Objective Discogenic pain is common cause of low back ache and may result in significant morbidity. Platelet-rich plasma (PRP) is an upcoming regenerative therapy that has treatment potential for this condition. The objective of this study was to correlate platelet concentration in intradiscal PRP injection with improvement in low back pain and functional status at three and six months. Design Prospective single-arm interventional study. Setting Outpatient pain clinic and operation theater. Subjects Twenty-five patients with discogenic pain diagnosed by clinical means and imaging with confirmation by provocative discography were recruited. Methods The patients received PRP injection at a single or multiple disc levels. Preprocedure numerical rating scale (NRS) pain scores and Oswestry Disability Index (ODI) scores were calculated. Platelet counts of patients and PRP samples were measured. At three and six months postprocedure, NRS and ODI scores were measured, and improvement in these scores was correlated with platelet concentrations in the PRP sample. Results Twenty patients completed the study. The improvement in NRS and ODI scores positively correlated with platelet concentrations in the PRP sample. We determined the correlation coefficient (r) of platelet concentrations with a reduction in NRS at three months (r = 0.65) and six months (r = 0.73) and in ODI score at three months (r = 0.72) and six months (r = 0.7). Conclusions This study supports the use of intradiscal PRP for treatment of discogenic pain with preferably higher platelet counts to elicit a favorable response.

Background:Midazolam is a water soluble benzodiazepine which is frequently administered by intravenous and oral routes in our institution. Its nasal spray has become recently available.Objectives:To compare the efficacy of midazolam administered orally and by intranasal spray, with the specific objective of assessing their efficacy in terms of acceptability to the patients, whether they achieve a satisfactory sedation score, and the overall ease of inducing general anesthesia.Patients and Methods:Sixty healthy children of ASA grade I or II, aged 2–6 years who were undergoing elective surgery of approximately 30 minutes duration, were assigned to receive midazolam premedication in a randomized controlled trial. They were divided into 2 groups of 30 patients each. Group I: 30 patients received midazolam orally (parenteral solution mixed in honey). Group II: 30 patients received a commercially available midazolam nasal spray.Results:The study shows that children better accepted the drug when administered orally than when administered intranasally, although satisfactory sedation scores at 10 and 20 minutes were better in the nasal spray group than in the oral group [i.e., 6 (20%) vs. 0 (0%) at 10 min and 16 (53.3%) vs. 13 (43.3%), respectively]. Satisfactory ease of induction scores [24 (80%) vs. 13 (43.3%)], recovery times [11.63 ± 4.19 minutes vs. 25.20 ± 9.36 minutes], and post-anesthesia recovery scores were better in the nasal spray group (group II) than in the oral group (group I).Conclusions:On the basis of our study, we conclude that nasal midazolam spray is acceptable and is a good alternative to oral midazolam as premedication in the pediatric population.

Human have lungs to breathe air and they have no gills to breath liquids like fish. When the surface tension at the air-liquid interface of the lung increases as in acute lung injury, scientists started to think about filling the lung with fluid instead of air to reduce the surface tension and facilitate ventilation. Liquid ventilation (LV) is a technique of mechanical ventilation in which the lungs are insufflated with an oxygenated perfluorochemical liquid rather than an oxygen-containing gas mixture. The use of perfluorochemicals, rather than nitrogen as the inert carrier of oxygen and carbon dioxide offers a number of advantages for the treatment of acute lung injury. In addition, there are non-respiratory applications with expanding potential including pulmonary drug delivery and radiographic imaging. It is well-known that respiratory diseases are one of the most common causes of morbidity and mortality in intensive care unit. During the past few years several new modalities of treatment have been introduced. One of them and probably the most fascinating, is of LV. Partial LV, on which much of the existing research has concentrated, requires partial filling of lungs with perfluorocarbons (PFC's) and ventilation with gas tidal volumes using conventional mechanical ventilators. Various physico-chemical properties of PFC's make them the ideal media. It results in a dramatic improvement in lung compliance and oxygenation and decline in mean airway pressure and oxygen requirements. No long-term side-effect reported.

