Congenital Diaphragmatic hernia – a review

Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes. Delivery of infants with CDH is recommended close to term gestation. Immediate management at birth includes bowel decompression, avoidance of mask ventilation and endotracheal tube placement if required. The main focus of management includes gentle ventilation, hemodynamic monitoring and treatment of pulmonary hypertension followed by surgery. Although inhaled nitric oxide is not approved by FDA for the treatment of PPHN induced by CDH, it is commonly used. Extracorporeal membrane oxygenation (ECMO) is typically considered after failure of conventional medical management for infants ≥ 34 weeks’ gestation or with weight >2 kg with CDH and no associated major lethal anomalies. Multiple factors such as prematurity, associated abnormalities, severity of PPHN, type of repair and need for ECMO can affect the survival of an infant with CDH. With advances in the management of CDH, the overall survival has improved and has been reported to be 70-90% in non-ECMO infants and up to 50% in infants who undergo ECMO

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

Texture of inner shelf sediments off Penner river, east coast of India

195-198Grain size studies of surface sediments off Penner river shelf have been carried out. Though there is wide range in the sediment types, the shelf is predominantly occupied by sands. The inner shelf(< 20 m isobath) is composed of silty sands and clays, which are transported towards north by prevailing waves and currents from the fluvial source. Grain size parameters and C-M pattern suggest that the offshore coarse sediments are deposited from beach and shallow marine origin predominantly by rolling. Further the coarse sands are considered to be relict and represent a beach deposit; which may be the result of Flandrian (Holocene) transgression. The well preserved sands indicate that the existing hydrodynamic conditions on the inner outer shelf are strong enough neither to rework the sediments nor transport river contributed fine sediments. to the outer parts

Clay mineral studies in the modern Penner delta, east coast of India

69-74Clay mineral studies have been carried out in the modern sediments of the river channel, estuary, lagoon, tidal creek and shelf of the Penner river. Smectite is the most abundant mineral followed by illite, kaolinite and chlorite. Smectite is more in river channel and in the shelf sediments and lower in estuary, tidal creeks and lagoon. High content of smectite corresponds to high content of clay in the sediments. Illite distribution is just reverse to smectite distribution. The type of clay minerals were determined by the source rocks but their distribution depends on various factors such as selective transport, differential flocculation and response to sediment depositional environment

Anaesthesia for non-obstetric surgery in obstetric patients

Anaesthesia for pregnant patients presenting for non-obstetric surgery needs a thorough understanding of the physiological changes and altered pharmacokinetics of pregnancy. Considering the effects of surgery and anaesthesia on the foetus, only essential and emergency surgeries are performed during pregnancy. Surgical procedures in second trimester have the advantage of better foetal outcome. The primary concerns of maternal and foetal safety are achieved by a focused multidisciplinary team-based approach with respect to the surgical condition. Meticulous attention to preoperative patient counselling, airway management, haemodynamic stability, and thromboprophylaxis are the key factors in anaesthetic management. Choice of anaesthesia or anaesthetic drugs has minimal impact on the foetus provided utero-placental perfusion and uterine relaxation are maintained. Foetal monitoring when feasible and when done by a trained person enables to diagnose and treat the factors responsible for foetal heart rate variability. Anaesthetic technique needs to be modified according to the type of surgery

Rhoeo discolor leaf extract as a novel immobilizing matrix for the fabrication of an electrochemical glucose and hydrogen peroxide biosensor

A novel natural immobilizing matrix for the immobilization of glucose oxidase (GOx) and horseradish peroxidase (HRP) is presented in this article. The electrochemical biosensor was constructed by immobilizing the enzymes on Rhoeo discolor (Rd) leaf extract with 2.5% glutaraldehyde (GLD) on functionalized multiwalled carbon nanotubes (f-MWCNTs) modified graphite (Gr) electrode. The Gr/f-MWCNTs/(Rd-GLD)/GOx and Gr/f-MWCNTs/(Rd-GLD)/HRP biosensors showed excellent electrocatalytic activity concerning the detection of glucose and hydrogen peroxide. The physical morphology of the biosensors was studied using SEM and EDX. The electrochemical performance of the proposed biosensors was evaluated using cyclic voltammetry, differential pulse voltammetry and chronoamperometry. The effects of experimental variables such as pH, temperature, and applied potential on the current response of the biosensors were studied and optimized. The Gr/f-MWCNTs/(Rd-GLD)/GOx biosensor exhibited a rapid response time of less than 5 s, displayed a wide linear range of 0.5 to 28.5 mM, showed a low detection limit of 0.16 μM and revealed a high sensitivity of 15 μA mM-1 cm-2 for glucose. Similarly the Gr/f-MWCNTs/(Rd-GLD)/HRP biosensor showed a fast response time of 3 s, a good linear range of 0.2 to 6.8 mM with a 0.01 μM detection limit and an exceptional sensitivity of 2.1 mA mM-1 cm-2 for hydrogen peroxide. Subsequently, the practical applicability of the glucose biosensor for the analysis of glucose in Eleusine coracana wine and tender coconut water was examined while the Gr/f-MWCNTs/(Rd-GLD)/HRP modified electrode was tested for the determination of H2O2 in herbal bleach. In addition, the biosensors displayed long term stability, anti-interference ability and good reproducibility. © 2014 The Royal Society of Chemistry.

Development of a simple bioelectrode for the electrochemical detection of hydrogen peroxide using Pichia pastoris catalase immobilized on gold nanoparticle nanotubes and polythiophene hybrid

In this paper, a simple and innovative electrochemical hydrogen peroxide biosensor has been proposed using catalase (CATpp) derived from Pichia pastoris as bioelectrocatalyst. The model biocomponent was immobilized on gold nanoparticle nanotubes (AuNPNTs) and polythiophene composite using 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide and N-hydroxysuccinimide (EDC-NHS) coupling reagent. In this present work, we have successfully synthesized gold nanoparticles (AuNPs) by ultrasonic irradiation. The tubular gold nanostructures containing coalesced AuNPs were obtained by sacrificial template synthesis. The assembly of AuNPNTs onto the graphite (Gr) electrode was achieved via S-Au chemisorption. The latter was pre-coated with electropolymerized thiophene (PTh) to enable S groups to bind AuNPNTs. The combination of AuNPNTs-PTh, i.e., an inorganic-organic hybrid, provides a stable enzyme immobilization platform. The physical morphology of the fabricated biosensor Gr/PTh/AuNPNTs/EDC-NHS/CATpp was investigated using scanning electron microscopy and energy-dispersive microscopy. The analytical performance of the bioelectrode was examined using cyclic voltammetry, differential pulse voltammetry and chronoamperometry. Operational parameters such as working potential, pH, and thermal stability of the modified electrode were examined. The beneficial analytical characteristics of the proposed electrode were demonstrated. Our results indicate that the Gr/PTh/AuNPNTs/EDC-NHS/CATpp bioelectrode exhibits a wide linear range from 0.05 mM to 18.5 mM of H2O2, fast response time of 7 s, excellent sensitivity of 26.2 mA mM-1 cm-2, good detection limit of 0.12 μM and good Michaelis-Menten constant of 1.4 mM. In addition, the bioelectrode displayed good repeatability, high stability and acceptable reproducibility, which can be attributed to the AuNPNTs-PTh composite that provides a biocompatible micro-environment. © the Partner Organisations 2014.