A prospective randomised control trial to study the role of intra-peritoneal instillation of ropivacaine versus normal saline irrigation in reduction of post-operative pain in patients undergoing laparoscopic cholecystectomy.

The study was done to compare the effect of intra-peritoneal instillation of ropivacaine versus normal saline irrigation on post operative abdominal pain and shoulder pain in laparoscopic cholecystectomy. Ninety patients with symptomatic gall stones disease undergoing laparoscopic cholecystectomy were randomized in three groups. In study group A (n=30 patients) 0.5% of 30 ml (150 mg) of ropivacaine was instilled at gall bladder bed, and in study group B (n=30) 0.9% of 25 – 30 ml/kg of normal saline irrigation was done at gall bladder bed and sub-diaphragmatic space or control group C (n=30) none of above two intervention was done. Pain abdomen is worse during first 24 hours after laparoscopic cholecystectomy. At 6 hours pain abdomen was significantly less in group A compared to group B (p<.035). At 12 hours pain abdomen was less in group A and group B compared to control group. Intensity of shoulder tip pain was almost similar in group A and group B. Group A experienced significantly reduced shoulder tip pain at 6hours and 12 hours as compared to group C. Group B experienced less shoulder tip pain during first postoperative day as compared to control group. Intra-peritoneal instillation of ropivacaine is more effective than normal saline irrigation at early post-operative hours in reducing post-operative pain abdomen after laparoscopic cholecystectomy. However, intra-peritoneal instillation of ropivacaine and normal saline irrigation are comparable in its effect on shoulder tip pain

Spacetime Singularities

We present here an overview of our basic understanding and recent developments on spacetime singularities in the Einstein theory of gravity. Several issues related to physical significance and implications of singularities are discussed. The nature and existence of singularities are considered which indicate the formation of super ultra-dense regions in the universe as predicted by the general theory of relativity. Such singularities develop during the gravitational collapse of massive stars and in cosmology at the origin of the universe. Possible astrophysical implications of the occurrence of singularities in the spacetime universe are indicated. We discuss in some detail the profound and key fundamental issues that the singularities give rise to, such as the cosmic censorship and predictability in the universe, naked singularities in gravitational collapse and their relevance in black hole physics today, and their astrophysical implications in modern relativistic astrophysics and cosmology.Comment: 45 pages, LaTex; Invited Review article for the `Springer Handbook of Spacetime' (eds A. Ashtekar and V. Petkov

Simultaneous EUV and Radio Observations of Bidirectional Plasmoids Ejection During Magnetic Reconnection

We present a multiwavelength study of the X-class flare, which occurred in active region (AR) NOAA 11339 on 3 November 2011. The EUV images recorded by SDO/AIA show the activation of a remote filament (located north of the AR) with footpoint brightenings about 50 min prior to the flare occurrence. The kinked filament rises-up slowly and after reaching a projected height of ~49 Mm, it bends and falls freely near the AR, where the X-class flare was triggered. Dynamic radio spectrum from the Green Bank Solar Radio Burst Spectrometer (GBSRBS) shows simultaneous detection of both positive and negative drifting pulsating structures (DPSs) in the decimetric radio frequencies (500-1200 MHz) during the impulsive phase of the flare. The global negative DPSs in solar flares are generally interpreted as a signature of electron acceleration related to the upward moving plasmoids in the solar corona. The EUV images from AIA 94 \AA reveal the ejection of multiple plasmoids, which move simultaneously upward and downward in the corona during the magnetic reconnection. The estimated speeds of the upward and downward moving plasmoids are ~152-362 and ~83-254 km/s, respectively. These observations strongly support the recent numerical simulations of the formation and interaction of multiple plasmoids due to tearing of the current-sheet structure. On the basis of our analysis, we suggest that the simultaneous detection of both the negative and positive DPSs is most likely generated by the interaction/coalescence of the multiple plasmoids moving upward and downward along the current-sheet structure during the magnetic reconnection process. Moreover, the differential emission measure (DEM) analysis of the active region reveals presence of a hot flux-rope structure (visible in AIA 131 and 94 \AA) prior to the flare initiation and ejection of the multi-temperature plasmoids during the flare impulsive phase.Comment: A&A (accepted), 13 pages, 9 figure