A Comparative Study Of 0.5% Lignocaine Versus 0.5% Lignocaine with Dexmedetomidine for Intravenous Regional Anaesthesia for Upper Limb Surgeries

Background: Intravenous Regional Anaesthesia (IVRA), commonly referred to as Bier's block, is a widely used technique for upper limb surgeries. While lignocaine has been the standard local anesthetic for this procedure, recent studies suggest that the addition of adjuncts like dexmedetomidine may enhance the quality of anesthesia and improve postoperative analgesia. This study aims to compare the efficacy and safety of 0.5% lignocaine versus 0.5% lignocaine with dexmedetomidine in patients undergoing upper limb surgeries under IVRA. Objective: To compare the onset, quality of anesthesia, duration of sensory and motor blockade, and postoperative analgesia between two different anesthetic regimens: 0.5% lignocaine and 0.5% lignocaine with dexmedetomidine for intravenous regional anaesthesia in upper limb surgeries. Methods: In this study 60 patients 30 in each group undergoing elective upper limb surgeries were randomly assigned to receive either 0.5% lignocaine (Group L) or 0.5% lignocaine with 0.5 μg/kg dexmedetomidine (Group LD) for IVRA. The onset time, duration of sensory and motor block, quality of anesthesia, and incidence of complications were recorded. Postoperative pain scores, the need for additional analgesia, and adverse events were also evaluated. Results: Patients in the dexmedetomidine group (Group LD) showed a significantly faster onset of anesthesia, longer duration of sensory and motor block, and better postoperative analgesia compared to the lignocaine-only group (Group L). The incidence of complications, including tourniquet pain, were comparable between the two groups, with no significant differences in adverse effects. Conclusion: The addition of dexmedetomidine to 0.5% lignocaine in intravenous regional anaesthesia for upper limb surgeries provides enhanced sensory and motor block characteristics, prolonged postoperative analgesia, and improved patient satisfaction without a significant increase in complications. Dexmedetomidine appears to be a useful adjunct in IVRA for upper limb surgeries, potentially improving the clinical outcomes and the overall quality of anesthesia

The Postural changes in intraocular pressure in normal and glaucomatous eyes in Indian population

Introduction: Intraocular pressure (IOP) increases when changing from sitting to supine position flat without pillow with an average difference of 0.85 to 6.01mm of Hg. These postural changes of IOP have been found in normal persons, patients with ocular hypertension and normal tension glaucoma. The eye is relatively non-distensible, even small changes in the volume of aqueous humor may significantly change IOP. The increase in resistance in aqueous flow is thought to be the reason for higher IOP in supine compared to sitting position. The aim of this study is to analyze the Postural changes in intraocular pressure in normal and glaucomatous eyes of Indian population. Method: It was a prospective cross sectional study done in Armed Forces Medical College Pune, between June, 2022 to June, 2024 with sample sized of 60 people 30 controls (Normal) and 30 Primary open angle glaucoma). Patients underwent complete ocular examination. Two drops of Topical 2% propacaine were instilled. IOP measurements were taken by Parkin handheld tonometer in sitting and supine flat without pillow and supine with pillow positions at 10 minutes, 20 minutes and 30 minutes interval respectively. Results: The IOP difference between the sitting and supine flat position was significantly higher in the POAG than non-glaucoma subjects (5.0667±0.09 vs 6.01±0.85 mm Hg, P<0.001). The IOP difference between the sitting and supine with pillow positions was 1.3667±0.14 mm Hg for POAG and 2.8±0.34 mm Hg in non-glaucoma (P<0.001), While difference between supine flat and supine with pillow positions was 3.7±0.23 mm Hg in POAG and 3.2±0.51 mm Hg in non-glaucomatous patients (P<0.001). Conclusions: The rise in IOP due to change of posture from sitting to supine positions was significantly higher in glaucomatous patients

Nanoparticles formulations of insulin glargine: an overview

Insulin glargine, a long-acting insulin analog, is a cornerstone in the management of diabetes mellitus. However, its therapeutic efficacy is often hindered by limitations such as variable pharmacokinetics and suboptimal bioavailability. Nano-particle formulations have emerged as promising strategies to address these challenges, offering improved stability, prolonged action, and targeted delivery. This article provides an in-depth exploration of nano-particle formulation of insulin glargine, covering synthesis methods, physicochemical characterization, in vitro release kinetics, pharmacokinetic and pharmacodynamic evaluation, and long-term efficacy studies. Various types of nano-particles, including liposomes, polymeric nanoparticles, and lipid nanoparticles, are discussed in detail, along with their potential advantages and challenges. Furthermore, preclinical and clinical studies assessing the therapeutic potential of nano-particle encapsulated insulin glargine are reviewed, shedding light on the translational opportunities and future directions in this fiel

