Group PF Research Articles

Sedation for Colonoscopy Procedures Using Dexmedetomidine Versus Propofol-Fentanyl Infusions: A Prospective Randomized Controlled Trial.

Different anaesthetists for sedation or monitored anaesthesia care have been used for colonoscopy. The target of this research was the ability to perform colonoscopy under a painless degree of sedation and the prevalence of undesired proceedings. A total of 60 patients were randomly divided into two groups: Group D received dexmedetomidine and Group PF received propofol-fentanyl. Patients in both groups received the same infusion ratio. The minimum infusion amount of dexmetatomidine is (0.1 to 0.4 μg kg-1 h-1) in Group D, whereas fentanyl is administered at a rate of 0.01 to 0.05 μg kg-1 min-1 in the PF group during the approximately 45-min colonoscopy. Group D exhibited significantly lower modified Observer's Assessment of Alertness/Sedation (OAA/S) scores at intraoperative time points T1-T12. Group D also exhibited significantly lower visual analog scale scores for pain at intraoperative time points T4 and T7. The mean arterial pressure was significantly lower in Group D at intraoperative times T6-T8 and T11-T12, as well as upon admission to the post-anaesthesia care unit (PACU) and 30 min after admission to the PACU. The results of the ANOVA tests revealed a significantly lower heart rate in Group D. The respiratory rate exhibited a notable decrease during time intervals T8 and T10 in the PF group. The administration of dexmetatomidine and propofol-fentanyl during colonoscopy was found to be safe. In addition, dexmetatomidine may present significant benefits in this context because of its lower occurrence of adverse respiratory events.

Correlation between quality of obturation and outcome of pulpectomized primary molars following root canal instrumentation with pediatric rotary file systems

IntroductionThe success of root canal treatment is influenced by several factors including the type and technique of root canal preparation, the type of irrigants used, the quality of obturation, and post-endodontic restoration. Recent systematic reviews have concluded that there is no substantial evidence to establish the superiority of rotary file systems over hand files in terms of clinical and radiographic success in pulpectomized teeth. AimTo determine the correlation between quality of obturation and long-term outcome of pulpectomized primary molars following root canal instrumentation with pediatric rotary file systems and a hand file system. MethodsThe study involved 100 primary molars from children aged 4–7 years that required pulpectomy. The teeth were divided into four groups, each consisting of 25 teeth. In the first, second, third, and fourth groups, root canal instrumentation was carried out with Pedo-Flex pediatric rotary files (Group PF), Kedo-SG pediatric rotary files (Group KS), Pro-AF Baby Gold pediatric rotary files (Group BG), and hand nickel titanium K files (Group HF), respectively. Obturation was performed with zinc oxide eugenol cement using an engine-driven Lentulo-spiral. The quality of the root filling was assessed immediately after obturation through radiographic examination. The pulpectomized teeth were then evaluated both clinically and radiographically over a two-year period. ResultsThe quality of obturation was superior in the root canals instrumented with pediatric rotary file systems compared to hand files. At the end of follow-up period, the clinical success rate was 100% and the radiological success rates were 88%, 92%, 92%, and 80% in Groups PF, KS, BG, and HF, respectively. The optimally filled pulpectomized primary molars resulted in a superior success rate than compared to underfilled or overfilled teeth. ConclusionThe quality of obturation significantly influences the success rate of pulpectomized teeth. Therefore, the use of pediatric rotary files is recommended as rotary files contribute to a greater number of optimally filled canals.

