Effect of Engineered Nanoparticles of Fe and Zn Oxides on Enzyme Activity and Bacterial Abundance in Soil at Ambient and Elevated Atmospheric CO2

Nanomaterials are finding widespread applications in industry, agriculture and environment due to their unique properties. But, before these materials are widely in use, their impact on soil ecology needs to be thoroughly investigated. In addition, how the nanoparticles behave in soil under elevated CO₂ is unknown. A pot culture experiment was conducted under controlled conditions in phytotron to study the effect of nanoparticles on microbial biomass and enzyme activity in soil under rice crop at ambient and elevated atmospheric CO₂. Manufactured nanoparticles of Fe and Zn (n-Fe₂O₃ and n-ZnO) were added to soil at concentrations of 100, 500 and 1,000 mg kg^?1. FeSO₄ (11.1 mg kg^?1), ZnSO₄ (5.33 mg kg^?1) and ‘control’ treatments were also included for comparison. Results showed highest bacterial population at 100 mg kg^?1 n-Fe₂O₃, which significantly decreased at 500 and 1,000 mg kg^?1 n-Fe₂O₃ or n-ZnO. Similarly the dehydrogenase activity is significantly higher with 100 mg kg^?1 n-Fe₂O₃ as compared to control and FeSO₄ or ZnSO₄. As compared to 100 mg kg^?1 concentration, there was twofold to fivefold decrease in fluorescein diacetate activity at 500 and 1,000 mg kg^?1 of nano-Fe₂O₃ treatment. At elevated CO₂, the microbial biomass and activities were higher at tillering than panicle initiation of rice crop over ambient CO₂ with 100 mg kg^?1 n-Fe₂O₃ and ZnO than other treatments. It is concluded that n-Fe₂O₃ and n-ZnO at 100 mg kg^?1 is effective to maintain various soil microbiological process but at higher concentrations (e.g., 500 and 1,000 mg kg^?1) negative impacts on soil ecology can be expected.     

Pupillary reflex dilation in response to incremental nociceptive stimuli in patients receiving intravenous ketamine

Pupillometry is a non-invasive monitoring technique, which allows dynamic pupillary diameter measurement by an infrared camera. Pupillary diameter increases in response to nociceptive stimuli. In patients anesthetized with propofol or volatile agents, the magnitude of this pupillary dilation is related to the intensity of the stimulus. Pupillary response to nociceptive stimuli has never been studied under ketamine anesthesia. Our objective was to describe pupillary reflex dilation after calibrated tetanic stimulations in patients receiving intravenous ketamine. After written consent, 24 patients of our pediatric burn care unit were included. They received an oral morphine premedication (0.3 mg kg^?1) 1 h before their scheduled daily dressing change. Just before the procedure, they received 1 mg kg^?1 of intravenous ketamine. Two minutes after this bolus, tetanic stimulations of incremental intensities were performed on the arm of each patient (5–10–20–30–40–60 mA, 60 s interval between stimulations). Pupillary diameter, heart rate and movements were recorded before and after each stimulation. Tetanic stimulations were associated with changes in pupillary diameter and heart rate. The magnitude of these changes was significantly influenced by the intensity of stimulation (ANOVA for repeated measures, p?<?0.001). Movement was associated with a 32% increase in diameter (ROC curves, AUC 0.758) with 65% sensitivity and 77% specificity. In children, pupillary reflex dilation to nociceptive stimuli persists under deep sedation obtained with 1 mg kg^?1 of intravenous ketamine combined with a 0.3 mg kg^?1 oral morphine premedication, and its magnitude depends on the intensity of the stimulation. Our results confirm that pupillometry could be a relevant way to monitor nociception in anaesthetised subjects, including those receiving ketamine. Trial registration clinicaltrials.gov, NCT 02648412     

