Expoldb: expression linked polymorphism database with inbuilt tools for analysis of expression and simple repeats

BACKGROUND: Quantitative variation in gene expression has been proposed to underlie phenotypic variation among human individuals. A facilitating step towards understanding the basis for gene expression variability is associating genome wide transcription patterns with potential cis modifiers of gene expression. DESCRIPTION: EXPOLDB, a novel Database, is a new effort addressing this need by providing information on gene expression levels variability across individuals, as well as the presence and features of potentially polymorphic (TG/CA)(n )repeats. EXPOLDB thus enables associating transcription levels with the presence and length of (TG/CA)(n )repeats. One of the unique features of this database is the display of expression data for 5 pairs of monozygotic twins, which allows identification of genes whose variability in expression, are influenced by non-genetic factors including environment. In addition to queries by gene name, EXPOLDB allows for queries by a pathway name. Users can also upload their list of HGNC (HUGO (The Human Genome Organisation) Gene Nomenclature Committee) symbols for interrogating expression patterns. The online application 'SimRep' can be used to find simple repeats in a given nucleotide sequence. To help illustrate primary applications, case examples of Housekeeping genes and the RUNX gene family, as well as one example of glycolytic pathway genes are provided. CONCLUSION: The uniqueness of EXPOLDB is in facilitating the association of genome wide transcription variations with the presence and type of polymorphic repeats while offering the feature for identifying genes whose expression variability are influenced by non genetic factors including environment. In addition, the database allows comprehensive querying including functional information on biochemical pathways of the human genes. EXPOLDB can be accessed a

A comparative study of intravenous fentanyl and ultrasound-guided femoral nerve block for positioning during spinal anaesthesia in femur fracture surgeries

Objective: To assist in the administration of spinal anesthesia for patients undergoing femur fracture procedures, we conducted comparison research to compare the analgesic efficiency of intravenous fentanyl against ultrasound-guided femoral nerve block (FNB). Material and Methods: A group of 112 patients ranging in age from 18 to 70 years old who had ASA Physical Status I and II and were having femur fracture procedures under spinal anaesthesia participated in the randomised, prospective, interventional trial. These individuals were divided into two groups through a random assignment process. Group FENT (n = 56) received Intravenous fentanyl 1 microgram/kilogram (µg/kg) and five minutes before positioning for spinal anaesthetic, group FNB (n = 56) received ultrasound-guided FNB with 20 millilitres (ml), 1.5% lignocaine and adrenaline (1:200,000). Results: Comparison of pain scores during positioning using the Visual Analog Scale (VAS) revealed that Group FENT had a score of 1.95 ± 0.585, whereas Group FNB had a score of 0.61 ± 0.562 (p-value 0.001). The FNB group demonstrated superior patient positioning quality. Patient satisfaction was similar in both groups, and no significant side effects were observed. Conclusion: FNB offers enhanced analgesia, improved patient positioning, higher patient satisfaction, reduced reliance on additional analgesia, and fewer side effects compared to intravenous fentanyl for spinal anesthesia

A comparative study of three different doses of nalbuphine as an adjuvant to intrathecal bupivacaine for postoperative analgesia in abdominal hysterectomy

Background: Spinal anesthesia is still the most commonly used technique for lower abdominal surgeries as it is very economical and easy to administer. Its main disadvantage remains the short duration of action. Hence, different additives have been used. Nalbuphine is an agonist-antagonist opioid that binds to μ-receptors, as well as to κ-and δ-receptors. The aim of this randomized, double-blind study was to evaluate the potentiating effect of intrathecal nalbuphine with bupivacaine for postoperative analgesia in three different doses. Materials and Methods: A total of 100 patients were randomized into four groups. Group A: Patients received 15 mg of 0.5% hyperbaric bupivacaine, group B: Patients received 15 mg of 0.5% hyperbaric bupivacaine plus 0.8 mg of nalbuphine, group C: Patients received 15 mg of hyperbaric bupivacaine plus 1.6 mg of nalbuphine, and group D: Patient received 15 mg of hyperbaric bupivacaine plus 2.4 mg of nalbuphine intrathecally. Results: The onset of sensory and motor block and duration of motor block were comparable in all groups. Two-segment regression was statistically significant when group A was compared to groups B, C, and D. The total durations of analgesia were 133.8 + 28.3 min, 199.8 + 25.9 min, and 166.8 + 27.8 min in groups B, C, and D, respectively. Conclusion: Our study showed that the combination of intrathecal bupivacaine with nalbuphine significantly prolonged postoperative analgesia as compared to the control group, and a 1.6 mg dose of nalbuphine administered intrathecally showed the best results among all other study groups

Comparison of intracuff alkalinized 2% lignocaine versus dexamethasone for attenuation of post operative laryngotracheal morbidity: a randomized comparative study

Introduction: This randomized comparative study was planned to compare intracuff alkalinized lignocaine versus dexamethasone in preventing postoperative laryngotracheal morbidity. During general anesthesia patients were intubated with cuffed endotracheal tubes to provide effective positive pressure ventilation as well to prevent risk of aspiration. The cuffs of endotracheal tubes were inflated with air. This air in these cuffed endotracheal tubes can cause significant laryngotracheal morbidity. So, we planned this study to find a better substitute other than air to prevent postoperative laryngotracheal morbidity. Material and methods: Total 56 cases were taken. In group A, the cuff of the endotracheal tube was filled with 2% lignocaine 2 ml (40 mg) and sodium bicarbonate (NaHCO3 8.4%) 1 ml (total 3 ml volume). In Group B, the cuff of the endotracheal tube was filled with dexamethasone (8 mg) 2 ml with 1 ml NS (total 3 ml volume). Results: The incidence of sore throat and hoarseness was less in the alkalinized lignocaine group. (p value > 0.05). While the incidence of coughing was roughly similar in both groups and at different time intervals (P value >0.05). Conclusion: Intracuff alkalinized Lignocaine in comparison to intracuff dexamethasone causes less incidence of sore throat and hoarseness in post operative period thus improved patient comfort levels and better recovery profile

Perioperative anaesthetic challenges in coronavirus disease associated mucormycosis: A retrospective study

Background & Aim: Mucormycosis is a life-threatening fungal infection that occurs in immune-compromised patients. There were large number of mucormycosis cases reported during COVID pandemic (2019-21) mainly as post COVID sequelae. In the present retrospective study we aimed to evaluate the perioperative challenges faced in the anaesthetic management of Coronavirus disease associated Mucormycosis (CAM) patients who underwent surgery under general anesthesia. Methods: The perioperative records of CAM patients who underwent surgery from May 2021-July 2021 for mucormycosis were reviewed and evaluated in terms of difficult bag mask ventilation, difficult intubation and other intraoperative and post-operative complications. Observation and Results: The incidence of CAM and its associated surgery was significantly more in males than females and the mean age of the patients was 50 years. In 39.8% patients we encountered difficult bag mask ventilation. and in 17.5% patients more than two attempts for intubation were required. Conclusion: Mucormycosis patients posted for surgery may pose various anesthetic challenges especially in airway management and anesthesiologists must be well prepared for i