Comparison of Segmental Thoracic and Lumbar Subarachnoid Block in Preeclamptic Patients Undergoing Cesarean Section: An Open-Label Randomized Trial.

Background Preeclampsia is a serious hypertensive disorder of pregnancy characterized by multi-organ dysfunction and often necessitates cesarean delivery. While spinal anesthesia is preferred for cesarean sections, lumbar subarachnoid block may result in significant hypotension due to extensive sympathetic blockade. Thoracic spinal anesthesia has emerged as a potential alternative with better hemodynamic control.

Hepatopulmonary Syndrome as First Presentation of Liver Cirrhosis.

A 46-year-old male nonsmoker presented to the outpatient department (OPD) with a history of progressively increasing breathlessness and central cyanosis since 1 month. He had a history of surgery for craniopharyngioma 6 years back and was on hormone replacement therapy. On evaluation, no cardiopulmonary cause was found for cyanosis.

Rapid Catalytic Recycling of Poly(ethylene terephthalate): Minimal Hydroxide, Minimal Biomass-Derived Recyclable Cosolvent.

The rapid hydrolysis of poly(ethylene terephthalate) (PET) waste using sodium hydroxide, a phase transfer catalyst and furfuryl alcohol is demonstrated in 10 min at 98.5 °C. The cosolvent is biodegradable, available from biomass-based sources and outperforms a range of commonly used protic and polar aprotic cosolvents.

Catalyst-free efficient synthesis of functionalized 1,2,4-triazole ring opening/cyclization of arylidene thiazolone with aryl/alkyl-hydrazine.

We report a catalyst-free synthesis of hydrazone-substituted 1,2,4-triazoles ring opening/intramolecular cyclization of arylidene thiazolone by aryl/alkyl-hydrazine. The reaction exhibits a broad substrate scope and is demonstrated on a gram scale in both batch and continuous flow synthesis. Furthermore, the direct one-pot synthesis of indole-substituted 1,2,4-triazole expands its structural diversity.

Regional anesthesia for scapular surgeries: a scoping review.

Scapular or shoulder blade surgeries are uncommon in routine anesthesia practice. Most undisplaced injuries are managed conservatively; therefore, the literature on appropriate anesthetic management plans for scapular surgeries is sparse. This bone is well-protected by the surrounding muscles and tissues, and any surgery is associated with significant tissue exploration and excessive postoperative pain.

Ultrasound-guided diaphragm evaluation and outcomes in severe acute exacerbation of chronic obstructive pulmonary disease (uDISCO Study): an observational study.

Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with compromised diaphragmatic function. This can be evaluated using point-of-care ultrasound. The association of diaphragm function with hospital length of stay or mortality has not been assessed earlier.

Diagnostic yield and complications of thoracic ultrasound-guided biopsy performed by pulmonologists.

Interventional pulmonology is a growing field in India, and adding thoracic ultrasound (TUS)-guided lung biopsy can be useful for interventional pulmonologists. This study evaluated whether TUS-guided lung biopsy performed by pulmonologists, without the help of radiologists, can accurately diagnose pulmonary disease. A single-center prospective study was conducted with patients with pulmonary lesions requiring transthoracic biopsy.

Hindu Spiritual Music for Perioperative Anxiolysis and Stress Modulation: An Open-Label, Randomized Comparative Trial in Lower Limb Surgery Patients.

Background Perioperative anxiety is a common concern in patients undergoing regional anesthesia, as they remain conscious during surgery. Various non-pharmacological interventions, including music therapy, have been explored to reduce anxiety and stress response. Spiritual interventions, particularly religious music, have been shown to provide emotional stability and enhance coping mechanisms during stressful situations.

Study of comparison of medical thoracoscopic guided biopsy versus closed pleural biopsy for etiological diagnosis of undiagnosed exudative pleural effusions: A randomized controlled study.

Background: Medical thoracoscopy (MT) has gained widespread acceptance in the diagnosis of undiagnosed exudative pleural effusions. In developing countries, including India medical thoracoscopy is not widely available.

Aims: 1.

An 80-Year-Old Man With Intractable Cough.

An 80-year-old man with no history of substance addiction presented with complaints of cough and breathlessness for 4 months. His cough was nonproductive, waxing and waning in nature with high symptom load during daytime, but not associated with chest pain or wheezing. He gives no history of nasal or sinus symptoms, aspiration, or reflux symptoms.

Photodynamic therapy for early and recurrent oral cancers and pre-malignant lesions. Need of the hour for India.

Oral cancer rates in India surpass those in any other nation, with patients manifesting varied disease stages, including pre-malignant phases. Tobacco chewing promotes field cancerization, and related surgical interventions can be remarkably morbid. Advanced-stage patients with frequent recurrences undergo treatments that significantly degrade their quality of life.

A Young Patient with Multiple Pathological Fractures.

A 26-year-old male was asymptomatic and active until the age of 19 years. At the age of 20 years, he underwent lithotripsy for ureteral stones. As he grew older, he experienced bone pain, recurrent bilateral shoulder dislocations, and long bone fractures following minor trauma for which he was operated.

Supported-amine-catalyzed cascade synthesis of spiro-thiazolone-tetrahydrothiophenes: assessing HSA binding activity.

