Spinal anaesthesia for emergency cesarean section in neurofibromatosis for an antepartum haemorrhage: a case report

Neurofibromatosis 1 (NF1) is an autosomal dominant disease and is usually diagnosed during childhood. Neurofibromatosis are group of genetic disorders that cause tumors to form, which can develop anywhere in the nervous system including brain, spinal cord and nerves. It poses a great challenge to the anaesthesiologist as it may have difficult airway, fibrosis in lungs and neuromas in spinal cord. Due to the involvement of CNS, regional anaesthesia in type 2 neurofibromatosis without careful preoperative examination can be extremely dangerous. Regional anaesthesia on the other hand could be useful in type 1 neurofibromatosis because CNS involvement is rare. This was a case report of management in a 24-year-old pregnant female with undiagnosed neurofibromatosis for an emergency cesarean section for antepartum haemorrhage and IUD under spinal anaesthesia. Although general anaesthesia is the safer option in neurofibromatosis patients, spinal anaesthesia can be a safe procedure in neurofibromatosis patients but special precautions should be taken to avoid neurological injury and uneventful anaesthesia

Comparison of efficacy of azilsartan with olmesartan in patients of hypertension: randomized controlled trial

Background: Azilsartan and olmesartan are members of ARBs, used in the management of hypertension. Objective was to evaluate efficacy of azilsartan with olmesartan in patients of hypertension. Methods: A randomized, prospective, open label, comparative study was carried out in Pharmacology and Medicine department at Dr. RPGMC Kangra at Tanda, HP. The study stretched over one year and blood pressure was monitored at first, third and sixth month. Out of 69 patients, 35 patients in group A were prescribed tablet azilsartan 40 mg/day and 34 patients in group B patients were prescribed tablet olmesartan 20 mg/day. Tablet chlorthalidone 12.5 mg/day was add on in both the groups. Data was presented as mean+SD. Student’s t test was used and p value <0.05 was considered significant. Results: In group A, systolic blood pressure (SBP) values improved from baseline of 153±10 mmHg to 111±18 mmHg (p<0.001) at 3 months and 109±6.1 mmHg (p<0.001) at 6 months and diastolic blood pressure (DBP) values from baseline of 87±7 mmHg to 67.1±4.6 mmHg (p<0.001) at 3 months and 67.6±2.5 mmHg (p < 0.001) at 6 months. In group B, SBP values improved from baseline of 154±8.5 mmHg to 127±3.6 mmHg (p<0.001) at 3 months and 123±4 mmHg (p<0.001) at 6 months and DBP values from baseline of 85±6.5mm Hg to 75.7±3.3 mmHg (p<0.001) at 3 months and 73±3.3 mmHg (p<0.001) at 6 months. On intergroup comparison improvement in hypertension was better in azilsartan group (p<0.001). Conclusions: The study concluded that azilsartan is significantly better than olmesartan in controlling the hypertension

ANTAGONISTIC AND ANTIBACTERIAL ACTIVITY OF ENDOPHYTIC FUNGI ISOLATED FROM NEEDLE OF CUPRESSUS TORULOSA D.DON

Objective: This study was undertaken to investigate antagonistic and antibacterial activities of the endophytic fungi isolated from living symptomlessneedle of Cupressus torulosa D.Don from Pauri, Garhwal region of Uttarakhand. The emergence of antibiotic-resistant microorganisms calls forinventive research and development strategies. Inhibition of these pathogenic microorganisms may be a promising therapeutic approach. Thescreening of antimicrobial compounds from endophytes may be a promising way to meet the increasing threat of drug-resistant strains of human andplant pathogens.Methods: A total of five different fungal endophytes were isolated from the needle of C. torulosa D.Don using potato dextrose agar medium. Thesefungal isolates morphotypically characterized. These isolates were further tested for antagonistic activity by the dual culture technique. Among fiveendophytic fungi, only two fungal endophytes were cultured to examine their antimicrobial properties and phytochemical analysis. Antimicrobialactivity was evaluated for crude hexane extracts against human pathogen Staphylococcus aureus, Bacillus subtilis, and Salmonella typhimurium usingan agar diffusion assay.Results: A total of five fungal endophytes characterized as such as Cladosporium sp., Aspergillus sp., Fuzaium sp., Curvularia sp., and Diaporthe sp.In which, only two endophytic fungal isolates such as PCTS23 and WCTS21 characterized morphotypically as Cladosporium sp. and Curvularia sp.,respectively, were able to show strong antagonism activity against fungal pathogen. The fungal isolate PCTS3 was more active against Macrophominaphaesolina with antagonistic index 88.88 while WCTS21 was more active against F. solani with antagonistic index 80. The fungal crude extract ofWCTS21 produced the highest zone of inhibition 12 mm for S. aureus, whereas crude extract of PCTS23 from hexane crude extract has shown thehighest zone of inhibition of 10 mm against S. aureus. A preliminary qualitative phytochemical analysis of fungal crude extracts also revealed thepresence of bioactive metabolites such as flavonoids, alkaloids, phenols, saponins, steroids, tannins, and terpenoids in endophytic fungi.Conclusions: This study concludes that endophytic fungi isolated from C. torulosa D.Don could be a potential source for bioactive metabolites andmay be used in pharmaceutical industry. The generated data has provided the basis for its application in the pharmaceutical industry in the form oftraditional and folk medicine.Keywords: Endophytic fungi, Cupresus torulosa, Antibacterial activity, Phytochemical analysis, Bioactive metabolites, Antagonistic activity

