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Research article:- Anaesthesia,
Meera Rani Nayak*
Assistant Professor, Department of Anaesthesia, Sree Balaji Medical College & Hospital, #7, Works Road, Chromepet, Chennai - 600 044.Tamil Nadu, India.
Abstract:- This study was carried out in 60 adult ASA I &II patients to evaluate prolongation of postoperative spinal analgesia by clonidine. Addition of intrathecal clonidine at the doses of 75µg & 37.5µg to 0.5% hyperbaric Bupivacaine prolongs both sensory blockade of spinal anaesthesia & time interval to first request for supplemental analgesia. Incidence of hypotension & bradycardia was more with higher doses of intrathecal clonidine (75µg) which was managed by I.V fluids, inj. Mephenteramine & inj. Atropine sulphate satisfactorily. Sedation – maximum with higher dose (75µg) of intrathecal clonidine.
Key words:- Intrathecal clonidine, Post operative analgesia, Lower abdominal surgeries.
References:-
1.Bonica J. Postoperative pain. In: Bonica J, ed. The management of pain. 2nd ed. Philadelphia: Lea & Febiger, 1990:461-80.
2.Eisenach J, De kock M, Klimscha W. alpha 2 adrenergic agonists for regional anaesthesia: aclinical review of clonidine (1994 - 1995). Anesthesiology 1996; 85:655-74.
3.Filos KS, Goudas LC, Patroni, Polyzou V. haemodynamic & analgesic profile after intrathecal clonidine in Humans. A dose response study. Anesthesiology 1994; 81: 591-601.
4.Niemi L. Effects of intrathecal clonidine on duration of Bupivacaine spinal anaesthesia , hemodynamics, postoperative analgesia in patients undergoing knee artroscopy. Acta Anaesth Scand 1994; 38:724-8.
5.Bonnet F, Brun –Bisson V, Saada M. Dose related prolongation of hyperbaric tetracaine spinal anaesthesia by clonidine in humans. Anaesthe Analg 1989; 68; 619-22.
6.Pettibone DJ,Mueller GP. Alpha adrenergic stimulation by clonidine increases plasma concentration of immunoreative β endorphins in rat . Endocrinology 1981;109:798-802.
7.Sites BD, Beach M, Biggs R , Rohan C, Wiley C, Rassias A, et al. Intrathecal clonidine added to a bupivacaine – morphine spinal anaesthetic improves postoperative analgesia for total knee artroplasty. Anesth Analg 2003;96:1083-8.
8.Vaghadia H, McLeod DH, Mitchell GW, Merrick PM, Chilvers CR. Small-dose hypobaric lidocaine –fentanyl spinal anaesthesia for short duration out patient laparoscopy. I. A randomized comparison with conventional dose hyperbaric lidocaine. Anesth Analg 1997; 84:59-64.
9.Eisenach JC, De Kock M, Klimscha W, Alpha(2) – adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984-1995).Anesthesiology 1996;85:655-74.
10.Kaabachi O, Zarghouni A, Ouezini R, Abdelaziz AB, Chattaoui O, Kokki H.Clonidine 1 microg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents. Anesth Analg 2007; 105:516-9.
11.Eisenach J,Detweiter D,Hood D. Hemodynamic and analgesic action of epidurally administered clonidine. Anesthesiology 1993; 78:277-87.
12.Nader ND,Ignatowski TA,Kurek CJ,Knight PR, Spengler RN. Clonidine suppresses plasma and cerebrospinal fluid concentrations of TNF-alpha during the perioperative period. Anesth Analog 2001; 93:363-9.
13.Larsen B, Dorscheid E, Macher-Hanselmann F,Buch U.Does intrathecal clonidine prolong the effect of spinal anesthesia with hyperbaric mepivacaine? A randomized double-blind study. Anesthesist 1998; 47:741-6.
Copyright © 2013 Meera Rani Nayak. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original article:- anatomy
K. Satheesh Naik 1*, G.M. Mahesh2 & Sudharani. P3
Department of anatomy, Basaveshwara Medical College & Hospital, Chitradurga - 577502 Karnataka, India.
Abstract:- In a 55 years old male cadaveric dissection for medical undergraduate students on right side we observed there was no communication between radial and ulnar arteries in the formation of Superficial Palmar Arch, On left side no such variation was found. Superficial palmar branch of radial artery supplied lateral two and half fingers by common and proper arteries, but the artery to radial side of index finger received one communicating branch from radial artery, supplying ulnar side of thumb. We also observed the superficial branch of ulnar artery supplied medial two and half fingers by common and proper arteries. Knowledge in variation of vascular Pattern of hand gaining more importance in Microsurgical techniques, & Reconstructive hand surgeries.
Keywords:- Reconstructive hand surgeries, Superficial palmar branches of radial & ulnar arteries, Communicating branch from radial artery.
