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The present study characterized complete mitochondrial genome of Blue-spotted maskray, Neotrygon indica and studied the evolutionary relationship of the species within the Dasyatidae family. The total length of the mitogenome was 17,974 bp including 37 genes and a non-coding control region. The average frequency of nucleotides in protein-coding genes was A: 29.1 %, T: 30.2 %, G: 13.0 % and C: 27.7 % with AT content of 59.3 %. The values of AT and GC skewness were -0.018 and -0.338, respectively. Comparative analyses showed a large number of average synonymous substitutions per synonymous site (Ks) in gene NADH4 (5.07) followed by NADH5 (4.72). High values of average number of non-synonymous substitutions per non-synonymous site (Ka) were observed in genes ATPase8 (0.54) and NADH2 (0.44). Genes NADH4L and NADH2 showed high interspecific genetic distance values of 0.224 ± 0.001 and 0.213 ± 0.002, respectively. Heat map analysis showed variation in codon usage among different species of the Dasyatidae family. The phylogenetic tree showed a sister relationship between the Dasyatinae and the Neotrygoninae subfamilies. Neotrygon indica formed as a sister species to the clade consisting of N. varidens and N. orientalis. Based on the present results, Neotrygon indica could have diverged from the common ancestor of the two latter in the Plio-Pleistocene. The present study showed distinct characteristics of N. indica from its congeners through comparative mitogenomics.

Present work is focused mainly on recovering maximum amount of soluble pentose and hexose sugars separately, direct from the kans grass (lignocellulosic biomass) by a novel fractional hydrolysis process (pretreatment + hydrolysis + detoxification) with minimum toxic products generation. Effect of biomass loading and preheating time on the fractional hydrolysis process was studied along with various strategies up to 30% H2SO4 (v/v) to reduce the number of stages for acid use minimisation. 84.88% of total reducing sugar present in the kans grass biomass was extracted as separate pentose and hexose sugar fractions with negligible toxics. Zymomonas mobilis and Scheffersomyces shehatae were used during co-culture fermentation; 92.13% of the sugar present in xylose-rich fraction (initial sugar: 21.87 g/L) and 96.32% of glucose-rich fraction (initial sugar: 40.32 g/L) were utilised to produce 25.0 g/L ethanol from the kans grass biomass hydrolysate; thereby achieving 78.6% of the maximum theoretical ethanol production with an average yield of 0.435.

Neurotrophic factors like Brain-Derived Neurotrophic Factor (BDNF), Neurotrophin 3 (NT3) and Nerve Growth Factor (NGF), play a role in neuroplasticity and neurogenesis contributing to the pathogenesis of schizophrenia. The objective of the present study was to investigate and compare the effect of olanzapine and lurasidone on the change in serum neurotrophins in patients with schizophrenia. The present study was a randomized, open-label, active-controlled, parallel design clinical trial. After randomization baseline evaluations of serum BDNF, NGF, NT3, Positive and Negative Syndrome Scale (PANSS) scoring, Social and Occupational Functioning Assessment Scale (SOFAS) scoring of 101 unmedicated schizophrenia patients were done. Patients were reassessed after 6 weeks of monotherapy with olanzapine or lurasidone. Serum BDNF increased after treatment with both the drug groups but rise with olanzapine was found to be significantly higher (916.22; 95 %CI: 866.07 to 966.37; p 0.001) in comparison to lurasidone. Increase in levels NGF and NT3 was also observed but there was no significant difference between the groups (NGF: 2.32; CI: 3.54 to -3.53; p = 0.57 and NT3: 0.99; CI: 2.11 to 0.14; p = 0.086). The difference in improvement in PANSS and SOFASS with both the drugs was not statistically significant. Both the drugs alleviate the symptoms of schizophrenia but olanzapine was better tolerated. Our findings suggest that increase in serum BDNF with olanzapine monotherapy is significantly higher than that with lurasidone but there is no significant difference in change in serum NGF and NT3. TRIAL REGISTRATION: ClinicalTrials.gov identifier: (NCT03304457).

