Background:Paravertebral and inter pleural blocks (IPB) reduce post-operative pain and decrease the effect of post-operative pain on lung functions after breast surgery. This study was designed to determine their effect on lung functions and post-operative pain in patients undergoing modified radical mastectomy.Materials and Methods:A total of 120 American Society of Anesthesiologists physical status 1 and 2 patients scheduled to undergo breast surgery were randomly allocated to receive IPB (Group IPB, n = 60) or paravertebral block (PVB) (Group PVB, n = 60) with 20 ml of 0.5% bupivacaine pre-operatively. A standard protocol was used to provide general anesthesia. Lung function tests, visual analog scale (VAS) for pain at rest and movement, analgesic consumption were recorded everyday post-operatively until discharge.Results:Lung functions decreased on 1st post-operative day and returned to baseline value by 4th post-operative day in both groups. VAS was similar in both groups. There was no significant difference in the consumption of opioids and diclofenac in both groups. Complete block was achieved in 48 patients (80%) in paravertebral group and 42 patients (70%) in inter pleural group.Conclusion:To conclude, lung functions are well-preserved in patients undergoing modified radical mastectomy under general anesthesia supplemented with paravertebral or IPB. IPB is as effective as PVB for post-operative pain relief. PVB has the added advantage of achieving a more complete block.

<p class="abstract"><strong>Background:</strong> Chronic maxillary sinusitis is one of the common ENT problems. Accessory maxillary ostium (AMO) has been postulated in many publications to play a role in the development of chronic maxillary sinusitis. AMO is found in the medial wall of maxillary sinus and located in the lateral wall of the nose. It’s been frequently identified in the routine nasal endoscopy. The variations in the location of AMO have been evaluated by nasal endoscopy in live subjects or through cadaver dissections by many authors. This live study is conducted to identify the prevalence of AMO during nasal endoscopic evaluation of chronic sinusitis patients.</p><p class="abstract"><strong>Methods:</strong> 52 adult patients with symptoms of chronic sinusitis attending the ENT outpatient department were selected and subjected to X-ray of the paranasal sinuses and laboratory tests. Nasal endoscopy was done in all patients to identify the presence and location of the AMO and the results presented.  </p><p class="abstract"><strong>Results:</strong> In the 52 patients studied the X-ray of the paranasal sinuses showed positive signs of sinusitis in 32 patients (61.5%). During nasal endoscopy in those 32 patients AMO was identified in 20 patients (62.5%).</p><p class="abstract"><strong>Conclusions:</strong> In patients presenting with symptoms of chronic sinusitis, apart from routine X-ray of the para nasal sinus, identification of the AMO during nasal endoscopy provides an additional evidence of obstruction of the natural ostia of the maxillary sinus. This will be valuable information to the surgeon who is contemplating on a surgical treatment to manage the chronic sinusitis.</p><p class="abstract"> </p>

<p><strong>Objective: </strong>The present investigations were undertaken to evaluate the hepatoprotective and antioxidant activity of the ethanolic extract of the whole plant of <em>Combretum albidum G </em>Don against CCl₄-induced hepatotoxicity in rats.</p><p><strong>Methods</strong><strong>:</strong><strong> </strong>Hepatoprotective effect of ethanolic extract of <em>Combretum albidum</em> (EECA) was determined by using carbon tetrachloride (CCl₄) intoxication of rats as experimental models. The extent of liver damage and effect of the plant extract was assessed by various biochemical parameters like alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total billrubin (TB) and total protein (TP) in blood serum and concentration of thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-s-transferase (GST) in liver were determined. Histopathological changes in the liver of different groups were also studied.</p><p><strong>Results: </strong>The administration of EECA at dose levels of 250 and 500 mg/kg/b.w., orally had decreased the rise of ALT, AST, ALP, TB and TBRAS levels and the effects were comparable to standard drug (Silymarin 25 mg/kg/b. w,) the GSH, SOD, CAT, GPx, GST and TP levels were significantly increased in the animals received EECA. The histopathological studies show decreased necrosis and hepatocellular degeneration when compared to the CCl  intoxicated liver.</p><p><strong>Conclusion: </strong>This study demonstrates that the hepatoprotective and the antioxidant activity of the whole plant of <em>Combretum albidum</em> therefore scientifically supports the use of this plant in traditional medicine for treatment of liver disorders.</p>

