CHARACTERIZATION OF Pr6O11 DOPED ZINC FLUOROBORATE GLASS

Pr3+ doped zinc fluoroborate glasses with the chemical composition [(mol %) 30ZnF2 – 20 TeO2 – (50-x) B2O3 – xPr6O11] (where x = 0.0, 0.1, 0.5, 1.0 and 1.5 mol %) of different concentration of rare earth element praseodymium (Pr3+) have been prepared by conventional melt quench technique. The physical parameters like density, refractive index, number density, molar refraction, molar electronic polarizability, electronic polarizability, dielectric constant, polaron radius, inter–ionic separation, molar volume and oscillator strength of these glasses were calculated as a function of dopant concentration. The densities and refractive indices of these glasses were found to be in the range 2.0 g/cm3 - 2.67 g/cm3 and 1.644 – 1.73 respectively. Stability of the glass doped with 1.0 mol % Pr3+ was found to be 120

Perspective Chapter: Epidural Administration-New Perspectives and Uses

Neuraxial techniques are commonplace in labor analgesia. Techniques for labor analgesia range from intrathecal and epidural anesthesia to peripheral nerve blocks, nitrous oxide, intravenous infusions, and acupuncture. The epidural approach is the most popular as it allows for local anesthetics to diffuse into the intrathecal space along with repeated or continuous doses of medication for labor and primary anesthetic for surgeries. The epidural technique affects differing spinal nerves (i.e., pain, autonomic, sensory, and motor) with varied effects depending on the concentration and volume of LA used. Adverse effects do exist following these techniques with hypotension being a major concern. A multitude of anesthetic agents can be given in the epidural; opioids are the most frequently used local anesthetic adjuvants. Alpha 2 adrenoreceptor agonists are also used as local anesthetic adjuvants. Although not performed routinely, peripheral nerve blocks play a complementary and supplementary role in epidural analgesia and anesthesia. There are absolute and relative contraindications to epidural anesthesia. Alternatives to neuraxial anesthesia that can be offered include infusion of ultrashort acting opioids, nitrous oxide, opioid agonist-antagonists, ketamine, TENS, and acupuncture. Local Anesthetic Systemic Toxicity may be more prevalent in the pregnant

Propofol induces MAPK/ERK cascade dependant expression of cFos and Egr-1 in rat hippocampal slices

Background: Propofol is a commonly used intravenous anesthetic agent, which produce rapid induction of and recovery from general anesthesia. Numerous clinical studies reported that propofol can potentially cause amnesia and memory loss in human subjects. The underlying mechanism for this memory loss is unclear but may potentially be related to the induction of memory-associated genes such as c-Fos and Egr-1 by propofol. This study explored the effects of propofol on c-Fos and Egr-1 expression in rat hippocampal slices. Findings: Hippocampal brain slices were exposed to varying concentrations of propofol at multiple time intervals. The transcription of the immediate early genes, c-Fos and Egr-1, was quantified using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). MAPK/ERK inhibitors were used to investigate the mechanism of action. We demonstrate that propofol induced the expression of c-Fos and Egr-1 within 30 and 60 min of exposure time. At 16.8 μM concentration, propofol induced a 110% increase in c-Fos transcription and 90% decrease in the transcription of Egr-1. However, at concentrations above 100 μM, propofol failed to induce expression of c-Fos but did completely inhibit the transcription of Egr-1. Propofol-induced c-Fos and Egr-1 transcription was abolished by inhibitors of RAS, RAF, MEK, ERK and p38-MAPK in the MAPK/ERK cascade. Conclusions: Our study shows that clinically relevant concentrations of propofol induce c-Fos and down regulated Egr-1 expression via an MAPK/ERK mediated pathway. We demonstrated that propofol induces a time and dose dependant transcription of IEGs c-Fos and Egr-1 in rat hippocampal slices. We further demonstrate for the first time that propofol induced IEG expression was mediated via a MAPK/ERK dependant pathway. These novel findings provide a new avenue to investigate transcription-dependant mechanisms and suggest a parallel pathway of action with an unclear role in the activity of general anesthetics

