Evaluation of adjunctive analgesia with intrathecal fentanyl along with hyperbaric bupivacaine in spinal anesthesia for elective cesarean section

Background: Cesarean section (CS) is one of the most common surgical procedures in female patients. Authors aimed to evaluate the postoperative analgesic efficacy of adding intrathecal fentanyl to bupivacaine, and its effect on the onset and duration of spinal anesthesia along with its effect on mother and neonate.Methods: Study was performed on 60 cesarean section parturients divided into two groups. Group F received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml fentanyl (20 µg), and Group B received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml of normal saline. The parameters taken into consideration were pain scores, analgesic requirement, hemodynamic stability and side effects.Results: It was found that duration of sensory block was prolonged in fentanyl group (111 minutes vs 86 minutes, p<0.001). Duration of effective analgesia (174.36 minutes vs 127.81; p value <0.001) were also found to be prolonged in Group F with requirement of fewer postoperative analgesics (1.02 vs 2.76, p=0.03). There was not much difference in the occurrence of side effects in both the groups.Conclusions: Addition of fentanyl to intrathecal bupivacaine for cesarean section increases the duration of postoperative analgesia without increasing maternal or neonatal side effects

Ruptured uterus outcome among the pregnant women admitted in a tertiary care centre

Background: Rupture of a previously unscarred uterus is usually a catastrophic event resulting in death of the baby and sometimes even maternal death from blood loss. Incidence of rupture uterus varies from 0.3/1000 to 7/1000 deliveries in India accounting for 5% to 10% of all maternal deaths. Hence, the present study was conducted to study the proportion of ruptured uterus among the antenatal women admitted, their associated clinical spectrum and maternal outcome.Methods: A cross sectional study was carried out among 46 antenatal women presented with ruptured uterus in the department of Obstetrics and Gynaecology at N.S.C.B medical college and Hospital at Jabalpur, (M.P) during 1st August 2011 to 31st August 2012.Results: The incidence of ruptured uterus was 1 in 118 (0.84%) of all hospital deliveries. Mostly, 18 (39.1%) patients were in 26 -30yrs of age. Maximum, 22 patients (47.83%) with ruptured uterus were in second gravidae. Most common site of scar rupture was lower uterine segment, observed in 42 (91.30%) patients. The most common form of management was rent repair done in 36 (78.26%) patients, followed by subtotal hysterectomy (STH) in 8 (17.39%) and total hysterectomy (TH) in 2(4.34%) patients. A perinatal mortality was seen in 38 (82.60 %) cases with 1 maternal death was observed.Conclusions: Reducing the primary cesarean section rate and early diagnosis with active surgical management will go a long way in reducing the incidence of ruptured uterus and maternal and fetal mortality

NeuroCUT: A Neural Approach for Robust Graph Partitioning

Graph partitioning aims to divide a graph into $k$ disjoint subsets while optimizing a specific partitioning objective. The majority of formulations related to graph partitioning exhibit NP-hardness due to their combinatorial nature. As a result, conventional approximation algorithms rely on heuristic methods, sometimes with approximation guarantees and sometimes without. Unfortunately, traditional approaches are tailored for specific partitioning objectives and do not generalize well across other known partitioning objectives from the literature. To overcome this limitation, and learn heuristics from the data directly, neural approaches have emerged, demonstrating promising outcomes. In this study, we extend this line of work through a novel framework, NeuroCut. NeuroCut introduces two key innovations over prevailing methodologies. First, it is inductive to both graph topology and the partition count, which is provided at query time. Second, by leveraging a reinforcement learning based framework over node representations derived from a graph neural network, NeuroCut can accommodate any optimization objective, even those encompassing non-differentiable functions. Through empirical evaluation, we demonstrate that NeuroCut excels in identifying high-quality partitions, showcases strong generalization across a wide spectrum of partitioning objectives, and exhibits resilience to topological modifications

Occupational therapy consensus recommendations for functional neurological disorder

BACKGROUND: People with functional neurological disorder (FND) are commonly seen by occupational therapists; however, there are limited descriptions in the literature about the type of interventions that are likely to be helpful. This document aims to address this issue by providing consensus recommendations for occupational therapy assessment and intervention. METHODS: The recommendations were developed in four stages. Stage 1: an invitation was sent to occupational therapists with expertise in FND in different countries to complete two surveys exploring their opinions regarding best practice for assessment and interventions for FND. Stage 2: a face-to-face meeting of multidisciplinary clinical experts in FND discussed and debated the data from stage 1, aiming to achieve consensus on each issue. Stage 3: recommendations based on the meeting were drafted. Stage 4: successive drafts of recommendations were circulated among the multidisciplinary group until consensus was achieved. RESULTS: We recommend that occupational therapy treatment for FND is based on a biopsychosocial aetiological framework. Education, rehabilitation within functional activity and the use of taught self-management strategies are central to occupational therapy intervention for FND. Several aspects of occupational therapy for FND are distinct from therapy for other neurological conditions. Examples to illustrate the recommendations are included within this document. CONCLUSIONS: Occupational therapists have an integral role in the multidisciplinary management of people with FND. This document forms a starting point for research aiming to develop evidence-based occupational therapy interventions for people with FND

