Efficacy of Tranexamic Acid in Reducing Blood Loss in Cesarean Section: A Comparative Study.

Introduction: Obstetric hemorrhage is one of the major causes of maternal morbidity and mortality. Blood loss during cesarean section is almost twice than that in vaginal delivery. The aim of this study was to evaluate the efficacy of tranexamic acid to reduce blood loss in cesarean section and its side effects. Methods: A comparative study was done in 100 women undergoing cesarean section between December 2015 to January 2017. The study group of 50 women received one gram intravenous tranexamic acid and the control group of 50 women did not receive tranexamic acid. Primary outcome measure was blood loss during cesarean section. Secondary outcome measures were drop in post-operative hemoglobin and hematocrit, change in pulse rate and blood pressure, need of additional uterotonics, auxiliary procedures to stop bleeding, blood transfusion rate and maternal and neonatal side effects of the drug. Results: Mean intraoperative blood loss in the study group was 443.62± 86.73ml; and in control group, 667.40±131.01ml (p<0.001). Mean postoperative drop in hemoglobin (g/dl) in the two groups were 0.82±0.27 and 1.86±0.64 respectively (p<0.001). Mean postoperative drop in hematocrit in the two groups were 2.60±0.91 and 5.49±1.97 respectively (p<0.001). Fourteen patients in the control group required additional uterotonics while none in the study group (p<0.001). There was no significant difference in the transfusion requirement (p=0.079). None of the mothers and the newborns had major side effects of drug. Conclusion: Tranexamic acid is a safe and effective drug to reduce blood loss in cesarean section

Chronic pain, its management and psychological issues: A review

Chronic pain is one of the most prevalent, disabling conditions both in clinical and psychological aspects and yet often remains inadequately treateddue to cost reasons. Moreover, chronic pain commonly occurs in conjunction with depression, anxiety and somatoform disorders. Chronic andrecurrent pain not associated with a disease is very common in childhood and adolescence, but there are very less studies and analysis has been doneon chronic pain epidemiology and management. As pain is the important factor influencing quality of life and also the reason for which a person seekthe advice of physician even require hospitalization that is why this systematic review highlights the different types of chronic pain, epidemiology,pathophysiology, and management of chronic pain along with psychological issues associated with it.Keywords: Pain, Psychological aspects, Epidemiology, Somatoform disor

Utilization of Fruit Peel Wastes for the Management of Chikungunya Vector, Aedes aegypti

Chikungunya, a widely spread viral disease transmitted to human beings by Aedes aegypti, is on rise in India, Africa and Asian subcontinent since last decade. Although chemical insecticides are used at a large scale for the control of Chikungunya vector, their applications have led to several undesirable effects including insecticide resistance, revival of pests species, appearance of secondary pests, environmental pollution, noxious hazards to human beings and non-target organisms forcing investigators to explore unconventional alternate strategies. As an environment-friendly approach, there is increased attention to devise and adopt suitable methods to utilize wastes as value-added products to reduce the problem of environmental pollution. Consequently, the larvicidal and adult irritant potential of hexane and petroleum ether peel extracts of three different Citrus species, C. limetta, C. sinensis and C. Limon, were assessed against Ae. aegypti. The results showed the larvicidal potential of all the three peels, C. limetta peel extracts exhibiting the least activity. Furthermore, hexane extracts were more effective than petroleum ether extracts, C. sinensis peels hexane extract being most effectual (LC50, 39.51 ppm) while petroleum ether peels extract of C. limon was the most effective larvicide with LC50 value of 51.25 ppm. All the extracts also exhibited significant elicit response and irritant potential against adults signifying their potential role in reduced mosquito bites and disease transmission. The qualitative phytochemical analysis of the extracts showed presence of certain components suggesting their probable role in bioefficacy of extracts. Further studies are needed to isolate and identify the active ingredient to formulate strategies for mosquito control

Evaluation of 15 Local Plant Species as Larvicidal Agents Against an Indian Strain of Dengue Fever Mosquito, Aedes aegypti L. (Diptera: Culicidae)

