Evaluation of surgical Apgar score in predicting post-laparotomy complications

Background: Surgical Apgar score is a simple, objective and economical ten point post-operative prognostic scoring system based on three readily recorded intra operative variables. Aim is to evaluate the applicability and accuracy of the surgical Apgar score in predicting post-operative complications and objectives are to identify patients at risk of developing post-operative complications based on intra-operative data, to study the incidence of post-operative complications and morbidity and mortality in patients undergoing elective and emergency laparotomy.Methods: This was a prospective analytical study carried out at SSG Hospital from November 2018 to October 2019 and achieved sample size was 160 patients. Surgical Apgar score was calculated at the end of the operation from these three parameters: heart rate, mean arterial pressure and expected blood loss.Results: Out of 160 patients, 77 patients were in group 0-5 and complications occurred in 45 patients (58.4%), 54 patients in group 6-7 in which 18 patients (33.3%) suffered a complication and 29 patients in 8-10 surgical Apgar score, rate of complications was 17.3% in category 8-10 Apgar score.Conclusions: Complications are more in low Apgar score patients compared to high Apgar score and in emergency cases compared to elective surgeries, would require more intensive monitoring in the postoperative period.

Protective effect of Zuroor-e-Qula' against gastric mucosal damage: an ultrastructural study

The gastro-protective activity of the PHF [Zuroor-e-qula'] and its extracts was assessed in three different models of experimentally induced gastric ulcers in rats. In case of both preventive and curative treatments at 400 mg/kg dose the PHF and the aqueous and alcoholic extracts reduced gastric lesions significantly which were induced by HCl/ethanol. Significant changes in gastric parameters such as pH, volume of gastric juice and gastric acidity after oral administration of the samples under ligated pylorus [Shay] conditions. Also, in this paper, we report the ultrastructural observations of gastric mucosa. The ultrastructural changes were observed by Scanning Electron Microscopy [SEM]. The preventive as well as curative treatments in rats revealed a protective action against HCl/ethanol induced gastric mucosal damage. Probably, polyphenols, flavonoids, essential and fixed oils of the formulation were involved

Botulinum toxin in neurological diseases

Botulinum neurotoxin is produced by the anaerobic bacterium Clostridium botulinum. It is the most poisonous biological substance known. Very small amounts of botulinum toxin can lead to botulism, a descending paralysis with prominent bulbar symptoms and often affecting the autonomic nervous system. Previously known only as a cause of a serious and often fatal paralysis acquired through ingestion of contaminated food, the toxin recently has been used for medicinal and cosmetic purpose. The toxin causes paralysis by blocking the presynaptic release of acetylcholine at the neuromuscular junction. Botulinum toxin A was first approved by US Food and Drug Administration in the year 1989, to treat two eye muscle disorders [blepharospasm and strabismus] and in the year 2000 to treat cervical dystonia, a neurological movement disorder causing severe neck and shoulder contractions. The use of botulinum toxin has further exp and ed and now it is being used as a safe and effective way to treat several neuromuscular disorders and to reduce facial wrinkles without surgery. Research is underway to use botulinum toxin for drug delivery, migraine, Alzheimer and treatment of cancer. Its effectiveness in the treatment of various neuromuscular diseases and its multi therapeutic uses has placed the toxin on top of new drug development list