Browsing by Author "Anitha, S"
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Item The effect of magnesium sulfate as an adjuvant to 0.5% bupivacaine on motor and sensory supraclavicular brachial plexus blockade.(2015-03) Rao, Lella Nageswara; Jeyalakshmi, V; Nagaraju, M; Anitha, SBackground: Magnesium is a physiologic cation that blocks neuromuscular transmission and does not allow the nerve to be stimulated. This study investigates the effect of adding magnesium sulfate to 0.5% bupivacaine to extend the duration of sensory and motor blocks of the supraclavicular brachial plexus in orthopedic surgeries of the upper extremities. Methods: This controlled randomized double-blind study was performed on patients who were candidates for orthopedic surgery of the upper extremities. A total of 60 patients between 18 and 60 years with ASA Class 1 or 2 participated in the study. One Group M received 0.5% bupivacaine (1.5 mg/kg) with magnesium sulfate 20% (3 ml) as the case group, while the second Group P received 0.5% bupivacaine (1.5 mg/kg) with normal saline (3 ml) as a placebo to block the supraclavicular brachial plexus using nerve locator. The duration of the sensory and motor block of the supraclavicular brachial plexus was monitored and evaluated using the pinprick and modifi ed Bromage scale. Results: A total of 60 patients were included in the study with 30 patients having received 0.5% bupivacaine plus magnesium and the other 30 patients having received 0.5% bupivacaine plus normal saline. The mean sensory block duration in the case Group M was 249±9.36 and in control Group P was 160±5.62 (p<0.39). The mean motor block duration in the case Group M was 232±9.64 and in control Group P was 147±26.52 (both p<0.32). The mean onset of sensory block in case Group M was 15.5±2.16 and the onset block in control Group P was 12.73±1.18 (p<0.49; statistically not signifi cant). The mean onset of motor block in case Group M was 23.5±1.1 and the onset block in control Group P was 41±3 (p<0.53; statistically not signifi cant). Conclusions: The addition of magnesium sulfate to 0.5% bupivacaine increased the duration of motor and sensory supraclavicular brachial block in the upper extremities during surgeries when compared to the use of 0.5% bupivacaine alone, though statistically not signifi cant, but defi nitely in clinically signifi cant proportions.Item Homology Modelling and Docking Studies of Plant Derived Natural Compounds on Staphylococcus Aureus.(2014-10) Anitha, SStaphylococcus aureus avoid innate immune responses including phagocytosis is crucial for the organism to cause infection. This process involves several secreted and cell-surface-associated proteins. In this study I identified the action of plant compounds on Iron regulated surface protein using docking studies with homology modeled Surface protein. Through the modeled protein, the flexible Docking study was performed with plant derived compounds with theoretically predicted active sites. The results indicated that amino acid CYS-88, TYR-112 and LEU-113 present in Iron regulated surface protein are core important for binding activities and these residues are having strong hydrogen bond interactions with compounds. I have investigated the plant derived compounds like vannillic interactions and scoring parameters in GOLD, and the GOLD score results are interesting. Our results may be helpful for further investigations in both in vivo and in vitro conditions.Item Pharmacokinetics of lamivudine & stavudine in generic fixed-dose combinations in HIV-1 infected adults in India.(2009-10) Kumar, A K Hemanth; Ramachandran, Geetha; Rajasekaran, S; Padmapriyadarsini, C; Narendran, G; Anitha, S; Subramanyam, Sudha; Kumaraswami, V; Swaminathan, SoumyaBackground & objectives: Antiretroviral drug concentrations are important determinants of clinical response to a drug accounting for both toxicity and efficacy. Several factors such as age, ethnicity, body weight and patients’ immune status may influence antiretroviral drug concentrations. The aim of the study was to determine the influence of immunological status, sex and body mass index on the steady state pharmacokinetics of lamivudine (3TC) and stavudine (d4T) in HIV-infected adults, who were undergoing treatment with generic fixed dose combinations (FDC) of these drugs in India. Methods: Twenty seven HIV-1 infected patients receiving antiretroviral treatment (ART) for at least two weeks at the Government ART clinic at Tambaram, Chennai, took part in the study. Serial blood samples were collected predosing and at different time points after drug administration. Plasma 3TC and d4T levels