Case Report: Broken Heart Syndrome – An intra operative complication

We report a case of Broken Heart Syndrome in a 56 year old Postmenopausal woman suffered while undergoing simple biopsy procedure for vocal cord polyp that lead to physical, mental and financial burden both for the patient as well as the doctors. A team of cardiologists based on clinical and echocardiographic findings made the diagnosis of this case.Keywords: Broken Heart Syndrome, Intraoperative myocardial infarction, Reversible myocardial infarction, Tako-Tsubo Cardiomyopathy, Stress related myocardial infarctio

Smart Surfaces with Tunable Wettability

Modification of surface wettability (ranging from complete wetting to complete non-wetting) of various surfaces is often required in many applications. Conventionally, it is done using a coating of suitable materials as per the requirement. In this approach, the old coating needs to be replaced every time by a new appropriate one. Alternatively, smart responsive surfaces can show tunable wettability with external stimulus. Electric field, temperature, light, pH, mechanical strain, etc. can be effectively used as external stimuli, and a suitable coating can be incorporated, which responses to the respective stimulus. These surfaces can be used to tune the surface wettability to any extent based on the magnitude of the stimulus. The primary role of the external stimulus is to vary the liquid-solid interfacial energy, which subsequently changes the surface wettability. The biggest advantage of this approach is that the surface wettability can be reversibly tuned. Each of the techniques mentioned above has many advantages along with certain limitations, and the combination of advantages and limitations helps users to choose the right technique for their work. Many recent studies have used this approach to quantify the tuning of the surface wettability and have also demonstrated its potential in various applications

Comparative Analysis of ESBL-Positive Escherichia coli isolates from Animals and Humans from the UK, the Netherlands and Germany

The putative virulence and antimicrobial resistance gene contents of extended spectrum β-lactamase (ESBL)-positive E. coli (n=629) isolated between 2005 and 2009 from humans, animals and animal food products in Germany, The Netherlands and the UK were compared using a microarray approach to test the suitability of this approach with regard to determining their similarities. A selection of isolates (n=313) were also analysed by multilocus sequence typing (MLST). Isolates harbouring blaCTX-M-group-1 dominated (66%, n=418) and originated from both animals and cases of human infections in all three countries; 23% (n=144) of all isolates contained both blaCTX-M-group-1 and blaOXA-1-like genes, predominantly from humans (n=127) and UK cattle (n=15). The antimicrobial resistance and virulence gene profiles of this collection of isolates were highly diverse. A substantial number of human isolates (32%, n=87) did not share more than 40% similarity (based on the Jaccard coefficient) with animal isolates. A further 43% of human isolates from the three countries (n=117) were at least 40% similar to each other and to five isolates from UK cattle and one each from Dutch chicken meat and a German dog; the members of this group usually harboured genes such as mph(A), mrx, aac(6’)-Ib, catB3, blaOXA-1-like and blaCTX-M-group-1. forty-four per cent of the MLST-typed isolates in this group belonged to ST131 (n=18) and 22% to ST405 (n=9), all from humans. Among animal isolates subjected to MLST (n=258), only 1.2% (n=3) were more than 70% similar to human isolates in gene profiles and shared the same MLST clonal complex with the corresponding human isolates. The results suggest that minimising human-to-human transmission is essential to control the spread of ESBL-positive E. coli in humans

Broken Heart Syndrome – An intra operative complication

We report a case of Broken Heart Syndrome in a 56 year old Postmenopausal woman suffered while undergoing simple biopsy procedure for vocal cord polyp that lead to physical, mental and financial burden both for the patient as well as the doctors. A team of cardiologists based on clinical and echocardiographic findings made the diagnosis of this case

Section: Anaesthesia Role of Laryngeal Spasm in Negative Pressure Pulmonary Oedema

ABSTRACT Negative-pressure pulmonary edema (NPPE) is a clinical entity of anaesthesiologic relevance, peri-operatively caused by obstruction of the conductive airways (upper airway obstruction, UAO) due to laryngospasm in approx. 50% of the cases, its early recognition and treatment by the anaesthesiologist is mandatory. Laryngospasm, a brief closure of the vocal cords is not an uncommon peri-operative occurrence. If recognized and managed appropriately, the effects are transient and reversible. However, in rare cases where recognition and management are delayed, the consequences are associated with a high morbidity including desaturation, awareness, negative pressure pulmonary edema, and mortality

Spinal versus general anaesthesia in percutaneous nephrolithotomy

Background: Hemodynamic stability and blood loss reduction are subjects to further consideration in patients undergoing percutaneous nephrolithotomy (PNCL). Objectives: This study compared the preference of spinal anaesthesia (SA) or general anaesthesia (GA) in respect to mentioned concerns. Methods: In this randomized clinical trial, 59 patients who underwent PCNL divided into SA and GA groups. 15-20 mg from intra-thecal bupivacaine 0.5%, and premedication of 0.01-0.02 mg from midazolam, were given to patients in SA group (n = 29). Patients in GA group (n = 30) received premedication of 1-2 μg/kg from fentanyl and 0.01-0.02 mg/kg from midazolam, and intravenously anaesthetized with 100 μg/kg/min of propofol and 0.5 mg/kg of atracurium, given by continuous infusion and N2O/O2 50%. Mean arterial pressure (MAP) and heart rate were recorded intra-operatively and during recovery. Results: MAP and heart rate show no significant differences at designated time points between two groups (P > 0.05). Surgery time, anesthesia time, bleeding volume, and analgesic intake were significantly reduced in SA group (P < 0.05). Conclusions: Regional epidural anaesthesia is an alternative technique for PCNL which achieves more patient satisfaction, less early postoperative pain and less adverse effects from medication with the same efficacy and safety compared to general anaesthesia. It seems that, in patients undergoing PNCL, SA is as effective and safe as GA and with many advantages over it