Endotracheal intubation is one of the most important anaesthetic skills. Trauma to the maxillofacial region is challenging in terms of airway management. Airway management in such patients is difficult and decides the survival of the patient. Endotracheal intubation in patients with difficult ventilation and difficult intubation always remains a challenge, especially in the absence of a flexible fibreoptic bronchoscope. The retrograde catheter technique is an acceptable option for airway management in cases where oral intubation is not possible because of difficult airway or is not recommended because of fear of dislodgement of fractured segments of facial bones. The author here reports a case of a 30-year-old male with firearm injury in maxillofacial region posted for emergency surgery with anticipated difficult airway. Emergency retrograde intubation was done for the management of airway with successful outcome.

Abstract: There are many way to by which human being communicate with each other verbal, sign language or facial expression are one of them. Here we propose artificial intelligence based facial expression detection system by which we can detect behaviour of human being by computer system. Facial expression detection have lot of real life applications including computer to human interaction, Human behaviour reorganisation, cognitive study, emotion analysis, personality development etc. Here we set a study which uses a new technique for facial expressions using single frame uses combination of vector and geometrical feature based classification method Generally to study human face the image of face is divided into small grid of pixels . In this Study we have divided whole face into sub region of local regions. This technique acquire most important sub regions of the domain and start collecting most important sub regions incrementally which enhance accuracy and speed. The consequences of looks acknowledgment utilizing highlights from space explicit locations , likewise contrasted and the outcomes acquired utilizing all encompassing portrayal. The presentation of the proposed look acknowledgment framework has been approved on openly accessible expanded Cohn-Kanade (CK+) look informational collections.

Background: Pain relief after surgery continues to be a major medical challenge in clinical practice. Lumbar spine surgery is associated with significant postoperative pain. Providing optimal analgesia locally in the area of surgical wound, with little systemic side-effects, is a favourable option and has become an intrinsic part of multimodal analgesia. We aimed to assess and compare the effectiveness of local infiltration and instillation of bupivacaine for postoperative analgesia in patients undergoing lumbar spine surgery. Materials and methods: Forty-four adult patients of the American Society of Anesthesiologists (ASA) class I and II were randomly assigned into two groups, incorporating 22 patients per group. After the completion of lumbar spine surgery and after hemostasis was achieved, patients in group A received instillation of 20 ml of 0.25% bupivacaine at the surgical wound site and patients in group B received 20 ml of 0.25% bupivacaine infiltration into the paravertebral muscles on either side. Postoperative numerical rating scale (NRS) pain scores at 1, 2, 3, 4, 5, 6, 7, 8, 14, 20, and 24 hours; the time to first analgesic required, total rescue analgesic consumption, and adverse effects were recorded. Statistical analysis was done using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp, Armonk, New York, United States). Results: Time to the first analgesic requirement was significantly longer in group A (12.39±1.56 hours) compared to the B group (2.48±0.58 hours) (P < 0.001). The amount of rescue analgesia (diclofenac sodium) required was significantly higher in group B (135.00±46.17 milligrams) compared to A (93.75±33.32 milligrams) (P = 0.001). The number of analgesic demands was higher in the infiltration group compared to the instillation group and was observed to be statistically significant. Hemodynamic parameters remained comparable between the groups. Conclusion: Local instillation of surgical wound site provided better pain control than infiltration technique and is effective and safe postoperative analgesia in patients undergoing laminectomy surgeries.

Ischemic heart disease is the leading cause of death in postmenopausal women. The activity of heart ACE increases whereas the activity of ACE-2 decreases after menopause. The present study was designed to investigate the role of ACE and ACE-2 in the abrogated cardioprotective effect of IPC in OVX rat heart. The heart was isolated from OVX rat and mounted on Langendorff’s apparatus for giving intermittent cycles of IPC. The infarct size was estimated using TTC stain, and coronary effluent was analyzed for LDH, CK-MB, and nitrite release. IPC induced cardioprotection was significantly attenuated in the ovariectomized rat heart as compared to the normal rat heart. However, this attenuated cardioprotection was significantly restored by perfusion of DIZE, an ACE-2 activator, and captopril, an ACE inhibitor, alone or in combination noted in terms of decrease in myocardial infarct size, the release of LDH and CK-MB, and also increase in the release of NO as compared to untreated OVX rat heart. Thus, it is suggested that DIZE and captopril, alone or in combination restore the attenuated cardioprotective effect of IPC in OVX rat heart which is due to an increase in ACE-2 activity and decrease in ACE activity after treatment.

