Prospective Randomized Trial on Effect of Adding Clonidine to Hyperbaric Bupivacaine Intrathecally in Patients Posted for Caesarean Section

INTRODUCTION: Caesarean section is one of the commonest surgeries performed. Unlike most surgical patients, many parturients express the desire to be awake and alert during and after childbirth. The recovery should be compatible with the initial newborn bonding and frequent feeding. The role of Obstetric Anaesthesiologist has been enhanced to include providing safe and satisfying postoperative pain relief to the parturient. The advantages of spinal anaesthesia in caesarean section include; • the simplicity of the technique. • rapid onset of anaesthesia. • less neonatal exposure to potentially depressant drugs. • decreased risk of maternal pulmonary aspiration. • awake mother at the birth of the child. • Option of using additives to local anaesthetics for postoperative pain relief. Bupivacaine was introduced by Eckenstam in 1957 and used clinically by Telivuo in 1963. Although Intrathecal Bupivacaine alone offers blockade upto T5 dermatome, a substantial number of patients still experience some pain or discomfort and require analgesic supplement during Caesarean delivery. Addition of α2 adrenergic agonist Clonidine to Bupivacaine has a variety of actions • potentiates the effects of local anaesthetic • improves the quality of intraoperative anaesthesia • prolongs the sensory blockade and reduces the requirement of postoperative analgesics • Does not produce pruritus and respiratory depression unlike spinal opioids. This study was designed to evaluate the efficacy and adverse effects of 75μg Clonidine added to 0.5% Hyperbaric Bupivacaine administered intrathecally in patients undergoing elective Caesarean section. AIM OF THE STUDY: This study aims to evaluate the effects of addition of Clonidine, an alpha -2 agonist to 0.5%Hyperbaric Bupivacaine administered intrathecally in patients posted for elective caesarean section comparing with a placebo. (Normal saline). MATERIALS AND METHODS: This study was conducted at the Institute of Obstetrics and Gynaecology, Madras medical College, Egmore, Chennai. Between January 2009 - March 2009 on 100 Patients of ASA Physical status I and II undergoing elective Caesarean Section. This study was done after ethical committee approval and written informed Consent obtained from all the Patients included in this study. STUDY DESIGN: This study was done in a prospective, double blind randomized manner. Each group consisted of fifty patients. Group BC - Patients in this group received 2ml of 0.5% Hyperbaric Bupivacaine + 75μg (0.5ml) of preservative free Clonidine to a total volume of 2.5 ml intrathecally. Group BN - Patients in this group received 2ml of 0.5% Hyperbaric Bupivacaine + 0.5 ml of normal saline intrathecally. The final volume of injected solution was 2.5ml in both groups. In this study 0.5% Hyperbaric Bupivacaine in 8% Dextrose manufactured by NEON Labs Ltd, Thane, and Clonidine hydrochloride (CLONEON) 150μg/ml manufactured by NEON Labs Ltd, Thane and Normal Saline manufactured by HASEEB pharmaceuticals Ltd, Nagpur were used. All the solutions were prepared under strict aseptic precautions, by the OT in charge anaesthesiologist uninvolved in the administration of SAB or in the Observation of results. The specific gravity of the injected solution is 1.025, 1.211 in group BC and BN respectively. All the solutions were hyperbaric relative to CSF. SELECTION OF CASES: Inclusion criteria: 1. ASA Physical status I & II. 2. Age between 18 – 35 years. 3. Height 145 – 160cm. 4. Patients who have given valid Informed consent. 5. Singleton fetus at term. Exclusion criteria: 1. Not satisfying inclusion criteria. 2. Age 35. 3. Preterm. 4. Hypertensive disorders of Pregnancy. 5. Cardio vascular, Neurological, Hepatic or Renal disease. 6. Known Hypersensitivity to the Study drug. 7. Contraindication to SAB. 8. Opioid exposure during pregnancy. 9. Unconscious, or severely ill Patients. OBSERVATION AND RESULTS: This study was conducted at the Institute of Obstetrics and Gynaecology, Egmore, Chennai. 100 patients were included in this double blinded randomized controlled study. The patients were divided in to two groups. Patients in group BC received 2ml (10mg) of 0.5% hyperbaric Bupivacaine plus 0.5ml (75μg) of Clonidine. Patients in group BN received 2ml (10mg) of 0.5% hyperbaric Bupivacaine plus 0.5ml of normal saline. Final volume of injected solution was 2.5ml in both groups. SUMMARY: This double blinded prospective randomized controlled trial was designed to evaluate the efficacy of 75 μg (0.5ml) Clonidine added to 10 mg (2ml) of 0.5% hyperbaric Bupivacaine intrathecally, in patients aged 18- 35years undergoing elective caesarean section. Patients receiving 0.5ml of normal saline with 2ml of Bupivacaine intrathecally served as the control. The following observations were made. • The addition of Clonidine significantly prolonged the two segment Regression time. • The addition of Clonidine significantly prolonged the duration of effective surgical analgesia. • The addition of Clonidine significantly prolonged the sensory block and motor block. • The addition of Clonidine significantly prolonged the duration of time for demand analgesia. • The addition of Clonidine intrathecally had no effect on the onset of sensory and motor block. • The incidence of side effects was limited to the occurrence of hypotension, bradycardia and sedation in the groups that received Clonidine intrathecally. • Addition of Clonidine did not have any effect on the fetal APGAR score. • Addition of Clonidine decreased the intra operative and post operative shivering. • Addition of Clonidine decreased the intra operative nausea and vomiting. CONCLUSION: This study confirms the efficacy of 75μg of Clonidine as a safe and effective adjuvant to 0.5% hyperbaric Bupivacaine in subarachnoid block for caesarean section. The addition of 75 μg of Clonidine to 2 ml of 0.5% hyperbaric Bupivacaine improved the quality of surgical anaesthesia. Clonidine 75 μg added to 10mg of 0.5% hyperbaric Bupivacaine intrathecally prolonged post operative analgesia and reduces the post operative analgesic requirements

