DEXMEDETOMIDINE PREMEDICATION WITH KETAMINE AND PROPOFOL DURING BURNS DEBRIDEMENT AND DRESSINGS

Background: Burn patients undergo frequent extensive burn debridement and painful dressing changes. Ketamine and Propofol are the most common anesthetic used along with Opioids and Benzodiazepines in burns dressings. Studies have shown that concomitant use of Dexmedetomidine with Propofol and Ketamine. Objectives: To study the effects of Dexmedetomidine as premedication with Ketamine and Propofol as sole anesthetic agents during burns debridement and dressing. Materials and methods: Total 60 Patients of scheduled for elective burn debridement and dressings at P.R.H. Loni admitted in the wards were enrolled for the study. Patients satisfying the following eligibility criteria were selected and grouped those who received Ketamine and Propofol (Group B) with and without Dexmedetomidine (Group A) and both the groups were assessed to find out difference in the dose requirement, haemodynamic variables and recovery time (using Ramsay Sedation scale). Results: The haemodynamic parameters like heart rate, systolic and diastolic Blood pressure was significantly higher in Group A as compared to Group B. The recovery time in Group A was 12.9 mins as compared to 9.5 mins in Group B. It was observed that dose requirement of Ketamine (228.8±21.9) and Propofol (263.2 ± 22.5) was significantly more in Group A as compared to Group B (101.1±20.3 and 120.8±22.4 respectively).Conclusion: Dexmedetomidine (1μg/kg IM dose) is a good anaesthetic adjuvant that decreases the requirement of Propofol and Ketamine during burns debridement and dressings, maintains stable intraoperative haemodynamics and also has an excellent recovery profile. Key words: Dexmedetomidine; Haemodynamic Changes; Ketamine; Propofol; Recovery Time

DEXMEDETOMIDINE PREMEDICATION WITH KETAMINE AND PROPOFOL DURING BURNS DEBRIDEMENT AND DRESSINGS

Background: Burn patients undergo frequent extensive burn debridement and painful dressing changes. Ketamine and Propofol are the most common anesthetic used along with Opioids and Benzodiazepines in burns dressings. Studies have shown that concomitant use of Dexmedetomidine with Propofol and Ketamine. Objectives: To study the effects of Dexmedetomidine as premedication with Ketamine and Propofol as sole anesthetic agents during burns debridement and dressing. Materials and methods: Total 60 Patients of scheduled for elective burn debridement and dressings at P.R.H. Loni admitted in the wards were enrolled for the study. Patients satisfying the following eligibility criteria were selected and grouped those who received Ketamine and Propofol (Group B) with and without Dexmedetomidine (Group A) and both the groups were assessed to find out difference in the dose requirement, haemodynamic variables and recovery time (using Ramsay Sedation scale). Results: The haemodynamic parameters like heart rate, systolic and diastolic Blood pressure was significantly higher in Group A as compared to Group B. The recovery time in Group A was 12.9 mins as compared to 9.5 mins in Group B. It was observed that dose requirement of Ketamine (228.8±21.9) and Propofol (263.2 ± 22.5) was significantly more in Group A as compared to Group B (101.1±20.3 and 120.8±22.4 respectively).Conclusion: Dexmedetomidine (1μg/kg IM dose) is a good anaesthetic adjuvant that decreases the requirement of Propofol and Ketamine during burns debridement and dressings, maintains stable intraoperative haemodynamics and also has an excellent recovery profile. Key words: Dexmedetomidine; Haemodynamic Changes; Ketamine; Propofol; Recovery Time

Role of Antioxidants in Male Reproduction: Review

To counter oxidative stress, cells constitutively express enzymes that detoxify the reactive oxygen species and repair the damage. An antioxidant is any substance that when present at low concentrations compared to those of an oxidizable substrate significantly delays or prevents oxidation of that substrate. The antioxidant enzymes are major cell defense against acute oxygen toxicity. The functions of these antioxidant enzymes are to protect the membrane and cytosolic components against damage caused by free radicals. Glutathione peroxidase, Superoxide dismutase, glutathione-s-transferase, catalase, xanthine oxidase. Amongst a variety of antioxidants; vitamin E antioxidant use is essential because it travels through the body in molecules called lipoproteins and protect them from oxidation. For Many years, vitamin E considered as an anti-sterility factor. In the male reproductive system, vitamin C is known to protect spermatogenesis, and it plays a major role in semen integrity and fertility in men. It increases testosterone levels and prevents sperm agglutination. It is an important chain-breaking antioxidant, contributing up to 65 % of the total antioxidant capacity of seminal plasma found intracellularly and extracellularly. N-Acetyl cysteine reacts with highly oxidizing radicals such as ˙OH, ˙NO2, CO3˙‑, and also bind redox-active metal ions. Thiosl can also afford radioprotection through the donation of reducing equivalents. Keywords: Antioxidants; Male fertility; Sperm quality

Role of Antioxidants in Male Reproduction: Review

To counter oxidative stress, cells constitutively express enzymes that detoxify the reactive oxygen species and repair the damage. An antioxidant is any substance that when present at low concentrations compared to those of an oxidizable substrate significantly delays or prevents oxidation of that substrate. The antioxidant enzymes are major cell defense against acute oxygen toxicity. The functions of these antioxidant enzymes are to protect the membrane and cytosolic components against damage caused by free radicals. Glutathione peroxidase, Superoxide dismutase, glutathione-s-transferase, catalase, xanthine oxidase. Amongst a variety of antioxidants; vitamin E antioxidant use is essential because it travels through the body in molecules called lipoproteins and protect them from oxidation. For Many years, vitamin E considered as an anti-sterility factor. In the male reproductive system, vitamin C is known to protect spermatogenesis, and it plays a major role in semen integrity and fertility in men. It increases testosterone levels and prevents sperm agglutination. It is an important chain-breaking antioxidant, contributing up to 65 % of the total antioxidant capacity of seminal plasma found intracellularly and extracellularly. N-Acetyl cysteine reacts with highly oxidizing radicals such as ˙OH, ˙NO2, CO3˙‑, and also bind redox-active metal ions. Thiosl can also afford radioprotection through the donation of reducing equivalents. Keywords: Antioxidants; Male fertility; Sperm quality

Lessons learned from performance of students of Pharmacology in self coded surprise test with negative marking.

Introduction: The present study aims to find the effect of instruction of negative marking in a self-coded MCQ examination on the performance of students in the subject of Pharmacology with respect to the raw score, correct score and negative score. Material and methods: This longitudinal study was conducted in the Department of Pharmacology, Rural Medical College, Loni. The Second MBBS students were exposed to a self-coded MCQ test twice by surprise. The first test (T1) was given without instructions of negative marking, while during the second test (T2) instructions for negative marking were given. The parameters of the raw score, negative score, corrected score and number of students who did not attempt respective MCQs were calculated. The number of students passing with modified Minimum Passing Level was calculated was compared with conventional Minimum Passing Level. Results: Sixty-seven students participated in the study. There was a statistically significant decrease in the raw score in the T2, while the increase in the negative score when compared with T1. The number of non-attempted questions was increased in T2. There was a statistically significant difference in the number of students passed with respect to raw score in T1 and T2, while no such difference was seen with respect to Negative score and Corrected score. Conclusion: The Corrected score and Negative score are not affected by the minimum passing level, indicating a better parameter of scoring than the raw score. Hence, the use of Negative score or Corrected score should be encouraged than the use of conventional Raw score. Keywords: Minimum Passing Level, Negative Marking, MCQ, Corrected score, Pharmacology, Formative assessment, surprise test, self-coded test