Ultrasound-Guided Subclavian Vein Catheterization: Contrasting Supraclavicular and Infraclavicular Approaches for Enhanced Procedural Precision.

Background Ultrasound-guided subclavian vein catheterization is crucial for central venous access, but the choice between the supraclavicular and infraclavicular approaches lacks comprehensive comparison. This study addresses this gap by conducting a prospective observational analysis of both techniques. The supraclavicular method accesses the vein from above the clavicle while the infraclavicular targets it below. Our model-driven approach aims to elucidate the procedural nuances, success rates, and complications associated with each method. The findings intend to equip clinicians with evidence-based insights, facilitating informed decision-making for improved procedural outcomes in ultrasound-guided subclavian vein catheterization. Aim and objective This study aims to comprehensively compare the supraclavicular and infraclavicular approaches in ultrasound-guided subclavian vein catheterization, evaluating the procedural minutiae, potential advantages, and challenges associated with each technique. Employing a prospective observational methodology, our objective is to provide evidence-based insights for approaches in ultrasound-guided subclavian vein catheterization, evaluating procedural nuances, success rates, and complications during the procedure. Methods In this prospective investigation, 276 patients aged between 20 and 55 years were randomly assigned to two groups: 143 patients in the supraclavicular group and 133 patients in the infraclavicular group. Specifically, patients admitted for elective surgery necessitating postoperative ICU care were considered. The study assessed various variables, including success rate, time required for venous visualization, venous puncture, catheterization, total procedure duration, and incidence of mechanical complications, to facilitate group comparisons. Results The mean procedural time was shorter in the supraclavicular group compared to the infraclavicular group, with durations of 2 minutes and 2 seconds versus 3 minutes and 40 seconds, respectively (95% CI). This difference was statistically significant. Similarly, the mean durations for venous visualization, venous puncture, and venous catheterization were also shorter in the supraclavicular group, and these differences were statistically significant. Both groups achieved a 100% success rate, with the first attempt success rate being higher in the supraclavicular subclavian vein group. Conclusion The findings of this study demonstrate a statistically significant advantage in favor of the supraclavicular approach for ultrasound-guided subclavian vein catheterization. The shorter mean procedural time, as well as durations for venous visualization, puncture, and catheterization, emphasize the efficiency of the supraclavicular technique. The consistently achieved 100% success rate, coupled with a higher first-attempt success rate, further underscores the proficiency of the supraclavicular subclavian vein group. These results collectively suggest that the supraclavicular approach is not only time-efficient but also superior in terms of successful central line placement, making it a promising choice for both emergency and critical care settings.

Micro RNA210 expression in pregnancies with preeclampsia.

Preeclampsia is one of the major causes of perinatal mortality and morbidity even in developed countries, the aetiology of which is not yet understood completely. In recent times, mi RNAs have gained prominence as regulators of the expressions of their target genes in health and pathological condition. mi RNA210, one of the important hypoxamirs, is reported to be a regulator of many cellular mechanisms including cell division, differentiation, apoptosis, cell cycle regulation, mitochondrial function, metabolism etc. Since hypoxia is the microenvironment that prevailed in preeclampsia it is worth full to see the expression pattern of mi RNA 210 as an attempt to unearth the preeclampsia pathogenesis. The placental tissue is collected from age-matched control and preeclamptic patients after strictly applying the inclusion and exclusion criteria. The present result shows 2.7 fold-up regulation of miRNA210 in preeclampsia in rt PCR study, the role of which need to be studied further to understand the pathogenesis of preeclampsia.

Ambispective study of adverse drug reactions in multi-drug resistant tuberculosis patients in Warangal, Telangana.

BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) has become a global threat concerning to a risk of high mortality with the potential to cause adverse drug reactions (ADRs) which if not managed properly may affect patient compliance, resulting in below par treatment outcome. AIM: The aim of the study was to study, assess, and report the ADRs of patients diagnosed with MDR-TB. SUBJECTS AND METHODS: An ambispective, observational study was conducted among confirmed cases of MDR-TB patients without any comorbidities during the period of January 2015-December 2018 in patients of age 15 years and above. STATISTICAL ANALYSIS: Data were analyzed descriptively using MS-Excel sheet 2013 and Chi-square test in GraphPad Prism 8.2.1. Results were expressed as either frequency, percentage, or mean ± standard deviation. ADRs were evaluated for causality, severity, and preventability attributes. RESULTS: In the sample size of 400 patients, 236 (ADRs) were reported among 136 patients. The proportion of ADRs was higher in males (P = 0.0001) and in the age group of 36-75 years (P = 0.0211). Most commonly encountered ADRs include nausea and vomiting (35.31%) and arthralgia (14.04%), followed by peripheral neuropathy (8.93%) and giddiness (8.93%). Overall, 53% were of possible category and 60% of moderate level severity and 85% were unpreventable ADRs. CONCLUSION: Our study included 13 types of ADRs, of which most commonly reported were nausea and vomiting, arthralgia, and peripheral neuropathy and least common were psychosis, nephrotoxicity, and gynecomastia with a higher incidence in males. Majority of ADRs were moderate, unpreventable ADRs and had a possible relationship with the suspected drugs.

Inkjet-printed paper-based colorimetric sensor coupled with smartphone for determination of mercury (Hg2+).

We report an inkjet-printed paper based colorimetric sensor with silver nanoparticles (AgNPs) using smartphone and color detector App for on-site determination of mercuric ion (Hg2+) from environmental water samples. The AgNPs printed on Whatman filter paper (No. 1) is employed for detection of Hg2+ which is reliant on the color change of NPs from yellow to discoloration depending on the concentration of target analyte in sample solution. The quantitative determination was performed by calculating the signal intensity of AgNPs on printed paper substrate after the introduction of Hg2+ using smartphone and RGB color detector. The mechanism for detection of Hg2+ on paper substrate is verified using UV-Vis spectrophotometry (UV-Vis), transmission electron microscope (TEM), X-ray photoelectron spectroscopy (XPS), dynamic light scattering (DLS) and basic chemical assays. The linear range acquired for paper based colorimetric detection in the range of 40-1200 µgL-1 with limit of detection of 10 µgL-1. The results obtained using an inkjet-printed paper-based chemical sensor combined with a smartphone is validated with data of inductively coupled plasma-atomic emission spectroscopy (ICP-AES) measurement. The advantages of paper based detection are simple, rapid, economic and can be applied at the sample sources for determination of Hg2+.

Casting of carbon cloth enrobed polypyrrole electrode for high electrochemical performances.

The present investigation deals with the fabrication of a novel flexible and highly conductive PPy electrode. This was made by festooning PPy nanoparticles on carbon cloth (CC) by using chemical liquid process. The developed porous PPy@CC composite have good flexibility with low weight (1.1 mg) and high electrical conductivity (89 Ω-1cm-1). Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction spectroscopy (XRD) confirmed the formation of PPy on carbon cloth. Scanning electron micrographs (SEM) reveals that the PPy nanoparticles are encapsulated in carbon cloth. The fabricated carbon cloth has been used for solid-state symmetrical supercapacitors (SC) and low-cost material for electrode in potential energy storage devices. These film electrodes showed much superior electrochemical performance i.e. high stability under different current density, encouraging energy density, lower internal resistivity and higher specific capacitance. Synthesized flexible PPy@CC composite electrodes have brilliant applications in various kinds of electrochemical energy storage devices.

MTHFR (Ala 222 Val) polymorphism and AMI in patients with type II diabetes mellitus.

The prevalent Ala222Val single nucleotide polymorphism of the MTHFR gene has been shown to be associated with type II diabetes. The objective of the present study was to find out whether there is genetic predisposition for development of acute myocardial infarction in type II diabetes mellitus among South Indian Tamil population. PCR-based restriction enzyme analysis was performed in DNA isolated from 120 acute myocardial infarction patients with diabetes mellitus and 100 non diabetic healthy individuals with no documented cardiovascular diseases. The results indicate that the MTHFR 677TT genotype is absent in both case and controls. The MTHFR 677CT genotype was observed among 32 (26.7 %) cases and 20 (20%) controls and the MTHFR 677CC genotype among 88 (73.3%) cases and 80 (80%) controls. The allelic frequencies were in accordance to Hardy Weinberg equilibrium. There was no statistical difference in genotype distribution between cases and controls. In conclusion, we suggest that the analysis of MTHFR genotyping for C677T polymorphism alone need not be considered to find out whether there is genetic predisposition for development of acute myocardial infarction in type II diabetes mellitus among South Indian Tamil population.