Hermetic storage - an ecofriendly safe storage method for long term storage of black gram: Poster

India is the primary origin of the black gram that is majorly cultivated in the southern part of Asian countries. About 70% of world black gram production comes from India. Black gram is more prone to insect infestation and microorganisms resulting in deterioration of grain quality. These losses can be controlled by following appropriate storage method at farmer’s level. Eco-friendly, safe storage methods are demanded by the customers due to food safety, quality and environmental issues. Hermetic storage is a safe storage method, suitable for long term storage without usage of chemical pesticides. It creates an air tight environment to rapidly exterminate insect development and suppresses micro floral activity. A study was conducted to identify the suitable, cost effective storage method for safe storage of black gram at the farm level. Hermetic bags were made by using different combinations of gunny, polypropylene & storezo bags for the safe storage of black gram. The properties of packaging materials viz., thickness, and water vapour transmission rate significantly affected the quality parameters of the black gram stored in various bags. Moisture content, thousand grain mass, bulk density, insect emergence, and germination percentage of black gram stored in various bags were studied over a storage period of 12 months. Black gram stored in polypropylene and gunny bags was infested with pulse beetle by the third month of the storage period. But black gram stored in bags with hermetic bag as inner layer was not infested up to 12 months and could retain the grain quality.India is the primary origin of the black gram that is majorly cultivated in the southern part of Asian countries. About 70% of world black gram production comes from India. Black gram is more prone to insect infestation and microorganisms resulting in deterioration of grain quality. These losses can be controlled by following appropriate storage method at farmer’s level. Eco-friendly, safe storage methods are demanded by the customers due to food safety, quality and environmental issues. Hermetic storage is a safe storage method, suitable for long term storage without usage of chemical pesticides. It creates an air tight environment to rapidly exterminate insect development and suppresses micro floral activity. A study was conducted to identify the suitable, cost effective storage method for safe storage of black gram at the farm level. Hermetic bags were made by using different combinations of gunny, polypropylene & storezo bags for the safe storage of black gram. The properties of packaging materials viz., thickness, and water vapour transmission rate significantly affected the quality parameters of the black gram stored in various bags. Moisture content, thousand grain mass, bulk density, insect emergence, and germination percentage of black gram stored in various bags were studied over a storage period of 12 months. Black gram stored in polypropylene and gunny bags was infested with pulse beetle by the third month of the storage period. But black gram stored in bags with hermetic bag as inner layer was not infested up to 12 months and could retain the grain quality

Investigation of deformation of the cornea during tonometry using FEM

A three dimensional finite element model of the human eye is developed to evaluate the force which will be applied over the surface of cornea during tonometry and gonioscopy tests. The standard tonometers and gonioscopy experiences deformation from 0.5mm to 3mm of the cornea is adopted during both point contact and boundary contact on the surface of the cornea. The results demonstrate the maximum force experienced by the tonometer with point contact at the center of the cornea for the maximum possible deformation of the cornea during tonometry. The study also analyzes for the force experienced by the tonometer or goniolens with boundary layer contact for the defined deformation of the cornea along the direction from cornea towards the retina

Rare earth element (REE) lanthanum doped zinc oxide (La: ZnO) nanomaterials: synthesis structural optical and antibacterial studies

