Maternal vegetarian diet in pregnancy, a predisposition to hypospadias?

Background: Hypospadias constitutes one of the commonest surgically treated patient subset in a pediatric surgery set up. The causative factors have always been multifactorial. Maternal age and diet during pregnancy have been attempted to be correlated with the prevalence of hypospadias.Methods: The current study aims to find a correlation between the rises of hypospadias with increased maternal vegetarian diet taken during pregnancy. The mothers of patients presenting with hypospadias were allotted structured self-completed questionnaires. Obstetric history, dietary patterns and lifestyle information during pregnancy was obtained.Results: The mothers of patients presenting with hypospadias who had been on a vegetarian diet had an increased incidence of babies presenting with hypospadias as shown in the chart.Conclusions: Diet during gestation may play a role in the etiology of hypospadias. Although this study is limited by less number of cases, it does show the trend of increased incidence of hypospadias amongst vegetarian mothers

Gabapentin a pre-emptive analgesic in post-operative pain: a randomised double blind placebo controlled study

Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with co-administered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period.Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded.Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a period of 24 hours.Conclusions: Gabapentin in the doses used was found to be effective in postoperative pain in patients undergoing planned laparoscopic cholecystectomy. It was found to be safe and no serious adverse events were reported

Gabapentin pre-treatment for pressor response to direct laryngoscopy and tracheal intubation: a randomized, double-blind, placebo-controlled study

Background: Laryngoscopy and endotracheal intubation are associated with an increase in blood pressure (BP) and heart rate (HR). The present study was conducted to evaluate the role of gabapentin in attenuation of these hemodynamic changes.Methods: Forty patients undergoing elective laparoscopic cholecystectomy under general anesthesia with standardized premedication and anesthetics were randomized to receive gabapentin or a matching placebo. The patients of Group I received gabapentin 600 mg orally 2 hrs before surgery and patients in Group II received a matching placebo. Patient’s HR, systolic BP (SBP), diastolic BP (DBP), mean BP (MBP), were monitored before and after 1, 2, 5, and 10 mins of endotracheal intubation.Results: Comparison of SBP, DBP, and MBP at 1, 2, 5 and 10 mins after endotracheal intubation showed statistically significant attenuation in the gabapentin group when compared to placebo. Changes in the HR were not significant.Conclusion: Gabapentin 600 mg, given 2 hrs before induction is effective in attenuating the pressor response to laryngoscopy and tracheal intubation

Gabapentin for post-operative nausea and vomiting: a pilot study

Background: Gabapentin has been used in perioperative setting for the management of post-operative pain for surgery performed under general anaesthesia. Post-operative nausea and vomiting (PONV) even with the use of newer agents remains a major problem. The primary aim of this study was to see if gabapentin use decreased PONV.Methods: A total of 40 patients undergoing elective laparoscopic cholecystectomy under general anesthesia with standardized premedication and anesthetics were randomized to receive gabapentin or a matching placebo. The patients in Group I received gabapentin 600 mg orally 2 hrs before surgery and 12 hrs after the first dose. The patients in Group II received a matching placebo orally 2 hrs before surgery and 12hrs after the first dose. Patients in both groups received diclofenac sodium 75 mg i.m b.i.d for pain and ondensetron 4 mg i.v for PONV. Additional doses were given on demand and recorded. The treatment was double blinded.Results: The present study did not find significant reduction in PONV score and antiemetic consumption in gabapentin group when compared to a placebo for a period of 24 hrs.Conclusions: Gabapentin in the doses used was found to ineffective in post-operative nausea and vomiting in patients undergoing planned laparoscopic cholecystectomy with standardized pre-anaesthetic and anaesthetic medication

Estimation of serum bilirubin level as a diagnostic laboratory marker of acute appendicitis and its role in prediction of appendicular perforation

Background: Acute appendicitis is the most common cause of surgical abdomen. A delay in diagnosis and subsequent delay in intervention may lead to appendicular perforation which leads to peritonitis and further complications including death. In this study, we tried to evaluate – “Estimation of serum bilirubin level as a diagnostic laboratory marker of acute appendicitis and its role in prediction of appendicular perforation.” Aims and Objectives: The objectives of the study are as follows: To study the relationship between hyperbilirubinemia and acute appendicitis and to evaluate its credibility as a diagnostic marker for acute appendicitis. To evaluate whether elevated Bilirubin levels have a predictive potential for diagnosis of appendicular perforation. Materials and Methods: Patients clinically diagnosed with acute appendicitis, supported by imaging studies, who gave consent for the study were included in the study. All those patients underwent estimation of serum bilirubin levels along with other investigations. Data collected were compiled and analyzed. Results: In this study, among 408 patients, sensitivity of serum bilirubin in predicting acute appendicitis was 74.59%. Specificity of serum bilirubin in predicting acute appendicitis was 12.38%. Positive predictive value of serum bilirubin in predicting acute appendicitis was 71.06%. Negative predictive value of serum bilirubin in predicting acute appendicitis was 14.44%. Odds ratio was 0.4147. Conclusion: Serum Bilirubin level appears to be a promising marker for diagnosing acute appendicitis and perforation

Child mental health differences amongst ethnic groups in Britain: a systematic review

BACKGROUND: Inter-ethnic differences have been reported for many mental health outcomes in the UK, but no systematic review on child mental health has been published. The aim of this review is to compare the population-based prevalence of child mental disorders between ethnic groups in Britain, and relate these findings to ethnic differences in mental health service use. METHODS: A systematic search of bibliographic databases for population-based and clinic-based studies of children aged 0-19, including all ethnic groups and the main child mental disorders. We synthesised findings by comparing each minority group to the White British study sample. RESULTS: 31 population-based and 18 clinic-based studies met the inclusion criteria. Children in the main minority groups have similar or better mental health than White British children for common disorders, but may have higher rates for some less common conditions. The causes of these differences are unclear. There may be unmet need for services among Pakistani and Bangladeshi children. CONCLUSION: Inter-ethnic differences exist but are largely unexplained. Future studies should address the challenges of cross-cultural psychiatry and investigate reasons for inter-ethnic differences