Butorphanol for Post-Operative Analgesia - A Comparative Clinical Study with Ketorolac

Introduction: Butorphanol, an opioid derivative has been shown to have, in addition to its analgesic properties, several other advantageous effects like antistressor, sedative and anti-shivering action. The efficacy and safety profile of ketorolac, yet another widely used post-operative analgesic is well documented. This study aims to compare the two analgesics. Aims and objectives: This study was conducted to compare the analgesic efficacy and other effects of butorphanol and ketorolac, administered intramuscularly, in post-operative patients who have undergone lower abdominal and pelvic surgeries. Materials and methods: 50 patients undergoing lower abdominal and pelvic surgeries under general or spinal anaesthesia were randomly divided into two Groups (25 each). At a particular level of post-operative pain, the patients Groups I and II were administered intramuscular ketorolac 30mg and butorphanol 2mg respectively. The analgesic effect was studied using Visual Analogue Scale (VAS) and the verbal category scale. Patients were monitored for the sedative action, respiratory status and other vital parameters for 300 minutes and for other adverse reactions over the next twelve hours. Observations: Butorphanol provided better analgesia within the first two hours of administration, while ketorolac was more effective at 4-5 hours. Better sedative action without any significant respiratory depressant effect was demonstrated with butorphanol. There were no clinically significant hemodynamic fluctuations or adverse reactions with butorphanol or ketorolac. Conclusions: Butorphanol provides better early analgesia as compared to ketorolac with a desirable and safe sedative effect in post-operative patients who have undergone lower abdominal and pelvic surgeries

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Isolated homonymous hemianopia: A case series

The purpose of this study was to describe five case series of patients who presented with isolated homonymous hemianopia (HH) heralding the ministroke. This was a retrospective observational case series. This was a retrospective case series of five patients who presented to the outpatient department with isolated HH and was followed up for 6 months. 30-2 Humphrey's perimetric analysis and neuroimaging was done. Patients also underwent 2D ECHO and 24 h holter monitoring. These patients who presented with isolated HH had best corrected visual acuity of 6/6, N6 with Snellen's chart. Pupils and color vision were normal. On neuroimaging, one patient had infarction only in the occipital lobe. Two had infarction in the cerebellar hemispheres along with the occipital lobe and one patient had infarction in the deep white matter of temporal lobe, corona radiata, and the last patient also had chronic infarct in the frontal lobe. But all these patients presented with isolated HH. 2D ECHO and 24 h holter monitoring were within normal limits and had no neurological deficits. They were put on oral antiplatelets, statins and nutritional supplements, followed up by neurologists for 6 months and showed no neurological deficits on follow up. On finger confrontation test, hemianopia was still persistent. Isolated visual symptoms may be an early presenting characteristic of stroke. As there is a finite window of time during which therapy for stroke is effective, prompt identification of such atypical symptoms is crucial

Study of association between fundus changes and serum lipid profile in patients of essential hypertension

Background: To evaluate the role of dyslipidemia on fundus changes in hypertensive patients,and to correlate above findings with the components of lipid profile (LDL, HDL, VLDL, Total cholesterol and triglycerides). Method: One hundred consecutive subjects who attended ophthalmology OPD and inpatients of A.J Institute of Medical Sciences Mangalore who were diagnosed with primary essential hypertension were enrolled in this prospective study. All the subjects (200 eyes) were subjected to a detailed ophthalmic examination. Fundus changes were classified according to Keith, Wagener and Barker (KWB), and Modified Scheie’s grading system. Investigations in this study include Complete blood count (Hb, TLC, DLC, ESR), Urine routine and microscopic examination, random blood sugar, fasting serum lipid profile. Other investigations like blood urea, serum creatinine, Chest X-ray, ECG, ECHO, CT scan were done based on clinical diagnosis and suspicion of end organ dysfunctions. Data were collected using apre-structured proforma and analysed using SPSS 13.0 Results: Out of the 100 patients with essential hypertension, 75(75%) had retinopathy and the remaining 25(25%) subjects had no retinopathy. Severity of hypertension correlated well with severity of retinopathy (p<0.008). No sex preponderance towards developing retinopathy was found in this study (p<0.544). Our study showed significant relationship between various grades of retinopathy and duration of hypertension (p<0.000). A positive correlation of hypertensive retinopathy was found with total cholesterol value (p<0.013), serum triglycerides (p<0.039) and cholesterol:high-density lipoprotein (cholesterol:HDL) ratio (p<0.015). Conclusion: This study proved a definite association between serum lipid parameters and the prevalence of hypertensive retinopathy (HR)

Transverse momentum and pseudorapidity distributions of charged hadrons in pp collisions at (s)\sqrt(s) = 0.9 and 2.36 TeV

Measurements of inclusive charged-hadron transverse-momentum and pseudorapidity distributions are presented for proton-proton collisions at sqrt(s) = 0.9 and 2.36 TeV. The data were collected with the CMS detector during the LHC commissioning in December 2009. For non-single-diffractive interactions, the average charged-hadron transverse momentum is measured to be 0.46 +/- 0.01 (stat.) +/- 0.01 (syst.) GeV/c at 0.9 TeV and 0.50 +/- 0.01 (stat.) +/- 0.01 (syst.) GeV/c at 2.36 TeV, for pseudorapidities between -2.4 and +2.4. At these energies, the measured pseudorapidity densities in the central region, dN(charged)/d(eta) for |eta| < 0.5, are 3.48 +/- 0.02 (stat.) +/- 0.13 (syst.) and 4.47 +/- 0.04 (stat.) +/- 0.16 (syst.), respectively. The results at 0.9 TeV are in agreement with previous measurements and confirm the expectation of near equal hadron production in p-pbar and pp collisions. The results at 2.36 TeV represent the highest-energy measurements at a particle collider to date

Measurement of the charge ratio of atmospheric muons with the CMS detector

We present a measurement of the ratio of positive to negative muon fluxes from cosmic ray interactions in the atmosphere, using data collected by the CMS detector both at ground level and in the underground experimental cavern at the CERN LHC. Muons were detected in the momentum range from 5 GeV/ c to 1 TeV/ c . The surface flux ratio is measured to be 1.2766±0.0032(stat.)±0.0032(syst.) , independent of the muon momentum, below 100 GeV/ c . This is the most precise measurement to date. At higher momenta the data are consistent with an increase of the charge ratio, in agreement with cosmic ray shower models and compatible with previous measurements by deep-underground experiments.We present a measurement of the ratio of positive to negative muon fluxes from cosmic ray interactions in the atmosphere, using data collected by the CMS detector both at ground level and in the underground experimental cavern at the CERN LHC. Muons were detected in the momentum range from 5 GeV/c to 1 TeV/c. The surface flux ratio is measured to be 1.2766 \pm 0.0032(stat.) \pm 0.0032 (syst.), independent of the muon momentum, below 100 GeV/c. This is the most precise measurement to date. At higher momenta the data are consistent with an increase of the charge ratio, in agreement with cosmic ray shower models and compatible with previous measurements by deep-underground experiments