Objective: Reactive oxygen species (ROS) and free radicals are involved in pathogenesis of cancer. D-Limonene, a monoterpene present in citrus fruit has been reported for its potential anticancer activities. The aim of present study was to evaluate the antioxidant effect of D-Limonene. Test solutions with different in vitro Material and methods: concentration of D-Limonene and Trolox (standard) were prepared. Six different antioxidant assays such as In vitro DPPH, ABTS, FRAP, iron chelating, hydroxyl radical scavenging and superoxide radical scavenging assay were performed for evaluation of antioxidant activity of D-Limonene. D-Limonene has shown appreciable Results: antioxidant activity in comparison with Trolox. The IC of D-Limonene in DPPH (ABTS (,), 50

Background:Dexmedetomidine, a α2 agonist as an adjuvant in general anesthesia, has anesthetic and analgesic-sparing property.Aims:To evaluate the effect of continuous infusion of dexmedetomidine alone, without use of opioids, on requirement of sevoflurane during general anesthesia with continuous monitoring of depth of anesthesia by entropy analysis.Materials and Methods:Sixty patients were randomly divided into 2 groups of 30 each. In group A, fentanyl 2 mcg/kg was given while in group B, dexmedetomidine was given intravenously as loading dose of 1 mcg/kg over 10 min prior to induction. After induction with thiopentone in group B, dexmedetomidine was given as infusion at a dose of 0.2-0.8 mcg/kg. Sevoflurane was used as inhalation agent in both groups. Hemodynamic variables, sevoflurane inspired fraction (FIsevo), sevoflurane expired fraction (ETsevo), and entropy (Response entropy and state entropy) were continuously recorded. Statistical analysis was done by unpaired student's t-test and Chi-square test for continuous and categorical variables, respectively. A P-value < 0.05 was considered significant.Results:The use of dexmedetomidine with sevoflurane was associated with a statistical significant decrease in ETsevo at 5 minutes post-intubation (1.49 ± 0.11) and 60 minutes post-intubation (1.11 ±0.28) as compared to the group A [1.73 ±0.30 (5 minutes); 1.68 ±0.50 (60 minutes)]. There was an average 21.5% decrease in ETsevo in group B as compared to group A.Conclusions:Dexmedetomidine, as an adjuvant in general anesthesia, decreases requirement of sevoflurane for maintaining adequate depth of anesthesia.

Background Fentanyl and clonidine both prolong sensory and motor block of spinal anaesthesia and duration of postoperative analgesia when used as an adjuvant to intrathecal bupivacaine. Lack of studies that directly compare them regarding their efficacy prompted us to compare both drugs as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section. Methods and Material In a prospective, randomized, study forty parturients between 18 to 35 years of age, of ASA grade I or II, awaiting caesarian section were randomly distributed into two equal groups. Patients were given 2.0 ml of hyperbaric bupivacaine 0.5% with either 60µg of clonidine or 25µg of fentanyl intrathecally. Duration of effective analgesia (primary outcome measure), onset peak and duration of sensory and motor blockade, level of sedation, maternal haemodynamic parameters and foetal parameters (secondary outcome measures)were compared. Results Both groups were comparable with respect to demographic profile, onset, peak and duration of sensory and motor block and overall haemodynamic stability. Duration of analgesia was significantly higher in bupivacaine with clonidine 60µg group (BC60 group) than in bupivacaine with fentanyl 25µg group (BF25 group). Sedation was more prevalent in BC60 group. Conclusion Intrathecal addition of 25µg fentanyl to bupivacaine provides good analgesia with less sedation and is a better option when sedation is not desirable. However intrathecal addition of 60µg clonidine to bupivacaine provides longer duration of postoperative analgesia than 25µg of fentanyl and is a preferred option when sedation is acceptable or required.

Aim:This study was designed to evaluate the efficacy of dexmedetomidine (DEX) as a hypotensive agent in comparison to nitroglycerin (NTG) in posterior fixation surgery for traumatic spine injury.Materials and Methods:Forty patients ASA I or II aged 18-65 years scheduled for posterior fixation surgery were randomly assigned to receive either DEX 1 μg/kg over 10 min before induction of anesthesia followed by 0.2-0.7 μg/kg/h infusion during maintenance in DEX group or NTG 3-5 μg/kg/min infusion after induction of anesthesia in NTG group to maintain mean arterial blood pressure (MAP) between 65 and 70 mmHg. The two groups were compared for achievement of target MAP, intraoperative blood loss, and reversibility of hypotensive state. Student's t-test was used for continuous variables and chi-square test for categorical variables. P-value < 0.05 was considered significant.Results:Patients in DEX group achieved the target MAP with better heart rate (HR) control, as compared to NTG group during the period of observation. The blood loss was significantly lesser in the DEX group (422.11 ± 149.34 ml) than the NTG group (564.51 ± 160.88 ml), P = 0.01. The time to hypotension reversal in NTG group (5.63 ± 1.93 min) was lesser compared to DEX group (9.15 ± 2.16 min), P = 0.65.Conclusion:DEX is an effective and safe agent in achieving controlled hypotension in adults undergoing posterior fixation spine surgery.

