Haemodynamic effects of intrathecal dexmedetomidine added to ropivacaine intraoperatively and for postoperative analgesia

Background: For lower abdomen and lower limb surgery, spinal anaesthesia is most common modality used in routine. This study was conducted on 50 ASA 1 and 2 planned for lower limb and lower abdomen surgery.Methods: 50 patients of ASA 1 and 2 scheduled for lower limb and lower abdominal surgery were selected. Each patient received 4 milliliter volume of 0.75% isobaric ropivacaine + 5 microgram dexmedetomidine. At the intervals of 1 minute, 2 minute, 5 minute, 10 minute, 20 minute, 30 minute and 1 hour, 2 hour and 3 hour reading of pulse rate and blood pressure were recorded. Postoperatively, pain scores were recorded by using Visual Analogue Scale.Results: There were no significant changes in systolic and diastolic blood pressure after induction. The combination of ropivacaine and dexmedetomidine provided better postoperative analgesia and reduced requirement of diclofenac injection in first 24 hour.Conclusions: The patients showed excellent hemodynamic stability and postoperative analgesia to ropivacaine + dexmedetomidine. Thus it is a safe modality for lower limb and lower abdomen surgery as far as haemodynamic effects and postoperative analgesia is concerned

Evidence of robust 2D transport and Efros-Shklovskii variable range hopping in disordered topological insulator (Bi2Se3) nanowires

We report the experimental observation of variable range hopping conduction in focused-ion-beam (FIB) fabricated ultra-narrow nanowires of topological insulator (Bi2Se3). The value of the exponent in the hopping equation was extracted as ~ 1/2 for different widths of nanowires, which is the proof of the presence of Efros-Shklovskii hopping transport mechanism in a strongly disordered system. High localization lengths (0.5nm, 20nm) were calculated for the devices. A careful analysis of the temperature dependent fluctuations present in the magnetoresistance curves, using the standard Universal Conductance Fluctuation theory, indicates the presence of 2D topological surface states. Also, the surface state contribution to the conductance was found very close to one conductance quantum. We believe that our experimental findings shed light on the understanding of quantum transport in disordered topological insulator based nanostructures.Comment: 14pages, 4 figure

Housing conditions, knowledge and perceived health effects of indoor air pollution in tribal women of rural Maharashtra

Background: Dependence on using biomass fuels for cooking and heating leads to Indoor Air Pollution (IAP) which can lead to adverse health outcomes. Aim of this study was to observe the housing and kitchen conditions in households of tribal areas, assess the knowledge of women regarding the IAP and perceived health effects due to it.Methods: Cross-sectional community- based study conducted in 100 women above the age of 18 years in a tribal village. A semi-structured questionnaire was used and spot observations were made. Chi-Square was used to calculate the association between type of stove, housing conditions and health effects of IAP. Logistic regression was used to identify determinants of the health effects of IAP.Results: The mean age of women was 29 years; all houses had a separate kitchen; 34% used mud stove with wood. Easy availability and economic reasons were cited for using wood. 47% of women thought IAP present in their homes and the most common source was cooking. Symptoms like asthma, sweating, burns/rash, and headache had a significantly higher association in women using mud stove (P<0.05) than LPG stove. A strong association was found between cooking hours and health effects due to IAP (P< 0.004).Conclusions: IAP due to cooking and unfavorable housing conditions are associated with health problems in women. Knowledge regarding IAP is poor. Reasons for reliance on using mud stove needs to be addressed

Misoprostol for Termination of Second Trimester Pregnancy

Introductions: The termination of second trimester pregnancy is challenging due unfavorable cervix. This study evaluate the efficacy and maternal side effects of intravaginal misoprostol for termination of second trimester pregnancy.Methods: During one year period from 15th June 2011 to 14th June 2012,Department of Obstetrics and Gynaecology of Patan Hospital, women admitted for second trimester termination of pregnancy for fetal congenital anomalies and intrauterine fetal demise were studied using the International Federation of Gynaecology and Obstetrics recommended doses of vaginal misoprostol. For congenital anomalies, 400 mcg 3 hourly to a maximum of 5 doses were used. For fetal demise, gestational age of 13-17 weeks received 200 mcg every 6 hourly to a maximum of 4 doses, and 18-26 weeks dose was adjusted to 100 mcg. Main outcome measures included success rate of abortion within 48 hours, induction to delivery interval and maternal side effects.Results: There were 40 patients during study period. Success rate for termination of 2nd trimester pregnancy within 48 hours was 88.8% for congenital anomalies. For fetal demise, success of termination was 90.9% at 13-17 weeks and 100% at 18-26 weeks. Median time from induction to delivery was 26.8 hours for congenital anomalies. For fetal demise, it was 18 hours for 13-17 weeks was and 24 hours at 18 to 26 weeks respectively. Abdominal pain was seen in all doses of misoprostol.Conclusions: Vaginal misoprostol is an effective method for termination ofsecond trimester pregnancy.Keywords: misoprostol, pregnancy, second trimester terminatio

