Gabapentin a pre-emptive analgesic in post-operative pain: a randomised double blind placebo controlled study

Background: Conventional analgesics, used in peri-operative period cause numerous adverse effects and are not free from interactions with co-administered drugs. Gabapentin has been shown to be effective in various types of neuropathic pain. The primary aim of this study was to evaluate gabapentin as a post-operative analgesic. The study also evaluates the analgesic requirement and safety of gabapentin in post-operative period.Methods: Forty patients undergoing elective laparoscopic cholecystectomy were randomized to receive gabapentin or a matching placebo. The patients of group I received gabapentin 600mg orally 2 hrs before surgery and 12hrs after the first dose. The patients in group II received a matching placebo. Patients in both groups received diclofenac sodium 75mg i.m b.i.d for pain. Additional doses were given on demand and recorded.Results: The present study found that gabapentin significantly reduced pain score and analgesic consumption as compared to a placebo for a period of 24 hours.Conclusions: Gabapentin in the doses used was found to be effective in postoperative pain in patients undergoing planned laparoscopic cholecystectomy. It was found to be safe and no serious adverse events were reported

Different oxidation states of manganese produced by the Fe(n, p)Mn reaction

Formation of Mn54 by (n, p) reaction in Fe54 has been confirmed. It has been found that Mn54 thus formed occurs in the several oxidation states

Gabapentin pre-treatment for pressor response to direct laryngoscopy and tracheal intubation: a randomized, double-blind, placebo-controlled study

Background: Laryngoscopy and endotracheal intubation are associated with an increase in blood pressure (BP) and heart rate (HR). The present study was conducted to evaluate the role of gabapentin in attenuation of these hemodynamic changes.Methods: Forty patients undergoing elective laparoscopic cholecystectomy under general anesthesia with standardized premedication and anesthetics were randomized to receive gabapentin or a matching placebo. The patients of Group I received gabapentin 600 mg orally 2 hrs before surgery and patients in Group II received a matching placebo. Patient’s HR, systolic BP (SBP), diastolic BP (DBP), mean BP (MBP), were monitored before and after 1, 2, 5, and 10 mins of endotracheal intubation.Results: Comparison of SBP, DBP, and MBP at 1, 2, 5 and 10 mins after endotracheal intubation showed statistically significant attenuation in the gabapentin group when compared to placebo. Changes in the HR were not significant.Conclusion: Gabapentin 600 mg, given 2 hrs before induction is effective in attenuating the pressor response to laryngoscopy and tracheal intubation

Gabapentin for post-operative nausea and vomiting: a pilot study

Background: Gabapentin has been used in perioperative setting for the management of post-operative pain for surgery performed under general anaesthesia. Post-operative nausea and vomiting (PONV) even with the use of newer agents remains a major problem. The primary aim of this study was to see if gabapentin use decreased PONV.Methods: A total of 40 patients undergoing elective laparoscopic cholecystectomy under general anesthesia with standardized premedication and anesthetics were randomized to receive gabapentin or a matching placebo. The patients in Group I received gabapentin 600 mg orally 2 hrs before surgery and 12 hrs after the first dose. The patients in Group II received a matching placebo orally 2 hrs before surgery and 12hrs after the first dose. Patients in both groups received diclofenac sodium 75 mg i.m b.i.d for pain and ondensetron 4 mg i.v for PONV. Additional doses were given on demand and recorded. The treatment was double blinded.Results: The present study did not find significant reduction in PONV score and antiemetic consumption in gabapentin group when compared to a placebo for a period of 24 hrs.Conclusions: Gabapentin in the doses used was found to ineffective in post-operative nausea and vomiting in patients undergoing planned laparoscopic cholecystectomy with standardized pre-anaesthetic and anaesthetic medication

Aerosol optical depths at Mohal-Kullu in the northwestern Indian Himalayan high altitude station during ICARB

First time observations of spectral aerosol optical depths (AODs) at Mohal (31.9°N, 77.11°E; altitude 1154 m amsl) in the Kullu valley, located in the northwestern Indian Himalayan region, have been carried out during Integrated Campaign for Aerosols, gases and Radiation Budget (ICARB), as a part of the Indian Space Research Organisation-Geosphere Biosphere Program (ISRO-GBP). AODs at six wavelengths are obtained using Microtops-II Sunphotometer and Ozonometer. The monthly mean values of AOD at 500 nm are found to be 0.27 ± 0.04 and 0.24 ± 0.02 during March and April, 2006 respectively. However, their monthly mean values are 0.33 ± 0.04 at 380 nm and 0.20 ± 0.03 nm at 870 nm during March 2006 and 0.31 ± 0.3 at 380 nm and 0.17 ± 0.2 at 870 nm during April 2006, showing a gradual decrease in AOD with wavelength. The Angstrom wavelength exponent 'α' had a mean value of 0.72 ± 0.05, implying reduced dominance of fine particles. Further, the afternoon AOD values are higher as compared to forenoon values by ~33.0% during March and by ~9.0% during April 2006 and are attributed to the pollutant lifted up from the valley by the evolving boundary layer. Besides the long-range transportation of aerosol particles by airmass from the Great Sahara and the Thar Desert regions to the observing site, the high values of AODs have also been influenced by biomass burning and frequent incidents of forest fire at local levels

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

The UN’s Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today’s gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030