Sanitary Landfill Performance During the Loma Prieta Earthquake

The October 17, 1989, Loma Prieta earthquake subjected a number of solid waste or sanitary landfills to significant shaking. The performance of sanitary landfills during large earthquakes is of great interest to the public, state and federal agencies, and the landfill owners. The observed performance of six sanitary landfills located within the Lorna Prieta earthquake damage zone is compared with the performance predicted by a commonly used deformation analysis technique. The six landfills were inspected immediately after the October 17, 1989, magnitude 7.1 earthquake. Damage and evidence of slope movement, or lack thereof, was recorded. The mean peak ground accelerations were estimated and used in a deformation analysis as proposed by Makdisi and Seed (1977). The deformations predicted by the analyses are compared with the observed conditions and from the results of the comparison; a preliminary assessment of the analytical techniques and input parameters is made

Assessing the pros and cons of vaginal birth after caesarean relative to elective repeat caesarean section

Background: Recent years have witnessed a rise in rate of primary caesarean section (CS). No. of women reporting with a previous CS scar is also increasing. Judicious trial of labor in such patients can prevent repeat caesarean section. Aim of this study was to assessing the safety and success rate of vaginal birth after caesarean (VBAC) in selected cases of patients who have undergone previous lower segment CS (LSCS) is the main aim of this study.Methods: In this prospective observational study carried out in a tertiary care teaching hospital over a period of 1 year. 375 pregnant women with a history of one previous LSCS for non-recurrent indications were enrolled. The statistical technique of t-test was administered for relative comparison with respect to maternal and neonatal complications across the two groups, i.e. repeat LSCS and vaginal delivery.Results: Out of 375 patients 187 patients (49.9%) underwent elective LSCS for recurrent indication and for non-recurrent indication associated with some complicating factor. Trial of labor in 188 (50.10%) was given out of which 59.3% had spontaneous vaginal delivery,7.20% had instrumental delivery and 33.50% landed into emergency CS. Commonest cause of Em. LSCS being Fetal distress. As regards maternal complications, no statistically significant difference was found between the Repeat LSCS and Vaginal delivery groups (t = 0.779, p > 0.05). On similar lines, there was no statistically significant difference across both groups as regards neonatal complications (t = 0.632, p > 0.05).Conclusions: Taking into account the increased trend of primary CS, trial of VBAC in selected cases is very important. It can be concluded that VBAC has chances of success in cases with previous one LSCS but it must be carefully investigated and monitored

Mid-trimester rupture uterus: case series

Uterine rupture is an obstetric catastrophe with significant maternal and fetal morbidity and mortality which occurs mainly in the third trimester of pregnancy or during labour, especially in previously scarred uterus. The occurrence of rupture in first and second trimester in women with unscarred uteri is quite rare. We report two cases of rupture uteri managed in our centre at 24 and 26 weeks gestation in women with unscarred uteri. First case was G3P1L1A1, 24 weeks with epigastric pain, stable vitals, epigastric tenderness, USG inconclusive, CT scan showed out pouching of amniotic sac through fundus. Laparotomy done, there was 8-9 cm fundal rupture extending between cornua, uterine repair done. Second case was G3P1L1A1 26 weeks with abdominal pain, stable vitals, corresponding fundal height, head engaged, USG revealed outpouching amniotic sac at the fundus. Laparotomy performed, there was 10 cm rent extending trans-fundal, uterine repair done. Unscarred uterine rupture, especially in early pregnancy is a rare event, posing significant difficulty in diagnosis. Uterine rupture should be first ruled out in all pregnant women presenting with acute abdomen irrespective of gestational age. Search for non-gynaecological causes can delay crucial obstetric intervention that can lead to loss of obstetric function, morbidity and mortality

A Comparative Clinical Study of Shamana Therapy and Shodhana Purvaka Shamana Therapy in the Management of Tamaka Shwasa w.s.r to Bronchial Asthma

Ayurveda is the science of life which deals with the prevention and cure of diseases. From the first breath of newly born till the last breath i.e, Shwasochhwasa Kriya is the sign of life. Any disturbance in this process leads to Shwasa Roga. Tamaka Shwasa is one of the important diseases of such disturbance. Shwasa is a Kapha-Vataja disease which is originated from Pittasthana. Tamaka Shwasa is very much similar to bronchial asthma in modern medicine which is a chronic disease of multifactorial origin. Ayurveda describes two type of management of all disease i.e. Shodhana and Shamana Chikitsa. In present scenario Panchakarma therapy is the best way to effectively and safely manage the condition without any specific side effects. It is one of the most effective and complete therapy in the management of the chronic disease such as Tamaka Shwasa (Bronchial Asthma). In Ayurvedic classics both Vamana and Virechana have been described specifically in the management of Tamaka Shwasa. Considering the Ayurvedic concept of treatment of Tamaka Shwasa, in present study we have used Virechana therapy along with certain herbal preparation. In this study we concluded that the cases who were treated with herbal preparation along with Virechana got better relief than herbal preparation alone

