Effectiveness of Midazolam Compared to Diazepam and Placebo For Reducing Anxiety after Premedication at Sylhet Women’s Medical College

Introduction: Anxiolytic premedication is debated most of thetime in the outpatient surgical community. The management ofanxiety reducing medications may be considered unnecessaryby anesthesiologists when anxiety rates are small inoutpatients with minor operations. Thanks to its rapid onsetand short halflife, intravenous (IV) midazolam is the mostwidely used premedicant in ambulatory environments, but itspersistent effects in the prompt postoperative period may leadto postoperative sedation, as well as delayed recovery anddischarge readiness after brief ambulatory surgery.Objective: This research is carried out specifically to checkwhether the use of the medicine for preanesthesia midazolamquantifiably decreases pain as opposed to having nopreanesthesia drug (placebo) or diazepam prior to medicalprocedures.Method: The examination's inclusion requirements arepatients aged between 18 and 68 years scheduled for electivesurgery or diagnostic procedures involving anesthesia. Aninterventional (clinical trial) study with 160 patients scheduledfor surgical or diagnostic procedures involving anesthesiatechniques was performed at a neighbourhood emergencyclinic called Sylhet Women’s Medical College located in Sylhet,Bangladesh. Research length from Aug 2018 to Aug 2019.Results: After multiple investigations of knowledge andanalysis it was discovered that diazepam with little or nosymptoms placed ahead of midazolam and placebo.Conclusion: It can be clearly inferred that in case of adecrease in anxiety, diazepam ranks first compared tomidazolam or placebo.

Effects of human erythropoietin on functional outcome of patients with traumatic cervical cord injury; a pilot randomized clinical trial

Objective: To determine the effects of recombinant human erythropoietin [rhEPO] on functional outcome and disability of patients with traumatic cervical spinal cord injury [SCI]

Methods: This was a randomized, double blind, placebo controlled clinical trial being performed in Nemazee and Shahid Rajaei hospitals of Shiraz during a 3-year period from 2011 to 2014. A total number of 20 patients with acute traumatic cervical SCI less than 8 hours after injury were included. We excluded those with anatomic cord dissection, penetrating cord injury and significant concomitant injury. Patients were randomly assigned to receive rhEPO in 500IU/mL dosage immediately and 24-hour later [n=11] or placebo [n=9]. All the patient received standard regimen of methylprednisolone. Neurological function was assessed on admission, 1, 6 and 12 months after the injury according to the American Spinal Cord Injury Association [ASIA]

Results: Overall we include a total number of 20 patients. The mean age of the patients was found to be 40.1 +/- 9.5 [ranging from 19 to 59] years. There were 18 [90.0%] men and 2 [10.0%] women among the patients. There was no significant difference between two study groups regarding the baseline characteristics. The baseline ASIA score was comparable between two study groups. The motor and sensory ASIA scores were comparable between two study groups after 1, 6 and 12 months follow-ups. We also found that there was no significant difference between two study groups regarding the motor and sensory outcome in complete cord injury and incomplete cord injury subgroups

Conclusion: Administration of rhEPO does not improve the functional outcome of patients with traumatic cervical SCI

randomized trial of epidural volume extension by sequential combined spinal epidural anesthesia using three different techniques

Sequential combined spinal epidural anesthesia [SCSEA] is gaining popularity in ASA grade III / IV, elderly, low cardiac output state and high risk patients. In view of contradicting results related to sensorimotor characteristics, we undertook this study with the null hypothesis that epidural volume extension [EVE] with local anesthetic or normal saline results in augmentation of initial intrathecal block. Prospective, randomized, double blind study. J N Medical College, Aligarh Muslim University, Aligarh, India. Seventy-five ASA I/II patients divided into three groups and operated upon from September 2007 to January 2009. Group I received 1.5 ml bupivacaine [0.5%] + 25 microg fentanyl in subarachnoid space and epidural catheter was inserted without any top ups. In group II and III with the same technique top ups were given after 10 minutes of the intrathecal block in the form of either 10 ml NS or 10 ml of 0.125% bupivacaine. Augmentation of initial intrathecal block. Significant increase in height of block was seen after EVE by different techniques of epidural top up [T4.64 +/- 0.86 and T3.92 +/- 0.99 in group II and III respectively, p-value < 0.05] as compared to group I [T7.12 +/- 0.83]. The average increase was 3.12 +/- 0.97 and 3.48 +/- 1.35 segments in group II and III respectively as compared to 0.48 +/- 0.51 segments in group I.. Height of low-dose intrathecal block can be enhanced by SCSE using EVE effect even with normal saline

Potential human health hazards

In our daily life we come in contact with innumerable chemicals and materials of which we have no knowledge about their toxicity. Sources of polyvinyl chloride [PVC], dioctylphthalate [DOP], Poly chlorinated biphenyls [PCBs], perta chloropherol [PCP], dioxin, formaldehyde and plastics have been identified in various items of daily use. ILL-effects of these materials have been discussed in detail in this article. Metallic contaminants such as lead, cadmium, arsenic, nickel have been identified in a number of non-conventional sources. Effects of nitrites, nitrates, nitrosamines have also been discussed. It is suggested that strict measures should be adopted to control the menace of such materials. Standards set by the developed countries should not be relaxed at any cost

Non-nutritive sweeteners, synthetic: part I

The use of sugars and carbohydrates has long been recognised as causing a variety of ailments like obesity, dental caries, diabetes mellitus, heart diseases and other metabolic disorders. It led to the recognition and importance of non-nutritive sweeteners which are the best means of reducing caloric intake. Among such sweeteners are saccharin, cyclamates, dulcin, exathiainone salts etc. The synthetic approaches employed for their synthesis/derivatives have been briefly discussed. Different peptides used have also been briefly mentioned. The comparison of their toxicity and sweetness has been made. The criteria set by the W.H.O. for their use as sweetener have also been reviewed. Thus, the entire background of these synthetic non-nutritive sweeteners has been thoroughly described

Gur as nutritive food and medicine

A brief history of the solidified cane juice [gur] and its traditional and present methods for its manufacturing have been described. Improvements made in its technique have been suggested, which eliminate the use of hazardous chemicals. Expert opinion about its nutritional and medicinal uses have been susbstantiated with its components, determined with modern techniques. It has suggested that the use of this cheap and useful material in the big cities be encouraged to control lead poisoning caused by gasoline emission