The adverse effects of chemical insecticides-based intervention measures for the control of mosquito vectors have received wide public apprehension because of several problems like insecticide resistance, resurgence of pest species, environmental pollution, toxic hazards to humans, and non-target organisms. These problems have necessitated the need to explore and develop alternative strategies using eco-friendly, environmentally safe, bio-degradable plant products which are non-toxic to non-target organisms too. In view of this, 15 plant species were collected from local areas in New Delhi, India. Different parts of these plants were separated, dried, mechanically grinded, and sieved to get fine powder. The 200 g of each part was soaked in 1000 mL of different solvents separately and the crude extracts, thus formed, were concentrated using a vacuum evaporator at 45°C under low pressure. Each extract was screened to explore its potential as a mosquito larvicidal agent against early fourth instars of dengue vector, Aedes aegypti using WHO protocol. The preliminary screening showed that only 10 plants possessed larvicidal potential as they could result in 100% mortality at 1000 ppm. Further evaluation of the potential larvicidal extracts established the hexane leaf extract of Lantana camara to be most effective extract exhibiting a significant LC50 value of 30.71 ppm while the Phyllanthus emblica fruit extract was found to be least effective with an LC50 value of 298.93 ppm. The extracts made from different parts of other five plants; Achyranthes aspera, Zingiber officinalis, Ricinus communis, Trachyspermum ammi, and Cassia occidentalis also possessed significant larvicidal potential with LC50 values ranging from 55.0 to 74.67 ppm. Other three extracts showed moderate toxicity against A. aegypti larvae. Further investigations would be needed to isolate and identify the primary component responsible for the larvicidal efficiency of the effective plants

Correlation between value of Hba1c and degree of sensorineural hearing loss in type 2 diabetics

Background: Diabetes mellitus and hearing loss are common public health problems. Sensorineural hearing loss in Type 2 diabetes mellitus patients is an underestimated complication. The aim was to study the correlation between level of HbA1c and degree of sensorineural hearing loss. Methods: It was a cross sectional study carried on 130 known cases of T2DM, aged 25-50 years. Various confounding factors such as coexisting hypertension, ear disease, ototoxic drug intake, any neuropathic disorder was excluded in advance. All patients underwent clinical ear examination and pure tone audiometry test. Their level of HbA1c was measured. This value of HbA1c was correlated with the hearing threshold. Results: Out of 130, 58 subjects had normal hearing while 72 had hearing impairment. Among subjects (72 out of 130) having hearing impairment, significant correlation (p-value 0.035 for right ear and 0.029 for left ear) between hearing threshold and HbA1c was found. Also, level of HbA1c significantly (p-value 0.049) correlated with degree of hearing loss. Conclusions: Hearing loss is an underestimated complication of T2DM. This needs to be addressed with periodic hearing assessment of diabetes patients

CENTRAL CORNEAL THICKNESS IN NORMAL TENSION GLAUCOMA, PRIMARY OPEN-ANGLE GLAUCOMA, AND OCULAR HYPERTENSION: A COHORT STUDY.

Background: Aim: The main goal of this research is to assess the corneal thickness of individuals with primary open-angle glaucoma (POAG), ocular hypertension (OHT), and normal tension glaucoma (NTG). Methods: This study was done from June 2022 to May 2024. 150 patients were included in this research. A detailed history of the individuals was recorded, and a clinical examination was done. Further, an optical evaluation was done to diagnose any defect in the cornea. Direct Ophthalmoscope was utilized to rule out any harm to the optic nerve. An indirect ophthalmoscope was used for the detection of any defect in the retina. Results: The study found that the majority of patients were aged 51-60 years (47.8%), with 62.7% being male. The distribution of patients included 36.2% normal, 19.8% NTG, 28.7% POAG, and 15.3% OHT. The mean intraocular pressure (IOP) for males was 21.56±5.30 (right eye) and 19.60±4.79 (left eye), while for females it was 21.16±5.47 (right eye) and 20.70±4.06 (left eye), with NTG patients exhibiting significantly lower central corneal thickness (CCT) leading to potential misdiagnoses of POAG and normal cases as NTG and OHT. Conclusion: The CCT in normal tension glaucoma cases was notably low. Because of the intra-optical pressure outcome of CCT measurement, a lot of primary open-angle glaucoma cases were wrongly diagnosed as normal tension glaucoma cases and normal cases were wrongly diagnosed as ocular hypertension leading to mistreatment Recommendation: Clinicians should routinely measure central corneal thickness to improve the accuracy of glaucoma diagnosis and ensure appropriate treatment

Structural and Electronic Properties of HfN: ab initio calculation

The structural and electronic properties of HfN from an electronic structure calculation have been presented.  The calculation is performed using self-consistent tight binding linear muffin tin orbital (TB-LMTO) method within the local density approximation (LDA).     The calculated equilibrium structural parameters are in good agreement with the available experimental results.  It is found that this compound shows metallic behavior under ambient condition.  The electronic structures of HfN in B1 phase are investigated.  It is found that HfN have strong metallization and the hybridizations of atoms in B1 phase. Keywords: Bulk modulus, band structure, density of states