A Prospective Randomized Study Comparing the Bolus Doses of Norepinephrine and Phenylephrine for the Treatment of Spinal Induced Hypotension in Cesarean Section.

BACKGROUND: Spinal anesthetic-induced hypotension is the most worrisome complication for patients undergoing cesarean section under spinal anesthesia. The present study compares norepinephrine and phenylephrine bolus for the treatment of hypotension during spinal anesthesia for cesarean section. METHODS: One hundred twenty- six women aged between 22 and 40 years with singleton pregnancy classified to the American Society of Anesthesiologists (ASA) physical class I and II posted for elective cesarean section under spinal anesthesia were randomly divided into two groups of 63 each. Group I patients received phenylephrine 50 mcg (microgram) as an intravenous bolus, and Group II received 4 mcg of norepinephrine as an intravenous bolus to treat spinal hypotension. RESULTS: On comparing the demographic data of the patients in terms of age, weight, height, ASA Grade, level of block and surgery time no significant differences were found between the groups. Similarly, the fetal parameters were found to be not significantly different between the groups. However, the number of bolus doses of vasopressors required for the treatment of spinal-induced hypotension was significantly reduced in Group II (p=0.02). The frequency of bradycardia was found to be higher in patients who were given phenylephrine as compared to patients administered noradrenaline boluses (p=0.03). Five (7.93%) patients had shivering in Group I, while similar episodes were observed in 10 (15.87%) patients (p=0.05). Moreover, no significant difference was observed in comparing the heart rate and mean arterial pressure between the groups. CONCLUSION: Intermittent boluses of norepinephrine are found to be effective in the management of spinal­induced hypotension during caesarean section.

Dietary Management in Slowing Down the Progression of CKDu.

Chronic kidney disease of unknown etiology (CKDu) is an emerging entity in the South Asian region. This predominately affects the farming community belonging to the lower socioeconomic status. CKDu being a progressive condition often leads to end-stage renal failurerequiring renal replacement therapy (RRT). Due to the high cost and limited availability of RRT in many areas of geographical locations in India and worldwide, there is an unmet need to slow down the progression of CKDu. The intestinal microbiota is different in patients with CKD, with low levels of beneficial bacteria such as Lactobacillus and Bifidobacteria. Prebiotics and probiotics modify the intestinal microbiota and thereby slow down the progression. Soda bicarbonate therapy is cheap and cost-effective in slowing down the progression of CKDu in a subset of patients. There is also evidence of the beneficial effect of N-acetyl cysteine in early stages of CKD and it should benefit CKDu also. Dietary interventions to prevent dehydration, by providing uncontaminated drinking water, sufficient protein containing diet with adequate calories, and tailored salt intake to prevent hypotension, are necessary compared to other causes of CKD. The objective is to prevent malnutrition, and uremic symptoms. Early diagnosis and prompt intervention may delay the progression of CKDu in the early stages.

Futuristic electron transport layer based on multifunctional interactions of ZnO/TCNE for stable inverted organic solar cells.

Solution-processed inverted bulk heterojunction (BHJ) organic solar cells (OSCs) are expected to play a significant role in the future of large-area flexible devices and printed electronics. In order to catch the potential of this inverted BHJ technology for use in devices, a solar cell typically requires low-resistance ohmic contact between the photoactive layers and metal electrodes, since it not only boosts performance but also protects the unstable conducting polymer-based active layer from degradation in the working environment. Interfacial engineering delivers a powerful approach to enhance the efficiency and stability of OSCs. In this study, we demonstrated the surface passivation of the ZnO electron transport layer (ETL) by an ultrathin layer of tetracyanoethylene (TCNE). We show that the TCNE film could provide a uniform and intimate interfacial contact between the ZnO and photo-active layer, simultaneously reducing the recombination of electron and holes and series resistance at the contact interface. After successful insertion of TCNE between the ZnO film and the active layer, the parameters, such as short circuit current density (J sc) and fill factor (FF), greatly improved, and also a high-power conversion efficiency (PCE) of ∼8.59% was achieved, which is ∼15% more than that of the reference devices without a TCNE layer. The devices fabricated were based on a poly[[4,8-bis[(2-ethylhexyl)oxy]benzo[1,2-b : 4,5-b']dithiophene-2,6-diyl]-[3-fluoro-2[(2-ethylhexyl)-carbonyl]-thieno[3,4-b]thiophenediyl]] (PTB7):(6,6)-phenyl C71 butyric acid methyl ester (PC71BM) blend system. These results suggest that this surface modification strategy could be readily extended in developing large-scale roll-to-roll fabrication of OSCs.

