Efficacy of intracuff dexamethasone in reducing the incidence of post-operative sore throat: an original article

Background: Postoperative sore throat is the most common and most distressing complaint of patients after general anaesthesia with cuffed endotracheal tube. By this study our aim was to assess the efficacy of intracuff dexamethasone in reducing the incidence of this distressing postoperative symptom.Methods: Patients were divided into two groups D and N depending on cuff filling with dexamethasone and normal saline respectively. The cuff was prefilled with dexamethasone or normal saline  one hour prior to intubation to allow time for cuff to be saturated following which the cuff was deflated. General anaesthesia was administered and patients were intubated, and cuff inflated with drug according to group allocated. Patients were assessed and graded for sore throat using VAS scale both at rest and with swallowing. Assessment was done one hour, six, 12 and 24hours post operatively. Presence of hoarseness of voice and cough was assessed on a 2-point scale 0=absent and 1=present, 24hrs after surgery.Results: The incidence of sore throat at 24hours postoperative was reduced in group D than in group N. 4 patients (8%) in group D had sore throat while 27 patients (57%) in group N had sore throat at 24hours. This was statistically significant (p<0.05). The cough incidence was reduced in group D while there was no difference in incidence of hoarseness of voice between the two groups.Conclusions: Intracuff dexamethasone decreases the incidence of postoperative sore throat when compared to intracuff normal saline. Dexamethasone also reduces postoperative cough incidence but does not reduce the incidence of hoarseness of voice

A rare poisoning with a still rarer presentation: imidacloprid

Imidacloprid is a neonicotinoid systemic insecticide. It is used to control agricultural pests. It controls the insects from within the plant. This product is applied to the soil and is taken up by the roots. Imidacloprid belongs to a new chemical family of chloronicotinyl compounds. Its mode of action on the insect nervous system differs from that of a traditional neurotoxic product. This compound is considered relatively safer to human beings, but it can lead to potentially life-threatening complications. Large quantity of this compound when ingested causes fatal complications like respiratory failure, cardiac arrythemias. We reported a case of imidacloprid poisoning with its rarest unreported complications

Cartap hydrochloride poisoning: a case report

Cartap hydrochloride is a thiocarbamate insecticide used for control of chewing and sucking insects of all stages of development, on many crops. It is an analogue of nereistoxin. Poisoning with cartap is very rarely reported from India. We report a 46 year old man who consumed cartap with alcohol, presented with nausea & vomiting and improved with supportive measures

Correlation between elevated serum ferritin and HbA1c in type 2 diabetes mellitus

Background: Serum Ferritin, an acute phase reactant is a marker of iron stores in the body. Recent studies indicate that increased body iron stores and subclinical hemochromatosis has been associated with the development of glucose intolerance, type 2 diabetes, metabolic syndrome and possibly the development of diabetic retinopathy, nephropathy and vascular dysfunction. This study was carried out to examine and establish a relationship between Serum Ferritin with Type 2 diabetes mellitus and metabolic syndrome and to examine whether a correlation between S. ferritin and FBS, HbA1c exists.Methods: 86 type 2 diabetes subjects (M:F - 57:29, mean age 54.3±9.2 years, mean BMI 24.28kg/m2) which included 24 patients with metabolic syndrome were studied and compared with controls. S. ferritin, Hb, ESR, FBS, PPBS, HbA1c and fasting lipid profile were measured.Results: Serum ferritin was significantly higher in diabetic patients when compared to controls and serum ferritin had a positive correlation with increasing duration of diabetes.Conclusions: There was a positive correlation between serum ferritin and FBS, HbA1c. There was no correlation between serum ferritin and age, sex, metabolic syndrome, coexistent hypertension, total cholesterol, LDL and serum triglycerides.

Familial esophageal achalasia in mother and son

Familial esophageal achalasia a rare presentation, is most often described in monozygotic twins or siblings. Parent/child association is very rare and exhaustive review of the literature found about 5 times as many instances of affected siblings than instances of affected parent/child. Only seven instances of parent/child association have been reported till date. We report a 75 -year-old lady with achalasia cardia and her son who developed the same illness one year later. Mother was treated by Heller's surgery and son is presently on medical management

Relationship of rheumatoid factor positivity to prevalence of joint manifestations in type 2 diabetes which are unrelated to rheumatoid arthritis

