Publications by authors named "Rupinder Singh"

41 Publications

Efficacy of premixed versus succedent administration of fentanyl and bupivacaine in subarachnoid block for lower limb surgeries: A randomised control trial.

Indian J Anaesth 2020 Aug 15;64(Suppl 3):S175-S179. Epub 2020 Aug 15.

Department of Urology, Father Muller's Medical College and Hospital, Mangalore, Karnataka, India.

Background And Aims: Subarachnoid block is the most commonly used anaesthesia technique for lower limb surgeries. Opioids are the most commonly used adjuvants with local anesthetics (LA). Adjuvants are given premixed with LA loaded in a single syringe. This study was conducted to evaluate differences in level of sensory and motor block and incidence of hypotension whilst administering hyperbaric bupivacaine and fentanyl either in a single syringe or different syringes. The effect of administering opioid prior to LA and vice versa on these parameters was also assessed.

Methods: One hundred and twenty patients were randomly allocated into three groups of 40 each: Group A received premixed 0.5% heavy bupivacaine 2.5 ml (12.5 mg) and 0.5 ml (25 microgram) of fentanyl in a single 3.0 ml syringe, Group B received 0.5 ml (25 microgram) of fentanyl in a 3.0 ml syringe followed by 0.5% heavy bupivacaine 2.5 ml (12.5 mg) in a 3.0 ml syringe, Group C received 0.5% heavy bupivacaine 2.5 ml (12.5 mg) in a 3.0 ml syringe followed by 0.5 ml (25 microgram) fentanyl in a 3.0 ml syringe. All statistical calculations were done using SPSS 21 version statistical program for Microsoft Windows.

Results: The mean time for onset of sensory and motor block was least in group C followed by group B. The duration of sensory and motor block was prolonged in groups B and C. Patients in group A experienced more hypotension as compared to groups B and C.

Conclusion: Administering hyperbaric bupivacaine first followed by fentanyl leads to an early onset and prolonged duration of sensory and motor block.
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http://dx.doi.org/10.4103/ija.IJA_264_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641052PMC
August 2020

Sign language in anesthesiology in times of novel corona virus pandemic.

J Anaesthesiol Clin Pharmacol 2020 Aug 17;36(Suppl 1):S81-S82. Epub 2020 Aug 17.

Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

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http://dx.doi.org/10.4103/joacp.JOACP_322_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573999PMC
August 2020

Thermomechanical investigations of PEKK-HAp-CS composites.

Proc Inst Mech Eng H 2019 Nov 23;233(11):1196-1203. Epub 2019 Sep 23.

Department of Mechanical Engineering, National University of Singapore, Singapore.

In this experimental study, a composite of poly-ether-ketone-ketone by reinforcement of hydroxyapatite and chitosan has been prepared for possible applications as orthopaedic scaffolds. Initially, different weight percentages of hydroxyapatite and chitosan were reinforced in the poly-ether-ketone-ketone matrix and tested for melt flow index in order to check the flowability of different compositions/proportions. Suitable compositions revealed by the melt flow index test were then taken forward for the extrusion of filament required for fused deposition modelling. For thermomechanical investigations, Taguchi-based design of experiments has been used with input variables in the extrusion process as follows: temperature, load applied and different composition/proportions. The specimens in the form of feedstock filament produced by the extrusion process were made to undergo tensile testing. The specimens were also inspected by differential scanning calorimetry and photomicrographs. Finally, the specimen showing the best performance from the thermomechanical viewpoint has been selected to extrude the filament for the fused deposition modelling process.
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http://dx.doi.org/10.1177/0954411919877979DOI Listing
November 2019

A Luminescent Probe for Ratiometric Optical Detection of Hg and Turn-On Fluorescent Sensing of Cu.

Chem Asian J 2019 Dec 24;14(24):4625-4630. Epub 2019 Jul 24.

Department of Chemistry, Indian Institute of Technology Guwahat, Guwahati, 781039, India.

Luminescent detection of heavy metals continues to be of growing importance considering their increasing inseparable roles in modern day lifestyle. To this end, we report a simple yet interesting thiourea derivative that results in detection of Cu in a turn-on fashion via a chemodosimetric redox reaction leading to oxidative cyclization of the chemosensor molecule. Elaborate studies with regard to the sensing process have been performed along with the proposal of a plausible cyclization mechanism of the molecule. Furthermore, the probe optically detects Hg , yet another heavy metal of prime importance, discernable even to the naked eye. The occurrence of a coordination complex has been proved by UV/Visible spectroscopic experiments as well as ESI-mass spectrometry.
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http://dx.doi.org/10.1002/asia.201900683DOI Listing
December 2019

Dimensionless Analysis for Investigating the Quality Characteristics of Aluminium Matrix Composites Prepared through Fused Deposition Modelling Assisted Investment Casting.

Materials (Basel) 2019 Jun 13;12(12). Epub 2019 Jun 13.

Mechanical Engineering, Imperial College London, Exhibition Rd., London SW7 2AZ, UK.

