In this paper alternate mechanism for design and analysis of small size
stone crusher mechanism is discussed. The basic idea is to optimize the
design of the crusher which would be best suited for stone which need
crushing force of 3 Tons. Presently for reducing sizes of stones from
10cm x 10cm to 2.5cm x 2.5cm in quarries is laborious job and is done
manually our approach is to design a best optimum mechanism for said
Promoting the active participation of local communities in equitable and ecologically sustainable management of natural forests, thus contributing to increase income and reduce poverty for forest dependent communities, and developing a knowledge management system on community forestry. The majority of the Joint Forest Management areas showed that women participated actively in meetings, decision making and executing the works compared to before Joint Forest Management committee. Findings indicate the need to promoting tribal people for protection more forest area of each village for their sustainable livelihood.
Introduction- The aim of the study was to evaluate and compare the efcacy and safety of topical Tacrolimus (0.1%) as compared to topical Cyclosporine (0.05%) in treatment of vernal keratoconjunctivitis patients. Methodology- A Prospective, comparative, interventional study was conducted in 142 patients of VKC between February 2020 to august 2021 attending the ophthalmic outpatient department of our hospital. Patients were screened for inclusion and exclusion criteria and included in the study after obtaining informed, written consent from the patients or their guardian. Right eye was be treated with Cyclosporine (0.05%) eye drop th th th twice daily and the left eye was treated with Tacrolimus (0.1%) eye ointment twice daily for 2 months. Patients were followed up on 15 , 30 , 60 st day on medication. Then the treatment was withdrawn and patients were reviewed after 4 weeks. At each follow up and at 1 visit patients symptoms were graded, recorded and compared as Total Subjective Symptoms Score (TSSS) and Total Objective ocular sign Score (TOSS). Result -Both TOSS and TSSS decreased in both the eye consistently without any effect on Intra-ocular pressure. Improvement in scores was more in left eye. But scores increased after the withdrawal of drug, still lower than baseline scores. Conclusion - Disease has greater propensity in males. Both the drugs were found to be effective and safe, but 0.1% Tacrolimus eye ointment found to be superior than 0.05% Cyclosporine eye drop. Only side effect with tacrolimus eye ointment was stinging sensation on instillation of drug.
INTRODUCTION: Postoperative pain management is one of most important components of adequate postoperative patient care. Poorly treated pain contributes to patient suffering and may prevent rapid recovery and rehabilitation. Laparoscopic operative procedures have revolutionized surgery with many advantages : a smaller and more cosmetic incision, reduced blood loss, reduced postoperative hospital stay and pain, which cut 1 down hospital costs . AIMS AND OBJECTIVES:Aim of the study is to evaluate the efcacy of intraperitoneal instillation of ropivacaine for postoperative pain relief after laparoscopic cholecystectomy surgeries in terms of : Duration of analgesia, 24 hour postoperative analgesic requirement, Postoperative pain assessment, Postoperative hemodynamic changes like pulse rate, blood pressure and Complications (if any). MATERIALS AND METHODS: Study area -Command Hospital (Eastern Command), Alipore, Kolkata (operation theatre and ward). Study population - Patients posted for Elective Laparoscopic Cholecystectomy. Study period -Jan 2017 to June 2018 Study Time– From rst intraoperative intraperitoneal instillation of study drug to next 24 postoperative hours. Sample Size - 80 (40 in each group) RESULTS AND ANALYSIS: In our study, intraperitoneal instillation of Ropivacaine at the end of surgery provided analgesia for 5.54 ± 4.61 hrs. When compared with the saline group, it was about 2.22 ± 2.93 hrs, which was found to be statistically signicant (-0.004). In this study, Injection Tramadol was used for rescue analgesia for postoperative pain relief. SUMMARYAND CONCLUSION: This study has a few limitations. First, eighty study population may be underpowered for the study. Second, the surgeon performing the surgeries is not the same in every case which may alter the postoperative consequences. From this study it may be concluded that intraperitoneal instillation of Ropivacaine is effective for postoperative pain relief after laparoscopic cholecystectomy. From this study we also conclude that, intraperitoneal instillation of Ropivacaine is useful for postoperative pain relief for patients undergoing laparoscopic cholecystectomy in terms of duration of analgesia, rescue analgesic requirement and pain perception.
BACKGROUND AND AIM:Brachial plexus block is a safe, effective, low-cost anesthesia with good postoperative analgesia. Adjuvants to local anesthetics may enhance the quality and duration of analgesia. The aim of the study was to study the efcacy of a combination of 0.25% bupivacaine alone versus 0.25% bupivacaine and dexmedetomidine in brachial plexus block by supraclavicular approach. METHODS: This is a prospective double-blind study conducted on sixty patients of ASA1 and ASA2 posted for upper limb surgeries, randomized in a double-blind fashion into two groups. Group A (N-30) received 34ml of 0.25% bupivacaine with 0.5ml of distilled water and group B (N-30) received 0.5ml dexmedetomidine (50 μg) with 34ml of 0.25% bupivacaine as supraclavicular brachial plexus block with help of a nerve stimulator. Onset and recovery time of sensory and motor block, duration of analgesia, sedation scores, quality of block, and side effects compared in both groups. RESULTS: Baseline characteristics were well matched in both groups. The intraoperative hemodynamic recording was done at 15 min time intervals from the administration of the drugs. There was a reduction in heart rate, systolic blood pressure, and diastolic blood pressure 30 mins onwards in both groups. There was no signicant difference in the onset of sensory and motor blocks. Duration of sensory block was 299.57 ± 35.94 mins in Group A and 782.2 ± 82.76 mins in Group B, duration of motor block was 272.17 ± 37.31 mins versus 755.63 +/- 86.6 mins respectively, total duration of analgesia was 321 ± 35.46 mins versus 815.80 +/- 88.1 mins respectively. Ramsay sedation score was similar at arrival in both groups but in post-op, the score of 3 was noted in 0% (0/ 30) in Gr A and 93.3% (28/ 30) in Gr B . Quality of analgesia was also better in Group B. There were no signicant adverse events noted in both groups. CONCLUSION: This double-blind Randomized Controlled study showing the combination of dexmedetomidine 50 μg with 34ml of 0.25% bupivacaine is better than 0.5ml of distilled water with 34ml of 0.25% bupivacaine in the duration of sensory and motor block, with better sedation and quality of analgesia with the good safety prole in brachial plexus block by supraclavicular approach.
