General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

Patient attitudes to intensive care and life-sustaining technology

We used a validated questionnaire to explore the views of patients regarding receiving intensive care and life-sustaining technology. Data was obtained from 38 patients. A score was obtained for ‘general attitude towards use of lifesustaining/prolonging technology’ that varied from 18.9 to 48.5 out of 52, the higher score reflecting a more positive attitude. There was no significant difference between men and women or correlation with age or ASA score. A score for ‘personal desire for life support’ was also obtained, ranging from zero to a maximum possible score of eight, which reflected the most positive view. The median score was 0.5. Women had a significantly lower median score of zero vs 1.5 for men (p=0.022). There was no significant correlation with age or ASA score. There was considerable heterogeneity of views regarding the use of life-sustaining technology. In this study, women were less likely to want intensive medical treatment than men

Molecular cloning and characterization of a cold-induced gene encoding DRE-binding transcription factor from cold-arid adapted ecotype of <i>Lepidium latifolium</i> L.</span></span>

26-32The dehydration-responsive element binding (DREB) transcription factors binds to dehydration responsive element (DRE)/C-repeat (CRT) cis-element, induces a set of abiotic stress-related genes and imparts stress endurance to plants. In the present study, a DREB1 like gene, designated as LlDREB1A, was isolated from highly cold adapted ecotype of Lepidium latifolium L. Its full-length cDNA (JN561592) sequence (925 bp) consisted of a 642 bp ORF, encoding a protein of 213 aa with deduced mol mass of 23.98 kDa and a theoretical pI of 4.81. LlDREB1A protein consisted of a typical AP2 domain, DREB1 type nuclear localization signal (NLS), C-terminal acidic domain and other signature sequences. Phylogenetic analysis suggested that it is genetically divergent from both monocot as well as dicot plants. Semi quantitative RT-PCR analysis revealed that this gene is up-regulated in response to cold stress but remained unchanged in response to either salt or drought stress. Further, functional validation of LlDRE1A gene may help its deployment in crop plants using genetic engineering approach for development of cultivars tolerant to abiotic stresses. </span

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Not AvailableA set of 100 inbred lines comprising of 50 normal and 50 quality protein maize (QPM) were analyzed for carotenoids composition such as total carotenoids, β-carotene, β-cryptoxanthin and zeaxanthin. Seven QPM HKI-3-4-8-6, HKI 34(1+2)-1, HKI 164-4(1-3), NP-06-07R-76-8, NP-06-07R-80-6, LQPM-42 and LQPM-40 and 9 normal lines (DML-288, DML-2, DML-112, DML-309, DML-45, BAJIM-08-27, BAJIM-13-1, HKI 1105 and HKI 1155) were found to possess significantly higher carotenoids as compared to the check (DMRQPM 103). Kernel colour intensity and total carotenoid contents showed highly significant positive correlation (r = 0.491 * *), whereas no significant correlation was observed between kernel colour and β-carotene (r = 0.014). Based on the carotenoids studied, a set of 16 lines HKI-3-4-8-6, HKI 34(1+2)-1, HKI 164-4(1-3), NP-06-07R-76-8, NP-06-07R-80-6, LQPM-42, LQPM-40, DML- 288, DML-2, DML-112, DML-309, DML-45, BAJIM-08-27, BAJIM-13-1, HKI 1105 and HKI 1155 was identified as promising lines which can effectively be utilized in the future breeding programmes towards the development of nutritionally improved maize (Zea mays L.).Not Availabl