Evaluation of effectiveness of intermittent inhalational entonox in comparison with opioid tramadol for labour analgesia

Background: Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation. Entonox, opioids as well as epidural analgesia are effective means for pain relief in labour, notwithstanding their shortcomings. The objectives of study are to compare the effectiveness of intermittent inhalational Entonox for labour analgesia with intramuscular opioid (Tramadol) and to compare the effects of Entonox and Tramadol as labour analgesia on the maternal and fetal outcome of labour.Methods: The study was a prospective randomized, comparative study of two established techniques of labour analgesia. The study was carried out in 100 subjects. These subjects are divided into two groups. Group A - Tramadol Group: 50 women in active labour who received 100 mg tramadol intramuscularly with repeat dose of 50mg tramadol 4 hourly. Group B - Entonox Group: 50 women in active labour who received entonox for labour analgesia.Results: The mean VAS (visual analogue score) i.e. the pain score in group I (Tramadol) was 4.58±1.54 and Group II (Entonox) was 4.02±1.99 which is significantly low when compared to Group I (Tramadol) p<0.001. Study also showed that both the analgesics Entonox as well as Tramadol does not cause any significant change when compared for duration of labor. The rate of instrumental assisted vaginal deliveries and normal vaginal deliveries were almost equal in both the groups. In our study, the mean overall satisfaction level of the parturients in group II (Entonox) at 1 hr post delivery was (5.06±1.42) and 24 hr post delivery was (6.64±1.66) which was more when compared with tramadol group. The difference was statistically significant (p value was <0.001). This indicates that overall satisfaction level of the parturients is more with the use of Entonox when compared with Tramadol.Conclusions: Therefore, it is concluded that intermittent inhalational Entonox provides better labour analgesia then intramuscular opioid Tramadol

Biological control potential of North West Himalayan strains of heterorhabditid nematodes against the turnip moth, Agrotis segetum (Denis & Schiffermuller) (Lepidoptera: Noctuidae)

Himachal Pradesh is a northern state of India and is situated to the southern of the mighty Himalaya. The agro-climatic conditions are conducive for the production of off-season vegetables. Biological control by entomopathogenic nematodes (EPNs) is one of the alternatives to manage the turnip moth, Agrotis segetum (Denis & Schiffermuller) (Lepidoptera: Noctuidae). The present study was, therefore, undertaken with the objective to assess the virulence of local EPN isolates from Himachal Pradesh, Heterorhabditis sp., against pests to minimize the use of insecticides during crop protection. Against L3–L5 of A. segetum, Heterorhabditis indica was found highly effective, resulting in 33.33–93.33% mortality at 40 infective juveniles (IJs)/larva after 96 h of treatment. Among local isolates, Heterorhabditis sp. (HSG) influenced maximum mortality of L3 and L4, whereas in L5, H. bacteriophora (HRJ) influenced maximum mortality. The sensitivity of L3 to different EPNs was (7.0–16.6%) higher than that of L4. In soil bioassay carried out against L4 of A. segetum, H. bacteriophora (HRJ) was found highly effective, followed by Heterorhabditis sp. (HKM) and Heterorhabditis sp. (HSG) at 10,000 IJs/kg of soil. The mortality varied from 78.33 to 81.67% with local isolates after 7 days of treatment. The results suggested that EPNs can be used as one of the components for managing A. segetum under field and greenhouse conditions to reduce over dependence on insecticides

Pathogenicity of Heterorhabditis nematodes isolated from north-western Himalaya against the larvae of Plutella xylostella (L.) (Lepidoptera: Plutellidae)