双镜联合用于阻塞性睡眠呼吸暂停综合征患者经鼻气管插管的观察*

目的观察纤维支气管镜(FOB)联合Glidescope视频喉镜(GVL)用于阻塞性睡眠呼吸暂停综合征(OSAS)患者经鼻气管插管的效果。方法拟行腭咽成型术的OSAS患者90例,随机分为M、G和F3组,每组30例,M组使用普通喉镜、G组使用GVL、F组使用FOB联合GVL经鼻气管插管,记录麻醉开始前(T_0)、气管插管即刻(T_1)、插管后1 min(T_2)和5 min(T_3)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)和气管插管时间,观察喉镜显露Cormack-Lehane(C-L)分级情况及一次插管成功率、按压喉外部和使用气管插管钳的发生率以及鼻腔出血和低氧血症的发生率。结果 C-L分级G和F组优于M组(P 0.05),一次插管成功率M组低于G和F组(P 0.05),需按压喉外部F组低于M和G组(P 0.05),G组低于M组(P 0.05),使用气管插管钳次数和鼻腔出血的发生率F组低于M和G组(P 0.05)。结论 FOB联合GVL用于OSAS患者经鼻气管插管,可提高气管插管成功率,减少鼻腔出血。     

Effect of Zinc Sulphate and Organics on Zn Content and Yield of <Emphasis Type="Italic">Chenopodium</Emphasis> Grown in Different Soils

Zinc (Zn) deficiency in humans is a widespread problem across the globe. Since, vegetables are the important constituent of daily diet, it is very useful to enrich leafy vegetables with Zn in alleviating Zn deficiency in humans. Greenhouse pot experiment was conducted to evaluate the effects of applied Zn and organics on shoot Zn content and dry biomass yield of Chenopodium album grown in acid and alkaline soils. Zinc content increased significantly with increase in Zn level. Zinc content gets reduced to a great extent due to application of farmyard manure (FYM) and sludge in acid soil. As far as dry biomass yield is concerned, the crop responded positively to applied level of Zn @ 5 mg kg^?1 in alkaline soil, while such response was conspicuously absent in acid soil. In case of alkaline soil, significant reduction in dry biomass yield occurred only at 100 mg Zn kg^?1, whereas such reduction was recorded in acid soil even at 50 mg Zn kg^?1. With reference to recommended dietary allowances of Zn for humans, substantial enrichment of Chenopodium in terms of Zn content is possible due to application of Zn from external sources. Taking health risk into consideration, applied rate of Zn may go up to 100 mg kg^?1 for alkaline soil as against 50 mg kg^?1 for acid soil in enriching Chenopodium with Zn.     

AANA journal course: update for nurse anesthetists. The SLAM Emergency Airway Flowchart: a new guide for advanced airway practitioners

Advanced airway practitioners in anesthesiology, emergency medicine, and prehospital care can suddenly and unexpectedly face difficult airway situations that can surface without warning during mask ventilation or tracheal intubation. Although tracheal intubation remains the "gold standard" in airway management, it is not always achievable, and, when it proves impossible, appropriate alternative interventions must be used rapidly to avoid serious morbidity or mortality. The SLAM Emergency Airway Flowchart (SEAF) is intended to prevent the 3 reported primary causes of adverse respiratory events (ie, inadequate ventilation, undetected esophageal intubation, and difficult intubation). The 5 pathways of the SEAF include primary ventilation, rapid-sequence intubation, difficult intubation, rescue ventilation, and cricothyrotomy. It is intended for use with adult patients by advanced airway practitioners competent in direct laryngoscopy, tracheal intubation, administration of airway drugs, rescue ventilation, and cricothyrotomy. The SEAF has limitations (eg, suitable only for use with adult patients, cannot be used by certain categories of rescue personnel, and depends heavily on assessment of Spo2). A unique benefit is provision of simple alternative techniques that can be used when another technique fails.     