To evaluate postoperative shoulder tip pain in low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy

INTRODUCTION : Laparoscopic cholecystectomy is the gold standard treatment for gallstone disease. Laparoscopic cholecystectomy has rapidly replaced open cholecystectomy for treatment of patients with gall bladder disease especially cholelithiasis .METHODS: The present study was conducted to evaluate the postoperative shoulder tip pain in low pressure versus standard pressure pneumo peritoneum during laparoscopic cholecystectomyRESULTS : The use of low pressure laparoscopic cholecystectomy (LPLC) as compared to standard pressure laparoscopic cholecystectomy (SPLC) significantly decreases the frequency and intensity of postoperative shoulder tip pain. LPLC decreases the demand for postoperative analgesics, decreases postoperative hospital stay and hence improves the quality of life in the early stage of postoperative rehabilitation. CONCLUSION: On the basis of these results, the widespread use of low pressure pneumoperitoneum during laparoscopic cholecystectomy is recommended

Candidiasis Among ICU Patients: Risk factors, Speciation and Antifungal Resistance Pattern: A Retrospective study from a tertiary care hospital in south Gujarat.

Introduction:Candidiasis is a significant cause of morbidity and mortality in immunocompromised patients admitted in intensive care units. Identification of Candida species is essential for effective treatment. However, in absence of proven fungemia, guidelines to initiate therapy are yet to be defined. Materials and methods - During the study (18 months: July 2018 to December 2019), samples (urine, sputum, blood, sterile body fluids) were collected from ICU patients and prospectively evaluated. Microscopy, culture, and antifungal susceptibility testing were performed as per standard laboratory protocol. Results- One hundred twenty-one non-duplicate samples (from 121 patients) positive on culture were included in the study. Female was significantly associated with the development of Candida infections than males with a ratio of 1.2:1. The most prevalent co-morbid condition among patients with Candida infections was diabetes mellitus (36.36%). Candida species revealed that Candida Albicans (51.24%) was the most frequently isolated species surpassing other non-albicans Candida species. Among non-albicans Candida species Candida glabrata (43.80%) was the most common isolated species followed by Candida tropical (4.13%). Candida species were mostly isolated from urine (70.25%) followed by blood(22.31%) and sterile body fluids(7.4%). Candida albican sensitivity was lowest for fluconazole (69.35%). Candida glabrata and candida tropicalis had shown alarming resistance to flucanazole and clotrimazole.Conclusion - The growing resistance to fluconazole necessitates the consideration of voriconazole as a highly effective alternative when initial treatment regimens do not succeed. In summary, the rising resistance of Candida species to ketoconazole emphasizes the vital need for precise species identification and antifungal susceptibility testing prior to the commencement of treatment. As resistance patterns develop, it is essential to maintain continuous surveillance and prudent application of antifungal medications to enhance patient outcomes and address the escalating challenge posed by drug-resistant fungal pathogens. This situation underscores the importance of antifungal susceptibility testing and monitoring to effectively tackle and manage resistance

Gastroretentive sustained release beads of Lamivudine

The objective of the investigation described is to develop gastroretentive sustained release beads of Lamivudine using sodium alginate and Eudragit S100 through the ionotropic gelation method. The resulting solution was extruded into a cross-linking solution containing calcium chloride (1% w/v) and acetic acid (10% v/v) using a 22 gauge syringe needleThe in vitro release profiles of the Lamivudine beads were assessed using 0.01N HCl as the dissolution medium. The oral bioavailability of the optimized microsphere dosage forms was evaluated through a single-dose study, revealing significant differences in parameters such as Cmax (maximum plasma concentration), Tmax (time to reach Cmax), T1/2 (elimination half-life), Ka (absorption rate constant), Ke (elimination rate constant), MRT (mean residence time), MDT (mean dissolution time), and AUC (area under the concentration-time curve) when compared to conventional tablets. Furthermore, a linear relationship was observed between the percentages of dissolved and absorbed Lamivudine, suggesting the possibility of predicting in vivo absorption by measuring in vitro dissolution.To determine the significance of the data, one-way ANOVA followed by the Tukey test was employed. The results indicated that the F3 formulation exhibited the best in vivo performance, demonstrating a controlled release profile that correlated well with the in vitro release profile of Lamivudine from the microspheres. This optimized formulation holds promise for the improved management of AIDS

