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Byline: Qazi. Ali, N. Nisanth, Syed. Amir, Asma. Rahat Background and Aims: Videolaryngoscopes with varying characteristics with regard to angulation of blades and video configurations are now available. However, the [...]

Background: Preemptive analgesia is a method of administration of drugs prior to surgery involving blocking noxious stimuli across the perioperative period. It involves blocking the pain pathway preemptively before injury-induced hypersensitivity manifests. Objective: To compare the analgesic efficacy of duloxetine with pregabalin as preemptive analgesic in lumbar spine surgeries. Design: Randomised, double-blinded, prospective study. Methods: Fifty patients of both sexes between 18-55yrs undergoing elective lumbar spine surgery were randomly allocated into two groups, group P and group D of twenty-five patients each. Group P received 75 mg pregabalin once daily for three days, followed by 150 mg pregabalin daily for the next four days till the day of surgery. Group D received 20 mg duloxetine once daily for three days, followed by 40 mg duloxetine twice daily for the next four days till the day of surgery. Outcome Measure: Both the groups were primarily evaluated in terms of time for request of 1st rescue analgesic and total intraoperative analgesic requirement in terms of fentanyl boluses required; among other parameters. Results: The time for request of 1st rescue analgesic postoperatively was significantly longer in the pregabalin group (396 ± 267.77 min) than in the duloxetine group (218.4 ± 96.9 min), P = 0.003. Pregabalin recipients required considerably less rescue analgesics in terms of dosage, P = 0.006. Also, pregabalin exhibited better postoperative pain control than duloxetine as reflected by NRS comparative scores. No statistical difference was appreciated in terms of intraoperative fentanyl requirement, intraoperative hemodynamic control; nausea and sleepiness. Conclusion: Pregabalin is more efficacious as a preemptive analgesic than duloxetine in lumbar spine surgery. [ABSTRACT FROM AUTHOR]

Byline: N. Nisanth, Qazi. Ali, Syed. Amir Background and Aims: Studies on simulated difficult airway provide an opportunity to evaluate the performance of intubation devices for use in limited neck [...]

Experiments are reported, which allow us to quantify the near-surface cation diffusion in (001) oriented Fe_{3}O_{4} single crystals at temperatures between 470 and 770 K. Thin homoepitaxial films of magnetite, grown using isotopically labeled ^{57}Fe, were investigated by neutron reflectivity and time-of-flight secondary ion mass spectrometry. By heating the thin films in high vacuum to different temperatures for a well-defined time and determining the ^{57}Fe distribution along the surface normal, the diffusion lengths are obtained. For the investigated temperature range, diffusion constants of the order of 10^{−20} m^{2}/s are deduced. These results are important in view of near-surface mass transport induced by oxygen chemical potential differences occurring when magnetite is exposed to different gas atmospheres or by adsorbates.

Background: Adhesive capsulitis is a condition that presents with pain and progressive limitation of both active and passive shoulder movements. It can be primary or secondary, the latter includes causes such as rotator cuff tear, cardiovascular disease, and diabetes mellitus. The American Shoulder and Elbow Surgeons defines that adhesive capsulitis is a condition of uncertain ethology characterized by a significant restriction of both active and passive shoulder motions that occur in the absence of known intrinsic shoulder disorder. Commonly described as: Stage 1 – Freezing stage, with pain and stiffness lasting around 9 months. Stage 2 – Frozen stage, with persistent stiffness lasting 4–12 months. Stage 3 – Thawing stage, with spontaneous recovery lasting 12–42 months. Ultrasonography (USG)-guided hydrodissection is used for adhesive capsulitis of the shoulder due to its cost-effectiveness and acceptance among patients. As adhesive capsulitis is postulated as an i nflammatory and fibrotic disease, easy treatment with intra-articular corticosteroids (CSs) injection may reduce synovitis, limit the development of capsular fibrosis, and alter the natural history of disease. CS injections are effective for shorter duration, but newer agents such as platelet-rich plasma (PRP) are more effective with no serious side effects. Materials and Methods: In this study, 40 patients were taken of adhesive capsulitis of the shoulder and were divided randomly into two groups. One group received injection PRP and the other group received injection CS. The outcome was recorded. Results: There was a statistically significant reduction in numeric rating scale pain scores in both the groups over a time period of 6 weeks, but the PRP injection was observed to be better in reducing the pain scores when compared to the CS injection after the 6th week (P = 0.037). Initially, the CS injection performed better in the 1st week due to anti-inflammatory action. By the 3rd week, both the injections showed a similar effect. However, at the end of the study period (6 weeks), there was a better reduction in the Shoulder Pain and Disability Index (SPADI) pain scores (P = 0.0057) and SPADI disability scores (P = 0.029) of the group PRP. Conclusion: We concluded that USG-guided hydrodissection with PRP is more effective therapy than CS in terms of reduction of pain and improvement in shoulder function in the treatment of adhesive capsulitis of shoulder. [ABSTRACT FROM AUTHOR]