Lanthanum (La) doped zinc oxide (ZnO) nanomaterials (LaxZn1-xO, x = 0.0, 0.03, 0.05, 0.07 M) were synthesized via co-precipitation method using zinc acetate, lanthanum nitrate as precursors, octylamine as capping and reducing agent. The structures, morphologies, optical activity and antibacterial properties of LaxZn1-xO were investigated by powder X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, High resolution scanning electron microscopy (HR-SEM), Energy dispersive X-ray (EDX), UV–Visible, Photoluminescence (PL) spectroscopy. The antibacterial activities of LaxZn1-xO were tested by modified disc diffusion method. The XRD results showed that the La3+ ions were successfully incorporated into the ZnO host, and the products were well-crystalline. The average size of undoped and doped La-doped ZnO was found to be in the ranges from 15.64 to 10.18 nm. In addition, the sphere-like nanoparticles morphology of LaxZn1-xO was confirmed by HR-SEM images. The band gap of La-doped ZnO nanoparticles were varied with the La3+ ions doping concentration. In addition, increasing the doping concentration of La3+ ions in ZnO increases the defects in ZnO lattice and hence resulting red-shift in UV emission, which indicate the presence of narrow band-gap in doped nanoparticles

Evaluation of in-vitro anti-cancer activity of aqueous extract of the C. maxima seed

The most frequent cancer in women worldwide is breast cancer, it is also the second leading cause of cancer-related death in women. As a consequence, there is a pressing need to develop more effective cancer medicines. The seed of pumpkin C. maxima reported to have medicinal properties and pharmacological activities like anti-inflammatory, antioxidant and anti-microbial activity. In the present study, we performed DPPH free radical scavenging activity and anti-microbial activity against microorganisms E. coli, P. aeruginosa, A. bracilences, S. aureus using aqueous extract of C. maxima seed were preferred. MCF-7 breast cancer cells were used to test anti-cancer activities In -vitro. The outcomes revealed high anti-oxidant activity of the extract 0.781 ± 0.016 in 100 μg/ml and anti-microbial activity showed the most prominent activity of the extract against all the tested microorganisms. The MTT assay showed IC50 value of 45.40 μg/ml of the extract. Further, the Ao/EtBr staining proved that the methanolic extract of C. maxima possess protective activity against MCF-7 cell lines

Crystal structure and Hirshfeld surface analysis of 4′-(2-chlorophenyl)-1′-methyl-3′′-phenyl-7′′,8′′-dihydro-5′′H-dispiro[indoline-3,2′-pyrrolidine-3′,6′′-isoquinoline]-2,5′′-dione

In the title dispiro compound, C32H26ClN3O2, the cyclohexanone ring of the isoquinoline unit has a distorted envelope conformation, with the methylene C atom adjacent to the spiro C atom as the flap. The central 1-methylpyrrolidine ring has an envelope conformation with the N atom as the flap. The mean planes of the indolin-2-one ring system, the chlorobenzene ring and the isoquinoline ring system are inclined to the mean plane of the central 1-methylpyrrolidine ring by 87.95 (11), 71.01 (12) and 88.81 (10)°, respectively. There are two short C—H...O intramolecular contacts present. In the crystal, molecules are linked via C—H... O hydrogen bonds, forming chains along the a-axis direction. The NH H atom is involved in a weak N—H...O hydrogen bond with the same carbonyl O atom. There are no further significant intermolecular contacts present. The largest contribution to the overall Hirshfeld surface of 52.3% is due to H—H contacts

Protic Ionic Liquid Assisted Synthesis and Characterization of Ferromagnetic Cobalt Oxide Nanocatalyst

Cobalt oxide (Co3O4) nanocatalyst was synthesized by sol-gel method using the protic ionic liquid namely 1-butylimidazolium glycolate as solvent and stabilizer. The obtained Co3O4 nanocatalyst was characterized by powder X-ray diffraction (XRD), Fourier transform infrared, High resolution scanning electron microscopy (HR-SEM), Energy dispersive X-ray (EDX), High resolution transmission electron microscopy (HR-TEM), Selected area electron diffraction, UV–Visible diffuse reflectance spectroscopy, Photoluminescence spectroscopy, Brunauer–Emmett–Teller surface area and Vibrating sample magnetometer (VSM). Powder XRD results showed the well-crystalline cubic structure of synthesized Co3O4 with size of 19.29 nm. Also, the sphere-like morphology of Co3O4 nanocatalyst was confirmed by HR-SEM and HR-TEM images. Furthermore, the synthesized Co3O4 nanocatalyst possessed optical band gap values of 1.75 and 2.46 eV and hence acted as a semiconducting material. In addition, the presence of small hysteresis loop in Magnetic measurement (VSM) confirmed the ferromagnetic nature of Co3O4 nanoparticles. Moreover, the synthesized Co3O4 nanocatalyst found to be used in photo-catalytic degradation of methylene blue and exhibited 94.61% efficiency