Iatrogenic gastric distension and subsequent rupture following nasal or nasopharyngeal catheter oxygen delivery is a rare but life-threatening condition that requires urgent laparotomy. We report two cases recently encountered at our institution. Both patients exhibited symptoms of abdominal pain and distension following oxygen delivery involving a nasopharyngeal catheter during procedural sedation. Oxygen flow rates were 4 l/minute in both cases. The diagnosis was made by urgent imaging. Both patients survived following laparotomy and repair of gastric rupture. Seventeen cases have been reported previously in the literature. We recommend avoidance of nasal or nasopharyngeal catheters and the use of alternative oxygen delivery methods such as nasal prongs and face masks.
We report a prospective study on the use of sublingual glyceryl trinitrate at Caesarean section to induce uterine relaxation; 23 women were entered into the study with both emergency and elective cases considered. A metered dose spray was used to deliver a dose of 400 or 800 microgrammes of glyceryl trinitrate to the women. There were no major side-effects of hypotension or postpartum haemorrhage. The mean maximal systolic blood pressure drop in the patients following drug administration was 18% of the systolic pressure prior to drug administration. Subjective assessment of uterine tone showed the uterus to contract well postdelivery in response to standard oxytocic regimens. Minimal maternal side-effects were reported. We conclude that glyceryl trinitrate is a safe form of uterine relaxation at Caesarean section which may be used in emergency situations and may also be given prophylactically in cases such as breech presentation and in delivery of the preterm infant where fetal trauma is possible. The use of a metered-dose sublingual spray is ideally suited to obstetric practice, being both easy to use and also rapidly administered.
The high performance anode supported single cells for ammonia fueled SOFCs comprising of BSCF (Ba0.5Sr0.5Co0.8Fe0.2O3- δ)//BCY//NiO-BCY have been fabricated by co-pressing for depositing 50 µm thin film electrolytes. The electrolytes prepared by co-pressing technology were fully dense with no formation of secondary phases and observed to be crack-free. The electrochemical performance of single cells was characterized at the temperature 600-700 {degree sign}C under humid 75% H2 in N2 (3% H2O) similar to cracked ammonia as the fuel gas and air as the oxidant gas at a gas flow rate of 100 mL min-1. The open circuit voltages were around 1.02 V at 600 {degree sign}C indicating little gas leakage or mixed conduction through the electrolyte. Maximum power densities of 220, 190 and 160 mW cm- 2 from single cells were obtained at 700, 650 and 600 {degree sign}C, respectively under humid 75% H2 in N2 (3% H2O) and air.
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