Coagulation conundrum in obstetric anesthesia with COVID-19.

Coronavirus disease (COVID-19) pandemic is an unprecedented public health calamity that has caused an immense setback to maternal health services in developing countries. In addition to morbidity and mortality caused by COVID-19 disease in parturient directly, the indirect adverse impact of lockdown imposed during pandemic causing loss of follow-up of patients with coexisting illness is significant. There are no standard protocols to manage COVID-19 patients with comorbid medical illness, who are not optimized during antenatal visits. We report an interesting case of an antenatal patient with COVID-19, with prosthetic aortic valve on warfarin with elevated International Normalized Ratio (INR) and severe pre-eclampsia, posted for emergency cesarean section.

Efficacy of saccharides bio-template on structural, morphological, optical and antibacterial property of ZnO nanoparticles.

Mono, di and polysaccharides of glucose (C6H12O6), sucrose (C12H24O12) and starch (C6H12O6)n bio-template ZnO nanoparticles (NPs) has prepared by chemical precipitation method. Saccharides bio-template ZnO (SBts-ZnO) NPs were efficiently prepared for their structural and optical properties were examined by using XRD, FE-SEM, AFM, FTIR, UV and PL techniques. All the samples are polycrystalline nature with a preferential orientation depending on the (1 0 1) plane. The reduction of crystalline size by utilizing glucose, sucrose and starch bio-template of ZnO NPs. FE-SEM images revealed that the spherical and nano-rods like morphologies for ZnO and SBts-ZnO NPs respectively. AFM recorded images shows spherical features that confirmed and also the morphological changes were noticed with the addition of polymers. Interaction of bio-templated saccharides (glucose G1, sucrose S2 & starch Sn) molecules was proved by FTIR study. Optical absorbance and emission behaviours were investigated using UV-Vis and photoluminescence techniques. The antibacterial study revealed that SBts-ZnO have excellent antibacterial effect than ZnO. The Sn-ZnO sample has potent antibacterial activity against the Proteus vulgaris followed by Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus.

Enhanced Antibacterial effect using carbohydrates biotemplate of ZnO nano thin films.

Carbohydrate biotemplates of glucose (C6H12O6) and starch (C6H12O6)n in to Zinc oxide (ZnO) nano thin films (NTFs) prepared for enhanced antibacterial activity by Successive Ionic Layer Adsorption Reaction (SILAR). X-ray diffraction (XRD) patterns revealed that the crystalline size values were decreased by the incorporation of carbohydrate molecules. Scanning electron microscope (SEM) and Field emission scanning electron microscope (FESEM) confirmed that the different morphologies by the addition of glucose and starch. The interactions of carbohydrate molecules with ZnO were identified by using FTIR and EDAX. Energy band gap of samples was calculated by UV absorption spectra. The emission property of Zinc oxide, Glucose/ZnO and Starch/ZnO was studied by photoluminescence (PL) spectra. The antibacterial activity of carbohydrate biotemplates (Cbts-ZnO) results showed that enhanced effect than pure ZnO for the selected pathogenic bacteria's.

Structural, optical and electrical characterization of nanostructured porous silicon: Effect of current density.

In this work, an attempt has been made to fabricate porous silicon (PS) from p-type crystalline silicon (c-Si) wafers by using the electrochemical etching process at six different current densities (40, 60, 75, 100, 125 and 150mA/cm(2)) with constant time (30min). The influence of varying current density on morphological, structural, optical and electrical properties of PS samples were analyzed by using SEM, AFM, XRD, FT-IR, PL and electrical (I-V) techniques, respectively. Microstructural images clearly showed that the average pore diameter and thickness increase with increase current densities up to 100mA/cm(2) and decrease for 125mA/cm(2). It could be related to breaking of pore walls and exposing to the next layer of c-Si. Further increase the current density about 150mA/cm(2), the average pore diameter increase as in the case of first layer (40-100mA/cm(2)) of c-Si wafer. The result is reflected in PL emission band (at 708nm) and the intensity of the emission band shifted towards red region. The X-ray diffraction pattern confirm the formation of porous silicon as appeared as a broad peak at 2θ=69.3° belongs to (400) reflection. The FTIR study supports the X-ray diffraction analysis that shows the vibrational bands of S-H2 and Si-O-Si at 2109cm(-1), 915cm(-1) and 615cm(-1) and 1107cm(-1), respectively. The I-V characteristic of PS exhibited rectifying behavior with different values of ideality factor (η) and barrier height (ϕb). It is concluded from the experimental results that the formed pores developed up to 100mA/cm(2) in the top layer of c-Si and the formed pores exposed to the next layer of c-Si when increase the high electrochemical etching process (above 100mA/cm(2)).

History, Epidemic Evolution, and Model Burn-In for a Network of Annual Invasion: Soybean Rust.

Ecological history may be an important driver of epidemics and disease emergence. We evaluated the role of history and two related concepts, the evolution of epidemics and the burn-in period required for fitting a model to epidemic observations, for the U.S. soybean rust epidemic (caused by Phakopsora pachyrhizi). This disease allows evaluation of replicate epidemics because the pathogen reinvades the United States each year. We used a new maximum likelihood estimation approach for fitting the network model based on observed U.S. epidemics. We evaluated the model burn-in period by comparing model fit based on each combination of other years of observation. When the miss error rates were weighted by 0.9 and false alarm error rates by 0.1, the mean error rate did decline, for most years, as more years were used to construct models. Models based on observations in years closer in time to the season being estimated gave lower miss error rates for later epidemic years. The weighted mean error rate was lower in backcasting than in forecasting, reflecting how the epidemic had evolved. Ongoing epidemic evolution, and potential model failure, can occur because of changes in climate, host resistance and spatial patterns, or pathogen evolution.