Techniques of Fabrication of Provisional Restoration: An Overview

A properly fabricated provisional restoration is important in achieving a successful indirect restoration. The importance of provisional restorations as an integral part of fixed prosthodontic treatment is evident from the abundance of the literature pertaining to their importance regarding margin fidelity, function, occlusion, and esthetics. There are a variety of techniques available to suit the individual needs of the clinician and of the clinical situation, from a single unit to a complete-arch provisional fixed prostheses

The Negative Correlation of Spice Intake and Colorectal Cancer: A Statistical Analysis of Global Health Databases

Background: Colorectal Cancer (CRC) has multiple risk factors and depends highly on diet. Positive associations of red meat and processed meat intake and CRC have been proven, but no research has been conducted on the relation of spice intake and CRC risk. Various in-vitro studies have demonstrated the anticancer activity of chemicals present in spices, which is the main driving force for our statistical analysis. Methods: We analyzed Global Burden of Disease (GBD) database, Food and Agricultural Organization of United Nations (FAO) database, and Global Dietary Database (GDD) using Pearson correlation statistics to find any significant correlation, mainly between spice intake and CRC risk. Data from 1990 to 2013 of 100 countries was collected for the analysis. Twenty-three-year average values (±SD) were calculated for CRC risk, spice, red meat, processed meat, vegetable, and fruit intake. CRC risk is taken as dependent variable whereas all other were independent variables. All variables were analyzed using Pearson correlation analysis. Results with p<0.05 were further analyzed using regression analysis. Results: Pearson correlation showed that spice intake had a significant negative correlation (r= -0.301, p=0.002) whereas red meat (r= 0.722, p<0.001) and processed meat (r= 0.339, p<0.001) had a significant positive correlation with CRC risk. Conclusion: Significant negative correlation between spice intake and CRC risk indicates that higher spice intake can be preventive against cancer and possibly decrease the risk of colorectal cancer in populations with higher CRC risk

Legionella pneumonia cases over a five-year period: a descriptive, retrospective study of outcomes in a UK district hospital

As the recent outbreaks in Edinburgh and Camarthen, UK, have shown, Legionella pneumonia (LP) remains a significant public health problem, which is not only confined to those who have travelled abroad. In both outbreaks and sporadic cases, diagnosis can go unrecognised. We reviewed the demographics, comorbidities, diagnosis, treatment and clinical outcome of LP cases over five years in a district general hospital in northwest England. Over half of LP cases were UK acquired and ‘classic’ clinical features were common. Clinical criteria for diagnosing LP were confirmed, but few sputum samples were sent to reference laboratories, limiting further essential epidemiological mapping of UK cases. Following current UK community-acquired pneumonia guidance would have missed nearly one quarter of LP cases in our series, potentially leading to further morbidity and mortality

Load Cell Based Fuel Theft Detection System

In this project we focuses on creating a universal digital display of the exact amount of fuel contained in the vehicles tank and also helps in cross checking the quantity of fuel filled at the vehicle fuel tank even if the vehicle is off at the time of filing of fuel by measuring the weight of the fuel. Here, we are indicating the amount of fuel in the tank in liters. This value in liters will be in numerical digits. As we say the device is universal so can easily be installed in any two wheeler automobile

AN EXPEDIENT APPROACH TO TREAT ASTHMA THROUGH NON-STEROIDAL, NATURAL TRANSFEROSOMES AEROSOL SYSTEM

Asthma is the most common respiratory disease, affecting an estimated 262 million people and resulting in 461,000 fatalities in 2019. The treatment is available on the market, but it is quite expensive, and it also has serious adverse effects due to the high concentration of steroids in the medicine. If given effectively, curcumin, formononetin, and matrine’s anti-inflammatory properties can play a significant role in treatment. To improve the chemical stability and therapeutic potential of these active pharmaceutical ingredients (APIs) in the respiratory tract, a transferosomes system was designed, which encapsulates the APIs inside its vesicular structure and delivers them selectively to the inflamed cells. The DPPC layer will allow for efficient penetration, whereas Tween-80 will aid in deformability and lower interfacial tension, resulting in a small Z-average diameter, allowing for efficient penetration between layers of cells. The APIs’ stability at alkaline pH (7.6) is ensured by the nano-vesicular structure, which significantly increases cellular antioxidant activity and ferric reducing antioxidant power values. On the RAW264.7 cell line, the formulation will be tested for anti-inflammatory activity. Nuclear factor kappa B, tumor necrosis factor, interleukin (IL)-1, IL-2, IL-6, IL-8, IL-12, nitric oxide, and cyclooxygenase-2 are all reduced by curcumin, formononetin, and matrine. They also have an inhibitory effect on the MAPK signaling pathway, preventing extracellular signal-regulated kinase, c-Jun N-terminal kinase, and p38 from causing inflammation. This formulation can effectively treat asthma without the use of steroids, has no adverse effects, and is inexpensive