Demographic study of endocrine tumours in northwestern India: a five-year retrospective chart review analysis of 3081 thyroid and other endocrine lesions from Jaipur, Rajasthan

Endocrine tumours are commonly encountered in clinical practice. The demographic data in a specific part of the country can be harnessed only from a tertiary care referral center. We aimed to analyze the epidemiological pattern of various histopathological subtypes of four major endocrine glands in the body in Northwestern India. In this retrospective chart review analysis, we reviewed three lakh records of histopathologically proven tumours coming to four major pathology departments and laboratories in Jaipur, Rajasthan over five years; of which 3081 were from patients with endocrine tumours. We included these endocrine tumours in our study and the results were obtained. The collected data were analyzed and results were obtained using Microsoft Excel 2019 Version 2107. Thyroid tumours were the most common tumours (96.8%) with adrenal, parathyroid and pituitary in order. Percentage of malignant cases among the thyroid disorders was 20.55%. Multinodular goitre (50.3%) and papillary carcinoma thyroid (77.67%) topped the benign and malignant thyroid tumours respectively. Females in 21 to 40 years age group were most affected in thyroid tumours. Pheochromocytoma was the most common adrenal tumour (60%) most commonly affecting females in the age group pf 21 to 40 years of age. Parathyroid adenoma constituted the majorchunk of parathyroid tumours (86.9%) with no sex predilection and affecting patients mostly in the age group of 31 to 45 years. Pituitary adenoma was found in 34 of 35 cases with a female preponderance and a wide range of affected age groups (21 to 50 years). Different histopathological subtypes of endocrine gland tumours have a varied epidemiological profile in NorthwesternIndia and incorporation of this knowledge will help improve the clinical acumen of the treating personnel in this part of the country.

The Effects of Different Feeding Regimes on Body Composition, Gut Microbial Population, and Susceptibility to Pathogenic Infection in Largemouth Bass.

This study investigated the effects of dietary commercial feed (n = 50,025 in triplicate, named group PF for soil dike pond, sampling n = 7; n = 15,000 in triplicate, WF for water tank, n = 8), iced fish (n = 50,025 in triplicate, PI, n = 7), and a combination of both (n = 50,025 in triplicate, PFI, n = 8) on different metabolic parameters of the largemouth bass, Micropterus salmoides (0.67 ± 0.09 g, culture period from June 2017 to July 2018). Throughout the experimental period, different areas of water (including input water of the front, middle of the pond, and from the drain off at the back) and their mixed samples were simultaneously analyzed to find the source of the main infectious bacteria. Various feeding strategies may differentially affect body composition and shape the gut microbiota, but the mode of action has not been determined. Results showed that no significant differences were found in the growth performance except for the product yield using a different culture mode (PFI vs. WF). For muscle composition, the higher ∑SFA, ∑MUFA, ∑n-6PUFA, and 18:3n-3/18:2n-6 levels were detected in largemouth bass fed with iced fish, while enrichment in ∑n-3PUFA and ∑HUFA was detected in largemouth bass fed with commercial feed. For the gut microbiota, Fusobacteria, Proteobacteria, and Firmicutes were the most dominant phyla among all the gut samples. The abundance of Firmicutes and Tenericutes significantly decreased and later increased with iced fish feeding. The relative abundance of species from the Clostridia, Mollicutes, Mycoplasmatales, and families (Clostridiaceae and Mycoplasmataceae) significantly increased in the feed plus iced fish (PFI) group relative to that in the iced fish (PI) group. Pathways of carbohydrate metabolism and the digestive system were enriched in the commercial feed group, whereas infectious bacterial disease resistance-related pathways were enriched in the iced fish group, corresponding to the higher rate of death, fatty liver disease, and frequency and duration of cyanobacteria outbreaks. Feeding with iced fish resulted in more activities in the digestive system and energy metabolism, more efficient fatty acid metabolism, had higher ∑MUFA, and simultaneously had the potential for protection against infectious bacteria from the environment through a change in intestinal microbiota in the pond of largemouth bass culturing. Finally, the difference in feed related to the digestive system may contribute to the significant microbiota branch in the fish gut, and the input and outflow of water affects the intestinal flora in the surrounding water and in the gut, which in turn affects growth and disease resistance.

The relationship between frailty and spinal alignment in the elderly general population: a two-year longitudinal study.

