Background
Oral nifedipine is recommended along with labetalol and hydralazine for treatment of severe hypertension during pregnancy by most authorities. Although nifedipine is cheap and easily ...administered, the usage pattern among health care providers suggests a strong preference for labetalol despite lack of evidence for the same.
Objectives
To determine the efficacy and safety of oral nifedipine for treatment of severe hypertension of pregnancy compared with intravenous labetalol.
Search strategy
We systematically searched for articles comparing oral nifedipine with intravenous labetalol for the treatment of severe hypertension during pregnancy in any language, over Medline, Cochrane Central Register of Clinical Trials and Google Scholar from inception till February 2014.
Selection criteria
We included all RCTs that compared intravenous labetalol with oral nifedipine for treatment of severe hypertension during pregnancy, addressing relevant efficacy and safety outcomes.
Data collection and analysis
Eligible studies were reviewed, and data were extracted onto a standard form. We used Cochrane review manager software for quantitative analysis. Data were analysed using a fixed effect model.
Main results
The pooled analysis of seven trials (four from developing countries) consisting of 363 woman–infant pairs showed that oral nifedipine was associated with less risk of persistent hypertension (RR 0.42, 95% CI 0.18–0.96) and reported maternal side effects (RR 0.57, 95% CI 0.35–0.94). However, on sensitivity analysis the outcome ‘persistent hypertension’ was no longer significant. Other outcomes did not reach statistical significance.
Conclusion
Oral nifedipine is as efficacious and safe as intravenous labetalol and may have an edge in low resource settings.
Tweetable
Although studies to date are few in number and small, nifedipine shows promise for severe hypertension in pregnancy.
Tweetable
Although studies to date are few in number and small, nifedipine shows promise for severe hypertension in pregnancy.
We present a generalized Landauer-Büttiker transport theory for multiterminal spin transport in the presence of spin-orbit interaction. Using this theory we point out that there exists equilibrium ...spin currents and nonequilibrium pure spin currents, without any magnetic element in the system. Quantitative results are presented for a Y-shaped conductor. It is shown that pure spin currents cause a voltage drop and, hence, can be measured.
Our aim was to evaluate the feasibility and role of sentinel lymph node (SLN) biopsy using methylene blue dye alone in identifying occult lymph node metastases in early oral cancer (cT1, T2, and ...cN0). The study was done from 2013–15 in 94 patients in a large cancer centre. The blue nodes were dissected and sent for frozen section, routine histopathological examination, and immunohistochemical testing for cytokeratin, and was followed by elective neck dissection in all patients. The identification rate was 93.61%. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for frozen section and haematoxylin and eosin (H&E) staining were 84.6%, 100%, 100%, 93.9% and 95.5%, respectively. Occult lymph node metastasis was seen in 27.6% cases. Biopsy of SLN with blue dye alone might be used successfully with good sensitivity and negative predictive value in countries with limited resources in the developing world. Immunohistochemistry contributes to it by increasing the sensitivity and NPV, and thereby improves the diagnostic value.
Time-lapsed Mach-Zehnder interferograms in (a) infinite fringe setting and (b) wedge fringe setting, and laser shadowgraph images (c) during unidirectional crystal growth of benzophenone.
Display ...omitted
•Online and in-situ optical imaging of unidirectional growth of benzophenone crystal.•Shadowgraphy was most appropriate to visualize the convective field during growth.•Frequency, number and plume behavior provide feedback about the growth mechanism.•M-Z interferometry was ideal technique to quantify concentration field during growth.•Growth rate and solutal boundary layer thickness were quantified during growth.
