Many of the drugs currently used in medical practice are mixtures of enantiomers (racemates). Many a times, the two enantiomers differ in their pharmacokinetic and pharmacodynamic properties. Replacing existing racemates with single isomers has resulted in improved safety and/or efficacy profile of various racemates. In this review, pharmacokinetic and pharmacodynamic implications of chirality are discussed in brief, followed by an overview of some important chiral switches that have yielded safer alternatives. These include levosalbutamol, S-ketamine, levobupivacaine, S-zopiclone, levocetirizine, S-amlodipine, S-atenolol, S-metoprolol, S-omeprazole, S-pantoprazole and R-ondansetron. Few potential chiral switches under evaluation and some chiral switches that have not been successful are also discussed.

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BACKGROUND: Some studies indicate unsafe injection practices, which are associated with the transmission of blood-borne pathogens, exist extensively, in the developing countries. AIMS: To investigate the status of injection services, knowledge and attitude of health workers with regard to injection practices at all levels of the health facilities in Jingzhou district of China; and to provide useful scientific data in order to formulate a feasible, standard measure on injection safety. SETTINGS: Four district health care facilities, 6 township health centers, 14 village clinics and 14 community health stations. DESIGN : A retrospective cross-sectional study. MATERIALS AND METHODS: By examining the medical records in 2004, observing injection practices and interviewing health workers, the quantitative and qualitative data were collected and analyzed. RESULTS: Out of 1,452 medical records sampled, 1,450 patients had received at least one injection in the period of hospitalization, with an injection rate of about 100% and an average of 10.9 injections per patient. The most frequent injected drug was antibiotic (48%, 7,674/15,857). The prescriptions of 5,655 outpatients were detected, with an injection rate of 52% (2,962). The field observation found that the proportion of unsafe injections was 16% (28/175) and that of unnecessary injections was 57% (99/175). Among 118 professional employees interviewed, those who knew that human immunodeficiency virus, hepatitis C virus and hepatitis B virus might be transmitted by the contaminated syringes and needles accounted for 95% (112), 59% (70) and 89% (105) respectively. CONCLUSIONS: Among the medical facilities of Jingzhou district, the injection rate was very high and the quality of injection practices should be further improved.

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BACKGROUND: Depression is considered as one of the main psychological disorders associated with infertility. Depression may play a significant role in the life of infertile individuals, their infertility treatment follow-up and in their hopefulness for the future; it may also influence the intensity and continuousness of the mutual relationship of the affected couple. AIMS: This study was done to determine the depression rate and make a comparison between infertile and fertile couples with respect to the same. SETTING AND DESIGN: The depression rate was evaluated between two groups - infertile couples (case group) and fertile couples (control group). MATERIALS AND METHODS: Ninety-one infertile couples (cases) and 9l fertile ones (controls) were randomly enrolled in our study. Beck depression inventory (BDI) and demographic information were provided. STATISTICAL ANALYSIS: We used Chi-square, t-test; and one-way Analysis of Variance (ANOVA) was performed to find out significant difference between infertility duration in various couples and its effect on the score of depression. RESULTS: The BDI mean difference between infertile and fertile couples was significant (P=0.015). It was significantly more among couples with infertility from 1-3 years' duration compared to those with infertility of 1-year duration or less. CONCLUSION: Regarding the high rate of depression among infertile couples, it seems necessary to pay more attention to infertility centers that offer psychological and psychiatric services.

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We describe two newborn infants with aortic arch obstructive malformations who became anuric after initiation of captopril. Since angiotensin converting enzyme inhibitors can alter renal blood flow by reduction in angiotensin II and blocking autoregulation phenomenon, it is important to use them with great caution in neonates with aortic arch obstructive malformations, while monitoring their renal function closely.

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[FULL TEXT]  [PDF]  [PubMed]

[FULL TEXT]  [PDF]  [PubMed]