Anaesthetic management of a pregnant woman with uncorrected tetralogy of fallot for caesarean section

Tetralogy of fallot (TOF) is the most commonly encountered congenital cyanotic heart disease in pregnant females and maternal mortality approaches 10% in unrepaired TOF. General anesthesia is classically considered the technique of choice for incidental surgery in TOF and neuraxial anesthesia is considered relatively contraindicated. However, general anesthesia for caesarean section can increase maternal morbidity. Author report a case of caesarean section performed under epidural anesthesia in patient with uncorrected TOF

Formulation and Evaluation of Transdermal Topical Gel of Ibuprofen

The present research work is based on the formulation and evaluation of topical gel of Ibuprofen where Carbopol 940 is used as the polymer. Gels were prepared by dispersing the polymers  in a mixture of water and glycerol with methyl paraben as the preservative and the varying amount of ibuprofen, being kept under magnetic stirring until the homogeneous dispersion was formed. The dispersion was then neutralized and made viscous by the addition of triethanolamine. The Carbopol gels of Ibuprofen were found to be homogenous with good drug loading. The pH of all the gel formulations was found within the neutral pH range which is compatible with skin. And the viscosity of the formulations was found to be feasible for topical drug delivery. The drug content of the three formulations was found in the range of 87.56% to 90.45% which shows efficient drug loading. Results of In vitro drug release study showed that F5 formulation has better diffusion of drug through egg membrane and hence further permeation studies were carried out through rat epidermis. The compatibility study showed that the major peaks in FTIR spectra of the pure drug were found to be intact in their physical mixture. Hence there is no interaction between drug and Carbopol in their physical mixture. Carbopol can be effectively used as the polymer for topical gel preparation. And F5 formulation containing 0.5 % w/w Carbopol 940 may be effectively used as topical transdermal delivery for Ibuprofen. Keywords: Ibuprofen, Transdermal Gel, Drug release, Compatibility stud

Pore modification of deca-dodecasil-rhombohedral zeolite membrane by carbon loading from in situ decomposition of 1-adamantanamine for improved gas separation

A simple method of pore modification coupled with the removal of surface defects of a deca-dodecasil-rhombohedral (DDR) zeolite membrane has been developed via carbon (C) deposition. Carbon deposition was achieved by controlled decomposition of the structure-directing agent (SDA), 1-adamantanamine (1-ADA), into the membrane pore surface. Membranes that were synthesized with and without pore modification were characterized by thermal analysis, X-ray diffraction analysis, infrared spectroscopy, transmission electron microscopy, and Raman spectroscopy. Finally, the performance of the membranes was evaluated by permeance studies. The non-wetting characteristics of C had imparted hydrophobicity to the membrane pores, leading to enhanced permeability of the gas mixture. Modified membranes were shown to offer a relatively high hydrogen permeance of 13.47 x 10(-7) mol m(-2) s(-1) Pa-1. The selectivity of H-2/CO2 was 4.9 based on single gas permeation and the separation factor increased to 8.5 for a H-2-CO2 gas mixture at room temperature. In the light of these findings, the current technique is proposed to be useful for making a defect-free C-loaded membrane in a single step with high separation selectivity and permeability in tandem. This is the novelty that was achieved

Silent uterine rupture in second trimester: a differential diagnosis to remember

Spontaneous silent uterine rupture is a life-threatening emergency situation requiring immediate laparotomy. High index of suspicion is key to prevent maternal mortality as at times the presentation can be nonspecific. Authors herein present a case of spontaneous silent uterine rupture during second trimester of pregnancy wherein the diagnosis was initially missed. To the best of authors knowledge, only a few cases with spontaneous fundal second trimester uterine rupture have been recorded so far

A study of nutritional assessment of newly diagnosed tuberculosis patients in a tertiary care hospital of Tripura, India

