Ml Of Normal Saline Research Articles

Normal Saline Instillation at Neonatal Intensive Care Units: A Descriptive Study of Neonatal Nurses' Knowledge and Practice

Background: Current evidence no longer supports the instillation of normal saline (NS) during endotracheal suctioning. However, it is unclear whether and to what extent nurses practice NS instillation in Jordan’s neonatal intensive-care units (NICUs). Purpose: To describe the knowledge and practice of Jordanian nurses regarding NS instillation before endotracheal suctioning. Methods: A cross-sectional descriptive method was used. Data was collected from 136 NICU nurses using a 29-item self-administered questionnaire. The participants were from 7 NICUs of 7 hospitals in Jordan (north, middle and south of Jordan). The questionnaire asked participants about their knowledge and practice regarding endotracheal suctioning. Results: Findings showed a high frequency of NS instillation during endotracheal suctioning. Among the participants, 44.1% believed that NS was beneficial in loosening secretions, 57.4% believed that it could stimulate the cough response, 56.6% believed that it promoted neonate comfort and 41.2% believed that it could reduce bacterial growth. In practice, 80.0% of nurses used open rather than closed suctioning, 57.1% did not use more than 5 ml of NS during suctioning and 92.4%. instilled 0.9% normal saline directly onto the endotracheal tube rather than the in-line suction adapter. Moreover, 53.7% of participants reported that suctioning mechanically ventilated premature neonates out of regularity and not because it was clinically indicated. Conclusion: This is the first study that explored NICU nurses’ knowledge and practice of NS use during endotracheal suctioning in Jordan. Educational programs can be implemented to improve knowledge regarding the complications of NS instillation. Implications for Nursing: NICU guidelines should be implemented to ensure that suctioning practices reflect current standards and education and training programs should be developed to target the knowledge and skills of nurses Keywords: Normal saline instillation, Suctioning, Endotracheal tube, NICUs, Jordan.

The Effect of Intravenous Ketamine on Suicidal Ideation in Depressed Patients: A Randomized Clinical Trial

Background: Major depressive disorder (MDD) generally occurs together with depression in patients with no history of manic, mixed, or hypomanic episodes. The suicidal ideation in MDD patients is very common and can potentially be considered an emergency circumstance in many cases. Among the developed drugs and medicines, ketamine (KET) is a potential option to treat patients with MDD. This study aims at investigating the effect of KET on the treatment of suicidal ideation and the reduction of the intensity of symptoms in patients suffering from MDD. Materials and Methods: This randomized double-blind clinical trial was performed on 30 patients who suffered from MDD and had suicidal ideation at Ibn Sina Hospital, Bandar Abbas, Iran, during 2016-2017. The patients were divided into two groups: the KET group which received 0.5 mg/kg of intravenous (IV) KET diluted in 500 mL of normal saline over 30 minutes and the control group which received 500 mL of normal saline without KET over 30 minutes. Results: According to the statistical analysis, 24 hours after the intervention, suicidal ideation score reached 2.53 and 20.6 in the KET and control groups, respectively. In fact, KET caused a significant reduction in the score of the suicidal ideation (SSI) (SSI<4) in comparison with the control group (P<0.001). Conclusion: It was observed that KET can play a key role in the treatment of depression disorders, especially severe and life-threatening forms that require immediate intervention, such as the use of electroconvulsive therapy.