Frailty is caused by age-related decline in physical function, which may contribute to worsening spinal alignment. Cardiovascular Health Study (CHS)-criteria for assessing physical function seem more appropriate than frailty index which evaluate comorbiduty. However, there have been no reports investigating the relationship between frailty and spinal alignment using the CHS criteria. This study aimed to examine spinal radiographic parameters using the CHS criteria in volunteers participating in a health screening study. The subjects were 211 volunteers (71 males and 140 females) aged 60-89years old who participated in the TOEI study in 2018 and 2020. They were divided into three groups (R: robust, PF: pre-frailty, and F: frailty) according to the score of the Japanese version of the CHS (J-CHS) criteria in 2018. The radiographic parameters were evaluated using a whole-spine standing X-ray. There were 67 volunteers in group R, 124 volunteers in group PF, and 20 volunteers in group F. Of the five items in the J-CHS criteria, low activity was the most common in the PF group (64%). Low activity was also the most common in the F group (100%). Regarding spinal alignment, significant differences were found in C7SVA in 2020 (R:PF:F = 26:31:62mm, P = 0.047), C2SVA in 2018 (20:34:63mm, P = 0.019), and C2SVA in 2020 (37:47:78mm, P = 0.041). Frailty was associated with a worsening in global alignment along the 2- year follow up. The frailty may begin with a decrease in activity and progression of exhaustion; preventing this progression is important through motivation to exercise. II.

Hemodynamic Effects and QTc Changes with Intravenous Phenytoin and Fosphenytoin during Propofol and Sevoflurane Anesthesia

Abstract Background Phenytoin is a commonly used antiepileptic drug (AED) for postoperative seizure prophylaxis; it is associated with adverse cardiovascular effects. Fosphenytoin is considered a safer alternative but can produce prolongation of QT interval. This hypothesis generating pilot study evaluated the changes in hemodynamics and the heart rate corrected QT interval (QTc) with phenytoin and fosphenytoin during propofol and sevoflurane anesthesia. Methods Eighty American Society of Anesthesiologists I and II patients aged 20 to 60 years undergoing elective supratentorial craniotomy requiring a loading dose of the intraoperative AED for seizure prophylaxis were randomized into four groups: group PP, receiving propofol (0.2 mg/kg/min) for maintenance and phenytoin (15 mg/kg) for seizure prophylaxis; group SP, receiving sevoflurane (1 minimal alveolar concentration) for maintenance and phenytoin(15mg/kg) for seizure prophylaxis; group PF, receiving propofol for maintenance and fosphenytoin (22.5 mg/kg) for seizure prophylaxis; and group SF, receiving sevoflurane for maintenance and fosphenytoin for seizure prophylaxis. The heart rate, systolic, diastolic, mean arterial pressure, and QTc were measured at baseline before anesthesia, during maintenance of anesthesia, and during various phases of AED infusion and up to 1 hour after completion of AED administration. Appropriate statistical analysis was done and a two-tailed p-value of less than 0.05 was considered significant. Results The incidence of changes in the heart rate and hypotension was not significant among the groups. Administration of fosphenytoin significantly prolonged QTc, which was more remarkable when coadministered with sevoflurane than with phenytoin. Conclusion Fosphenytoin did not confer hemodynamic benefits over phenytoin. Fosphenytoin produces prolongation of QTc, and when coadministered with sevoflurane, the prolongation is more significant, suggesting a possible additive effect.

The antimicrobial peptide MetchnikowinII enhances Ptfa antigen immune responses against avian Pasteurella multocida in chickens.

Immunostimulants and vaccines are the main means for controlling infectious diseases and searching highly effective and low toxic immunestimulants has always been the focus of researchers. The MetchnikowinII (MetII) had been expressed by us and exhibited both antibacterial and antifungal activities, in this study, we evaluated its potential for an adjuvant effect. In chickens, antigen-specific immunoglobulin Gs (IgGs) were increased after MetII adjuvanted vaccination using the Ptfa protein. Compared to group Ptfa + iFA, which was only adjuvanted with incomplete Freund's adjuvant (iFA), the antibody titers of the group Ptfa + iFA + Met20 μg·mL-1 (PFM20) and Ptfa + iFA + Propolis (PFP) significantly increased (P<0.05). Likewise, Interleukin-2 (IL-2) and Interferon-γ (IFN-γ) cytokines in group Ptfa + iFA + Met20 μg·mL-1 (PFM20) and Ptfa + iFA + Propolis (PFP) were significantly higher than those of the other three experimental groups (P<0.05). The stimulation index (SI) value in chickens of group PFM20 was significantly higher than that of the other four experimental groups (P<0.05). Chickens that received MetII adjuvanted vaccinations benefitted from higher protection rate (88%) when challenged with Pasteurella multocida (P. multocida), which was significantly higher than those of group PF and PFP (P<0.05). These results suggested that the antimicrobial peptide MetII may play an adjuvant role in the immune response in chickens but need a proper usage, because the higher usage of 40 μg·mL-1 and 60 μg·mL-1 resulted poor effect. Whether MetII could be a potential adjuvant or a biomolecule as part of a complex adjuvant for vaccines needs more experimental evidence, the study still provides an examples for understanding vaccine adjuvants.

