Comparative study of bupivacaine alone and bupivacaine along with buprenorphine in axillary brachial plexus block: a prospective, randomized, single blind study

Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomized single-blind study to compare Bupivacaine alone and Bupivacaine along with Buprenorphine for onset, quality, and duration of block as well as post-operative analgesia and any complication in axillary brachial- plexus block.Methods: Randomized controlled study was carried out among 60 patients of either sex, aged 20-60 years. ASA grade I or II undergoing elective hand, forearm, elbow surgery under axillary brachial plexus block. Patients were randomly divided into two groups.Group-l received 30 ml of 0.35% Bupivacaine alone in axillary block.Group-II received 30 ml of 0.35% Bupivacaine with 3µg/kg Buprenorphine in axillary block. Time taken for onset and completion of motor and sensory block as well as complete duration of block were noted in both groups. Any complication during procedure, during surgery as well as post-operatively were noted and treated.Results: Addition of Buprenorphine (3µg/kg) to Bupivacaine mixture in peripheral nerve block did not affected the onset time for motor as well as sensory block. Mean duration of motor block was 284.33±78.94 mins. in group I and in group II 307.33±60.26 mins. Mean duration of sensory block 305.066±83.64 mins. in group I while 580.166±111.45 mins. in group II. It suggests duration of sensory block was prolonged in group II then group I.Conclusions: Addition of Buprenorphine to local anesthetic drug provides good post-operative analgesia. Buprenorphine significantly prolongs sensory block and lengthens duration of analgesia without prolonging duration of motor block

A case series of percutaneous tension band wiring technique for fixation of fractures of olecranon and patella

There are several advantages in the treatment of fractures by means of closed reduction. Percutaneous fixation is a type of biological fixation. The aim and objectives of this study are to demonstrate the technique of percutaneous tension band wiring in cases of transverse, non- comminuted olecranon and patella fractures and to decrease the soft tissue dissection, blood loss, chances of infection and to ensure speedy mobilization using the innovative percutaneous fixation technique. This retrospective study includes ten patients of olecranon and ten patients of patella operated by the same surgeon. All patients were operated with percutaneous tension band wiring for olecranon and patella. There were six males and four females with olecranon fractures. There were seven males and three females who suffered patella fractures. The average duration of surgery was 55 minutes and average follow up was 24±6 weeks. The suture removal was done at 2 weeks. All patients had full range of movements at six weeks with significantly improved DASH score and Oxford knee score. None of the patients had any complications. Percutaneous fixation decreases the chances of bleeding secondary to unnecessary soft tissue dissection, thereby decreasing the post-operative morbidity. It also, convincingly, decreases the chances of post-operative infection and promotes early mobilization. Closed reduction with percutaneous fixation is believed to be an innovative, safe, reliable and efficient method of managing these difficult fractures

Laparoscopic assisted reduction of jejuno-jejunal intussusception with resection of jejunal polyp in children: A case series

Jejunojejunal intussusceptions secondary to polyp as a lead point are extremely rare. Only a few cases have been reported in the English literature. Here, we report the case series of two such cases who presented to us as irreducible intussusceptions and were managed successfully by laparoscopic-assisted transumbilical reduction and resection. Thus laparoscopic-assisted management of this rare presentation is feasible even in smaller children

UNMANNED AERIAL VEHICLE (UAV)

ABSTRACT Unmanned aerial vehicles (UAV) are the logical successors to modern aircraft and advancements in automated technology. The current generation of UAV's is focused on wartime capabilities and reconnaissance, leaving an existing market untapped by UAV technology: the commercial field. There are hundreds of applications for UAV technology in the civilian market, from emergency response applications and media outlets to communication technicians and horticulturalists. The vehicle can even act as a path guider in normal case and as a fire extinguisher in emergency. This project will help generate interests as well as innovations in the fields of unmanned vehicles, thereby working towards a practical and obtainable solution to save lives and mitigate the risk of property damage

Detubularized isolated ureterosigmoidostomy in a complicated common cloaca: A case report

Urinary incontinence in a child secondary to a severe congenital anatomical disorder or due to complication of a previous surgery can be difficult to manage. Decisions can be especially hard when a redo procedure is being considered. We present one such case where a 6 year old girl previously operated for cloaca was brought with incontinence and after much consideration of options available, underwent a modified ureterosigmoidostomy to aid in her continence. The modification used was detubularized isolated ureterosigmoidostomy, described by Atta et al in 1996

Winnowing DNA for Rare Sequences: Highly Specific Sequence and Methylation Based Enrichment