COMPARISON OF BUPIVACAINE VERSUS BUPIVACAINE WITH FENTANYL INTRATHECALLY IN CESAREAN SECTION

Objectives: The objectives of the study were to evaluate the efficacy and safety of fentanyl with hyperbaric bupivacaine in spinal anesthesia for caesarean section. Methods: This prospective observational study was conducted in anesthesia department of tertiary care teaching hospital of Gujarat. Group A was given 2.0 ml of 0.5% hyperbaric bupivacaine with 0.25 ml of normal saline and Group B received 2.0 ml of 0.5% hyperbaric bupivacaine with 0.25 ml of injection fentanyl (12.5 μg). Characteristics of sensory blockade, motor blockade, analgesia, APGAR score, surgical variables, hemodynamic parameters, and complications were noted and compared in both the groups. Results: There was no significant difference in onset of sensory block in both groups (p>0.05) but there was statistically significant difference present regarding duration of regression of sensory blockade (p<0.05). Time of motor onset and time to get Grade 0 from Grade 3 block were comparable in both groups (p>0.05). Duration of complete analgesia and duration of effective analgesia were significantly prolonged in Group B as compared to Group A (p<0.001). There was also no statistically significant difference observed in mean pulse rate, systolic blood pressure and diastolic blood pressure, and mean arterial pressure in both the groups during entire period of time (p>0.05). Conclusions: The present study concluded that intrathecal fentanyl 12.5 μg with bupivacaine produce prolonged sensory block as well as post-operative analgesia compared to bupivacaine alone for cesarean section with insignificant hemodynamic changes without affecting neonatal outcome.

Cathelicidin Attenuates Hyperoxia-Induced Lung Injury by Inhibiting Ferroptosis in Newborn Rats.

High oxygen concentrations are often required to treat newborn infants with respiratory distress but have adverse effects, such as increased oxidative stress and ferroptosis and impaired alveolarization. Cathelicidins are a family of antimicrobial peptides that exhibit antioxidant activity, and they can reduce hyperoxia-induced oxidative stress. This study evaluated the effects of cathelicidin treatment on lung ferroptosis and alveolarization in hyperoxia-exposed newborn rats. Sprague Dawley rat pups were either reared in room air (RA) or hyperoxia (85% O2) and then randomly given cathelicidin (8 mg/kg) in 0.05 mL of normal saline (NS), or NS was administered intraperitoneally on postnatal days from 1-6. The four groups obtained were as follows: RA + NS, RA + cathelicidin, O2 + NS, and O2 + cathelicidin. On postnatal day 7, lungs were harvested for histological, biochemical, and Western blot analyses. The rats nurtured in hyperoxia and treated with NS exhibited significantly lower body weight and cathelicidin expression, higher Fe2+, malondialdehyde, iron deposition, mitochondrial damage (TOMM20), and interleukin-1β (IL-1β), and significantly lower glutathione, glutathione peroxidase 4, and radial alveolar count (RAC) compared to the rats kept in RA and treated with NS or cathelicidin. Cathelicidin treatment mitigated hyperoxia-induced lung injury, as demonstrated by higher RAC and lower TOMM20 and IL-1β levels. The attenuation of lung injury was accompanied by decreased ferroptosis. These findings indicated that cathelicidin mitigated hyperoxia-induced lung injury in the rats, most likely by inhibiting ferroptosis.

Comparative Study Between Intravenous Clonidine and Preservative Free Intravenous Lignocaine in Attenuation of Pressor Response to Laryngoscopy and Endotracheal Intubation

Objectives To compare the attenuation of pressor responses by intravenous clonidine and preservative-free lignocaine to laryngoscopy and endotracheal intubation. Materials and Methods A randomized, prospective, comparative, double-blinded study was conducted in 80 adult patients who were randomized into two groups of 40 each, group clonidine (Group C) and group lignocaine (Group L). Group C patients were given 2 µg/kg clonidine in 20 ml of normal saline as a slow infusion over 10 min prior to intubation. Group L patients were given 1.5 mg/kg of preservative-free 2% lignocaine in 20 ml of normal saline as a single-dose infusion over 3 min prior to intubation. Baseline vital and hemodynamic parameters were monitored during the perioperative period at 1-, 5-, and 10-min post-intubation. Results The attenuation of heart rate (HR) after intubation was much better with clonidine than lignocaine as there is statistically significant difference in the mean HR between the two groups at 1, 5, and 10 min after intubation with the HR significantly lesser in the Group C than the Group L at all times after intubation. Both clonidine and lignocaine were effective in attenuating systolic blood pressure response after intubation, but clonidine was more effective than lignocaine as systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in the Group C remained much lower than the Group L and the difference between the two groups was statistically significant at all times after intubation. Conclusion Premedicating with a single slow infusion of 2 µg/kg i.v. clonidine has been proven to be effective in maintaining perioperative hemodynamic stability at 1, 5, and 10 min post-intubation than lignocaine.