Propofol induces ERK-dependant expression of c-Fos and Egr-1 in neuronal cells

This study explored the effects of propofol on c-Fos and Egr-1 in neuroblastoma (N2A) cells. We demonstrate that propofol induced the expression of c-Fos and Egr-1 within 30 and 60 min of exposure time. At 16.8 μM concentration, propofol induced a 6 and 2.5-fold expression of c-Fos and Egr-1, respectively. However, at concentrations above 100 μM, propofol failed to induce expression of c-Fos or Egr-1. Propofol-induced c-Fos and Egr-1 transcription was unaffected by bicuculline, a γ-aminobutyric acid-A receptor antagonist, but was abolished by PD98059, a mitogen-activated protein kinase/extracellular signal-regulated kinase inhibitor. Our study shows that clinically relevant concentrations of propofol induce c-Fos and Egr-1 expression through an extracellular signalregulated kinase mediated and γ-aminobutyric acid-A independent pathway

Successful Regional Anesthetic for a Parturient with Moyamoya Syndrome

Anesthesia for Cesarean section could be challenging due to the physiological changes during pregnancy, but it can be more complicated if associated with sickle cell disease and moyamoya disease. The moyamoya syndrome is nothing but sickle cell disease complicated by cerebral vasculopathy. Incidence of moyamoya disease in the USA is 0.086/100,000 people. We report a case of a pregnant woman with sickle cell disease and moyamoya syndrome, who underwent a successful spinal epidural for primary cesarean section, with careful monitoring of blood pressure

Case series of central retinal artery occlusion in COVID-19-associated rhino-orbital-cerebral mucormycosis

Rhino orbital Mucormycosis caused by filamentous fungus of mucoraceae family was considered a rare disease affecting immunocompromised and diabetics with ketoacidosis until the recent COVID 19 pandemic. We are presenting a series of six cases of Rhino orbital cerebral Mucormycosis with central retinal artery occlusion. All six cases had common history of COVID 19 infection in recent past with sinusitis, proptosis and total ophthalmoplegia with central retinal artery occlusion on presentation. MR imaging showed invasive pan sinusitis with orbital and cerebral involvement. Urgent debridement was done and histopathological examination showed broad, filamentous aseptate fungi suggestive of Mucormycosis. All patients inspite of intravenous Amphotericin B with local debridement did not show any improvement and expired within a week of presentation. Hence our study shows poor prognosis of post covid 19 associated Mucormycosis with central retinal artery occlusion

Effect of remote ischemic preconditioning on cerebral vasospasm and biomarkers of cerebral ischemia in aneurysmal subarachnoid hemorrhage (ERVAS): A protocol for a randomized, controlled pilot trial

INTRODUCTION: Cerebral vasospasm is a dreaded complication of aneurysmal subarachnoid hemorrhage (aSAH) predisposing to delayed cerebral ischemia. We intend to study the cerebroprotective effects of remote ischemic preconditioning (RIPC) in patients with aSAH. MATERIALS AND METHODS: This is a single-center, prospective, parallel group, randomized, pilot trial, approved by the Institutional Ethics Committee. Patients with aSAH admitted to our hospital for surgical clipping; fulfilling the trial inclusion criteria will be randomized to true RIPC (n = 12) (inflating upper extremity blood pressure cuff thrice for 5 min to 30 mmHg above systolic blood pressure) or sham RIPC (n = 12) (inflating blood pressure cuff thrice for 5 min to 30 mmHg) in 1:1 allocation ratio using a computerized random allocation sequence and block randomization. RESULTS: Our primary outcome measure is vasospasm on cerebral angiography and transcranial Doppler study, and concentration of serum S100B and neuron-specific enolase at 24 h after RIPC and on day 7 of ictus. Our secondary outcomes are safety of RIPC, cerebral oxygen saturation, and Glasgow coma score, and extended Glasgow outcome scale scores at discharge and at 1, 3, and 6 months following discharge. Outcome measures will be assessed by an observer blinded to the study intervention. CONCLUSION: If our preliminary results demonstrate a beneficial effect of RIPC, this would serve as a clinically applicable and safe preemptive method of protection against cerebral ischemia