Introduction: To compare 0.25% bupivacaine with dexamethasone and 0.25% bupivacaine with clonidine for TAP block as post-operative analgesia in patients undergoing LSCS. A randomized prospective controlled study wa Study Design: s conducted in 100 patients undergoing LSCS. Participants were divided into 2 groups. Group A received 0.25% bupivacaine with dexamethasone 4mg.Group B received 0.25% bupivacaine with 75mcg clonidine. The postoperative pain was evaluated by VAS scoring. The average duration of analgesia with TAP Results: block for overall study population was 316.15min. The average VAS score in patients who received 0.25% bupivacaine with dexamethasone was 1.50 which is signicantly lower than for whom received 0.25% bupivacaine with clonidine which is 1.95. Further the duration of analgesia is longer in Group A than Group B. TAP block is safe and effective way of relieving post Conclusion: operative pain in LSCS patients. Addition of dexamethasone to bupivacaine signicantly enhances its effect in terms of block quality and analgesia duration as compared to clonidine
Introduction : Spinal anesthesia is one of the commonest and preferred mode of anesthesia for lower abdominal and lower limb surgeries because of its safety and faster post-operative recovery. Bupivacaine is the commonly used anesthetic for intrathecal administration. Drugs such as Fentanyl, Buprenorphine, Clonidine, Dexmeditomedine have been tried as adjuvants to increase the duration of Analgesia and decrease post-operative pain, but addition of these drugs is wrought with side-effects like hypotension and bradycardia. This study aims to compare the efficacy of Fentanyl and Buprenorphine as adjuvants to intrathecal Bupivacaine in lower abdominal surgeries. Methodology : A total of 112 patients undergoing lower abdominal surgeries where administered either the combination of Buprenorphine with Bupivacaine (56 patients, Group B) or Fentanyl with Bupivacaine (56 patients, Group F). Intraoperatively, patients’ vitals HR, NIBP, SpO2, ECG were monitored every 2 minutes once for the first 10 minutes, every 10 minutes once for the next 50 minutes, and 15 minutes once till the end of surgery. Motor and Sensory blockade, duration of Analgesia and Post-operative pain were also recorded. Results : There was no significant difference in the baseline characteristics and intra-operative vitals between the groups. Patients in Group B had a faster Motor and Sensory blockade, longer duration of analgesia and lesser post-operative pain as compared to Group F. None of he patients included in the study had significant intra-operative hypotension or respiratory depression. Conclusion : The addition of Buprenorphine to Bupivacaine is more efficacious than the addition of fentanyl to Bupivacaine and leads to better intra-operative and post-operative analgesia withourt significant side-effects.
Introduction: One of the indication of total abdominal hysterectomy and bilateral salpingo -oophorectomy is the patient is suffering from menometrorrhagia, excessive or irregular menstrual bleeding that occurs between or during a female's menstrual cycle. Menometrorrhagia is a indication of urogenital malignancy (such as cervical malignancy), uterine broids, hormonal discripancies and endometriosis. Other possible indications for TAHBSO are pelvic inammatory disease,ovarian cyst, cancer of overies, uterus and or cervix. If remains untreated this can lead to anemia. Aims And Objectives: Compare maximum sensory block level in each group (Smax), Period when Smax was rst achieved, Period for 2 segment regression of sensory block from its highest level, Period for block regression to level of T10 dermatome e. Maximum motor blockade achieved, Time to attain maximum motor block, Time for complete regression of motor block(modied Bromage score=6),To compare any difference in haemodynamic parameters(Spo2,mean blood pressure). Materials And Methods Study Setting:This study will be conducted in the gynaecology OTComplex of IPGME&R. Study Period: March 2017-August 2018 Definition Of Problem: Comparative evaluation of the effect of epidural volume extension on spinal block with 0.5% heavy bupivacaine for total abdominal hysterectomy such as Results And Analyses: Our study showed that the distribution of body weight between Group E and Group S. Body weight was normally distributed, it was found that there was no statistical signicance difference between the groups (p=0.4054). Distribution of ASAstatus in groups, In group E 25patient were. Summary And Conclusion: This technique is, however, not without its disadvantages, which draws special attention from an anesthesiologist such as rapid rise of spinal block, accidental migration of catheter in intravascular and intrathecal space along with an increased incidence of meningitis. In future We in subsequent case series will try to highlight the efcacy of this novel technique in patients of different setting with compromised cardiac functional status.
Aim:To study the onset and duration of sensory and motor blockade Introduction: Brachial plexus block provides a useful alternative to general anaesthesia for upper limb surgeries. Bupivacaine is one of the most frequently used local anaesthetic which has a longer duration of action of 3 to 8 hours but has drawbacks of delayed onset and patchy analgesia. Dexamethasone is a very potent glucocorticoid with very good anti-inammatory and analgesic activity. Materials and methods: A prospective, randomised single-blinded study was undertaken in patients posted for upper limb surgeries under the supraclavicular block. 60 patients with ASA class I and II were randomly grouped into two groups. Group I received 30ml bupivacaine 0.5% and Group II received a combination of 28ml bupivacaine 0.5% and 2ml dexamethasone 8mg. 30ml solution is used for a single shot blockade of supraclavicular brachial plexus. Results: Group II patients had a faster onset of action and prolonged duration of action. Discussion: The addition of dexamethasone 8mg to bupivacaine 0.5% speeds the onset of sensory and motor blockade also prolongs the duration thus provides better analgesia and reduces the requirements of rescue analgesics. Conclusion:Acombination of bupivacaine 0.5% and dexamethasone 8mg has a signicantly faster onset and prolonged duration of action.
Background and Aim : Background the present study was planned to evaluate the effect of 0.5% ropivacaine with adjuvants 0.15mg clonidine or 8 mg dexamethasone with consideration to the onset and duration of sensory-motor blockade, hemodynamic variables, postoperative analgesia and adverse effects. Material and Methods The study was conducted in the department of Anaesthesiology, Darbhanga medical college and hospital from April 2018 to December 2019. 105 consenting patients were included scheduled for moderate duration of upper limb surgeries of orthopedics and general surgery. Results : 124 patients were assessed for eligibility. Eleven patients did not give consent for participation and eight was not included due to not meeting inclusion criteria. 105 patients were enrolled and randomized to any of the three groups; 35 each in the intervention and the comparator groups. Finally, 35 patients in placebo and dexamethasone group each and 35 patients in clonidine group were analyzed, the rest being excluded due to failed block. Conclusion : we conclude that dexamethasone as an adjuvant is a good choice to prolong the duration of postoperative analgesia without any serious adverse effect. However, prolonged motor block is a matter of concern and the search for an adjuvant that selectively prolongs analgesia without impairing motor function continues.