Clinical experience with exenatide in a routine secondary care diabetes clinic.

Exenatide use in type 2 diabetes is limited in routine clinical practice. We examined a cross-section of 90 patients. Mean weight and HBA(1c) were 114.9+/-20.6 kg, 10.3+/-2.1% at initiation; 108.0+/-15.3 kg (p<0.0001), 9.0+/-2.1% (p<0.001) at 3 months; 109.2+/-18.2 kg (p<0.0001), 9.5+/-2.3% (p=0.08) at 6 months. Exenatide appears effective in reducing HBA(1c) and weight.

Preliminary evaluation of anti-pyretic and anti-ulcerogenic activities of Sida cordifolia methanolic extract.

The anti-pyretic and anti-ulcerogenic properties of methanolic extract of Sida cordifolia aerial parts (MESC) were investigated in rats. Oral dose of 500 mg/kg MESC significantly reduced pyrexia induced by TAB vaccine. MESC exhibited significant anti-ulcerogenic effect against aspirin and ethanol induced damage. Both these properties were comparable to the reference drugs.

An ethnopharmacological study from thane district, maharashtra, India: traditional knowledge compared with modern biological science.

This paper is a synthesis of local traditional knowledge of plants used as medicine and western biological science. In many areas women are responsible for curing their family members and others for various illness. Ethnomedical uses of 51 plants by women in hamlets/villages of Jawhar and Mokhada talukas in Thane district, Maharashtra, have been recorded. Information from scientific literature for each plant collected has been incorporated with traditional knowledge to explain or substantiate traditional medicinal uses.

An ethnopharmacological study from kulu district, himachal pradesh, India: traditional knowledge compared with modern biological science.

A synthesis of ethnopharmacological knowledge and western biological science has been attempted in this paper. Thirty-four species of plants used by local women in hamlets of Banjar taluka, Kulu district, Himachal Pradesh have been recorded. The knowledge of medicinal plants that local women have is important as they have a lifetime experience in using them through caring for themselves, their families and others around them. For the plants recorded, information from scientific literature has been included in order to explain or justify the traditional medical use.

Noise estimation and filtering using block-based singular value decomposition.

Preprocessing of image and video sequences with spatial filtering techniques usually improves the image quality and compressibility. We present a block-based, nonlinear filtering algorithm based on singular value decomposition and compression-based filtering. Experiments show that the proposed filter preserves edge details and can significantly improve the compression performance.

Foreign body in the hypopharynx--an unusual presentation.

A case is described of a foreign body (a metallic paper clip) in the hypopharynx of an 18 month old child presenting with recurrent respiratory tract infections. The child was treated with antibiotics at two accident and emergency departments without any benefit. A high degree of suspicion is necessary in young children, as a history of ingestion of a foreign body may not be forthcoming. It is important to be aware of the possibility of a foreign body in young children, particularly when the clinical presentation is atypical.

The laryngectomee and swimming.

Following laryngectomy patients are usually advised that swimming is no longer possible. Under supervised conditions and using a swimming aid, such as described, a laryngectomee may return to an activity previously considered unavailable, rehabilitation thus being more complete. However, for a laryngectomee to proceed a safe supervised environment is required, and the path to this goal is often long and arduous, but with persistent dedication the Laryngectomy Swimming Club may become a reality bringing rich reward.

Button battery in the nose--an unusual foreign body.

We present two rare, but similar, cases of button batteries in the nose in male children of Caucasian origin. The importance of early diagnosis, treatment and the long-term morbidity of such a foreign body in the nose are discussed.

The Provox voice prosthesis and Candida albicans growth: a preliminary report of clinical, mycological and scanning electron microscopic assessment.

Provox voice prostheses are low-resistance speech values available since 1990 for post-laryngectomy voice rehabilitation. Candida spp. mycelial growth has always been a major problem in all prosthetic valves causing leakage and limiting valve life. We found that the Provox new valves were not exempt from the old problem. We performed a preliminary clinical, mycological and scanning electron microscopic assessment of Candida spp. growth on these valves. In contrast to studies done with other valves we found that the Candida mycelium on these new valves was a surface colony rather than growing into the valve substance, thus it might be feasible to control the mycelial growth by either mechanical cleansing or by using topical anti-fungal agents.

Unilateral anterior jugular phlebectasia.

We present a rare case of unilateral anterior jugular venous phlebectasia in an 82-year-old female patient presenting as a soft cystic lump in the anterior aspect of the neck increasing in size during straining and valsalva manoeuvre. Although cases of internal and external jugular phlebectasia have been reported, as far as we are aware no case of anterior jugular phlebectasia has been reported in the literature previously.

Preparation of a temporal bone exhibit.

Temporal bone dissection forms an important aspect in the training of an otolaryngologist. The more dissection one does the more confident one is in the operating room. The aim of this paper is to advise in the preparation of temporal bones for the purpose of display, exhibition or competition. The practical aspects of dissection are deliberately avoided concentrating on the selection of bones pre- and post-dissection, preparation of the bones, fixing and display of vessels and nerves and also mounting and lighting for exhibition purposes. The temporal bone laboratory should be well equipped with a microscope, a power drill with a range of cutting and polishing burrs, a range of fine instruments, a suction machine with different sizes of suction tips, water source, a place to store the bones etc., thus creating an ideal environment for temporal bone dissection.