The Effect of Dexamethasone on Postoperative Pain in Patients After Laparoscopic Cholecystectomy.

Objectives The objective of the study was to determine the effect of a single dose of IV dexamethasone onpostoperative pain in patients after laparoscopic cholecystectomy. The outcome will be measured in the terms of mean pain score. Study design andsetting This is a prospective study. We did a randomized control trial to compare the outcome in two groups. This study was conducted in the Department of Surgery, Benazir Bhutto Hospital, Rawalpindi, from December 2021 to May 2022. The total duration of the study was six months. Methodology A total of 160 patients were randomly divided into group A and group B. We performed laparoscopic cholecystectomies on all the patients under standard general anesthesia. In group A (control group), 5 mL of normal saline was injected intravenously at the time of induction of anesthesia. In group B, the dexamethasone group, the inj. dexamethasone with a dose of 0.1 mg/kg diluted in 5 mL normal saline was given intravenously at the time of induction of anesthesia. Postoperatively, the median pain score was measured using visual analog scale (VAS) at 2, 6, 12, and 24 hon a specially made proforma. The results were further stratified according to gender and age. Results The postoperative VAS in group B was significantly low compared with group A when measured at 2, 6, 12, and 24 h.It means that the median pain score was markedly less in the study group than in the placebo one, and it was statistically significant (p<0.05). Conclusion Administration of a single dose of dexamethasone preoperatively in laparoscopic cholecystectomy patients is effective to control postoperative pain.

Optimising the measurement of intra-bladder pressure in patients with predicted severe acute pancreatitis

BackgroundMeasuring intra-abdominal pressure (IAP) is important for management of patients with severe acute pancreatitis (SAP). Intra-bladder pressure (IBP) is an indirect index that reflects IAP, but measuring techniques vary. We sought to optimise IBP measuring techniques in predicted SAP patients. MethodsPredicted SAP patients consecutively admitted between June 2018 and January 2020 were scrutinised. Eligible patients had their IBP monitored for the first 72 h at 6-h intervals, and were then sequentially allocated into three research scenarios: (1) in the supine position along with head of bed elevation(HoBE)of 0, 15 and 30° at various points including the iliac crest the midaxillary line, pubic symphysis, and right atrium level, instilled with 25 mL normal saline (NS) at room temperature (RT); (2) NS instillation volume from 0, 10, 25, 40–50 mL at the iliac crest with HoBE15 at RT; and (3) NS instillation (25 mL) at either RT or 37 °C with HoBE15. ResultsThe dynamic IBP values measured at the pubic symphysis and iliac crest were fairly similar between HoBE0 and HoBE15 (all P > 0.05), but greatly increased at HoBE30 (all P < 0.01). IBP was significantly increased with escalating instillation volumes of NS (all P < 0.01 versus 0 mL NS), while there was no significant difference between 25 mL and 10 mL (P = 0.055). IBP was similar between NS at RT and under 37 °C (P = 0.643). ConclusionIn predicted SAP patients, measuring IBP at the iliac crest with HoBE15 after instilling 10 mL of NS seems to be appropriate for monitoring IAP.

Automated Optimized Synthesis of [18F]FLT Using Non-Basic Phase-Transfer Catalyst with Reduced Precursor Amount.

3′-deoxy-3′-[18F]fluorothymidine ([18F]FLT) is a positron emission tomography (PET) tracer useful for tumor proliferation assessment for a number of cancers, particularly in the cases of brain, lung, and breast tumors. At present [18F], FLT is commonly prepared by means of the nucleophilic radiofluorination of 3-N-Boc-5′-O-DMT-3′-O-nosyl thymidine precursor in the presence of a phase-transfer catalyst, followed by an acidic hydrolysis. To achieve high radiochemical yield, relatively large amounts of precursor (20−40 mg) are commonly used, leading to difficulties during purification steps, especially if a solid-phase extraction (SPE) approach is attempted. The present study describes an efficient method for [18F]FLT synthesis, employing tetrabutyl ammonium tosylate as a non-basic phase-transfer catalyst, with a greatly reduced amount of precursor employed. With a reduction of the precursor amount contributing to lower amounts of synthesis by-products in the reaction mixture, an SPE purification procedure using only two commercially available cartridges—OASIS HLB 6cc and Sep-Pak Alumina N Plus Light—has been developed for use on the GE TRACERlab FX N Pro synthesis module. [18F]FLT was obtained in radiochemical yield of 16 ± 2% (decay-corrected) and radiochemical purity >99% with synthesis time not exceeding 55 min. The product was formulated in 16 mL of normal saline with 5% ethanol (v/v). The amounts of chemical impurities and residual solvents were within the limits established by European Pharmacopoeia. The procedure described compares favorably with previously reported methods due to simplified automation, cheaper and more accessible consumables, and a significant reduction in the consumption of an expensive precursor.