USE OF BISPECTRAL INDEX (BIS) FOR MONITORING OF SEDATION AND TOTAL INTRAVENOUS ANESTHESIA (TIVA) IN PEDIATRIC PATIENTS UNDERGOING COLONOSCOPY

The objectives of this study were to determine whether there was a correlation between bispectral index (BIS) and Ramsey Sedation Scale (RSS) in regard to the type of sedation and total intravenous anesthesia (TIVA) during colonoscopy procedures in children, and to assess the utility of ketamine and propofol combination (ketofol) for this kind of procedures at children’s age. In our prospective study, 40 ASA I-II patients, 3 to 17 years of age, were randomly divided into two groups of 20 patients each. After premedication with atropine and midazolam, sedation was induced with propofol and fentanyl in Group PF, whereas in Group PK propofol and ketamine were used for induction. Both groups were further divided into two subgroups depending on whether anesthesia was maintained with intermittent doses or continuous infusion of propofol. Ketamine and/or fentanyl were administered as bolus doses. Heart rate (HR), peripheral oxygen saturation (SpO2), RSS and BIS values of all patients were recorded every 5 minutes throughout the colonoscopy procedures. The strongest degree of correlation between RSS and BIS existed when sedation or TIVA was maintained by the boluses of propofol and fentanyl. The use of ketamine significantly reduced the doses of propofol and fentanyl. BIS can be monitored in all pediatric patients in whom sedation and TIVA are administered during colonoscopy, but the effect of different anesthetics on the EEG signal should be considered in order to adequately assess the depth of sedation and anesthesia.Key words: awareness, monitoring, child, anesthetics, endoscopy

Electronic and structural computing features of some chromene derivatives and evaluating their anticancer activities

Electronic and structural features of some of representative chromene derivatives were investigated in this work towards recognizing their anticancer roles. Density functional theory (DFT) calculations were performed to obtain five structures of chromene derivatives with the same skeleton of original structure. In addition to obtaining optimized structural geometries, electronic molecular orbital features were evaluated for the models. Energy levels of the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) indicated effects of additional R group pf chromene derivatives on electronic features. Based on such results, it was predicted that one of derivatives, L5, could better participate in interactions with other substances in comparison with other ligand structures. This achievement was obtained based on availability of HOMO and LUMO levels in lower energies easily catchable for electron transferring. On the other hand, L5 was assumed to interact in the weakest mode with other substances. Indeed, the main goal of this work was to examine anticancer activity of the investigated chromene derivatives, in which each of L1–L5 chromene derivatives were analyzed first to recognized electronic and structural features. Next, molecular docking (MD) simulations were performed to examine anticancer role of L1–L5 against methyltransferase cancerous enzyme target. The results indicated that formations of ligand-target complexes could be occurred within different types of interactions and surrounding amino acids of central ligand. In agreement with the achievements of analyses of single-standing L1–L5 compounds, L4-Target was seen as the strongest complex among possible complex formations. Moreover, values of binding energies and inhibition constant indicated that all five chromene derivatives could work as inhibitors of methyltransferase cancerous enzyme by the most advantage for L4 ligand. And as a final remark, details of such anticancer activity were recognized by graphical representations of ligand-target complexes showing types of interactions and involving amino acids in interactions.

