Comparison Of Maternal And Fetal Outcome Following Caesarean Section In Pre- Eclamptic Patients Under General And Spinal Anesthesia

Background:Pre-eclampsia is a multi-system disorder in pregnancy associated with significant maternal morbidity and mortality and also affects neonatal outcome. Choice of anesthesiatechnique and skillful management is equally important for maternal and fetal well-being. So, this study was designed to compare the maternal and fetal outcome following cesarean section in pre-eclamptic patients under general and spinal anesthesia. Material And Methods:This prospective, randomized observational study was carried out in 60 parturients age between 18 to 40 years divided in two groups 30 parturients in each. ASA Physical Status II and III who delivered after 34 weeks of gestation with criteria of mild pre-eclampsia by means of Elective/emergency C-section were included. After giving pre medication Group G received thiopentone, succinylcholine intravenously before intubation followed by oxygen, sevoflurane and atracurium (after delivery of baby). Group S received spinal anesthesia by using 2 ml of 0.5% heavy bupivacaine. Heart rate, blood pressure, SpO2 of mother and neonate were recorded at specific time points. Also post of ICU shifting of mother for maternal outcome and APGAR score at 1,5,7minutes, ABGA, resuscitation requirement and NICU admission data were recorded for fetal outcome.Result:After induction maternal heart rate and blood pressure were higher side (still within 30% from baseline) in group G as compared to group S. APGAR score, ABGA and NICU shifting requirements had favorable outcome in group S. Conclusion:Spinal anesthesia is first choice as it is more safe, simple and with better maternal and fetal outcome.

Intravesical Foreign Body: A Rare Case Report and Review of Literature.

Foreign bodies related to urogenital tract represent a relatively rare pathology and are most commonly found in the urinary bladder. Foreign body of the urinary bladder may occur by migration from surrounding organs or by self-insertion via urethra. Vesicovaginal fistula (VVF) is commonly caused by obstructed labor, gynecological surgeries, occasionally due to malignancy, but rarely by the foreign body; in most cases being ring pessaries. A 25-year-old female presented in our clinic with urinary incontinence and irritative lower urinary tract symptoms. Radiological investigation revealed intravesical foreign body (wooden abortion stick) with VVF. It was removed via suprapubic cystostomy and fistula managed conservatively.

Degradation of xenobiotic compounds by lignin-degrading white-rot fungi: enzymology and mechanisms involved.

White-rot fungi (WRF) are ubiquitous in nature with their natural ability to compete and survive. WRF are the only organisms known to have the ability to degrade and mineralize recalcitrant plant polymer lignin. Their potential to degrade second most abundant carbon reserve material lignin on the earth make them important link in global carbon cycle. WRF degrade lignin by its unique ligninolytic enzymatic machinery including lignin peroxidase, manganese peroxidase, laccase, cellobiose dehydrogenase, H2O2-generating enzymes, etc. The ligninolytic enzymes system is non-specific, extracellular and free radical based that allows them to degrade structurally diverse range of xenobiotic compounds. Lignin peroxidase and manganese peroxidase carry out direct and indirect oxidation as well as reduction of xenobiotic compounds. Indirect reactions involved redox mediators such as veratryl alcohol and Mn2+. Reduction reactions are carried out by carboxyl, superoxide and semiquinone radicals, etc. Methylation is used as detoxification mechanism by WRF. Highly oxidized chemicals are reduced by transmembrane redox potential. Degradation of a number of environmental pollutants by ligninolytic system of white rot fungi is described in the present review.