Mucoadhesive tablets of acetaminophen

Mucoadhesive drug delivery systems have gained significant attention in pharmaceutical research due to their potential to enhance drug bioavailability, provide controlled drug release, and improve patient compliance. Acetaminophen, a widely used analgesic and antipyretic drug, has limitations such as short half-life and hepatic first-pass metabolism, which can reduce its therapeutic efficacy. To overcome these challenges, the formulation of mucoadhesive buccal tablets has emerged as an effective alternative drug delivery approach. This review highlights various studies on the formulation and evaluation of mucoadhesive buccal tablets of acetaminophen, focusing on polymer selection, drug release kinetics, and bioadhesion strength. Key mucoadhesive polymers such as Carbopol, Hydroxypropyl Methylcellulose (HPMC), Sodium Carboxymethyl Cellulose (NaCMC), and Polyvinyl Pyrrolidone (PVP) have been extensively studied for their role in enhancing mucoadhesion and sustaining drug release. Studies have demonstrated that combining these polymers results in improved adhesion, prolonged retention time, and controlled drug release, leading to enhanced therapeutic efficacy.Additionally, the incorporation of permeation enhancers like propylene glycol has shown significant improvement in drug absorption through the buccal mucosa. Advances in multi-layered tablets and pH-sensitive formulations have further optimized drug release profiles. In-vivo and in-vitro studies have validated the effectiveness of these formulations in achieving prolonged therapeutic action.Overall, mucoadhesive buccal tablets of acetaminophen offer a promising alternative to conventional oral administration, improving bioavailability and patient compliance. Future research should focus on clinical trials, optimization of polymer blends, and innovative formulation strategies to enhance therapeutic outcomes

Clinico- Hematological Study of anaemia Among Adolescent Age Group of N.M.C.H, Jamuhar,Bihar

Background :Anaemia is a major global health problem especially in developing countries like India and is a widespread nutritional problem more commonly seen in women and children during their most crucial periods like during pregnancy and growth, and as the studies on school age children were very few, hence this study was taken. Objective:To study the clinico-hematological profile of anaemia in adolescent age group at tertiary care centre, NMCH, Jamuhar, Bihar. Methods:A retrospective study done in adolescent age group presenting with anaemia during the period from January 2023 to June 2023. A total of 250 cases were studied.Results:A total of 250 cases were studied of which the maximum incidence of anaemia was found in the female age group Pallor was the commonest clinical sign followed by weakness and fatigability. Anaemia was graded according to WHO criteria. The maximum cases were under Grade I category (severe: Hb->10gm/dl) i.e. mild anaemia.Among the morphological type, majority were Microcytic hypochromic anaemia (64 %), Normocytic hypochromic anaemia (36 %), Dimorphic anaemia (2%). Interpretation and conclusion: Complete haemogram evaluation was analyzed with Erba-360 analyzer (5 parts). Leishman stain, New Methylene blue, May Grunwald Giemsa were used for peripheral smear. The most common type of anaemia was Microcytic hypochromic anaemia. Majority of the cases were from rural area (75%) than urban (25%).The present study concludes that early diagnosis and management will help in better cognitive and motor development in childre

Formulation, evaluation and optimization of microspheres of anti-inflammatory drug diacerein using polymer carbopol for the treatment of osteoarthritis

The objectives of the present study were to select a formulation that has an ideal in vitro dissolution profile and to compare the sustaining/ controlling efficacy of the selected formulation with that of the commercial conventional tablet in order to establish a good degree of in vitro–in vivo correlation. The microspheres were subjected to characterization for particle size, encapsulation efficiency, loose crystal study, stability study, in vitro release rate profile, release kinetics and in vivo study in New Zealand white rabbit species. A single-dose oral bioavailability study revealed significant differences in Cmax, Tmax, T, Ka, Ke, MRT, MDT and AUC between the conventional tablet and optimized microsphere dosage forms. Furthermore, linear relationship obtained between the percentages dissolved and absorbed suggests a means to predict in vivo absorption by measuring in vitro dissolution. Thus F5 formulation showed the best in vivo performance exhibiting deliberate release

Herbal Medicated Chewing Gum Used To Treat Mouth Ulcer

Mouth ulcers are a prevalent oral mucosal condition that significantly affects daily activities such as eating, drinking, and speaking. While various pharmaceutical treatments exist, they often have side effects or provide only temporary relief. Herbal formulations present a safer, more effective alternative with minimal adverse effects. This review focuses on the formulation and evaluation of herbal medicated chewing gum (HMCG) incorporating liquorice (Glycyrrhiza glabra) and guava leaves (Psidium guajava) for treating mouth ulcers. The medicinal properties of these herbs, their mechanism of action, different formulation techniques, and essential evaluation parameters are explored in detail to provide insight into their potential as a novel therapeutic option