Thyroid dysfunctions in patients with chronic renal failure

Background: Chronic renal failure (CRF), or end-stage renal disease (ESRD), is a progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic and fluid and electrolyte balance fails, resulting in the development of clinical symptoms like uraemia or azotemia. Thyroid hormones have an important role in regulating metabolism, development of the kidney, maintenance of water and electrolyte homeostasis, protein synthesis and influencing other hormone function. Tri-iodothyronine (T3) and thyroxin (T4) are the two main hormones produced by the thyroid. The patients with chronic renal failure often exhibit clinical features and laboratory findings which are indicative of thyroid dysfunction, since, kidney is involved in the metabolism and elimination of TH.Methods: This was a cross sectional single centre descriptive study, including 50 patients of either gender between the age of 45-70 years.Results: Present study found a significant positive correlation between the TSH levels and Zulewski score in patients with CRF.Conclusions: Since there was found to be a correlation between the TSH levels and Zulewski score, the evaluation of symptoms and signs with Zulewski score in addition to thyroid function testing in patients with thyroid dysfunction is essential, since it can be a marker for CRF

Approach to failed spinal anaesthesia for caesarean section

Failure of spinal anaesthesia for caesarean section may have deleterious consequences for the mother as well as the newborn baby. In this article, we discuss the mechanisms of failure of spinal anaesthesia as well as the approach to a failed block. We performed a literature search in Google Scholar, PubMed, and Cochrane databases for original and review articles concerning failed spinal anaesthesia and caesarean section. Strategies for a failed spinal anaesthetic include manoeuvers to salvage the block, repeating the block, epidural anaesthesia or a combined spinal–epidural (CSE) technique, or resorting to general anaesthesia. Factors influencing the choice of these alternative options are discussed. A “failed spinal algorithm” can guide the anaesthesiologist and help reduce morbidity and mortality

Crystallization study and morphology behaviour of calcium carbonate crystals in aqueous Surfactant-Pluronics® prototype

A facile procedure to fabricate the hydrophobic surfaces of calcium carbonate-polymer composites has been well described. Nano-sized highly ordered CaCO3 clusters i.e. calcite/vaterite have been synthesized by simple precipitation in the presence of template made of cationic surfactant: cetyl trimethyl ammonium bromide (CTAB) and different non-ionic amphiphilic triblock copolymers comprising of PEO–PPO–PEO units: F98 and F127 commercially known as Pluronics® or Synperonics® or Poloxamers. The morphology of these nano-composites so formed was characterized in detail using spectroscopy, microscopy, diffraction, and scattering techniques. It was found that the surfactant-polymer prototype turned out to be an important parameter to tune and understand the shape-controlled morphology and crystallization in precipitated calcium carbonate (PCC). Our diffraction pattern depicted the presence of calcite/vaterite, while the microscopic investigations indicated the bunch/clusters of calcite (nano-flakes) arranged in stacks which could be attributed to the attractive hydrophobic interaction between the alkyl group of cationic surfactant and -PPO unit of the block copolymer. Similar assumptions were inferred by structural optimization using Gauss View 5.0.9. The scattering measurements described the polydispersity of nano-aggregates based on the scattering intensity. Results expounded the growth mechanism of CaCO3 crystals to be a step-by-step build process with respect to the polarity. Keywords: Calcium carbonate, Surfactant, Pluronics®, Crystal growth, Diffraction, Scattering, Microscop

Omental torsion

Omental torsion is a rare cause of acute abdominal pain, and clinically mimics acute appendicitis. A 11-year-old boy presented with symptoms and signs suggestive of appendicitis. A computed tomography of abdomen revealed findings suggestive of omental torsion. Diagnostic laparoscopy confirmed the diagnosis of torsion of a segment of the greater omentum

Omental torsion

Omental torsion is a rare cause of acute abdominal pain, and clinically mimics acute appendicitis. A 11-year-old boy presented with symptoms and signs suggestive of appendicitis. A computed tomography of abdomen revealed findings suggestive of omental torsion. Diagnostic laparoscopy confirmed the diagnosis of torsion of a segment of the greater omentum