Background: Tuberculosis kills more than any infection in India. TB is a serious public health problem in India. Tuberculosis causes immense morbidity. The mortality rate of this disease is also very high. Tuberculosis causes a great distress to the patients. To control this infection is a challenge to the health care facility of India. A lot of steps are being taken at various levels to end this disease. Still a huge number of patients are dying everyday from these deadly diseases. Out of so many recognised risk factors, malnutrition is considered to be as one of the most important among them. The immunity of a malnourished patient is suppressed. When the patient’s immunity is ineffective, the conversion of latent tuberculosis to diseases happens. Malnutrition invites tuberculosis and tuberculosis again causes morbidity, so there is a complex relation between this two. Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world.Methods: In this cross sectional hospital based study involving 400 newly diagnosed Tuberculosis cases were taken. Their nutritional status was measured by BMI.Results: It was found that 66% of the study population is having malnutrition (BMI <18.5kg/m2). Malnutrition was more in females (71%). Mean BMI is 17.9Kg/m2. Mean height of the population is 1.53 meters.Conclusions: Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world. This study has demonstrated that half of newly diagnosed adult TB patients were malnourished at the time of starting treatment, with more than a quarter having moderate to severe malnutrition

Long-term impacts of integrated nutrient management with equivalent nutrient doses to mineral fertilization on soil organic carbon sequestration in a sub-tropical Alfisol of India

Limited evidence is available on carbon sequestration potential of long-term integrated nutrient management (INM) versus mineral fertilization, when equivalent amounts of nutrients were added. Hence, this study was carried out to understand the impact of 60 years of INM with adjusted nutrient doses and mineral fertilization in an Alfisol in a maize (Zea maysL.)-wheat (Triticum aestivumL.) system on soil organic carbon (SOC) sequestration in surface (0-30 cm) and deep (30-60 cm) soil layers. Conventional tillage was done twice before sowing of both maize and wheat using a spade. In farmyard manure (FYM) and lime treated plots (FYMP'K'L: plots with nitrogen (N) applied in terms of FYM; additional dose of phosphorus (P) and potassium (K) and lime) total SOC concentration was nearly 83% higher than unfertilized control plots. The FYMP'K'L plots had similar to 11% more total SOC concentration than plots treated with mineral fertilizer and lime (NPKL: recommended dose of N, P, K and lime) in the 0-30 cm soil layer. Labile C, including KMnO4-C, was more in plots with FYM than NPKL plots, whereas the recalcitrant C stock was more in NPKL than FYM treated plots. In the 0-60 cm soil layer, the labile C stock was highest in FYMP'K'L plots, but the recalcitrant C stock was highest in NPKL. Total SOC accumulation rate (over unfertilized control plots) was highest for FYMP'K'L plots (0.38 Mg ha(-1 )year(-1)) in the surface soil layer, whereas SOC sequestration rate was highest in NPKL plots (0.18 Mg ha(-1 )year(-1)) in the deep layer and in the 0-60 cm layer. Overall, although NPKL management practice had the highest C sequestration in the 0-60 cm layer, FYMP'K'L had the best CMI and labile C pools. Thus, resource poor farmers need not to use full doses of NPK and FYM for soil C management in the region

Role of oxidative stress, gut microbiota and derived metabolites in the etiology and progression of nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease or NAFLD is a complex and multifactorial liver disease that is affecting a majority of the world’s population now more than ever. The review focuses on two major contributing factors in the etiology of the disease – oxidative stress and the gut microbiota. There is a complex interplay between oxidative stress and the gut microbiota in the pathogenesis of NAFLD. Oxidative stress in NAFLD can result from both the accumulation of lipids in the liver and the interactions between gut-derived metabolites and the liver. Dysbiosis in the gut microbiota can contribute to oxidative stress by promoting the production of reactive oxygen species and altering the balance of antioxidant systems. This interplay between oxidative stress and the gut microbiota can create a vicious cycle, where dysbiosis contributes to oxidative stress, and oxidative stress further promotes dysbiosis, exacerbating liver damage in NAFLD. Understanding the intricate relationship between oxidative stress, the gut microbiota, and NAFLD is essential for developing targeted therapeutic strategies. In this context, more scientific research is required to unravel the complex and interconnecting pathways underlying NAFLD pathogenesis and progression. Modulating the gut microbiota through dietary interventions, prebiotics, probiotics, and change in lifestyle may help restore microbial balance and reduce oxidative stress in NAFLD