79 research outputs found

    A case of PRES following intracranial hypotension, with spontaneous resolution with epidural blood patch

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    Posterior reversible encephalopathy syndrome (PRES (also known as reversible posterior leukoencephalopathy syndrome)) presents with rapid onset of symptoms including headache, seizures, altered consciousness, and visual disturbance. It is often but by no means always associated with acute hypertension. Diffusion-weighted MRI is the most sensitive exam to confirm the diagnosis of PRES. If promptly recognized and treated, the clinical syndrome usually resolves within a week, and the changes seen in magnetic resonance imaging (MRI) resolve over days to weeks. Posterior reversible encephalopathy syndrome is an increasingly recognized disorder, with a wide clinical spectrum of both symptoms and triggers, and yet it remains poorly understood. Differential diagnosis includes venous sinus thrombosis, cerebral haemorrhage, encephalitis, vasculititis and metabolic encephalopathys. No clinical trials have evaluated the management of PRES, but rapid withdrawal of the trigger appears to hasten recovery and to avoid complications: for example, aggressive blood pressure management, withdrawal of the offending drug, or delivery in eclampsia. We report a case of women presenting with severe headache, tonic clonic convulsions 7 days after spinal anaesthesia for caesarean delivery, MRI showed evidence of intracranial hypotension and posterior reversible encephalopathy syndrome. She was treated with Blood patch which lead to complete resolution of symptoms and radiological findings. The possible pathogenetic relationship between intracranial hypotension, secondary to the inadvertent dural puncture, and PRES is discussed. Prompt diagnosis and proper treatment results in complete cure without permanent neurological sequelae

    Fatal case of acute fatty liver of pregnancy

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    Acute fatty liver in pregnancy is a catstrophic condition with high mortality and morbidity. Delay in managing complications would result in fatality. We present a case of 22-year-old primi, who presented to us in labor with jaundice and later developed, disseminated intravascular coagulation, Vulval haematoma, reexploration, sepsis, ARDS and cardiac arrest and death

    COVID-19 Pandemic and Indices Volatility:Evidence from GARCH Models

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    This study examines the impact of volatility on the returns of nine National Stock Exchange (NSE) indices before, during, and after the COVID-19 pandemic. The study employed generalized autoregressive conditional heteroskedasticity (GARCH) modelling to analyse investor risk and the impact of volatility on returns. The study makes several contributions to the existing literature. First, it uses advanced volatility forecasting models, such as ARCH and GARCH, to improve volatility estimates and anticipate future volatility. Second, it enhances the analysis of index return volatility. The study found that the COVID-19 period outperformed the pre-COVID-19 and overall periods. Since the Nifty Realty Index is the most volatile, Nifty Bank, Metal, and Information Technology (IT) investors reaped greater returns during COVID-19 than before. The study provides a comprehensive review of the volatility and risk of nine NSE indices. Volatility forecasting techniques can help investors to understand index volatility and mitigate risk while navigating these dynamic indices.</p

    Attenuation of Mycobacterium species through direct and macrophage mediated pathway by unsymmetrical diaryl urea

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    Tuberculosis is a major threat for mankind and the emergence of resistance strain of Mycobacterium tuberculosis (Mtb) against first line antibiotics makes it lethal for human civilization. In this study, we have synthesized different diaryl urea derivatives targeting the inhibition of mycolic acid biosynthesis. Among the 39 synthesized molecules, compounds 46, 57, 58 and 86 showed MIC values ≀ 10 Όg/ml against H37Rv and mc26030 strains. The best molecule with a methyl at ortho position of the first aromatic ring and prenyl group at the meta position of the second aromatic ring showed the MIC value of 5.2 Όg/ml and 1 Όg/ml against H37Rv and mc26030 respectively, with mammalian cytotoxicity of 163.4 Όg/ml. The effective compounds showed selective inhibitory effect on mycolic acid (epoxy mycolate) biosynthesis in14C-radiolabelled assay. At the same time these molecules also executed their potent immunomodulatory activity by up-regulation of IFN-Îł and IL-12 and down-regulation of IL-10.Fil: Velappan, Anand Babu. Sastra University; IndiaFil: Charan Raja, Mamilla R.. Sastra University; IndiaFil: Datta, Dhrubajyoti. Indian Institute of Science Education and Research Pune; IndiaFil: Tsai, Yi Ting. Consejo Nacional de Investigaciones CientĂ­ficas y TĂ©cnicas. Centro CientĂ­fico TecnolĂłgico Conicet - Rosario. Instituto de BiologĂ­a Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias BioquĂ­micas y FarmacĂ©uticas. Instituto de BiologĂ­a Molecular y Celular de Rosario; ArgentinaFil: Halloum, Iman. UniversitĂ© de Montpellier; Francia. Centre National de la Recherche Scientifique; FranciaFil: Wan, Baojie. University of Illinois; Estados UnidosFil: Kremer, Laurent. UniversitĂ© de Montpellier; Francia. Inserm; Francia. Centre National de la Recherche Scientifique; FranciaFil: Gramajo, Hugo Cesar. Consejo Nacional de Investigaciones CientĂ­ficas y TĂ©cnicas. Centro CientĂ­fico TecnolĂłgico Conicet - Rosario. Instituto de BiologĂ­a Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias BioquĂ­micas y FarmacĂ©uticas. Instituto de BiologĂ­a Molecular y Celular de Rosario; ArgentinaFil: Franzblau, Scott G.. University of Illinois; Estados UnidosFil: Kar Mahapatra, Santanu. Sastra University; IndiaFil: Debnath, Joy. Sastra University; Indi

