Anaesthetic Management of A Child with Multiple Congenital Anomalies Scheduled for Cataract Extraction

In infants& children variety of conditions and syndromes are associated with difficult Airway. Anaesthetic management becomes a challenge if it remains unrecognized until induction and sometimes results in disaster, leading to oropharyngeal trauma, laryngeal oedema, cardiovascular& neurological complications. A 4-month-old child with multiple congenital anomalies was posted for cataract extraction for early and better development of vision. He had history of post birth respiratory distress, difficulty in feeding, breath holding with delayed mile stones. He was treated as for Juvenile asthma. This child was induced with inhalation anaesthesia. There was difficulty in laryngoscopic intubation and could pass much smaller size of the tube than predicted. He developed post operative stridor and desaturation. The problems which we faced during the anaesthetic management and during postoperative period are discussed with this case

A comparative evaluation of hyperbaric ropivacaine versus hyperbaric bupivacaine for elective surgery under spinal anesthesia

Background: Recently introduced ropivacaine is 40% less potent than bupivacaine. Ropivacaine made hyperbaric by the addition of dextrose is known to provide reliable spinal anesthesia (SA).This study was designed to compare the clinical efficacy of equal doses of hyperbaric 0.5% ropivacaine with 0.5% bupivacaine for SA. Materials and Methods: Eighty American Society of Anesthesiologists grade I-II patients undergoing elective infraumbilical surgeries under SA were recruited and randomized to receive 3ml of hyperbaric ropivacaine 5mg/ml containing dextrose 83 mg/ml (by the addition of desired dose of 25% dextrose) in Group R or 3ml of hyperbaric bupivacaine 5mg/ml containing dextrose 80 mg/ml in Group B. Monitoring of vitals and observation for the block parameters were carried out. The data were presented as mean with a standard deviation and frequency with percentage. Statistical analysis was performed using InStat computer software with appropriate tests and P < 0.05 was considered to be significant. Results: Ropivacaine produced a slower onset of sensory block (ropivacaine 4.5 min; bupivacaine 3.2 min; P < 0.05) and the mean total duration of sensory block was significantly lesser (ropivacaine155 min; bupivacaine 190.5 min; P < 0.05). Patients in the ropivacaine Group R had significantly more rapid recovery from the motor blockade (ropivacaine120 min; bupivacaine 190 min; P < 0.05) and passed urine sooner than the patients in bupivacaine Group B (ropivacaine 257 min; bupivacaine 358 min; P < 0.05). Conclusion: Ropivacaine 15 mg in dextrose 8.3% provides reliable SA of shorter duration than bupivacaine 15 mg in 8% dextrose

Attitude toward protective behavior engagement during COVID-19 pandemic in Malaysia: the role of E-government and social media

The coronavirus disease 2019 (COVID-19) pandemic is still evolving and affecting millions of lives. E-government and social media have been used widely during this unprecedented time to spread awareness and educate the public on preventive measures. However, the extent to which the 2 digital platforms bring to improve public health awareness and prevention during a health crisis is unknown. In this study, we examined the influence of e-government and social media on the public's attitude to adopt protective behavior. For this purpose, a Web survey was conducted among 404 Malaysian residents during the Recovery Movement Control Order (RMCO) period in the country. Descriptive and multiple regression analyses were conducted using IBM SPSS software. Social media was chosen by most of the respondents (n = 331 or 81.9%) as the source to get information related to COVID-19. Multiple regression analysis suggests the roles of e-government and social media to be significantly related to people's attitudes to engage in protective behavior. In conclusion, during the COVID-19 outbreak, public health decision makers may use e-government and social media platforms as effective tools to improve public engagement on protective behavior. This, in turn, will help the country to contain the transmission of the virus

GC-MS analysis and antibacterial activities of some plants belonging to the genus Euphorbia on selected bacterial isolates

Plant extracts have always been used as an alternative source of antimicrobial compounds. The recent spread of multi-drug-resistant bacteria and their increased treatment costs necessitated the study of alternative, cheap sources. The family Euphorbiaceae has over 300 genera and is widely used in traditional medicine. Euphorbia triaculeata, E. fractiflexa, and E. inarticulata were selected to study the antibacterial activity of the methanolic extract against 13 Gram-positive Staphylococcus aureus strains (including methicillin-resistant S. aureus) and 2 Gram-negative isolates, Escherichia coli and Klebsiella pneumoniae, by the Kirby Bauer Disc diffusion test. Paper discs with different concentrations of the extracts (100, 50, and 25 µg mL−1) were prepared, along with the methanol control and standard antibiotic control. A gas chromatography-mass spectrometry (GC/MS) analysis was done to study the phytochemical components present in the plant methanolic extracts. A total of 50 different phytochemical compounds with antibacterial activity were detected by GC/MS analysis of the plants. Twenty-five compounds were detected in E. inarticulata, 24 in E. triaculeata, and 21 in E. fractiflexa. Out of 37 compounds found in E. inarticulata and E. triaculeata, 12 (32.43%) were common to both. Eleven (22%) compounds were unique to E. inarticulata, while 9 (18%) compounds were unique to E. triaculeata, and 13 (26%) compounds were unique to E. fractiflexa. E. fractiflexa showed the best antibacterial activity against MRSA and Gram-negative bacteria. It also showed higher unique compounds with antibacterial activity (26%), followed by E. inarticulata (11, 22%). This is the first GC/MS analysis and antimicrobial activity report of E. triaculeata and E. fractiflexa