The efficacy of three entomopathogenic nematodes (Heterorhabditis spp.), from north western Himalaya, India was studied against the diamondback moth, Plutella xylostella (Linnaeus, 1758) (Lepidoptera: Plutellidae), under laboratory conditions. The larvae were exposed to 10, 20, 30 and 40 infective juveniles (IJs) of each nematode species for different time periods and they were found to be susceptible to all the EPNs tested. However, the susceptibility of larvae to nematode infection varied according to the dosages of IJs and their exposure periods. The efficacy of these indigenous entomopathogenic nematodes was also evaluated against the commercially available entomopathogenic nematode H. indica. An indigenous isolate, H. bacteriophora (HRJ), along with the commercial isolate H. indica recorded 100.0% mortality of insect larvae in 96 h exposure time against third instar larvae of P. xylostella. However, it was noticed that with the advancement of larval stage its mortality rate reduces and vice versa with the exposure period. All the tested nematode species were also found to reproduce within the host and produced infective juveniles. In conclusion, the evidence obtained in this study suggests that all the three indigenous EPN species are virulent enough to produce 100% mortality of larvae of P. xylostella. These EPN species thus have potential for the management of P. xylostella under integrated management practices

Status of soluble vascular cell adhesion molecule-1 in knee osteoarthritis among type 2-diabetic postmenopausal women

Background: Knee osteoarthritis is the most common form of joint disorder and a leading cause of pain and functional disability among elderly female population.  Type 2-diabetes is frequently reported comorbidity in elderly female patients with knee osteoarthritis. VCAM-1 is emerging as a strong and independent predictor for severe osteoarthritis. VCAM-1 is an inducible cell surface sialo glycoprotein and mediates heterotypic cellular aggregation. Therefore, the aim of this study is to assess the role of soluble vascular cell adhesion molecule-1 at the onset of knee osteoarthritis among type 2 diabetic postmenopausal women.Methods: The present study includes 100 type 2-diabetic female subjects of age above 50 years as cases and 100 normal healthy female age matched individuals as controls. Osteoarthritis of knee was ascertained using the American college of rheumatology classification criteria. Serum soluble VCAM-1 concentration was measured by ELISA method in all 200 subjects. Biochemical parameters-Fasting blood sugar and lipid profile were measured using Mind ray BS-400 and HbA1c was measured by turbidimetric immunoassay method. Statistical analysis was made by student independent sample t-test. Correlation was determined by using spearman’s rank correlation coefficient.Results: Serum level of soluble VCAM-1 was found statistically highly significant (p&lt;0.001) in type 2 diabetic postmenopausal women having early stage of knee osteoarthritis as compared to control healthy subjects. The mean levels of fasting blood sugar, HbA1c, total cholesterol, TG, LDL-C and VLDL-C were also found significantly increased while HDL-C was found significantly decreased in cases as compared to controls.Conclusions: The increased level of soluble VCAM-1 in type 2 diabetic subjects shows active inflammation or cartilage damage. Therefore, it can be used as an early biomarker for osteoarthritis among type 2 diabetic postmenopausal women

Mouse models for preeclampsia: disruption of redox-regulated signaling

The concept that oxidative stress contributes to the development of human preeclampsia has never been tested in genetically-defined animal models. Homozygous deletion of catechol-Omethyl transferase (Comt-/-) in pregnant mice leads to human preeclampsia-like symptoms (high blood pressure, albuminurea and preterm birth) resulting from extensive vasculo-endothelial pathology, primarily at the utero-fetal interface where maternal cardiac output is dramatically increased during pregnancy. Comt converts estradiol to 2-methoxyestradiol 2 (2ME2) which counters angiogenesis by depleting hypoxia inducible factor-1 alpha (HIF-1 alpha) at late pregnancy. We propose that in wild type (Comt++) pregnant mice, 2ME2 destabilizes HIF-1 alpha by inhibiting mitochondrial superoxide dismutase (MnSOD). Thus, 2ME2 acts as a pro-oxidant, disrupting redox-regulated signaling which blocks angiogenesis in wild type (WT) animals in physiological pregnancy. Further, we suggest that a lack of this inhibition under normoxic conditions in mutant animals (Comt-/-) stabilises HIF-1 alpha by inactivating prolyl hydroxlases (PHD). We predict that a lack of inhibition of MnSOD, leading to persistent accumulation of HIF-1 alpha, would trigger inflammatory infiltration and endothelial damage in mutant animals. Critical tests of this hypothesis would be to recreate preeclampsia symptoms by inducing oxidative stress in WT animals or to ameliorate by treating mutant mice with Mn-SOD-catalase mimetics or activators of PHD