Background And Aims: Both dexmedetomidine and dexamethasone have individually been shown to be benecial as an adjuvant to ropivacaine. We compared the efcacy of combination of ropivacaine with dexmedetomidine and ropivacaine with dexamethasone in ultrasound guided supraclavicular brachial plexus (SCBP) block. Material And Methods: In this prospective randomised double blind controlled trial, 60 ASA physical status I/II patients undergoing elective upper limb surgery under ultrasound guided SCBP block with 30 ml of 0.5% ropivacaine were randomised into three groups. Group 1 (n = 20) received 1 μg/kg of dexmedetomidine, and group 2 (n = 20) received 8 mg of dexamethasone in addition to ropivacaine, while group 3 (n = 20) received only ropivacaine. The primary outcomes studied were onset and duration of sensory and motor block. Secondary outcomes included duration of analgesia, total analgesic consumption in 24 h postoperatively and quality of block. ANOVA and Chi-square test were used to compare results on continuous measurements and categorical measurements, respectively. Results: Onset of sensory and motor block was faster in group 1 (13.5 ± 4.1 and 17.0 ± 4.1 min) and group 2 (15.6 ± 3.6 and 18.5 ± 3.7 min) as compared to group 3 (20.1 ± 5.3 and 24.9 ± 5.6 min; P < 0.001). Block duration was signicantly longer in group 1 and group 2 than in group 3. Duration of analgesia was prolonged in group 1 and 2 (1218.0 ± 224.6 and 1128.0 ± 207.5 min, respectively) as compared to group 3 (768.0 ± 273.7 min; P < 0.001). Twenty four hours analgesic consumption postoperatively was reduced in the two study groups. Conclusion: Both dexmedetomidine and dexamethasone when used as adjuvants to ropivacaine for SCBP block, block onset time, and prolong' block duration
Background And Aims: We compared the block quality and characteristics between dexmedetomidine versus buprenorphine as an adjuvant to bupivacaine in Peripheral nerve stimulator guided supraclavicular brachial plexus block. The quality of block by dexemetomidine was found to be better than buprenorphine and thus has opioid sparing action. Duration of sensory and motor block along with duration of analgesia were the primary outcomes studied. Methods:Total 80 patients of either sex, 40 patients in each group presenting for upper limb surgeries Each participant fullling our inclusion criteria then included. Results: In our study group D represents the group that received dexemotomidine while group B represents the group that received buprenorphine Mean duration of sensory block in group D was (704.05± 123.16) min and in group B it was (543.25 ± 60.14) min while mean duration of motor block in Group D (& (662.05± 121.83) was longer than Group B (397.50±56.51) and Duration of analgesia in Group D (782.88 ±115.44) was also longer than Group B (636.25±53.62).The results were statistically signicant. Conclusion: Dexmedetomidine I dose of 1ug/kg prolongs the duration of sensory and motor blockade and duration of analgesia as compared with buprenorphine when used as an adjuvant to 0.5%bupivacaine in supraclavicular brachial plexus block, with no major adverse side effects
 Kanazi GE, Aouad Mt, KJabbour-Khoury SI et al: Effect of low dose dexmedetomidine or clonidine on the characteristics of spinal bupivacaine block. Act a Anaesthesiol Scand 2006;50:222-7  Hala EEA, Mohamed SA, Hend Y. Dose related prolongation of hyperbaric bupivacaine spinal anaesthesia by dexmedetomidine. Ain Shams J Anaesthesiology 2011;4:83-95  Kim JE, Kim NY, Lee HS, Kil HK. Effects of intrathecal dexmedetomidine on low dose bupivacaine spinal anaesthesia in elderly patients undergoing transurethral prostectomy. Bio Pharm Bul 2013;36;959-965.  Mahendru V, Tewari A, Katyal S et al. A Comparison of intrathecal dexmedetomidine, clonidine, & fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study. J Anaesthesiol Clin Phrmacol 2013;29:496-502  Soumya samal et al: Intrathecal buterphenol or intrathecal dexmedetomidine for post operative analgesia a comparative study: healt agenda, vol 2. Issue 1. Jan 2014  Dexmedetomidine in anaesthesia practice: a wonder drug? IJAaug 2014 by S K Harsoor  Sudheesh K, Raghvendra Rao R S, Kavya M, Aarthi J, Rani D D, Nethra S S. Comprative study of 2 doses of intrathecal dexmedetomidine as adjunct with low dose hyperbaric bupivacaine in ambulatory perianal surgeries. A prospective randomized controlled study. Indian J Anaesth 2015;59:648-52  El-Attar A, Aleen MA, Beltagy R, Ahmed W. A comparative study of intrathecal dexmedetomidine and fentanyl as additives to bupivacaine. Res Opin Anesth Intensive care 2015;1:43-9  Kurhekar P, Kumar SM, Sampath D. Comparative evaluation of intrathecal morphine and intrathecal dexmedetomidine in patients undergoing gynecological surgeries under spinal anaesthesia. A prospective randomized double blind study. Indian J anaestg 2016;60:382-7
INTRODUCTION Abdominal hysterectomy (AH) is a quite common gynaecological surgical procedure and electively done under central neuraxial blockade. AH is performed for malignant as well as benign indications such as uterine leiomyoma, persistent vaginal bleeding, or pelvic organ prolapse. AIMS AND OBJECTIVES Compare the onset of motor and sensory block. Find out the duration of the sensory and motor blockade. Observe intraoperative hemodynamic changes and assess post-operative analgesia requirements in 24 hour. Duration of analgesia assessed by requirement of rst rescue analgesic. Observe any untoward incident during intraoperative and post-operative period and managed accordingly MATERIALS AND METHODS Study Area: Department of Anesthesiology & critical care, DARBHANGAMEDICALCOLLEGE AND HOSPITAL. Study Population: Adult patients (30- 65 years) undergoing elective abdominal hysterectomy with regional anaesthesia were included for this study. Study Period:January 2019 to March 2020 Sample Design: Subjects were divided into two groups (n=35) equal in numbers and they sampled as per computerized randomization chart. These patients were divided into two groups, group B (with epidural 0.5% bupivacaine and 100g fentanyl) and group R (with epidural 0.75% ropivavaine and 100g fentanyl). Study Design: Prospective, open, randomized, controlled study. RESULTS: In Our study showed that 3.38kg/m2 and 24.86 3.60 kg/m2in group B and R respectively. The duration of surgery was 100.86 9.35minutes and 98.86 8.32 minutes and the duration of stay, was4.86 0.81days and 4.60 0.914 days in group B and group R respectively. Now with comparison of both groups, time to onset of sensory block (uptoT6) has signicant variation. But the other parameters namely, time to onset of motor block, two segment regression or duration of sensory block, rescue analgesia timing and complete motor recovery time were comparable and not signicant statistically in both groups. SUMMARY & CONCLUSIONS To conclude that in the present study using 0.5% bupivacaine with fentanyl and 0.75% ropivacaine with fentanyl epidurally, ropivacaine produced an earlier onset but similar duration of sensory block. The onset, quality and duration of motor block werecomparable in both the groups. It is important that new local anaesthetics with lower cardiotoxic property are adopted to ensure that regional techniques using large amounts of local anaesthetics remain safe with minimal complications. The recovery prole of ropivacaine may be useful where prompt mobilization is require
