Growth Hormone-Secreting Pituitary Adenoma and Difficult Airway: Awake Oral Fiberoptic Intubation Approach.

Acromegaly is a rare endocrine disorder characterized by excessive growth hormone (GH) secretion, usually due to a pituitary adenoma. This condition leads to progressive somatic disfigurement, including enlarged hands, feet, and facial features, and is often associated with systemic complications such as cardiovascular disease, diabetes mellitus, and sleep apnea. Anesthesia for patients with acromegaly presents unique challenges due to the characteristic anatomical and physiological changes associated with the condition. Acromegaly, resulting from excessive GH secretion, often leads to difficult airway management, cardiovascular complications, and metabolic abnormalities. Transnasal transsphenoidal excision of pituitary adenoma is a minimally invasive surgical technique employed to remove pituitary tumors. This approach, which utilizes the nasal passages and sphenoid sinus to access the pituitary gland, offers several advantages, including reduced recovery time, minimal scarring, and lower risk of complications compared to traditional craniotomy. Awake fiberoptic intubation is one of the recommended strategies to secure an expected difficult airway such as in acromegaly. This case highlights the importance of preoperative planning and the role of an oral fiberoptic technique in managing the airway in surgeries like the transnasal approach.

Foliar application of Zn at flowering stage improves plant's performance, yield and yield attributes of black gram.

Black gram plants subjected to varying levels of Zn supply (0.01 to 10 microM Zn) showed optimum growth and dry matter yield in plants receiving 1 microM Zn. The dry matter yield of plants decreased in plants receiving 0.01 and 0.1 microM Zn (deficient) and excess levels of Zn (2 and 10 microM Zn). The plants grown with Zn deficient supply showed delayed flowering, premature bud abscission, reduced size of anthers, pollen producing capacity, pollen viability and stigma receptivity resulting in poor pod formation and seed yield. Providing Zn as a foliar spray at pre-flowering stage minimized the severity of Zn deficiency on reproductive structure development and enhanced the seed nutritional status by enhancing seed Zn density, seed carbohydrate (sugar and starch content) and storage proteins (albumins, globulins, glutenins, and prolamines).

Zinc is critically required for pollen function and fertilisation in lentil.

The role of zinc (Zn) in reproduction of lentil (Lens culinaris Medik. cv. DPL 15) and the extent to which the Zn requirement for reproduction can be met through supplementation of Zn at the time of initiation of the reproductive phase have been investigated. Low supply (0.1micromol/L) of Zn reduced the size of anthers, the pollen producing capacity and the size and viability of the pollen grains. Scanning electron microscopy (SEM) of pollen grains of Zn deficient plants showed enhanced thickening of exine and wide and raised muri. In vitro germination of pollen grains was reduced by >50% and growth of pollen tubes was retarded. Unlike Zn sufficient plants, the cuticle around the stigmatic papillae of Zn deficient plants remained intact, preventing the interaction between pollen grains and stigmatic exudates that provides the polarity for the growth of pollen tubes through the stylar tract. Zn deficiency increased the activity of acid phosphatase and peroxidase in extracts of pollen grains. Histochemical localisation on the stigmatic surface and native PAGE of the enzyme extracts of pollen grain and stigma exudates showed enhanced expression of acid phosphatase and peroxidase and suppressed expression of esterase in response to Zn deficiency. Zn deficiency reduced the setting of seeds and also their viability. The effect on seed setting was more marked than on in vitro germination of pollen grains, suggesting that the latter was not the exclusive cause of inhibition of fertility. Possibly, loss of fertility was also caused by impairment in pollen-pistil interaction conducive to pollen tube growth and fertilisation. Impairment in pollen structure and function and seed setting was observed even when plants were deprived of Zn at the time of flowering, but to a lesser extent than in plants maintained with low Zn supply from the beginning. Increasing the Zn supply from deficient to sufficient at the initiation of flowering decreased the severity of Zn deficiency effects on pollen and stigma morphology, pollen fertility and seed yield. In conclusion, structural and functional changes induced in pollen grains and stigma of Zn deficient plants and associated decrease in seed setting of lentil indicate a critical requirement of Zn for pollen function and fertilisation that can be partially met by supplementing Zn at the onset of the reproductive phase.