Study Objective: Intravenous (IV) midazolam is widely used for sedation during brief medical procedures. Existing literature indicates concern for potential excessive sedation or respiratory compromise when midazolam is administered to individuals concurrently taking CYP3A4 enzyme inhibiting medications. The aim of this study was to evaluate the safety of moderate sedation with IV midazolam during outpatient endoscopic procedures in patients taking concurrent CYP3A4 inhibitors.

Two generations of terrestrial plants were exposed to non-lethal levels of lithium chloride (LiCl) and the mRNA transcript abundance of the matured and seeding plants were analyzed using next generational sequencing. Arabidopsis thaliana plants received 0 or 0.05mM LiCl for their F0 and F1 generations with cumulative Li exposures of 1.80 to 3.2mg Li kg-1 dry weight soil. Gene and gene isoform changes relative to the controls were obtained for LiCl-treated and control plants in the F0 and F1 generations. Sublethal effects in the F0 and F1 plants exposed to LiCl were a decrease in photosynthetic genes and a significant increase in up-regulatedstress and defense genes that were associated with water stress or dehydration. Gene isoforms changes were mainly observed with lower abundance genes that were up-regulated. They included genes for calciumand calmodulin binding: ACA2, ACA8, CEN2, and CP1. In general, chronic Li+ exposure produced down-regulation of several ATP-binding and photosynthesis related gene isoforms of: ACA1, ACA4, ADK1, BAM1, EPR1, ER,FLS2, HSL1, HST, PGM, and SEP1. No phenotypic or seed viability differences occurred other than yellowing of leaves in the LiCl-treated plants near the end of the life cycle.

The benefits or detriments of caffeine on the human cardiovascular system have not been thoroughly studied and are still poorly understood. In a world where caffeinated beverages are evidently the adult drug of choice (e.g. coffee, energy drinks, soda, tea) investigating its effects on our bodies is of great importance. In this study we examined the effects of caffeine, taken as a tablet, on pressure-flow autoregulation. Young adults between 18 and 21 years of age were the experimental subjects. They were instrumented to monitor systemic arterial blood pressure, peripheral blood flow, calculated peripheral vascular resistance, and the electrocardiogram during an autoregulatory maneuver in the absence and presence of caffeine. Caffeine-mediated vasoconstriction was observed as early as 15 minutes after its consumption. Sixty minutes post-caffeine, vasoconstriction was so prominent that autoregulation was abolished. This was reflected, in part, as a significant reduction in blood flow that accompanied a 3-fold increase in calculated peripheral resistance and a significant increase in systemic arterial pressure. Heart rate was unaffected by caffeine under our experimental conditions. We conclude that caffeine has the ability to inhibit significant cardiovascular properties including pressure-flow autoregulation. Even though more work is needed, the significant caffeine-mediated changes in flow, pressure and resistance during autoregulation could have serious consequences for the cardiovascular system specifically, and for one’s overall health in general.

Coagulopathy is an important, common systemic clinical syndrome caused by snake envenoming in the world. The reference ranges, so far, used in the Veterinary Teaching Hospital (VTH) for clinical evaluation of dogs with coagulation abnormalities were from western countries which not the ideal is considering the geographical differences. Therefore, in this study have been established reference intervals for coagulation tests (PT, aPTT, CT, and BT) for dogs in Sri Lanka. Selection of dogs for suitable blood samples was done during January to June in 2012. Apparently healthy dogs that were brought to VTH for routine medical attention, routine general check-up, vaccination, and routine elective surgical interventions i.e. ovariohysterectomy or castration, were used for this purpose. First, a general clinical examination was performed on each selected dog and those who qualified were blood sampled for laboratory tests namely, Full Blood Count (FBC), Total Protein (TP), Albumin (Alb), Fibrinogen, Alanine aminotransferase (ALT), and Aspartate aminotransferase (AST). The blood samples from these 45 dogs were used to establish reference ranges for PT, aPTT, CT and BT. At the end of the period, 45 dogs were selected which were clinically healthy, with normal FBC and liver function test values. The reference intervals obtained using dogs for PT, aPTT, CT and BT were 7-11 seconds, 11- 22 seconds, 3 -12.5 minutes and 0.5-5 minutes, respectively. These values are of extreme importance in order to treat, manage and monitor snake envenomed dogs better.