Second generation (2G) ethanol production is facing major research challenges primarily because of an absence of suitable technology for the extraction of maximum fermentable sugars from complex lignocellulosic structure as well as unavailability of suitable fermentation technique and single microorganism to convert these sugars (pentose and hexose) efficiently into ethanol. Present study is focused on the exploration of various lignocellulosic feedstocks using different inorganic acids for the recovery of maximum amount of fermentable sugars as separate fractions, direct from the biomass by a novel process called “fractional hydrolysis” with minimum toxics generation. Different physical and chemical parameters were optimised for the process previously. Four different inorganic acids (HCl, H3PO4, HNO3, and H2SO4) up to 30% concentration (v/v) were used in 7- and 8-stage fractional hydrolysis processes to treat dry biomass in a fractional hydrolysis column. Using kans grass biomass, H2SO4 resulted in maximum extraction of pentose and hexose sugars separately with negligible toxics. Furthermore, the technique was explored using three different wide and easily available lignocellulosic feedstocks, resulting in saccharification (%): Kans grass 84.88; Sugarcane bagasse 82.55; Wheat straw: 81.66. Hydrolysate fractions without any detoxification were taken into a co-culture system containing Zymomonas mobilis (for glucose fermentation) and Candida shehatae (for xylose fermentation) at bioreactor level. 93.28% of the sugar present in xylose-rich fraction (initial total reducing sugar: 59.74 g/L) and 95.44% of glucose-rich fraction (initial total reducing sugar: 100.25 g/L) were utilised to produce 67.28 g/L ethanol from the kans grass biomass hydrolysate; thereby achieving 82.45% of the maximum theoretical ethanol production.

The role of sodium benzoate, an NMDA receptor enhancer, in schizophrenia has been evaluated in a few clinical trials, but results are contradictory and inconclusive. The present meta-analysis has evaluated the efficacy and safety of add-on sodium benzoate for the treatment of schizophrenia.After performing a literature search on MEDLINE/PubMed, Scopus, Cochrane databases and International Clinical Trial Registry Platform, reviewers assessed eligibility and extracted data from four relevant articles. PRISMA guidelines were followed in the selection, analysis, and reporting of findings. The random-effect model was used to estimate effect size. Quality assessment was done using the risk of bias assessment tool, and sensitivity analysis was done in case of high heterogeneity.Add-on sodium benzoate can improve positive symptoms of schizophrenia significantly (MD: -1.87; 95%CI: -3.25 to -0.48; p = 0.008) but had no significant favourable effect on negative symptoms (p = 0.84), general psychopathology (p = 0.49), and total PANSS score (p = 0.19) over the control. There was no significant improvement in GAF (p = 0.43), CGI (p = 0.58), cognitive function (p = 0.46) and quality of life (p = 0.73). Extrapyramidal symptoms were significantly higher (MD: 0.39; 95% CI:0.19-0.60; p = 0.0002) in the sodium benzoate group in comparison to the control group; however, there was no significant difference in respect to other adverse events.Sodium benzoate can improve the positive symptoms of schizophrenia without any beneficial effect on other symptomatology, cognition, quality of life and functioning. Further studies are needed to evaluate long-term efficacy, safety and use in specific subgroups of patients.