Prevalence of anxiety and depression among physiotherapy students of private institutes in Faisalabad

Objective: The objective of this study was to determine the prevalence, incidence, and related variables of anxiety and depressive disorders among physical therapy students in Faisalabad's private institutes. Material and methodology: This is a cross-sectional study including medical students from the University of Faisalabad's Department of Physical Therapy. Using convenient sampling, 98 subjects were enrolled in the study after the ethics committee approved it. Questions about socio-demographic characteristics like gender, age, and parental education were included in the data collection tool. Descriptive results are represented in the form of Mean ± S.D. Chi-square test was applied for comparison of anxiety and depression with other variables. Checked significance at p-value 0.05. Results: Out of 98 participants, 63(64%) were male and 35(36%) were female. Out of 98 participants, 31(31.36%) were in age group pf 18-22 years, 39(39.79%) were in age group of 23-26 years and 28(27.57%) were in age group of 27-30 year. Average of age was 25.22 ± 2.19 years. Semester wise students included in the study out of 98 26.53% belonged to 2nd semester. 32.65% belonged to 4th semester and 40.85% belonged to 6th semester. After checking the association between variables and anxiety and depression significant difference were found between all variables with p-values less than 0.05. Conclusion: The study discovered high discomfort among physical therapy students. Furthermore, no significant gender variations in the incidence of anxiety and depression were found. Anxiety and depression have a significant societal and individual cost, including failure in clinical and written exams, medical dropouts, professionalism and personality development.

Determination of clinical efficiency of pediatric rotary file systems for root canal preparation in primary molars - A comparative study

Introduction: To meet the demand of pediatric endodontists, exclusive pediatric rotary file systems have been recently introduced by the manufactures. However, no study has been conducted to compare the clinical efficiency between pediatric rotary file systems. Aim: To determine the clinical efficiency (instrumentation time, obturation time, quality of obturation and postoperative pain) of two pediatric rotary file systems following the root canal preparation of primary molars. Materials and Methods: A total of 75 primary molars requiring pulpectomy were selected from children aged 4 to 7 years. These teeth were divided into three groups of 25 teeth each. In the first, second, and third groups, the cleaning and shaping of the root canals were carried out with Pedo-Flex pediatric rotary files (Group PF), Kedo-S pediatric rotary files (Group KS), and, manual nickel-titanium K-files (Group MF), respectively. Obturation was carried out with zinc oxide eugenol cement with an engine-driven Lentulo spiral. The instrumentation and obturation times were recorded. The quality of the root filling was radiographically assessed immediately after obturation. The postoperative pain was evaluated at time intervals of 6, 12, 24, 48, 72 h, and 1 week. Results and Discussion: The instrumentation and obturation times were significantly less with the use of pediatric rotary file systems compared to the manual file system. The quality of obturation was superior in the root canals instrumented with pediatric rotary file systems compared to manual files. There was decreased postoperative pain with the use of pediatric rotary file systems as compared to manual files. In all three groups, postoperative pain decreased over time. The optimally filled root canals showed a significant correlation with the absence of postoperative pain. Conclusions: The use of pediatric rotary file systems for root canal instrumentation of primary molars resulted in the superior quality of obturation in decreased instrumentation and obturating times with the least postoperative pain. The overfilled root canals were not associated with significant postoperative pain.

Europejski Zielony Ład jako narzędzie modernizacji i legitymizacji projektu europejskiego

Covid-19 pandemic created a new environment to New Green Deal - flagship initiative of European Commission and crucial element of Ursula von der Leyen political manifesto. Author argues, that faced with the possibility of weakening or postponing ambitious environmental programme because of new challenges the commission, backed by important group pf member states decided to build a direct link between reconstruction after pandemics and greening of the economy. The result was a push forward with decarbonisation commitments - the stimuli for change should be bound together to strengthen their interdependence and build a momentum for modernization of EU in both economic and political dimensions. Conditionality of Next Generation Europe financial instrument is one of the links between these two dimensions.