References:-
1.Williams PL, Bnnister LG, Berry MM, eds. Gray’s Anatomy. 38th Ed, New York, Churchill L ivingstone.2000; 1544.
2.Datta AK Essentials of Human Anatomy, Superior and Inferior Extremities 2nd Ed, Calcutta, Current Books International.2000; 98 – 100.
3.Coleman SS, anson BJ. Arterial patternes in the hand based a study of 650 specimens. Surg gynecol obstet. 1961; 409 – 24.
4.Ruengsakulrach P, Brooks M, Hare DL, Gordon I, Buxton BF. Preoperative assessment of hand circulation by means of Doppler Ultrasonography and the modified Allen test. J Thoracic Cardiovascular Surg. 2001; 121:528 – 31.
5.Gellman H, Botte MJ, Shankwiler J, Gelberman R. Arterial patterns of deep & superficial palmar arches. Clin Orthop Relat Res 2001: 383:41-6.
6.Adachi B. [Das Arteriensystem der Japaner].In: Anatomie der Japaner. Vol 1.Kyoto:Verlag der Kaiserlich,1928.German.
7.Ikeda A, Ugawa A, Kazihara Y, Hamada N. Arterial Patterns in the hand based on a three dimentional analysis of 220 cadavers hands. J Hand surg Am 1988; 13:501-9.
8.Agur AM, Lee MJ. Grant’s Atlas of Anatomy.9th Ed, Philadelphia, Lippincott, Williams and wilkins.1999:419.
9.FazanVP, Borges CT, Da silva JH, caetano AG, filho OA. Superficial palmar arch: an arterial diameter study. J Anat. 2004; 204:307–11.
10.Moore KL, Dalley AF, Clinically Oriented Anatomy, 4th ed. Philadelphia: Lippincott, Williams & Wilkins, 1999: 773-4.
11.Sinnatamby CS. Last’s Anatomy. Regional & Applied. 10th ed. Edinburgh Churchill Livingston. 1999:78 – 80.
12.Onderoglu S, Basar R, Erbil KM, Cumhur M. Complex variation of the superficial palmar arch – case report. Surg Radiol Anat 1997; 19:123 – 5.
13.Pola P, Serricchio M,Flore R,Manasse E,Favuzzi A,Possati GF.Sate removal of the radial artery for myocardial revascularization:a Doppler study to Prevent ischemic Complication to the hand. J Thoracic Cardiovascular Surg.1996;112:737-44.
Copyright © 2013 K. Satheesh Naik, G.M. Mahesh & Sudharani.P. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Review article:- Orthodontics
Gupta Akshay1, Sharma Rakesh2, Kumar Piush3 & Chandra Pavan Kumar4
1PG Student (Orthodontics),2Professor,3Reader,4Professor and Head, Department of Orthodontics &Dentofacial Orthopedics, I.T.S-C.D.S.R, Muradnagar Ghaziabad,India.
Abstract:- Many patients today are taking a range of medications and nutritional supplements that can influence orthodontic treatment. Any pharmacologic agent or supplement consumed by patients can reach the periodontal tissues through the circulation and thus interact with and influence a cell’s response to orthodontic forces. These agents may have the effect of potentiating or inhibiting tooth movement as well as exacerbating or reducing root resorption. Orthodontic treatment is based on the principle that when force is delivered to a tooth and thereby transmitted to the adjacent investing tissues, certain mechanical, chemical, and cellular events take place within these tissues, which allow for structural alterations and contribute to the movement of that tooth. Molecules present in drugs and nutrients consumed regularly by patients can reach the mechanically stressed paradental tissues through the circulation and interact with local target cells. The combined effect of mechanical forces and one or more of these agents may be inhibitory, additive, or synergistic. This article discusses in detail the various drugs that can bring about alterations in the desired orthodontic tooth movement.
Keywords:- Paradental tissues, pharmacological agent, periodontal tissues.
References:-
1.Masella RS, Meister M. Current concepts in the biology of orthodontic tooth movement. Am J OrthodDentofacialOrthop 2006;129:458-68.
2.Yamasaki K, Miura F, Suda T. Prostaglandin as a mediator of bone resorption induced by experimental tooth movement in rats. J Dent Res 1980;59:1635-42.
3.Sandy JR, Harris M. Prostaglandins and tooth movement. Eur J Orthod 1984;6:175-82.
4.Mohammed AH, Tatakis DN, Dziak R. Leukotrienes in orthodontic tooth movement. Am J Orthod 1989; 95:231-7.
5.Ishnan V, Davidovitch Z. The effect of drugs on orthodontic tooth movement. OrthodCraniofac Res 2006;9:163-71.
6.Arias OR, Marquez-Orozco MC. Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement. Am J OrthodDentofacialOrthop 2006;130:364-70.