Neuron-specific enolase (NSE) is the most investigated biomarker in the context of epilepsy and brain damage. The present study was conducted to investigate the change in serum NSE in patients with focal seizure and the effect of carbamazepine and oxcarbazepine on serum NSE. The present study is a randomized, open-label, parallel design clinical trial (ClinicalTrials.gov Identifier: NCT02705768) conducted on 60 patients of focal seizure. After recruitment, detailed history, clinical evaluations including Chalfont-National Hospital seizure severity scale (NHS3), Quality of Life in Epilepsy Inventory (QOLIE-31) and serum NSE estimation were done at baseline. Thirty healthy volunteers were recruited for a baseline evaluation of serum NSE. After randomization, one group received tablet oxcarbazepine and another group received tablet carbamazepine. At 4 weeks follow-up, all the parameter were reassessed. Serum NSE level was found to be significantly increased in patients with focal seizure in comparison to healthy volunteers. In both drug groups, serum NSE decreased significantly but the reduction in carbamazepine group (1.43; 95%CI: 0.18-2.67; p=0.025) was significantly higher than oxcarbazepine group.NHS3 score, score in all seven domains of QOLIE-31 and final QOLIE-31 score improved significantly in both the groups. In conclusion, serum NSE increases in the patients with focal seizure within 48h of a seizure episode. Therapy with carbamazepine and oxcarbazepine can decrease serum NSE level but the reduction is significantly higher with carbamazepine. Therapy with both the drugs can decrease the severity of epilepsy and improve the quality of life but adverse events were more with carbamazepine.

In the present work exchange bias in Mn rich Ni-Mn-Al film has been studied. The film has been deposited by cosputtering from the targets of Ni, Mn and Al. It exhibits an antiferromagnetic B2 phase at room temperature. At low temperature, magnetization versus temperature (M-T) measurement shows a bifurcation among ZFC and FC curves. Hysteresis (M-H) loops measurements reveal the occurrence of exchange bias phenomenon at low temperature. Large HEB of 2.2 kOe for 20 kOe cooling field has been observed. There occurs a field induced ordering at temperature ~50 K reflected as coinciding ZFC (zero-field cooled) and FC (field-cooled) curves at large magnetic field. AC susceptibility measurement indicates the occurrence of cluster glass behaviour at low temperature. The exchange constant obtained from the best fit to the experimental data was found to be Ji ≈ −2 meV. The negative interface exchange constant indicates AFM coupling occurs among the coexisting phases. Exchange bias phenomenon may be associated to the coexistence of antiferromagnetic and ferromagnetic like ordering at low temperature. Cooling field dependence of HEB and coercive field HC indicate that an increase in anisotropy and growth of ferromagnetic clusters occurs at high magnetic field.

The effect of Habrobracon hebetor venom and the role of the adipokinetic hormone (AKH) in poisoned adult females of the firebug Pyrrhocoris apterus were studied 24 and 48h after treatments. Venom application elicited total neuromuscular paralysis in firebugs, but the co-application of venom and Pyrap-AKH significantly reduced paralysis (up to 3.2 times) compared to the application of venom only. Although the mechanisms of their action are unknown, both agents might affect neuromuscular junctions. Venom application significantly increased the expression of both P. apterus Akh genes (Pyrap-Akh 5.4 times and Peram-Cah-II 3.6 times), as well as the level of AKHs in the central nervous system (2.5 times) and haemolymph (3.0 times). In the haemolymph, increased AKH levels might have led to the mobilization of stored lipids, which increased 1.9 times, while the level of free carbohydrates remained unchanged. Total metabolism, monitored by carbon dioxide production, significantly declined in paralysed P. apterus individuals (1.4 times and 1.9 times, 24 and 48h after the treatment, respectively), probably because of a malfunction of the muscular system. The results suggest an active role of AKH in the defence mechanism against the stress elicited by neuromuscular paralysis, and the possible involvement of this hormone in neuronal/neuromuscular signalling.

Hindu women though constitutes almost 38% of the total Indian population has been critically affected by the denial of ownership in agricultural property. Hindu Succession Act, 1956 (HSA, 1956) was passed with the object of permitting daughters to inherit equally with the son and granting absolute rights to females in property but had placed a huge bar with respect to agricultural property. Agricultural property was exempted from the application of HSA, 1956 till 2005 under sub-section 4(2). The statutory omission of sub-section 4(2) of HSA, 1956 has created confusion as legislature has not expressly provided or confirms the application of HSA, 1956 to agricultural property. This paper deals with the effect of omission of sub-section 4(2) on the rights of women in agricultural property.

