Importance, indication and safety of maternal immunization

Vaccination is a very important spectrum for building immunity to fight certain infections. Doing vaccination on the mother as well as the baby, which safeguards both of them, is known as maternal immunization. After childbirth, babies are prone to get infected by many diseases as their immunity is inferior during that time. Over the years, numerous studies have shown that vaccinating mothers can effectively reduce the risk of illnesses such as smallpox, polio, etc. This vaccination process helps strengthen the body's system and enables it to combat these diseases effectively when necessary. This approach works by boosting the transfer of antibodies from the person to the fetus through the placenta, providing passive immunity to the infant during their initial months of life until they become eligible for their own vaccines. In addition to protecting infants, maternal immunization can also help prevent complications for individuals caused by infections that could impact their health and pregnancy outcomes. This review focuses on discussing the significance, indications, and safety of immunization for diseases that pose a high risk to both pregnant individuals and their infants.

Subarachnoid lavage following inadvertent intrathecal injection of tranexamic acid

Tranexamic acid (TXA) is a commonly used antifibrinolytic drug during surgical procedures to reduce blood loss. An Inadvertent intrathecal injection of TXAmay lead to serious side effects including seizures and ventricular fibrillation with reported fatalities. We report a case of an inadvertentintrathecal injection of TXAwhich occurred as a result of similarities in appearance between TXAand heavy bupivacaine ampoules. The patient had subarachnoid lavage after experiencing back pain, systemic hypertension followed by generalized tonic clonic seizures

Different modalities of management for ischemic mitral regurgitation

Mitral regurgitation [MR] resulting from prior myocardial infarction is now recognized as an important clinical sequel that directly impacts the long-term outcome of patients.' Defining Ischemic MR. Carpentier's pathophysiologic triad I defines the relationship between etiology, lesion[s] [pathological changes in the valve], and dysfunction [abnormalities of leaflet motion] that results in MR. Carpentier's classification of leaflet dysfunction is based on the motion of the margin of the leaflet in relation to the annular plane. Often authors use an etiologic definition for ischemic MR such as "mitral regurgitation resulting from prior myocardial infarction associated with normal mitral valve leaflets and chordae. In terms of defining ischemic MR it is important to note that the majority of patients have an etiologic basis of prior myocardial infarction, not an acute myocardial infarction or papillary ischemic event. Resulting wall motion abnormalities and left ventricular remodeling leading to lateral and apical displacement of papillary muscles are the key pathophysiologic events. The predominant mitral valve lesion, therefore, is leaflet tethering, mainly of the posterior-medial scallop of the posterior leaflet [P-3] adjacent to the posterior commissure area, particularly in the setting of posterior infarction. Mitral annular dilatation often accompanies leaflet tethering as an associated lesion. The leaflet dysfunction resulting in the most common form of ischemic MR is Type IIIb. with restricted motion of the margin of the leaflet[s] in systole. Therefore for the majority of patients ischemic MR is defined by the presence of the following [a] prior history of myocardial infarction [b] tethering of predominantly the posterior-medial scallop of the posterior leaflet, and [c] Type III b Carpentier dysfunction with restricted leaflet motion in systole. Other forms of ischemic MR are less common. Type I dysfunction without leaflet restriction [normal leaflet motion] and isolated annular dilatation can occur in the setting of isolated basilar rnyocardial infarction Some patients with ischemic MR have Type II dysfunction [excess leaflet motion], resulting from either an acute [ruptured papillary muscle] or chronic [fibrotic and elongated papillary muscle] myocardial ischemic event. It should be emphasized that the prior concept of "acute ischemia with papillary muscle dysfunction" that would reverse with revascularization is now recognized to be valid in only a small percentage of patients with ischemic MR. This review will concentrate on ischemic MR with restricted leaflet motion that is most frequently seen in clinical practice