Search results

Clozapine is often considered the gold standard for the treatment of schizophrenia. Clinical guidelines suggest a gradual titration over 2 weeks to reduce the risks of adverse events such as seizures, hypotension, agranulocytosis, and myocarditis. The slow titration often delays time to therapeutic response. This raises the question of whether, in some patients, it may be safe to use a more rapid clozapine titration. The following case illustrates the potential risks associated with the use of multiple antipsychotics and rapid cloza-pine titration. We present the case of a young man with schizophrenia who developed life threatening neuroleptic malignant syndrome (NMS) during rapid clozapine titration and treatment with multiple antipsychotics. We were unable to find another case in the literature of NMS associated with rapid clozapine titration. This case is meant to urge clinicians to carefully evaluate the risks and benefits of rapid clozapine titration, and to encourage researchers to further evaluate the safety of rapid clozapine titration. Rapid clozapine titration has implications for decreasing health care costs associated with prolonged hospitalizations, and decreasing the emotional suffering associated with uncontrolled symptoms of psychosis. Clozapine is considered the most effective antipsychotic available thus efforts should focus on developing strategies that would allow for safest and most efficient use of clozapine to encourage its utilization for treatment resistance schizophrenia.

This audit was conducted on acute psychiatric in‐patient wards with the aim of establishing if valproate prescribing in acute mania followed evidence‐based guidelines with particular emphasis on formulations used and whether accelerated valproate dosing was employed.

Case notes from 43 (42 percent male) patients admitted with mania and subsequently discharged on valproate were reviewed. Valproate formulation, weight measurement (necessary for dose‐calculation in accelerated dosing), initial valproate dose and increments, serum valproate monitoring and other prescribed psychotropic agents were noted.

Most (95 percent) patients received sodium valproate (epilim chrono/generic), the remaining received valproate semi‐sodium (depakote). All but one patient received antipsychotic medication in combination. Weight was recorded in only four (9 percent) patients. The mean valproate daily dose after the first week was 1,027 mg (sd=408). It took 29 (sd=42) days to reach the maximum daily dose (1,426 mg sd=467) from valproate initiation. Serum levels were monitored in 34 (79 percent) cases, but the mean period between valproate initiation to the first serum level test was 38 (sd=47) days. A significant positive correlation was found between days taken to reach maximum dose and hospital stay (Spearman's rho=0.41, n=43, p=0.006, two‐tailed).

Accelerated valproate dosing was not common practice, which may have resulted in suboptimal efficacy, probably leading to combination treatment.

This study highlights the need for adequate initial dosing and dose increments when treating manic patients and suggests current practice is not evidence‐based. Local prescribing policy and national guidelines' influence on practice are discussed.

The purpose of this paper is to examine whether it is possible to switch patients from heroin or methadone to buprenorphine without needing to experience symptoms of withdrawal?

Review of author’s experience in 1980s where three patients transferred to 4 mg buprenorphine from 40 ml (1mg/ml) methadone without symptoms of withdrawal. Review of literature where patients were transferred to buprenorphine without waiting for withdrawal symptoms to occur. Presentation of six case histories in author’s clinic.

Provided the buprenorphine is commenced at a very low dosage, is gradually increased and the heroin/methadone is reduced over a period of time, it is possible to change from heroin or methadone without inducing withdrawal symptoms. It is not necessary to stop the heroin/methadone and wait for withdrawal symptoms to occur.

Due to the author’s retirement in October 2015 further research into the production of a template which could be used universally has not yet been possible.

Transferring patients from heroin and methadone to buprenorphine has often been difficult. Waiting for withdrawal symptoms to occur has often resulted in treatment failure. The method described eliminates the problem for patients.

Patients find the method is more acceptable and allows normal functioning.

Confirmation that the findings of the original case histories from 1980s were valid. The value to the treatment service should be considerable in simplifying the prescribing practice.

The present study seeks to evaluate the role of village bamboo management in the rural landscape of North East India in global climate change mitigation.

A set of 100 home gardens and 40 bamboo groves were selected from Irongmara and Dargakona village, in Cachar district, Assam, North East India through random sampling. Sampling was done mostly for smallholders. Culm growth, carbon storage, carbon sequestration and carbon in litter floor mass and soil of bamboo growing areas in homegarden was explored from 2003‐2007.