Intramuscular administration of l-arginine boosts testicular hemodynamics, plasma concentrations of testosterone and nitric oxide in heat-stressed rams

The current study aimed to assess, for the first time, the effects of intramuscular injection of l-arginine (L-arg) on testicular hemodynamics, echogenicity, and plasma concentrations of testosterone, total antioxidant capacity, and nitric oxide (NO) in Ossimi rams. Twelve sexually matured heat-stressed rams were randomly assigned to one of two groups: the L-arg group (n = 6) received 5 mg/kg L-arg dissolved in 2 ml normal saline 0.9%, or the control group (n = 6) received merely 2 ml of normal saline 0.9%. Blood sampling, B-mode ultrasound assessment of the testicular parenchyma, and pulsed-wave Doppler ultrasound of the testicular artery for both right and left testis were performed immediately before 0 min and 1, 4, 24, 48, 72, and 168 h after L-arg or saline administration. In the L-arg group, resistive index (RI) and pulsatility index (PI) means were significantly lower compared to the control group at 4–168 h post-treatment. Plasma testosterone concentrations were higher (P < 0.05) at 4 h and onward in the L-arg treated compared to the control rams, the same for NO levels however its increase (P < 0.05) was observed as soon as 1 h post-treatment. In L-arg treated rams, NO concentrations were positively correlated to plasma testosterone concentrations (r = 0.7, p < .01), but negatively correlated to both RI and PI (r = −0.8 and −0.6, respectively, p < .01). In conclusion, l-arginine administration enhanced testicular blood flow and increased plasma testosterone and nitric oxide concentrations in heat-stressed rams.

Intravenous Versus Wetting Solution Magnesium Sulphate to Counteract Epinephrine Cardiac Adverse Events in Abdominal Liposuction: A Randomized Controlled Trial.

The increased frequency of liposuction has resulted in more complications being reported. Adding epinephrine to the wetting solution could induce some cardiac adverse effects, some of which may be fatal. For instance, magnesium sulfate (MgSO4) is known for its cardioprotective effects. This study aimed to evaluate the efficacy of intravenous (IV) versus wetting solution containing MgSO4 in decreasing such cardiac adverse events during abdominal liposuction. This randomized controlled study included 129 adult cases undergoing abdominal liposuction under general anesthesia. The participants were divided into 3 groups: Group I (control group) was only subjected to the injection of the wetting fluid (1 mL 1/1000 epinephrine added to every 1000 mL of normal saline), group II was subjected to IV MgSO4 (40 mg/kg over 1 minute) at the same time of installing the wetting solution, and group III was subjected to MgSO4 (40 mg/kg) added to the wetting solution. Intraoperative isoflurane consumption, intraoperative heart rate (HR), mean arterial pressure (MAP), and postoperative pain scores were significantly lower in the MgSO4 groups (groups II and III) than group I. Cardiac adverse events (sinus tachycardia and premature ventricular contractions (PVCs)) were also significantly less frequent in groups II and III compared to group I. Adding MgSO4, either through IV or subcutaneous routes, is associated with lower intraoperative HR, MAP, and postoperative pain scores and a remarkable decrease in epinephrine-induced cardiac adverse events during liposuction.