Assessment of Century Plant (<Emphasis Type="Italic">Agave americana</Emphasis>) for Remediation of Chromium Contaminated Soils

Agave americana was evaluated for its tolerance to different levels of Cr (0, 25, 50, 100 and 200 mg kg^?1 soil) and its suitability for the remediation of Cr contaminated sites. The pot culture experiment was carried out for 3 months in clay soil which was collected from 0 to 30 cm depth from the nearby agricultural field. The partitioning of Cr between roots and shoots and its uptake by the plant, bio-concentration factor, translocation factor, translocation efficiency etc. were used to determine the remediation potential of the crop. Overall, the plant could tolerate up to 200 mg Cr kg^?1 soil, but a concentration of 81 mg Cr kg^?1 soil caused a reduction in the dry weight of the plant by 50 %. The highest total uptake of Cr (2286 µg g^?1 plant) and bio-concentration factor (6.59) was found at Cr 200 mg kg soil^?1. However, the translocation factor values were found to be <1 (0.18–0.13) indicating that Cr was mainly located in the roots exhibiting an exclusion mechanism. Based on these findings, it was concluded that A. americana could not be considered as a hyperaccumulator for Cr. Nevertheless, as shown by the accumulation ratios the plant has a massive potential for phytostabilization of Cr.     

Prehospital Standardization of Medical Airway Management: Incidence and Risk Factors of Difficult Airway

Objectives: The rate of difficult intubation in prehospital emergency medicine varies greatly among studies already published and depends on several factors. The authors' objective was to determine the rate of difficult intubations and to determine factors associated with prehospital difficult airways when a standard protocol for sedation and intubation was applied. Methods: This 30‐month clinical, observational, prospective study was performed in a suburb of Paris, France (Val de Marne, population 1,300,000) by a prehospital emergency medical unit. Airway management for patients who needed tracheal intubation was standardized. The pharmacological procedure recommended rapid sequence intubation for patients with spontaneous cardiac activity. In cases of difficult, laryngoscopy‐assisted intubation, a predefined algorithm was proposed. The Intubation Difficulty Score (IDS) was calculated for all patients requiring tracheal intubation, and factors associated with difficult intubation, defined by IDS of >5, were identified by using multivariate statistical analysis. Results: During the study period, 1,442 patients were included; 640 (44%) were in cardiorespiratory arrest, and 802 had a spontaneous cardiac activity. Deviation from the pharmacological and airway management procedures occurred in 1% of cases. When the predefined difficult airway management algorithm was followed, failure to intubate was encountered twice (0.1%). One hundred six (7.4%) patients had an IDS of >5, and 60 (4.1%) required first (n= 56) then second (n= 4) alternative techniques for tracheal intubation. Semirigid leaders allowed tracheal access in 93% of difficult‐intubation patients. One patient required a prehospital cricothyroidotomy. Factors associated with difficult intubation were the following: a history of ear, nose, or throat neoplasia or surgery; obesity; facial trauma; the operator's status; and the operator's position. Conclusions: If prehospital medical airway management is standardized and performed by trained operators, failure to intubate is rare (0.1%), and the incidence of difficult tracheal intubation is 7.4%, independent of cardiorespiratory status.     

Respiratory parameters as a surrogate marker for duration of intubation: potential application of automated vital sign collection

Prolonged time during endotracheal tube placement has been associated with poor outcomes, including cardiac arrest and death. For this reason, the accurate measurement of the duration of intubation time is an important metric in studies that evaluate interventions to improve airway outcomes. In the current study we correlated the gaps in routinely measured ventilatory parameters with duration of the intubation procedure to determine if these intervals could be used to accurately calculate the intubation time. Fifty-six random airway management encounters were video recorded along with a continuous video feed of the patient monitor. Intubation event times were measured and correlated with “gap” times of end-tidal carbon dioxide, airway pressure, airway flow, tidal volume, and respiratory rate defined as the disappearance of the parameter at the end of mask ventilation to the reappearance after intubation. Scatter plots were generated for intubation times versus each parameter time gap and correlation coefficients were calculated. Of the 56 recordings 50 of were suitable for analysis. The correlation of the gaps in airway pressure and airway flow correlated best with the duration of intubation (R² = 0.88) and were available on all cases. The gap in measured tidal volume of 39 ± 53 s most closely approximated the actual duration of intubation of 38 ± 28 s, (R² = 0.85, y = x ? 0.87). During intubation, the disappearance gaps in tidal volume, and the airway pressure and flow waveforms highly correlate with the duration of the intubation procedure and may be useful in the evaluation of airway management interventions. However, just as there are limitations to a labor-intensive method of recording airway management timing, there are limitations to using an automated method.     