Background: Various intrathecal additives are added to local anesthetics to increase the speed of onset, improve the quality, and prolong the inuence of spinal anesthesia. Midazolam has a synergistic effect on postoperative analgesia when administered intrathecally with bupivacaine. Opioids such as fentanyl are extensively used as an adjunct to local anesthetics in neuraxial blockade to enhance the duration of postoperative analgesia. Aim: The aim of our study was to compare the effects of intrathecal midazolam(1mg) and fentanyl (25 micrograms) as additives to intrathecal hyperbaric bupivacaine 0.5% (15mg) with spinal anesthesia.Materials and Methods: Prospective, observational study was conducted at SRI SIDDHARTHAMEDICAL COLLEGE AND RESEARCH INSTITUTE,TUMKUR. from 1st Jan 2021 to 30th June 2022 on 94 patients. Results: In Bupivacaine and Midazolam group, mean duration of surgery was 84 ± 12.3 minutes and in Bupivacaine and Fentanyl group, mean duration of surgery was 92 ± 14.4 minutes. In Bupivacaine and Midazolam group, mean time for onset of sensory block was 7.1 ± 0.9 minutes and in Bupivacaine and Fentanyl group, mean time for onset of sensory block was 6.9 ± 1.1 minutes. In Bupivacaine and Midazolam group, mean time for onset of motor block was 7.6 ± 1.3 minutes and in Bupivacaine and Fentanyl group, mean time for onset of motor block was 8.1± 1.2 minutes. In Bupivacaine and Midazolam group, mean duration of sensory block was 213.6 ± 16.1 minutes and in Bupivacaine and Fentanyl group, mean duration of sensory block was 218.3 ± 19.2 minutes. Conclusion- The onset of sensory and motor blockade was comparable in Fentanyl with Bupivacaine and Midazolam with Bupivacaine. Additional of intrathecal Fentanyl prolonged the duration of analgesia signicantly than that of Midazolam. There was signicantly less consumption of rescue of analgesia among patients with Fentanyl with Bupivacaine than Midazolam with Bupivacaine. The duration of postoperative analgesia was also signicantly prolonged in the fentanyl and midazolam groups
INTRODUCTION: Regional anaesthesia is the preferred technique for most infra-umbilical surgeries. It allows the patient to remain awake, minimizes or completely avoids the problem associated with airway management. With spinal anaesthesia, the onset of anaesthesia is more rapid allowing the surgical incision to be made sooner and also provides post operative analgesia. AIM: To determine the duration of analgesia determined by the rst demand for rescue analgesia in two groups of a dened study population. To compare intraoperative hemodynamics between two groups of population. To note the incidence of any complications in either group, specically sedation and pruritus. MATERIALS AND METHODS: This study was undertaken in Command Hospital (EC), Kolkata (West Bengal, India) during the period Mar 2017 to Feb 2018. One hundred twenty patients, scheduled for infra-umbilical surgeries belonging to ASAI and II were included in the study. The study population was randomly divided into two groups with 60 patients in each group. RESULT: Association of ASA vs. group was not statistically signicant (p=0.6985). Association of Comorbidity vs. group was not statistically signicant (p=0.9833). Association of diagnosis/surgery vs. group was statistically signicant (p=0.0301). We found that in group-I, the mean duration of motor block (mean ± s.d.) of patients was 359.3333 ± 34.3431 min. In group-II, the mean duration of motor block (mean ± s.d.) of patients was 265.7167 ± 28.4737 min. Difference of mean duration of motor block vs. group was statistically signicant (p<0.0001). CONCLUSION:Intrathecal dexmedetomidine with 0.5% hyperbaric bupivacaine produces excellent surgical analgesia and an extended analgesia in postoperative period. Intrathecal dexmedetomidine with 0.5% hyperbaric bupivacaine increases the duration of sensory and motor blockade.
Background: Subarachnoid block is a simple technique that provides a deep and fast surgical block through the injection of small doses of local anaesthetic drug in Subarachnoid space. Various local anesthetic agents have been used in subarachnoid block since their introduction, isobaric drugs along with opioids provide excellent combination of shorter motor and longer sensory block which is useful for short duration infraumbilical surgeries. Methods: The present study is a prospective, comparative and clinical study between age group 18-45 years of either sex belonging to ASA grade I and II undergoing elective infra-umbilical surgeries. 40,40 patients were taken into each group. Mean duration of surgery in each group was around 90 minutes. Perioperative vitals like heart rate, blood pressure, oxygen saturation, ECG were recorded. Motor block was assessed through modied Bromage scale and post operative pain was assessed through VAS visual analogue scale , also need for rescue analgesia was monitored postoperatively. Results: We found that 150 microgram intrathecal morphine added as an adjuvant to 0.5% isobaric ropivacaine provided prolonged duration of analgesia and early recovery as compared to 150 microgram intra thecal morphine added with 0.5% isobaric levobupivacaine in patients undergoing infra-umbilical surgeries without causing signicant hemodynamic variation and adverse effects. Conclusion: In present study, we conclude that time of onset of sensory block was more and duration of sensory and motor block was less in isobaric ropivacaine with morphine as compared to isobaric levobupivacaine with morphine. Which revealed that ropivacaine group provides good postoperative analgesia and shorter motor block, that leads to early recovery and better patient satisfaction So, ropivacaine with morphine seems to be better as compared to levobupivacaine with morphine group.
INTRODUCTION Lower limb surgeries may be performed under local, regional (spinal or epidural) or general anaesthesia, but neuraxial blockade is the preferred mode of anaesthesia. Spinal block is still therst choice because of its rapid onset, superior blockade, low risk of infection as from catheter in situ, 1 less failure rates and cost-effectiveness. Intrathecal local anaesthesia alone is associated with relatively short duration of action and thus early analgesic intervention is needed in post-operative period. AIMS AND OBJECTIVES With use of dexmedetomidine in 3 different graded doses with hyperbaric bupivacaine intrathecally as regional anaesthesia for lower limb surgeries. MATERIALS AND METHODOLOGY This Prospective double blinded randomized controlled study. The study will be conducted in adult patients aged between 18-50 years undergoing lower limb surgeries under spinal anaesthesia in orthopedic OT, dept. of Anaethesiology, Medical college & hospital, Kolkata. Duration of the study One year (9 months for data collection & 3 months for data analysis, review& report writing). Total 63 patients in our study. RESULTS We found the mean of two segment regression time from highest sensory level in Group B was 130.56min; in group C was 171.34min; ingroup D was 217.85min So, block regression was signicantly slower with the addition of intrathecal dexmedetomidine (Group D) as compared to group C & B ( P < 0.0001) The mean regression time to S1 from highest sensory level for Group Bwas 289.43 min ( SD- 12.43) For Group C, the mean regression time to S1 from highest sensory level was 402.71 min ( SD- 28.60) For Group D, the mean regression time to S1 from highest sensory level was 584.43min ( SD- 38.92) Overall the mean regression time to S1 from highest sensory level was 425.52 min ( SD- 125.71) The sensory regression time to S1 from highest sensory level was signicantly higher with increasing dose of dexmedetomidine i. e. D>C>B . (P< 0.0001). CONCLUSION We recommend the use of 10mcg of intrathecal dexmedetomidine as an adjuvant to bupivacaine as it seems to be a good alternative to other additives for long duration surgical procedures due to its profound intrathecal anesthetic and analgesic properties. It provides good quality of intraoperative analgesia, thermodynamically stable conditions, minimal side effects, and excellent quality of postoperative analgesia.