Background d ‐Limonene, a monoterpene from citrus fruit has been found to have chemopreventive and chemotherapeutic activities in various types of cancers. In this study, we evaluated the in vivo effect of d ‐Limonene on a K562‐induced model of chronic myeloid leukemia ( CML ) in C57 BL /6 mice. Method The tail vein injection model of K562 cells in immunocompromised C57BL/6 mice was developed and evaluated for characteristics of the disease. The mice were treated with d ‐Limonene and evaluated for haematological parameters. We also evaluated the effect of d ‐Limonene on angiogenesis using the chick chorioallantoic membrane ( CAM ) assay. Results In a complete blood count, a significant dose‐dependent reduction in white blood cell, neutrophil and lymphocyte counts, but an elevation in red blood cell count and haemoglobin content was observed with d ‐Limonene treatment compared to the disease control or untreated group. In the CAM assay, d ‐Limonene produced a significant dose‐dependent reduction in number of blood vessels in treatment groups compared to the vehicle‐treated group. Conclusion These studies suggest promising anti‐leukemic and anti‐angiogenic effects of d ‐Limonene in the treatment of CML .

Context:Ropivacaine, s-enantiomer of amide local anaesthetic produces differential neural blockade with less motor blockade, cardiovascular and neurological toxicity makes it suitable for day case surgery in children.Aims:To compare the effectiveness of Inj. Ropivacaine (0.2 or 0.25%) or Inj. Bupivacaine (0.25%) with fentanyl in caudal block for intra and postoperative analgesia.Settings and Design:Double blind retrospective randomized study.Materials and Methods:All the patients (n=112) varying from age group 3.02 ± 3.29 years belonging to ASA I-IV were randomly allocated to receive caudal analgesia Group BF inj. Bupivacaine (0.25%, 2 mg/kg) + Inj. Fentany1 μg/kg (n=70) and group RF: Inj. Ropivacaine (0.25% or 0.2%, 2 mg/kg) + inj. Fentanyl 1 μg/kg (n=42). We monitored vitals and requirement of inhalational gases inraoperatively and also observed pain by pain score (Visual Analogue Score in verbal group and Objective Pain Scale in nonverbal group) and vitals postoperatively. We used rescue analgesics (inj. Paracetamol 5 mg/kg iv) when VAS score ≥4.Statistical Analysis:Student's t-test.Results:Duration of analgesia was prolonged in both group RF and BF. Time for first rescue analgesic for group RF (6.1 ± 1.1 hr) compared to group BF (5.6 ± 0.9 hr). Haemodynamic stability and less requirement of inhalation agent intraoperatively with group RF than others.Conclusions:Ropivacaine with Fentanyl found to be better combination for pediatric surgeries for below umbilical surgeries as an adjuvant to general anaesthesia or sole technique with chances of less complication with high success rate.

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Background and Objectives:The purposes of this study were to evaluate the onset, quality and duration of sensory and motor blockade between hyperbaric bupivacaine and clonidine combination with bupivacaine alone when administered intrathecally for unilateral spinal anesthesia in below-knee orthopedic surgery, efficacy of clonidine for post-operative analgesia and side-effects of clonidine, if any.Methods:Sixty ASA I and ASA II patients scheduled for elective surgery with time duration up to 90 min were studied. Patients were randomised in two equal groups by the lottery method. Group A (control group) was given Inj. bupivacaine (hyperbaric) 0.5% - 12.5 mg (2.5 ml) + 0.5 ml of normal saline intrathecally. Group B (clonidine group) was given Inj. bupivacaine (hyperbaric) 0.5% - 12.5 mg (2.5 ml) + 50 mcg clonidine in 0.5 ml volume intrathecally.Results:The mean peak sensory block was earlier in Group B (4.7±1.23 min) as compared with Group A (6.27±1.51 min). The mean peak motor block was earlier in Group B (6.17±1.20 min) as compared with Group A (8.63±1.71 min). The two-segment regression of sensory block was longer in Group B (106.23±9.17 min) as compared with Group A (104.43±17.75 min), which is clinically significant. Requirement of rescue analgesia was considerably prolonged in Group B (450.33±95.10 min) as compared with Group A (220±36.36 min), which was also clinically highly significant.Conclusion:Intrathecal clonidine potentiates bupivacaine induced spinal sensory block and, motor block and reduces the analgesic requirement in the early post-operative period in unilateral spinal anesthesia for lower limb below knee surgery.