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

Introduction

Endotracheal intubation in the ICU is a challenging procedure and is frequently associated with life-threatening complications. The aim of this study was to investigate the effect of the C-MAC^? video laryngoscope on laryngeal view and intubation success compared with direct laryngoscopy.

Methods

In a single-center, prospective, comparative before-after study in an anesthetist-lead surgical ICU of a tertiary university hospital, predictors of potentially difficult tracheal intubation, number of intubation attempts, success rate and glottic view were evaluated during a 2-year study period (first year, Macintosh laryngoscopy (ML); second year, C-MAC^?).

Results

A total of 274 critically ill patients requiring endotracheal intubation were included; 113 intubations using ML and 117 intubations using the C-MAC^? were assessed. In patients with at least one predictor for difficult intubation, the C-MAC^? resulted in more successful intubations on first attempt compared with ML (34/43, 79% vs. 21/38, 55%; P = 0.03). The visualization of the glottis with ML using Cormack and Lehane (C&L) grading was more frequently rated as difficult (20%, C&L grade 3 and 4) compared with the C-MAC^? (7%, C&L grade 3 and 4) (P < 0.0001).

Conclusion

Use of the C-MAC^? video laryngoscope improved laryngeal imaging and improved the intubating success rate on the first attempt in patients with predictors for difficult intubation in the ICU setting. Video laryngoscopy seems to be a useful tool in the ICU where potentially difficult endotracheal intubations regularly occur.     

Utility of the Pentax-AWS without interruption of chest compression: Comparison of the Macintosh laryngoscope with the Pentax-AWS in manikin model

Background

Emergency airway management in suboptimal conditions can result in difficulties in tracheal intubation. The video laryngoscope (Pentax-AWS^®) has potential advantages during difficult tracheal intubations. According to the 2005 guidelines for cardiopulmonary resuscitation (CPR), all rescuers should minimize interruption of chest compressions. Our hypothesis is that tracheal intubation using the Pentax-AWS^® is possible without interruption of chest compressions. We tested this using tracheal intubation performed by less experienced medical personnel in a manikin model.

Methods

Thirty-two less experienced (<10 tracheal intubations) medical interns performed intubation using the Pentax-AWS^® and the Macintosh laryngoscope in an ALS simulator (Laerdal, Stavanger, Norway) in each of three scenarios. The three scenarios were: (1) normal airway without chest compression, (2) normal airway with continuous chest compression, and (3) difficult airway with continuous chest compression. The success rate, time required to complete tracheal intubation and to visualize vocal cords, POGO (percentage of glottic opening) score, dental compression and the ease of intubation were recorded.

Results

All participants performed successful intubation with the Pentax-AWS^® in the three scenarios. In the two continuous chest compression scenarios (scenarios 2 and 3), the success rate was significantly higher with the Pentax-AWS^® than with the Macintosh laryngoscope.

Conclusions

The Pentax-AWS^® was an effective tool for endotracheal intubation during chest compression performed by less experienced medical personnel in a manikin model simulating cardiac arrest, both under conditions of normal and difficult airways.     

Comparison of Three Tracheal Intubation Techniques in Thyroid Tumor Patients with a Difficult Airway: A Randomized Controlled Trial

Objective

To investigate the effectiveness of the Shikani optical stylet (SOS) and GlideScope video laryngoscope (GVL) for tracheal intubation of thyroid tumor patients with a difficult airway.

Subjects and Methods

One hundred and twenty thyroid tumor patients with a difficult airway, who were undergoing elective surgery requiring general anesthesia, were enrolled in the study. They were randomly allocated to 3 groups (n = 40 each) who underwent direct laryngoscopy (DL), SOS or GVL. The outcomes recorded were time to intubation, first-attempt success rate, mean artery pressure (MAP), heart rate (HR) and incidence of complications.