Context: Non surgical periodontal therapy is the gold standard treatment for periodontitis. But the invasive nature of subgingival microorganisms makes the use of antimicrobials inevitable. These antimicrobials can be used systemically and locally. Due the side effects posed by systemic administration of antibiotics local drug delivery is more favourable. Various local drug delivery agents are commercially available for periodontal therapy. Studies have shown that azithromycin is effective against periodontal pathogens so, it can be used in periodontitis treatment. But the use of azithromycin as local drug delivery agent is rare. Aims: The present study aims at formulation of 0.5% azithromycin gel as local drug delivery agent for periodontal therapy with PLGA as vehicle and invitro drug release evaluation in articial saliva. Settings and Design: Formulation of 0.5%azithromycin was done and articial saliva prepared. Azithromycin gel was placed in a dialysis tube. The dialysis tube was then placed in a beaker containing 100ml of articial Saliva. A total of eight samples were collected for a period of seven days. The amount of drug release was estimated using HPLC. Results: The results showed that the concentration of azithromycin in samples collected was greater than the minimum inhibitory concentration of most the periodontal pathogens. Conclusions:The formulation of 0.5% azithromycin can be used as local drug delivery agent adjunct to scaling and root planning.
Background: Spinal anaesthesia is the preferred anaesthetic technique in lower abdominal surgeries but in case of short surgeries (< 60 min), appropriate choice of local anaesthetic is of prime importance to prevent problems like prolonged motor block, delayed ambulation and delayed micturition postoperatively. Preservative free 2-Chloroprocaine has recently come up as a good alternative as compared to commonly used local anaesthetics. Aim: The aim of this study was to compare the efcacy between 1% 2-Chloroprocaine and 0.5% Bupivacaine (heavy) in terms of early block resolution and early ambulation. Material And Methods: This prospective, randomised, double blinded, comparative study was conducted in the Department of Anaesthesiology, North Bengal Medical College and Hospital. One hundred and ten (110) patients of ASA physical status I or II and age of 18-60 yrs undergoing lower abdominal surgeries under spinal anaesthesia were chosen and randomly divided into two groups, Group A and Group B. Group A received 40 mg (4ml) of intrathecal 1% preservative free 2-Chloroprocaine and Group B received 12 mg (2.4ml) of intrathecal 0.5% Bupivacaine (heavy). After administration of intrathecal drugs, vital parameters were monitored and any intraoperative complications recorded. Onset and height of sensory block were monitored by pinprick method and degree of motor block was monitored by modied Bromage Scale – (0-3). Time to reach readiness for surgery, duration of sensory block and motor block, time to ambulation and micturition, any supplementation required and any complications were recorded. The data were analysed using appropriate statistical tests. Results: The patients in Group A had a lower duration of motor block in comparision to those in Group B [81 ± 11 min vs 142 ± 29 min (P<0.001)]. The duration of sensory block was also signicantly lower in Group A as compared to Group B [100 ± 14 min vs 188 ± 39 min (P<0.001)]. Also patients in Group A had lower time to ambulation than those in Group B[142 ± 24 min vs 280 ± 51 min (P<0.001)] as well as lower time to micturition as compared to those in Group B[204 ± 37 min vs 365 ± 57 min (P<0.001)]. Conclusion: For spinal anaesthesia in lower abdominal short surgical procedures, intrathecal 2-Chloroprocaine produces a satisfactory surgical block and is a better drug in comparison to hyperbaric bupivacaine with respect to faster block resolution and ambulation.
Aim:To study the onset and duration of sensory and motor blockade Introduction: Brachial plexus block provides a useful alternative to general anaesthesia for upper limb surgeries. Bupivacaine is one of the most frequently used local anaesthetic which has a longer duration of action of 3 to 8 hours but has drawbacks of delayed onset and patchy analgesia. Dexamethasone is a very potent glucocorticoid with very good anti-inammatory and analgesic activity. Materials and methods: A prospective, randomised single-blinded study was undertaken in patients posted for upper limb surgeries under the supraclavicular block. 60 patients with ASA class I and II were randomly grouped into two groups. Group I received 30ml bupivacaine 0.5% and Group II received a combination of 28ml bupivacaine 0.5% and 2ml dexamethasone 8mg. 30ml solution is used for a single shot blockade of supraclavicular brachial plexus. Results: Group II patients had a faster onset of action and prolonged duration of action. Discussion: The addition of dexamethasone 8mg to bupivacaine 0.5% speeds the onset of sensory and motor blockade also prolongs the duration thus provides better analgesia and reduces the requirements of rescue analgesics. Conclusion:Acombination of bupivacaine 0.5% and dexamethasone 8mg has a signicantly faster onset and prolonged duration of action
INTRODUCTION:The recent trend in health care centres everywhere is to provide cost effective care to the patients. There is an increasing trend towards ambulatory day care surgery and rapid discharge of the patients. The operation of inguinal hernia or incisional hernia and even simple ligation surgeries are done without much complexities nowadays and can be completed in 60-90min without much intra or postoperative complications. Hence these have become an ideal procedure for outpatient setting and thereby reducing length of hospital stay. AIMS AND OBJECTIVE:A comparative study of efcacy, potency and recovery of intrathecal 0.5% ropivacaine with fentanyl and 0.5% levobupivacaine with fentanyl in lower abdominal surgeries in patients of 18-60years of age. MATERIALS AND METHOD: This is a prospective, comparative, observational study was conducted on 60 patients undergoing various lower abdominal surgeries under subarachnoid block (SAB) at Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal. This study was conducted over a period of 24-month. Approval of the Institutional Ethics Committee was taken. Awritten informed consent in the local language was taken from every patient. RESULT AND ANALYSIS: In RF 5 patients (17%) had onset at 3min, 17patients (57%) at 6min, 7 patients (23%) at 9min, 1 patient (3%) at 12min. In LBF 8 patients had onset at 0 min, 22 patients had onset at 3min. p value is less than 0.0001 which is statistically signicant. In RF, 23 patients (77%) had duration of motor block for 150min and 7 patients (23%) had for 180min. In LBF, 26 patients (87%) had duration of motor block for 210 min and 4 patients (13%) had for 180min. The p value is less than 0.0001, which is statistically signicant. SUMMARYAND CONCLUSION: This study was to compare potency, efcacy and recovery between the two groups of drugs. A potency of a drug is a measure of drug activity expressed in terms of the amount required to produce an effect of given intensity. Here both the drugs in comparison was given in equal concentration and found that levobupivacaine produced higher effect, reached Bromage 3 in lesser time than ropivacaine. So levobupivacaine was more potent drug. Efcacy is the ability to get a job done satisfactorily
Background: Pain relief is imperative to success of a surgical procedure. Provision of adequate and effective anesthesia has been challenging. Due to its lower cost, simpler technique and higher patient acceptance spinal and epidural anesthesia are fast becoming the procedure of choice for lower limb and lower abdominal surgeries. : A prospective, observational study was conduc Material ted in tertiary centre teaching hospital. Total 76 cases (randomly divided in two groups) undergoing elective lower abdominal surgeries, during the study period and meeting the inclusion and exclusion criteria. Group L: Received 15ml 0.5% isobaric levobupivacaine by epidural anesthesia. Group B: Received 15ml of 0.5% isobaric bupivacaine by epidural anesthesia. : Majority of the cases belonged to the a Results ge group of 40 to 49 years. The age distribution was similar in the two groups. There was a female preponderance in both the groups. The distribution was similar in the two groups. Weight and height were similar in the two Groups. The onset and time to reach T6 level was similar in the two Groups. There was no statistically signicant difference between both the groups. When assessed according to the duration of sensory analgesia, it was observed that the duration was signicantly longer in cases in the levobupivacaine Group (417.26 ± 9.13 minutes) as compared to bupivacaine Group (391.37 ± 9.18 minutes). The changes in heart rate, blood pressure and respiratory rate between the two groups were clinically and statistically not signicant. Both levobupivacaine and bupivacaine groups did not exhibit signicant side effects. levobupivacaine can be used as Conclusion: a safe alternative to bupivacaine for epidural anesthesia in lower abdominal surgeries. It can be effectively concluded from the present study that Levobupivacaine has longer duration of sensory analgesia and slower onset of motor block as compared with bupivacaine.