Exophytic interstitial ectopic pregnancy removal: novel use of Endoloop for uterine cavity preservation

Exophytic interstitial ectopic pregnancy removal: novel use of Endoloop for uterine cavity preservation

Thermally oxidized sunflower oil diet alters leptin/ghrelin balance and lipid profile in rats: Possible role of reactive aldehydes in dyslipidemia.

Sunflower oil is a common edible oil in the world, which is highly prone to oxidative degradation during the frying process. The present study aimed to investigate the effects of products obtained from the thermal oxidation process of sunflower oil on metabolic indices, and the secretion status of leptin and ghrelin in rats. In vivo studies were designed after determining the rate of formation of active aldehydes and peroxide value in sunflower oil following 300°C in a period of 30-240 min. To this end, 36 rats in 6 separate groups were fed with 2ml of normal saline, fresh sunflower oil, and heated oils at 30, 60, 120, and 240 min for 45 days. Finally, lipid profile changes and leptin/ghrelin secretion were examined, along with histological changes in the liver tissue. The results indicated a significant increase in serum LDL, VLDL and triglycerides, and a decrease in HDL, in the groups treated with heated oils. These changes were associated with a higher accumulation of triglycerides, active aldehydes, and histological changes in the hepatic tissue. Although the serum ghrelin level in the groups receiving heated oil did not change significantly compared to the fresh oil, the serum leptin level increased significantly in the groups receiving heated oil. According to our findings, increasing the time of sunflower oil heating enhanced the formation of active aldehydes, so that daily consumption of such oxidized oils might be associated with the occurrence of dyslipidemia, fatty liver and the development of leptin resistance. PRACTICAL APPLICATIONS: Sunflower oil is highly prone to oxidative degradation during the frying process. Increasing time of sunflower oil heating enhanced the formation of active aldehydes. Daily consumption of oxidized oils might be associated with the occurrence of dyslipidemia, fatty liver and the development of leptin resistance.

A prospective study evaluating the effect of nebulised lidocaine on haemodynamic responses during nasotracheal intubation

: Laryngoscopy and endotracheal intubation result in a significant increase in haemodynamic stress response which is well tolerated by healthy patients but in patients with significant coronary artery or cerebrovascular diseases, if it is not prevented adequately may lead to myocardial ischemia and cerebral haemorrhage.: This prospective comparative study was conducted between August 2019-July 2020 to study the effect of nebulised lidocaine on haemodynamic stress responses (primarily mean arterial blood pressure also heart rate, systolic blood pressure and diastolic blood pressure) during nasotracheal intubation. 94 patients who underwent head and neck surgery under general anaesthesia requiring nasotracheal intubation were randomised into two groups using a computational random number, Group A (control group): was nebulised with 5 ml of normal saline. Group B: was nebulised with 5ml of Lidocaine 4% solution. Heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial blood pressure(MAP), and SpO2 were observed before and after nebulisation, just before intubation, immediately after intubation and at 3, 5 10 min after intubation.: On comparing SBP, DBP, MAP and heart rate immediately after intubation with pre-intubation values, there was a significant surge in both groups but an increase in the control group was more in comparison to the lidocaine group(p&amp;#60;.05). Thereafter MAP, SBP, DBP and HR gradually decreased till the duration of study i.e. 10 minutes.: The administration of nebulised 4% Lidocaine inhalation before induction attenuates cardiovascular response (primarily in terms of MAP also SBP, DBP and HR) that occurs due to nasotracheal intubation.

The Effect of Superficial Cervical Plexus Blockage With Ultrasound Guidance on Pain After Thyroidectomy