Background: The use of ultrasonography (USG) to identify fascial layers has led to the development of several newer interfascial techniques for analgesia of the chest and abdominal wall. Two such modalities are the Pectoral nerve block (PEC) and Serratus Anterior Plane (SAP) block. Objective: To compare the duration and quality of analgesia provided by ultrasound-guided SAP block with PEC block II in patients undergoing breast surgeries after induction of general anesthesia. Design: Randomized, double-blinded, prospective study. Methods: Sixty female patients were divided into two groups of 30 each. Patients in Group P received USG guided PEC II block, whereas patients in Group S received USG-guided SAP block after induction. Outcome Measure: The primary objective was to compare the duration of pain relief, whereas the secondary objectives were to compare the degree of pain relief, postoperative analgesic requirement within 24 h after the completion of the surgery, patient satisfaction score and complications if any. Results: The mean time of the first dose of analgesic given was 826 ± 405.24 min. in Group P and 1280 ± 264.29 min. in Group S (P < 0.001). The mean numeric rating scale score at rest at 6 h, on movement at 2 h and 6 h and satisfaction scores in Group P were significantly more than Group S. Conclusion: Ultrasound-guided SAP block provides better postoperative analgesia both in quality and duration over PEC II block. [ABSTRACT FROM AUTHOR]

Byline: Qazi. Ali, L. Manjunatha, Syed. Amir, Shaista. Jamil, Abdul. Quadir Background and Aims: Bupivacaine has been the most frequently used local anaesthetic in brachial plexus block, but ropivacaine has [...]

Byline: Qazi. Ali, Syed. Amir, Obaid. Siddiqui, Shaista. Jamil Introduction Burns due to a variety of reasons are an important medico-social issue in developing countries, including India. Patients with chronic [...]

Byline: Qazi. Ali, Syed. Amir, Muzammil. Shafi, Tariq. Chaudhri Sir, Plexiform neurofibromas (PNF) are benign tumors originating from nerve sheath cells, subcutaneous, or visceral peripheral nerves and can involve multiple [...]

Byline: Qazi. Ali, Syed. Amir, Obaid. Siddiqui, Abu. Nadeem, Abdulla. Azhar Airway management in patients of ankylosing spondylitis remains a challenge for anaesthesiologists. Many new airway devices have been used [...]

Background and Aims: Video Stylet (VS) is a new intubating modality that provides real-time video of endotracheal intubation (ETI). This device does not need alignment of the oral, pharyngeal and tracheal axes to view glottis and can be used in patients with limited mouth opening. The aim of this study was to compare flexible fibre-optic (FO) bronchoscope with VS in elective surgical patients in apparently normal airway patients requiring oral ETI. Methods: Sixty patients undergoing elective surgery under general anaesthesia of age group 20-60 years, weight 40-70 kg, American Society of Anesthesiologist 1 and 2 and modified Mallampatti I and II were included in the study. Patients in group FO (n = 30) were intubated by flexible FO bronchoscope, whereas patients in group VS (n = 30) were intubated by VS. Primary outcome measure was time taken for intubation (TTI). Secondary outcome measures were successful intubation, haemodynamic response and post-operative complications if any. Results: Average TTI in cases of FO group was 38.2 s (95% confidence interval [CI] 36-41) and in VS group was 19.7 s (95% CI 19-21; P = 0.0001). Three patients required a second attempt for successful intubation in FO group compared to eight in VS group (P = 0.2), with no failures in any group. Haemodynamic response and complications rate were greater in VS group; however, the differences were not statistically significant. Conclusion: VS takes lesser time to intubate than flexible FO bronchoscope. [ABSTRACT FROM AUTHOR]

Tissue composition of the atria plays a critical role in the pathology of cardiovascular disease, tissue remodeling, and arrhythmogenic substrates. Optical coherence tomography (OCT) has the ability to capture the tissue composition information of the human atria. In this study, we developed a region-based automated method to classify tissue compositions within human atria samples within OCT images. We segmented regional information without prior information about the tissue architecture and subsequently extracted features within each segmented region. A relevance vector machine model was used to perform automated classification. Segmentation of human atrial ex vivo datasets was correlated with trichrome histology and our classification algorithm had an average accuracy of 80.41% for identifying adipose, myocardium, fibrotic myocardium, and collagen tissue compositions. [ABSTRACT FROM AUTHOR]

This paper's aim is to determine the success and failure status of bio gas technology (BGT) in one purposively selected district in Khyber Pakhtunkhwa (Pakistan). Five villages were selected randomly as a sample out of all villages in the district. Data were collected by using qualitative methods involving secondary sources, community transect walks, informal interviews, group interviews from February to April 2015. Results reveals that overall BGT success rate was not very good (i.e. 69%) in the context of available resources. Proper bio digester (BD) operation was the main reason of success characterized with sufficient as well as regular feeding of substrate to bio digesters and eventually it resulted in better maintenance level. In addition, farmers' rationality and activeness were found significant factors in BGT success regarding their attempts to know about highly recommended bio digester construction and operation procedure. Another reason of success was experienced masons who knew the design of BD construction but unfortunately they were not good enough for the whole project area, some were good while others were careless. The main reasons of BGT failure were use of poor quality of construction materials and inexperienced masons, poor quality of construction materials, improper and irregular feeding to bio digesters, poor monitoring of The Foundation for Integrated Development Action (FIDA) field staff, improper need assessment of beneficiaries by FIDA, improper site selection for building BD and 100% subsidization rate by FIDA to provide bio digesters. [ABSTRACT FROM AUTHOR]

Abstract: Meningocele is a neural tube defect where meninges protrude through a skeletal defect. Occipital meningocele compounded with the problems of paediatric airway itself pose challenges to anaesthesiologist in securing and maintaining airway. We present a case report of a 3month-old-child with occipital meningocele posted for ventriculo-peritoneal shunt for hydrocephalus, who was successfully intubated using a size 1 Airtraq optical laryngoscope. [Copyright &y& Elsevier]