Traumatic bilateral hip dislocation with bilateral sciatic nerve palsy

AbstractBilateral hip dislocation rarely occurs. In this paper, a case of bilateral hip dislocation associated with bilateral sciatic nerve palsy resulted from a road traffic accident is reported. Both hips were emergently reduced under general anaesthesia. Acetabular reconstruction was done bilaterally due to the unstable hips. The patient subsequently developed heterotopic ossification and avascular necrosis on the left hip and underwent total hip arthroplasty. The sciatic nerve on the right side achieved complete recovery but that on the left side only partly recovered and was augmented by tendon transfer. Such injuries are serious and one should be aware of the complications because they can resurface and so patients should be followed up for a long time. To the best of our knowledge, this kind of injury has not been reported in the English language literature

Effect of peribulbar block on emergence agitation in children undergoing strabismus surgery under desflurane anaesthesia

Background: Strabismus surgery in children may be associated with a high incidence of emergence agitation that may be related to pain and visual disturbances. The objective was to evaluate the effect of peribulbar block on the incidence of emergence agitation in children undergoing strabismus surgery under desflurane anaesthesia.Methods: Fifty-six healthy children aged 2–10 years, undergoing strabismus surgery under general anaesthesia, were recruited. Children were randomly allocated to receive fentanyl 2 μg/kg (Group F) or peribulbar block (Group PB) with 0.3 ml/kg of 0.25% bupivacaine + 2% lignocaine. The primary outcome of the study was incidence of emergence agitation; secondary outcome measures were time to first rescue analgesia, the incidence of oculocardiac reflex and vomiting.Results: Of 52 children, 14/25 (56%) children in Group F developed emergence agitation compared with 3/27 (11.11%) in group PB (p = 0.001). Postoperatively, the paediatric anaesthesia emergence delirium scores showed significantly lower emergence agitation in the PB group with a median (IQR) of 0.00 (0.00–2.00) compared with group F (5.5 (0.75–8.75) at all time intervals (p = 0.003 Mann–Whitney test). Pain scores were comparable between groups (group F 48% vs. group PB 25.9%). The time to first rescue analgesia was increased in group PB (126.875 ± 38.22 min vs. 88.08 ± 28.48 min in group F). The oculocardiac reflex occurred in 7/25 in Group F compared with 1/27 in Group PB (p = 0.015). There was no difference in the incidence of postoperative vomiting (24% in Group F vs. 22% in Group PB).Conclusion: Use of peribulbar block in children undergoing strabismus surgery under desflurane anaesthesia was associated with reduced incidence of emergence agitation and oculocardiac reflex but did not significantly increase the time to first analgesic or the incidence of pain and vomiting. A sub-tenon block may be safer and provide better operating conditions and equal analgesia.Keywords: agitation, children, anaesthesia, strabismus surgery, peribulbar bloc

COMPARATIVE STUDY OF THE SHIVA GUGGULU AND SIMHANADA GUGGULU IN THE MANAGEMENT OF AMAVATA (RHEUMATOID ARTHRITIS)