The present work focuses on the application of Taguchi technique and Analysis of Variance for investigating the effect of machining parameters such as Depth of cut, Feed and spindle speed on Tool life for machining of EN08. The results obtained were used to find out the main factors affecting the Tool life. Linear regression equation was developed to establish a correlation between the machining parameters and Tool life. Spindle speed was found to be the most influencing factor.
INTRODUCTION : Blunt trauma abdomen is very common in India. In our institute in K.D Medical College Mathura we manage liver and spleen injury with (NOM), MIS and Open laparotomy . The aim of this study was to compare NOM and MIS and RS in Grade1,2,3 liver and spleen injuries . We managed 27 cases of blunt trauma abdomen in K.D.Medical college. Mathura from Nov 2019 –MATERIAL AND METHOD: June 2022 with Grade 1,2,3 liver and spleen injury.It is retrospective Comparative Analytical study in Grade 1,2,3 liver and spleen injury between the 2 groups of treatment NOM and f NOM . It was hypothesize in our study that NOM is comparatively more benecial inRESULT: liver and spleen injury than in comparison to MIS,RS but hypothesis was rejected and p value was .018 signicant at p< .05 . InCONCLUSION : our institute, various treatment options, Nonoperative conservative management, f NOM depends upon the patient hemodynamic status , haemoperitoneum, grade of liver and spleen injury.
In this research article we synthesized 1,2,4 (H) triazole 3-amine as a core molecule from aminoguinidine and formic acid in basic medium sodium 0 carbonate heated at 120-123 C for 12 h. It has excellent medicinal application. In synthetic modication especial emphasis on free –NH as a20 pharmacophore which is synthetically active group. A series of 03 innovative molecules were synthesized by isocyanate in ethanol solvent at 0 C to room temperature, 2 h. Urea as important moiety found in synthesized molecule. The purity of all compounds will be checked by TLC and wherever found necessary the compounds will be puried by column chromatography. The structure of all compounds will be established on the 1 13 basis of microanalysis, FTIR, HNMR, CNMR, DEPT and mass spectral data. Antibacterial and antifungal evaluation of synthesized derivatives in vitro has done by Kirby Bauer Method. NCIM provides pure, non-pathogenic, viable and authentic cultures with their standard code number and testing symbols; Ciprooxacin (10 lg) and uconazole (5 lg) were used as standard antibacterial and antifungal drugs, respectively. Minimum zone of inhibition & % activity has been determined; from these values its predicted that antibacterial value of the derivatives are more prominent that core molecule against Gram positive bacterial strains Staphylococcus aureus & Bacillus subtilis. Antifungal activity is more prominent in TZA2 derivative where urease moiety connected with cyclohexyl group against Aspergillus niger & Penicillium Chrysogenum
The incidence of oral squamous cell carcinoma (OSCC) remains high .Oral and oro-pharyngeal carcinomas are the sixth most common cancers in the world. Aim- The present study was conducted in a tertiary care cancer hospital in India to evaluate recurrence in squamous cell carcinoma of oral cavity. The present study was carried out in department of pathology at regional cancer tertiary centre from .Material And Methods- February 2011 to June 2021 .The cases were selected on basis of inclusion and exclusion criteria. The average age of the patients sufferingResults- from oral squamous cell carcinoma ( 48.8 years) with male predominance (M:F =9.7:1). Recurrence rate was 23.6%. Most common site of presentation was buccal mucosa. The most common grade in recurrent as well non recurrent cases was moderately differentiated . 388 patients out of 1000 had pathologically node positive disease. The recurrence rate among node positive was 27.5 % (107 out of 388). Non-cohesive pattern was more common in recurrent cases (55.92%) . Risk of recurrence was 82.62% with depth of invasion > 5 mm . Extranodal extension was seen in 34 cases (14.40%) . Perineural invasion , lymphovascular invasion and bone invasion was seen in 44.5% , 26.7% and 22.45% respectively . Out of total 236 recurrent cases, 3 year survival rate was 64.8%, 5 year survival rate was 34.7% and disease free survival rate was 81%. Conclusion- Squamous cell carcinoma of oral cavity has poor overall prognosis with high tendency to recur. Risk factors for recurrence are -lymphatic permeation, depth of invasion – 5 mm or more, poorly differentiated tumor, non- cohesive pattern of invasion .
