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Objectively measuring animal behavior is key to understanding the neural circuits underlying pain. Recent progress in machine vision has presented us with unprecedented scope in behavioral analysis. Here, we apply DeeplabCut (DLC) to dissect mouse behavior on the thermal-plate test — a commonly used paradigm to ascertain supraspinal contributions to noxious thermal sensation and pain hypersensitivity. We determine the signature characteristics of the pattern of mouse movement and posture in 3D in response to a range of temperatures from innocuous to noxious on the thermal-plate test. Next, we test how acute chemical and chronic inflammatory injuries sensitize mouse behaviors. Repeated exposure to noxious temperatures on the thermal-plate can induce learning, and in this study, we design a novel assay and formulate an analytical pipeline that will facilitate the dissection of plasticity mechanisms in pain circuits in the brain. Last, we record and test how activating Tacr1 expressing PBN neurons — a population responsive to sustained noxious stimuli-affects mouse behavior on the thermal plate test. Taken together, we demonstrate that by tracking a single body part of a mouse, we can reveal the behavioral signatures of mice exposed to noxious surface temperatures, report the alterations of the same when injured, and determine if a molecularly and anatomically defined pain responsive circuit plays a role in the reflexive hypersensitivity to thermal pain.

Stress is a powerful modulator of pain. Specifically, acute stress due to physical restraint facilitates stress-induced analgesia (SIA). However, where, and how acute stress and pain pathways interface in the brain must be better understood. Here, we describe how the lateral septum (LS), a forebrain limbic nucleus, facilitates SIA through its downstream targets in the lateral hypothalamus (LH). We show that the LS→LH circuitry is sufficient to drive analgesia and is required for SIA. Further, we reveal that the LS→LH pathway is opioid-dependent and modulates pain through the pro-nociceptive neurons in the rostral ventromedial medulla (RVM). Remarkably, we found that the LS neurons are inhibitory, are recruited specifically when the mice struggle to escape under restraint, and, in turn, inhibit excitatory LH neurons. As a result, the RVM neurons downstream of LH are disengaged when the mice try to escape, thus suppressing nociception. Next, our data indicate that the efforts to escape are communicated by the lateral periaqueductal gray (lPAG) to the LS and activation of the upstream lPAG→LS circuit phenocopies LS→LH activation and results in analgesia. Thus, we have revealed a polysynaptic pathway that can transform escape behavior in mice under restraint to acute stress and resultant analgesia.

Background:Endoscopic retrograde cholangiopancreatography (ERCP), often require sedation during the procedure. The most commonly used drugs for this purpose are midazolam and propofol, which are used as sedative and hypnotic agents with minimal analgesic potential. Aims & objectives:Effects of Sedoanalgesia with Midazolam/ ketamine long with Dexmedetomidine nfusion & Rescue propofol alliquotes regimes on hemodynamic and respiratory variables& recovery profile in patients undergoing ERCP. Methods:In this Retrospective observational study adult patients of ASA gradel- lll were enrolled after taking inform consent from patient & their relatives. Premedication was given in form of inj.Midazolam 0.02 mg/kg iv in Group l,.inj ketamine 0.5 mg/kg iv was given in group ll. Inj.Dexmedetomidine ( bolus dose of 1 μg/kg over 10 min) followed by 0.5μg/kg/hour as maintenance in both the groups.intermittent Intravenous Propofol alliquotes was used for maintain BIS 70-80 in both groups. Amount of propofol used during procedure was notified.. Hemodynamic and respiratory variables, recovery time and adverse events weremonitored & recorded. Results:The hemodynamic and respiratory variables were similar in both groups. Total propofol consumption was significantly lower in the group ll. (205+/-80 mg vs.155+/-20 mg p < 0.001). The recovery period was shorter in group ll (time to achieve the Aldrete score 9 was 9.0 ±2.2 vs. , 6.2+/-1.1min p < 0.001).Adverse events were comparable between the two groups. Conclusion:Ketamine-Dexmedetomidinecombination with propofol may be a safe and useful alternative for sedation for ERCP patients.

Background: Primary caesarean section is defined as caesarean section to be performed in women who have not had previous caesarean delivery. The increase in the rates of primary caesarean section is not only due to increased caesarean section in nulligravida but also due to upward rise in caesarean section rates in parous women. Through this study we aimed to examine the frequency and the indications of primary caesarean section in nulliparous and multiparous women.Methods: A prospective study was carried out in the OBGY department of smt. SCL Hospital, NHL municipal medical college from April 2020 to April 2021. All multiparous women with previous normal vaginal delivery who underwent caesarean section this time were included in this study. Patients with previous caesarean section

Background: Referral is a coordinated movement of healthcare seekers through the health system to reach a high level of care in a small and often fatal window of time. Even physiological processes like pregnancy and childbirth are not free of complications. The purpose of this study is to understand maternal and foetal outcome in caesarean sections in referred cases.Methods: A prospective study was carried out in the OBGY department of SMT.SCL HOSPITAL, NHL Municipal medical college from April 2020 to April 2021. All referred antenatal and intranatal patients to our tertiary care centre with >20 weeks of gestation who underwent caesarean section with referral note.Results: A total 64% patients were referred from community health center. 63.5% patients were referred due to lack of high-risk management services. 211 patients underwent caesarean section while 69 patients had normal vaginal delivery. Difficulty in delivery of the baby was encountered in 53% of cases due to deep engagement of the fetal head. Major cause of admission in NICU was sepsis (38.6%) followed by prematurity (23.8%).Conclusions: Cesarean section is one of the quickest and most efficient method in the delivery of the baby and thus should in considered in patients in critical situations .The millennium development goals defined by united nation includes one goal (MDG 5) towards improving maternal health which still remains a challenge. Thus, improving knowledge of women regarding good antenatal care and strengthening referral services will play a big role in this.