Dichlorvos is an organophosphate pesticide widely used in agriculture and industry for controlling insect pests. Indiscriminate and widespread use of this pesticide may result in impending toxicity to environment and human health. Dichlorvos has been banned in some countries and marked as a restricted pesticide in several other countries including India. The current review presents a chronological abridgement of dichlorvos pesticide as well as the research performed in the last three decades on biosensors for the detection and monitoring of dichlorvos, particularly in food, environment and agriculture. This review describes the progressive development of biosensors to detect dichlorvos pesticide from the use of conventional immobilizing supports to more advanced hybrid/composite nanomaterials. Furthermore, we summarize the development of biosensors by enzyme inhibition methods, wherein the enzymes acetylcholinesterase (AChE), tyrosinase etc., are immobilized on the transducer either by traditional immobilization methods or employing advanced nanomaterials for better integration.

A single step method (spray drying) was explored for the synthesis of nano silica- Saccharomyces cerevisiae bio-hybrid material (cells@SiO2) with the objective to create new technological solutions for water remediation. Synthesized bio-hybrid was characterized using techniques like SEM, BET, TGA and FTIR. Further, bio-hybrid was applied as sorbent for the removal of mercury (II) and showed rapid removal, with more than 98 ± 2 % of total uptake in 30 min. The maximum sorption capacity (qmax) of Hg (II) at pH 6.5 and temperature 298 K was 185.19 mg g−1. The kinetic data of adsorption of Hg (II) are best described by a pseudo-second-order kinetic model. Thermodynamic parameters obtained from this study reveal an endothermic and spontaneous adsorption process. Present study suggests that bio-hybrid of nano silica-S. cerevisiae cells are useful for the efficient removal of mercury from liquid waste.

Dependence on fossil fuels such as oil, coal and natural gas are on alarming increase, thereby causing such resources to be in a depletion mode and a novel sustainable approach for bioenergy production are in demand. Successful implementation of zero waste discharge policy is one such way to attain a sustainable development of bioenergy. Zero waste discharge can be induced only through the conversion of organic wastes into bioenergy. Waste management is pivotal and considering its importance of minimizing the issue and menace of wastes, conversion strategy of organic waste is effectively recommended. Present review is concentrated on providing a keen view on the potential organic waste sources and the way in which the bioenergy is produced through efficient conversion processes. Biogas, bioethanol, biocoal, biohydrogen and biodiesel are the principal renewable energy sources. Different types of organic wastes used for bioenergy generation and its sources, anaerobic digestion-biogas production and its related process affecting parameters including fermentation, photosynthetic process and novel nano-inspired techniques are discussed. Bioenergy production from organic waste is associated with mitigation of lump waste generation and its dumping into land, specifically reducing all hazards and negativities in all sectors during waste disposal. A sustainable bioenergy sector with upgraded security for fuels, tackles the challenging climatic change problem also. Thus, intensification of organic waste conversion strategies to bioenergy, specially, biogas and biohydrogen production is elaborated and analyzed in the present article. Predominantly, persistent drawbacks of the existing organic waste conversion methods have been noted, providing consideration to economic, environmental and social development.

For efficient utilization of immobilized invertase enzyme, a novel bio-hybrid support comprising silica nanoparticles and Ocimum basilicum seed was synthesized. Ocimum basilicum seeds provide a natural fibrouspellicular structure which acts as template for assembly of silica nanoparticles. Bio-hybrids of two different morphologies have been obtained by changing the physico-chemical conditions of the assembly process. Developed bio-hybrids were characterized through small angle X-ray scattering (SAXS), scanning electron microscopy (SEM), Synchrotron radiation based X-ray micro-computed tomography (SRμCT), Brunauer-Emmett-Teller (BET) and Fourier transform infrared spectroscopy (FTIR). Incorporation of the nanoparticles results to a fourfold increase in the available surface area of the seeds which is one of the important criteria for an immobilizing support. Synthesized bio-hybrids were used for the immobilization of commercially applicable invertase enzyme and efficient loading of enzyme was realized. Enzyme immobilized bio-hybrids could be easily separated out and reused up to eight times with 82 % retention of enzyme activity. Present work suggests that the unique features of the bio-hybrid make it suitable candidate for immobilization of enzymes in general.