LES investigation into the generation of momentum deficits in the supersonic wake of a micro-ramp

Implicitly implemented large eddy simulation (LES) with a fifth-order WENO scheme was conducted in this study. Based on Navier-Stokes equations, this LES was carried out to explore the origin of momentum deficit caused by a supersonic micro-ramp at flow conditions of M a = 2.5 and Re θ = 5760. The numerical results were validated through qualitative and quantitative comparisons with existing experimental data. After describing the aerodynamic properties of the supersonic wake, such as the deficit and the streamwise vortices, the momentum deficit was later detected to originate from the lower portion of the upstream boundary layer, while the high momentum fluid originated from close to the wall at the upper portion. Position alternation trigged by the micro-ramp was finally proposed as a revised mechanism

Probing the Role of Magnetic-Field Variations in NOAA AR 8038 in Producing Solar Flare and CME on 12 May 1997

We carried out a multi-wavelength study of a CME and a medium-size 1B/C1.3 flare occurring on 12 May 1997. We present the investigation of magnetic-field variations in the NOAA Active Region 8038 which was observed on the Sun during 7--16 May 1997. Analyses of H{\alpha} filtergrams and MDI/SOHO magnetograms revealed continual but discrete surge activity, and emergence and cancellation of flux in this active region. The movie of these magnetograms revealed two important results that the major opposite polarities of pre-existing region as well as in the emerging flux region (EFR) were approaching towards each other and moving magnetic features (MMF) were ejecting out from the major north polarity at a quasi-periodicity of about ten hrs during 10--13 May 1997. These activities were probably caused by the magnetic reconnection in the lower atmosphere driven by photospheric convergence motions, which were evident in magnetograms. The magnetic field variations such as flux, gradient, and sunspot rotation revealed that free energy was slowly being stored in the corona. The slow low-layer magnetic reconnection may be responsible for this storage and the formation of a sigmoidal core field or a flux rope leading to the eventual eruption. The occurrence of EUV brightenings in the sigmoidal core field prior to the rise of a flux rope suggests that the eruption was triggered by the inner tether-cutting reconnection, but not the external breakout reconnection. An impulsive acceleration revealed from fast separation of the H{\alpha} ribbons of the first 150 seconds suggests the CME accelerated in the inner corona, which is consistent with the temporal profile of the reconnection electric field. In conclusion, we propose a qualitative model in view of framework of a solar eruption involving, mass ejections, filament eruption, CME, and subsequent flare.Comment: 8 figures, accepted for publication in Solar Physic

Klebsiella pneumoniae is able to trigger epithelial-mesenchymal transition process in cultured airway epithelial cells

The ability of some bacterial pathogens to activate Epithelial-Mesenchymal Transition normally is a consequence of the persistence of a local chronic inflammatory response or depends on a direct interaction of the pathogens with the host epithelial cells. In this study we monitored the abilities of the K. pneumoniae to activate the expression of genes related to EMT-like processes and the occurrence of phenotypic changes in airway epithelial cells during the early steps of cell infection. We describe changes in the production of intracellular reactive oxygen species and increased HIF-1α mRNA expression in cells exposed to K. pneumoniae infection. We also describe the upregulation of a set of transcription factors implicated in the EMT processes, such as Twist, Snail and ZEB, indicating that the morphological changes of epithelial cells already appreciable after few hours from the K. pneumoniae infection are tightly regulated by the activation of transcriptional pathways, driving epithelial cells to EMT. These effects appear to be effectively counteracted by resveratrol, an antioxidant that is able to exert a sustained scavenging of the intracellular ROS. This is the first report indicating that strains of K. pneumoniae may promote EMT-like programs through direct interaction with epithelial cells without the involvement of inflammatory cells