Introduction: Newer light emitting diodes (LED) phototherapy units have become indigenous part in the management of neonatal hyperbilirubinemia almost replacing the conventional compact fluorescent light (CFL) units. Only few studies from India available compare the efficacies of two, so a randomised control study was undertaken. Methods: 60 healthy neonates ≥ 35 weeks gestational age were randomised into CFL and LED groups using computerised random number sequence. The rate of fall of bilirubin levels at 6 hours and at completion along with total duration of phototherapy in both groups was measured. Results analysed by standard statistical methods. Results: LED phototherapy units showed higher rate of fall bilirubin at 6hrs (LED 0.41± 0.10mg/dl/hr VS CFL 0.23± 0.17 mg/dl/hr, C.I=95%, p<0.05) and after completion of therapy (LED 0.29± 0.08 mg/dl/hr VS CFL 0.19± 0.06 mg/dl/hr with p<0.05 C.I 95%) compared to CFL group. There was no statistically significant difference in total duration of therapy in both the groups (LED 18.8±8hrs VS CFL 20±6 hrs C.I=95% p=0.56). 2 among CFL group had failure of phototherapy whereas 1 was lost to follow up in LED group. Both groups didn't show any side effects. Conclusion: The LED phototherapy units are more efficacious in terms of higher rate of fall of bilirubin levels in similar time duration compared to CFL units. But the total duration of phototherapy was equal; it can be because there was significant difference between both the groups in terms of bilirubin levels at start and at end of therapy which couldn't be prevented even after effective randomisation.

More than half of patients with oral cancer recur even after multimodality treatment and recurrent oral cancers carry a poorer prognosis when compared to other sites of head and neck. The best survival outcome in a recurrent setting is achieved by salvage surgery; however, objective criteria to select an ideal candidate for salvage surgery is difficult to frame, as the outcome depends on various treatment-, tumor-, and patient-related factors. The following is summarizes various tumor- and treatment-related factors that guide our decision-making to optimize oncologic and functional outcomes in surgical salvage for recurrent oral cancers. Short disease-free interval, advanced tumor stage (recurrent and primary), extracapsular spread and positive tumor margins in a recurrent tumor, regional recurrence, and multimodality treatment of primary tumor all portend worse outcomes after surgical salvage. Quality of life after surgical intervention has shown improvement over 1 year with a drastic drop in pain scores. Various trials are underway evaluating the combination of immunotherapy and surgical salvage in recurrent head and neck tumors, including oral cavity, which may widen our indications for salvage surgery with improved survival and preserved organ function.

BACKGROUND Shivering is one of the most frequent complications of spinal anaesthesia, which is very distressing for the patients as well as surgeons. Shivering increases metabolic rate, which causes increased oxygen consumption. Tramadol is opioid analgesic. It is commonly used for treatment of shivering. Dexmedetomidine is alpha-2 receptor agonist. It causes vasoconstriction by acting on vascular smooth muscles and prevents shivering. In this study, efficacy of Tramadol and Dexmedetomidine for treatment of post spinal shivering was compared. MATERIAL AND METHODS This study was prospective, double-blind, randomized controlled trial conducted in 50 patients of ASA grade I and II, ages between 18-40 years scheduled for caesarean section under spinal anaesthesia. Patients were divided in two groups of 25 each, receiving either Tramadol 0.5 mg/kg or Dexmedetomidine 0.5 µg/kg intravenously. Time of onset of shivering, time taken for cessation of shivering, recurrence and adverse effects were observed. RESULTS Both groups were demographically similar and comparable at baseline. Duration of surgery and onset of shivering were also similar in both groups. Dexmedetomidine taking significantly less time in treatment of shivering and having less recurrence rate in comparison to Tramadol. Nausea and vomiting were side effects of Tramadol only. Sedation was similar in both groups. CONCLUSION In conclusion both drugs are effective in treatment of shivering but Dexmedetomidine taking less time for cessation of shivering, less recurrence rate and having less side effects.

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BACKGROUND The commonest and most discussed side effects of laryngoscopy and endotracheal intubation are acute rise in blood pressure, tachycardia and transient arrhythmias. Clonidine, an alpha-2 adrenoreceptor agonist has been shown to attenuate the cardiovascular response during laryngoscopy and intubation by various workers. The aim of the present study was to evaluate effect of clonidine on attenuation of haemodynamic responses during laryngoscopy and intubation. MATERIALS AND METHODS This study was a prospective, double-blinded, randomised controlled trial conducted on 60 patients of both sexes within the age of 18-60 years, ASA grade I and II physical status, MPS-I or II admitted for elective abdominal surgeries under general anaesthesia. Patients were randomly divided into two groups containing 30 patients in each group, received normal saline or clonidine 3 µg/kg, 15 minutes before induction of anaesthesia. Pulse rate, blood pressure, oxygen saturation and ECG changes were recorded from baseline to 10 minutes after laryngoscopy and intubation at fixed time intervals. RESULTS Both groups were demographically similar and comparable at baseline. The pulse rates and blood pressures were increased in both groups upto 1 minute after laryngoscopy and intubation, then decreased progressively and similar to baseline in 10 minutes. Increase in pulse rates and blood pressures were found much more in Group I than Group II. It was seen that clonidine prevents rise in pulse rates and blood pressures in Group II and leads to early normalisation of haemodynamic changes. There was no noticeable change on ECG and oxygen saturation in both groups during the study period. The side effects and complications of clonidine like bradycardia and hypotension were not observed in any patient during the study period. CONCLUSION In conclusion, Clonidine is beneficial in attenuating the haemodynamic responses to laryngoscopy and intubation. So, clonidine is a useful pre-medicant for routine use.