We have devised a supported-amine-catalyzed efficient synthesis of spiro-thiazolone-tetrahydrothiophenes a sulfa-Michael/aldol cascade approach. The catalyst demonstrated sustained efficacy over 21 cycles. These derivatives were found to exhibit excellent binding abilities with purified human serum albumin as indicated by both and -based experiments.

Pyridinium Ylide-Mediated Diastereoselective Synthesis of Spirocyclopropanyl-pyrazolones via Cascade Michael/Substitution Reaction.

We have devised a highly diastereoselective formal [2 + 1] annulation reaction of arylidene/alkylidine-pyrazolones with in situ-generated supported as well as standard pyridinium ylides to construct spirocyclopropanyl-pyrazolones. The cascade approach exhibits a wide range of functional group tolerance, gram-scale capability, and substrate versatility. A diverse range of spirocyclic cyclopropanes was synthesized extensively with both mediators, and the supported pyridine was reused in subsequent cycles.

Follow-up study of COVID-19 sequelae (FOSCO study).

Introduction: We undertook the first study from India to evaluate the long-term health effects of coronavirus disease 2019 (COVID-19).

Methods: The patients enrolled in our post-COVID-19 clinic were followed up for assessment at 1, 3, 6 and 12 months after recovery from acute disease prospectively.

Results: 200 patients with mean age of 50.

On-Arrival Lumbar Epidural Analgesia for Lower Limb Trauma Pain in Emergency Care: A Superiority Randomized Controlled Trial.

Background: Lower limb trauma in emergency settings often leads to pain management challenges. Traditional methods, primarily non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, have limitations. This study explores the efficacy of epidural analgesia in emergency for lower limb trauma patients (ELETRA) as an alternative for managing pain in lower limb trauma patients upon arrival in emergency care.

An upcycled fraction of Melaleuca alternifolia essential oil regenerates the skin through the skin melatonin pathway and improves sleep quality.

Background: Sleep is one of the most important factors affecting overall health. During the night, the skin repairs damage caused by daily stresses. Melatonin plays a key role in this process.

Diastereoselective synthesis of -2,3-dihydroindoles formal [4 + 1] annulation reactions of a sulfonium ylide.

We have established an generated sulfonium-ylide mediated annulation to construct 2,3-disubstituted-2,3-dihydroindoles. The [4 + 1] annulation approach relied on Michael addition/substitution reactions. These reactions were carried out at ambient temperature to deliver dihydroindoles with excellent yields and diastereoselectivities.

Prevalence and spectrum of haemoglobinopathies in females of reproductive age group- A first tertiary care center experience in Punjab, North India.

Background: Thalassemia and hemoglobinopathies are a group of inherited conditions characterized by abnormalities in the synthesis or structure of hemoglobin (Hb). According to estimates, approximately 7% of the world population is a carrier of Hb disorders, leading to high morbidity and mortality. To reduce the burden of these highly prevalent monogenic disorders, detecting them in the carrier stage is crucial to prevent disease progression.

Recyclable Polymer Supported DMAP Catalyzed Cascade Synthesis of α-Pyrones.

Polymer-supported catalysts have emerged as one of the sustainable and cost-effective alternatives in organic synthetic chemistry. We have developed the first polymer-supported DMAP catalyzed one-pot synthesis of diversely substituted α-pyrones. The cascade approach involves C5 conjugate addition of 5-oxazol-4-ones to α,β-unsaturated-β-ketoesters followed by lactonization/elimination.

Differential Radiographic Chest Findings in COVID-19 Positive Patients with and Without Comorbidities.

Background: The pandemic of Covid-19 resulted in significant morbidity and mortality, especially in those with pre-existing diseases like diabetes mellitus, cardiovascular diseases, etc., primarily due to extensive pulmonary involvement. The chest radiograph is the first imaging tool used in all Covid-19 patients.

A reusable polymer anchored pyridine mediated formal [4 + 1] annulation reaction for the diastereoselective synthesis of 2,3-dihydrobenzofurans.

We have developed a highly stereoselective formal [4 + 1] annulation reaction to construct -2,3-dihydrobenzofurans utilising generated supported pyridinium ylide. This approach has excellent substrate versatility and gram-scale synthesis capability. Moreover, the polymer-anchored pyridine has been recovered and reused multiple times.

Reusable Supported Pyridine-Mediated Cascade Synthesis of -2,3-Dihydroindoles via In Situ-Generated -Ylide.

Merrifield resin-anchored pyridines were prepared and applied as reusable mediators for -selective cascade synthesis of 2,3-dihydroindoles. The developed approach relied on in situ -ylide formation followed by Michael substitution reactions. The cascade reaction was also carried out efficiently with simple pyridine.

Neural gradient boosting in federated learning for hemodynamic instability prediction: towards a distributed and scalable deep learning-based solution.

Federated learning (FL) is a privacy preserving approach to learning that overcome issues related to data access, privacy, and security, which represent key challenges in the healthcare sector. FL enables hospitals to collaboratively learn a shared prediction model without moving the data outside their secure infrastructure. To do so, after having sent model updates to a central server, an update aggregation is performed, and the model is sent back to the sites for further training.