7.Hellsing E, Hammarström L. The effects of pregnancy and fluoride on orthodontic tooth movements in rats. Eur J Orthod 1991;13:223-30.
8.Igar K, Adachi H, Mitani H, Shinoda H. Inhibitory effect of the topical administration of a bisphosphonate (risedronate) on root resorption incident to orthodontic tooth movement in rats. J Dent Res 1996;75:1644-9.
9.Dolce C, Vakani A, Archer L, Morris-Wiman JA, Holliday LS. Effects of echistatin and an RGD peptide on orthodontic tooth movement. J Dent Res 2003;82:682-6.
10.Collins MK, Sinclair PM. The local use of vitamin D to increase the rate of orthodontic tooth movement. Am J Orthod 1988;94:278-84.
11.Kale S, Kocadereli I, Atila P, Asan E. Comparison of the effects of 1,25 -dehydroxycholecalciferol and prostaglandin E2 on orthodontic tooth movement. Am J Orthod 2004;125:607-14.
12.Kawakami M, Takamo-Yamamoto T. Local injection of 1,25-dihydroxyvitamin D3 enhanced bone formation for tooth stabilization after experimental tooth movements in rats. J of Bone and Mineral Metabolism 2004;22:541-6.
13.Krishnan V, Davidovitch Z. The effect of drugs on orthodontic tooth movement. OrthodCraniofac Res 2006;9:163-71.
14.Shirazi M, Dehpour AR, Jafari F. The effect of thyroid hormone on orthodontic tooth movement in rats. J ClinPediatr Dent 1999;23:259-64.
15.Krishnan V, Davidovitch Z. The effect of drugs on orthodontic tooth movement. OrthodCraniofac Res 2006;9:163-71.
16.Madan MS, Liu ZJ, Gu GM, King GJ. Effects of human relaxin on orthodontic tooth movement and periodontal ligaments in rats. Am J Orthod 2007;131:8.e1-8.10.
17.Soma S, Iwamoto M, Higuchi Y, Kurisu K. Effects of continuous infusion of PTH on experimental tooth movement in rats. J Bone Miner Res 1999;14:546-54.
18.Kalia S, Melsen B, Verna C. Tissue reaction to orthodontic tooth movement in acute and chronic corticosteroid treatment. OrthodCraniofac Res 2004;7:26-34.
19.Shdayfat NB. Effects of drugs on periodontal tissue remodeling and clinical responses to orthodontic mechanotherapy. Pak Oral and Dental J 2011;31:379-88.
20.Karsten J, Hellsing E. Effect of phenytoin on periodontal tissues exposed to orthodontic force--an experimental study in rats. Br J Orthod 1997;24:209-15.
Copyright © 2013 Gupta Akshay et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report:- Obstetrics and Gynecology
Chaudhari shilpa N.1*, Gaikwad Vidya A.1,Mahajan Vinayak2& Bamane Shubhangi3
1M.D. (Obstetrics and Gynecology) Professor, 2M.D. (Obstetrics and Gynecology) Lecturer, 3M.B.B.S. Senior Resident, Dept of OBGY, Padmashree Dr.D.Y.Patil Medical College and Research Centre, Pimpri, Pune, India
Abstract:- There are many causes of abnormal uterine bleeding (AUB) like fibroids, polyps, endometrial hyperplasia and malignancy. But prolonged retention of fetal bones after abortion as an etiology for AUB is a rare one. Incidence given in only one study was 0.15% where fetal bones were found on Diagnostic hysteroscopy. A 24 years woman, presented with pain in lower abdomen and continuous bleeding per-vaginum for 2 months. Her transvaginal ultrasonography showed hyperechogenic shadow in uterine cavity .She underwent an office hysteroscopy which showed multiple fetal bones in the uterine cavity. They were removed in the same sitting.
Key words:- Abnormal uterine bleeding, Hysteroscopy, Retained intrauterine fetal bones, Transvaginal ultrasonography.
References:-
1.Kalu E, Richardson R. Retained foetal bones: an intrauterine cause of chronic pelvic pain. Arch Gynecol Obstet. 2009, Feb; 279(2): 233-4. PMID: 18506460
2.Makris N, Stefanidis K, Loutradis D, Anastasiadou K, Hatjipappas G, Antsaklis A. The incidence of retained fetal bone revealed in 2000 diagnostic hysteroscopies. JSLS. 2006, Jan-Mar; 10(1):76-7. PMID: 16709364
3.Shalev J, Meizner I, Bar-Hava I, Dicker D, Mashiach R, Ben-Rafael Z. Fertil Steril. Predictive value of transvaginal sonography performed before routine diagnostic hysteroscopy for evaluation of infertility. 2000, Feb; 73(2):412-7. PMID 10685552.
4.Verma U, et. al. Fetal bones retained in uterine cavity as a rare cause of chronic pelvic pain: Case Report. J Reprod Med 2004, Oct; 49(10):853-5. PMID: 15568412.
