Caesarean section in Eisenmenger’s syndrome: anaesthetic management with titrated epidural and nebulised alprostadil

Pregnancy in patients with Eisenmenger’s syndrome is associated with a high mortality. This article reports two cases of women with Eisenmenger’s syndrome (secondary to two different primary cardiac defects) who presented with near-term pregnancies. Both the patients underwent successful elective Caesarean section with slowly titrated epidural anaesthesia. Nebulised prostaglandin E1(PGE1) analogue, alprostadil, administered immediately post-delivery resulted in a significant drop in systolic pulmonary artery pressures as measured from tricuspid regurgitant jet by transthoracic echocardiography. The postoperative period was uneventful in both patients. A slow induction of epidural anaesthesia can be a safe mode of anaesthesia for Caesarean section in pregnant patients with Eisenmenger’s syndrome. Nebulised alprostadil intraoperatively or postoperatively in the intensive care unit (ICU) is readily available and a relatively cheap option as a selective pulmonary vasodilator in developing countries.Keywords: alprostadil, Caesarean section, Eisenmenger’s syndrome, epidura

Resveratrol Regulates Antioxidant Status, Inhibits Cytokine Expression and Restricts Apoptosis in Carbon Tetrachloride Induced Rat Hepatic Injury

Recent studies indicate the chemopreventive role of resveratrol in many animal models like ischemia, rheumatoid arthritis, human cancer, and diabetes. The present study was designed to investigate the chemopreventive potential of resveratrol in rat hepatic injury model by carbon tetrachloride. Male Wistar rats were treated with carbon tetrachloride (0.4 g/kg body weight) intraperitoneally daily for 8 weeks. Resveratrol (100 mg/kg, 200 mg/kg body weight) was given orally from first day until the last day of experiment. The investigation assesses the effect of resveratrol on morphological, oxidative status, histopathological, immunohistochemical, and apoptotic analysis in carbon tetrachloride-challenged liver tissue. The study indicated that the inflammatory cytokines TNF-α and IL-6 were profoundly expressed in experimental rats, whereas resveratrol decreases the immunopositivity of TNF-α and IL-6 and restored the altered architectural structure of challenged hepatic tissue. Resveratrol also protects liver cells by suppressing oxidative stress and apoptosis

No magic bullet: limiting in-school transmission in the face of variable SARS-CoV-2 viral loads

In the face of a long-running pandemic, understanding the drivers of ongoing SARS-CoV-2 transmission is crucial for the rational management of COVID-19 disease burden. Keeping schools open has emerged as a vital societal imperative during the pandemic, but in-school transmission of SARS-CoV-2 can contribute to further prolonging the pandemic. In this context, the role of schools in driving SARS-CoV-2 transmission acquires critical importance. Here we model in-school transmission from first principles to investigate the effectiveness of layered mitigation strategies on limiting in-school spread. We examined the effect of masks and air quality (ventilation, filtration and ionizers) on steady-state viral load in classrooms, as well as on the number of particles inhaled by an uninfected person. The effectiveness of these measures in limiting viral transmission was assessed for variants with different levels of mean viral load (ancestral, Delta, Omicron). Our results suggest that a layered mitigation strategy can be used effectively to limit in-school transmission, with certain limitations. First, poorly designed strategies (insufficient ventilation, no masks, staying open under high levels of community transmission) will permit in-school spread even if some level of mitigation is present. Second, for viral variants that are sufficiently contagious, it may be difficult to construct any set of interventions capable of blocking transmission once an infected individual is present, underscoring the importance of other measures. Our findings provide practical recommendations; in particular, the use of a layered mitigation strategy that is designed to limit transmission, with other measures such as frequent surveillance testing and smaller class sizes (such as by offering remote schooling options to those who prefer it) as needed.National Science Foundationhttps://www.frontiersin.org/articles/10.3389/fpubh.2022.941773/fullPublished versio

Adsorption and diffusion of gases in barium exchanged small pore titanium silicate

Master'sMASTER OF ENGINEERIN

Deep learning and benchmark machine learning based landslide susceptibility investigation, Garhwal Himalaya (India)

Garhwal Himalaya is the worst affected landslide prone region in Indian subcontinent mainly due to its complex geological settings and active tectonic activities. The data showed that every year, around 400 fatalities occur in Himalayan terrain due to landslide. In the current study, we have mapped the landslide susceptibility zones in the segment of Garhwal Himalaya using robust machine and deep learning algorithms. Individual machine and deep learning models have its own limitations like low generation capacity with nonlinear functions to describe the intricate relationship among predictors. In this study total five models i.e., SVM (Support Vector Machine), RF (Random Forest), bagging, ANN (Artificial Neural Network), DLNN (Deep Learning Neural Network) have been used along with twenty landslide controlling factors. Here, the principal objective of the study is to precisely delineate landslide susceptibility zones of the Garhwal Himalaya. The selecting factors have been considered through multi-collinearity test and information gain ratio statistics and the previous landslide points have been taken as training (70%) and testing (30%) dataset. According to area under curve value (AUC), the DLNN technique has high capability (AUC = 0.925) and accuracy for landslide area demarcation. The approach of integrated physical and social factors creates more precise prediction aptitude that can support large scale landslide management. These high precision models identified most of the parts of Rudraprayag and Tehri Garhwal as a very high landslide susceptibility zone. The generated maps can assist to policy makers for micro scale landslide management and sustainable land use planning particularly in Himalayan terrain

LEOPARD Syndrome

LEOPARD syndrome (LS) is an autosomal dominantly inherited or sporadic disorder of variable penetrance and expressivity. The acronym LEOPARD stands for its cardinal clinical features including Lentigines, Electrocardiographic conduction abnormalities, Ocular hypertelorism, Pulmonary stenosis, Abnormalities of genitalia, Retardation of growth, and Deafness. We present herein a patient with LEOPARD syndrome and distinctive features. It was noteworthy that our patient presented with the concern of generalized lentiginosis and subsequent evaluation revealed that the patient had LEOPARD syndrome. In this report we would like to highlight the importance of detailed clinical examination and appropriate imaging in patients with multiple lentigines

LEOPARD Syndrome

LEOPARD syndrome (LS) is an autosomal dominantly inherited or sporadic disorder of variable penetrance and expressivity. The acronym LEOPARD stands for its cardinal clinical features including Lentigines, Electrocardiographic conduction abnormalities, Ocular hypertelorism, Pulmonary stenosis, Abnormalities of genitalia, Retardation of growth, and Deafness. We present herein a patient with LEOPARD syndrome and distinctive features. It was noteworthy that our patient presented with the concern of generalized lentiginosis and subsequent evaluation revealed that the patient had LEOPARD syndrome. In this report we would like to highlight the importance of detailed clinical examination and appropriate imaging in patients with multiple lentigines