Understanding charge carrier dynamics in a P3HT:FLR blend.

In organic semiconductors, optical absorption is pivotal for the performance of optoelectronic devices. The absorption by the semiconductors generates excitons which dissociate into free charge carriers, resulting in energy conversion. Although high performance has been achieved in non-fullerene organic solar cells, their charge generation behavior is far from being well understood. Keeping this in view, we have employed optical spectroscopic tools to study the charge generation mechanism in FLR (1,6,7,10-tetramethylfluoranthene) as a non-fullerene electron acceptor blended with P3HT (poly(3-hexylthiophene)) as an electron donor in five different solvents. Through steady state UV-visible and photoluminescence spectroscopy, we provide a basic understanding of charge transport by enlightening the influence of solvents on the aggregation behavior and exciton bandwidth. Furthermore, for the first time, by employing ultrafast vis-NIR transient absorption spectroscopy, we address the ultrafast charge generation and charge separation mechanism with systematic variation in solvent polarity by incorporating the time evolution of the transient species under various pump-probe wavelengths in the range of 450 nm to 1600 nm. For the different excitation wavelengths, the lifetime kinetics have been depicted by their multiexponential fits. The results show a fast decay term at a lifetime of a few picoseconds (ps) (∼1 to 5 ps) and a slow decay term at a lifetime of ∼500 ps. The charge generation in the P3HT:FLR blend proceeds on a ps time scale, which implies good intermixing of the components. It is clearly established that the non-halogenated solvents influence this aggregation behavior and higher conjugation lengths with higher photoluminescence quenching contribute to the higher charge generation. The enhanced polaron population in P3HT with the addition of FLR illustrates the importance of this acceptor material in the blend because a good solvent-material combination is essential to enhance the charge generation. As such, this comprehensive study explicitly shows the role of FLR as an emerging efficient non-fullerene acceptor for further improving the performance of devices.

Investigating the influence of charge transport on the performance of PTB7:PC71BM based organic solar cells.

A key challenge for researchers in the field of organic solar cells (OSCs) is to develop a physical model for a device that correctly describes the charge carrier transport phenomenon. In this article, an analytical study on the charge carrier transport phenomenon in an OSC is reported, which expresses a balance between free charge carrier generation and recombination in low mobility PTB7:PC71BM blend layers. First, the current density-voltage (J-V) data for the fabricated OSC were extracted from experiments by varying the incident power light intensity (IPL) and then analysis through theoretical simulation was used to quantify the dominant interface recombination parameters limiting the device's performance. It was found that although the generation of free charge carriers increased at higher IPL values, the performance of the device remained low due to poor electrical transport properties which resulted in a considerable accumulation of generated charge carriers in the active layer. Therefore, it has become important to work out the complex relation between charge carrier mobility, exciton-recombination dynamics and the overall electrical performance parameters in a single framework. This article explains the influence of incident power light intensity and charge carrier mobility on performance parameters, which limits the power conversion efficiency (PCE) of the OSC. The presented analysis could be helpful in optimizing the architecture of future devices to increase the PCE of OSCs.

Revealing the correlation between charge carrier recombination and extraction in an organic solar cell under varying illumination intensity.

The design and fabrication of better excitonic solar cells are the need of the hour for futuristic energy solutions. This designing needs a better understanding of the charge transport properties of excitonic solar cells. One of the popular methods of understanding the charge transport properties is the analysis of the J-V characteristics of a device through theoretical simulation at varied illumination intensity. Herein, a J-V characteristic of a polymer:fullerene based bulk heterojunction (BHJ) organic solar cells (OSCs) of structure ITO/PEDOT:PSS (∼40 nm)/PTB7:PC71BM (∼100 nm)/Al (∼120 nm) is analyzed using one- and two-diode models at varied illumination intensity in the range of 0.1-2.33 Sun. It was found that the double diode model is better with respect to the single diode model and can explain the J-V characteristics of the OSCs correctly. Further, the recombination mechanism is investigated thoroughly and it was observed that fill factor (FF) is in the range of 62.5%-41.4% for the corresponding values of the recombination-to-extraction ratio (θ) varying from 0.001 to 0.023. These findings are attributed to the change in charge transport mechanism from trap-assisted to bimolecular recombination with the variation of illumination intensity.