Anaesthetic management of a pregnant patient with intracranial space occupying lesion for craniotomy

Intracranial space occupying lesion [SOL] during pregnancy presents several challenges to the neurosurgeons, obstetricians and anaesthesiologists in not only establishing the diagnosis, but also in the perioperative management as it requires a careful plan to balance both maternal and foetal well-being. It requires modification of neuroanaesthetic and obstetric practices which often have competing clinical goals to achieve the optimal safety of both mother and foetus. Intracranial tuberculoma should be considered in the differential diagnosis of intracranial SOL in pregnant women with signs and symptoms of raised intracranial pressure with or without neurological deficits, especially when they are from high incidence areas. We report a 28-week pregnant patient with intracranial SOL who underwent craniotomy and excision of the lesion, subsequently diagnosed as cranial tuberculoma

Uterine-sparing minimally invasive interventions in women with uterine fibroids: a systematic review and indirect treatment comparison meta-analysis.

OBJECTIVE: To evaluate the effectiveness of uterine-sparing interventions for women with symptomatic uterine fibroids who wish to preserve their uterus. DESIGN: Systematic review and indirect comparison meta-analysis. METHODS: MEDLINE, EMBASE, CENTRAL, conference proceedings, trial registers and reference lists were searched up to October 2013 for randomized controlled trials. MAIN OUTCOME MEASURES: Outcome measures were patient satisfaction, re-intervention and complications rates, reproductive outcomes, and hospitalization and recovery times. RESULTS: Five trials, involving 436 women were included; two compared uterine artery embolization with myomectomy and three compared uterine artery embolization with laparoscopic uterine artery occlusion. Indirect treatment comparison showed that myomectomy and uterine artery embolization resulted in higher rates of patient satisfaction (odds ratio 2.56, 95% credible interval 0.56-11.75 and 2.7, 95% credible interval 1.1-7.14, respectively) and lower rates of clinical failure (odds ratio 0.29, 95% credible interval 0.06-1.46 and 0.37, 95% credible interval 0.13-0.93, respectively) than laparoscopic uterine artery occlusion. Myomectomy resulted in lower re-intervention rate than uterine artery embolization (odds ratio 0.08, 95% credible interval 0.02-0.27) and laparoscopic uterine artery occlusion (odds ratio 0.08, 95% credible interval 0.01-0.37) even though the latter techniques had an advantage over myomectomy because of shorter hospitalization and quicker recovery. There was no evidence of difference between the three techniques in ovarian failure and complications rates. The evidence for reproductive outcomes is poor. CONCLUSION: Our study's results suggest that laparoscopic uterine artery occlusion is less effective than uterine artery embolization and myomectomy in treatment of symptomatic fibroids. The choice between uterine artery embolization and myomectomy should be based on individuals' expectations and fully informed discussion

Uterine-sparing minimally invasive interventions in women with uterine fibroids: a systematic review and indirect treatment comparison meta-analysis.

OBJECTIVE: To evaluate the effectiveness of uterine-sparing interventions for women with symptomatic uterine fibroids who wish to preserve their uterus. DESIGN: Systematic review and indirect comparison meta-analysis. METHODS: MEDLINE, EMBASE, CENTRAL, conference proceedings, trial registers and reference lists were searched up to October 2013 for randomized controlled trials. MAIN OUTCOME MEASURES: Outcome measures were patient satisfaction, re-intervention and complications rates, reproductive outcomes, and hospitalization and recovery times. RESULTS: Five trials, involving 436 women were included; two compared uterine artery embolization with myomectomy and three compared uterine artery embolization with laparoscopic uterine artery occlusion. Indirect treatment comparison showed that myomectomy and uterine artery embolization resulted in higher rates of patient satisfaction (odds ratio 2.56, 95% credible interval 0.56-11.75 and 2.7, 95% credible interval 1.1-7.14, respectively) and lower rates of clinical failure (odds ratio 0.29, 95% credible interval 0.06-1.46 and 0.37, 95% credible interval 0.13-0.93, respectively) than laparoscopic uterine artery occlusion. Myomectomy resulted in lower re-intervention rate than uterine artery embolization (odds ratio 0.08, 95% credible interval 0.02-0.27) and laparoscopic uterine artery occlusion (odds ratio 0.08, 95% credible interval 0.01-0.37) even though the latter techniques had an advantage over myomectomy because of shorter hospitalization and quicker recovery. There was no evidence of difference between the three techniques in ovarian failure and complications rates. The evidence for reproductive outcomes is poor. CONCLUSION: Our study's results suggest that laparoscopic uterine artery occlusion is less effective than uterine artery embolization and myomectomy in treatment of symptomatic fibroids. The choice between uterine artery embolization and myomectomy should be based on individuals' expectations and fully informed discussion

