Objective: The aim of this study was to compare the effect of dexmedetomidine with midazolam for intranasal premedication in children posted for elective surgery. Trial design: This was a prospective, randomised, double-blinded clinical study. Method: 60 children, 3 to 10 years of age, with American Society of Anaesthesiologists (ASA) physical status I, scheduled for elective surgery, were randomly divided into two groups, group D (dexmedetomidine) and group M (midazolam). Group D patients received intranasal dexmedetomidine 1 μg/kg and group M patients intranasal midazolam 0.2 mg/kg, approximately 30 minutes before induction of anaesthesia, in the form of a spray. Outcome: Preoperative effects on heart rate, blood pressure, sedation and anxiety including parental separation and mask acceptance were assessed. Results: Intranasal dexmedetomidine (1 μg/kg) premedication resulted in statistically significant but clinically unimportant lower heart rate and blood pressure at 10, 20, and 30 minutes following administration compared with intranasal midazolam (0.2 mg/kg). There were no episodes of hypotension or bradycardia. Children in group D achieved better parental separation and mask acceptance scores compared with group M. Conclusion: Dexmedetomidine resulted in better parental separation and mask acceptance scores than intranasal midazolam. Thus it would seem to offer some advantage compared with midazolam.
Removal of heavy metals (Pb 2? , Zn 2? ) from aqueous solution by dried biomass of Spirulina sp. was investigated. Spirulina rapidly adsorbed appreciable amount of lead and zinc from the aqueous solutions within 15 min of initial contact with the metal solution and exhibited high sequestration of lead and zinc at low equilibrium concentrations. The specific adsorption of both Pb 2? and Zn 2?increased at low concentration and decreased when biomass concentration exceeded 0.1 g l -1 . The binding of lead followed Freundlich model of kinetics where as zinc supported Langmuir isotherm for adsorption with their r 2 values of 0.9659 and 0.8723 respectively. The adsorption was strongly pH dependent as the maximum lead biosorption occurred at pH 4 and 10 whereas Zn 2? adsorption was at pH 8 and 10.
Background: GDM is a complex clinical entity and its screening, diagnosis, and management warrants attention. With this issue in mind, we aimed to study the prevalence of gestational diabetes mellitus in the antenatal group of patients attending tertiary hospital in New Delhi and its association with maternal outcome.Methods: 300 pregnant patients were enrolled in the first trimester and RBS (random blood sugar) was done. Those who had RBS >200mg/dl were labelled as overt diabetes and excluded from the study. The patients who were screened negative in phase 1 of screening were subjected to the next phase of screening at 24-28 weeks of gestation with 2-hour 75g OGTT using IADPSG criteria. Those who were diagnosed as GDM were followed in the antepartum, intrapartum and postpartum period.Results: The prevalence of overt diabetes and GDM in the study population is 1.33% and 13.33%. The prevalence of gestational hypertension, pre-eclampsia, chronic hypertension, polyhydramnios was 15%, 5%, 5%, 7.5% respectively. Normal and instrumental vaginal delivery was in 50 %, 5% patients respectively and 45 % had the caesarean section.Conclusions: The single step OGTT with lower threshold value cut-offs and single abnormal value for the diagnosis of GDM as advocated by IADPSG seem to be effective as it helps to screen and diagnose GDM at the same time as a single step procedure and thus more cost-effective.
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