In the present work thin films of off-stoichiometric Ni–Mn–Al thin films have been successfully deposited on Si substrates. The films have been deposited by DC/RF magnetron sputtering by co-sputtering of the targets of Ni, Mn and Al. The films have been studied for their structural and magnetic properties. Nanoindentation has also been done for film hardness and resistant to crack properties. It has been observed that Martensitic transformation occurs in the film exhibiting large thickness (1.5 μm). All the films exhibit exchange bias at low temperature with the exchange bias field depending strongly on the thickness of the film. ac susceptibility result shows the existence of spin glass state at low temperature. The exchange bias appearing in the sample may be associated with the interface containing spin glass SG/FM phase. The appearance of exchange bias in all the samples shows that in Ni–Mn–Al system, exchange bias is independent of the occurrence of martensitic transition in the system. The existence of mixed phase (L2 1 and B2) is an intrinsic property of Ni–Mn–Al system and the formation of L2 1 phase can be controlled by using different deposition and annealing parameters. In this respect, exchange bias properties of Ni–Mn–Al may be tuned by controlling the formation of ferromagnetic L2 1 phase. Nanoindentation results reveal that the film exhibits high hardness (H) ~ 21 GPa and is resistant to scratch.

An assembled microstructure of silica nanoparticles and Streptococcus lactis (S. lactis) cells has been synthesized by evaporation induced self assembly, with the objective of its application in bioremediation. Different morphologies have been realized by tuning the physico-chemical conditions of the assembly process. The potential of these microstructures in removal of uranium (VI) has been evaluated. Morphology dependent uptake has been demonstrated and maximum uptake was seen for the spray dried doughnut shaped microstructure (SDSM). For a fixed morphology, the variation in uptake varies with solution pH, contact time, temperature and initial uranium (VI) concentration. The U (VI) removal was significantly rapid, with more than 85 ± 2% of total uptake in 10 min. The maximum sorption capacity (qmax) of U (VI) at pH 5.0 and temperature 298 K was 169.5 mg/g using SDSM as sorbent. The kinetic data of adsorption of U (VI) are best described by a pseudo-second-order kinetic model. Calculated thermodynamic parameters reveal an endothermic and a spontaneous adsorption process. The present work opens up the possibility of a means for the functionalization of silica microstructures through the incorporation of micro-organism and the potential for the use of these functionalized materials for bioremediation.

Summary A new class of systematically designed ultrasmall (tri- to heptamer) peptides presents the smallest natural, non-aromatic structures that self-assemble in water to hydrogels. The peptide motif consists of an aliphatic amino acid tail of decreasing hydrophobicity capped by a polar head. The fibrous scaffolds assemble from nanostructured aggregates to condensed three-dimensional (3D) meshes, entrapping up to 99.9% water and resembling collagen fibers in the extracellular matrix. The resulting hydrogels are biocompatible, heat resistant up to 90 °C and demonstrate tunable, high mechanical strength. Given their facile and cost-effective synthesis, these new materials would be attractive for applications ranging from injectable medical therapies to tissue-engineered scaffolds.

