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Introduction: The study of mortality allows for the monitoring and review of therapeutic measures in a health facility. Maternal death is a major concern in the world and constitutes a social tragedy. We present a study on the etiologies of maternal death in the mother and child health center in the Zinder region. Methodology: This was a retrospective, descriptive study covering three years from January 1st, 2017 to December, 31st, 2019. The study was carried out at the mother and child health center in the Zinder region, the main regional referral site for obstetrics and gynecology. The objective was to determine the etiologies and epidemiological profile of deceased parturients. Patients admitted directly or evacuated from other health facilities and who died according to the definition of maternal death were included. Accidental and incidental deaths and those that did not meet the WHO framework were excluded. Data were collected from the admission register, the maternal death audit report and the patient file. The variables studied were epidemiological data, causes of death, mode of transport and length of stay of the patient. Results: A total of three hundred and ninety-seven (397) files were retained out of 13874 admissions, including 7606 live births. The mortality rate was 2.86% and the maternal mortality ratio was 5219.56 per 100,000 live births. The average age was 26 years with extremes of 15 and 45 years. The 25-29 year old age group was the most affected with 23.92% (n=95). Large multiparous women (6-13 parities) were the majority with 28.21% (n=135). Most patients (87.15) were evacuated and transported medically in 92.77%. They were from rural areas in 72.83% (305). More than half, 81.86% (n=325) were uneducated. The pregnancy was not monitored in 84.39% (n=335 cases). Management was immediate, in less than one hour in 70.78% (281 cases) of patients. It was provided by the midwife alone in 34.50% (137 cases) versus 26.44% (105 cases) by the ..........

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Introduction: Eclampsia, a major neurological complication of pre-eclampsia, is defined by a convulsive manifestation and /or consciousness disorder occurring in a preeclampsia context and cannot be attributed to a pre-existing neurological problem. Pre‐eclampsia is a leading cause of maternal morbidity and mortality. Substandard care is often present and many deaths are preventable. Objective: To assess the peculiarities of anesthesia-resuscitation and the prognostic factors of morbidity and mortality of eclampsia. Materials and Methods: This is a retrospective, descriptive and analytical study of all patients admitted for eclampsia from January to December, 2020 in the intensive care unit of the Department of Anaesthesia, Chattogram Maa-O-Shishu Hospital Medical College, Chattogram, Bangladesh. All patients admitted to resuscitation for management of eclampsia were included. The diagnosis of eclampsia was based on the occurrence of peripartum seizures in a woman whose history and examination revealed no other cause for the convulsion. All patients with eclampsia were treated according to the management protocol, namely: stabilization (peripheral venous catheter, oxygen therapy, Guedel cannula, lateral safety position, standard monitoring), administration of 4gSMgO4 in 20 minutes then 1g/h for 48h, control of arterial hypertension/Nicardipine, childbirth by the quickest method, admission for resuscitation. All patients had blood samples analyzed for: azotemia, creatinine, blood count with platelet count, hemostasis balance (TP and INR, TCA), bilirubinemia and liver aminotransferases. Results: We collected 51 cases of eclampsia for 4550 deliveries in the study. The average age of the patients was 22.23 years. Primiparity was found in 28 patients (54.9%). Antenatal consultations were effective in 4 patients (7.8%). Consciousness was clear at admission in 42 patients (82.36%) and for one patient a Glasgow score <8 was reported (1.96%). Severe hypertension was ........

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Objective: using plain bupivacaine with dexamethasone in spinal anesthesia is a new technique in total hip replacement operation. It provide good sensory and motor block with less complication. Dexamethasone is a potent corticosteroid drug was mixed with bupivacaine. This study was done to compare the incidence of side effects of spinal anesthesia, the duration of both sensory and motor block following administration of heavy bupivacaine alone with administration of plain bupivacaine mixed with dexamethasone. Materials and Methods: 100 patients whose ages between 40 &90 years and weight between 70 &110 KG and American society of anesthesia (ASA) 2/3/4 who underwent total hip replacement under spinal anesthesia were randomly allocated into 2 groups by sealed envelope method, each group with 50 patients. First group received 15 mg heavy spinal bupivacaine alone while the second group received 15 mg heavy bupivacaine mixed with dexamethasone. Results: The duration of both sensory and motor block was longer in dexamethasone group in comparison to control group (p<0.001). The incidence of hypotension, breadycardia and shivering was less in dexamethasone group. Conclusion: Dexamethasone when mixed with plain bupivacaine prolong the duration of sensory and motor block and reduce the incidence of hypotension, Breadycardia and shivering.

