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Intraoperative bleeding causing poor visibility of surgical field is of major concern during functional endoscopic sinus surgery (FESS) and impaired visibility may result in many complications. The study aimed to compare surgical conditions for FESS during controlled hypotension provided by esmolol or nitroglycerine (NTG) under general anaesthesia. 52 adult patients of both sexes requiring FESS under general anaesthesia were randomly divided to receive either esmolol (group ESM, n = 26) or NTG (group NTG, n = 26) to provide controlled hypotension. Surgical condition was assessed by surgeon using average category scale (ACS) of 0-5, a value of 2-3 being ideal. In both groups mean arterial blood pressure (MABP) was gradually reduced till ACS for assessment of surgical condition (ACS) of 2-3 or lowest targeted MABP (60 mm of Hg) was achieved. Both the drugs produced desired hypotension and improved surgical condition by reducing operative field bleeding but ideal operative conditions were achieved at mild hypotension (MABP 75-70) in ESM group while same conditions were achieved at MABP of 69-65 mm of Hg in NTG group. Mean heart rate was significantly higher in NTG group as compared to ESM group. Blood loss was significantly less in ESM group. Both NTG and esmolol can be used safely to provide controlled hypotension during FESS. Both the drugs improved visibility of surgical field by reducing capillary bleeding. But esmolol offered better operative conditions with only minimal reduction in MABP. No reflex tachycardia and less intraoperative haemorrhage were additional advantages of esmolol.

Since the emergence of novel Coronavirus (SARS-CoV-2) infection in Wuhan, China in December 2019, it has now spread to over 205 countries. The ever-growing list of globally spread corona virus-19 disease (COVID19) patients has demonstrated the high transmission rate among human population. Although 12 new drugs are being tried for management of COVID19, currently there are no FDA approved drugs or vaccines to prevent and treat the infection of the SARS-CoV-2. Considering the current state of affairs, there is an urgent unmet medical need to identify novel and effective approaches for prevention and treatment of COVID19 by re-evaluating the knowledge of traditional medicines and repurposing of drugs.Here, we used molecular docking approach to explore the beneficial roles of an array of phytochemicals and active pharmacological agents present in the Indian herbs (Tulsi, Haldi, Giloy, Black pepper, Ginger, Clove, Cardamom, lemon, and Ashwagandha) which are widely used in the preparation of Ayurvedic medicines in the form of Kadha to control various respiratory disorders such as cough, cold and flu. The evaluation was made based on the docking scores calculated by AutoDock Vina. Our study has identified an array of phytochemicals present in these herbs which have significant docking scores and potential to inhibit different stages of SARS-CoV-2 infection as well as other Coronavirus target proteins.Molecular docking also indicated that, the phytochemicals present in these herbs possess significant anti-inflammatory property. Overall our study provides scientific justification in terms of binding of active ingredients present in different plants used in Kadha preparation with viral proteins and target proteins for prevention and treatment of the COVID19. This preparation can boost individual's immunity and inhibit the viral severity by interfering at different stages of virus multiplication in the infected person.Ayurveda's immunity boosting measures for self care during COVID 19 crisis. The Ministry of Ayurvedic, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH),

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During preoperative staging the authors performed upper abdominal computed tomographic (CT) scanning in 38 patients with non‐small cell lung carcinoma. Five of the 38 patients had occult adrenal metastases based on CT images. Two of these five patients, who would otherwise have been surgical candidates for definitive thoracotomy, underwent percutaneous fine‐needle aspiration cytology of the suspected adrenal metastases. Cytology results in both cases were positive for metastatic carcinoma, thereby precluding thoracotomy. Upper abdominal CT scanning may optimize preoperative staging of selected non‐small cell lung cancer patients.