5.Chervenak FA, et. al. Symptomatic intrauterine retention of fetal bones. Obstet Gynecol 1982; 59:58–61. PMID: 7088429.
6.Chan NS. Intrauterine retention of fetal bone. Aust N Z J Obstet Gynaecol. 1996, Aug; 36(3):368-71. PMID: 8883773
7.Vercellini P, Cortesi I, Oldani S, Moschetta M, De Giorgi O, Crosignani PG. The role of transvaginal ultrasonography and outpatient diagnostic hysteroscopy in the evaluation of patients with menorrhagia. Hum Reprod. 1997, Aug; 12(8):1768-71. PMID: 9308809
8.Towbin NA, Gviazda IM, March CM. Office hysteroscopy versus transvaginal ultrasonography in the evaluation of patients with excessive uterine bleeding. Am J Obstet Gynecol. 1996 Jun; 174(6):1678-82. PMID: 8678126.
Copyright © 2013 Chaudhari shilpa et al.. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article:- Pediatrics
Basavaraj M Patil1*, Sandeep V H2, Harish G3, Venaktesh M Patil4 & Vijayanath.V5
1Associate professor,2Assistant professor,3Resident, Dept of pediatrics, M R medical college, Gulbarga, Karnataka, India.
4Associate Professor, Department of Pharmacology,Navodaya Medical College,Raichur,Karnataka,India.
5Associate Professor,Department of Forensic Medicine & Toxicology, VMKV Medical College & Hospital,Salem, Tamil Nadu,India.
Abstract:-
As per UNAIDS in 2006 estimated that there were 5.6 million people living with HIV in India, which indicated that there were more people with HIV in India than in any other country globally. In 2007, following the initial stage of HIV among the general population, UNAIDS and NACO agreed on a new estimate between 2 million and 3.1 million people living with HIV. And in 2008 the figure was estimated to be 2.31 million. Similarly in 2009 it was estimated that 2.4 million people were living with HIV in India, which equates to a prevalence of 0.3%. Whereas this may seem low, because India's population is so large, it is third in the world in terms of greatest number of people living with HIV. With a population of around a billion, a mere 0.1% increase in HIV prevalence would increase the estimated number of people living with HIV by over half a million. Throughout the world, the number of children younger than 15 yrs living with HIV has increased from 1.6 million in 2001 to 2.5million in 2009. Whereas the number of newly infected children has been declining since 2003 due to increasing access to PPTCT services. And in 2009 similarly, alone, worldwide, 3, 70,000 children under the age of 15 yrs were newly infected, of which 90% were acquired through mother to child transmission of HIV, i.e. Around 1000 a day and 2, 60,000 died the majority under the age of 5. INDIA has, with 27 million pregnancies annually, and estimated HIV prevalence of 0.48% in antenatal women, it is estimated that there are 1, 29,600 HIV-infected pregnant women annually. In South India Karnataka accounts for 0.50%. Whereas incidence of mother to child transmission is 5.4% as on Jan 2011 according to NACO annual report 2010-11. In the present study IUGR was noted in 14% of newborns born to HIV positive mothers and the incidence increased with lower CD4 count. At the same time preterm births were of 28% and low birth weight were noted in 36%. There were high incidence of still birth rate (4%) and Intrauterine death rate (4%) and have an inverse relationship with CD4 count. Follow up study done to know the somatic growth of the newborns revealed infected newborns were lighter and shorter when compared to exposed but uninfected newborns.HIV infection in pregnant mothers have adverse neonatal outcome and fetal complications. Perinatal transmission is the commonest mode of acquisition of paediatric HIV infection.
Keywords:- Mother; Infant; Infection.
References:-
1.UNAIDS. Report on the global AIDS epidemic'.2006.
2.UNAIDS.Press release: 2.5 million people in India living with HIV, according to new estimates. 2007.
3.UNAIDS.India: Country Situation. 2008.
4.UNAIDS.UNAIDS report on the global AIDS epidemic. 2010.
5.Unaids-global report 2010
6.NACO-Antiretroviral Therapy Guidelines for HIV infected adults and adolescents including post-exposure(Dateuploaded:29/08/2007.
7.Tripathi Pensi, HIV in children: clinical features and diagnosis, chapter 45, In Advances in paediatrics 2nd edition volume 1, editors-Anupam sachdeva, AK Dutta Page no:351-372
8.National guidelines for prevention of parent-to-child transmission(PPTCT) June 2012 National AIDS control organisation, India with support from WHO, UNICEF,UNAIDS.
9.Ellis et al. Human immunodeficiency virus infection is a risk factor for adverse perinatal outcome. American Journal of Obstetrics & Gynaecology. 2002 May;l 86(5):903-6.
Copyright © 2013 Basavaraj M Patil et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.