Homogeneous and heterogeneous catalysts for multicomponent reactions

[EN] Organic synthesis performed through multicomponent reactions is an attractive area of research in organic chemistry. Multicomponent reactions involve more than two starting reagents that couple in an exclusive ordered mode under the same reaction conditions to form a single product which contains the essential parts of the starting materials. Multicomponent reactions are powerful tools in modern drug discovery processes, because they are an important source of molecular diversity, allowing rapid, automated and high throughput generation of organic compounds. This review aims to illustrate progress in a large variety of catalyzed multicomponent reactions performed with acid, base and metal heterogeneous and homogeneous catalysts. Within each type of multicomponent approach, relevant products that can be obtained and their interest for industrial applications are presented.The authors wish to gratefully acknowledge the Generalitat Valenciana for the financial support in the project CONSOLIDER-INGENIO 2010 (CSD2009-00050)Climent Olmedo, MJ.; Corma Canós, A.; Iborra Chornet, S. (2012). Homogeneous and heterogeneous catalysts for multicomponent reactions. RSC Advances. 2(1):16-58. https://doi.org/10.1039/c1ra00807bS16582

Ruptured uterus outcome among the pregnant women admitted in a tertiary care centre

Background: Rupture of a previously unscarred uterus is usually a catastrophic event resulting in death of the baby and sometimes even maternal death from blood loss. Incidence of rupture uterus varies from 0.3/1000 to 7/1000 deliveries in India accounting for 5% to 10% of all maternal deaths. Hence, the present study was conducted to study the proportion of ruptured uterus among the antenatal women admitted, their associated clinical spectrum and maternal outcome.Methods: A cross sectional study was carried out among 46 antenatal women presented with ruptured uterus in the department of Obstetrics and Gynaecology at N.S.C.B medical college and Hospital at Jabalpur, (M.P) during 1st August 2011 to 31st August 2012.Results: The incidence of ruptured uterus was 1 in 118 (0.84%) of all hospital deliveries. Mostly, 18 (39.1%) patients were in 26 -30yrs of age. Maximum, 22 patients (47.83%) with ruptured uterus were in second gravidae. Most common site of scar rupture was lower uterine segment, observed in 42 (91.30%) patients. The most common form of management was rent repair done in 36 (78.26%) patients, followed by subtotal hysterectomy (STH) in 8 (17.39%) and total hysterectomy (TH) in 2(4.34%) patients. A perinatal mortality was seen in 38 (82.60 %) cases with 1 maternal death was observed.Conclusions: Reducing the primary cesarean section rate and early diagnosis with active surgical management will go a long way in reducing the incidence of ruptured uterus and maternal and fetal mortality

In vitro cost-effective methods to detect carbapenemases in Enterobacteriaceae

The rise in carbapenemases-producing organisms has challenged the scientific community. Infections caused by these bacteria have limited treatment options. There are various types such as Klebsiella pneumoniae carbapenemase (Ambler class A), metallo-beta-lactamases of VIM-type, IMP-type, NDM-type (Ambler class B), and OXA-48-types (Ambler class D). An efficient strategy for detection of carbapenemase producers is important to determine the appropriate therapeutic modalities. In this study, four methods - Carba NP test, modified Carba NP (MCNP) test, carbapenem inactivation method (CIM) test, and Rapidec Carba NP kit test were evaluated. We evaluated an in-house MCNP test to detect carbapenemase production using a single protocol which gave reliable results. Furthermore, CIM using routine antibiotic discs gives good results. Both these tests were found to be cost-effective

Parental awareness, knowledge, and attitude toward conscious sedation in North Indian children population: A questionnaire-based study

Aim: The purpose of this study is to find the opinion, attitude, beliefs, and the existing knowledge of parents of Himachal Pradesh suburban city about conscious sedation. Objective: To know the effect of education of parent and prior sedation experience of the child on opinion, attitude, and knowledge of parent about conscious sedation. Methodology: A questionnaire in Hindi/English was provided to parents who accompanied their child for the treatment in the Paedodontics Department of HPGDC College Shimla. Information regarding demography, existing knowledge gained through television, the internet, opinion about the safety of the procedure, knowledge of nothing by mouth guidelines, restraints usage, and knowing their preferences of staying with the child during treatment was explored. Questions were straight yes or no type and multiple choice type. Some questions were statements and wanted the respondents to strongly agree, agree, disagree, or strongly disagree. Results and Conclusion: A total of 350 questionnaires were collected. Parents feel sedation is safe in the dental office as an adjunct to dental treatment. Education played a role in existing knowledge about sedation and perception about the safety of conscious sedation

PREVALENCE OF MALNUTRITION AMONG SCHOOL CHILDREN WITH REFERENCE TO OVERWEIGHT AND OBESITY AND ITS ASSOCIATED FACTORS

Research Question: What influence does diet and physical activity have on the occurence of overweight and obesity in school aged children? Objectives: To study the diet and physical activity factors influencing overweight and obesity in school aged children. Study Design: Cross sectional Study. Settings: Field Practice area of Department of Community Medicine, LLRM Medical College, Meerut. Participants: 400 children between 5-14 years age group Statistical Analysis: Chi Square Test Results: The prevalence of overweight and obesity in children was 9.8% and 3.7% respectively. Among dietary factors, a significant association was seen in the prevalence of overweight and obesity with consumption of &gt;3 meals per day(P&lt;0.001), habit of eating in between meals(P&lt;0.05) and in having dinner as the heaviest meal of the day (P&lt;0.02). Among physical activity factors, a significant association was seen in the prevalence of overweight and obesity with the habit of not playing outdoor games (P&lt;0.001), not participating in household activities(P&lt;0.001), using some vehicular transport to go to school (P&lt;0.001) and watching T.V. for more than 3hrs/day(P&lt;0.001).Conclusion:Diet and Physical activity have an influence on occurrence of overweight and obesity in school aged children. Dietary and lifestyle modification must be advised to children to prevent occurrence of overweight and obesity in them