The aluminium matrix composites (AMCs) have become a tough competitor for various categories of metallic alloys, especially ferrous materials, owing to their tremendous servicing in the diversified application. In this work, additional efforts have been made to formulate a mathematical model, by using dimensionless analysis, able to predict the mechanical characteristics of the AMCs that have already been optimized and characterized by the authors. Here, the experimental and statistical data obtained from the Taguchi L18 orthogonal array and analysis of variance (ANOVA) have been used. They permit collection of the output responses and allow the identification of significant process parameters, respectively, which thereafter were used to design the mathematical model. Second order polynomial equations have been obtained from the specific output response and the relevant input parameter were incorporated with the highest level of contribution. The obtained quadratic equations indicate the regression values (R) equal to unity, hence, proving the performances of the fit. The results demonstrate that the developed mathematical models present very high accuracy for predicting the output responses.
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http://dx.doi.org/10.3390/ma12121907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630298PMC
June 2019

Investigations on joining of orthopaedic scaffold with rapid tooling.

Proc Inst Mech Eng H 2019 Jul 27;233(7):754-760. Epub 2019 May 27.

1 Department of Mechanical Engineering, Punjabi University, Patiala, India.

Poly lactic acid reinforced with hydroxyapatite and chitosan is one of the commonly used thermoplastic composite materials in three-dimensional printing of orthopaedic scaffolds. This article is an extension of work reported on hydroxyapatite- and chitosan-reinforced, poly lactic acid-based biocompatible feedstock filament for three-dimensional printing of functional prototypes on low cost commercial fused deposition modelling setup. In this work, joining of orthopaedic scaffolds has been performed with rapid tooling by using friction stir welding process. Finally, the mechanical properties (such as tensile strength and hardness) of the orthopaedic scaffolds joints were studied with support of the photomicrographs and thermal images. The results of study suggest that best settings for joining of micro cracks in orthopaedic scaffolds of poly lactic acid-hydroxyapatite-chitosan are rotational speed of 1000 r/min with length of consumable tool as 4 mm and staring time as 40 s.
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http://dx.doi.org/10.1177/0954411919852811DOI Listing
July 2019

Multi-Material Additive Manufacturing of Sustainable Innovative Materials and Structures.

Polymers (Basel) 2019 Jan 4;11(1). Epub 2019 Jan 4.

Department of Civil Engineering, University of Salerno, 84084 Fisciano (SA), Italy.

This paper highlights the multi-material additive manufacturing (AM) route for manufacturing of innovative materials and structures. Three different recycled thermoplastics, namely acrylonitrile butadiene styrene (ABS), polylactic acid (PLA), and high impact polystyrene (HIPS) (with different Young's modulus, glass transition temperature, rheological properties), have been selected (as a case study) for multi-material AM. The functional prototypes have been printed on fused deposition modelling (FDM) setup as tensile specimens (as per ASTM D638 type-IV standard) with different combinations of top, middle, and bottom layers (of ABS/PLA/HIPS), at different printing speed and infill percentage density. The specimens were subjected to thermal (glass transition temperature and heat capacity) and mechanical testing (peak load, peak strength, peak elongation, percentage elongation at peak, and Young's modulus) to ascertain their suitability in load-bearing structures, and the fabrication of functional prototypes of mechanical meta-materials. The results have been supported by photomicrographs to observe the microstructure of the analyzed multi-materials.
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http://dx.doi.org/10.3390/polym11010062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6401995PMC
January 2019

Transient splenial hyperintensity in a rare case of chikungunya encephalitis.

Neurol India 2019 Jan-Feb;67(1):273-275

Department of Neurology, Sri Bala Ji Action Medical Institute, New Delhi, India.

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http://dx.doi.org/10.4103/0028-3886.253649DOI Listing
January 2020

"Turn-on" Pb sensing and rapid detection of biothiols in aqueous medium and real samples.

Analyst 2019 Jan;144(2):567-572

Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati 781039, India.

Detection of lead has continued to be of immense interest in the present industrial as well as environmental diaspora. To this end, we report a prudent Schiff base which enables the sensitive detection of Pb2+ ions in mixed aqueous medium. The probe is afforded by simple synthetic and purification processes. Further, the probe employs simple mechanistic detection of Pb2+ and also successively detects a host of biothiols. The sensor is also used to detect Pb2+ ions in real water samples and consecutive detection of a variety of biothiols, including functionalized thiouracils, in onion and garlic extract. The fact that the Pb2+-L ensemble is 'non-selective' towards any particular thiol substituted analyte in real samples could as well prove to be an interesting contribution for chemical and biological detoxification processes.
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http://dx.doi.org/10.1039/c8an01624kDOI Listing
January 2019

Al sensing through different turn-on emission signals vis-à-vis two different excitations: Applications in biological and environmental realms.

Anal Chim Acta 2018 Sep 29;1025:172-180. Epub 2018 Mar 29.

Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati 781039, India. Electronic address:

A rationally designed Schiff base chemosensor (L) could render specific detection of Al ions with two distinct turn-on emission signals, separated by over 100 nm upon excitation at two different wavelengths. The utility of the probe lies in facilitating sensing in 80% aqueous medium with an emission close to 600 nm via an intramolecular charge transfer (ICT) mechanism. The biocompatible and cell permeable probe could readily sense Al in live HeLa cells as well. The affinity of the probe for Alcould be leveraged to specifically study DNA- Al interaction in solution.
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http://dx.doi.org/10.1016/j.aca.2018.03.053DOI Listing
September 2018

Adult cervical lung herniation: Importance of valsalva manoeuvre in imaging.

Indian J Radiol Imaging 2018 Jan-Mar;28(1):134-135

Department of Gynaecology, Kasturba Hospital, New Delhi, India.