The plant Delonix regia (Bojer ex Hook) Raffin, family Caesalpiniaceae, grows in Madagascar, India, Africa, and Northern Australia. The plant is well known as flame of forest or royal poinciana and has been extensively used traditionally or in Ayurveda for the treatment of various diseases including jaundice, ulcer, wound, arthritis, malarial, emetic, infection, inflammatory, pain, and diarrhea. Phytochemical studies show that plant D. regia contains flavonoids, tannins, saponins, sterols, steroids, alkaloids, triterpenoids, anthocyanins, carotene hydrocarbons as bioactive secondary metabolites. In this chapter, we present an up-to-date compilation according to the latest references on various phytochemical constituents including bioactive as well as pharmacological effects.

Present investigation Studies on the effect of different surface sterilization agents under in-vitro culture of Strawberry (Fragaria × ananassa Duch.) variety “Chandler” was carried out at the Tissue Culture Laboratory Department of Horticulture, Sardar Vallabhbhai Patel University of Agriculture & Technology, Meerut during the year 2018-2019. Effect of two different surface sterilization agents’ i.e., mercuric chloride and ethanol were tested on the contamination-free establishment of Strawberry cv. Chandler under in vitro conditions. All the sterilization agents performed better results when used individually for different time intervals. Minimum contamination percentage of explants after 10 days (32.72%) was noted under HgCl2 0.1 per cent treating for a period of 2 min. A critical observation was recorded as the maximum survival percentage of explants after 25 days (68.71%) was noted under the treatment of HgCl2 0.1 per cent for a period of 2 min. Minimum contamination percentage of explants after 10 days (35.41%) was noted under ethanol 70 per cent treating for a period of 2 min. A critical observation was recorded as the maximum survival percentage of explants after 25 days (70.78%) was noted under the treatment of ethanol 70 per cent for a period of 2 min. The combination of 0.1 per cent Hgcl2 with 70 per cent ethanol was also found effective for sterilization of Strawberry explants. Best results with lower contamination 0.1 per cent with HgCl2 for a period of 1 min. (21.76%). Whereas higher explant survival per cent (79.88%) was observed HgCl2 0.1 per cent with ethanol 70 per cent for a period of 1 min. The present study concludes that combination use of 0.1 per cent mercuric chloride + 70 percent ethanol for different time intervals was found to be best to generate contamination-free plants in Strawberry cv. Chandler.

# #, Nidhi Jasani , Nagja Tripathi Vimal Kumar* # Department of Phytopharmaceuticals and Natural Products, Institute of Pharmacy, Nirma University, Ahmedabad-382481, India *ITM School of Pharmacy, ITM Universe, Vadodara -391510, India Background: Lagenaria siceraria Mol. Standley commonly known as bottle gourd is a climbing perennial herb cultivated as a vegetable in the tropical countries. Lagenaria siceraria leaves are used traditionally for cough, bronchitis, asthma and inflammation. Purpose: On basis of ethano-medicinal uses, the anti-allergic activities of the methanolic extract of Lagenaria siceraria leaves was planned to investigate scientifically using animal models for allergic inflammation and anti-allergic activity. Method: Leaves of Lagenaria siceraria were collected from Nirma Herbal Wealth, Nirma University, Ahmedabad, Gujarat, India and the sample was identified and authenticated by ethanobotanist. The methanolic extract of the leaves was prepared from 500 gm of leaves using soxhlet extraction; it yielded 16.70 % (w/w) of dry extract. The Wistar rats were killed by exsanguinations. The pieces of mesenteries were spread and challenged with 1μg/ml of compound 48/80 for 10 min as negative control. Methanolic extract L. siceraria at different concentrations or standard ketotifen incubated mesenteries were challenged with 1μg/ml of compound 48/80 for 10 min. Pieces of mesentery were stained with 0.1% toludine blue solution and the % of degranulated mast cells were counted under microscope and the protection offered by methanolic extract / ketotifen of was calculated. In another model the Compound 48/80 (0.3μg in 0.05ml) were administered subcutaneously in the plantar region of the right hind paw of albino mice's. Result: The methanolic extract of L. siceraria (LSM) showed significant dose dependent (10-30 μg/ml) anti allergic activity against compound 48/80 induced mast cell degranulation in rat mesenteries. LSM also showed significant anti-inflammatory effects at the dose of 100 mg/kg against compound 48/80 induced paw edema in mice. Conclusion: The ethno medicinal uses of L. siceraria leaves were proved by us scientifically for treatment of allergic inflammation and anti-allergic activity using various animal models.

Dengue fever is known for its life-threatening complications of bleeding and capillary leak syndrome. We report an unusual complication of dengue fever causing panophthalmitis, leading to rapidly progressive painful visual loss within days. Later on, the patient developed secondary bacterial infection of the eyeball and developed multiple brain abscesses due to spread of infection from the eyeball. Culture from pus swab of the right eye grew Staphylococcus epidermidis. The patient was promptly treated with broad spectrum antibiotics and after stabilisation, evisceration of the affected eye was done. Supportive therapy in the form of mechanical ventilation in view of poor sensorium, platelet transfusions for thrombocytopenia and guided fluid therapy was also provided. After multiple challenges in the management of the patient, fortunately, the patient survived but we failed to save his right eye. Therefore, it is necessary to carefully examine all vital organs at an early stage to prevent unfortunate outcome.