Europejski Zielony Ład jako narzędzie modernizacji i legitymizacji projektu europejskiego

Covid-19 pandemic created a new environment to New Green Deal - flagship initiative of European Commission and crucial element of Ursula von der Leyen political manifesto. Author argues, that faced with the possibility of weakening or postponing ambitious environmental programme because of new challenges the commission, backed by important group pf member states decided to build a direct link between reconstruction after pandemics and greening of the economy. The result was a push forward with decarbonisation commitments - the stimuli for change should be bound together to strengthen their interdependence and build a momentum for modernization of EU in both economic and political dimensions. Conditionality of Next Generation Europe financial instrument is one of the links between these two dimensions.

Flaxseed Oil Supplementation Afford Comparable Therapeutic effect to Metformin in Bleomycin Induced Pulmonary Fibrosis Rat model

Background: Pulmonary Fibrosis is a chronic lung disease characterized by scar formation and respiratory insufficiency. Metformin is an antidiabetic drug that has recently been shown to prevent lung fibrosis via NADPH oxidase-4 suppression. Flaxseed oil has been shown to be a potent antioxidant that attenuates oxidative damage by inhibition of lipid peroxidation and the proinflammatory cytokine production of IL-6 and TNF-alpha. Aim: To investigate whether metformin and/or flaxseed oil could protect against bleomycin-induced pulmonary fibrosis and if this protection is mediated by inhibiting NOX-4 signaling pathway and the synthesis and release of inflammatory and oxidative stress markers. Material and Methods: Fifty adult male rats were randomized into 5 groups/10 rats each.Pulmonary fibrosis was induced by Bleomycin, delivered intratracheally at a concentration of 1.5mg/kg body weight once in group PF, MET, Flax and combined MET& Flax. Both metformin and Flaxseed oil were administered orally for 21 day after induction of PF. Withdrawal of blood samples for chemical and spectral assay of antioxidant markers was done. Histopathology and assessment of inflammatory and fibrotic markers and PCR expression of NOX4 gene were done. Results: There was a significant reduction in inflammatory cell count, histopathological score of inflammation and fibrosis in the three treatment groups. Also there was marked improvement in inflammatory (IL-6, TNF-a) and fibrotic markers (TGF-B and Col-1) in metformin group rather than flaxseed and combined group.Nox4 gene expression was significantly reduced in metformin treated group rather than other 2 groups

Evaluation of efficacy and hemodynamic stability of propofol- ketamine and propofolfentanyl in patients undergoing dilatation and curettage

Background: To evaluate and compare the efficacy and hemodynamic stability of ketamine / fentanyl along with propofol and also assess recovery profile, post-operative analgesia and complications in patients undergoing Dilatation and Curettage (DandC). Method: Total 100 patients of ASA grade I and II, age between 18-55 years were enrolled and divided into two equal groups with adjuvant drugs in group PK- ketamine (0.75mg/kg IV) and in group PF-fentanyl (2ug/kg IV). Both groups received induction dose of Propofol- 2-2.5 mg/kg. Depth of sedation maintained with 0.5 mg/kg boluses of Inj.Propofol and assessed with Ramsay Sedation Score (RSS). The total dose of propofol was noted in both the groups. Intraoperative and postop vital parameters and complications were compared. Visual Analog Scale(VAS) was recorded and if VAS Score &gt;6, then patients received Inj.Paracetamol 15mg/kg IV as rescue analgesia. The recovery was assessed by Modified Aldrete Score (MAS). The time from completion of procedure to reach MAS of 9-10 was noted. Results: The hemodynamics was better with ketamine than fentanyl group. The total dose of propofol requirement, intraoperative and postop complications, and VAS scores were higher in group PF than in group PK, thus more patients required rescue analgesia in fentanyl group as compared to ketamine group. The recovery was delayed in ketamine group as compared to fentanyl (higher MAS and prolonged time to reach MAS&gt;9). Conclusion: Ketamine (0.75 mg/kg) provides better perioperative hemodynamic stability with good analgesia and fewer complications as compared to Fentanyl (2ug/kg) in patients undergoing DandC.

Main Risk Factors of Development of Postoperative Pancreatic Fistula Development after Pancreatoduodenectomy.

