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Background: In this study, we have compared the addition of fentanyl 25 mcg and dexmedetomidine 5 mcg to 15 mg of 0.5% hyperbaric bupivacaine for spinal anesthesia separately for patient undergoing lower limb orthopedic surgery. Dexmedetomidine is an α-2 adrenoreceptor agonist and it can prolong the motor and sensory block for long spinal anesthesia. It act by binding to presynaptic C-fiber and postsynaptic dorsal horn neurons. The analgesic action is a result of depression of release of C-fiber transmitters and hyperpolarization of postsynaptic dorsal horn neurons. Aims and Objectives: The present study compares the onset, duration of sensory and motor block, postoperative analgesia, hemodynamic changes, and adverse effects of intrathecal dexmedetomidine and intrathecal fentanyl as an adjuvant to bupivacaine during spinal anesthesia for lower limb orthopedic surgery. Materials and Methods: Patient was randomly grouped by close-envelope technique into the three equal group of 30 in each group. Total 90 patients were including in this study. The blind nature of the study was maintained and the study drug is given according as, Group-1: 15 mg of 0.5% hyperbaric bupivacaine. (Control group), Group-2: 15 mg of 0.5% hyperbaric bupivacaine with 25 mcg of fentanyl, and Group-3: 15 mg of 0.5% hyperbaric bupivacaine with 5 mcg dexmedetomidine for spinal anesthesia. Results: Patients in dexmedetomidine Group-3 had a significantly longer sensory (160±18.5 min) and motor block (242±22 min) time as compared to patients in fentanyl and control group (P<0.001). The time to first request of analgesic in the post-operative period was also longer in dexmedetomidine group (245±3.6 min) when compared to bupivacaine and fentanyl in which it was 125±1.0 min and 220±2.5 min, respectively (P<0.001). Conclusion: We concluded that intrathecal dexmedetomidine with bupivacaine for spinal anesthesia is associated with prolong motor and sensory block then fentanyl 25 μg with bupivacaine and bupivacaine alone. [ABSTRACT FROM AUTHOR]

Background: In this study, we have compared the analgesic effect of addition of dexmedetomidine and clonidine as an adjuvant to 20 ml solution of 0.5% bupivacaine in ultrasound guided supraclavicular brachial plexus block .Dexmedetomidine is an a-2 adrenoreceptor agonist and it can prolong the motor and sensory block for local anaesthesia. It acts by binding to presynaptic C- fibre and postsynaptic dorsal horn neurons. The analgesic action is a result of depression of release of C- fiber transmitters and hyperpolarization of postsynaptic dorsal horn neurons. Methodology: Patient were randomly grouped by close-envelope technique into the three equal group of 30 in each group. Total 90 patients were including in this study. The blind nature of the study was maintained and the study drug is given according as, Group -1: 20 ml of 0.5% bupivacaine.(Control group). Group -2: 20 ml of 0.5% bupivacaine with 1mcg/kg of clonidine and. Group -3: 20 ml of 0.5% bupivacaine with 1mcg/kg dexmedetomidine for spinal anesthesia. Result: Patients in dexmedetomidine group-3 had a significantly longer sensory. Results: Patients in dexmedetomidine group-3 had a significantly longer sensory (546±32.5min) and motor block (442± 42.2min) time as compared to patients in clonidine and control group.(P<0.001). The time for first request of analgesic in the post-operative period was also longer in dexmedetomidine group (445±33.6 min) when compared to bupivacaine (control group) and clonidine group in which it was (292±18.5min) and (362±22.6 min Respectively. (P<0.001). Conclusion: We concluded that dexmedetomidine with bupivacaine for local anaesthesia is associated with more prolonged motor and sensory block than clonidine with bupivacaine and bupivacaine alone. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine important work on MOOCs by researchers in the form of major contributing universities, sources of funding, authors, journals, keywords, and citation data. Design/Methodology/Approach: In this study, the researchers assessed by conducting a systematic review of MOOC literature, as other researchers have rightly said that reviewing entails learning from experience. In this study, patterns of research publications within particular topics and historical periods were described using bibliometric analysis, quantitative analysis, and statistical analysis. Findings: The results of this study's cluster analysis revealed the areas where future academics might focus their efforts on MOOCs for future research. There were a total of 199 entries in the notifications, which were then sorted into seven clusters. Every cluster contains different numbers of items. According to the study's findings, education, e-learning, online learning, massive open online courses, and data mining are the most often used keywords. Mostly, Social sciences and computer sciences articles have the highest contribution to research. Research Limitation: The current study only makes use of the Scopus database. The study's focus was taken into consideration when selecting the keywords. Only three keywords were used in this study. The sole language employed in this study was English. Managerial Implications: Tthe paper would help the policymakers Future studies can analyse actual challenges faced by higher education institutions and suggest methods for incorporating MOOCs into the teaching environment to address them. In-depth reporting on real-world case studies can be helpful to academics as well as practitioners. Originality/Value: The evaluation of selected papers yielded a major contribution and food for thought for both scholars and policymakers. [ABSTRACT FROM AUTHOR]

Odontogenic myxoma in the jaws is infrequent, accounting for only 3%-6% of odontogenic tumours. People in the second and third decades of their life are believed to suffer the most, with the posterior part of mandible is the most affected site. The radiological appearance of this tumour is complicated. The "sunray" or "sunburst" appearance in Odontogenic myxoma has been reported in the literature although rarely. Here we report a case of a 22 year old male presenting with odontogenic myxoma in the mandible showing sunburst appearance. [ABSTRACT FROM AUTHOR]

Adductor canal block (ACB) till now has been administered mostly by anesthesiologists who have access to ultrasound machines. It can be done blindly but the success rate is poor and variable. In this article, we describe peripheral nerve stimulation (PNS) guided ACB. Use of PNS will not only widen the acceptance of this block but also improve the success rate of analgesia for surgeries around the knee. We also describe the anatomical basis of this block and our experince with PNS guided ACB. [ABSTRACT FROM AUTHOR]