/mL with the detection limit 0.17 μg/mL,whereas in pharmaceutical formulation 0.25-2.25 μg/mL with the detection limit 0.08 μg/mL.

The present study reports voltammetric reduction of nitazoxanide in Britton-Robinson (B-R) buffer by cyclic and square-wave voltammetry at glassy carbon electrode. A versatile fully validated voltammetric method for quantitative determination of nitazoxanide in pharmaceutical formulation has been proposed. A squrewave peak current was linear over the nitazoxanide concentration in the range of 20-140 mg/mL. The limit of detection (LOD) and limit of quantification (LOQ) was calculated to be 5.23μg/mL and 17.45μg/mL, respectively.

Retrieval of a broken guide wire transfixing the acetabulum or with intrapelvic migration is challenging and frustrating for surgeons. We here present a case report on a method to remove a broken guide wire transfixing the acetabulum through the proximal hole of recon nail using a grasping forceps. This method is little invasive, easy, time-saving and without need for changing the inital fixation.
Adult ; Bone Wires ; adverse effects ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans ; Male ; Prosthesis Failure

INTRODUCTIONNeonatal priapism is known to be associated with a wide range of aetiologies, but an association with spontaneous purulent cavernositis has not been reported in the paediatric literature. We report the first of such case.

CLINICAL PICTUREA 24-day-old neonate was brought with the history of persistent erection of penis since day 4 of life and swollen penis of 4 days' duration, which revealed frank pus on cavernosal aspiration bilaterally.

TREATMENTThe child was treated with closed aspiration drainage; cross-irrigation with antibiotic solution under systemic antibiotic cover helped in achieving complete detumescence.

OUTCOMEOn follow-up, child demonstrated normal full bladder tumescence and colour doppler revealed bilateral normal corporo-cavernosal appearance and blood flow, indicating good functional and anatomical recovery.

CONCLUSIONThis case report describes the presentation, successful management and excellent functional and anatomical outcome, on follow-up, of this rare association of neonatal priapism with spontaneous bilateral pyocavernositis. An attempt has been made to describe the underlying pathophysiology.

Algorithms ; Humans ; Infant, Newborn ; Inflammation ; complications ; Male ; Penile Diseases ; complications ; Priapism ; complications ; therapy ; Suppuration

In the present work,a chemically modified electrode has been fabricated utilizing Bi2O3/ZnO nano-composite.The nanocomposite was synthesized by simple sonochemical method and characterized for its structural and morphological properties by using XRD,FESEM,EDAX,HRTEM and XPS techniques.The results clearly indicated co-existence of Bi2O3 and ZnO in the nanocomposite with chemical interaction between them.Bi2O3/ZnO nanocomposite based glassy carbon electrode(GCE)was utilized for sensitive voltammetric detection of an anti-biotic drug(balofloxacin).The modification amplified the electroactive surface area of the sensor,thus providing more sites for oxidation of analyte.Cyclic and square wave voltammograms revealed that Bi2O3/ZnO modified electrode provides excellent electrocatalytic action towards balofloxacin oxidation.The current exhibited a wide linear response in concentration range of 150-1000 nM and detection limit of 40.5 nM was attained.The modified electrode offered advantages in terms of simplicity of preparation,fair stability(RSD 1.45％),appreciable reproducibility(RSD 2.03％)and selectivity.The proposed sensor was applied for determining balofloxacin in commercial pharmaceutical formulations and blood serum samples with the mean recoveries of 99.09％and 99.5％,respectively.

OBJECTIVEMonteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a review of the literature.

METHODSA retrospective record of Monteggia fracture dislocation (2003-2008) was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade II and III cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients.

RESULTSFollow-up ranged from 1-4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20 degree 116 degree, 50 degree and 55 degree for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures.

CONCLUSIONSMonteggia fracture dislocation equivalents are rare injuries and pre-surgery recognition by radiographs and 3-D CT helps make optimal plan. The poor results usually relate to intraarticular damage, coronoid fractures and comminution of the ulna and radial head fractures.

