ABSTRACT
A 25years old female patient with pregnancy of 16weeks (G2 P1), diagnosed to have distal anterior cerebral artery aneurysm (DACA) with Hunt & Hess grade I, subarachnoid hemorrhage (SAH) and coexisting atretic type of aortic coarctation posted for aneurysmal clipping under general anesthesia is a challenge to anesthesiologists in perioperative period. Hypertensive surges in a pregnant patient may result in rupture of aneurysms. Mortality in the mothers with CoA has been reported to be in the range of 0 to 9%. Anesthetic management of a pregnancy with CoA and SAH has never been reported.
Subject(s)
Anesthesia, General/methods , Aortic Coarctation/complications , Craniotomy/adverse effects , Intracranial Aneurysm/complications , Subarachnoid Hemorrhage/complications , Adult , Aortic Coarctation/diagnosis , Aortic Coarctation/surgery , Female , Fentanyl/administration & dosage , Humans , Intracranial Aneurysm/surgery , Intracranial Hypertension/etiology , Intraoperative Complications/etiology , Lidocaine/administration & dosage , Magnetic Resonance Angiography , Methyl Ethers/administration & dosage , Monitoring, Intraoperative , Monitoring, Physiologic , Perioperative Care/methods , Pregnancy , Sevoflurane , Subarachnoid Hemorrhage/diagnosis , Subarachnoid Hemorrhage/surgery , Tomography, X-Ray ComputedABSTRACT
INTRODUCTION: The potency of oral polio vaccine (OPV), a heat-labile vaccine, is preserved by the cold chain. The Vaccine Vial Monitor, a heat-sensitive label, is critical to the monitoring and maintenance of the cold chain. This study was conducted to evaluate the relationship between the adequacy of cold chain infrastructure and the proper use of Vaccine Vial Monitor in a rural district of India. METHODS: Forty-six health centers in a rural district were included in our evaluation of the cold chain equipment and the Vaccine Vial Monitors. Cold chain equipment and vaccine vials within each health center were evaluated for adherence to WHO cold chain maintenance protocols and the Vaccine Vial Monitor stage, respectively. RESULTS: Among the 46 health centers, Vaccine Vial Monitor stage I was found at 58% of the health centers, 33% of the health centers reported stage II and 9% reported a stage III, indicating weaknesses in the cold chain mechanism CONCLUSION: Cold chain for the OPV was not adequately maintained at primary and sub-health centers in this rural district. Well maintained ice packs and vaccine carriers will help ensure delivery and availability of a safe and potent vaccine to children in rural areas of India.
Subject(s)
Drug Monitoring , Poliovirus Vaccine, Oral/chemistry , Refrigeration/methods , Rural Health Services/organization & administration , Drug Storage/methods , Humans , India , Time FactorsABSTRACT
The instability, rupture, and subsequent growth of holes in a thin Jeffreys-type viscoelastic film under the influence of long-range van der Waals force are investigated using both linear stability analysis and nonlinear numerical solutions. The linear stability analysis of full governing equations valid for arbitrary wave numbers shows that although fluid rheology does not influence the dominant length scale of the instability, it significantly affects the growth rate. It is shown that neglect of inertia and solvent dynamics results in a nonphysical singularity in the growth rate beyond a critical value of relaxation time. We further carry out numerical simulations of a set of long-wave, nonlinear differential equations (also derived in Rauscher et al., Eur. Phys. J. E 17, 373 (2005)) governing the evolution of the free surface. The nonlinear simulations, in their domain of validity, confirm the results of the linear analysis. Interestingly, results from nonlinear simulations further show that both for Newtonian and viscoelastic liquids, the shape and the dewetting dynamics of a hole are identical when examined in terms of a rescaled time which depends on rheological parameters. Thus, viscoelasticity of Jeffreys type merely accelerates the growth rate, without however affecting the important morphological characteristics.
Subject(s)
Computer Simulation , Membranes, Artificial , Solutions/chemistry , Elasticity , Mathematics , Models, Chemical , Nonlinear Dynamics , Surface Properties , Time Factors , ViscosityABSTRACT
Infective hepatitis ia an acute inflamatory condition of liver. It is usually manifested in the form of Jaundice. In this clinical study Kalmegh(Andrographis paniculata Nees) was given in the decoction form to the patients of infective hepitis. The results were assessed on the basis of clinical and biochemical parameters. A marked symptomatic improvement in majority of the cases was observed. A statistically highly significant decrease was noted in various liver function tests viz., serum bilirubin, thymol turbidity, alkaline phosphatase, S.G.O.T.; S.G.P.T. and serum globulin fraction of protein. Moreover it increased significantly total serum globulin fraction of protien. Moreover it increased significantly total serum protein level along with albumin fraction. On the total assessment 80% cases of this series were cured and 20% patients were relieved. Therefore, Kalmegh appears to be a useful remedy for the treatment of infective hepatitis.