Evaluation of in vitro antioxidant activity of a few wild cucurbitaceae plants against cancer

The methanolic extract of whole plant of Diplocyclos palmatus, roots of Corallocarpus epigaeus and fruits of Lagenaria siceraria were evaluated for their antioxidant efficacy by DPPH radical scavenging assay. Reactive Oxygen Species (ROS) and many of the free radicals are natural by-products of metabolism of drugs, environmental chemicals and other Xenobiotics as well as endogenous chemicals, especially stress hormones like adrenalin and noradrenalin. ROS has a high reactive potential and is responsible for many of the human diseases like diabetes, cancer, viral infections, cardiovascular diseases and inflammations and is known to cause oxidative damage to DNA, proteins and lipids in humans. Antioxidants nowadays are increasingly sought as components of the diet owing to their benefits upon human health through protection of cells against oxidative stress which might otherwise lead to cell damage and death. The antioxidants present in the medicinal plants quench the free radicals by donating a hydrogen atom. The antioxidant activity of the medicinal plants namely, Diplocyclos palmatus, Corallocarpus epigaeus and Lagenaria siceraria were estimated by using 2, 2�Diphenly 1-Picryl Hydrazyl (DPPH) assay. The present study aims at evaluating therapeutic potential of these medicinal plants due to their high free radical scavenging activity

Perfusion Index as A Predictor of Hypotension Following Subarachnoid Block in Parturients with Non-severe Pre-eclampsia Undergoing Lower Segment Cesarean Section

Background and Aims: Perfusion index, which assesses perfusion dynamics is used as a non‑invasive method in spinal anesthesia cases to detect the occurrence of hypotension. A Perfusion Index value after which hypotension is common can be assessed. Methods: In this prospective double-blind observational study, 100 parturients were included. Baseline Perfusion Index was recorded and spinal anesthesia was carried out with Injection bupivacaine 0.5% (hyperbaric), 10 mg at L3 - L4 / L2 - L3 intervertebral space. Fall in Systolic Blood Pressure < 20 % of baseline was defined as hypotension. Chi-Square test and independent sample t-test was used for the statistical analysis. Spearman's rank correlation coefficient was applied to assess the correlation between baseline PI and hypotension. The receiver operating characteristic (ROC) curve was mapped for PI and the occurrence of hypotension. Results: The occurrence of hypotension in parturients with PI < 4.25 was 40.9% compared to 94.6% in parturients with PI > 4.25. There was a remarkable association between baseline PI > 4.25, the number of episodes of hypotension 53/100 (p-value < 0.0001) and the total dose of phenylephrine used 53/100 (p-value 0.02).

Is soilless agriculture feasible for hybrid seed production in tomato (<i>Solanum lycopersicum</i> L.)?

Hydroponics and aeroponics are advanced techniques for cultivating plants under controlled conditions without soil in polyhouses to address soil-related problems. An experiment was designed to evaluate the potentiality of soilless methods over conventional soil-based methods for hybrid seed production of tomatoes. For initial standardization of nutrient solution and pH of the media, six different nutrient solutions viz., Hoagland’s, CPRI, Chikkaballapur, Ethiopia, USDA and Komosa nutrient solutions, were tested, and pH was standardized. The crop performance was superior in Hoagland’s nutrient solution with a pH range of 5.5–6.4. The experiment comprised three methods of production, two parental lines (TAG 1 F and TAG 2 F), and two seed treatments (S1: Control and S2: Thiram @ 2 g kg-1 + chlorpyrifos @3 g kg-1) for hybrid seed production of tomato. A hundred percent survival rate was recorded in a soilless medium, whereas seed treatment increased the percent survival rate by 9% under the conventional system. Soiless method performed better than the conventional method. Aeroponics recorded a higher plant relative growth rate (1.17), fruit weight (124.54 g), total biomass (106.44 g), and seed index (3.95 g). Hydroponics produced a higher number of seeds fruit 1 (98.42), SVI-II (294), and 6% higher protein than the conventional method. The soilless method may open up a new approach for high-quality and year-round healthy hybrid tomato seed production under protected cultivation.</p