Fracture Fixation, Internal ; Humans ; Monteggia's Fracture ; Retrospective Studies ; Treatment Outcome ; Ulna Fractures

This was a prospective, randomized, and double-blind study.

Thoraco-lumbar spine surgery is associated with severe postoperative pain and can cause chronic pain. We aimed to compare the impact of epidural ropivacaine with and without dexmedetomidine on postoperative analgesia after thoracolumbar spine instrumentation wherein an epidural catheter was placed by the surgeon intraoperatively.

Very few studies have reported the use of epidural dexmedetomidine in spine surgeries. When used via the epidural route, dexmedetomidine is safe and efficacious and is associated with reduced rescue analgesia consumption, increased duration of analgesia, reduced pain scores, but not with major hemodynamic adverse effects.

Total 60 American Society of Anesthesiologists I–III adult patients aged 18–65 years who were scheduled to undergo thoraco-lumbar spine instrumentation were randomly allocated into group RD (epidural ropivacaine+dexmedetomidine) or group R (epidural ropivacaine plus saline). We aimed to compare the total rescue analgesic consumption on postoperative day 0, 1, and 2. Moreover, we studied the time to first rescue analgesia with visual analogue scale score <4 and the overall patient satisfaction scores.

There was no difference between the demographic characteristics of the two groups. The mean value of total rescue analgesia consumption was 162.5±68.4 mg in the RD group and 247.5±48.8 mg in the R group. The mean time to first rescue analgesia was 594.6±83.0 minutes in the RD group and 103.6±53.2 minutes in the R group. The mean patient satisfaction score was 4.2±0.7 in the RD group and 3.2±0.6 in the R group. No patient had any respiratory depression or prolonged motor blockade during the postoperative period.

This study demonstrated the superior efficacy, in terms of postoperative analgesia and patient satisfaction scores, of epidural ropivacaine plus dexmedetomidine over that of ropivacaine alone in patients undergoing surgery for thoraco-lumbar spine.

This was a prospective, randomized, and double-blind study.

Thoraco-lumbar spine surgery is associated with severe postoperative pain and can cause chronic pain. We aimed to compare the impact of epidural ropivacaine with and without dexmedetomidine on postoperative analgesia after thoracolumbar spine instrumentation wherein an epidural catheter was placed by the surgeon intraoperatively.

Very few studies have reported the use of epidural dexmedetomidine in spine surgeries. When used via the epidural route, dexmedetomidine is safe and efficacious and is associated with reduced rescue analgesia consumption, increased duration of analgesia, reduced pain scores, but not with major hemodynamic adverse effects.

Total 60 American Society of Anesthesiologists I–III adult patients aged 18–65 years who were scheduled to undergo thoraco-lumbar spine instrumentation were randomly allocated into group RD (epidural ropivacaine+dexmedetomidine) or group R (epidural ropivacaine plus saline). We aimed to compare the total rescue analgesic consumption on postoperative day 0, 1, and 2. Moreover, we studied the time to first rescue analgesia with visual analogue scale score <4 and the overall patient satisfaction scores.

There was no difference between the demographic characteristics of the two groups. The mean value of total rescue analgesia consumption was 162.5±68.4 mg in the RD group and 247.5±48.8 mg in the R group. The mean time to first rescue analgesia was 594.6±83.0 minutes in the RD group and 103.6±53.2 minutes in the R group. The mean patient satisfaction score was 4.2±0.7 in the RD group and 3.2±0.6 in the R group. No patient had any respiratory depression or prolonged motor blockade during the postoperative period.

This study demonstrated the superior efficacy, in terms of postoperative analgesia and patient satisfaction scores, of epidural ropivacaine plus dexmedetomidine over that of ropivacaine alone in patients undergoing surgery for thoraco-lumbar spine.