Clinico-Etiopathogenesis of Vitamin B12, Folic Acid and Iron Deficiency in Severe Acute Malnutrition Children: A Tertiary Care Hospital Experience from Central India.

In severe acute malnutrition, micronutrient deficiency as well as protein energy malnutrition is a major obstacle to growth & development. Iron deficiency dominates the spectrum of nutritional anemia. After taking informed consent, 211 SAM children and 211 age-and sex-matched healthy children with normal nutritional status were enrolled for the study. MUAC was used to diagnose SAM. A 5-part automated hematoanalyzer was used to measure the complete blood count and red cell indices, and the peripheral smear method to determine the red cell morphology. We measured serum ferritin, Vitamin B12, and folic acid using the ELISA method. Compared to controls, children with SAM had significantly lower red cell indices, platelet counts, and white cell counts. The most common clinical symptoms seen in SAM children were diarrhea, pneumonia, acute gastroenteritis, and acute respiratory infection. Children with SAM are more likely to suffer from iron deficiency and B12 deficiency. Severe vitamin B12 deficiency was more frequently associated with severe anemia. The severe anemia in SAM children constantly changes the body's defense mechanism, affecting the haematopoiesis. In this study, haematological indices are recommended for predicting severity of anemia, and hematopoietic changes are described, in order to improve anticipatory care and outcome in children with SAM.

Comparative Study of Adductor Canal Block and Femoral Nerve Block for Postoperative Analgesia After Arthroscopic Anterior Cruciate Ligament Tear Repair Surgeries.

OBJECTIVE: The study aimed to compare an adductor canal block (ACB) with a femoral nerve block (FNB) with regard to their analgesic efficacy and the quadriceps muscle strength in patients following arthroscopic anterior cruciate ligament (ACL) tear repair surgeries. MATERIALS AND METHODS: Ninety patients in the American Society of Anaesthesiologists (ASA) status I or II undergoing arthroscopic ACL tear repair surgeries under subarachnoid block were divided into three groups to receive ACB (Group ACB), FNB (Group FNB), and control (Group C). Each patient was assessed for Visual Analogue Scale (VAS) score, tramadol consumption, and quadriceps muscle strength postoperatively in the post anaesthesia care unit (PACU). RESULTS: There was no significant difference between the Group ACB and Group FNB regarding postoperative analgesia and total rescue analgesic consumption at 24 hrs postoperative. The mean VAS score at two, four, and six hours and total rescue analgesic consumption in 24 hrs were higher in the control group, which was statistically significant (p-value <0.05). Quadriceps muscle strength by straight leg raise test was significantly higher in the Group ACB compared with the Group FNB at 0, 6, 12, 18 hours postoperatively (p-value <0.0001), whereas the difference between both study groups become statistically insignificant at 24 hours postoperative. CONCLUSION: ACB preserved quadriceps muscle strength better than FNB, without a significant difference in postoperative analgesia after arthroscopic ACL tear repair surgeries.

Current Challenges for the Effective Management of the COVID-19 Pandemic.

INTRODUCTION: Within a short period, the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) spread all over the globe and became the first pandemic of the present century. Early diagnostic tools and effective drugs are urgently needed to effectively manage the COVID-19 pandemic. Based on current literature, we provide recent updates on SARS-CoV-2 biology, available diagnostic methods, and therapeutic options for the management of COVID-19 pandemic. METHODS: A literature survey was done using Google and PubMed and Web of Science to summarize the current updates on this topic. RESULTS: Current coronavirus diagnostic tests are reverse transcription polymerase chain reaction (RT-PCR), real-time RT-PCR (qRT-PCR), and reverse transcription loop-mediated isothermal amplification (RT-LAMP) which detects the presence of specific genome sequence of virus. Existing antiviral drugs or new therapeutic options such as neutralizing antibody or plasma therapy are mostly used to restrict the virus growth with a limited success. CONCLUSION: As there is no specific treatment or vaccine available to limit the infection of SARS-CoV-2, we need to rely on the existing way to limit the disease. The first priority to fight COVID-19 is development of early diagnostic tools so that infected persons can be identified and further viral transmission can be blocked. Evaluation of existing drugs or identification of new therapeutic entities becomes the major challenge to deal with the present pandemic.

Intraoperative autologous blood transfusion of peritoneal blood during laparotomy for ectopic pregnancy: prospective study.

OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of intraoperative autologous blood transfusion during laparotomy for hemoperitoneum in ectopic pregnancy and also safety of homologous blood transfusion along with autologous blood transfusion. METHOD: Fresh blood, from peritoneal cavity, was collected for autotransfusion in sterile dish, filtered through eight layers of sterile gauze pieces, and collected in a sterile bowl. The collected blood was transferred into blood infusion bag containing citrate phosphate dextrose adenine solution in the proportion of five parts of blood to one part of citrate solution. RESULTS: Mean volume of autologous blood transfused in patients without homologous transfusion was 573 ± 328. Mean preoperative hemoglobin was 4.95 ± 1.5, and postoperative hemoglobin was 6.85 ± 1.3. Hence, rise in hemoglobin was 1.9 g%. Autologous blood volume transfused in 29 patients (who required homologous blood transfusion) was 488 ± 216. Preoperative hemoglobin was 4.35 ± 1.94. The result was compared with other studies. CONCLUSION: Intraoperative autologous blood transfusion enabled the performance of laparotomy in hemodynamically unstable ectopic pregnancy patients without availability of homologous blood transfusion. Homologous blood transfusion is compatible with autologous blood transfusion.

Reactivity of the oxime/oximato group in ruthenium(II) complexes.

Oxime targeted reactions of the complexes trans-[(kappa(3)-dapdOH)Ru(CO)(PPh(3))(2)]PF(6) (1) (dapdOH = diacetylpyridinedioxime) and trans-[(kappa(3)-dapmOH)RuCl(PPh(3))(2)]PF(6) (2) (dapmOH = diacetylpyridinemonooxime) with SOCl(2), NaBH(4), or HCHO led into conversion of oxime to oximato, imino, or hydroxymethylimino groups. The reaction products have been characterized by analytical and spectral studies. Molecular structures of the representative homo/heteroleptic oxime/oximato complexes trans-[(kappa(3)-dapdOH)Ru(CO)(PPh(3))(2)]PF(6) (1), trans-[(kappa(3)-dapdO)Ru(CO)(PPh(3))(2)] (11) and oximato/imino complex trans-[(kappa(3)-dapd-NH)Ru(CO)(PPh(3))(2)]PF(6) (13) have been authenticated by single-crystal X-ray diffraction analyses. Structural studies revealed the presence of various oxime/oximato/imino based O-H...O, C-H...O, and N-H...F interactions in the complexes 1, 11, and 13.