Background: It is important to control the pain associated with root canal treatment (RCT) in endodontic. Pain accompanying fear and anxiety due to endodontic treatment can be reduced by anesthetic techniques. The present study aims to compare the effect of articaine versus lidocaine local anesthesia for inferior alveolar nerve block (IANB) and long buccal nerve block on pain during RCT. METHODS: Twenty patients diagnosed with symptomatic irreversible pulpitis of mandibular posterior tooth were selected. The patients randomly received either cartridge of lidocaine or articaine using IANB and long buccal nerve block. The patients were randomly divided into two groups of ten. Group 1: patients received IANB and long buccal nerve block 2% lidocaine with 1:100000 epinephrine. Group 2: patients received IANB and long buccal nerve block with 4% articaine with 1:100000 epinephrine. Before the Injection, the patient received all information about the visual analysis scale (VAS). Pain was evaluated using VAS scale in numberic value 1 to 10 number. The pain was evaluated at three different stages: before administration of LA, after immediate access opening, and after immediate obturation procedure. Data were analyzed using various suitable statistical tests. RESULT: The mean value of efcacy of pain before administration of local anesthesia (LA) was 8.50 ± 0.97 for lidocaine and 8.30 ± 0.48 for articaine had no signicant difference. A signicant difference was observed at two different duration after immediate access opening and after immediate obturation where articaine has a lower mean value 3.60 ± 1.08 and 1.60 ± 0.17 respectively (P>0.05) as compared to the mean value of lidocaine 4.10 ± 1.10 and 1.60 ± 0.17 respectively Conclusion: Within the limitations of the study, in cases of symptomatic irreversible pulpitis articaine 4% did not alleviate pain much and showed better anesthetic efcacy than 2% lidocaine with IANB and long buccal nerve block.
Background: Functional endoscopic sinus surgery (FESS) is most widely recognized surgery done for management of chronic sinusitis. The aim of this study was to compare the optimization of operating conditions produced by either 100 μg or 200 μg oral tablet clonidine as the mainstay for circulatory manipulation during Functional Endoscopic Sinus Surgery. Method: A double-blind randomized comparative study was done in 60 cases divided into two groups. Group 1(n=30) patients were given 100 μg tablet clonidine; group 2(n=30), patients were given 200 μg of tablet clonidine orally 1 hour 30 minutes before surgery with 75ml water. Hemodynamic monitoring (HR, NIBP, SBP, DBP, MAP, SPO , ETCO ). Quality of bloodless surgical eld created intraoperatively was assessed2 2 by Fromme-Boezzart scale, Likert's scale at the end of procedure. Postoperatively, patients were assessed using Brussel's sedation score, and adverse effects like Bradycardia, Somnolence, Delayed recovery were recorded. Result: No statistically signicant difference seen in age, weight, gender, and ASA grading in both groups. Comparison of quality of surgical eld created, assessment through Fromme-Boezzart grading system and Surgeon's satisfaction using Likert scale between both the groups was not statistically signicant between the groups (P-value >0.05). We infer that both doses of clonidine tablets were equally effective in creating bloodless surgical eld. Conclusion: Non inferiority of 100microgram oral clonidine compared with 200 microgram oral clonidine for induction of hypotension during FESS surgery with less side effects and creating an intraoperative blood less surgical eld.
It deals with the design and implementation of Fast Fourier Transform (FFT) algorithm which can be uti- lized for wireless-communication. The computational scheme is two dimensional and implementation of this scheme on VIRTEX 5 LX330 FF1145 based XILINX's FPGA. This algorithm written in VHDL Language, which is verified and simulated in the MODEL SIM SE tool This provides new methodology to design and develop the processor for the Digital Signal processing aspects, and is implemented on the basis of pipelined architecture and Fast Fourier Transform approach. The proposed design has successfully worked on VIRTEX-5 FPGA, and it is applicable wireless communications. This will provide new era of the DSP processing technique and has the capability to extend the application to the REAL TIME ENVIRONMENT, which will provide a unique solution.
Background: Breast cancer is a major public health problem worldwide. It's the most common cause of death from cancer in women, it considers a heterogeneous disease, shows variable morphological and biological features, they have different clinical behavior, and prognoses, and respond to therapy differently despite similarities in histological types, grade, and stage. The classication aims for an accurate diagnosis and prediction of behavior, however, histological classication isn't enough in this era of personalized medicine, this results in « overtreatment » of many patients, so, molecular proling allows tumors to be dened by the expression pattern or genomic alteration of thousands of genes. A Methods: retrospective, descriptive and analytic study was performed among 1040 women with invasive breast carcinoma, which was diagnosed in the department of surgical pathology at University Hospital Center of Hassan 2 of Fez in Morocco, during a period ranging from 2012 to 2019. The prevalence of different molecular subtypes of breast carcinoma was estimated, in addition, clinicopathological features such as age, tumor size, tumor grade, lymph node involvement, hormonal receptors prole, and HER2 status have been compared. The mean age of diagnosis was Results: 49.5 years (DS12,5 years, 17-88 years), among these, 637 (55%) were under 50 years. NOS invasive breast carcinoma was the histological type the most common in 1030 (89%), with an SBR II in 60% of cases. The Mean tumor size was 2.8cm. Axillary lymph nodes (LN) were metastatic in 60% of cases. 76% of cases showed positive staining for estrogen receptors, 75,5% for progesterone receptors, and 18,5% for HER2/neu. Luminal A subtype was found in 22% of patients while Luminal B was present in 62,5% of patients, HER2 enriched in 5%, and triple-negative (TN) in 10,5 % of cases. There is signicant difference between the 4 subclasses by age (P=0.02), SBR grading (p<0,0001), tumor size (p=0,05), lymph node metastasis (0,0001). There are more young women in HER2 enriched and luminal B subtypes than in luminal A and TN subtypes, while the rate of older women is increased in luminal A subtypes. The proportion of patients with histological grade III in the TN subtype and HER2 subtype, is signicantly increased (P<0.0001) while grade I is signicantly increased in the luminal A subtype. LN metastasis in the luminal B and Her2 cancers are more signicant than in luminal A and TN. Disease-free survival (DFS) among older women above 50 years is signicantly greater among young women under 40 years ( p=0,021). Regarding SBR grading, and DFS, we found that survival was signicantly highest for patients with grade I, followed by those with grade II and then grade III (P<0.0001). According to molecular subtypes, we noted that DFS was signicantly highest for patients with luminal-A subtype, followed by those with luminal B subtype, then HER2 and TN cancers (P<0.0001). The Conclusion: present study shows the particularities of women breast carcinoma in our countryo, through our results, we found that BC is diagnosed at a younger age, a decade earlier than in developed countries, and we found a predominance of luminal B subtype in contrary with others studies suggesting that there are clinico-biological differences, as well as disparities in the expression proling in our population. This highlights the importance of early screening and the need to improve women's awareness of breast cancer in our region and additional research is needed to understand these results in hopes of adopting more effective therapies.
We present the evolution of magnetic non potential parameter in AR 10930, during December 9-15, 2006. This AR highly active and produced a large number of flares with two X-class flare. We used 27 high-resolution vector magnetograms obtained with Hinode/SOT-SP. We studied the evolution of spatially averaged signed shear angle (SASSA) and mean weighted shear angle (MWSA) in the N-polarity and S-polarity regions separately. We found the SASSA is same for both polari- ties. In S-polarity, the MWSA is high compare to N-polarity. SASSA and MWSA show similar trends during the observed period.