Background and Aims:Evidence and utility of the individual steps of the rapid sequence induction and tracheal intubation protocols have been debated, especially in the setting of traumatic brain injury. The purpose of this survey was to determine preferences in the current approach to rapid sequence intubation (RSI) in head injury patients among a population of anaesthesiologists from South India.Methods:A questionnaire was E-mailed to all the members of the Indian Society of Anaesthesiologists’ South Zone Chapter to ascertain their preferences, experience and comfort level with regard to their use of rapid sequence intubation techniques in adult patients with head injury. Participants were requested to indicate their practices for RSI technique for a head-injured patient upon arrival at the Emergency Medical Services department of their hospital.Results:The total response rate was 56.9% (530/932). Of the total respondents, 35% of the clinicians used cricoid pressure routinely, most respondents (68%) stated that they pre-oxygenate the patients for about 3 min prior to RSI, thiopentone (61%) and propofol (34%) were commonly used prior to intubation. Rocuronium was the muscle relaxant of choice for RSI among the majority (44%), compared to succinylcholine (39%). Statistical analyses were performed after the initial entry onto a spreadsheet. Data were summarised descriptively using frequency distribution.Conclusion:In a rapid sequence intubation situation, the practice differed significantly among anaesthesiologists. Owing to disagreements and paucity of evidence-based data regarding the standards of RSI, it is apparent that RSI practice still has considerable variability in clinical practice.

Objective: The present investigations were undertaken to identify phytochemicals by GC MS/MS, to evaluate the cardioprotective and antioxidant activity of the ethanolic extract of leaves of Cucumis Callosus against DOX-induced cardiotoxicity in rats.Methods: GC MS/MS method was carried out for identification of phyto-compounds present in the Cucumis Callosus. The Cardioprotective effect of Cucumis Callosus (CC) was determined by using Doxorubicin (DOX) intoxication of rats as experimental models. The extent of heart damage and effect of the plant extract was assessed by various biochemical parameters like alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total cholesterol (TC) and triglycerides (TGs) in blood serum and concentration of malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-s-transferase (GST) in heart tissue were determined. Results:In the Cucumis Callosus extract 32 compounds were identified by GC-MS/MS. Doxorubicin is used to bring significant changes in biochemical parameters and antioxidants in the heart. The pretreatment with Cucumis Callosus at two doses (250 mg/kg and 500 mg/kg) to DOX treated rats significantly prevented the altered enzymes SGPT, SGOT, CPK and LDH, lipid profile LDL, VLDL, TGs, HDL, TC and antioxidant SOD, GSH, CAT, GSH-Px and MDA to near normal level. Serum urea, uric acid, and ALP which are increased on DOX administration registered near normal values on pretreatment with Cucumis Callosus. Conclusion:This study showed that the cardioprotective and antioxidant activity of Cucumis Callosus, therefore scientifically rampart the use of this plant in traditional medicine for treatment of heart diseases.

Constrictive pericarditis (CP) is a chronic condition where pericardium gets thickened, fibrosed, and calcified, thereby restricting the filling of the ventricles. Surgical removal of the pericardium is the best effective treatment for CP. Because of the advent of newer and better antibiotics, the need for surgical pericardiectomy has declined at least in the developing countries [1]. Nevertheless, malignancy and radiation induced CP is not that uncommon. Pericardiectomy can be either radical or subtotal depending upon the extent of release of adhered pericardium. It can be done via midline sternotomy or anterolateral thoracotomy either on bypass or off bypass. Each technique has got its own merits and demerits. Two main factors determining the clinical and hemodynamic improvement after surgery are the extent of adequate resection and status of the underlying ventricles. Adequate resection is said to be achieved when both ventricles, atrioventricular grooves, and the bases of the great vessels are freed of the disease process [2]. The adequacy of resection intraoperatively is generally monitored by the fall in the baseline central venous pressures and rarely by the improvement in the voltages of electrocardiogram (ECG) complexes. However, these monitors are not without drawbacks. The central venous pressure monitored by the internal jugular vein (IJV) catheter is influenced by many factors like patient position, volume status, inotrope therapy, anesthetic drugs, and usage of chest retractors. ECG monitor also has got inherent drawbacks like being less sensitive, prone for cautery disturbances, and poor signals owing to loss of contact of electrodes because of the disinfectants used for cleaning, whereas

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The aim of the present study was the synthesis of hydrogel incorporated with chitosan blend with polyvinyl alcohol (PVA) from red cabbage Brassica oleracea and its application in wound healing and antibacterial activity. The chitosan/PVA hydrogel was synthesized by the combination of chitosan and PVA treated with acetic acid. The silver nanoparticles (AgNPs) were synthesized from the B. oleracea extract and its antibacterial efficacy was examined. The synthesized nanoparticles (NPs) were characterized using UV-spectroscopy and X-ray diffraction methods. The synthesized NPs were purified and combined with the hydrogel. This combined hydrogel and AgNP mixture was then subjected to Fourier transform infrared analysis, and the results were observed to conclude the effectiveness of the hydrogel. This hydrogel would differ in the part of dressing the wound, that is it can last on the wound for a longer period, thus reducing the pain and frequency of dressing and in turn naturally healing the wound in less time.