Fluid convection and concentration during unidirectional growth of benzophenone crystal were imaged in an online and in-situ manner using optical techniques of laser shadowgraphy and Mach-Zehnder (MZ) interferometry. The fluid dynamic behavior of the plumes, the frequency of their appearance and the number of plumes provide information about the crystal growth mechanism and also growth rates as a function of supersaturation. Comparing the images captured using above techniques, it was found that shadowgraphy was most appropriate to visualize the convective field. It was used to image the life cycle of convection plume starting from its birth at the crystal surface to its diffusion in to the bulk of the solution. Comparative analysis of the images grabbed using different type of imaging techniques reveal that MZ infinite fringe technique is best suitable for visualizing the concentration gradient. This is followed by MZ horizontal wedge setting and then MZ vertical wedge setting fringes. The shadowgraph technique is not able to discern the concentration gradient as clearly as seen in the MZ images. The solutal boundary layer (SBL) was better visualized using shadowgraphy as compared to Mach-Zehnder interferometry. The thickness of SBL was an indicator of the relative growth kinetics. It is demonstrated that by choosing appropriate optical technique, one can monitor as well as control the growth process to achieve the desired results.
► Effects of 200MeV Ag15+ ion irradiation of nanocrystalline Mn–Ca ferrite investigated using utmost techniques. ► Characterization results confirmed formation of cubic spinel structure and spherical ...morphology consistent with the crystalline diameter. ► After irradiation, the saturation magnetization, coercivity, and blocking temperature enhance appreciably. ► SHI irradiation induced modifications in surface states of the nanoparticles and cationic re-distribution identified as probable reasons. ► Irradiation caused increase in dielectric constant, attributed to surface modifications through slight crystal growth.
The effects of 200MeV Ag15+ ion irradiation on structural, magnetic and dielectric properties of nanocrystalline Mn–Ca ferrite have been investigated. The specimens characterized using XRD confirmed the formation of cubic spinel structure. The TEM images revealed the spherical morphology consistent with the crystalline diameter. After irradiation by 200MeV Ag ions, saturation magnetization, coercivity, and blocking temperature were enhanced appreciably which could be attributed to swift heavy ion (SHI) irradiation induced modifications in surface states of the nanoparticles, slight increase in crystallite size and cationic re-distribution. The dielectric measurements revealed that both dielectric constant (ɛr) and the loss tangent (tanδ) disperse normally as a function of frequency of the externally applied electric field. The increase in ɛr and tanδ on irradiation could be attributed to the surface modifications through slight crystal growth and hence the availability of sufficient number of Fe2+/Mn3+ ions particularly at the octahedral site on grain boundaries showing a fair agreement with the magnetization results.
Fluoride toxicity through potable water, particularly ground water, is not uncommon in countries such as India, China, Iran, Iraq, Turkey, parts of Africa and Afghanistan. Kidney being the main organ ...involved in fluoride removal, it accumulates considerable amount of fluoride. Here, we report toxic effects of oral exposure of Swiss albino mice to fluoride (sub-acute: 190 mg/kg body wt. for 7 days; and sub-chronic: 94 mg/kg body wt. for 90 days) and recovery of sub-chronic fluoride exposed mice after 90 days of sodium fluoride (NaF) withdrawal. The role of diet supplements (Spirulina and tamarind fruit pulp @ 230 mg/kg body wt. independently as well as in combination) in amelioration of fluoride toxicity has also been screened. Compared with controls, feed intake decreased from 3-43%, body wt. 4-18%, and kidney wt. 5-12% in treated mice (except diet supplement groups of sub-chronic exposure) while their water intake increased from 4-43%. Histopathological changes in the cortical region of kidney in fluoride treated mice were as follows: dilation of bowman's capsule and thickening of its parietal and visceral layer; alterations in glomeruli size and their sclerotization; increase in bowman's space; proliferation of mesangial cells; reduction in podocyte counts; and dilation of proximal and distal tubules. Fluoride exposure altered tissue biochemistry (protein, acid phosphatase and alkaline phosphatase content) and increased urea (23-58%) and creatinine content (14-127%) in the serum. Sub-acute exposure was found more toxic. The diet modulation not only reduced fluoride toxicity but also led to better recovery of treated mice after withdrawal, especially in combination.
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