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Cerebrovascular manifestations are uncommon presentations of scorpion sting in the Indian subcontinent. A prospective study was carried out on 42 patients with scorpion sting in the intensive care unit (ICU) of the Institute of Medical Sciences, Banaras Hindu University, Varanasi-05, INDIA, during the period of May 2005 to October 2007. In all the patients detailed history, physical examination with a specific neurological examination and routine biochemical testing and fundus examination were done. Computerized tomography and magnetic resonance imaging were done in cases with neurological deficit. All these patients also underwent a complete hematological, rheumatologic and cardiovascular work-up for stroke. Cerebrovascular involvement was noted in three patients (7.15%). Hemorrhagic stroke was noted in two patients (4.77%) and thrombotic stroke was noted in one patient (2.39%). The mean time of presentation of neurological symptoms was 3 days. Contrary to world literature, there have been no reports of cranial nerve palsies or neuromuscular involvement in our series.

IntroductionHydatid cysts are most commonly found in the liver and lungs but they are rarely found in pericardium.Case PresentationWe present a rare case of isolated hydatid cyst in pericardium of heart of a 70 year old female presented in casualty with unusual features like, dyspnea, palpitation and chest pain mimicking acute coronary syndrome.DiscussionHydatid cyst in Pericardium represents only 0.5-2% of cases of systemic echinoccocal infection. Isolated pericardial cyst is very rare in endemic region and may present mimicking acute coronary syndrome. Cardiac hydatid cysts should always be considered in presence of eosinophilia as present like acute coronary syndrome in endemic area.

Background: Discogenic pain is a common, yet underdiagnosed cause of low backache, for which a wide array of radiofrequency (RF) ablative techniques and regenerative therapies have been tried with variable results. The objective of the study was to compare pain relief and improvement in function between percutaneous intradiscal RF ablation and platelet-rich plasma (PRP) injection for the treatment of discogenic low backache. Methods: This double-blind, randomized, parallel-group interventional study was carried out in patients with chronic lumbar discogenic pain. Twenty-four patients each in percutaneous intradiscal radiofrequency (PIRF) ablation (Group R) and PRP injection (Group P) groups were analyzed. Numeric Rating Scale (NRS) and Oswestry Disability Index (ODI) were calculated before the procedure, and at 3 and 6 months after the procedure. Results: At 3 months, NRS score was significantly less in group R compared to group P ([Formula: see text]). However at 6 months, there was no statistically significant difference between NRS and ODI of both groups ([Formula: see text] and 0.369, respectively). Both NRS and ODI decreased significantly over 6 months within each group. Conclusion: No significant difference in efficacy of PIRF ablation and intradiscal PRP injection was observed at 6 months follow-up, although there was a significant improvement in pain and disability with both the procedures.

Background: Disinfectants are frequently used in hospital settings as prophylaxis. Superoxidised water is one of them, which is claimed to have disinfectant property against different microbes. Aim:This study aims to assess the in vitro efficacy of different dilutions of superoxidised water against Candida spp. and filamentous fungi apart from several pathogenic bacterial isolates. Material and Methods:The freshly grown clinical isolates of selected bacteria and fungi including Candida spp.,Aspergillus sp., Fusarium spp., Acremonium sp., Curvularia sp, and Bipolaris sp. were subcultured on culture plate with and without exposure of undiluted, five and ten times diluted, freshly generated superoxidised water.Results: There was complete inhibition of all bacteria and Candida species in undiluted as well as five and ten times diluted freshly generated superoxidised water whereas filamentous fungi used in the present study were inhibited only with the use of undiluted superoxidised water. Conclusion:Undiluted superoxidised water should be used to prevent the occurrence of molds infection as nosocomial pathogens.