Objective: Comparison of effectiveness of two drugs (Shiva Guggulu and Simhanada Guggulu in the same dose of both drug given separately in two different groupA and Group B) on patients of Amavata. Methods: Patients between 18-60 y of age with classical features of Amavata [9] from OPD and IPD of Government autonomous Ayurvedic College and Hospital were selected for the present work; irrespective of their sex, religion, education, etc. Detailed research Performa was prepared to incorporate all the signs and symptoms of the disease Amavata is the second most common joint disorders. Nowadays erroneous dietary habits, lifestyle and environment have led to various autoimmune disorders i.e. Amavisajanya Vikaara and Amavata is one among them. Rheumatoid arthritis can be correlated with Amavata in view of its clinical features. Many research studies have been done to solve this clinical enigma, but an effective, safe, less complicated treatment is still required for the management of Amavata. In the present study, 24 patients of Amavata were registered and randomly grouped into two. In group A, Shiva Guggulu 6 g/day in divided doses and in group B, Simhanada Guggulu 6 g/day in divided doses were given for 8 w. On analysis of the results, it was found that Simhanada Guggulu provided better results as compared to Shiva Guggulu in the management of Amavata. In group A, the mean score of grip strength was 1.14 before treatment, which was reduced to 0.57 after treatment, with 50% relief. It was statistically insignificant. The mean score of grip strength in group B was 2.4 before treatment, which was reduced to 1.5 after treatment, with 37.5% relief. It was statistically highly significant. Results: Before treatment the mean score of walking time in group A was 2, which was reduced to 1 after treatment, with 50% relief. It was statistically insignificant. The mean score of walking time in group B was 1.75 before treatment, which was reduced to 0.75 after treatment, with 45.71% relief. It was statistically significant. In group A, the mean score of foot pressure was 1 before treatment, which was decreased to 0.66 after treatment, with 33.33% relief. It was statistically insignificant. The mean score of foot pressure in group B was 2.3 before treatment, which was decreased to 1.4 after treatment with, 39.13% relief. It was statistically highly significant. In group A, the mean score of general functional capacity was 1.33 before treatment, which was reduced to 0.66 after treatment, with 50% relief. It was statistically highly significant. The mean score of general functional capacity in group B was 1.66 before treatment, which was reduced to 0.66 after treatment, with 60% relief and was statistically insignificant. In group A, the mean score of the degree of disease activity was 1.75 before treatment, which was reduced to 1 after treatment, with 42.85% relief. It was statistically highly significant. The mean score of the degree of disease activity in group B was 1.5 before treatment, which was reduced to 0.75 after treatment, with 50% relief. It was statistically significant. Regarding ESR value, the mean scores before treatment in A and B groups were 54.5 and 55.2, respectively, and they were reduced to 45.3 and 40.1, respectively, after treatment. Group A percentage relief was 16.88%, while in group B it was 27.35%. An apparent difference in improvement of all the cardinal symptoms was observed with the treatment. On comparing Group B proved to be better than Group A. Statistically highly significant difference was found in the improvement of Sandhigraha and statistically significant difference was found in the improvement of Sandhishoola and Sparshasahyata by Simhanada Guggulu than Shiva Guggulu, whereas insignificant difference was observed in the improvement of Sandhishotha. So, from the obtained data it may be inferred that group B is more effective than groupA. Conclusion: It was observed from the treatment that Simhanada Guggulu provided comparatively better relief in cardinal signs and symptoms of Amavata. Keywords: Agni, Ama, Amavata, Rheumatoid arthritis, Shiva Guggulu, Simhanada Guggul

White-Light Emission from Annealed ZnO:Si Nanocomposite Thin Films

As grown ZnO:Si nanocomposites of different compositional ratios were fabricated by thermal evaporation techniques. These films were subjected to post deposition annealing under high vacuum at a temperature of $\rm 250C^o$ for 90min. The photoluminescence (PL) spectra of annealed samples have shown marked improvements both in terms of intensity and broadening. For the first time in ZnO:Si nanocomposite films we see huge UV, red and orange peaks at 310, 570 and 640nm. Structural and Raman analysis show formation of a Zn-Si-O shell around ZnO nano clusters wherein on heating $\rm Zn_2SiO_4$ compound forms. The new emissions are due to $\rm Zn_2SiO_4$ which completes white light spectrum.Comment: 9 figure

Synthesis, characterization, and electrocatalytic ability of γ-Fe2O3 nanoparticles for sensing acetaminophen

Maghemite (γ-Fe2O3) nanoparticles have been synthesized using co-precipitation method followed by chemically induced transition process. As prepared nanoparticles have been analyzed by X-ray diffraction, Raman and FTIR spectroscopies which reveal the γ-Fe2O3 phase. These γ-Fe2O3 nanoparticles have been used to modify the glassy carbon electrode (GCE) to form nano γ-Fe2O3 modified GC electrode for electrochemical sensing of acetaminophen (C6H9NO2) using potential controlled cyclic voltammetric (CV) technique. The obtained modified electrode shows an excellent electrocatalytic ability to sense acetaminophen in 0.1 M KCl supporting electrolyte. In addition, a significant enhancement in anodic peak current has been observed using nano γ-Fe2O3 modified GC electrode than the bare electrode. The CV plots reveal that redox peaks have been linearly co-related to the acetaminophen concentration in the range of 0.031 mM to 1 mM with sensitivity ~30.78 µA/mM