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http://dx.doi.org/10.4103/ijri.IJRI_282_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894310PMC
April 2018

Role of time-resolved-CTA in intracranial arteriovenous malformation evaluation at 128-slice CT in comparison with digital subtraction angiography.

Neuroradiol J 2018 Jun 25;31(3):235-243. Epub 2018 Jan 25.

2 Department of Radio Diagnosis and Imaging, 29751 Postgraduate Institute of Medical Education and Research , India.

Introduction The present study aimed to evaluate the accuracy of time-resolved-computed tomographic angiography (TR-CTA) on a 128-slice CT scanner vis-à-vis cerebral digital subtraction angiography (DSA) in defining the morphological and haemodynamic characteristics of cerebral arteriovenous malformation (AVM). Methods Twenty-one patients (age range 10-46, mean 24.8 years) with clinical suspicion of AVM and three patients (age range 23-35, mean 24.3 years) with diagnosed AVM who were on follow-up underwent DSA and TR-CTA, on average 1.5 days apart. Three independent neuroradiologists analysed both studies in a blinded fashion based on the following parameters: AVM location, arterial feeder territories, venous drainage pattern, nidus flow characteristics, venous outflow obstruction, arterial feeder enlargement, external carotid artery feeder, location of aneurysm if any, leptomeningeal and transdural recruitment, neoangiogenesis, and pseudophlebitic pattern. Results The TR-CTA correctly demonstrated AVM in all 21 positive cases. It concordantly detected location (21/21), venous drainage pattern (21/21), nidus flow characteristics (21/21), and the venous outflow obstruction (9/9). However, discordance was seen in the demonstration of the arterial feeder (2/45) ( p = 0.49), arterial enlargement (13/17) ( p = 0.103), external carotid artery feeder (0/1), aneurysmal location (3/5) ( p = 0.40), leptomeningeal recruitment (1/3) ( p = 0.40), neoangiogenesis (0/4) ( p = 0.028) and in the pseudophlebitic pattern (2/5) ( p = 0.167) demonstration. Conclusions The results suggest that TR-CTA can provide the important features of cerebral AVM which are required in patient management.
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http://dx.doi.org/10.1177/1971400917744403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958501PMC
June 2018

Investigations for Thermal and Electrical Conductivity of ABS-Graphene Blended Prototypes.

Materials (Basel) 2017 Jul 31;10(8). Epub 2017 Jul 31.

Department of Engineering, University of Naples Parthenope, 80143 Naples, Italy.

The thermoplastic materials such as acrylonitrile-butadiene-styrene (ABS) and Nylon have large applications in three-dimensional printing of functional/non-functional prototypes. Usually these polymer-based prototypes are lacking in thermal and electrical conductivity. Graphene (Gr) has attracted impressive enthusiasm in the recent past due to its natural mechanical, thermal, and electrical properties. This paper presents the step by step procedure (as a case study) for development of an in-house ABS-Gr blended composite feedstock filament for fused deposition modelling (FDM) applications. The feedstock filament has been prepared by two different methods (mechanical and chemical mixing). For mechanical mixing, a twin screw extrusion (TSE) process has been used, and for chemical mixing, the composite of Gr in an ABS matrix has been set by chemical dissolution, followed by mechanical blending through TSE. Finally, the electrical and thermal conductivity of functional prototypes prepared from composite feedstock filaments have been optimized.
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http://dx.doi.org/10.3390/ma10080881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578247PMC
July 2017

Sequential MR imaging (with diffusion-weighted imaging) changes in metronidazole-induced encephalopathy.

Indian J Radiol Imaging 2017 Apr-Jun;27(2):129-132

Department of Neurology, Sri Bala Ji Action Medical Institute, New Delhi, India.

Metronidazole-induced neuro-toxicity, though rare, is known. A characteristic spatial distribution of lesions in cerebellar dentate nuclei and dorsal pons is known. However, temporal progression of lesions on magnetic resonance imaging (MRI) has not been described previously. We describe two such cases which presented initially with splenial hyperintesity and showed progression to characterstic lesions. Both cases improved with stoppage of metronidazole.
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http://dx.doi.org/10.4103/ijri.IJRI_341_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510308PMC
July 2017

Time resolved computed tomography angiography in the evaluation of brain arteriovenous malformation: a feasibility study.

Neuroradiol J 2018 Jun 10;31(3):230-234. Epub 2017 Jul 10.

2 Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, India.

Background and purpose Digital subtraction angiography is the current gold standard for diagnosing as well as the follow-up of cerebral arteriovenous malformations. However, as it is invasive, relatively expensive and time-consuming, a non-invasive alternative is of interest. We aimed to evaluate the feasibility of time resolved computed tomography angiography (TR-CTA) in a series of five diagnosed cranial arteriovenous malformation patients, demonstrated by conventional digital subtraction angiography with respect to acquisition, depiction of angiographic phases and radiation exposure. Materials and methods Five patients demonstrating a cranial arteriovenous malformation on digital subtraction angiography were studied with TR-CTA. The TR-CTA imaging was done by using a 128-detector computed tomography scanner. Digital subtraction angiography and TR-CTA studies were independently read by two blinded observers, by using a standardised scoring sheet. TR-CTA results were analysed with digital subtraction angiography as the criterion standard. Results TR-CTA generated comparable angiographic phases. In all five cases, there was complete agreement between digital subtraction angiography and TR-CTA regarding the size, arterial feeders, nidal morphology and venous drainage of the arteriovenous malformation. Conclusions TR-CTA imaging as a technique is feasible, providing images with good temporal and spatial resolution at an acceptable radiation dose. It appears to be a promising non-invasive adjunct to digital subtraction angiography.
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http://dx.doi.org/10.1177/1971400916684669DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958491PMC
June 2018

Treatment of chronic hepatitis C genotype 3 with Sofosbuvir-based therpy: a real-life study.