Rare mutations in cell populations are known to be hallmarks of many diseases and cancers. Similarly, differential DNA methylation patterns arise in rare cell populations with diagnostic potential such as fetal cells circulating in maternal blood. Unfortunately, the frequency of alleles with diagnostic potential, relative to wild-type background sequence, is often well below the frequency of errors in currently available methods for sequence analysis, including very high throughput DNA sequencing. We demonstrate a DNA preparation and purification method that through non-linear electrophoretic separation in media containing oligonucleotide probes, achieves 10,000 fold enrichment of target DNA with single nucleotide specificity, and 100 fold enrichment of unmodified methylated DNA differing from the background by the methylation of a single cytosine residue

Decision trees to characterise the roles of permeability and solubility on the prediction of oral absorption

Oral absorption of compounds depends on many physiological, physiochemical and formulation factors. Two important properties that govern oral absorption are in vitro permeability and solubility, which are commonly used as indicators of human intestinal absorption. Despite this, the nature and exact characteristics of the relationship between these parameters are not well understood. In this study a large dataset of human intestinal absorption was collated along with in vitro permeability, aqueous solubility, melting point, and maximum dose for the same compounds. The dataset allowed a permeability threshold to be established objectively to predict high or low intestinal absorption. Using this permeability threshold, classification decision trees incorporating a solubility-related parameter such as experimental or predicted solubility, or the melting point based absorption potential (MPbAP), along with structural molecular descriptors were developed and validated to predict oral absorption class. The decision trees were able to determine the individual roles of permeability and solubility in oral absorption process. Poorly permeable compounds with high solubility show low intestinal absorption, whereas poorly water soluble compounds with high or low permeability may have high intestinal absorption provided that they have certain molecular characteristics such as a small polar surface or specific topology. © 2014 Published by Elsevier Masson SAS

Global burden of disease due to smokeless tobacco consumption in adults : analysis of data from 113 countries

BACKGROUND: Smokeless tobacco is consumed in most countries in the world. In view of its widespread use and increasing awareness of the associated risks, there is a need for a detailed assessment of its impact on health. We present the first global estimates of the burden of disease due to consumption of smokeless tobacco by adults. METHODS: The burden attributable to smokeless tobacco use in adults was estimated as a proportion of the disability-adjusted life-years (DALYs) lost and deaths reported in the 2010 Global Burden of Disease study. We used the comparative risk assessment method, which evaluates changes in population health that result from modifying a population's exposure to a risk factor. Population exposure was extrapolated from country-specific prevalence of smokeless tobacco consumption, and changes in population health were estimated using disease-specific risk estimates (relative risks/odds ratios) associated with it. Country-specific prevalence estimates were obtained through systematically searching for all relevant studies. Disease-specific risks were estimated by conducting systematic reviews and meta-analyses based on epidemiological studies. RESULTS: We found adult smokeless tobacco consumption figures for 115 countries and estimated burden of disease figures for 113 of these countries. Our estimates indicate that in 2010, smokeless tobacco use led to 1.7 million DALYs lost and 62,283 deaths due to cancers of mouth, pharynx and oesophagus and, based on data from the benchmark 52 country INTERHEART study, 4.7 million DALYs lost and 204,309 deaths from ischaemic heart disease. Over 85 % of this burden was in South-East Asia. CONCLUSIONS: Smokeless tobacco results in considerable, potentially preventable, global morbidity and mortality from cancer; estimates in relation to ischaemic heart disease need to be interpreted with more caution, but nonetheless suggest that the likely burden of disease is also substantial. The World Health Organization needs to consider incorporating regulation of smokeless tobacco into its Framework Convention for Tobacco Control

The Global Burden of Disease Study 2010: Interpretation and Implications for the Neglected Tropical Diseases

This article analyzes the "Global Burden of Disease Study 2010" and examines the study's implications for neglected tropical diseases

RNA interference approaches for treatment of HIV-1 infection

HIV/AIDS is a chronic and debilitating disease that cannot be cured with current antiretroviral drugs. While combinatorial antiretroviral therapy (cART) can potently suppress HIV-1 replication and delay the onset of AIDS, viral mutagenesis often leads to viral escape from multiple drugs. In addition to the pharmacological agents that comprise cART drug cocktails, new biological therapeutics are reaching the clinic. These include gene-based therapies that utilize RNA interference (RNAi) to silence the expression of viral or host mRNA targets that are required for HIV-1 infection and/or replication. RNAi allows sequence-specific design to compensate for viral mutants and natural variants, thereby drastically expanding the number of therapeutic targets beyond the capabilities of cART. Recent advances in clinical and preclinical studies have demonstrated the promise of RNAi therapeutics, reinforcing the concept that RNAi-based agents might offer a safe, effective, and more durable approach for the treatment of HIV/AIDS. Nevertheless, there are challenges that must be overcome in order for RNAi therapeutics to reach their clinical potential. These include the refinement of strategies for delivery and to reduce the risk of mutational escape. In this review, we provide an overview of RNAi-based therapies for HIV-1, examine a variety of combinatorial RNAi strategies, and discuss approaches for ex vivo delivery and in vivo delivery