Perforated Appendicitis Preoperatively complicated by Multiple Intra-Abdominal Abscesses | Crimson Publishers

Perforated Appendicitis Preoperatively complicated by Multiple Intra-Abdominal Abscesses by Tarik Zahouani in Surgical Medicine Open Access Journal

Acute appendicitis is the most common surgical emergency in the pediatric population [1]. Complications are seen in 30 to 40% of cases, and include perforated, gangrenous, intra-abdominal abscess and peritonitis [1]. The rate of perforated appendicitis is higher in children compared to adults and varies from 30% to 74% [2]. We report a case of perforated appendicitis preoperatively complicated by multiple intra-abdominal abscesses.

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Appraisement of Genetic Variability and Character Association of Bitter Gourd (Momordica charantia L.) Land Races for Yield and Yield Contributing Characters in Bangladesh | Crimson Publishers

Appraisement of Genetic Variability and Character Association of Bitter Gourd (Momordica charantia L.) Land Races for Yield and Yield Contributing Characters in Bangladesh by Hasan Khan M in Journal of Biotechnology and Bioresearch

 A field experiment was conducted with 20 genotypes of bitter gourd (Momordica charantia L.) at the experimental field of Sher-e-Bangla Agricultural University, Dhaka, to study the variability among the genotypes for yield and yield contributing characters, estimate genetic parameters, association among the characters and their contribution to yield during April 2015 to September 2015. There was a great deal of significant variation for all the characters among the genotypes. Considering genetic parameters high genotypic co-efficient of variation (GCV) was observed for fruit weight, yield per plant and fruit length whereas low genotypic co-efficient of variation (GCV) was observed for nodes per vine, days to first male and female flowering. In all the cases, it was found that phenotypic co-efficient of variation was greater than genotypic co-efficient of variation which indicated a wide variability among the genotypes and offered better scope of selection. The accession G9 and G13 were the lowest vine length of 3.90m while G8 was the maximum vine length for 4.83. The minimum and maximum branches per vine were required by the genotypes G3 and G4, respectively. The maximum nodes per vine (87.33) were recorded by the genotype G9 and the lowest nodes per vine (78.00) were recorded by G19. The earliest male flowering was recorded in G17 and G2 genotype showed the late flowering. The maximum fruit length was recorded in the genotype G7 and minimum fruit length in the genotype G1.

The maximum fruit diameter was recorded in the genotype G1 and the minimum fruit diameter in the genotype G4. The minimum fruit weight was recorded by the accession G4 and accession G16 showed the maximum fruit weight. The line G2 showed the minimum fruits per plant and the maximum fruits per plant were recorded in the accession G9. The highest fruit yield per plant was recorded by the accession G19 while accession G14 showed the lowest fruit yield per plant. High heritability (>60%) was observed for the characters like vine length, branches per vine, nodes per vine, fruit length, fruit weight, fruits per plant and fruit yield per plant. The high heritability coupled with high genetic advance in percent of mean observed in branches per vine, fruit length, fruit weight and fruit yield per plant suggested that effective selection may be done for these characters. Fruit yield per plant showed the highest positive direct effect (0.88) with branches per plant. Firstly, genotypes G19, G9, G12 and G4 could be included in the furthest study in view of fruit yield for releasing as bitter gourd verities. Secondly the maximum variability found for branches per vine, fruit length, fruit weight and fruit yield per plant. So, selection based on these characters could be effective for the improvement of bitter gourd yield.

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Mentored by Me-Crimson Publishers

Mentored by Me by  Rakesh Bhargava in Crimson Publishers: Annals of Medicine and Surgery

Crimson Publishers: Annals of Medicine and Surgery

Surgery I was given to understand was an art learnt by apprenticeship. When I was choosing a subject for my postgraduation, therefore, the paramount consideration was the mentor. I chose Dr P K Sethi, with whom the Jaipur Foot is associated.

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Dexmedetomidine as a Sole Sedative Agent versus Propofol for Sedation during Upper and Lower Gastrointestinal Endoscopies | Crimson Publishers

Dexmedetomidine as a Sole Sedative Agent versus Propofol for Sedation during Upper and Lower Gastrointestinal Endoscopies by Alaa Ali Elzohry in Developments in Anaesthetics & Pain Management

Introduction and objectives: Diagnostic and therapeutic procedures recently are done in gastroenterology setup as a part of fast-track concept. A major volume of gastrointestinal procedures are performed routinely on daycare basis under sedation as upper and lower GIT endoscopy. Many anesthetic agents used to provide sedation for these procures. Propofol, opioids, and midazolam form the backbone of the various regimes employed in the endoscopic suites all over the world. Dexmedetomidine is a pharmacologically active selective α 2-adrenergic receptor agonist. It was approved it in the intensive care unit (ICU) for sedation and analgesia for the duration of less than 24 hours. The aim of this study was to study efficacy and safety of Dexmedetomidine efficacy as sole sedating agent versus propofol for sedation during upper and lower GIT endoscopy.

Methods: This randomized controlled trial was carried out on 60 patients of either sex, aged 21-70 years of age undergoing upper and lower GIT endoscopy, with ASA I-II. Patients were randomly assigned into two groups, (30 patients in each group).

Dex group: Sedation was induced by loading dose of (dexmedetomidine 1μg/kg) followed by infusion of (dexmedetomidine 0.8μg/kg /h) Propofol group: Sedation was initially started by bolus dose of 0.5mg/kg propofol IV Then, infusion was started at the rate of 50μg /kg/min. Upper and lower GIT endoscopies were carried out in the usual standard manner for all patients, then patients were discharged to PACU after attaining an Aldrete Recovery Scale Score of 9-10 Time taken to achieve this score was recorded. The patient’s vital signs, Respiratory complications, VAS score for pain measurement, PONV, and any other adverse events were recorded.

Results: There was significant decrease in (HR and MAP) but not respiration rate (RR) and SpO2, in (Dex group) during the procedure and early post-operative (P. value 0.000**). But during the remaining of post-operative periods (HR and MAP) were comparable. VAS pain scores in both groups were decreased in comparable manner at all measured time points. But complications (atthythmia, air way obstruction, nausea, and vomiting) was significantly increased in Propofol group (P. value 0.001**). Mean time to achieve RSS 3-4 was 6 (±1.5) min in Dex group versus 9 (±1.9) min in Propofol group (P< 0.005) and to achieve an Aldrete Recovery Scale Score of 9-10 was 8 (±2.1) min in Dex group versus 6 10 (±1.6) min in Propofol group (P< 0.029).

Conclusion: In conclusion, there is evidence to support dexmedetomidine as a potential sole sedative agent in small diagnostic and therapeutic procedures like GIT endoscopies, our study support these evidences and although dexmedetomidine resulted in longer onset and recovery, more side effects but sufficient levels of sedation and analgesia are good advantages to use it as sole sedating agent.

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