Hepatol Int 2017 May 31;11(3):277-285. Epub 2017 Mar 31.

Himalayan Institute of Medical Sciences, Dehradun, UttarKhand, India.

Background And Aims: Recently, Sofosbuvir was launched in India at affordable cost. We conducted a real-life study to determine the efficacy and safety of Sofosbuvir plus Ribavirin, with and without peginterferon-alfa 2a, in patients with chronic hepatitis C (CHC) genotype 3, the commonest genotype in South Asia.

Methods: This study included data of CHC patients from 11 sites in northern India between March 2015 and December 2015 (n = 1203). Patients with CHC genotype 3 (n = 931), who were treated with either Sofosbuvir 400 mg plus weight-based Ribavirin, daily ×24 weeks (n = 432) (dual therapy), or Peginterferon-α2a 180 mcg weekly, Sofosbuvir 400 mg plus weight-based Ribavirin, daily ×12 weeks (n = 499) (triple therapy) were included for analysis. Primary outcome was the proportion of patients achieving sustained viral response at 12 weeks post-therapy.

Results: The overall SVR rates were 91 and 92% in the dual and triple therapy arms, respectively. The SVR rates in treatment experienced were 67 and 74% versus 93 and 96% in naïve patients, on the dual and triple therapy arms, respectively. The SVR rates of cirrhotics were 73 and 75% on the dual and triple treatment arms, respectively. The SVR rates were low in the experienced cirrhotic patients: 44% (dual therapy) and 58% (triple therapy). Common adverse events were fatigue, headache, and myalgia.

Conclusion: Both dual and triple therapy regimes resulted in SVR rates of >95% in CHC genotype 3 who were naive non-cirrhotics. However, the SVR rates were low in treatment-experienced cirrhotics.
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http://dx.doi.org/10.1007/s12072-017-9794-1DOI Listing
May 2017

Effective Management of Early Cervical Pregnancy with Bilateral Uterine Artery Embolization Followed by Immediate Evacuation and Curettage: A Case Report.

J Obstet Gynaecol India 2017 02 18;67(1):66-69. Epub 2016 Oct 18.

Department of Intervention Radiology, Sri Bala Ji Action Medical Institute Paschim Vihar, New Delhi, 110063 India.

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http://dx.doi.org/10.1007/s13224-016-0943-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5306105PMC
February 2017

Endoinulinase production by a new endoinulinase producer Aspergillus tritici BGPUP6 using a low cost substrate.

Int J Biol Macromol 2016 Nov 9;92:1113-1122. Epub 2016 Aug 9.

Chembiotech Laboratories, Advanced Science and Technology Institute, 5 The Croft, Buntsford Drive, Stoke Heath, Bromsgrove, Worcs B60 4JE, UK.

Endoinulinase is an inulolytic enzyme which is used for the production of fructooligosaccharides from inulin. A new endoinulinase producing fungal strain BGPUP6 was identified as Aspergillus tritici on the basis of its molecular characterization. Response surface methodology was used to optimize the endoinulinase production at shake-flask level from Aspergillus tritici BGPUP6 using raw Asparagus inulin as carbon source. Four independent variables (raw inulin, 2-4%; peptone, 0.3-0.7%; (NH)HPO, 0.3-0.7% and pH, 4.5-6.5) were selected for the study based on the CCRD model of RSM. The other media supplements (FeSO·7HO, 0.001%; MgSO·7HO, 0.05% and KCl, 0.02%) were kept constant in the production medium, throughout the study. Endoinulinase production and biomass yield were selected as dependent responses. The optimal combination of media ingredients obtained from the study was 3% raw inulin, 0.5% peptone, 0.5% (NH)HPO and pH 5.5. Using the optimized media constituents, maximum endoinulinase production (25.01 IU/mL) and biomass yield (0.514g dry weight/50 mL) obtained were in good agreement with the predicted values. Crude enzyme produced was also used for the hydrolysis of inulin. The hydrolysate showed the presence of a mixture of fructooligosaccharides with varied degree of polymerization. This is the first report on the production of an endoinulinase from Aspergillus tritici.
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http://dx.doi.org/10.1016/j.ijbiomac.2016.08.026DOI Listing
November 2016

Efficacy of Magnesium Sulphate as an Adjunct to Ropivacaine in Local Infiltration for Postoperative Pain Following Lower Segment Caesarean Section.

J Clin Diagn Res 2016 Apr 1;10(4):UC18-22. Epub 2016 Apr 1.

Professor and Head, Department of Anaesthesia, Dayanand Medical College & Hospital , Ludhiana, India .

Introduction: Intravenous and peri-articular magnesium has been shown to reduce perioperative analgesic consumption. With this background, subcutaneous infiltration was hypothesized to potentiate the subcutaneous infiltration of local anaesthetic agent.

Aim: To comparatively evaluate the efficacy of magnesium sulphate as an adjunct to ropivacaine in local infiltration for postoperative pain following lower segment cesarean section.

