Epidemiology of Pancreatitis in the State of Odisha

Backgroundand Aims: Background and Aim of the Study: Acute pancreatitis is a surgical condition which may impact other organsresulting in damage to multiple organs or death. Chronic pancreatitis (CP) has deadly long-term consequences such as diabetes mellitusand pancreatic cancer. Although there have been several studies evaluating the epidemiology of pancreatitis in India, due to the diversityof the country, more evidence is required from different regions of the country. Therefore, this study evaluates the epidemiology of acuteand CP in the state of Odisha.Methodology: This study was a prospective study carried out in a single hospital, Institute of Medical Sciences and Sum Hospital,Bhubaneswar, during 2016–2017.Results: Results showed that there were more acute cases of pancreatitis (n=65, 73.9%) and overall pancreatitis was more prevalent inmen (n = 70; 79%). Unfortunately, an overwhelming majority of the patients do not know what aggravates (n = 71; 81.8%) or alleviates(n = 79; 89.8%) their condition. There was no significant difference in the type of pancreatitis (acute, chronic, acute, or chronic) bygender, smoking, educational status, diet, alcohol intake, socioeconomic status, and religion (P > 0.05).Conclusion: Men were more likely to develop acute and CP than women. Future studies should explore the genetic interactionsmodifying disease development, especially in India

Comparison of levosimendan and nitroglycerine in patients undergoing coronary artery bypass graft surgery.

Background: Levosimendan a calcium ion sensitizer improves both systolic and diastolic functions. This novel lusitropic drug has predictable antiischemic properties which are mediated via the opening of mitochondrial adenosine triphosphate‑sensitive potassium channels. This action of levosimendan is beneficial in cardiac surgical patients as it improves myocardial contractility, decreases systemic vascular resistance (SVR), and increases cardiac index (CI) and is thought to be cardioprotective. We decided to study whether levosimendan has any impact on the outcomes such as the duration of ventilation, the length of Intensive Care Unit (ICU) stay, and the hospital stay when compared with the nitroglycerine (NTG), which is the current standard of care at our center. Materials and Methods: Forty‑seven patients undergoing elective coronary artery bypass surgery were randomly assigned to two groups receiving either levosimendan or NTG. The medications were started before starting surgery and continued until 24 h in the postoperative period. Baseline hemodynamic parameters were evaluated before beginning of the operation and then postoperatively at 3 different time intervals. N‑terminal fragment of pro‑brain natriuretic peptide (NT‑proBNP) levels were also measured in both groups. Results: In comparison to the NTG group, the duration of ventilation and length of ICU stay were significantly less in levosimendan group (P < 0.05, P = 0.02). NT‑proBNP level analysis showed a slow rising pattern in both groups and a statistically significant rise in the levels was observed in NTG group (P = 0.03, P = 0.02) in postoperative period when compared to levosimendan group of patients. Conclusion: Levosimendan treatment in patients undergoing surgical revascularization resulted in improved CI, decreased SVR and lower heart rate. And, thereby the duration of ventilation and length of ICU stay were significantly less in this group of patients when compared with NTG group.

Use of dexmedetomidine as an adjunct in the treatment of paradoxical hypertension after surgical repair of coarctation of the aorta in infants.

Severe persistent hypertension is seen infrequently in newborns and infants, but we came across two infants who developed severe paradoxical hypertension after successful coarctation repair. Treatment of systemic hypertension following repair of coarctation of the aorta is always challenging particularly in infants. Dexmedetomidine was used successfully as an adjunct to the established anti‑hypertensive drugs in the immediate postoperative period in our cases to treat postoperative paradoxical hypertension.

In vivo and in vitro bradycardia induced by local anesthetics is potentiated by calcium channel blockers.

The present study examined the interactions of local anesthetics (LA) and calcium channel blockers (CCBs) on rhythmicity of heart using in vivo and in vitro experiments. ECG recordings were made from the anesthetized rats for in vivo preparations and spontaneously beating isolated rat right atrial potential for the in vitro experiments. The in vivo experiments with LA showed dose-dependent bradycardia with lignocaine (LIG, 100-500 μg/kg) and bupivacaine (BUP, 10-100 μg/kg). BUP was 4-5 times more potent than LIG. Verapamil (VML) and diltiazem (DTZ), CCBs also produced dose (10-100 μg/kg) -dependent bradycardia. However, none of them affected the PR/QT interval or QRS complex. Further, LA-induced bradycardia was potentiated by CCBs. In addition, flattening of P-wave in ECG was observed with doses (10-25 μg/kg) of LA in the presence of CCBs. Similarly, the in vitro experiments demonstrated a concentration-dependent decrease in atrial rate by BUP or VML. The BUP-induced decrease was potentiated in the presence of VML. Thus, the results suggest that CCBs potentiate the LA-induced bradycardia by involving pacemaker activity. Further, the flattening of P-wave in ECG serves as an early indicator of the cardiotoxicity produced by these drugs.