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.

Clerodendrum serratum: A clinical approach.

Clerodendrum serratum Linn. (Family: Verbenaceae) is very widely distributed in tropical and subtropical regions of the world. Ethno-medicinal importance of the plant has been reported in various indigenous systems of medicines like Ayurveda, Siddha and Unani for the treatment of various life-threatening diseases such as syphilis, typhoid, cancer, jaundice and hypertension. Some of the chief constituents found in the plant are D-mannitol, hispidulin, cleroflavone, apigenin, scutellarein, serratagenic acid, acteoside, verbascoside, oleanolic acid, clerodermic acid, γ-sitosterol, β-sitosterol, cholestanol, clerosterol, campesterol and 24-ethyl cholesterol. Traditionally, it has been also used as anti-rheumatic, anti-asthmatic, febrifuge, in cephalagia and ophthalmia. The roots of C. serratum are also used as anti-oxidant, anti-bacterial, and anti-fungal. Besides these the antimicrobial value of this herbal plant have also been reported in its stems and leaves. These reports are very encouraging and indicate that herb should be studied more expensively for its therapeutic benefits.

Mechanism responsible for mucoadhesion of mucoadhesive drug delivery system: a review.

Mucoadhesion had been a topic of interest in the design of drug delivery system to prolong the residence time of the dosage form with the under lying absorption surface to improve and enhance the bioavailability of drugs. Mucoadhesion occurs between two surfaces, one of which is a mucous membrane and another is drug delivery system. Pharmaceutical aspects of mucoadhesion had been the subject of great interest during recent years because mucoadhesion could be a solution for bioavailability problems that result from a too short length of stay of the pharmaceutical dosage form at the absorption site within the gastro-intestinal tract. It had been a great challenge to the pharmaceutical sciences in order to enhance localised drug delivery or to deliver ‘difficult’ molecules (proteins and oligonucleotides) into the systemic circulation. Mucoadhesive systems remain in close contact with the absorption tissue, the mucous membrane releasing the drug at the action site leading to increase in bioavailability (both local and systemic effects). Extending the residence time of a dosage form at a particular site and controlling the release of drug from the dosage form are useful especially for achieving controlled plasma level of the drug as well as improving bioavailability. The main objective of this study was to selectively collect the data which were extended the gastrointestinal residence time of the dosage form and controlled the release of mucoadhesives.

Allergen specific immunotherapy in nasobronchial allergy.

BACKGROUND: More than one antigen has been used for immunotherapy of allergic disorders. So far less than five antigens have been employed with variable results. AIM: To evaluate effect of multiple antigens up to six in the immunotherapy of nasobronchial allergy. SETTING AND DESIGN: Based on clinical history, symptoms present for at least 3 years with set criteria of immunomodulation for asthma and rhinitis: documented IgE mediated asthma and rhinitis, failure in allergen avoidance and moderate to severe clinical manifestations. MATERIAL AND METHODS: Five hundred cases of various allergic disorders attending allergy clinic of Bombay hospital were screened. Allergen specific immunotherapy was initiated in 131 subjects (56 -rhinitis and 75 asthma) with prior consent. Patients suffering from allergic disorders secondary to diseases or drug therapy were excluded. Multiple allergen immunotherapy was given at specific intervals up to a period of one year. Allergen extracts were prepared as per standard technique. For statistical analysis "students't test" was used. RESULTS AND CONCLUSIONS: Significant improvement in PEFR, reduction in skin sensitivity to allergens used in immunotherapy formulation and symptomatic relief without any untoward reaction show that multiple allergen immunotherapy is as effective as monoallergen immunotherapy in nasobronchial allergy.

Evaluation of a novel, two component, two step AFB cold staining method.

AFB smear is a clinically useful and a cost effective test for screening of sputum samples for Mycobacterium tuberculosis. Routinely, Ziehl Neelsen stain, using the traditional hot staining procedure is the mainstay of sputum smear AFB tests. We have evaluated a novel two components, two step cold AFB stain to establish its sensitivity, simplicity and reproducibility as compared to the traditional 'ZN Hot' stain still regarded as the standard AFB stain in routine laboratory practice. This study was conducted over a period of four months at the TB Hospital, Taleigao Goa. Comparatively the two components, two step AFB stain was easy to use, time, labour and cost saving. It gave reproducible results during the study period. The most important characteris tics were that it nearly doubled (~91%) the detection rate of AFB positive sputum in our hospital.

Identification of bovine sperm specific polypeptides reactive with antisperm antibodies.

The present study was taken to characterize molecular weights of sperm specific polypeptides antigenic to rabbits and calf with the aim to assess their immunoreactivity with IgG antibodies in sera from immuno-infertile cows. Seropositivity for antisperm IgG antibodies in 75 repeat breeder and 15 pregnant control cattle was tested by cellular ELISA using washed spermatozoa antigen from 4 bulls. Molecular weights of bovine sperm polypeptides antigenic to rabbit and calf were determined by 10% SDS-PAGE and Western blotting. Molecular weights of sperm peptides reactive with sera from immuno-infertile cows were also determined. Seropositivity of antisperm IgG antibodies for bull I, II, III and IV was 23.6, 14.6, 26.6 and 20%, respectively. A total of 16 polypeptides were discernible on gel. Out of these, 7 polypeptides were immunoreactive with sera from hyperimmunized rabbits as compared to 3 poly-peptides which reacted with sera from hyper-immunized calf. Only two polypeptides were reactive with sera from immuno-infertile cows. Variable number of sperm polypeptides and their immunoreactivity have been reported in different species. Antigenicity of different polypeptides in sperm needs further investigations.