Hypertension is a becoming a major threat to the world. Angiotensin converting enzyme (ACE) is a key part in the renin angiotensin aldosterone system (RAAS) which control blood pressure. Over expression of RAAS is related with vascular hypertension, ACE inhibition has turned into a noteworthy target for controlling hypertension. In the search of lead molecules from plant origin as a substitute for toxic synthetic drugs, 25 Indian medicinal plants and foods were screened for their ACE inhibitory activity. IC50 (50% inhibition of ACE) values of hydroalcoholic crude extracts and fraction were determined by a colorimetric method. Active fractions were further screened to determine the enzyme kinetics, mode, specificity and mechanism of inhibition. Standardization was done by determining total phenolics and flavonoids as gallic acid and quercetin equivalents/mg of extract respectively. Among 25 crude extracts, Cynara scolymus extract showed the best activity, IC50 value 356.62 μg/mL. ACE inhibition resulting from protein precipitation was highest in Coscinium fenestratum. Lineweaver-Burk plots revealed a competitive mode of inhibition for Punica granatum ethyl acetate fraction. Fractions of Cassia occidentalis, Cynara scolymus and Embelia ribes were found to be non-specific inhibitors of ACE. Embelia ribes, Cassia occidentalis and Coscinium fenestratum fractions inhibited the ACE by Zn2+ ion chelation. Research revealed the potential of tested plants fractions as ACE inhibitors along with their inhibition kinetics and mechanism of inhibition. These active plant fractions might find importance in the development of potential antihypertensive agents after further investigations using preclinical and clinical trials.

Background In the search of safe and effective lead molecules from natural sources, Mucuna pruriens (MP) L. (Fabaceae) seeds were utilized for exploring the antihypertensive potential. Traditionally, it is used as diuretic and hypotensive. Methods Bioassay-guided fractions were utilized for the isolation of active compounds by column chromatography. IC50 value, enzyme kinetics and inhibition mechanism were determined. In vivo time and dose-dependent hypotensive study followed by changes in mean arterial pressure (MAP) induced by angiotensin I (3 nmol/kg), angiotensin II (3 nmol/kg), and bradykinin (10 nmol/kg) in anesthetized rats was done. Plasma and tissue angiotensin I-converting enzyme (ACE) activities were also determined. Results Phytochemical analysis by spectroscopic techniques revealed the presence of known compounds like genistein, ursolic acid and L-DOPA from the ethyl acetate and water fraction, respectively. In vitro study revealed MP ethyl acetate (MPEA) fraction and genistein as the most active fraction (IC50 156.45 µg/mL) and compound (IC50 253.81 µM), respectively. Lineweaver-Burk plots revealed a non-competitive mode of inhibition. ACE protein precipitation was the suggested mechanism for inhibition. The extract showed a time- and dose-dependent decrease in MAP. Genistein was able to dose-dependently reduce the MAP, up to 53±1.5 mmHg (40 mg/kg, i.v.). As compared to control, it showed a dose-dependent decrease in plasma ACE activity of 40.61 % and 54.76 % at 10 mg/kg and 20 mg/kg, respectively. It also decreased the ACE activity in the aorta (107.67nM/ml min at 10 mg, p<0.001; 95.33nM/ml min at 20 mg p<0.001). Captopril was used as a standard for various in vitro and in vivo assays. Conclusions The study revealed the antihypertensive potential of MP seed compounds via ACE inhibition.

The aim of the present study was to determine the anti-diabetic activity of a polyherbal formulation in streptozotocin induced type 2 diabetic rats. The hydroalcoholic extracts of Eugenia jambolana, Gymnema sylvestre, Momordica charantia and Andrographis paniculata and sodhana processed extract of Myristica fragrans were prepared. The 2 day old neonatal rats were injected with 90 mg/kg of streptozotocin intraperitoneally to induce type 2 diabetes. After six weeks of streptozotocin injection, polyherbal formulation was daily administered at a dose of 400 mg/kg body weight to diabetic rats for a period of 28 days. Blood samples were collected from the retro orbital plexus of the eye and blood glucose level was estimated by glucose oxidase-peroxidase method. The study indicated that polyherbal formulation at a dose of 400 mg/kg body weight showed significant decline (p<0.001) in blood glucose level.

