Anesthesia Methods in Pregnant Women: A Review Study

Background: Manage and deal with the pregnant patient undergoing anesthesia for surgical non-obstructed surgery, assess the effects of non-obstetric surgeries on both fetus and mother during pregnancy, and measures to prevent it. Methods: A review search study was currently managed in PubMed, MEDLINE, Embase, Science gate, Elsevier, Scientific report, Google Scholar, and Cochrane Evidence-Based Medicine Reviews, after obtaining approval from the ethics committee of Tehran University of Medical Sciences. All the reviews identified were restricted to human studies and available in English. Results: Elective surgery ideally should be avoided during pregnancy while emergency surgery should proceed with consideration for the anesthetic implications of the altered physiology of pregnancy. Caution must be taken during anesthetic application and Airway management. Conclusion: Pre-oxygenation is essential and consider the rapid-sequence induction accompanied with cricoid pressure to lower the incidence of aspiration. Lower MAC values of the volatile anesthetic should be used and medications titrated to preferably produce beneficial effects only.

COVID 19 in Pregnancy: Immunology Savior or Culprit

Corona pandemic has been a nightmare for health care, from the point of view of transmission, pathogenesis, diagnosis and treatment, everything in doldrums. Pregnancy in itself encompasses altered physiology, immunity and often is characterized by unpredicted bodily responses. The short review is an attempt to summarize the knowledge gained so far in context with COVID 19 infection in pregnancy. The paper highlights gaps in our present understanding and emphasize on more research for understanding the double edged sword - immune system and its response to COVID 19 infection in pregnant woman.

Perioperative analgesia in obese patients

Obesity in general and morbid obesity (MO) in particular are becoming more common around the world. MO is associated with altered physiology of the body and increased number of comorbidities, which can make perioperative pain control particularly difficult in such patients. Given the higher incidence of respiratory disorders, traditional opioid-oriented treatment of pain in patients with MO can often lead to ventilation disorders and increased morbidity and/or mortality. Multimodal analgesia strategies based on a step-by-step, according to the pain severity, opioid-sparing approach can improve patient safety and treatment outcomes. Further progress in understanding the mechanisms of acute pain forces doctors to actively detect and treat both its nociceptive and pro-nociceptive components (hyperalgesia, etc.). Such multimodal analgesia protocols should be standardized and implemented in perioperative care of patients with MO. In addition to standardizing the treatment of postoperative pain, regardless of used regimen of anesthesia and analgesia, some patients with MO require enhanced respiratory monitoring to prevent possible airway side effects. This review briefly describes the physiological changes in obese patients, the pathophysiology of pain, and the evidence-based clinical updates for pain management in MO. Also, the role of opioid-sparing pharmacological adjuvants is discussed and future directions of research in the field of perioperative pain management in patients with MO are highlighted.

Management of Male Infertility Caused by Oligospermia Using Ayurveda: A Case Report

In India, 1 out of 10 couples suffers from infertility are owing to impaired spermatozoa production or its function, impaired sperm delivery, improper ejaculation, due to sedentary life styles and day to day stress nowadays. Male infertility can be defined as an inability to induce conception, due to defect in spermatozoic functions like low sperm count, unhealthy sperm production, low sperm motility and altered delivery of sperms due to altered physiology of male reproductive system. A 29-year-old married man was diagnosed with oligospermia, visited Shuddhi Ayurveda Clinics, Noida for his condition management and treated successfully with Ayurvedic drugs. This married couple was facing infertility issue from last 2-3 years. Patient was treated with Ayurvedic drugs and kept on strict diet monitoring for four months and results were counted in terms of improved total sperm count after treatment. Before treatment sperm count was 10 million per ml which got improved up to 90 million per ml after four months of Ayurvedic treatment with strict diet regimen. No any side effects were observed during the treatment period. Other morphological parameters of sperm were also found to be healthy and normal for fertility. From the results of this case report, Ayurvedic treatment is proved to be effective in the treatment of male infertility associated with oligospermia.

An I for an A: Dynamic Regulation of Adenosine Deamination-Mediated RNA Editing

RNA-editing by adenosine deaminases acting on RNA (ADARs) converts adenosines to inosines in structured RNAs. Inosines are read as guanosines by most cellular machineries. A to I editing has two major functions: first, marking endogenous RNAs as “self”, therefore helping the innate immune system to distinguish repeat- and endogenous retrovirus-derived RNAs from invading pathogenic RNAs; and second, recoding the information of the coding RNAs, leading to the translation of proteins that differ from their genomically encoded versions. It is obvious that these two important biological functions of ADARs will differ during development, in different tissues, upon altered physiological conditions or after exposure to pathogens. Indeed, different levels of ADAR-mediated editing have been observed in different tissues, as a response to altered physiology or upon pathogen exposure. In this review, we describe the dynamics of A to I editing and summarize the known and likely mechanisms that will lead to global but also substrate-specific regulation of A to I editing.

The Plastic Waste Menace and Approaches to Its Management Through Biodegradation

In contemporary society, the production and use of plastics is growing due to their assorted applications. However, these tendencies result to production of plastic waste whose effects to the environment are destructive. This chapter explores the production tendencies of plastics and plastic-waste chronologically, discusses its negative environmental effects, and proposes the adoption of biodegradation as a management approach. A number of effects including death, retarded growth and development, emergence of cancers, and altered physiology are associated with ingestion of plastics in animals and humans. Water and air pollution is associated with unscientific disposal of plastic waste resulting to leaching and release of greenhouse gases. The use of microbes such as bacteria and fungi that have inherent enzymes such as lipases, esterases, hydrolases, and amylases is discussed as a sustainable solution to the plastic menace. The successful use of biodegradation must be coupled with scientific research to optimise the factors influencing the process.

Absent expansion of pericentral hepatocytes and altered physiology in Axin2CreERT2 mice

Abstract/IntroductionUnderstanding how the liver regenerates is a key biological question. Hepatocytes are the principle regenerative population in the liver. Recently, numerous lineage tracing studies (which apply genetic tagging to a restricted population and track its descendants over time) have reported conflicting results using a variety of hepatocyte based reporting systems in mice1,2. The first significant lineage tracing from a distinct subpopulation of hepatocytes in homeostasis reported hyper-proliferation of self-renewing pericentral hepatocytes with their subsequent expansion across the liver lobule3. This study used a CreERT2 construct knocked into the endogenous Axin2 locus; here termed Axin2CreERT2. Subsequent studies, using either a different pericentral marker (Lgr54) or a different AxinCreERT2 transgene5, did not show lineage tracing. Here we aim to reconcile these discrepancies by re-evaluating lineage tracing in the Axin2CreERT2 knock-in model and explore the physiological consequences of this mutant allele. We were unable to find evidence of expansion of an Axin2CreERT2 labelled population and show that this population, whilst zonated, is spread throughout the lobule rather than being zonally restricted. Finally, we report that this allele results in profound perturbation of the Wnt pathway and physiology in the mouse.