Materials And Methods: Sixty parturients undergoing cesarean delivery were randomized to either group A or B in a double blinded manner. After uterine and muscle closure but before skin closure, Group A was administered local subcutaneous wound infiltration of Injection (Inj) ropivacaine 0.75% 150 milligram (mg) or 20 millilitres(ml) whereas, group B patients were given a local subcutaneous wound infiltration of Inj magnesium sulphate 750 mg (1.5 ml of Inj 50% Magnesium sulphate) added to Inj ropivacaine 0.75% (18.5 ml) making a total volume of 20 ml. In postoperative period, Heart rate (HR), Mean Arterial Pressure (MAP), Visual Analogue Score (VAS), supplemental analgesic consumption and timing of each subsequent analgesic was noted for the initial 24 hours.

Results: There was no difference in the timings for the requirement of first Intravenous (IV) rescue analgesic among both the groups (p=0.279). However, the need for 2(nd) and 3(rd) doses of rescue analgesics was significantly later in group B and the difference was statistically significant with p-value of 0.034 and 0.031 respectively. The number of patients who were administered 2(nd), 3(rd) and 4(th) doses of rescue analgesics was significantly greater in group A as compared to group B. None of the patients in group B needed more than 4 doses of rescue analgesia while in group A, 5 patients were administered a rescue analgesic for 5(th) time. The cumulative analgesic requirement in the initial 24 hours was also greater in group A as compared to group B and the difference was statistically significant (p =0.01). The incidence of adverse effects was similar in both the groups.

Conclusion: Subcutaneous infiltration of magnesium along with local anaesthetic prolongs the analgesic efficacy of local anaesthetic and is not associated with any significant adverse effects.
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http://dx.doi.org/10.7860/JCDR/2016/17119.7683DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866222PMC
April 2016

Effect of intrathecal clonidine versus fentanyl on bupivacaine spinal block in transurethral resection of prostate surgeries.

Anesth Essays Res 2016 Jan-Apr;10(1):65-70

Department of Urology and Kidney Transplant, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Aims: Our study aimed at comparing the onset, degree and recovery time of sensory and motor block, the hemodynamic effects and postoperative pain relief using intrathecal bupivacaine alone, bupivacaine along with fentanyl and clonidine.

Materials And Methods: A total of 90 patients, undergoing transurethral resection of prostate (TURP) surgeries under spinal anesthesia were studied. Patients were randomly divided in a double-blind manner into three groups of 30 patients each. Group A (control) patients given subarachnoid block with 0.5% hyperbaric bupivacaine with 0.5 ml of normal saline. Group B patients were given subarachnoid block with 0.5% hyperbaric bupivacaine along with fentanyl 25 μg. Group C patients were given subarachnoid block with 0.5% hyperbaric bupivacaine 10 mg along with clonidine 30 μg and 0.3 ml of normal saline. After administering the subarachnoid block, vitals were recorded before and after surgery. Level of sensory block, the duration of motor block (DOMB), duration of sensory blockade (DOSB), the quality of postoperative analgesia using linear visual analog scale (VAS), and side effects were evaluated.

Results: The time required to attain a maximum height of the block was significantly more in Group B as compared to Groups A and C, which was statistically significant. However, there was no statistically significant difference between Groups A and C. The mean DOSB in Groups A, B, and C were 90.83 ± 9.48 min, 135.33 ± 12.59 min, and 155.17 ± 17.49 min, respectively. The mean DOMB in Groups A, B, and C were 83.83 ± 6.52 min, 115.50 ± 14.70 min and 120.67 ± 11.50, respectively. Time of the first request of analgesia in Groups A, B and C in postoperative period were 132.50 ± 21.53 min, 296.00 ± 50.07 min, and 311.83 ± 65.34 min. patients had. VAS was significantly of higher value in Group A than Groups B and C.

Conclusions: Intrathecal clonidine in a combination of bupivacaine for TURP provides more satisfactory anesthesia and analgesia and has less side effects.
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http://dx.doi.org/10.4103/0259-1162.165513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767068PMC
March 2016

Recent insights in enzymatic synthesis of fructooligosaccharides from inulin.

Int J Biol Macromol 2016 Apr 11;85:565-72. Epub 2016 Jan 11.

Chembiotech Laboratories, Advanced Science and Technology Institute, 5 The Croft, Buntsford Drive, Stoke Heath, Bromsgrove, Worcs B60 4JE, UK.

In the past few years, people are paying more attention to their dietary habits, and functional foods are playing a key role in maintaining the health of man. Prebiotics are considered as a main component of the functional foods which are usually composed of short chains of carbohydrates. Fructooligosaccharides (FOSs) are considered as one of the main group of prebiotics which have recognisable bifidogenic properties. FOSs are obtained either by extraction from various plant materials or by enzymatic synthesis from different substrates. Enzymatically, these can be obtained either from sucrose using fructosyltransferase or from inulin by endoinulinase. Inulin is a potent substrate for the enzymatic production of FOSs. This review article will provide an overview on the inulin as potent substrate, microbial sources of endoinulinases, enzymatic synthesis of FOSs from inulin, commercial status of FOSs, and their future perspectives.
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http://dx.doi.org/10.1016/j.ijbiomac.2016.01.026DOI Listing
April 2016

Fluid Administration Before Caesarean Delivery: Does Type and Timing Matter?

J Clin Diagn Res 2015 Jun 1;9(6):UC01-4. Epub 2015 Jun 1.

Professor, Department of Anesthesia, DMC & H , Ludhiana, India .