Background: The present study was designed to investigate the relationship of rheumatoid factor positivity to the prevalence of joint manifestations in type 2 diabetes which are not attributable to rheumatoid arthritis.Methods: We evaluated 192 type 2 diabetes patients with rheumatological complications and age and sex matched non-diabetic controls for rheumatoid factor (RF) positivity. Diabetic patients with frozen shoulder, LJM syndrome, carpal tunnel syndrome, trigger finger, DISH and Dupuytren’s contracture were evaluated for RF positivity.  Results: RF was positive in 47 patients (24.4%) when compared to controls (4.2%). RF positivity was associated with an increased prevalence of joint manifestations in diabetic group when compared to controls. RF positivity was not related to the duration of diabetes nor was it related to long term glycemic control.Conclusion: RF positivity resulted in an increased prevalence of joint manifestations in diabetes, which were unrelated to rheumatoid arthritis

Thyroid Profile and Serum Lipid Level in Women with Normal Pregnancy

Objective: To evaluate the changes in thyroid profile and serum lipid level in normal pregnancy. Methods: This observational study was conducted at the Department of Biochemistry of Santosh Medical College, Ghaziabad, UP, India, from June 2021 to February 2022. In this study, 200 average pregnant women were enrolled. The thyroid profile was estimated using the ELISA method, and the lipid profile was measured using the enzymatic kit method. All data were expressed as means and standard deviations, and SPSS version 17 was used for statistical analysis. Results: This observational study observed that the mean T3, T4, and TSH levels increased significantly in the second trimester compared to the first trimester. In contrast, the mean value of T3, T4, and TSH decreased in the third trimester as compared to the second trimester. The mean levels of total cholesterol, triglyceride, and LDL-cholesterol increased significantly, while the mean value of HDL-cholesterol decreased significantly in the second and third trimesters when compared to the first trimester. Conclusion: This study demonstrated abnormal lipid and thyroid metabolism. Changes in thyroid profile may be associated with adverse obstetric outcomes. The altered lipid parameters, mainly High TG and low HDL-C concentrations, may promote vascular dysfunction and oxidative stress

Conflict-Tolerant Real-time Specifications in Metric Temporal Logic

A framework based on the notion of “conflict-tolerance ” was proposed in [3, 4] as a compositional methodology for developing and reasoning about systems that are composed of multiple independent controllers. A central notion in this framework is that of a “conflict-tolerant ” specification for a controller. In this work we propose a way of specifying conflict-tolerant real-time controllers in Metric Interval Temporal Logic (MITL). We call our logic CT-MITL for Conflict-Tolerant MITL. We consider the associated verification and synthesis problems for CT-MITL and give decision procedures to solve them.

Conflict-Tolerant Specifications in Temporal Logic

A framework based on the notion of conflict-tolerance was proposed in [1] as a methodology for developing and reasoning about systems that are composed of multiple independent features. In [1] the authors use annotated transition systems to specify conflict-tolerant features. In this paper we propose a way of specifying conflict-tolerant features in Temporal Logic, which is a specification language widely used in practice. We call our logic Conflict-Tolerant LTL or CT-LTL. We provide an algorithm for verifying whether a given feature implementation meets a specification given in our logic. The paper concludes by providing a constructive procedure for synthesising a finite-state feature implementation from a given CT-LTL specification

Rheumatological manifestations of type 2 diabetes and its relationship to glycemic control and duration of diabetes

Background: While so much emphasis is given to micro and macro vascular complications of diabetes, other long-term complications especially musculoskeletal are often overlooked and underappreciated. This study investigates the prevalence of joint complications among patients with type 2 diabetes mellitus and to examine their relationship with duration of diabetes and glycemic control. Materials and Methods: The presence of various rheumatological complications were assessed in 763 type 2 diabetes patients and their age and sex-matched non-diabetic controls. The relationship between these complications and duration of diabetes and long-term glycemic control was determined. Results: Frozen shoulder (15.6%), LJM syndrome (30.1%), carpal tunnel syndrome (10.2%), trigger finger (9%), DISH (26%) and dupuytren′s contracture (12%) were significantly more prevalent in the diabetic than the control group. Prevalence of OA did not show any significant difference between the two groups. The risk of rheumatological complications increased with deteriorating glycemic control. Conclusion: Periarthritis, diabetic cheiroarthropathy, dupuytren′s contracture, carpal tunnel syndrome, trigger finger and DISH are the most prevalent rheumatological complications n the study diabetic population