For patients undergoing cardiopulmonary bypass, myocardial protection is a key for successful recovery and improved outcomes following cardiac surgery that requires cardiac arrest. Different solutions, components and modes of delivery have evolved over the last few decades to optimise myocardial protection. These include cold and warm and blood and crystalloid solution through antegrade, retrograde or combined cardioplegia delivery approach. However, each method has its own advantages and disadvantages, posing a challenge to establish a gold-standard cardioplegic solution with an optimised mode of delivery for enhanced myocardial protection during cardiac surgery. The aim of this review is to provide a brief history of the development of cardioplegia, explain the electrophysiological concepts behind myocardial protection in cardioplegia, analyse the current literature and summarise existing evidence that warrants the use of varying cardioplegic techniques. We provide a comprehensive and comparative overview of the effectiveness of each technique in achieving optimal cardioprotection and propose novel techniques for optimising myocardial protection in the future.
Moringa is an expeditious-growing evergreen perennial plant and has wide adaptability to grow in different environmental conditions. The nutritive value and medicinal benefits of its leaves, flowers, pods, roots, and stem barks are established by philanthropic research. Edible parts are rich in protein, vitamins, minerals, antioxidants, and other chemical compounds with medicinal properties. The pods and leaves are mainly used as vegetables and ingredients in soups and curries. It is used to boost the nutritional value of food, as well as to boost the immune system and antioxidant levels, lower blood sugar levels and maintain inflammation. Moreover, Moringa leaves flavonoid amelioration of total antioxidant capacity in the lens. Its leaves, pods, and leaf powder contain a high proportion of Vitamin A, which can help to prevent night blindness and eye problems in children.
Objective: To compare clinical outcomes of reimplantation versus remodeling in patients undergoing valve-sparing aortic root replacement (VSRR) surgery. Method: Electronic database search at PubMed, Scopus, Embase, Ovid, and Google scholar was performed from inception to January 2020. Primary outcomes were aortic valve (AV) reintervention and postoperative grade of aortic insufficiency (AI) while secondary outcomes were 30-day mortality, reoperation for bleeding, and operative times. Results: A total of 21 articles met the inclusion criteria. A total of 1283 patients had reimplantation while 1150 had remodeling. No difference in preoperative demographics was noted except reimplantation patients were younger (48 ± 16 vs. 56 ± 15 years; p < .00001). The cardiopulmonary bypass and aortic cross-clamp times were shorter in the remodeling cohort (168 ± 38 vs. 150 ± 37 min; p = .0001 and 133 ± 31 vs. 112 ± 30 min; p = .0002, respectively). No difference in concomitant total arch surgery (14% in reimplantation vs. 15% in remodeling; p = .53). Postoperatively, there were similar stroke rates (3% in both cohorts; p = .54), rates of reoperation for bleeding (9% in reimplantation vs. 12% in remodeling; p = .88), and 30-day mortality (3% in reimplantation vs. 4% in remodeling; p = .96). No difference in early AV reintervention (1% in reimplantation vs. 2% in remodeling; p = .07), and late AV reintervention (4% in reimplantation vs. 7% in remodeling; p = .07). The AI of +2 grade was significantly lower in the reimplantation cohort (5% vs. 8%; p = .01). Conclusion: Our study shows comparable clinical outcomes between both techniques. The practice of each technique is largely center and surgeon dependent. Larger sample size cohorts with minimal confounding factors are required to confirm the above findings.
Objective: The purpose of the study was to collect information to assess the level of sterilization practice and to identify the method of sterilization in the dental clinics in Rangpur city for further research and evaluation of the treatment quality. The study was carried out from January 2012 to June 2012 among 25 Dental clinics in Rangpur city for 6 months period. Results: Among the Respondents (16%) said draping sheet was supplied by the authority, while in 84% were not supplied. Distribution of Respondents by wearing theater shoes in the clinic were (96%) whereas (4%) didnt wear and 52% of the patients wore theater shoes in the clinic whereas 48% didnt wear it. Among the respondents 8% said plastic syringe was used in the clinic while 92% didnt use, Dental surgeons of 72% (18) of the total clinics used to wear disposable hand gloves where 28% didnt wear, 52% (13) of the Dental surgeons used to wear apron whereas 48% didnt. Among the clinics gloves were available in 92% for the service providers and 68% apron were available for the service providers. (24%) of the respondents used dettol to wash the floor, whereas 76% used savlon. Among all the operative rooms 8% used separate container to deposit sharp and other waste and 92% didnt use.(96%) of the clinics used chlorohexidine with cetrimide (savlon), and 4% (1)used Chlorohexidine with alchohol (hibisol) ). Among all the clinics 24% used sterilized Cotton and 76% didnt and 64% used sterilized gauge .(96%) of the clinics had availability of disinfectants. Only (4%) of the clinics had all the available sterilization methods. (96%) of the clinics had availability of surface disinfected. Only (8%) of the clinics had all the available instruments sterilizer. DOI: http://dx.doi.org/10.3329/bjdre.v3i2.16601 Bangladesh Journal of Dental Research & Education Vol.3(2) 2013: 1-4
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