Delonix regia (Bojer ex Hook) Raffin (Fabaceae), also known as flame of forest, is a semi-deciduous tree, distributed throughout Madagascar, India, Africa, and Northern Australia. Various parts of the plant are traditionally used for the treatment of different ailments such as inflammation, rheumatism, bronchitis, diabetes, anemia, fever, gynecological disorders, and pneumonia. The plant possess antioxidant, hepatoprotective, gastroprotective, wound healing, antiarthritic, larvicidal, antimalarial, antiemetic, antibacterial, antifungal, antiinflammatory, analgesic, antidiarrhoeal, antiheamolytic, diuretic, and anthelmintic activities. This review is an up-to-date compilation on its traditional uses in context to phytochemical and pharmacological perspectives.

Delivery of anticancer agents, genes, and others having cytoplasmic, nuclear, or other subcellular compartments as a site of action, is usually affected by presence of endocytic pathway. This is the most common pathway for intracellular drug delivery. Besides this, drugs suffer with basic problems such as toxicity, instability, and improper biodistribution. One of the several methods to overcome these problems is encapsulation of the drug in a suitable carrier. However, problems like infavorable biodistribution, high risk of toxicity and instability can be solved by delivery carriers but proper delivery to the site of action should also be considered while selecting a carrier. Several nanocarriers are developed and explored so far to release drugs at desired sites. Among these, exhaustive research has established liposomes as an effective carrier to trigger the release of loaded cargo to site of action. Liposomes are one of the well recognized and effective drug delivery vehicles of the present era that protects the drug from the body milieu as well as improves its stability, safety, and effectiveness. This chapter covers various aspects of triggering modalities found and tested to date such as temperature, pH, enzymes, and light, using liposomes.

Zizyphus xylopyrus (Retz.) Willd (Rhamnaceae) is an ever-green shrub of tremendous medicinal importance, distributed throughout the North-Western India, Pakistan, and China. Various parts of plant are used in Ayurvedic and other folk medicine for the treatment of different ailments such as obesity, diabetes, snake bite, fever, diarrhoea, insomnia and digestive disorders. The plant also possesses antisteroidogenic, anticonvulsent, antinociceptive, antiinflammatory, antidepressant, antidiarroheal and wound healing activity. Research has been carried out using different techniques to support most of these claims. This review is an attempt to compile an up-to-date on its folkloric or traditional uses, phytochemical as well as pharmacological properties of Zizyphus xylopyrus.

Administration of drugs is often associated with basic problems such as toxicity, instability and improper biodistribution. Encapsulation of the drug in a suitable carrier such as liposomes is one of the well recognized methods that protects the drug from the body milieu to improve stability, safety and targeting efficiency of the drug towards the target site. However, while encapsulation provides a favorable biodistribution, low toxicity and improved stability of drugs, delivery carriers should be capable of releasing encapsulated material at the appropriate site to exert their activity. Effective intracellular drug delivery is desired for many therapeutic agents those having specific molecular targets in the cytoplasm, nucleus, or other subcellular compartments of a cell such as mitochondria. Several nanocarriers that are designed to release drugs at desired sites have been developed so far. Among these, exhaustive research has established liposomes as an effective triggerable drug carrier. This mini review covers various aspects of triggering modalities examined to date such as temperature, pH, enzymes and light using liposomes. Keywords: Drug delivery, liposomes, pH sensitive, photosensitive, thermo sensitive.

Luffa echinata Roxb. (Cucurbitaceae) is a spreading climbing herb of tremendous medicinal importance, distributed throughout Pakistan, India, Bangladesh and Northern Tropical Africa. Traditionally various parts of the plant are being used for the treatment of different ailments such as jaundice, intestinal colic, enlargement of liver and spleen, leprosy, diabetes, bronchitis, nephritis, rheumatism, cirrhosis, dropsy, anthelmintic, stomach ache, snake bite, dog bite, fever, diarrohea and hemorrhoid disorder. The plant also possesses antioxidant, analgesic, anti-inflammatory, antidepressant, anxiolytic, antiepileptic, hepatoprotective, antibacterial, antifungal, antiulcer and anticancer activity. Research has been carried out using different techniques to support most of these claims. This review is an attempt to compile an up-to-date data on its ethanomedicinal, phytochemical and pharmacological perspective.

The present attempt was aimed to evaluate the anti-asthmatic and anti-allergic activity of the aqueous extract of Lagenaria siceraria leaf (LSA) using various animal models like histamine and acetylcholine induced bronchoconstriction in Guinea pigs, compound 48/80 induced mast cell degranulation in rats and paw edema in mice. LSA exhibited significant and dose dependent bronchodilatory activity at the doses of 150 and 300 mg/kg intraperitonially (i.p.). LSA at the concentrations of 10, 20 and 30 I¼g/ml significantly inhibited compound 48/80 induced mast cell degranulation. The anti inflammatory activity was observed at the doses of 50, 75 and 100 mg/kg (i.p.) against compound 48/80 induced paw edema in rats. These results prove the traditional claim of the drug in treatment of asthmatic disorders.