The main complaint after thyroidectomy is pain upon swallowing. It has been proven that postoperative uncontrolled pain can lead to chronic pain. We investigated the effectiveness of superficial cervical plexus block with ultrasound guidance on pain after thyroidectomy. This is a prospective, double-blind clinical trial study on patients aged 18-60 years who are candidates for thyroidectomy. Patients were randomly divided into two groups. The treatment group underwent superficial cervical plexus block under ultrasound guidance with an injection of 10 ml of ropivacaine 0.2%, and the control group received 10 ml of normal saline after sedation and before general anesthesia. The hemodynamic variables, amount of remifentanil used for hemodynamic stability, the severity of perioperative pain, postoperative nausea and vomiting, and the need for analgesics were compared between the two groups. The severity of pain in the treatment group at the time of discharge from recovery, 2, 6, 12, and 24 hours after surgery was 1.36, 1.76, 1.46, 1.24, and 0.44, respectively and in the control group was 3.12, 3.30, 3.82, 2.96 and 2.02 (P&lt;0.001). The average dose of meperidine administration for pain relief during recovery in the treatment group was 2.8 (±7.84) mg, and in the control group was 9.2 (±11.92) mg (P&lt;0.002). The need for diclofenac for analgesia during 24hours after surgery in the block group was 4 (±19.79) mg and in the control group was 64 (±69.28) mg, (P&lt;0.001). Superficial cervical plexus block can significantly reduce perioperative pain and need analgesic administration during and after thyroidectomy.

A rabbit model for embolic infarct potentials of injectables using ultrasound-guided carotid artery puncture

In order to evaluate the in vivo thrombogenicity of injectable agents, a suitable animal model is needed. We introduce an ultrasound-guided non-selective cerebral artery occlusion model via the common carotid arteries of rabbits. A total of 30 rabbits were assigned to an experimental group (n = 20) and a control group (n = 10). Each group received 2 mL suspension of embolic agent or 2 mL of normal saline, respectively, under ultrasound guidance. The animals were observed for immediate reaction and underwent magnetic resonance imaging (MRI) scan. Follow-up neurologic examination was conducted 24 h following the procedure. In 7 of the 30 rabbits, 2 in the control group and 5 in the experimental group, the administration of either normal saline or the embolic agent failed. Among the successfully injected 15 experimental animals, 14 showed neurologic impairment or deceased, whereas 1 animal did not show significant neurologic deficit. The MRI of 4 experimental animals showed detectable cerebral infarction on diffusion-weighted imaging. None of the 8 control animals showed neurologic abnormality and their brain MRI was normal. Our minimally invasive model is technically feasible and competent to show thrombogenecity of an injectable agent and consequent in vivo neurologic outcome.

Effect of Intranasal Dexamethasone on the Incidence of Nausea and Vomiting After Adult Strabismus Surgery.

Due to the high prevalence of postoperative nausea and vomiting (PONV), this study aimed to determine the preventive effect of intranasal dexamethasone on the incidence of nausea and vomiting after adult strabismus surgery. This randomized clinical trial study was performed on 72 patient candidates for strabismus surgery at Feiz University Hospital in Isfahan in 2020. Patients were divided into 2 groups of 36 with random allocation software and entered into the study. After induction of similar anesthesia, endotracheal intubation was performed in patients. Immediately after inflating the cuff, the first group (intranasal dexamethasone (ND)) received 1 mL of dexamethasone (4 mg) per nasal passage, and the second group (intranasal normal saline (NS)) received 1 mL of normal saline per nasal passage. Patients of the 2 groups were evaluated and compared at first 2 hours and 2 - 24 hours after surgery for the incidence and severity of nausea and vomiting, and pain after surgery. Data were analyzed using SPSS software version 23. There were no significant differences in terms of age (P = 0.304), weight (P = 0.21), gender (P = 0.81), and American Society of Anesthesiologists (ASA) Physical Status class (P = 1) between the 2 groups. In the first 2 hours after surgery, the incidence of nausea (P = 0.034) and its severity (P = 0.019) was significantly lower in the ND group compared to the NS group. Also, 24 hours after surgery, the incidence of nausea (P = 0.38) and its severity (P = 0.55) were insignificantly lower in the ND group. Both groups showed no significant difference in the incidence of vomiting at 2 hours (P = 0.11) and 24 hours (P = 0.16) postoperative. Two hours after surgery, the incidence of pain (P = 0.001) and its severity (P < 0.001), and also 24 hours after surgery, the incidence of pain (P < 0.001) and its severity (P < 0.001) were significantly lower in the ND group. Getting ondansetron (P = 0.023) and pethidine (P < 0.001), extubation time (P < 0.001), and recovery time (P = 0.03) were significantly lower in the ND group. Patients' satisfaction was significantly higher in the ND group compared to the NS group (P = 0.031). The findings of the present study show that the intranasal use of dexamethasone with a dose of 8 mg compared to saline is associated with a decrease in PONV and postoperative pain, a decrease in the use of ondansetron and pethidine, and an increase in patient's satisfaction. Intranasal use of dexamethasone may be an effective and safe method, especially in cases where we do not have access to an intravenous line.

