Instability of digoxin in acid medium using a nonisotopic method.

A selective nonisotopic assay was used to investigate the digoxin hydrolysis rates at 37 +/- 0.1 degrees over the pH 1.1--2.2 range. The colorimetric method adopted is based on the use of a xanthydrol reagent after extraction with chloroform. The spectrofluorometric method specified in the dissolution test for digoxin tablets was nonspecific because of digoxigenin interference. Digoxin hydrolysis followed specific acid hydrolysis, and K values of the apparent first-order reaction varied from 0.0357 to 0.0027 min-1 over the pH range used. The effect of the dissolution medium on digoxin stability during the dissolution tests of the tablets also was studied. Water (the BP medium) and 0.6% HCl (the USP medium) were compared using the fluorometric method and the xanthydrol method. In the USP medium (pH 1.3), no hydrolysis was revealed by the fluorometric estimation whereas the xanthydrol method showed about 74% hydrolysis. In water, the two methods revealed no hydrolysis. The extent of hydrolysis after 1 hr in the USP medium was studied using three brands of digoxin tablets of differing dissolution characteristics. The fast dissolving brand showed relatively more hydrolysis than the slow dissolving tablets.     

Admiral Lord Nelson's death: known and unknown--a historical review of the anatomy

STUDY DESIGN: Reviewing documents about Lord Admiral Nelson's wound inflicted at the Battle of Trafalgar and studying the collected data in connection with ballistics and human anatomy. OBJECTIVES: Attempting to find out the actual cause of death of Lord Nelson as soon as 4 h postinjury by a musket ball. SETTING: United Kingdom. METHODS: (1) Review of the original report of Mr W Beatty, Lord Nelson's surgeon, on his examination of His Lordship's wound. (2) Investigating the course of the musket ball in connection with an atlas of human anatomy. (3) Investigating the course of the musket ball on a cadaver by RP (one of the authors). (4) Reviewing modern medical literature. RESULTS: The report of Mr Beatty suggested that division of a large branch of the pulmonary artery was the cause of Lord Nelson's early death. Assuming the left pulmonary artery was injured, anatomical studies based on atlases and dissection on a cadaver failed to support a simple straight-line course of the musket ball that could have divided the artery and damage the spinal cord on its path forward. CONCLUSION: The question remains open as to how the musket ball following a relatively straight-line trajectory by entering the body at the acromion, could have divided the left pulmonary artery and damaged the spinal cord later in its course. The mechanism needs further investigation.     

Bioactive compounds,antioxidant potential,and hepatoprotective activity of sea cucumber (Holothuria atra) against thioacetamide intoxication in rats

ObjectiveThe identification of the active phenolic compounds in the mixed extract of sea cucumber (Holothuria atra) body wall by high-performance liquid chromatography and an assessment of its hepatoprotective activity against thioacetamide-induced liver fibrosis in rats.MethodsFemale Swiss albino rats were divided into four groups: normal controls; oral administration of a sea cucumber mixed extract (14.4 mg/kg of body weight) on days 2, 4, and 6 weekly for 8 consecutive weeks; intoxication with thioacetamide (200 mg/kg of body weight, intraperitoneally) on days 2 and 6 weekly for 8 wk; and oral administration of a sea cucumber extract and then intoxication with thioacetamide 2 h later for 8 wk.ResultsHigh-performance liquid chromatographic analysis of the sea cucumber mixed extract revealed the presence of some phenolic components, such as chlorogenic acid, pyrogallol, rutin, coumaric acid, catechin, and ascorbic acid. In vitro studies have shown that the extract has a high scavenging activity for the nitric oxide radical, a moderate iron-chelating activity, and a weak inhibitory effect of lipid peroxidation. The subchronic oral administration of sea cucumber extract to the rats did not show any toxic side effects but increased hepatic superoxide dismutase and glutathione peroxidase activities. The coadministration of sea cucumber extract and thioacetamide (protection modality) normalized serum direct bilirubin, alanine and aspartate aminotransferases, hepatic malondialdehyde, and hydroxyproline concentrations and antioxidant enzyme activities. In addition, the histologic examination of liver sections from the protection group that were stained with hematoxylin and eosin showed substantial attenuation of the degenerative cellular changes and regressions in liver fibrosis and necrosis induced by the thioacetamide intoxication.ConclusionSea cucumber mixed extract contains physiologically active phenolic compounds with antioxidant activity, which afforded a potential hepatoprotective activity against thioacetamide-induced liver injury in a rat model.     

The effectiveness of vitamin "E" in the treatment of oral mucositis in children receiving chemotherapy

The aim of this study was to study the effect of vitamin "E" in the treatment of oral mucositis. 80 patients with oral mucositis were randomly distributed into 2 groups: group A, topically applied vitamin "E" and group B, vitamin "E" was given systemically. The 2 groups were evaluated for 5 days. Results showed that in group A grades of oral mucositis improved significantly, while in group B no significant improvement was noticed. It is concluded that topical application of 100 mg vitamin "E" twice daily is an effective measure for the treatment of chemotherapy-induced oral mucositis.     

Mother-daughter genetic relationship in central obesity

Central obesity is an important predictor of all-cause mortality. Children of obese parents bear a greater risk to develop obesity themselves.

Diagnosis of pancreatic tumors by endoscopic ultrasonography

Pancreatic tumors are highly diverse, as they can be solid or cystic, and benign or malignant. Since their imaging features overlap considerably, it is often difficult to characterize these tumors. In addition, small pancreatic tumors, especially those less than 2 cm in diameter, are difficult to detect and diagnose. For characterizing pancreatic tumors and detecting small pancreatic tumors, endoscopic ultrasonography (EUS) is the most sensitive of the imaging procedures currently available. This technique also provides good results in terms of the preoperative staging of pancreatic tumors. EUS-guided fine needle aspiration (EUS-FNA) has also proved to be a safe and useful method for tissue sampling of pancreatic tumors. Despite these advantages, however, it is still difficult to differentiate between benign and malignant, solid or cystic pancreatic tumors, malignant neoplasms, and chronic pancreatitis using EUS, even when EUS-FNA is performed. Recently, contrast-enhanced EUS with Doppler mode (CE-EUS) employing ultrasound contrast agents, which indicate vascularization in pancreatic lesions, has been found to be useful in the differential diagnosis of pancreatic tumors, especially small pancreatic tumors. However, Doppler ultrasonography with contrast-enhancement has several limitations, including blooming artifacts, poor spatial resolution, and low sensitivity to slow flow. Consequently, an echoendoscope was developed recently that has a broad-band transducer and an imaging mode that was designed specifically for contrast-enhanced harmonic EUS (CEH-EUS) with a second-generation ultrasound contrast agent. The CEH-EUS technique is expected to improve the differential diagnosis of pancreatic disease in the future. This review describes the EUS appearances of common solid and cystic pancreatic masses, the diagnostic accuracy of EUS-FNA, and the relative efficacies and advantages of CE-EUS and CEH-EUS along with their relative advantages and their complementary roles in clinical practice.