Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block

Background: Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block.Methods: In this double-blinded study, a total of 60 patients between 18 to 80 years of age, undergoing surgery for hip fracture were enrolled. Patients in Group A received 40 ml of 0.25% ropivacaine +2 ml saline and patients in Group B received 40 ml of 0.25% ropivacaine +8 mg dexamethasone. USG guided FICB and postoperative monitoring was done by the chief investigator who was unaware of group allotted and drug administered.Results: There is no significant difference in the heart rate between the two groups after 30 min of the block. The variation of systolic blood pressure of both the group for the first 30 min after giving FICB block was not significant (p>0.05). The absolute value of diastolic blood pressure (DBP) was significantly lower in Group B compared to group A just before the block, a variation of DBP with time was not significant. There was a gradual improvement of pain score from mean 6.7 in Group A and 6.6 in Group B at 0 min to score of 2 at the end of 30 min in both the group. This improvement was achieved earlier in Group B compared to Group A, although the difference was not significant (p>0.05). Vital parameters like HR, SBP, DBP, SpO2 values were similar in both the groups. No patients in either group required any interventions both pre-operatively and pos-operatively. Time of rescue analgesia was noted with the VAS score was significantly more in Group B (p≤0.004). The incidence of hematoma, accidental intravascular injection, convulsion, and paresthesia were nil in both groups.Conclusions: Although both the groups had comfortable and pain-free positioning for administering spinal anaesthesia before surgery. USG guided FICB is easy to perform block and give excellent analgesia for positioning and mobilization of hip fracture patients pre and post-operatively both, and dexamethasone as an adjuvant to 0.25%ropivavaine prolong its local anesthetic effect significantly

Disarmament, demobilisation and reintegration: opportunities in post-conflict settings

The international community has learned much over recent years about the need and potential for integration of HIV awareness into the disarmament, demobilisation and reintegration process

A study of exposure to sexual contents in print and audio-visual media and trends of sexual behaviour of late adolescent boys

Objective: To study the relationship between exposures to sexual contents in print and audiovisual media and attitude and sexual behavior of late adolescent boys. Methods: This study was undertaken in the Department of Pediatrics of a tertiary care centre in the year 2017. All respondents who gave informed consent were assessed using a preformed questionnaire. The questionnaire consisted of six sections. Results: The study consisted of 500 late teen boys aged between 17-19 years, 350 from government and 150 from public schools. Mean age of onset of puberty was 12.47 in both groups. Majority of respondents were exposed to media (94.8%). High percentage of respondents from public schools (74.67%) watches pornography. Only 17% of respondents were educated about pubertal changes. Presence of depression was witnessed in 16.6% of respondents. Conclusion: Development of normal sexual behavior during the late adolescent phase of life has lifelong impact on the life of the adolescent and later on his family. Media use is rampant in all strata of society. Pediatricians, parents and teachers can help the adolescents realize the importance of media and incorporate basic principles of media literacy into their sex education program

TO STUDY THE CLINICAL & DEMOGRAPHIC PROFILE OF COVID 19 PEDIATRIC PATIENTS (UP-TO 18 YEARS) IN A TERTIARY CARE CENTRE OF JAIPUR, RAJASTHAN

Objective: COVID-19 infection has quickly developed into a global pandemic. According to the available evidence, children appear to be less likely to be afflicted and the condition may be less severe, but things could change. Rapid deterioration & enhancements in physiologic state are a hallmark of the pediatric community. Therefore, this study was conducted with the aim to study demographic and clinical parameters of Pediatric COVID patients. Methods: This Hospital Based Prospective and Retrospective Study was conducted during 1st April 2020 to July 2022 at COVID Ward and OPD, Mahatma Gandhi Medical College and Hospital, Jaipur. We included 276 Children up to 18 years suffering from COVID-19 infection. We collected data of our study population from medical records and filled up the predesigned proforma for admitted patients. Admitted children were classified as, per ICMR guidelines as: Asymptomatic, Mild, moderate and Severe variety. Statistical analysis was done with the SPSS software. Results:  Highest percentage of cases 48.39% in the age group 12-18 years, were followed by 31.45% in the 7–12-year-old age group. 13.04% of patients were asymptomatic, while the remaining cases were symptomatic, with severity levels of mild 49.28%, moderate 26.81%, and severe 10.87%. Fever was the most prevalent symptom 69.2%, cough 43.84%, throat-ache 18.12%, Breathing difficulties 15.22%, headache 2.54%. Conclusions: In the present study, we concluded that during the third wave of the pandemic, most children had symptomatic illnesses, but recovery was fast among non-hospitalized children. MIS-C was more common in elderly children. Key words: COVID-19, pandemic, MIS-

Is it safe and efficacious to remove central lines in pediatric bone marrow transplant patients with platelets less than 20,000/μl?

Abstract Background Patients with tunneled central venous lines (CVL) may develop bloodstream infections which at times are difficult to control without line removal. Concomitant severe thrombocytopenia with platelet transfusion refractoriness is often considered a major contraindication to any procedure involving a major blood vessel. There is very little literature on the clinical risks of tunneled central line removal in febrile pancytopenia patients. Procedure We analyzed complications and outcomes in all our patients, a total of 52, who underwent CVL removal with platelets <20,000/μl. Results CVL removal was done on a median day of 17.5 with 47 of the 52 patients never having achieved platelets engraftment prior to line removal. No bleeding episodes or unplanned transfusions could be associated with CVL removal. No other complications were also reported. All patients had time to hemostasis within 5 min of catheter removal. Removal of CVL under local anesthesia remained complication‐free even at platelet counts less than 20,000/ul. A total of 31 patients were febrile at the time of CVL removal, of which 17 became afebrile within 2 days. We found no difference in defervescence when comparing those whose antibiotic therapy was changed/escalated versus those in whom it was not. Conclusion Our findings suggest that central lines can be safely removed with platelet counts less than 20,000/ul and that this may result in enhanced bloodstream infection control. This might be particularly relevant to neutropenic patients in this day and age of multidrug‐resistant organism emergence and paucity of new effective antibiotics

Low-cost matched sibling bone marrow transplant for standard-risk thalassemia in a limited-resource setting

Thalassemias are the most common inherited genetic disorder in India and a major public health burden with bone marrow transplant (BMT) considered the only established curative therapy. We describe outcomes for patients (n = 71) with standard-risk thalassemia (liver size 80 at the last follow up. 5 patients (7%) died, mortality related to transplant. Enough data existed for 2 centers in India (36/71 transplants) to analyze overall costs from admission up to one-year post-BMT which revealed a median cost of Rs 7,30,445 ($11519) [Range Rs 4,52,821–10,32,842 ($ 7079–16147)]. In conclusion, children with thalassemia in resource limited settings can achieve good outcomes with BMT at a reasonable cost