Anaesthetic management of emergency exploratory laparotomy for ruptured ectopic pregnancy in a patient with Ebstein’s anomaly and Wolff-Parkinson-White syndrome: a challenge for the anaesthesiologists

Ebstein's anomaly (incidence 1:110,000) is characterized by the downward displacement and elongation of the tricuspid valve with poorly contractile right ventricle, an enlarged right atrium along with tricuspid regurgitation. It has shown particular association with Wolf-Parkinson-White syndrome (up to 20 % of patients). Wolff-Parkinson-White syndrome (WPW syndrome) is a rare cardiac anomaly characterised by aberrant conduction pathway between atria and ventricles. Here we describe the successful management of a patient with Ebstein’s anomaly and co-existing WPW syndrome, who presented in our institute with ruptured ectopic pregnancy and was posted for emergency exploratory laparotomy. The anaesthetic management of these patients is very challenging as they can develop life threatening tachyarrthmias like atrial fibrillation (AF) and paraoxysmal supraventricular tachycardia (PSVT)

A comparative evaluation between median and paramedian approaches for sub-arachnoid block in elderly patients

Background: Spinal anaesthesia in elderly patients is frequently associated with significant technical difficulties. Spinal anaesthesia can be given by either paramedian or median approach. Paramedian approach has been used as an alternative in case of failure with median approach. The goal of this study is to determine which of these two approaches should be preferred as a first choice of spinal anaesthesia in elderly patients.Methods: The study included 100 patients of either sex, aged 50 years and above, who received spinal anaesthesia either with the midline approach (group M, n=50) or paramedian approach (group PM, n=50).Results: The success rate of paramedian group was 100% as compared to 96 % in median group.  The first attempt success rate was 90% in group PM and 70% in group M. Paraesthesia was felt in 5 patients (10%) in midline group and in 2 patients (4%) in paramedian group. Hemorrhagic tap was seen in 2 patients each in both the groups . None of the patients in Group M had postdural puncture headache (PDPH) as opposed to 2 patients in Group M.Conclusions: Thus the study conclude that paramedian approach is a better approach for spinal anaesthesia in elderly patients in terms of success rate, success at first attempt, complications like paraesthesia, PDPH and failure of sub-arachnoid block. Thus study recommends the routine use of paramedian approach for sub-arachnoid block in elderly patients as first choice

Rhabdomyolysis with acute kidney injury after single episode of generalized seizure in a known case of epilepsy: a case report

Rhabdomyolysis is defined as breakdown of skeletal muscle fibers with subsequent release of its cellular components into the circulation. It is associated with variety of causes and status epilepticus is one of it. The excessive muscular activity associated with seizure is possible explanation for it. It is clinically evident by the new onset severe generalized bodyache, weakness and myalgia associated with dark coloured urine. Acute kidney injury is one of the most serious complications associted with rhabdomyolysis. Single episode of generalized seizure is not a frequent cause for rhabdomyolysis. Acute kidney injury due to rhabdomyolysis, following a single episode of seizure is a rare entity. Here we report a case of rhabdomyolysis with acute kidney injury following a single episode of generalized seizure. High index of suspicion is required to timely diagnose and treat such patients. Timely intervention with hemodialysis along with other supportive care can completely revert this potentially serious complication to normal

Effect of zoledronic acid on functional outcome in cases of pertrochanteric femoral fractures in elderly patients operated with proximal femoral nailing

Background: Osteoporosis is a very common problem in geriatric population and postmenopausal women. Zoledronic acid injection is a very convenient and effective treatment option available for osteoporosis. Our study aimed to study the effect of zoledronic acid on functional outcome and fracture related complications in elderly patients with low energy pertrochanteric femoral fractures who were operated with proximal femoral nail. Methods: This was a case control study. Elderly patients who underwent surgery in the form of proximal femoral nailing for low energy pertrochanteric femoral fractures were included. Injection zoledronic acid was given to every alternate patient who underwent surgery. Radiological healing was evaluated at six weekly intervals for six months and then 12 weekly intervals for one year. The Harris hip score was used to measure the functional outcome of the patient. Results: Effective study population consisted of total 49 patients (25 cases and 24 controls). The mean union time in the cases and the control was 8.76±9.12 weeks and 7.04±1.57 weeks respectively. The mean Harris hip score was 86.742±7.55 in the cases and 84.339±11.20 in the control group. The p value was 0.3815. This study concluded that the two groups had no statistically significant difference between functional outcome and fracture related complications. Conclusions: Zoledronic acid in patients admitted for surgery with osteoporotic fracture does not improve the functional outcome of the patients. It does not affect the mortality of the patients

Thermal and electrical performance of uncooled, nature-cooled, and photovoltaic thermal module

The experimental study is aimed at analyzing photovoltaic module's thermal and electrical performance (PV) with back surface cooling under Malaysian tropical climate conditions. The performance of a passively cooled PV module integrated with biomaterial (moist coconut fiber) was compared with a photovoltaic thermal (PVT) system with water circulation at the rate of 0.02 kg s-1 and a reference PV module. The study observed that the passively cooled PV module succeeded in reducing the module surface temperature by more than 20%. However, the PVT system reduced the temperature only by less than 17%. The electrical energy efficiency was improved remarkably in the passively cooled PV module by almost 11%, but the PVT system managed to increase the electrical efficiency by 9%, approximately. It can be concluded that nature-inspired coconut fiber-based cooling can be one of the potential alternatives to active cooling methods