    Remdesivir use in pregnant women with severe COVID-19

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    Numerous therapeutic strategies are proposed and tested for SARS CO-V2 infection. Remdesivir is researched and proposed by various societies. Studies about efficacy and safety in pregnancy are limited. A case series of 22 pregnant women effected with severe COVID disease and who received remdesivir, over a period of 1 year from May 2020 to May 2021 is presented. The 12 antenatal and 10 post-partum women were included. Demographic factors, baseline, day 3 and day 7 blood values of haemoglobin, total leukocyte count, platelets, liver enzymes, serum creatinine and D-dimers were collected. Adverse events were reported. Pregnancy complications and foetal and neonatal complications were studied. Pre-eclampsia was the most common comorbidity. The 99% of pregnant women and 100% of postpartum women recovered from COVID disease after remdesivir use. Lab investigations did not change considerably during the week of remdesivir use, suggesting its safety. Incidence of adverse events reported is 36.3%, of these 9% are serious adverse events. There are no antenatal or post-natal complications. No incidence of teratogenicity, foetal or neonatal complications. Incidence of feto-maternal transmission was 9%. Remdesivir is effective in treating severe SARS-CoV2 infection and has safety profile in pregnancy with regard to maternal and foetal effects

    Prenatal Opioid Exposure and Intermittent Hypoxemia in Preterm Infants: A Retrospective Assessment

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    Introduction: Intermittent hypoxemia (IH) is defined as episodic drops in oxygen saturation (SpO2). Preterm infants are at increased risk for IH due to their immature respiratory control/apnea of prematurity. The clinical relevance of IH is a relatively new observation with rising evidence linking IH to neonatal morbidities and long-term impairment. Hence, assessing factors that influence IH in preterm infants is imperative. Given the epidemic of opioid misuse in the USA, there is an urgent need to understand the impact of prenatal opioid exposure on neonatal outcomes. Hence, we wanted to assess the relationship between isolated prenatal opioid exposure and IH in preterm infants. Methods: In order to accurately calculate IH, SpO2 data were prospectively collected using high-resolution pulse oximeters during the first 8 weeks of life in preterm infants less than 30 weeks gestational age. Data related to prenatal opioid misuse were retrospectively collected from medical charts. Infants with tobacco or poly-drug exposure were excluded. The primary outcome measure is percent time spent with SpO2 below 80% (%time-SpO2 \u3c 80). The secondary outcome measure is the number of severe IH events/week with SpO2 less than 80% (IH-SpO2 \u3c 80). Results: A total of 82 infants with isolated opioid exposure (n = 14) or who were unexposed (n = 68) were included. There were no significant differences in baseline characteristics between opioid exposed and unexposed groups. There was a statistically significant increase of 0.23 (95% CI: 0.03, 0.43, p = 0.03) in mean of the square root of %time-SpO2 \u3c 80. The number of IH-SpO2 \u3c 80 events was higher in the opioid exposed group (mean difference = 2.95, 95% CI: −0.35, 6.25, p-value = 0.08), although statistical significance was not quite attained. Conclusion: This study shows that preterm infants prenatally exposed to opioids have increased IH measures compared to unexposed infants. Interestingly, the increased IH in the opioid exposed group persists beyond the immediate postnatal period

    Separation of monochloroacetic acid and dichloroacetic acid by reactive extractive distillation

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    Separation of monochloroacetic acid and dichloroacetic acid by reactive extractive distillation

    No full text
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