Evaluation of insulin resistance in adolescent girl with menstrual irregularities

Background: Polycystic ovary syndrome is most commonly recognized endocrinopathy in reproductive age group. The symptoms of PCOS vary with age, race, weight, and medications, which lead to the challenges of accurate diagnosis particularly in adolescent age group. Adolescent with PCOS most commonly encountered by gynecologist, for their menstrual irregularities. During early puberty, menstrual irregularities can occur normally due to immature Hypothalamo-pituitary-ovarian axis. Early detection of PCOS is required to control high risk of insulin resistance followed by reproductive and metabolic consequences latter on in life. Also diabetes mellitus is asymptomatic at early stage of insulin resistance and impaired glucose tolerance. Few studies have been conducted in Indian population, for prevalence of insulin resistance and metabolic syndrome in adolescents with PCOS, with varying results and hence further study is required. The aim and objectives of the study was to evaluate the presence of insulin resistance in adolescents with menstrual disorders persisting 2 years after menarche.Methods: A Cross sectional Study consisting of 102 adolescent girls done in Gynecology Outpatient Clinic of the Indira Gandhi Institute Of Medical Science Biochemical analysis was done on(day 3 to day 5) of menstruation for clinical/laboratory hyperandrogenism ,and various cause of anovulation. HOMA-IR value was evaluated for insulin resistance by following formula: fasting serum insulin (μU/ml) × fasting plasma glucose (m mol/l)/22.5. The 2003 Rotterdam consensus workshop criteria were used for ultrasonographic feature of polycystic ovarian syndrome.Results: Most common pattern of menstrual irregularities was Oligomenorrhea. 4 (7.84%) cases had insulin resistance (HOMA-IR >3.9) and 25 (49.01%) cases had elevated HOMA-IR values (HOMA-IR >1). PCOS was seen in 35.29% of cases and only 1.96% of control.Conclusions: Adolescents with persistent menstrual irregularities even after two year of menarche, especially with oligomenorrhea and hypomenorrhoea, more frequently have the diagnosis of PCOS and also present with elevated HOMA-IR values

A Review on Pottali Kalpana w.s.r. to Kaparda Purana Putapaka method of preparation

Pottali Kalpana is one of the unique Kalpana mentioned in our classics. It is one among the four Moorchita Parada Yogas. Kaparda Purana Putapaka method is one the methods mentioned for preparation of this Kalpana. It brings in the compactness of the Dravyas. Pottali Kalpana are a blend of extremely important trace elements which form the crux of the immune system. Various Kaparda Purana Method of preparation of Pottalis have been compiled here which have been mentioned in classical Rasashastra texts along with its ingredients and other variations. The alkalinity of the Kaparda Purana method of preparation owing to calcium probably has a significant role to play in the management of Atisara and Grahani. This Kalpana can be used in emergency care as well

SAFETY OF HYDROXYCHLOROQUINE FOR COVID-19 PROPHYLAXIS AMONG HEALTHCARE WORKERS: AN OBSERVATIONAL STUDY

Objective: Indian Council of Medical Research recommended hydroxychloroquine (HCQ) for prophylaxis of COVID‐19 for healthcare workers and the Food and Drug Administration approved its use in the treatment and prophylaxis of COVID‐19 disease. Even though HCQ is adequately tolerated in usual circumstances, still questions about the harmful effects of the drug remain a cause for concern in adults treated with HCQ. The objective of this study was to evaluate the major and minor adverse effects of prophylactic HCQ for COVID-19 among healthcare workers. Methods: Our analysis was intended to analyze HCQ’s adverse drug reaction profile for COVID‐19 prophylaxis in prophylactic doses in health-care staff. This was a cross-sectional study carried out among healthcare workers taking HCQ prophylaxis for COVID‑19. The study was carried out over 08 weeks period from April to May 2020. The data were obtained regarding age, sex, comorbidities, and possible adverse effects. A pretested and validated online questionnaire was provided to the participants to assess the harmful effects that they experienced when taking HCQ. Furthermore, pre and post 8 weeks prophylaxis, individuals underwent general and systemic examination, along with ECG and blood sugar level monitoring. Results: The research group comprised 70 previously healthy and health-care staff. In 70 patients, 27 minor adverse effects were reported (18.9%). Headache was the most frequently reported symptoms followed by nausea and vomiting, itching, and skin rashes. There was no statistically relevant variation in harmful effects due to age or number of doses administered. However, none of the adverse effects was serious or debilitating. Conclusion: With adequate pre-prophylaxis evaluation, health education, and regular monitoring, HCQ prophylaxis is safe and devoid of any serious adverse effects in previously healthy individuals