Purpose: To study the main risk factors of pancreatic fistula (POPF) after pancreatoduodenectomy (PD), in order to determine the degree of possible influence on them and reduce the development of early postoperative complications. Method: The results of examination and PD of 108 patients were studied from the period from 2016 to 2020. The criteria influencing the formation of POPF involved in the study: the consistency of the pancreas (determined subjectively according to the soft / hard), the diameter of the pancreatic duct, intraoperative blood loss, presence of biliary decompression (BD) before PD. Results: BD for the obstructive jaundice before PD were performed in 71 patients (65.7%), among them POPF developed in 17 patients (23.9%). In the group without BD (37 patients) in 9 (24.3 %) (p ˃ 0.05) .In patients with soft pancreas (50 patients), POPF developed in 21 patients (42.0%), among patients with hard pancreas - in 5 (5.8%) (p < 0.01). It was proposed to consider a diameter of up to 3 mm inclusively as «narrow» and «wide» from 4 or more. In 45 (41.7%) patients with a narrow duct POPF occured in 17 patients (37.8%), in 63 patients with a wide Wirsung duct (58.3%) POPF developed in 9 patients (14.3%) (p < 0.01). The volume of intraoperative blood loss less than 400 ml was regarded as physiological, this volume of blood loss was observed in 90 patients (83.3%), POPF occurred in 24 patients (26.7%), in 18 patients (17.7%) intraoperative blood loss exceeded 400 ml, POPF developed in 2 patients (11.1%) (p ˃ 0.05). All 100% of patients underwent pancreatojejunostomy at the reconstructive stage of the operation. 89 patients underwent duct-to-mucosa anastomosis, in the standard version without transanastomotic catheter, POPF occurred in 18 patients (20.0%), the rest included different options with transanastomotic catheter with or without invagination component , in this group (19 patients) PF developed in 8 people (44.4%). A statistically significant difference (p < 0.05) was obtained, however, due to the fact that a departure from the standard in the group of patients with combination of a narrow duct and soft pancreas, objectification of such a risk factor is impossible. Conclusion: In our study, the factors that significantly increase the frequency of POPF formation were the degree of pancreas density and the diameter of the pancreatic duct.

Ketamine- Propofol or Fentanyl- Propofol intravenous infusion a better combination for short surgical procedures in paediatric patients, a comparative study

Ketamine- Propofol or Fentanyl- Propofol intravenous infusion a better combination for short surgical procedures in paediatric patients, a comparative study - IJCA- Print ISSN No: - 2394-4781 Online ISSN No:- 2394-4994 Article DOI No:- 10.18231/2394-4994.2018.0072, Indian Journal of Clinical Anaesthesia-Indian J Clin A

Evaluation of safety and efficacy with propofol and etomidate for induction of Anaesthesia in dilatation and curettage

Introduction and Aims: We compared the safety, efficacy, hemodynamic variation, recovery duration and adverse effects of propofol and etomidate, with or without fentanyl, in patients undergoing dilatation and curettage for incomplete abortions. Materials and Methods: One hundred patients, ASA status I & II, aged 20-50 years, undergoing dilatation and curettage, were randomly divided into four groups of 25 patients each. Group P received propofol 2 mg/kg + normal saline 2 ml for anesthesia induction. Group PF received propofol 2 mg/kg +fentanyl 1mcg/kg to make volume 2 ml for anesthesia induction. Group E received etomidate 0.2 mg/kg + normal saline 2 ml for anesthesia induction and Group EF received etomidate 0.2 mg/kg + fentanyl 1 mcg/kg to make volume 2 ml for anesthesia induction. Heart rate, arterial pressure and SpO2 were recorded at different time intervals. The recovery time, pain on injection, myoclonus and postoperative nausea vomiting were also recorded. Results: During induction, mean arterial pressure fall significantly in both propofol groups. Amongst four groups, there was no significant difference observed in recovery time after anesthesia. The incidence of pain on injection was lower in etomidate groups. Myoclonus and Postoperative nausea and vomiting were significantly higher in etomidate groups. Conclusion: This study demonstrates that etomidate is superior in term of hemodynamic stability and less incidence of pain on injection. Etomidate combined with low dose fentanyl is more favourable than etomidate alone for attenuating myoclonus. Keywords: Etomidate, Dilatation and curettage, Propofol.