The Indian Succession Act 1925 (ISA 1925) is based on common law principles and driven only by the principle of consanguinity; it does not provide for adoptive relationships or grant rights to illegitimate children thereby denying inheritance rights to both adopted and illegitimate children. The Juvenile Justice (Care and Protection of Children) Act 2000 (JJ Act 2000) was passed with the object of providing for proper care, protection and treatment of juveniles in conflict with the law and children in need of care and protection with the ultimate aim of their rehabilitation. Adoption, as one of many other modes of rehabilitation under the JJ Act 2000, and as affirmed by the Supreme Court in the Shabnam Hashmi case, reflect legislative and judicial support for making adoption a secular act and independent of the religion of the person adopting. Though the JJ Act 2000 grants the right to all Indian citizens, including Christians and Muslims, to adopt and confers the same rights as biological children have on the adopted child, it lacks clarity as to the application of succession law with respect to adopted children receiving inheritance rights in property. The question remains open as to the applicability of the ISA 1925 in respect of devolution of inheritance rights on children adopted by Christian parents under the JJ Act 2000 particularly when ISA 1925, which regulates the Christian law of succession, denies inheritance rights to an adopted child.

This article investigates judicial developments in the Indian law of succession whereby laws have recently been interpreted by the courts to grant more property rights to Indian women. Tribal women who had been denied inheritance rights under their customary laws have been judicially granted rights in their favour. Also, the applicability of coparcenary claims by Hindu daughters, granted under the Hindu Succession (Amendment) Act, 2005 (IND), has now been finally settled by the Supreme Court of India. Applying legal maxims for recognising the right of a Hindu widow to claim partition of her deceased husband’s share in coparcenary property, in the absence of a definite statutory right, is another judicial development; while the interpretation of Hanafi law to grant inheritance rights to a sister in the presence of daughters of the deceased shows a judicial approach of uplifting the position of women even under uncodified Muslim personal law. At the same time, however, restricting the right of a Hindu daughter to claim her coparcenary right only after a certain date, when no such limitation has been fixed for a male coparcener; and the courts’ affirmation of granting preferential rights to agnates over cognates under Hindu inheritance law, appear to promote gender inequality without any justification. More than a decade after the passing of the Constitution, the courts continue to adopt a cautious approach when considering the constitutional validity of personal laws. With the increase in social integration, economic independence and reform movements, there needs to be a further call for the improvement of the woman’s position in Indian society with respect to equal property rights.

Expression of many disease-related aggregation-prone proteins results in cytotoxicity and the formation of large intracellular inclusion bodies. To gain insight into the role of inclusions in pathology and the in situ structure of protein aggregates inside cells, we employ advanced cryo-electron tomography methods to analyze the structure of inclusions formed by polyglutamine (polyQ)-expanded huntingtin exon 1 within their intact cellular context. In primary mouse neurons and immortalized human cells, polyQ inclusions consist of amyloid-like fibrils that interact with cellular endomembranes, particularly of the endoplasmic reticulum (ER). Interactions with these fibrils lead to membrane deformation, the local impairment of ER organization, and profound alterations in ER membrane dynamics at the inclusion periphery. These results suggest that aberrant interactions between fibrils and endomembranes contribute to the deleterious cellular effects of protein aggregation. VIDEO ABSTRACT.

Women’s economic status and social security is influenced by their ownership and control over immovable property. Contemporary Indian society has refused to give up traditional ideologies and perpetuates the age-old pattern of ownership of material assets. Despite some progressive interpretations and statutory law, justice with respect to property has not progressed in a linear trajectory for Indian women, particularly Hindu women. This article examines the scheme of succession for Hindu males and females, its wider implications, the policy of non-interference by the courts, the recommendations of the Law Commission of India and the National Commission for Women and makes suggestions for removing the disparity between Hindu males and females in respect to devolution of property.

Christian constitute the third major population in India after Hindu and Muslim but still has been not able to act as influential group either socially or politically to draw sufficient attention of the Legislature to their problems in personal law particularly in field of succession. Majority of Christians are governed by the Indian Succession Act, 1925 (ISA, 1925) in matters of succession. The ISA, 1925 guided by patriarchal mindset allows unfairness to women in intestate succession. The irony is that the law framed more than one and a half century ago discriminating women in succession rights continues even today. The share of Christian widow fluctuates with the presence or absence of lineal descendants, she gets rights over entire property only in absence of distant kindred of the deceased husband extending up to great great uncle or great uncle’s son, widowed daughter-in-law has no right in her father-in-laws property. Mother has been relegated to lower position as she inherits only in absence of father and even when she inherits she gets rights with the deceased’s brother and sister. There appears no justifiable reason to continue with such provisions which do not give equal rights to women. The present study deals with the drawbacks in the ISA, 1925 with respect to inheritance rights of Christian women, the transition of law for granting her such rights with the reports of Law Commission of India and the proposed amendments in the existing legal framework to ensure them such rights based on principle of rationality and fairness.

