Citrate is the first intermediate of the citric acid cycle and tricarboxylic acid (TCA) cycle. It also plays an important role in fatty acid synthesis which takes place in the cytoplasm. The movement is assisted by two enzymes, citrate-condensing enzyme, which catalyzes the condensation of the acetyl unit with oxaloacetate in the mitochondria, and citrate-cleavage enzyme (citrate lyase), which catalyzes the release of the acetyl radical in the cytoplasm of the cell. The citrate test detects the ability of an organism to use citrate as the sole source of carbon and energy. The medium contains citrate as the sole carbon source and inorganic ammonium salts (NH4H2PO4) as the sole source of nitrogen.
1.Dissolve above salts in deionized water.
2.Adjust pH to 6.9.
3.Add agar and Bromothymol blue.
4.Gently heat, with mixing, to boiling until agar is dissolved.
5.Dispense 4.0 to 5.0 ml into 16-mm tubes.
6.Autoclave at 121 degree C under 15 psi pressure for 15 minutes.
7.Cool in slanted position (long slant, shallow butt).
8.Tubes should be stored in a refrigerator to ensure a shelf life of 6 to 8 weeks.
9.The uninoculated medium will be a deep forest green due to the pH of the sample and the bromothymol blue.
Citrate utilization test is often part of a battery of tests used to identify gram-negative pathogens of Enterobacteriaceae family and environmental isolates. For instance, test kits such as the API-20E and Enterotube II include citrate utilization medium as one of the diagnostic tests. If the results are positive growth on the medium even without colour change will be considered as positive. A colour change in the medium would be observed if the test organism produces acid or alkali during its growth. The usual colour change observed is from green (neutral) to blue (alkaline). If the results are negative no growth is observed.
1.Inoculate Simmons citrate agar lightly on the slant by touching the tip of a needle to a colony that is 18 to 24 hours old.
2.Incubate at 35 degree C to 37 degree C for 18 to 24 hours. Some organisms may require up to 7 days of incubation due to their limited rate of growth on citrate medium.
3.Observe the development of blue colour as it changes from green colour along the slant which is denoted as alkalinization.
Adverse respiratory events (AREs) are leading causes of post-operative morbidity and mortality. Anesthesia is the use of medicine to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures (such as getting stitches). Giving as an injection or through inhaled gases or vapours, different types of anesthesia affect the nervous system in various ways by blocking nerve impulses and, therefore, pain.
Anesthesia can help control your breathing, blood pressure, blood flow, and heart rate. It may be used to:
Adverse Respiratory Events (ARE)
Adverse outcomes of such events are fatal and lead to Death & Brain Damage. Three mechanisms of injury are reported to account for highest adverse respiratory events:
Inadequate Ventilation: Insufficient Gas Exchange can produce the adverse outcome. Esophageal Intubation: Incubation between the two sides of the esophagus inadvertently.
Difficult tracheal intubation: Tracheal Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway. It is performed facilitate ventilation of lungs in severely ill, anesthetized patients.
Other’s are as listed below:
Residual neuromuscular blockade is an important postoperative complication associated to the use of neuromuscular blocking drugs and is commonly observed in the post-anesthesia care unit (PACU) after non-depolarizing neuromuscular blocking agents (NMBAs) are administered intra-operatively. Incomplete neuromuscular recovery can be minimized with acceleromyography monitoring. The risk of adverse respiratory events during early recovery from anesthesia can be reduced by intra-operative acceleromyography use.
Reintubation is a serious adverse respiratory event and the consequences include increased cardiac and respiratory complications, prolonged length of stay at the PACU, intensive care unit (ICU) and hospital, prolonged mechanical ventilator support, higher costs, and increased mortality. Overweight and obesity have also been identified as risk factors for postoperative respiratory complications. Most adverse respiratory events are considered preventable with improved monitoring such as:
Closed observation of the clinical factors and appropriate monitoring by well trained people are factors necessary to prevent adverse outcome. If you wish to discuss about any specific problem, you can consult a General Surgeon.
Glucose is the primary ingredient within the body which is turned into an energy source. This is what we use when we move, walk or make the slightest movements. To metabolize glucose into energy, your body needs insulin, which is a hormone produced within the pancreas. However, if the body doesn't react to the insulin or the pancreas is unable to produce enough, glucose cannot be converted into energy and thus results in type 2 diabetes.
Symptoms of type 2 diabetes
Causes of Type 2 diabetes
Some of the most common causes of Type 2 diabetes could be:
Reverse Diabetes
There three major factors that can help you prevent and reverse pre- and type II diabetes: proper diet and appropriate nutritional and herbal supplementation, exercise, and weight management.
1) Diabetes is curable :
Diabetes is mainly due deficiency of Insulin (hormone produced by Beta cells of pancreas), plus resistance to action of insulin, overweightor obesity and inactivity. Therefore, to treat diabetes we need drugs that initiate insulin secretion, reduce insulin resistance. In some cases insulin itself. Plus dietary control and regular exercise to maintain normal weight or reduce excess weight. Hence it can only be effectively controlled. Cure is not possible.
2) Eating Sugar or Sweets causes Diabetes :
It is incorrect to say that eating sweets and / or sugar causes diabetes. Basically excess food intake will lead to excess production of glucose. That puts excess load on insulin producing cells in pancreas due glucotoxicity. Also due to central obesity the fat around internal organs causes lipotoxicity affecting the beta cells. Therefore, excess food intake in general and weight gain are the reasons for diabetes.
3) Jaggery is better or safe in diabetes :
Jaggery and sugar both are essentially same. Both contain sucrose, as they are prepared from sugar cane juice. Hence eating either of these will increase blood glucose considerably. In jaggery there are some vitamins and a few antioxidants. But both are bad for a diabetic person.
4) Rice should not be eaten in diabetes :
Not really true. Because in south India this is the major or at times only main food. Rice has a high glycemic index so gets converted to glucose rapidly. So polished rice is not good. Brown rice is better. Quantity should be regulated. All other cereals also are converted glucose after digestion.
5)Allopathic Medications Damage Kidneys, so go for either Ayurvedic or Homeopathic Drugs :
In fact diabetes itself affects kidney, particularly the filtering membrane of glomerulurous (a filtering unit in the kidney). Even when diabetes fairly well controlled, kidney does get affected. The drugs used to treat diabetes help in overcoming kidney damage. Therefore it is wrong to think that modern drugs cause kidney damage. In fact some of the other drugs contain heavy metals (Bhasmas), which can be harmful to the kidney.
6) Sugar intake is essential for body :
Some people keep asking that eating sugar is very necessary for getting energy for the body tissues. This is not at all true. Because all the cereals like rice, jowar, wheat, ragi, bajra and other millets, contain starch as the main ingredient. Hence intake of each of these foods provides glucose after digestion. So there is no separate need for taking sugar.
Few things to be remembered and practiced are :
Pain is a feeling of distress that is caused by intense damaging stimuli. It is one of the most common reasons that compels the patient to consult a physician and take painkillers. In the long run, painkillers have adverse effects on our body. While most of the times, the cause of the pain is diagnosed, there are cases in which the cause remains undiagnosed. Homeopathy is a system of medicine that is based on symptoms and has no side effects and thus, it is most effective in the treatment of both muscle and joint pains.
Here we give you a list of common homeopathic pain medications that are prescribed to give relief to patients and the circumstances under which they can be used.
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