“TO COMPARE THE EFFICACY OF INTRAVENOUS PARACETAMOL VS COMBINATION OF INTRAVENOUS PARACETAMOL AND MAGNESIUM SULPHATE ON POST OPERATIVE PAIN RELIEF.”

Introduction: Recent studies have shown the positive effect of magnesium sulphate as an adjunct on post-operative pain relief. This study is comparing effect of paracetamol with and without magnesium sulphate as an adjunct on post operating pain relief. AIMS: “To compare the efcacy of intravenous paracetamol vs combination of intravenous paracetamol and magnesium sulphate on post operative pain relief.” (1) To compare the duration of post operative Objectives: analgesia based on VAS score. (2) To note the requirement of rescue analgesia in the rst 24 hrs post operative period. This ra Materials And Methods: ndomised trial was conducted on 30 patients at Dr. D.Y.Patil medical college and research hospital. The patients who were candidates were randomised into two groups, Group 1 (n=15) and Group 2 (n=15). Spinal anaesthesia was given to all the patients. Group 1 were given 1 gm of IV paracetamol (100ml) with 100 ml of normal saline and group 2 were given 1gm of IV paracetamol (100ml) with 50mg/kg Magnesium sulphate in 100 ml of normal saline (max 2gm). VAS (visual analogue score) was used to assess post operative pain relief and requirement of rescue analgesia post operatively was measured. Result: There was a decrease inn rescue analgesic consumption and pain in the group receiving MgSo4 as an adjunct. In comparison to group 1, Group 2 showed statistically signicant reduction in post operative pain at 12, 24 and 36 hours. Intravenous MgSo4 with Conclusion: paracetamol is effective in reducing post operative pain and requirent of total opioid consumption in 72 hour post operative period as well as increased total duration of analgesia.

Effects of curcumin on liver injury induced by chronic alcohol addiction

Objective: To investigate the intervention effects of curcumin (Curc) on liver injury induced by chronic alcohol addiction in mice. Methods: Thirty Balb/c mice were randomly divided into normal control group (Control), model group (Model), low-dose Curc group (5 mg/kg, Curc-L), medium dose Curc group (10 mg/kg, Curc-M) and high-dose Curc group (15 mg/kg, Curc-H), with 6 mice in each group. The chronic alcohol addiction liver injury model was prepared with 20% liquor. The mice in control group were given 2 ml of normal saline every day. The mice in model group were given 5 ml/kg of 20% liquor every day, and the mice in Curc treatment group were treated with Curc at the doses of 5, 10, 15 mg/kg in 2 ml saline every day for 35 days. The weight of liver was measured and the health status of mice was observed. Serum ALT, AST, ALP and liver TG, TC, HDL-C, LDL-C, MDA, SOD, GSH-Px and NO were measured. The pathological changes of liver tissues stained with hematoxylin and eosin were observed. Results: Compared with the control group, the liver mass and serum levels of ALT, AST, ALP, MDA, NO, TC, TG, HDL-C, LDL-C in the model group were increased significantly (P＜0.05, P＜0.01), the activities of SOD and GSH-Px were decreased significantly (P＜0.05, P＜0.01), the liver cells were vacuolated and infiltrated with inflammatory cells, and the expression levels of NF-κB and MAPK protein in liver tissues were increased significantly (P＜0.01). Compared with the model group, the levels of ALT, AST, ALP, MDA, NO, TC, TG, HDL-C, LDL-C in Curc group were decreased significantly nd the activities of SOD and GSH-Px were increased significantly (P＜0.05, P＜0.01). Conclusion: Curc can effectively reduce liver tissue damage by regulating NF-κB/MAPK signal pathway.

