A Randomized Controlled Trial Study on the Effect of Adding Dexmedetomidine to Bupivacaine in Supraclavicular Block Using Ultrasound Guidance

BACKGROUND: The benefits of regional anesthetic techniques are well established. Use of additives to local anesthetics can prolong these benefits. The aim of this study was to find out the effect of adding dexmedetomidine to bupivacaine for supraclavicular block.METHODS: In this randomized, double-blind study, 70 ASA I & II patients of either sex undergoing elective surgeries on the upper limb were given supraclavicular block under ultrasound guidance. Group C (n=35) received 38 mL 0.25% bupivacaine + 2mL normal saline and group D received 38 mL 0.25% bupivacaine + 1 μg/kg dexmedetomidine (2mL). Patients were observed for, onset of motor and sensory block, duration of motor and sensory block, duration of analgesia, sedation score, hemodynamic changes and any adverse events.RESULTS: In group D, the onset was faster (P< 0.001), durations of sensory and motor block duration of and analgesia were prolonged as compared to group C (P < 0.0001).There was a significant drop in heart rate (HR) from the baseline in group D (P < 0.05) at 30, 60, 90 and 120 min. However, none of the patients dropped HR below 50/min. Mean Arterial Pressure (MAP) remained unaffected. The patients in group D were more effectively sedated than those in group C (P < 0.05). No adverse event was reported in either group.CONCLUSION: Dexmedetomidine as adjuvant to bupivacaine in supraclavicular block resulted in faster action, prolonged motor and sensory block, prolonged analgesia with hemodynamic stability and adequate sedation.KEYWORDS: Dexmedetomidine, analgesia, supraclavicular bloc

Perceptions of Indian women on hysterectomy

Background: Women who undergo hysterectomy face a multitude of physical and psychosocial problems. The objective of the study was to assess the impact of pre-operative education on post-operative psychosocial health.Methods: It was an interventional research in 96 women who were randomly divided into two groups; one received pre-operative education about surgery and the other given routine preoperative advice. With the help of a questionnaire the perceptions of women on hysterectomy were assessed.Results: Post-operation, 47 of the intervened patients and all the patients of control group were satisfied with the surgery, statistically insignificant; fisher's exact of 1. For 20 intervened patients and 6 patients of control group were very acceptable with the fact that the uterus was no longer present in the body post-surgery, statistically significant; fisher's exact of 0.001. 45 of the intervened group were not feeling depressed whereas 19 patients of the control group were feeling depressed, statistically significant; fisher's exact of 0.0005.Conclusions: Thus, there was a positive impact of pre-operative education on perceptions about hysterectomy. Women who underwent hysterectomy after receiving preoperative education were content with the results of surgery. Resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted

Pharos the Egyptian and the Gothic Other as Excess

Guy Boothby’s Pharos the Egyptian, published in 1889, employs the category of the Gothic to discuss various anxieties plaguing the late Victorian society. It deals with issues such as the Gothic Other’s ‘magical’ capabilities, revenge, disease, and the colonial extraction of wealth, among others. The novel overwhelms the binary between the rational European self and the Gothic colonial other by presenting the Egyptian Pharos not as an opposite but as an excess of the European self. Pharos is as rational as he is Gothic and in this excess of being both, he destabilizes the hierarchy and binary at once. We argue that the Gothic Other is terrifying not just in its ‘Otherness’ but also in its similarity. The familiarity it exhibits with the European worldview is a major cause for concern for the European self, leading to a deeply disturbing sense of anxiety

Automatic Blood Vessel Extraction of Fundus Images Employing Fuzzy Approach

Diabetic Retinopathy is a retinal vascular disease that is characterized by progressive deterioration of blood vessels in the retina and is distinguished by the appearance of different types of clinical lesions like microaneurysms, hemorrhages, exudates etc. Automated detection of the lesions plays significant role for early diagnosis by enabling medication for the treatment of severe eye diseases preventing visual loss. Extraction of blood vessels can facilitate ophthalmic services by automating computer aided screening of fundus images. This paper presents blood vessel extraction algorithms with ensemble of pre-processing and post-processing steps which enhance the image quality for better analysis of retinal images for automated detection. Extensive performance based evaluation of the proposed approaches is done over four databases on the basis of statistical parameters. Comparison of both blood vessel extraction techniques on different databases reveals that fuzzy based approach gives better results as compared to Kirsch’s based algorithm. The results obtained from this study reveal that 89% average accuracy is offered by the proposed MBVEKA and 98% for proposed BVEFA