were estimated by HPLC. Results: The patients’ immune status, sex or body mass index had no impact on the pharmacokinetics of 3TC. In the case of d4T, peak concentration was significantly lower in patients with CD4 cell counts < 200 cells/μl than those with ≥ 200 cells/ μl (P < 0.05), but were within the therapeutic range. The mean CD4 cell counts increased from 101 cells/μl at initiation of ART to 366 cells/μl at 12 months of treatment. Interpretation & conclusions: Blood levels of 3TC and d4T drugs that are part of generic FDCs commonly used by HIV-infected individuals in India were within the therapeutic range and not influenced by nutritional or immune status. There was a significant improvement in CD4 cell counts over 12 months of treatment. Indian generic FDCs manufactured and used widely in the developing world provide effective concentrations of antiretroviral drugs.Item Prevalence of ESBL producing enterobacteriaceae in diabetic foot ulcers(Educational Society for Excellence, 2017) Anitha, S; Natarajan, VIntroduction: Diabetic foot ulcer is one of the dreaded complications among the diabetic patients which are disabling, leading to repeated hospitalizations and even amputation, drastically reducing the quality of life. Hence proper management of diabetic foot infections by choosing appropriate antibiotic is crucial. The aim of the study: This study was undertaken to know about the prevalence of ESBL producing Enterobacteriaceae in Diabetic foot ulcers and their antibiotic sensitivity pattern to aid in the effective treatment of infection. Materials and methods: A total of 200 Pus samples were collected from the patients admitted and/ or attending in-patient or out-patient departments of Rajah Muthiah Medical College and Hospital. Only Enterobacteriaceae were isolated and antibiotic sensitivity testing was done according to CLSI guidelines. All the isolates were screened for ESBL and confirmed by phenotypic confirmatory tests. Results: A total of 60 Enterobacteriaceae were isolated from diabetic foot ulcer patients among which 27 (45%) isolates were ESBL producers. ESBL production is predominantly seen in E.coli (48.1%) followed by Klebsiella (44.4%), P. mirabilis (3.3%) and P. vulgaris (3.3%). ESBL producers were sensitive to Imipenam (88.9%), Amikacin (77.8%) and Gentamicin (55.6%) whereas highly resistant to Ampicillin, Amoxyclav, Cefuroxime and Ceftriaxone. Conclusion: This study shows the higher prevalence of ESBL producing Enterobacteriaceae in diabetic foot ulcers. Imipenam, Amikacin and Gentamicin can be used for empirical treatment but early identification and treatment according to antibiotic sensitivity pattern helps in preventing the emergence and propagation of multidrug resistance strains.Item Urine levels of rifampicin & isoniazid in asymptomatic HIV-positive individuals.(2007-06-21) Ramachandran, Geetha; Hemanth Kumar, A K; Sarala, K; Padmapriyadarsini, C; Anitha, S; Tharani, C B; Kumaraswami, V; Swaminathan, SoumyaBACKGROUND & OBJECTIVE: AIDS and its associated gastrointestinal complications may impair the absorption of anti-tuberculosis (TB) drugs. Impaired absorption of anti-TB drugs could lead to low drug exposure, which might contribute to acquired drug resistance and reduced effectiveness of anti-TB treatment. The aim of this study was to obtain information on the status of absorption of rifampicin (RMP) and isoniazid (INH) in asymptomatic HIV- positive individuals, who are less immunocompromised. The D-xylose absorption test was also carried out to assess the absorptive capacity of intestive. METHODS: The absorption of RMP, INH and D-xylose was studied in 15 asymptomatic HIV-positive individuals with CD4 cell counts>350 cells/mm3 and 16 healthy volunteers, after oral administration of single doses of RMP (450 mg), INH (300 mg) and D-xylose (5 g). Urine was collected up to 8 h after drug administration. Percentage dose of the drugs and their metabolites and D-xylose excreted in urine were calculated. RESULTS: A significant reduction in the urinary excretion of INH and D-xylose in HIV-positive persons compared to healthy volunteers was observed. The per cent dose of RMP and its metabolite, desacetyl RMP was also lower in HIV-positive persons compared to healthy volunteers, but this difference was not statistically significant. INTERPRETATION & CONCLUSION: Decreased urinary excretion of D-xylose and INH are suggestive of intestinal malabsorption in HIV-positive individuals. HIV infection could cause malabsorption of anti-TB drugs even at an early stage of the disease. The clinical implications of these findings need to be confirmed in larger studies.