Laparoscopic Hemi-Hysterectomy for Excision of a Functional Rudimentary Uterine Horn Keys to Success

<h3>Study Objective</h3> To present a case of unicornuate uterus with a non-communicating rudimentary horn complicated with hematometra and describe important steps for successful laparoscopic surgical management. <h3>Design</h3> Description of the relevant anatomy and surgical technique with the use of video. <h3>Setting</h3> academic tertiary hospital. <h3>Patients or Participants</h3> A 19-yo female patient with history of dysmenorrhea. Exam revealed normal vagina and cervix deviated to the left, with an adnexal mass on the right. Ultrasound and MRI further delineated a right rudimentary horn with active endometrium, possible hematometra. A renal ultrasound ruled out renal anomaly. Hysteroscopy revealed a normal appearing unicornuate uterus with a tubal ostium. A Rummi manipulatorwas placed. Then, laparoscopic pelvic survey confirmed a left unicornuate uterus with an enlarged right rudimentary horn, no endometriosis was found. Next, ureterolysis was performed, followed by right salpingectomy with ovarian preservation. Vasopressin was injected to the base of the horn (20 units in 100 ml of normal saline). The right utero-ovarian and round ligament were taken down with ligasure device and bladder flap was developed. Next, monopolar L hook was used to resect the rudimentary horn. This was followed by uterine closure in two layers with 2-0 V lock barbed suture. Rudimentary horn was exteriorized in a 10 cm endobag. <h3>Interventions</h3> surgical procedure: diagnostic hysteroscopy, laparoscopic hemihysterectomy for excision of a functional non communicating rudimentary horn. <h3>Measurements and Main Results</h3> Patient was discharged on the same day of the procedure and had an uncomplicated postsurgical course. <h3>Conclusion</h3> Understanding the nature of the uterine anomaly before surgery is of paramount importance for the management of obstructive anomalies of the female genital tract. Laparoscopy is a safe and effective treatment modality to provide pain relief, avoid sequelae, and allow for the preservation of reproductive function.

The Efficacy of N-Acetyl-Cysteine (NAC) Supplementation in FST Model for Screening Antidepressants.

The model for screening antidepressant-like activity in pre-clinical drug studies include, rat forced swimming test (FST). The reports on N-acetylcysteine (NAC) as an antioxidant supplement in stress related disorder is well documented. This study was aimed at potential antidepressant mechanism of N-Acetyl Cysteine (NAC), a glutamate precursor on FST animal model for screening antidepressant drugs using fluoxetine, a selective serotonin reuptake inhibitors (SSRIs) as standard antidepressant drug. Thirty adult male Wistar rats used for this study were randomly divided into six groups each with five (n=5) rats. The control group (A) received 1 ml of normal saline daily, group B served as the FST model, group C received 200mg/kg/day of NAC, group D received 20mg/kg/day of fluoxetine, group E the FST model treated with 200mg/kg/day of NAC, and F is the FST model treated with 20mg/kg/day of fluoxetine. Drugs were given orally. The effects of NAC on brain weights, the FST paradigms, sucrose preference test (SPT) for anhedonia were assessed and data analyzed using ANOVA where Tukey post-hoc test for statistical significance was set at (p < 0.05). The brains fixed in 4% paraformaldehyde, were processed and the paraffin embedded tissue were serially sectioned at 5 μm thick to be stained using Haematoxylin and Eosin (H and E) stain, immuno-histochemistry for synaptophysin (p38) and astrocytes (GFAP) activities in the prefrontal cortex (PFC). Findings showed that NAC prevented FST-induced anxiety-like behaviors demonstrated by an increased SPT (that alleviates anhedonia), mobility time, and reduced immobility time. NAC caused an increase in brain weights and prevented FST-induced neurodegeneration, the proliferation of reactive astrocytes, and diminished synaptophysin immunoreactivity in the PFC similar to that seen in fluoxetine a standard anti-depressant drug. NAC treatment significantly exhibits its neuroprotective mechanism via inhibiting the proliferation of reactive astrocytes, which protects neurons and synapses from oxidative tissue damage induced by FST, hence an increase in synaptophysin activity that culminates in increased neural activity, increased SPT, and reduced immobility time.