SYNTHESIS, SPECTRAL, AND PHARMACOLOGICAL EVALUATION OF 3 AND 5 SUBSTITUTED 2,4-THIAZOLIDINEDIONE DERIVATIVES

Background: 2,4-Thiazolidinedione derivatives was launched as antidiabetics in 90's. Later the derivatives of 2,4-thiazolidinedione were banned due to hepatotoxicity. To the date, much research has been directed toward the synthesis and novel uses of 2,4-thiazolidinedione compounds.Aim: The aim of the present study is to synthesize a set of 3,5-disudstituted-2,4-thiazolidinediones as antimicrobial. These compounds were evaluated for their antimicrobial activity.Method: First, the 2,4-thiazolidinedione was substituted at the position of 3 using sodium hydroxide and ethanol and then substituted at the position of 5 in the presence of piperdine by the Knoevenagel condensation method. The structures of the compounds were established on the basis of infrared and nuclear magnetic resonance spectral studies.Result: 3,5-disubstituted-5-benzylidine-2,4-thiazolidinediones derivative was synthesized using benzyl halides and aromatic aldehydes. The results obtained showed that TZ-1 exhibited good activity against Bacillus subtilis while no activity against Escherichia coli.Conclusion: Attachment of more heterocyclic rings containing Nitrogen on the 3rd position of 2,4-thiazolidinedione can enhance the antimicrobial activity. Addition of more lipophilic agents may increase the bioavailability and efficacy of the drug. Long alkyl chains on the benzylidene ring can also increase the lipophilic character, and further attachment of these kind of agents on benzylidene chain may produce safe and effective compounds in future

Impact of COVID-19 pandemic on safe abortion and family planning services at a tertiary care women’s hospital in Nepal

Background: The COVID-19pandemic emerged as a major public health crisis, which has affected all dimensions of the health care system. Sexual and reproductive health services were severely affected, leading to a decrease in access and service utilization, affecting the overall health of women.Methods: A two-year comparative study, before and during the COVID-19 pandemic, on safe abortion services and family planning, was conducted at Paropakar maternity and women's hospital to assess the impact of COVID-19 on service utilization.Results: Safe abortion services were decreased by 34.4%, and family planning services by 39%, in 2020 as compared to the previous year. Uptake of long-acting reversible contraceptives and permanent methods was most affected. Utilization of services was affected markedly during lockdown, and showed a persistent decline, even after the lockdown was lifted.Conclusions: The COVID-19 pandemic has seriously affected safe abortion and family planning services in Nepal due to lockdown, travel restriction, home isolation, resource reallocation, health facilities serving only emergencies and confusing messages about COVID-19 control. The decline in these services will create additional demand and pressure on the health care system, resulting from unplanned pregnancies and unsafe abortions. Health care staffs should be reoriented about the essential nature of safe abortion and family planning services during emergencies, and the implications of service disruption, on society and the country. Pragmatic and gender sensitive changes to national policies should be made, to ensure that women's health is safeguarded, and safe abortion and family planning included as essential health care services during emergencies.

Comparative analysis of injection clonidine and injection dexmedetomidine added to injection bupivacaine for spinal anaesthesia in lower abdominal surgeries

Background:Efficacy of sub-arachnoid block can be improved by addition of various adjuvants to local anesthetics. Intrathecal administration of clonidine or dexmedetomidine has improved the quality of spinal anesthesia in terms of longer duration of post-operative analgesia with comparatively lesser side effects. In present study we compared the onset and duration of motor and sensory block, hemodynamic effects, post-operative analgesia and adverse effects of clonidine and dexmedetomidine used intrathecally with bupivacaine.Methods: Present study was conducted in 150 patients (ASA class I and II) undergoing lower abdominal surgeries. Patients were randomly divided into three group’s viz. B, C and D. Group B received bupivacaine (12.5 mg), group C received clonidine (30 µg) with bupivacaine and group D received dexmedetomidine (5 µg) with bupivacaine. Volume of administered drug was set at 3ml in all the groups. The onset time to reach peak sensory and motor block level, regression time to sensory and motor block, hemodynamic changes and side effects if any were assessed and recorded.Results: In our study we observed that there was no significant difference in patient demography and duration of surgical procedure. The time to onset of sensory blockage was similar in all the three groups but time to onset of motor block was shorter in group C and D compared to group B. Total duration of sensory and motor block was significantly higher in group D compared to group C and B. The duration of sensory block in group D was 139.58+14.49, in group C it was 122.46+18.55 and in group B it was 100+13.43 minutes. The duration of motor block in group D was 250.40+27.33, in group C it was 229.28+23.68 and in group B it was 175.64+17.41 minutes.Conclusions: It was concluded that though both clonidine and dexmedetomidine prolonged duration of sensory and motor block of Bupivacaine, Dexmedetomidine is better in terms of longer duration of action.