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Background: There are various adjuvant used with hyperbaricbupivacaine to prolong the effect of spinal anesthesia butcommonly used fentanyl and clonidine. The present study wasundertaken to compare clonidine and fentanyl as adjuvant inspinal anesthesia in terms of time to onset of sensory andmotor blockade, duration of sensory and motor blockade andduration of postoperative analgesia and complications.Methods: The present study was undertaken in thedepartment of Anaesthesia, Government Medical College,Barmer, Rajasthan, India with primary aim to compare durationof postoperative analgesia. A total of 80 patients were enrolledin the present study. Ethical approval was obtained frominstitutional ethical committee and written consent wasobtained from all the patients. Complete demographic details ofall the patients were obtained. All the results were recorded inMicrosoft excel sheet and were analyzed by SPSS software.Results: In our study we found that time for first dose ofrescue analgesic was delayed in Group C (492.32 ± 17.32min) compared to Group F (418.80 ± 19.68min) which wasstatistically significant (P < 0.0001). Duration of sensory blockin Group C was 146.17 ± 19.42 min compared to 128.24 ±18.68min in Group F and Duration of motor block was 190.12 ±25.13 min in Group C in comparison to 176.18 ± 23.54 min in.
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Background: The advantage of regional anaesthesia overgeneral anaesthesia are many and well documented. Brachialplexus can be blocked by various methods includingparesthesia technique, nerve stimulation technique and ultrasound guided. The present study was undertaken forassessing time taken to perform block, Successful blockade,complication of supraclavicular brachial plexus block byparesthesia technique.Methods: The present study was undertaken in thedepartment of Anaesthesia, Government Medical College,Barmer, Rajasthan, India with aim of assessing success rateand Complications of brachial plexus block. A total of 100patients were enrolled in the present study. Ethical approvalwas obtained from institutional ethical committee and writtenconsent was obtained from all the patients after explaining indetail of the entire research process. Complete demographicdetails of all the patients were obtained. All the results wererecorded in Microsoft excel sheet and were analyzed by SPSSsoftware.Results: Mean time to perform block was 5.35 minutes andsuccesfull blockade in 92% patients, in 6% patient’s partialblockade and in 2% patient’s complete failure of block.Incidence of complications were vessels puncture 8 % patientsand pneumothorax 1% patients.Conclusion: Supraclavicular brachial plexus block byparesthesia technique is an easy and relatively safe procedurefor the upper limb surgeries below mid shaft of humerus withfew complications and provide good post-operative analgesia.
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Breast carcinoma is the most common malignant tumor and the leading cause of carcinoma death in women. With an annual incidence of approximately 1, 44,000 new cases of breast cancers in India, it has now become the most common female cancer in urban India and the second commonest in the rural Indian women. Nottingham applied histological grading system,and Robinson applied cytological grading system, which are one of the established methodologies to determine the histological and cytological grade of the tumor. By using these prognostic factors from pathological reports, the prognosis of the patient can be estimated individually. Aim: To analyze cytological and histological grading and their correlation along with tumor size and lymphnode status in breast carcinomas and its prognostic importance. Methods: All patients presenting with palpable breast lesions were subjected to an FNAC procedure after a detailed history, general physical and local examination. After performing fine needle aspiration diagnosis of various breast lesions were made on the basis of morphological and cytological findings and cytological grading for the malignant breast lesions was done. It was followed by excision biopsy, mastectomy, and cytohistological comparison was done to assess the efficiency and accuracy of cytological grading done after fine needle aspiration. Results: The most common type found in study was Ductal carcinoma (not otherwise specified) seen in 95.2% cases. The maximum no. of cases i.e. 36 (44.45%) were found in upper outer quadrant. all patients (100%) presented with complaint of lump in the breast. On assessing all 6 features, the maximum number of cases were in grade- II i.e. 48 (59.3%). A significant agreement was seen between cytological and histological grades. Conclusion: Assigning a cytological grade of breast carcinoma aspirates can be done with little effort, is reproducible and with rare exceptions depending on sample limitations correlates precisely with the histological grade. The tumor grading can be used as a very good prognostic and predictive marker for breast carcinomas.
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Sarcopenia (loss of muscle mass and/or strength) frequently complicates liver cirrhosis and adversely affects the quality of life; cirrhosis related liver decompensation and significantly decreases wait-list and post-liver transplantation survival. The main therapeutic strategies to improve or reverse sarcopenia include dietary interventions (supplemental calorie and protein intake), increased physical activity (supervised resistance and endurance exercises), hormonal therapy (testosterone), and ammonia lowering agents (L-ornithine L-aspartate, branch chain amino acids) as well as mechanistic approaches that target underlying molecular and metabolic abnormalities. Besides other factors, hyperammonemia has recently gained attention and increase sarcopenia by various mechanisms including increased expression of myostatin, increased phosphorylation of eukaryotic initiation factor 2a, cataplerosis of α ketoglutarate, mitochondrial dysfunction, increased reactive oxygen species that decrease protein synthesis and increased autophagy-mediated proteolysis. Sarcopenia contributes to frailty and increases the risk of minimal and overt hepatic encephalopathy.