Background: The effectiveness of fluid preloading is in doubt, so co-loading has been attempted to reduce the incidence of spinal anaesthesia induced hypotension in caesarean patients.

Aim: To compare crystalloid preloading, colloid preloading and colloid co-loading for prevention of maternal hypotension in caesarean delivery.

Settings And Design: Study conducted in tertiary level hospital on 90 ASA I/II term parturients posted for elective caesarean section. Patients were randomly allocated to three Groups.

Materials And Methods: Group A (n=30) was given 10 ml/kg of 6% hydroxyethyl starch (HES) 20 minutes prior to spinal anaesthesia, Group B (n=30) was given 10 ml/kg of 6% HES by rapid infusion in 10 minutes immediately after spinal anaesthesia and Group C (n=30) was given 10 ml/kg of Ringer's Lactate 20 minutes prior to spinal anaesthesia. Intraoperatively, Heart rate, systolic, diastolic and mean arterial pressure were recorded every five minutes. Episodes of hypotension were recorded and treated with bolus of 5 mg of ephedrine and total amount of ephedrine was noted. Adverse effects, if any were recorded.

Statistical Analysis: ANNOVA for Quantitative Analysis and chi-Square test and Z-test for Qualitative Analysis.

Results: Baseline parameters were similar in all the three Groups. Heart rate decreased from the baseline in all the three Groups, however, mean heart rate was highest in Group C. Heart rate was statistically similar in Groups A and B. MAP decreased in all three Groups from baseline, however, highest fall was recorded in Group C whereas, MAP was statistically similar in Groups A and B. Incidence of hypotension was 66.66% in Group C as compared to 36.66% in Groups A and 40% in Group B respectively. Group C patients received 5.33±4.54 mg of ephedrine as compared to 2.00±2.82 mg in Group A and 2.33±3.14 mg in Group B. Thus, the incidence of hypotension and ephedrine consumption was significantly higher in Group C as compared to Groups A and B whereas, this difference was statistically not significant among Groups A and B.

Conclusion: Colloid preloading and co-loading are equally effective and both are superior to crystalloid preloading for prevention of maternal hypotension in caesarean section patients.
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http://dx.doi.org/10.7860/JCDR/2015/12083.6008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525580PMC
June 2015

Scalloping Sacral Arachnoid Cyst as a Cause of Perianal Pain- A Case Report.

J Orthop Case Rep 2014 Apr-Jun;4(2):28-32

Dept. of Orthospine, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi, India-110060.

Introduction: Scalloping sacral arachnoid cyst though a rare condition, should be suspected in cases of persistent perianal pain without any obvious urological or anorectal pathology. Such difficult cases justify ordering an M.R.I of spine as plain X-Rays and clinical examination may come out to be inconclusive. X-ray in later stages may show changes corresponding to scalloping of bone due pressure effect of cyst on surrounding tissue. Diagnosis may further be confirmed by doing contrast MRI which differentiates arachnoid cyst from other intradural and extradural pathologies. Though anatomically spinal arachnoid cysts are just an out pouching from the spinal meningeal sac or nerve root sheath they may be extradural or intradural in their location, communicating to main C.S.F column through their pedicle or an ostium leading to continuous enlargement in size.

Case Report: A 32 year old female was admitted under our spine unit with 1.5 year history of chronic pain, swelling and reduced sensation in perianal region. On examination she had tenderness and hypoesthesia over lower sacral region. The pain was continuous, dull aching in nature, not related to activity, localized over lower sacrum and perianal area. The neurological examination of her both lower limbs were unremarkable. Anal tone and anal reflex were normal. No sign of inflammation or tenderness was found over coccyx. Since the X-rays were inconclusive an MRI scan was done which showed a cystic lesion in the sacral area extending from S2 to S4 region with mechanical scalloping effect on the surrounding bone. The lesion had same intensity as C.S.F in both T1 &T2 weighted images. The treatment was done by way of surgical decompression with complete excision of cyst and obliteration of space by a posterior midline approach. Presently the patient is 1 year post operative and no sign of recurrence is there.

Conclusion: Sacral arachnoid cysts should be considered as a differential diagnosis of perianal pain. Large symptomatic sacral cysts should be treated early with complete removal of the cyst including the cyst wall, to reduce the chances of recurrence. Complete decompression of the cyst cavity should be aimed at, but careful dissection of neural element is of highest importance.
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http://dx.doi.org/10.13107/jocr.2250-0685.163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719369PMC
June 2016

A comparison of intrathecal dexmedetomidine, clonidine, and fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study.

J Anaesthesiol Clin Pharmacol 2013 Oct;29(4):496-502

Department of Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Background: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. Dexmedetomidine, the highly selective 2 adrenergic agonist is a new neuraxial adjuvant gaining popularity.

Settings And Design: The study was conducted in prospective, double blind manner. It included 120 American Society of Anesthesiology (ASA) class I and II patients undergoing lower limb surgery under spinal anesthesia after approval from hospital ethics committee with written and informed consent of patients.

Materials And Methods: The patients were randomly allocated into four groups (30 patients each). Group BS received 12.5 mg hyperbaric bupivacaine with normal saline, group BF received 12.5 mg bupivacaine with 25 g fentanyl, group BC received 12.5 mg of bupivacaine supplemented 30 g clonidine, and group BD received 12.5 mg bupivacaine plus 5 g dexmedetomidine. The onset time to reach peak sensory and motor level, the regression time of sensory and motor block, hemodynamic changes, and side effects were recorded.