Mungbean (<em>Vigna radiata</em> L. Wilczek): Retrospect and Prospects

Mungbean (Vigna radiata L. Wilczek) is economically most important crop of Vigna group. It is also known as green gram, golden gram, moong, Chickasaw, Oregon pea, and chop suey bean and this legumes have a strategic position in Southeast Asian countries for nutritional security and sustainable crop production. Being rich in quality protein, minerals and vitamins, they are inseparable ingredients in the diets of a vast majority of Indian population. When supplemented with cereals, they provide a perfect mix of essential amino acids with high biological value. These crops have the ability to fix atmospheric nitrogen (58–109 kg per ha in kg per ha mungbean) in symbiotic association with Rhizobium bacteria, which enables them to meet their own nitrogen requirement and also benefit the succeeding crops. This crop has also been reported to smother weed flora appreciably (20–45%) when intercropped with tall cereals or pigeonpea and consequently, minimize the cost incurred on weed control. On account of short duration and photo-thermo insensitivity, they are considered excellent crops for crop intensification and diversification. A seed of mungbean is highly nutritious containing 24–28% protein, 1.0–1.5% fat, 3.5–4.5% fibre, 4.5–5.5% ash and 59–65% carbohydrates on dry weight basis and provide 334–344 kcal energy. Mungbean protein is considered to be easily digestible. Mungbean are tropical grain legumes widely grown in the sub-tropical countries of South and Southeast Asia. Nevertheless, these crops are cultivated over a wide range of latitudes in the regions where average diurnal temperatures during the growing season are warmer than about 20°C

Current Scenario of Breeding Approaches in Rice

Rice is the predominant crop in India and is the staple food in eastern and southern Indian populations. One of the oldest grown crops is rice. The initial discovery of cytoplasmic male sterile (CMS) three-line system made it possible to produce hybrids that significantly increase rice yields compared to its inbred counterparts. Further genetic and molecular studies help elucidate the mechanisms involved in CMS male sterility. Additional CMS types were also discovered with similar genetic control from wild sources by interspecific hybridization. In India more than 1200 varieties were released for cultivation suitable different ecosystems and out of them 128 varieties have been contributed from NRRI, Cuttack. A list of these varieties are furnished below with their duration, grain type, yield potential, reaction to major disease and insects grain quality and tolerance to different adverse situations. Recent advances in molecular approaches used in modern rice breeding include molecular marker technology and marker-assisted selection (MAS); molecular mapping of genes and QTLs and production of hybrids and alien introgression lines (AILs). Genomic selection (GS) has been projected as alternative to conventional MAS. GS has huge potential to enhance breeding efficiency by increasing gain per selection per unit time. Due to the adaptation of semi dwarf high yielding varieties, combined with intensive input management practices, the country witnessed an impressive rice production growth in the post-independent period. Rice production was increased four times, productivity three times while the area increase was only one and half times during this period. The projected rice requirement by 2025, in order to keep up with increasing population, is about 130 m.t. The challenge of growing rice production is made more difficult by declining trends in HYV’s yields, decreasing and degrading natural resources such as land and water and a severe labour shortage

Genomic-based-breeding tools for tropical maize improvement

Maize has traditionally been the main staple diet in the Southern Asia and Sub-Saharan Africa and widely grown by millions of resource poor small scale farmers. Approximately, 35.4 million hectares are sown to tropical maize, constituting around 59% of the developing worlds. Tropical maize encounters tremendous challenges besides poor agro-climatic situations with average yields recorded <3 tones/hectare that is far less than the average of developed countries. On the contrary to poor yields, the demand for maize as food, feed, and fuel is continuously increasing in these regions. Heterosis breeding introduced in early 90 s improved maize yields significantly, but genetic gains is still a mirage, particularly for crop growing under marginal environments. Application of molecular markers has accelerated the pace of maize breeding to some extent. The availability of array of sequencing and genotyping technologies offers unrivalled service to improve precision in maize-breeding programs through modern approaches such as genomic selection, genome-wide association studies, bulk segregant analysis-based sequencing approaches, etc. Superior alleles underlying complex traits can easily be identified and introgressed efficiently using these sequence-based approaches. Integration of genomic tools and techniques with advanced genetic resources such as nested association mapping and backcross nested association mapping could certainly address the genetic issues in maize improvement programs in developing countries. Huge diversity in tropical maize and its inherent capacity for doubled haploid technology offers advantage to apply the next generation genomic tools for accelerating production in marginal environments of tropical and subtropical world. Precision in phenotyping is the key for success of any molecular-breeding approach. This article reviews genomic technologies and their application to improve agronomic traits in tropical maize breeding has been reviewed in detail

A comparative evaluation between median and paramedian approaches for sub-arachnoid block in elderly patients

Background: Spinal anaesthesia in elderly patients is frequently associated with significant technical difficulties. Spinal anaesthesia can be given by either paramedian or median approach. Paramedian approach has been used as an alternative in case of failure with median approach. The goal of this study is to determine which of these two approaches should be preferred as a first choice of spinal anaesthesia in elderly patients.Methods: The study included 100 patients of either sex, aged 50 years and above, who received spinal anaesthesia either with the midline approach (group M, n=50) or paramedian approach (group PM, n=50).Results: The success rate of paramedian group was 100% as compared to 96 % in median group.  The first attempt success rate was 90% in group PM and 70% in group M. Paraesthesia was felt in 5 patients (10%) in midline group and in 2 patients (4%) in paramedian group. Hemorrhagic tap was seen in 2 patients each in both the groups . None of the patients in Group M had postdural puncture headache (PDPH) as opposed to 2 patients in Group M.Conclusions: Thus the study conclude that paramedian approach is a better approach for spinal anaesthesia in elderly patients in terms of success rate, success at first attempt, complications like paraesthesia, PDPH and failure of sub-arachnoid block. Thus study recommends the routine use of paramedian approach for sub-arachnoid block in elderly patients as first choice