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Background: Laparoscopic surgery is among the routinely performed surgeries. However, it leads to hemodynamic instability with potentially harmful consequences. Dexmedetomidine is found to provide good hemodynamic stability required during laparoscopy when performed under general anesthesia. The aim of the study was to assess the efficacy of dexmedetomidine in attenuation of hemodynamic responses. Method: A prospective comparative study was conducted at a tertiary care center, Kolhapur including a total of 60 patients between 18-60 years and belonging to Grade I and II as per American society of Anesthesiologists (ASA) who underwent laparoscopic surgeries under general anesthesia. All the patients were equally randomized and infused with either dexmedetomidine (Group D) or 0.9% saline (Group S) and baseline hemodynamics were recorded prior to the administration of general anesthesia. Post-operative requirement of analgesia (within 24 hours) and the recovery time were recorded. Outcomes of both the groups were compared by Chi square and a P-value <0.05 was considered significant. Result: No significant difference was found in preoperative heart rate and Mean Arterial Pressure (MAP) in both the groups (P= 0.8994; P= 0.5643, respectively). Post intubation, heart rate and MAP were significantly lower throughout the surgery, in group D (P<0.05). Requirement of isoflurane and incidence of hypertension were significantly higher in group S (P= 0.0031) whereas the requirement of post-operative analgesia were significantly less group D (P=0.0015; P=1.51e-08 respectively). Conclusion: Perioperative IV dexmedetomidine is very useful in stabilizing haemodynamics in patients undergoing laparoscopic surgeries under general anesthesia.

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Objectives: There are so many in-vitro and in-vivo studies proved the hepatoprotective and antiviral effect of silymarin and derivatives. Number of antiviral activities of Silymarin and derivatives has shown against liver and non-liver pathogens, it indicates potential broad spectrum antiviral. In addition, considering the poly-pharmacological activity of silymarin and derivatives towards multiple host cell targets, such as cell innate immunity and inflammation, oxidative stress production, and autophagy, which are all cell physiological processes that are known to be elicited or subverted by many viral infections, these natural products are likely to exert their antiviral activities by modulating the cellular environment in addition to any potential direct antiviral function(s) against a specific viral protein. Highly contagious SARS-CoV-2 causes high grade fever with joint pain and lethal organ injuries. The infection of COVID-19 across world has led to a global health emergency. COVID-19 disease caused by the severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) has affected nearly all the continents with around 1.52 million confirmed cases worldwide. Methods: In the present research an attempt had been made to find new COVID-19 main protease inhibitor by molecular docking approach. Grid based docking approach has been selected to find out the binding using AutoDock software. The two-dimensional structure of was converted into 3-D structure and optimized with 3D geometry. Results: Silibinin, are extracts obtained from the medicinal plant milk thistle (Silybum marianum) and have conventionally been used for the treatment of liver diseases. It is major constituent of Silymarin. Recent studies reported its significant in anti-neoplastic effects in a diversity of in vitro and in vivo cancer models, including skin, breast, lung, colon, bladder, prostate and kidney carcinomas. The Silibinin was docked and the binding energy was found to be -7.92 kcal/mol. .....

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Poisoning due to deliberate self-harm with the leaves or seeds of pink or yellow oleander results in significant morbidity and mortality. A wide variety of symptoms like nausea, vomiting, bradyarrhythmias and tachyarrhythmias occur following ingestion. Usually more cases will be seen in suburban parts of India and South Asia. We present an unusual case of poisoning by the ingestion of oleander leaves manifested with refractory bradycardia at tertiary care.

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Introduction: Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. Pediatric patients differ in their drug requirements because of their smaller body size, differences in body composition and handling capacity of drugs. Usually dosages are based on body weight, because it correlates so intimately with body water compartments. Objective: To find out the Intra-Operative & Post-Operative Complications in Pediatric Anesthesia. Materials & Methods: The present study was conducted in the Department of Anaesthesiology, Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh during from April 2020 to March 2021. It included 83 pediatric patients of both gender. Parents were informed regarding the study and written consent was obtained. Ethical clearance was taken from institutional ethical committee. General information such as name, age, sex, ASA status, technique of anesthesia and complications were recorded. Results: The prospective study was conducted to identify anesthesia-related complications in pediatric patients. The present study was conducted on 83 pediatric patients of both genders. Factors such as conscious state, colour, respiration, pulse and blood pressure were also assessed. Age group 1 month- 1 year had 12 males and 18 females. 1-5 years had 10 males and 15 females, 6-10 years had 11 males and 15 females and 11-18 years had 01 males and 01 females. The difference was non- significant (P-0.5). Patients had ASA I (72), ASA 2 (17), ASA 3 (5), ASA 4 (1) and ASA 5 (1) Status. The difference was significant (p-0.05). Type of anesthesia was general anesthesia (50), general anesthesia with caudal block (14), subarachnoid block (1) and general anesthesia with local anesthesia (18). The Difference was significant (p-0.01). Common intra- operative complications were bradycardia (3), tachycardia (2), hypotension (2), cardiac arrest (2), ...............