Results: Patients in Group BD had significantly longer sensory and motor block times than patients in Groups BC, BF, and BS with Groups BC and BF having comparable duration of sensory and motor block. The mean time of two segment sensory block regression was 147 ± 21 min in Group BD, 117 ± 22 in Group BC, 119 ± 23 in Group BF, and 102 ± 17 in Group BS (P > 0.0001). The regression time of motor block to reach modified Bromage zero (0) was 275 ± 25, 199 ± 26, 196 ± 27, 161 ± 20 in Group BD, BC, BF, and BS, respectively (P > 0.0001). The onset times to reach T8 dermatome and modified Bromage 3 motor block were not significantly different between the groups. Dexmedetomidine group showed significantly less and delayed requirement of rescue analgesic.

Conclusions: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand of rescue analgesics in 24 h as compared to clonidine, fentanyl, or lone bupivacaine.
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http://dx.doi.org/10.4103/0970-9185.119151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819844PMC
October 2013

Preemptive analgesia with Ketamine for Laparoscopic cholecystectomy.

J Anaesthesiol Clin Pharmacol 2013 Oct;29(4):478-84

Department of Anesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Background: The aim of preemptive analgesia is to reduce central sensitization that arises from noxious inputs across the entire perioperative period. N-methyl d-aspartate receptor antagonists have the potential for attenuating central sensitization and preventing central neuroplasticity.

Materials And Methods: Patients undergoing laparoscopic cholecystectomy were randomized into four groups of 20 patients each, who were administered the study drug intravenously 30 min before incision. Groups A, B, and C received ketamine in a dose of 1.00, 0.75 and 0.50 mg/kg, respectively, whereas group D received isotonic saline. Anesthetic and surgical techniques were standardized. Postoperatively, the degree of pain at rest, movement, and deep breathing using visual analogue scale, time of request for first analgesic, total opioid consumption, and postoperative nausea and vomiting were recorded in postanesthesia care unit for 24 h.

Results: Pain scores were highest in Group D at 0 h. Groups A, B, and C had significantly decreased postoperative pain scores at 0, 0.5, 3, 4, 5, 6, and 12 h. Postoperative analgesic consumption was significantly less in groups A, B, and C as compared with group D. There was no significant difference in the pain scores among groups A, B, and C. Group A had a significantly higher heart rate and blood pressure than groups B and C at 0 and 0.5 h along with 10% incidence of hallucinations.

Conclusion: Preemptive ketamine has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. The lower dose of 0.5 mg/kg being devoid of any adverse effects and hemodynamic changes is an optimal dose for preemptive analgesia in patients undergoing laparoscopic cholecystectomy.
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http://dx.doi.org/10.4103/0970-9185.119141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819841PMC
October 2013

Purification and characterization of peroxidase from papaya (Carica papaya) fruit.

Appl Biochem Biotechnol 2012 May 3;167(2):367-76. Epub 2012 May 3.

Department of Biochemistry, University of Lucknow, Lucknow 226007, UP, India.

Ripening of papaya fruit was found to be characterized with a decrease in peroxidase activity and its transcript. This peroxidase was purified to homogeneity through successive steps of ammonium sulfate fractionation, ion exchange and molecular exclusion chromatography. The peroxidase was purified 30.22-folds with overall recovery of 44.37% and specific activity of 68.59. Purified peroxidase was found to be a heterotrimer of ~240 kDa, containing two subunits each of 85 and one of 70 kDa. Purified enzyme exhibited pH and temperature optima of 7.0 and 40 °C, respectively. K(m) values for substrates o-dianicidin, guaiacol and ascorbic acid were found to be 0.125, 0.8 and 5.2 mM, respectively. K(m) for H(2)O(2) was found to be 0.25 mM. Salicylic acid was found to activate peroxidase up to 50 μM concentration, beyond which it acted as inhibitor. Ca(2+) and Mg(2+) activated peroxidase while sodium azide, SDS, and Triton X-100 were found to inhibit peroxidase.
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http://dx.doi.org/10.1007/s12010-012-9672-1DOI Listing
May 2012

Teaching cardiac electrophysiology modeling to undergraduate students: laboratory exercises and GPU programming for the study of arrhythmias and spiral wave dynamics.

Adv Physiol Educ 2011 Dec;35(4):427-37

Department of Applied Mathematics and Statistics, Stony Brook University, New York, USA.

As part of a 3-wk intersession workshop funded by a National Science Foundation Expeditions in Computing award, 15 undergraduate students from the City University of New York(1) collaborated on a study aimed at characterizing the voltage dynamics and arrhythmogenic behavior of cardiac cells for a broad range of physiologically relevant conditions using an in silico model. The primary goal of the workshop was to cultivate student interest in computational modeling and analysis of complex systems by introducing them through lectures and laboratory activities to current research in cardiac modeling and by engaging them in a hands-on research experience. The success of the workshop lay in the exposure of the students to active researchers and experts in their fields, the use of hands-on activities to communicate important concepts, active engagement of the students in research, and explanations of the significance of results as the students generated them. The workshop content addressed how spiral waves of electrical activity are initiated in the heart and how different parameter values affect the dynamics of these reentrant waves. Spiral waves are clinically associated with tachycardia, when the waves remain stable, and with fibrillation, when the waves exhibit breakup. All in silico experiments were conducted by simulating a mathematical model of cardiac cells on graphics processing units instead of the standard central processing units of desktop computers. This approach decreased the run time for each simulation to almost real time, thereby allowing the students to quickly analyze and characterize the simulated arrhythmias. Results from these simulations, as well as some of the background and methodology taught during the workshop, is presented in this article along with the programming code and the explanations of simulation results in an effort to allow other teachers and students to perform their own demonstrations, simulations, and studies.
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http://dx.doi.org/10.1152/advan.00034.2011DOI Listing
December 2011

Mammalian testis-determining factor SRY and the enigma of inherited human sex reversal: frustrated induced fit in a bent protein-DNA complex.

