Background: Epidural anaesthesia with adjuvant is normally used for postoperative pain management in infra umbilical surgeries but search for ideal adjuvant without any side effect goes on. Aim: This study was done to assess the onset and duration of sensory and motor block and side effects of dexmedetomidine, when used as an adjuvant in epidural anaesthesia in infra umbilical surgeries. Subjects and Methods: 60 patients of ASA status I and II, posted for infra umbilical surgeries were randomly allocated into two groups of 30 each. Group L patients received epidural 0.5% levobupivacaine. Group LD patients received epidural 0.5% levobupivacaine and 1μg/kg dexmedetomidine. Preoperative and postoperative block characteristics as well as hemodynamic parameters and side effects were monitored. Results: Dexmedetomidine as an adjuvant had an earlier onset and longer duration of sensory and motor block compared to levobupivacaine alone. Sedation scores were statistically significant with dexmedetomidine group in comparison to levobupivacaine alone group. Conclusion: Dexmedetomidine, as an adjuvant to epidural levobupivacaine provided prolonged analgesia in infraumbilical surgeries.
Background: Most of the hanging cases are consider as suicidal until the homicidal and accidental are prove, because both homicidal and accidental hanging are rare. In these cases a watchful forensic examination plays an important role to determine the ante mortem character of the lesion and to exclude causes of hanging other than suicidal hanging. Aim: This study done to know the internal and external assessment findings among hanging cases. Subjects and Methods: Hanging deaths with external neck injuries along with ligature mark were included in this study. In this study a total of 60 cases of deaths due to hanging, was subjected to medico legal autopsy. Results: Most of the cases were observed in the age group of 21-40 years i.e., 41 (69.4%) out of 59 hanging deaths. Out of 59 deaths, 32 (54.2%) were females and 27 (45.7%) were males. Among neck structure injuries, majority of hanging cases had rupture / contusion of sternocleidomastoid and other strap muscles of neck, it was 57.6%. 33.8% cases had carotid intimal tear, 5% cases showed hyoid bone fracture and 3.3% thyroid cartilage. No fractures noted in Cricoid cartilage and cervical vertebra. Conclusion: Social awareness, problem solving and family support of most common age group is extremely necessary.
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