Culm growth extension revealed the brief periodicity of culm growth in a single growth period. Of the total carbon storage soil contributed 84.6 per cent of the total (50.1 Mg ha⁻¹) followed by carbon in above ground vegetation 15 per cent (9 Mg ha⁻¹) and carbon in litter floor mass 0.4 per cent (0.2 Mg ha⁻¹).

Bamboo plantation development and its management in home gardens has social, ecological and economical benefits for the rural life in North East India and its promotion can become an effective choice for climate change mitigation strategy.

Bamboo forms an important component in the traditional home garden system of North East India where the practice of bamboo cultivation and management provides an important sink for CO₂. Village bamboos play an important role in local economics, societies and environments and, considering its potential to mitigate global climate change, the authors recommend the promotion of bamboo in agroforestry expanding practices and rehabilitation of degraded lands. Management of village bamboos in rural landscape is highlighted in context to environmental sustainability and as a sink measure under the Clean Development Mechanism (CDM) of Kyoto Protocol.

The principles of acidity and basicity measurement are explained by describing colour‐indicator titration of aqueous solutions. Similar methods are used to determine neutralisation values of non‐aqueous solutions such as petroleum products, although electrometric titration is more suitable for dark‐coloured oils and used oils. The practical importance of neutralisation value tests is discussed, with particular reference to additive oils, turbine oils, gear lubricants and transformer oils.

Combination of ASTM D 855‐56 and cationic titration methods to evolve a very rapid and precise method for the analysis of petroleum sulfonates with respect to molecular weight and sulfonate content. Active ingredient as R·SO3Na where R is a naphthenic aromatic nucleus having one side chain).

This paper seeks to apply an improved electrometric method using polarized electrodes to quantify iodine in 241 salt samples pertaining to 15 different brands procured from the local market.Design/methodology/approach – Comparative evaluation of the method is made with the iodometric titration and the colorimetric methods.

The results obtained reveal that the electrometric method excels in attaining higher level of accuracy, precision and lower detection limit, backed by ease of operation.

The method warrants reproducible results both for replicate synthetic and market samples, with a lower detection limit of about 0.1ppm within an acceptable limit of error.

The study shows significant difference between the estimated and labelled iodine values in various brands of iodized salts. Most of the salt samples analysed contain iodine levels far exceeding the WHO permitted limit. The method has the potential of application for in‐situ iodine measurement in iodine fortified salts to ensure rapid quality control, both at the retailer and production levels.

The present situation in the industry demands reliable and rapid methods of material control, from the raw materials to the final product. New methods and techniques are constantly being introduced to fulfil this requirement; it is essential, particularly for the routine analyst, to choose a method of control which is both precise and rapid. It is the purpose of this paper to investigate some of the methods applicable to the determination of the sulphonate content of the oil soluble petroleum sulphonates. These are believed to consist of the mono sulphonic derivative of hydrocarbons of an approximate formula CnH2n‐13SO3H, containing an aromatic naphthenic nucleus with a long side chain. A brief outline of the manufacture and use of the petroleum sulphonates will be given, together with a brief survey of some of the analytical methods available for their determination; this will be developed to include an investigation of the precision and comparison of two of these methods.

This Society, originally known as “The National Pure Food Association,” has been reconstituted under the above title. The objects of the Society are to assist as far as possible in checking the widespread evils of food adulteration, for this purpose to bring about a public realisation of the admittedly serious character of food frauds, and, under expert advice, to co‐operate with constituted authority in effecting their repression. The policy of the Society is directed by a representative Council, and, the Society being thus established on an authoritative basis, cannot fail to become a powerful and valuable organisation if adequately and generously supported by the public. The governing body of the Society is constituted as follows:—

After reviewing the literature upon the subject, the author observes :—It is apparent that the determination of sulphur dioxide in most foods, in the amounts in which it is usually present as a preservative, does not present any special difficulties. When simple titration methods, either direct or after distillation, cannot be applied, distillation into bromine, iodine, or hydrogen peroxide solution, followed by gravimetric determination as barium sulphate, will always give accurate results, provided that certain precautions are taken. The most important points are (i) to ensure that the whole of the sulphur dioxide has been separated from combination with aldehydes, sugars, etc., and has been driven over into the distillate, (ii) to prevent oxidation of sulphur dioxide during distillation, and (iii) to correct the results for volatile sulphur compounds oxidized to sulphuric acid in the distillate.