The effect of heparin binding-epidermal growth factor (HB-EGF) on the in-vitro development of hamster 8-cell embryos was investigated. Supplementation of HB-EGF to culture medium accelerated zona escape of blastocysts (63 +/- 9% compared with 33 +/- 9% after 36 h; P0.05). Complete zona escape of blastocysts persisted even after 48 h (61 +/- 11% versus 30 +/- 4%) and 60 h (75 +/- 6% versus 42 +/- 8%). Addition of anti-HB-EGF antibody drastically reduced the percentage of zona escaped-blastocysts (30.0 +/- 5.0% versus 92.3 +/- 2.8%; P0.05). Interestingly, a significant increase in the area of trophoblast outgrowth occurred in the presence of HB-EGF (116 x 10(3) +/- 8 x 10(3) microm(2) versus 74 x 10(3) +/- 8 x 10(3) microm(2) at 48 h; P0.05). This, however, was not due to an increased number of trophectodermal cells in HB-EGF-treated blastocysts. Immunoreactive HB-EGF was localized in blastocysts and uterine sections, visible by intense immunostaining in the luminal epithelium, particularly on the apical surface. Moreover, the expression of HB-EGF in the uterus was maximum on day 4 of pregnancy, coinciding with the timing of zona escape and implantation. The receptor of HB-EGF, viz. EGF receptor was also detected in blastocysts and the luminal epithelium of day 4 pregnant uterus. These results show that HB-EGF improves blastocyst hatching and trophoblast outgrowth in hamsters.

Background Various cardiac electrophysiologic effects have been attributed to erythromycin. During the course of treating a pneumonia patient with IV erythromycin, the conversion of atrial fibrillation to a sinus rhythm, and its subsequent reversal, appeared to be causally related to the introduction and cessation of this antibiotic. Objective This observation suggested the need for studying the changes in the ECG following the use of IV erythromycin in a typical clinical setting. Design A prospective comparative drug study. Setting A university-affiliated teaching hospital. Patients Nineteen patients being treated for uncomplicated community-acquired pneumonia. Intervention IV erythromycin, 500 mg, and/or IV cefuroxime, 750 mg, infused in 250 mL of saline over 20 min. In the 11 patients who were receiving both of the antibiotics, cefuroxime was administered immediately before erythromycin was infused. Measurements The 12-lead ECG measurements were obtained before infusion, at 5-min intervals during each infusion, and at 5 and 10 min after the infusions had been completed. All of the ECG complexes and intervals were measured using a software program (Interpretive Cardiograph; Hewlett Packard; Palo Alto, CA). Results The administration of IV erythromycin increased heart rate and prolonged the corrected QT (QTc) interval. These changes were significant at 15 min of the infusion, and were no longer evident 5 min after the infusion had been stopped. The administration of IV cefuroxime did not produce any ECG changes. Conclusions A single, standard dose of IV erythromycin prolongs the QTc interval; therefore, the drug should always be administered as a slow infusion. ECG monitoring should accompany erythromycin therapy in critically ill patients, in patients with electrolyte disorders, or in patients taking other drugs with similar cardiac effects.

Sleep-related hallucinations (hypnagogic and hypnopompic) are transient and occur in normal individuals. Rarely, they are prominent and distressing and are associated with diverse conditions including narcolepsy. We report a case of prominent hypnopompic auditory hallucinations — which gradually became continuous and distressing with characteristics of schizophrenia-like hallucinations — that responded to a low dose of olanzapine.