Results

The mean time to intubation in the SOS group (group S; 42.4 ± 24.1 s) and the GLV group (group G; 29.8 ± 22.3 s) was significantly less than that in the DL group (group D) (68.8 ± 26.6 s). The first-attempt success rate in group S (90.0s%) and group G (97.5s%) was significantly higher than that in group D (75.0s%; all p < 0.05). The HR and MAP at 1 min after intubation were lowest in group S (76.4 ± 9.2 beats/min and 12.9 ± 1.1 kPa), followed by group G (79.9 ± 9.3 beats/min and 13.0 ± 0.9 kPa) and then group D (90.4 ± 8.1 beats/min and 16.6 ± 1.2 kPa). The difference was statistically significant (all p < 0.05). The incidence of lip or mucosal trauma was lowest in group S, followed by group G and then group D.

Conclusion

The SOS and the GLV had advantages over the DL in the management of thyroid tumor patients with a difficult airway in terms of a shorter time to intubation, a higher first-attempt success rate and a reduced incidence of complications. Thus, a rational choice of one of these techniques may be better for the perioperative safety of thyroid tumor patients with a difficult airway.Key Words: Tracheal intubation, Thyroid tumor, Direct laryngoscopy, Shikani optical stylet, GlideScope video laryngoscope     

Implementation of a combo videolaryngoscope for intubation in critically ill patients: a before–after comparative study

Purpose

Airway management in intensive care unit (ICU) patients is challenging. The main objective of this study was to compare the incidence of difficult laryngoscopy and/or difficult intubation between a combo videolaryngoscope and the standard Macintosh laryngoscope in critically ill patients.

Methods

In the context of the implementation of a quality-improvement process for airway management, we performed a prospective interventional monocenter before–after study which evaluated a new combo videolaryngoscope. The primary outcome was the incidence of difficult laryngoscopy (defined by Cormack grade 3–4) and/or difficult intubation (more than two attempts). The secondary outcomes were the severe life-threatening complications related to intubation in ICU and the rate of difficult intubation in cases of predicted difficult intubation evaluated by a specific score (MACOCHA score ≥3).

Results

Two hundred and ten non-selected consecutive intubation procedures were included, 140 in the standard laryngoscope group and 70 in the combo videolaryngoscope group. The incidence of difficult laryngoscopy and/or difficult intubation was 16 % in the laryngoscope group vs. 4 % in the combo videolaryngoscope group (p = 0.01). The severe life-threatening complications related to intubation did not differ between groups (16 vs. 14 %, p = 0.79). Among the 32 patients with a MACOCHA score ≥3, there were significantly more patients with difficult intubation in the standard laryngoscope group in comparison to the combo videolaryngoscope group [12/23 (57 %) vs. 0/9 (0 %), p < 0.01].

Conclusions

The systematic use of a combo videolaryngoscope in ICU was associated with a decreased incidence of difficult laryngoscopy and/or difficult intubation.     

Comparison of Pharmacokinetics of Enrofloxacin After Single Oral Bolus and Pulse Dose Administration in Broiler Chicken

Enrofloxacin was administered to commercial broiler chicken of 6 weeks of age at 10 mg kg^?1 as oral bolus and pulse dose to two groups of twelve birds each. Blood was collected at predetermined time interval and plasma samples were analyzed for enrofloxacin concentration by using HPLC. Mean plasma concentration was significantly higher in oral bolus dose up to 2 h and at 48 h. In both the groups enrofloxacin concentration was above 0.30 μg mL^?1 up to 24 h. Pharmacokinetic parameters were calculated by non compartmental analysis which revealed significant increase in AUC_0–∞ (25.35 ± 1.92 vs. 19.66 ± 1.68 μg h mL^?1) and t_1/2β (10.63 ± 0.35 vs. 8.70 ± 0.74 h) in oral bolus dose when compared to pulse dose. There was no significant difference in other pharmacokinetic parameters such as MRT, MAT, V_{d area}/F, V_dss/F, Cl_B/F, C_max and t_max. Hence it can be concluded that enrofloxacin administered to broiler chicken at 10 mg kg^?1 every 24 h as pulse dose will result in better clinical efficacy at par with oral bolus dose.     