Relaparatomy after caesarean section

Introductions: Relaparotomy after caesarean section is rare and literature are scanty. The decision requires a good clinical judgment to save mother’s life. Our objective was to analyse the outcome of relaparotomy after caesarean section at Patan hospital.Methods: This was a cross sectional study done at the department of obstetrics and gynaecology, Patan Hospital, Nepal. Charts of caesarean section from January 2010 to December 2014 were reviewed to analyze the cases of relaparotomy for incidence, indication, management and outcome. Descriptive analysis was done using SPSS.Results: During 5 years, there were 17,538 caesarean deliveries, 39.15% of total 44,788 deliveries. Relaparotomy was done in 15 cases, 0.085% of 17538 caesarean. Mean age was 26.6±4.7 years, 14 (93.3%) were between 25-35 years, 12 (80%) were primigravida. Indications of relaparotomy were pyoperitonium (40%), hemoperitoneum (33.3%) and rectus sheath hematoma (26.7%). Out of 15 relaparotomy, 14 were conservative surgery and one required hysterectomy. There was no maternal mortality. Conclusions: Relaparotomyin our study the rate was eight in 10,000. Those requiring relaparatomy had fetal distress as indication for first caesarean.Keywords: caesarean section, pyoperitoneum, relaparotom

Spinal Cord Injury Prevalence and Treatment Modalities

Spinal cord injury (SCI) is a devasting neurological condition producing physical dependency, morbidity, psychological stress, and financial burden. During the last 30 years, its global prevalence has increased from 236 to 1298 cases per million populations. Two types of spinal cord injury are primary and secondary injury. Primary injury is mechanical damage to the cord itself whereas secondary injury results from one or more biochemical and cellular processes that are triggered by the primary lesion. In 1700 BC, in an Egyptian surgical papyrus, they describe the frustration of health care professionals in treating a severe spinal cord injury, the Papyrus reported spinal fractures as a “disease that should not be treated”. Most of these studies approach a patient with acute spinal cord injury (ASCI) in one of four manners: corrective surgery or a physical, biological, or pharmacological treatment method. Science is unraveling the mechanisms of cell protection and neuroregeneration, but clinically, we only provide supportive care for patients with spinal cord injuries. By combining these treatments, researchers attempt to enhance the functional recovery of patients with spinal cord injuries. Advances in the last decade have allowed us to encourage the development of experimental studies in the field of spinal cord regeneration. The combination of several therapeutic strategies should, at a minimum, allow for partial functional recoveries for these patients, which could improve their quality of life. More studies were done on spinalized animals that indicate that most of these pharmacological agents may act on receptors present in the spinal cord, thus facilitate to produce coordinated locomotor movement, whereas some other drugs used to improve the neuropathological changes caused because of spinal cord injury (SCI), such as spasticity or demyelination, to improve walking

Identification and management of atherosclerotic cardiovascular disease risk in south Asian populations in the U.S.

South Asians (SAs, individuals with ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) are among the fastest growing ethnic subgroups in the United States. SAs typically experience a high prevalence of diabetes, abdominal obesity, and hypertension, among other cardiovascular disease risk factors, which are often under recognized and undermanaged. The excess coronary heart disease risk in this growing population must be critically assessed and managed with culturally appropriate preventive services. Accordingly, this scientific document prepared by a multidisciplinary group of clinicians and investigators in cardiology, internal medicine, pharmacy, and SA-centric researchers describes key characteristics of traditional and nontraditional cardiovascular disease risk factors, compares and contrasts available risk assessment tools, discusses the role of blood-based biomarkers and coronary artery calcium to enhance risk assessment and prevention strategies, and provides evidenced-based approaches and interventions that may reduce coronary heart disease disparities in this higher-risk population

2-(4-Chloro­phen­yl)chromen-4-one

The title compound, C15H9ClO2, is a synthetic flavonoid obtained by the cyclization of 3-(4-chloro­phen­yl)-1-(2-hy­droxy­phen­yl)prop-2-en-1-one. The 4-chloro­phenyl ring is twisted at an angle of 11.54° with respect to the chromen-4-one skeleton. In the crystal, pairs of mol­ecules are inter­connected by weak Cl⋯Cl inter­actions [3.3089 (10) Å] forming dimmers which are further peripherally connected through inter­molecular C—H⋯O hydrogen bonds

Electronics design and development of Near-Infrared Imager, Spectrometer and Polarimeter

NISP, a multifaceted near-infrared instrument for the upcoming 2.5m IR telescope at MIRO Gurushikhar, Mount Abu, Rajasthan, India is being developed at PRL, Ahmedabad. NISP will have wide (FOV = 10' x 10') field imaging, moderate (R=3000) spectroscopy and imaging polarimetry operating modes. It is designed based on 0.8 to 2.5 micron sensitive, 2048 X 2048 HgCdTe (MCT) array detector from Teledyne. Optical, Mechanical and Electronics subsystems are being designed and developed in-house at PRL. HAWAII-2RG (H2RG) detector will be mounted along with controlling SIDECAR ASIC inside LN2 filled cryogenic cooled Dewar. FPGA based controller for H2RG and ASIC will be mounted outside the Dewar at room temperature. Smart stepper motors will facilitate motion of filter wheels and optical components to realize different operating modes. Detector and ASIC temperatures are servo controlled using Lakeshore's Temperature Controller (TC) 336. Also, several cryogenic temperatures will be monitored by TC for health checking of the instrument. Detector, Motion and Temperature controllers onboard telescope will be interfaced to USB Hub and fiber-optic trans-receiver. Remote Host computer interface to remote end trans-receiver will be equipped with in-house developed GUI software to control all functionalities of NISP. Design and development aspects of NISP Electronics will be presented in this conference.Comment: 6 pages, 3 figures, Submitted to SPIE Conference Astronomical Telescopes + Instrumentation 202