Trousseau’s sign in orthopedic: a rare sequelae of inadequate postoperative pain management

Background: Pain management in orthopedic is very crucial matter to handle, which is many a times not managed properly and that leads to various medical complications to the patients. Trousseau sign of latent tetany is a medical sign observed in patients with low calcium. This is the first and one of a kind case series describing the development and pathogenesis of Trousseau sign in orthopedics.Methods: This is a case series of 5 patients with lower limb fractures who underwent surgery. All these patients developed Trousseau's sign in immediate postoperative period. All the patients were investigated and were diagnosed with respiratory alkalosis. They were managed with closed bag ventilation which relieved the symptoms.Results: Here we put forward a direct physiological and psychological relation between a low pain threshold and associated hyperventilation with lead to development of Trousseau's sign in our patients. So, next time in postoperative round, if we see patient hyperventilating and complaining about fixed hand’s position, do not start calcium gluconate drip immediately, it may be due to respiratory alkalosis, then closed bag ventilation would be suffice.Conclusions: Trousseau’s sign seen postoperatively in Orthopedics may be commonly due to inadequate pain management rather than altered calcium metabolism.

Extraction of Stevioside from Stevia Rebaudiana Leaves Using Cellulase

Stevioside is a diterpene glycoside present in Stevia Rebaudiana leaves that has the ability to sweeten at rated between 70 to 350 times than sucrose (0.4% w/v). It has no calorific value. Unlike many low calorie sweeteners, stevioside is stable at high temperature. The objective of this research is to extract stevioside from stevia rebaudiana leaves by using cellulase from Aspergillus Niger. Acetate buffer and ethanol were used as a medium for enzyme and as a solvent, respectively. In this present study, the enzymatic extraction of stevioside from stevia rebaudiana leaves was carried out using cellulase with various parameters that affect the production of stevioside such as concentration of enzyme, incubation time and temperature. Cellulase was observed to give the highest stevioside yield (16230 ± 0.3 μg/ml) at 40oC. This indicated that the maximum temperature for cellulase activity was 40oC. The results signify that the enzymatic extraction method is an alternative to solvent based stevioside extraction, based on its higher efficiency. Thus, it can be concluded that the extraction of stevioside from Stevia rebaudiana leaves using cellulase can be maximized under the maximum conditions for the cellulase activity where the used of solvent can be minimized in degrading the cell wall Together with the maximum heat and correct combination of the solvent used, a new and efficient way of extracting high yield of stevioside can be obtained

Status of the ITER Ion Cyclotron H&CD

The ITER Ion Cyclotron Heating and Current Drive system (IC H&CD) is designed to deliver 20MW to a broad range of plasma scenarios between 40 and 55MHz, during very long pulses. It consists of two broadband equatorial port plug antennas, their pre-matching and matching systems, transmission lines, Radio Frequency (RF) Sources and High Voltage Power Supplies. The overall project schedule has been revised and agreed by ITER Council; it re-integrates the second antenna and its power supplies in construction baseline and sets the dates for progressive installation with DT phase planned in 2035. Recent progress on ICRF subsystems is reported, covering design evolution, qualification of test articles and specific R&D results in domestic agencies, suppliers, associated laboratories and IO

Status of the ITER Ion Cyclotron H&CD

The ITER Ion Cyclotron Heating and Current Drive system (IC H&CD) is designed to deliver 20MW to a broad range of plasma scenarios between 40 and 55MHz, during very long pulses. It consists of two broadband equatorial port plug antennas, their pre-matching and matching systems, transmission lines, Radio Frequency (RF) Sources and High Voltage Power Supplies. The overall project schedule has been revised and agreed by ITER Council; it re-integrates the second antenna and its power supplies in construction baseline and sets the dates for progressive installation with DT phase planned in 2035. Recent progress on ICRF subsystems is reported, covering design evolution, qualification of test articles and specific R&D results in domestic agencies, suppliers, associated laboratories and IO