ABSTRACT
BACKGROUND:Clonidine is added to intrathecal bupivacaine to improve intraoperative analgesia and to increase the duartionof sensory and motor block.AIMS: The aim of the study to evaluate and compare the effect of additon of three different doses of clonidine (15 μg, 30 μg and 45 μg) to 12.5mg hyperbaric bupivacaine in patients undergoing lower limb surgeries under spinal anesthesia.STUDY DESIGN: Randomized, prospective study was conducted at tertiary academic hospital.MATERIALS AND METHOD: 100 patients enrolled in the study were randomly divided into four groups of 25 each. Group-I received bupivacaine, whereas group-II, III and IV received 15μg, 30μg and 45μg clonidine respectively as an adjuvant to 12.5mg bupivacaine. The volume of solution was kept constant 3ml by adding normal saline whenever needed.RESULT: Highest level of sensory block, time to achieve this level and highest Bromage scale recorded were comparable among the groups. The regression of sensory block to S2 dermatome and mean duration of motor block were greatest in group IV followed by group III, II and I. There was significant fall in mean arterial pressure (MAP) in group IV as compared to other groups. Significant prolongation of sensory and motor blockade and duration of postoperative analgesia with group-IV as compared to other groups.CONCLUSION: Thus, addition of 30μg clonidine gives excellent analgesia with less adrehemodynamic instability and sedation
ABSTRACT
Objective: This study was undertaken to evaluate the antibody response of hepatitis B virus infection in patients on maintenance hemodialysis (MHD) by detecting different viral markers. Method: Study subjects comprised a total of 88 chronic kidney disease (CKD) patients from Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) and Bangabandhu Sheikh Mujib Medical University (BSMMU). Of them 63 patients on MHD and 25 predialysis patients served as cases and controls respectively. Clinical history was taken and serological markers for HBV (HBsAg, Anti-HBs, and Anti-HBc) were determined by using ELISA. Results: Hepatitis B virus was positive in 1.6% of maintenance hemodialysis (MHD) patients and in 16% of controls (p<0.02). Anti-HBc antibody was positive in 62% of dialysis patients and 72% of controls (p=NS) and the positivity was significantly associated in dialysis subjects with longer duration of dialysis (18 ± 22 vs. 10 ± 7, months, p<0.04), multiple units of blood transfusions (22 ± 29 vs. 10 ± 12, units, p<0.04) and more reuse of dialyzer (3 ± 1 vs. 2 ± 1, times, p<0.03) than the negative ones. Among MHD patients 84% were vaccinated against HBV with a schedule of 3 (79%) and 4 (21%) doses and protective antibody titer (>10 IU/L) was found in 57%. None of the controls were vaccinated but 66% had protective titer indicating post exposure natural immunity. Conclusions: Hepatitis B virus positivity was significantly higher among the predialysis subjects compared to dialysis group.
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Methodology: Effect of pretreatment by crude and n-Hexane extract of Nigella (10mg/kg body wt./day for 21 days) on streptozotocin (STZ, 50 mg/kg body wt. single dose i.p.) administered rats were observed in the present study. Biochemical parameters (Serum glucose, serum TG, serum cholesterol, pancreatic GSH) were compiled together with pancreatic histology. Results: Both the crude and the n-Hexane extract of Nigella pre-treated diabetic rats had demonstrated significant (P<0.001) alleviation from the elevated serum glucose, lowered pancreatic reduced glutathione (P<0.01) and elevated serum TG concentrations (P<0.01). 72% β cells appeared to be damaged by STZ administration, while in the crude and the n-Hexane extract of Nigella pretreated diabetic groups this damage was 31% and 46% respectively, the crude Nigella pretreated group thus appeared to have better amelioration. Conclusions: Further studies are suggested to obtain the protective ingredient from the crude Nigella and to observe its effect upon the above mentioned parameters of diabetic rats in higher doses for prolonged periods.
ABSTRACT
This review will indicate the quality of the evidence supporting the clinical effects of a number of commonly used types of herbal medicines for psychiatric and neurological disorders. We conducted a review of literature to understand the biochemical and evidential bases for the use of herbs in psychiatric and neurological disorders as follow: 1] Alzheimer's disease, 2] Depression, 3] Anxiety, 4] Insomnia, 5] Substance use disorders, 6] Attention deficit/hyperactivity disorder [ADHD], 7] Migraine. Evidences support use of Ginkgo biloba, Huperzine A, Galantamine, Melissa officinalisand Salvia officinalis for Alzheimer's disease; St. John's wort, Lavender. and Saffron for depression; Passionflower, and Kava, for anxiety disorders; Valerian and English Lavender for sleep disorders; Hypericum for substance related disorders; Ginkgo biloba, and Passionflower for ADHD; and feverfew, and Butterbur root for migraine. The highest level of confidence derives from well-designed, randomized, double blind controlled studies. Herbs may have beneficial effects in variety of psychiatric and neurological disorder; however we must consider their potential side effects and drug-drug interactions