Total intravenous anesthesia in domestic chicken (Gallus gallus domesticus) with propofol alone or in combination with methadone, nalbuphine or fentanyl for ulna osteotomy

ObjectiveTo compare the propofol infusion rate and cardiopulmonary effects during total intravenous anesthesia with propofol alone and propofol combined with methadone, fentanyl or nalbuphine in domestic chickens undergoing ulna osteotomy. Study designProspective, randomized, experiment trial. AnimalsA total of 59 healthy Hissex Brown chickens weighing 1.5 ± 0.2 kg. MethodsAnesthesia was induced with propofol (9 mg kg–1) administered intravenously (IV) and maintained with propofol (1.2 mg kg–1 minute–1) for 30 minutes. Birds were intubated and supplemented with 100% oxygen through a nonrebreathing circuit under spontaneous ventilation. Thereafter, each animal was randomly assigned to one of four groups: group P, no treatment; group PM, methadone (6 mg kg–1) intramuscularly (IM); group PN, nalbuphine IM (12.5 mg kg–1); and group PF, fentanyl IV (30 μg kg–1 loading dose, 30 μg kg–1 hour–1 constant rate infusion). During the osteotomy surgery, the propofol infusion rate was adjusted to avoid movement of birds and provide adequate anesthesia. Pulse rate, invasive blood pressure, respiratory frequency, end-tidal carbon dioxide partial pressure (Pe′CO2) and hemoglobin oxygen saturation (SpO2) were recorded. ResultsData were available from 58 chickens. The mean ± standard deviation propofol infusion rate (mg kg–1 minute–1) for the duration of anesthesia was: group P, 0.81 ± 0.15; group PM, 0.66 ± 0.11; group PN, 0.60 ± 0.14; and group PF, 0.80 ± 0.07. Significant differences were P versus PM (p = 0.042), P versus PN (p = 0.002) and PF versus PN (p = 0.004). Pulse rate, blood pressure and SpO2 remained acceptable for anesthetized birds with minor differences among groups. Values of Pe′CO2 >60 mmHg (8 kPa) were observed in all groups. Conclusions and clinical relevanceMethadone and nalbuphine, but not fentanyl, decreased the propofol infusion rate required for anesthesia maintenance, but resulted in no obvious benefit in physiological variables.

Effect of surface flattening and phototherapy on shear bond strength immediately after bleaching with different modes of universal adhesive.

The aim of this study was to compare to effect of phototherapy and surface flattening after immediately bleaching on the shear bond strength to bleached enamel. Ninety-six human upper incisors were divided into 4 groups (n = 24). Group NB: no bleached, group P: phototherapy with YSGG laser, group F: 0.5 mm surface flattening, group PF: 0.5 mm surface flattening and phototherapy with Er;Cr:YSGG laser. Then, each group was assigned to 2 subgroups according to adhesive mode (n = 12) as; subgroup S (self-etching mode), subgroup T (total-etching mode) which are universal adhesives. All surface conditionings and restorations were performed with composite resin materials immediately after bleaching. Shear bond strength test was performed by using universal testing machine. The surfaces were also evaluated with SEM. The data were statistically analyzed with one-way ANOVA post-hoc Tukey tests. The lowest SBS values were achieved in FS (13.72 ± 2.29) while the highest ones in PT (28.01 ± 6.81). However, the differences were not significant (P > 0.05). All surface conditioning methods provided SBS values similar to the control (P > 0.05). All subgroups of self-etching mode were significantly lower than their total-etching counterparts (P < 0.05). The present study showed that surface removal and phototherapy have a potential clinical application for eliminate to undesirable effect of bleaching treatment. Surface conditioning with either flattening and/or phototherapy may provide clinicians to restore bleached teeth at the same visit with bleaching and reduce chair-time.