Retinal blood vessel localization to expedite PDR diagnosis

Ophthalmologist relies on the retinal fundus image segmentation for accurate diagnosis of Diabetic Retinopathy caused due to prolonged deterioration in retinal blood vessels. Blood vessel and optical disc localization determines the vascular alterations helpful in identifying retinal diseases with accurate identification of pathologies like microaneurysms and exudates. This work comprises evaluation of proposed Optical Disc Segmentation and blood vessel localization techniques followed by a statistical analysis using three fractal dimensions; box count, information and correlation. Fractal dimensions explored are beneficial for Proliferative Diabetic Retinopathy (PDR) diagnosis as its value for vascular structures increases with increasing level of PDR. Two benchmark fundus image databases, DRIVE and STARE were evaluated by utilizing shape and fractal features for performance validation and average accuracies of 96.79% and 95.68% were achieved for extracted blood vessels using proposed approach

Acceptance, safety and complications of postpartum intra uterine contraceptive device: a prospective study in tertiary care hospital

Background: Intrauterine contraceptive device is a long acting, effective and reversible method of contraception. It can be inserted post placental during vaginal or LSCS delivery and within 48 hours of delivery.  This study evaluates the acceptance, safety, side effects and complications associated with immediate post-partum intrauterine contraceptive device (PPIUCD) insertion.Methods: The study was conducted at Hindu Rao Hospital and NDMC Medical College, Delhi for a period of 18 months. Patients admitted and delivered at Hindu Rao Hospital were counseled for PPIUCD, CuT 380 A / CuT 375 insertions and it was inserted within 10 minutes of delivery of placenta during vaginal delivery or LSCS or within 48 hours of delivery. Patients were followed at 6 weeks and then between 6 to 12 months of delivery for continuation, side effects or any complications.Results: After counseling 1253 (9.8%) patients agreed for PPIUCD insertion out of which 650 patients came for follow up. 46% women came for routine follow up while 54.06% came with one or the other complications. Missed thread was most common complications, followed by bleeding P/V and pain abdomen. Expulsion in 5.5% and CuT failure was seen in 0.92% women only. Removal of IUCD was done in 94 patients for one or other reasons. There was retention of PPIUCD in 84.5% while removal was done in 14.5% during period of 6 months to one year follow up. Missed thread was main cause of anxiety among acceptors.Conclusions: Immediate PPIUCD is safe and effective method of contraception with a high retention rate. Though acceptance in initial months was less but it gradually increased over time with increasing awareness, counseling of patients and training of health personnel

First international conference on the theme 'The Art(s) of/in Foreign Language Teaching': Organised by the Global Languages Centre of the O.P. Jindal Global University, Sonipat, Haryana, India (December 6 – 7, 2019)

In times when foreign language education is increasingly becoming susceptible to the dictates of neoliberal consumerism, prevalent metaphors in the field of education such as 'student as customer', 'teacher as service provider' or 'language as product' distract from the beauty of the process of learning itself. Unfortunately, these metaphors are seldom subjected to critical reflection and therefore continue to subtly shape institutional frameworks in which foreign language education takes place, in turn affecting the curriculum and foreign language educational policies

Examination of Efficient Market Hypothesis in Indian Stock Markets and behavioural patterns of Institutional and Individual Investors in India

Over 5 decades a lot of body of evidences have claimed that stock markets are efficient and it is not possible to beat the market consistently. In recent years, however, financial economists have increasingly questioned the efficient market theory. Market efficiency has an influence on the investment strategy of an investor If market is efficient, trying to find undervalued and overvalued stocks and trying to beating the market will be a waste. In an efficient market there will be no undervalued securities offering higher than deserved expected returns, given their risk. On the other hand if markets are not efficient, excess returns can be made by correctly picking the winners. This study examines the efficiency of Indian stock markets and shows that Indian stock markets are not completely efficient. There are existence of mispriced securities and opportunities for investors to outperform the market. As against many claims that it is not possible for any Mutual Fund to beat the market consistently, this study shows that, in India, active funds exist that have beaten the markets consistently. Behavioural finance is also important in making investment decisions in India and market participants are prone to irrationalities like herding behaviour, greed, relying too much on current information that causes market inefficiency and prices of securities to deviate from their intrinsic value. The study also outlines how investors can identify good investment opportunities

Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status