J Biol Chem 2011 Oct 17;286(42):36787-807. Epub 2011 Aug 17.

Department of Biochemistry, Case Western Reserve University, Cleveland, Ohio 44106, USA.

Mammalian testis-determining factor SRY contains a high mobility group box, a conserved eukaryotic motif of DNA bending. Mutations in SRY cause XY gonadal dysgenesis and somatic sex reversal. Although such mutations usually arise de novo in spermatogenesis, some are inherited and so specify male development in one genetic background (the father) but not another (the daughter). Here, we describe the biophysical properties of a representative inherited mutation, V60L, within the minor wing of the L-shaped domain (box position 5). Although the stability and DNA binding properties of the mutant domain are similar to those of wild type, studies of SRY-induced DNA bending by subnanosecond time-resolved fluorescence resonance energy transfer (FRET) revealed enhanced conformational fluctuations leading to long range variation in bend angle. (1)H NMR studies of the variant protein-DNA complex demonstrated only local perturbations near the mutation site. Because the minor wing of SRY folds on DNA binding, the inherited mutation presumably hinders induced fit. Stopped-flow FRET studies indicated that such frustrated packing leads to accelerated dissociation of the bent complex. Studies of SRY-directed transcriptional regulation in an embryonic gonadal cell line demonstrated partial activation of downstream target Sox9. Our results have demonstrated a nonlocal coupling between DNA-directed protein folding and protein-directed DNA bending. Perturbation of this coupling is associated with a genetic switch poised at the threshold of activity.
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http://dx.doi.org/10.1074/jbc.M111.260091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3196072PMC
October 2011

Functional stability of a hybrid anaerobic digester/microbial fuel cell system treating municipal wastewater.

Bioresour Technol 2011 Jan 7;102(2):842-7. Epub 2010 Sep 7.

Lincoln Ventures Limited, P.O. Box 133, Lincoln University, Lincoln 7640, New Zealand.

A thermophilic anaerobic digester (AD) was combined with a microbial fuel cell (MFC) to evaluate whether either component had increased stability when operated in combination as a hybrid system, perturbed by the addition of acetic acid. The MFC and the anaerobic digester were able to operate effectively together. The MFC was more susceptible to high acetic acid load than the AD. The hybrid system did not have increased resilience compared to the solitary systems in the conditions tested. However, the low pH had a relatively delayed effect on the MFC compared to the AD, allowing the hybrid system to have a more stable energy output. Also, at very low pH, when operating as a hybrid, the AD component was able to recover pH to normal levels when the MFC component failed. These results demonstrate that there are synergies that can be gained from this hybrid system.
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http://dx.doi.org/10.1016/j.biortech.2010.09.002DOI Listing
January 2011

An acetazolamide based multimodal analgesic approach versus conventional pain management in patients undergoing laparoscopic living donor nephrectomy.

Indian J Anaesth 2009 Aug;53(4):434-41

Senior Resident, Department of Anaesthesia & Intensive care, and Department of Transplant Surgery, Post Graduate Institute of Medical Education & Research, Chandigarh, India, 160012.

Summary: Choice of an appropriate anaesthetic technique and adequate pain relief during laparoscopic living donor nephrectomy (LDN) is likely to make the procedure more appealing to kidney donors. Various analgesic regimens proposed to relieve pain after laparoscopic surgery include: opioids, non-opioid analgesics followed by opioids for the breakthrough pain and intra-peritoneal normal saline irrigation and instillation of local anaesthetics at surgical sites. Thorough literature review and medline search did not reveal any study where a combination of orogastric acetazolamide along with intraperitoneal saline irrigation and bupivacaine instillation techniques have been tried in these patients. In a prospective, double blind, randomized trial, eighty healthy adults undergoing LDN under general anaesthesia were enrolled to compare the efficacy of an acetazolamide based multimodal analgesic approach (Group A) with conventional pain management (Group B). Donors' demographics, intra-operative variables, early allograft function and recovery characteristics were evaluated for 72 hours. The primary end points were postoperative pain intensity on a visual analog scale and the incidence of shoulder tip pain (STP). The secondary end points included the latency of the rescue analgesia request rate, total analgesic consumption and patient satisfaction. Consistently lower mean pain scores were observed in Group A (p<0.03 for visceral pain). Frequency as well as the total dose of rescue analgesics administered was significantly less in Group A (p=0.001). Twelve patients (30.7%) in Group B complained of STP compared to three (7.5%) in Group A (p=0.025). Shoulder pain also presented earlier (8 hours versus 12 hours) and persisted for longer period in Group B (72 hours versus 48 hours, p 0.025). To conclude, a multimodal analgesic approach consisting a combination of orogastric acetazolamide, intraperito-neal saline irrigation and use of bupivacaine in the operated renal fossa, pfannenstiel incision and laparoscopic port sites provide significant reduction in postoperative pain after LDN.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894495PMC
August 2009