Fipronil-Induced Biochemical Alterations During Oral Subacute Toxicity in Buffalo Calves

In the present investigation, detailed oral subacute toxicity study of fipronil, a phenylpyrazole insecticide, was undertaken in male buffalo calves. In oral subacute toxicity study, fipronil was administrated to male buffalo calves at repeated oral dose of 0.5 mg kg^?1 day^?1 for 21 consecutive days. Fipronil produced varying degree of mild to moderate toxic signs in buffalo calves. Fipronil produced toxic signs of salivation, lachrymal discharge, dullness, depression, decreased body weight gain, alopecia and sunken eyes. All the fipronil-exposed animals recovered within 7 days after insecticidal treatment was stopped. Repeated oral administration of fipronil at the dose rate of 0.5 mg kg^?1 day^?1 for 21 consecutive days produced significant elevation of whole blood cholinesterase to the extent of 45.17 %. Fipronil on repeated oral administration produced significant increase in the plasma levels of lactate dehydrogenase (7.08 %), aspartate aminotransferase (43.55 %) and acid phosphatase (11.647), but no significant effect on the plasma levels of alanine aminotransferase and alkaline phosphatase in male buffalo calves. Subacute oral administration of fipronil elevated the levels of gamma-glutamyl transferase (25.53 %), total plasma proteins (20.59 %) and blood glucose (40.75 %). However, no significant alteration in the levels of blood urea nitrogen, plasma creatinine and cholesterol was seen following daily oral administration of fipronil in the buffalo calves.     

In Vitro Plantlet Regeneration from Alysicarpus monilifer,a Source of Hepatoprotective Drug

A plantlet regeneration protocol has been developed for Alysicarpus monilifer, a medicinal plant that is a source of hepato-protective drugs. Callus was induced from mature cotyledonary leaves from 4 to 5 days old seedling on Murashige and Skoog (MS) medium supplemented with 1.0 mg l^?1 2,4-dichlorophenoxyacetic acid (2, 4-D). Proliferation of cultures occurred on MS medium with 1.0 mg l^?1 each of 2,4-D, 6-benzylaminopurine (BA) and kinetin (Kin). Shoot regeneration from proliferated callus was influenced by a number of factors namely plant growth regulators (PGRs), gelling agents, culture vessels and carbohydrate source. The highest (85.6 %) shoot regeneration was recorded in 250 ml culture flasks on agar gelled MS medium + 0.1 mg l^?1 α-naphthalene acetic acid (NAA) + 1.0 mg l^?1 each of BA, Kin and 2-isopentenyladenine (2iP) + 1 % glucose and 2 % maltose in addition to the usual 3 % sucrose. The shoots differentiated on PGRs, free MS medium, were stronger and longer than the shoots developed on MS medium containing PGRs (0.1 mg l^?1 NAA + 1.0 mg l^?1 each of BA, Kin and 2iP) with different leaf morphology and were easy to root. Rooting of the regenerated shoots was achieved both in vitro and ex vitro. About 80.4 % of the shoots rooted in vitro on half strength MS medium containing 1.0 mg l^?1 indole-3-butyric acid (IBA), while 84.9 % of the shoots rooted under the ex vitro condition when treated with 250 mg l^?1 IBA for 5 min. The plants were hardened in the green house and showed 85 % survival rate.     