The incidence of primary retroperitoneal teratoma in infancy is rare but in children it is seen in 3-4% of overall germ cell tumors and 1-11% of primary retroperitoneal neoplasms . Most often they are asymptomatic and diagnosed incidentally and presents clinically only after attaining large size in the form of abdominal distension, abdominal mass with or without compressive symptoms. It is basically diagnosed using the help of radiological investigations like ultrasonography and contrast-enhanced computed tomography(CECT) of abdomen and nal diagnosis is conrmed after a thorough histopathological examination of the specimen. The denitive treatment includes complete surgical removal of teratoma. Here we are reporting a case of primary retroperitoneal teratoma in a 11month old male infant who presented with right sided abdominal mass and treated by complete surgical resection. Histopathological examination suggested the diagnosis of mature cystic teratoma.
. Further more, phytotoxicity is often species and environment specific. Thus studies on Pb uptake by agricultural crops assume greater im- portance especially in the regions where such contamination of soils and agricultural fields is a possibility. So the present experimental studies are made to study the effect of lead contamination in agricultural soils on sesamum which is a widely grown edible oil seed crop in India which is in a leading position in oil seed map both in production and acreage. Seeds of this crop are taken as food and also for oil extractions. Oil cake, and vegetative parts of the plant are used as feed for the cattle. Thus lead uptake and accumulations studies were carried out in Sesamum ( Sesamum Indicum L Var YLM - 11)
Oligodontia is the congenital absence of six or more than six teeth in either permanent or primary dentition. Because of the missing teeth in these patient’s esthetic, functional and psychological problems may arise. Oral rehabilitation is recommended for the positive development of self-esteem as well as for improved speech, masticatory function and facial esthetics. Congenital absence of incisors may jeopardize the esthetic appearance of a child, especially during years of transition into adolescence. In such situations, interim restorations can be provided before any definitive treatment. This paper deals with the full mouth oral rehabilitation of an 11-year old child using a multidisciplinary approach involving acrylic crowns, 2*4 appliance, anterior functional space maintainer and direct composite restoration.
Hepatoblastoma is the most common tumour in children under the age of 5 years. Diagnosis is made usually by combination of clinical, laboratory and radiological ndings. Biopsy is the gold standard for diagnosis. We present a case of hepatoblastoma of an 11 years old boy which is unusual in his age
Introduction: A signicant proportion of pregnancies presenting with early bleeding end up in poor outcome (abortion). Present study aim to evaluate CA-125 level as diagnostic and prognostic indicator in threatened abortion. Material and Methods: This Hospital based prospective cohort study was conducted included 75 cases of threatened abortion and 75 controls. “Threatened abortion” group included females presenting with 6 to 12 weeks gestation, with a demonstrable fetal heartbeat on ultrasonography, with complain of vaginal bleeding with or without abdominal cramps. 'Threatened abortion' group females were followed and divided into two groups based on their outcome- Threatened abortion ended with Abortion (TAEA) or Threatened abortion with ongoing pregnancy (TAOP). Results: Out of the 75 patients with threatened abortion, 27 (36%) ended with abortion. The mean CA-125 levels were found to be signicantly higher (p<0.001) in TAEAgroup (89.44 U/ml) as compared to TAOP group (44.69 U/ml) and Control group (24.73 U/ml). Ahigh Area under the ROC curve of 0.916 (95% CI- 0.828 – 1.00) indicated that CA-125 is a good predictor of abortion among females presenting with threatened abortion (p<0.001). At the critical cutoff of 58.5 U/ml, CA-125 had sensitivity and specicity of 88.9% and 93.7% respectively for predicting abortion. Conclusion: Evaluation of maternal serum CA-125 levels in females with early pregnancy bleeding would allow closer and individualized antenatal monitoring, earlier diagnosis, and timely interventions, which could potentially improve pregnancy outcomes.
Background Ovarian tumor is commonest cancer in female in India. About 80% is benign and 20% of these tumors are malignant. Due to its complex nature, vagueness and non-specificity of the symptoms it produces, the ovarian neoplasm can mislead both the doctor and patients. Hence this study was undertaken with aims & objectives to study the morphology of ovarian specimens as well as estimate serum CA125 as screening tool. Material and Methods: A study of over one year comprised of 75 specimens of ovary diagnosed in the Department of Pathology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar. After thorough gross examination and preparation of H&E stained slides the lesion of ovary were classified as per WHO classification. Also, preoperative blood samples were obtained from patients for estimation of serum CA125 level. Blood samples was also drawn from 20 healthy females in reproductive age group who acted as controls. Results: Of the 75 cases of ovarian mass, based on histology 75% were benign, and 25% were malignant. Surface epithelial tumors were the commonest (68%) of all ovarian tumor, followed by germ cell tumors (13%), sex cord–stromal tumors (6%). Serous Cystadenoma (29%) was the commonest benign tumor and serous cystadenocarcinoma (9%) commonest malignant neoplasm. CA125 levels was raised in epithelial ovarian cancers. Maximum rise was seen in serous cystadenocarcinoma. Exceptionally a small percentage of epithelial cancer showed normal level (false negative). Also, few benign tumors, non-epithelial tumors and even non-neoplastic lesions showed false positive rise in CA125 (false positive). Conclusion: Accurate histopathological evaluation of ovarian specimen is necessary both in terms of therapeutic intervention as well as prognosis. CA125 is an important screening tool for detection of epithelial ovarian cancers.
Background: Urolithiasis is one of the common conditions in the society and it needs medical attention due to its increase in prevalence. The use of the homeopathic medicines has found to be,of great importance in the treatment of urolithiasis and certainly homoeopathy is a promising eld in this condition. Objectives: The aim of this study was to evaluate the mechanism of urolithiasis and the inhibitory action of homeopathic drug Tribulus terrestris by in vitro experiment. Materials and Method: Homoeopathic preparation of Tribulus terrestris Q, 6C, 12C, 30C, 200C, 1M was planned to evaluate in vitro calcium oxalate and calcium phosphate crystallization using spectro-photometric and colorimetric assay respectively. Considering the role of reactive oxygen species as one of the etiological factors in stone formation, effective antioxidant activity of Tribulus terrestris was also performed by 2,2- diphenyl -1-picrylhydrazyl (DPPH) free radical scavenging assay. Result: Tribulus terrestris Q, 200C and 1M exerted maximum inhibition as 33.62%, 23.89% and 23.00% respectively to calcium oxalate nucleation assay whereas, Tribulus terrestris Q, 6C, 12C, 30C, 200C, 1M exerted maximum inhibition to calcium oxalate aggregation assay up to 76.19%. Tribulus terrestris 12C and 30C showed maximum inhibition as 82.28% and 16. 21% to calcium and phosphate ions respectively. Presence of antioxidant activity by DPPH radical assay for Tribulus terrestris Q and 12C which showed percentage inhibition as 33.11% and 0.95% respectively. Conclusions:Homoeopathic preparation Tribulus terrestris has potential effect on inhibition of calcium oxalate and calcium phosphate crystallization and also homoeopathic preparation of Tribulus terrestris is capable of showing presence of phytochemicals; anti-oxidant activity when performed by in vitro experiment.