SummaryObjectiveRetinol binding protein 4 (RBP4) transports vitamin A (Retinol) in the blood and contributes mechanistically to the linkage between obesity, insulin resistance and associated comorbidities including type 2 diabetes mellitus, coronary artery and neoplastic diseases. Circulating RBP4 levels have variably been associated with body mass and gender differences. Many of these differences have been demonstrated after limited dietary interventions, and/or at single unique time points. This study investigated the impact of sex and age as biologic variables as well as high versus low fat diets on development of obesity, RBP4 levels and insulin resistance in C57BL/6J mice.MethodsMale and female C57BL/6J mice were fed for 400 days with either low or high fat diets. Female mice were also evaluated on same diets after ovariectomy or sham ovariectomy. Mice were monitored for changes in weight, circulating levels RBP4, glucose and insulin at 100‐day intervals and also by 2‐hour glucose tolerance tests.ResultsAll mice on low or high fat diets gained weight. Mice on high fat diets showed significantly greater weight gain than those on low fat. Male mice showed significantly greater weight gain compared with females on corresponding diet. Male mice compared with females already showed significantly higher RBP4 levels even before starting diets. Sex differences were maintained for more than 1 year. Gender differences in RBP4 were associated with significant differences in development of glucose intolerance and insulin resistance.ConclusionsMale compared with female C57BL/6J mice show significant gender differences in circulating RBP4 levels from 6 weeks of age, extending more than 1 year. Gender differences in RBP4 may be mechanistically associated with protection against glucose intolerance and insulin resistance. Targeting RBP4 pathways could be useful to disrupt gender differences in insulin resistance and disparities in comorbidities.

Background: There is increasing use of laryngeal mask airway in children because of ease of insertion and minimal disturbances in cardio respiratory system and lesser risk of airway injury during perioperative period as compared to endotracheal tube. It is also simple, well-tolerated, safe, reusable, cost effective method of airway management in paediatric patients. Intravenous propofol (1%) is a preferred induction agent for LMA insertion till date, while sevoflurane, a halogenated volatile inhalational, non-irritating anaesthetist agent with pleasant odour is also suitable for inhalational induction of children. This study was carried out to study and compare clinical efficacy of propofol and sevoflurane for laryngeal mask airway (LMA) insertion in children undergoing short surgical procedures.Methods: In this study, total 100 children of ASA grade I/II of either sex with age group 3-8 years, weighing between 10-20 kg were enrolled. They were induced with either sevoflurane (group S) or intravenous propofol (group P) 3 mg/kg. Then appropriate size LMA was inserted. Various parameters like jaw relaxation and ease of insertion attempts required hemodynamic changes were noted and compared in two groups.Results: In group P, 94% patients and groups S, 90% patients had full jaw relaxation. The LMA insertion was easy in 98% patients in groups P and 94% patients in groups S. In 98% patients of groups P and 96% patients in groups S, LMA was inserted successfully in first attempt. The mean time required for LMA insertion was 19.16±5.29 seconds in groups P and 20.8±6.39 seconds in groups S. Both the groups were comparable with respect to haemodynamic changes observed which were transient and clinically not significant though statically significant.Conclusions: Both the groups showed comparable and satisfactory LMA insertion conditions, hence both can be routinely used for induction of anaesthesia in children.

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Background And Aims: Parturients posted for LSCS present with physiological changes due to pregnancy and gravid uterus, may have associated co-morbidities, superadded by COVID 19 infection poses a real challenge for an anesthesiologist. Urgency in obstetric anesthesia and extreme precautions needed to avoid this contagious disease further increase the burden on the anesthesiologist. This study focuses on perioperative presentation, management, and outcome of patients in a tertiary level hospital. Method: 329 pregnant females with RAT or RTPCR positive for COVID 19 and undergoing cesarean section from 1st May 2020 to 31st July 2021 were included in this retrospective observational study. Data was collected and analyzed from OT, ICU, WARD records, patient medical and electronic records, and maternal mortality data. Results: Amongst 329 parturients, 98.48%(324/329) received spinal anesthesia, one received epidural anesthesia (0.30%) and 1.21%(4/329) required general anesthesia. The incidence of hypotension was 5.77% (19/329), managed with inj. Mephentermine without inotropes. The intraoperative course was uneventful except for one case of CRA, revived successfully. Nine patients (2.73%) required ICU care. Oxygen support by either nasal prongs or face masks was given to 3.95% (13/329) patients. Three patients (0.91%) required NIV support and three patients (0.91%) required invasive ventilation postoperatively. The overall mortality was 0.61% (2/329). The mean duration of hospital stay was found to be 8.2 ± 5.03 days Conclusion: Neuraxial anesthesia remains a technique of choice for LSCS and can be safely employed in the parturients even with moderate pneumonia. General anesthesia can be reserved for patients of severe covid pneumonia.