General anaesthesia for obstetric surgery has distinct characteristics that may contribute towards a higher risk of accidental awareness during general anaesthesia. The primary aim of this study was to investigate the incidence, experience and psychological implications of unintended conscious awareness during general anaesthesia in obstetric patients. From May 2017 to August 2018, 3115 consenting patients receiving general anaesthesia for obstetric surgery in 72 hospitals in England were recruited to the study. Patients received three repetitions of standardised questioning over 30 days, with responses indicating memories during general anaesthesia that were verified using interviews and record interrogation. A total of 12 patients had certain/ probable or possible awareness, an incidence of 1 in 256 (95%CI 149-500) for all obstetric surgery. The incidence was 1 in 212 (95%CI 122-417) for caesarean section surgery. Distressing experiences were reported by seven (58.3%) patients, paralysis by five (41.7%) and paralysis with pain by two (16.7%). Accidental awareness occurred during induction and emergence in nine (75%) of the patients who reported awareness. Factors associated with accidental awareness during general anaesthesia were: high BMI (25-30 kg.m -2 ); low BMI (<18.5 kg.m -2 ); out-of-hours surgery; and use of ketamine or thiopental for induction. Standardised psychological impact scores at 30 days were significantly higher in awareness patients (median (IQR [range]) 15 (2.7-52.0 [2-56]) than in patients without awareness 3 (1-9 [0-64]), p = 0.010. Four patients had a provisional diagnosis of post-traumatic stress disorder. We conclude that direct postoperative questioning reveals high rates of accidental awareness during general anaesthesia for obstetric surgery, which has implications for anaesthetic practice, consent and follow-up.

Five (1–5) new bioactive oleanane type triterpenoids have been isolated from ethyl acetate soluble fraction of ethanolic extract ofCoriandrum sativumLinn. of Umbelliferae family. Ethanolic extract of the whole plant was fractionated in organic solvents. Ethyl acetate fraction was subjected to column chromatography on HPLC RP-18 to get 1-oxo-11β,21β-dihydroxy-oleanane (1), 1-oxo-11β-hydroxy-21β-O-acetyloleanane (2), 1-oxo-11β-hydroxy-21β-O-angeloyloleanane (3), 1-oxo-11β-O-angeloyl-21β-O-acetyloleanane (4), and 1-oxo-11β,21β-O-dibenzoyloleanane (5). The structures were elucidated after analysis of spectroscopic data, UV, IR, NMR (1H,13C, 1D, and 2D), and mass measurements. Suspension in water of crude ethyl acetate extract was employed to treat sheep with ringworm disease. All isolated compounds (1–5) displayed excellent activity in terms of inhibition zones, MICs, MBCs, and MFCs against both bacteria and fungi. Ethyl acetate extract showed excellent antiringworm activity in sheep.

<p><strong>Objective:</strong><strong>  </strong>To determine the toxic effects of quinolones on serum testosterone level in male albino rats.</p><p><strong>Methods:</strong><strong>  </strong>Eighty male albino rats were randomly divided into A, B, C and D groups each group having 20 albino rats. These groups were further subdivided into A1, A2, B1, B2, C1, C2, D1 and D2 having 10 albino rats each. Ciprofloxcin, ofloxacin and enoxacin dissolved in distilled water were given at 135mg/kg/ day, 72mg/kg/day and 12.5mg/kg/day to groups A, B and C respectively for 12 weeks. Only distilled water was given to group D which was control group for the same time period. Blood samples were drawn for testosterone hormone level estimation at 0, 14^th, 28^th and 42^nd day in subgroups Al, B1, Cl and D1 and then the animals in said groups were sacrificed on 42^nd day to identify testicular morphological changes. Rats in subgroup A2, B2, C2 and D2 were kept alive till 84^th day after stopping drugs at 42 days to find out if there is any change in levels of testosterone after discontinuation of the treatment. Blood samples for testosterone hormone estimation were taken at 0, 14^th, 28^th, 42^nd,56^th, 70^th and 84^th day from subgroups A2, B2, C2 and D2. Testosterone hormone estimation assay was performed on the collected samples.</p><p><strong>Results:</strong><strong>  </strong>Testosterone assay showed significant decrease in serum testosterone levels in all experimental groups, when compared with control group. These levels did not return back to normal even after withdrawal of drugs. This study suggests a gonadotoxic potential of quinolones.</p><p><strong>Conclusion:  </strong>Quinolones reduce serum testosterone levels and should be used carefully for long term therapy.<strong></strong></p>

Background: Obesity has become a major health issue in the world over past two decades. . This leads us to the need of immense exploration of life style modification options, dietary supplementation and weight loss friendly elements. Aim: Our study aims to highlight the comparative analysis of independent supplementation of vitamin E and iron to young adult females for their weight loss regime. Methods: 90 young adult non pregnant females of age between 25-39 years with BMI ranging between 30-34.9 (obese) were asked to take a fixed 1500 calorie diet for two months. They were divided into three groups with no supplement group, vitamin E group and iron group. Body mass index(BMI), LDL levels and prevalence of fatty liver was assessed among all individuals. Results: vitamin E and iron supplementation reduced BMI in their respective groups. Vitamin e and iron supplementation also reduce the prevalence of fatty liver among groups. Vitamin E reduces serum LDL levels. Conclusion: vitamin E and iron supplementation helps in weight loss. Keywords: obesity, vitamin E, iron, weight loss

Introduction: Medical treatment is the first step in the treatment of ectopicpregnancy (EP) now days. Medical treatment with Methotrexate for EP is safe and effectivemethod without the risks associated with the surgical procedure. Objectives: To determine thesuccess rate of single dose of Methotrexate for medical management of females presentingwith EP. Study Design: Quasi trial study. Setting: Department of Obstetrics & Gynaecology,Fatima Memorial hospital, Lahore. Period: 1 year from September 2014 till August 2015.Material & Methods: Study design was prospective descriptive case series in which a totalof 140 women, age 20-45 years of any parity with confirmed EP, were included. Females wereprescribed Methotrexate 50mg/m2, as a single dose. β-HCG level was measured again at 7thday. If β-HCG was decreased by >15% of baseline levels and decrease in the size of masson USG, then success was labeled. Data was entered and analyzed using computer programSPSS version 20. Results: Mean age of women in this study was 32.38±6.34 years. At 3rd daypost-treatment day, mean level of β-HCG was 2019.51 ± 293.39 and at 7th day, mean β-HCGlevel was 1127.44 ± 403.78. At 7th day, there were 125(89.3%) patients whose β-HCG level wasdecreased by >15% and success was labelled. Conclusion: Based on findings of this study itcan be concluded that Methotrexate can be used as first line management protocol for EP as itwas successful in a high percentage of patients.