Background: Ultrasound imaging techniques have gained great popularity in anaesthesia during the last decade. We aimed to compare an ultrasound-guided transversus abdominis plane (TAP) block and an ultrasound-guided caudal block for postoperative analgesia in children undergoing lower abdominal surgeries.Methods: This study randomly allocated 62 children to two groups of 31 children each. One group received a caudal block with 0.25% bupivacaine 0.5 ml/kg with 1 µg/kg dexmedetomidine while the other group received a TAP block with 0.25% bupivacaine 0.5 ml/kg with 1 µg/kg dexmedetomidine. The parameters that were compared were the duration of postoperative analgesia, cumulative dose of rescue analgesic consumed, FLACC pain scores postoperatively, intraoperative and postoperative haemodynamic changes and incidence of side effects.
Results:The duration of analgesia was comparable between the two groups, with 6.61 ± 0.76 hours for the caudal block group and 6.65 ± 0.915 hours for the TAP block group. However, the total amount of cumulative rescue analgesic consumed was significantly higher in the caudal block group (375.8 ± 120.5) compared to the TAP block group (314.5 ± 127.7). The pain scores in 0-6 hours postoperatively were higher in the TAP block group, whereas the caudal block group had higher pain scores 6-24 hours postoperatively with steady rescue analgesic consumption at 8, 12, 16 and 20 hours. Patient-parent satisfaction was better in the TAP block group (7.39 ± 0.76) compared to the caudal block group (6.48 ± 0.811).
Conclusion:The TAP block provided superior analgesia compared to the caudal block, as demonstrated by a statistically significant decrease in the required cumulative rescue analgesic and lower pain scores 6-24 hours postoperatively.
The outcome of patients with crescentic nephritis and the presence of both ANCA and anti GBM disease (double positive disease) is controversial. Initial data supported the view that this condition has a more favorable prognosis than anti GBM disease but larger and more recent series found much worse renal outcome especially in patients with severe renal failure requiring dialysis. We present a case with severe renal failure due to double positive disease who recovered renal function with aggressive immunosuppression including steroids, cyclophosphamide and plasma exchange.
Background
Type 2 Diabetes Miletus (T2DM) is a common metabolic and lifestyle disorder leading to increased oxidative stress and DNA damage. The present study aims to evaluate the feasibility of utilizing the cytokinesis-block micronucleus assay (CBMN) as a biomarker for assessing the DNA damage induced due to variations in oxidative stress.
Methodology
The study group includes diabetic (n = 50) and non-diabetic (n = 50) subjects. The assays for the diabetes-like fasting blood sugar, postprandial glucose and hemoglobin A1c (HbA1c), lipid profiling, and serum ferritin level along with c-reactive protein (CRP) were applied. Further, the CBMN assay was performed to evaluate the micronuclei present in the lymphocytes of control and T2DM groups.
Results
Significant imbalance in the glycaemic index, dyslipidemia, increased ferritin levels, and CRP levels, with a significant increase of micronucleus frequency, was found in T2DM patients compared with the control group. Results suggest a trend of positive correlation between HbA1c and the micronuclei, indicating the assay’s potential importance as a biomarker for T2DM-induced risk assessment.
Conclusion
From the observed results, it can be suggested that the CBMN assay could be used to assess the risk of oxidative stress-induced DNA damage in high glycaemic index diabetic patients.
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