插管型喉罩用于困难气道的临床研究

目的:观察插管型喉罩(intubating laryngeal mask airway,ILMA)在困难气道中应用的可行性。方法:25例Cormack与lehaneⅢ-Ⅳ级预测为困难气道的择期手术患者(Difficut组,简称D组),另匹配25例Cormack与lehaneⅠ-Ⅱ级的择期手术患者(Control组,简称C组),在静脉诱导后行ILMA插管。观察喉罩置入时间和次数、气管插管时间和次数、插管并发症以及成功率。结果:D组24例(96％)成功经ILMA插入气管导管,其中1次插管成功16例,成功率64％;2次插管成功6例;1例操作失败。C组25例(100％)全部经ILMA成功插入气管导管,其中1次插管成功23例,成功率92％。2次插管成功1例。D组和C组喉罩置入加插管总时间分别为(90．24±8．50)s和(81．26±7．20)s,插管时间分别为(41．73±7．86)s和(40．80±6．93)s。两组在气管导管插入时间、总的ILMA置入时间,成功率、术后并发症等方面无显著差异。结论:插管型喉罩是处理困难气道的有效应用工具之一。     

Emergency Tracheal Intubation in an Ankylosing Spondylitis Patient in a Sitting Position Using an Airway Scope Combined with Face-to-Face and Digital Intubation

Background

Emergency intubation in a patient with advanced ankylosing spondylitis (AS) who presents with severe thoracic kyphosis deformity, rigid cervical flexion deformity of the neck, and an inability to achieve the supine position is particularly challenging to emergency physicians.

Effect of Oral Subacute Exposure of Acetamiprid on Some Biochemical Parameters in Buffalo Calves

Acetamiprid is popular for crop protection against piercing-sucking pests and is highly effective for flea control in cats and dogs. Repeated oral administration of acetamiprid at the dose rate of 1.5 mg kg^?1 day^?1 for 21 consecutive days in buffalo calves did not exhibit any significant toxic signs. It however produced significant elevation in plasma aspartate aminotransferase (14 %), alanine aminotransferase (35.98 %) and gamma glutamyl transpeptidase (30.26 %), whereas no significant effect was observed on total plasma protein, blood cholinesterase, lactate dehydrogenase, phosphatases, cholesterol, creatinine, blood urea nitrogen and blood glucose. Present investigation reveals that acetamiprid is a mild-risk insecticide in buffalo calves.     

Clinical review: Management of difficult airways

Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainly at induction of anesthesia. Nevertheless, claim reports emphasize that airway emergencies, tracheal extubation and/or recovery of anesthesia phases are still associated with death or brain damage, indicating that additional educational support and management strategies to improve patient safety are required. The present brief review analyses specific problems of airway management related to difficult tracheal intubation and to difficult mask ventilation prediction. The review will focus on basic airway management including preoxygenation, and on some oxygenation and tracheal intubation techniques that may be performed to solve a difficult airway.     

Protective Mechanisms of Quercetin on Cisplatin Induced Oxidative Damage in Hepatic Tissue of Wistar Rats

The present study was undertaken to investigate the cisplatin (cDDP) induced oxidative damage in hepatic tissue of wistar rats and mechanisms of protection by quercetin. A total of 24 wistar rats were randomly divided into four groups with six animals in each. Group I served as control, group II received cDDP (12 mg kg^?1 body weight) and group III quercetin (50 mg kg^?1 body weight) intra-peritoneally. Group IV received quercetin 6 h prior to cDDP administration intra-peritoneally. Administration of cDDP in rats resulted in significant (P < 0.05) elevation of plasma hepatic biomarkers, reduction of antioxidant system and marked histopathological alterations indicating acute hepatotoxicity. Treatment with quercetin prior to cDDP administration prevented hepatic dysfunctions as indicated by alterations in hepatic biomarkers, alleviated enzymatic and non-enzymatic components of the antioxidant system with reduced histopathological changes in hepatic tissue. The results suggest that cDDP induced hepatic damage is due to imbalance in oxidant and antioxidant system of hepatic tissue. The pretreatment with quercetin attenuated the oxidative damage induced by cDDP in hepatic tissue and this hepatoprotective effect of quercetin may be due to its direct scavenging of free radicals and/or enhancing antioxidant defense system of hepatic tissue in wistar rats.