Evaluation of Risk Factors of Postoperative Urinary Retention in Male Patients Undergoing Surgery Under Spinal Anaesthesia : A Prospective Study

Background : Postoperative Urinary Retention (POUR) is common after regional anaesthesia with a reported incidence between 5% and 70%. POUR can lead to significant morbidity with additional surprise and mental trauma to the patient when unwarned. This study aimed to assess the occurrence of POUR in male patients undergoing Surgery under Spinal Anaesthesia and to study the risk factors related to it. Methods : 692 male patients were analysed prospectively for the need for catheterisation which was defined as 搕he inability to void in the immediate Postoperative period with accompanying discomfort and a palpable Bladder.� All such patients were catheterised as an emergency. A record was made about the mean age, surgical condition, comorbidities, duration of Surgery, use of intra-operative sedatives, intra-operative fluid infused and International Prostate System Score (IPSS). Results : The overall mean age of patients with POUR was 46 years. The incidence of POUR was highest among Perianal Surgeries ie, 52/70 (13%) followed by Hernia Surgeries, 18/70 (6.3%). An appreciable reduction was observed in urinary retention after administration of intra-operative sedatives (p=0.022) and lower IPSS (p=0.001). Factors such as age, intra-operative fluid administration, duration of Surgery and previous history of Diabetes did not reach statistical significance as being predictive of urinary retention. Conclusion : An IPSS greater than 7 increases the risk of Postoperative Urinary Retention while the use of intraoperative Sedative in combination with Spinal Anaesthesia decreases the risk. In high-risk patients undergoing perianal procedures, pre-operative patient counselling about the possibility of Postprocedure retention is recommended.

Influence of glide path size and operating kinetics on time to reach working length and fracture resistance of Twisted File adaptive and Endostar E3 nickel-titanium file systems

Objectives@#This study investigated the influence of glide path size and operating kinetics on the time to reach the working length and the fracture resistance of Twisted File (TF) and Endostar E3 files. @*Materials and Methods@#A total of 120 mandibular single-rooted premolars were selected. Two methods of kinetic motion (TF adaptive and continuous rotary motion) and file systems (TF and Endostar E3) were employed. The files were used in root canals prepared to apical glide path sizes of 15, 20, and 25. The time taken to reach the working length and the number of canals used before the instrument deformed or fractured were noted. Fractured instruments were examined with scanning electron microscopy. @*Results@#The TF system took significantly more time to reach the working length than the Endostar E3 system. Both systems required significantly more time to reach the working length at the size 15 glide path than at sizes 20 and 25. A greater number of TFs than Endostar E3 files exhibited deformation, and a higher incidence of instrument deformation was observed in adaptive than in continuous rotary motion; more deformation was also observed with the size 15 glide path. One TF was fractured while undergoing adaptive motion. @*Conclusions@#No significant difference was observed between continuous rotary and adaptive motion. The TF system and adaptive motion were associated with a higher incidence of deformation and fracture. Apical glide path sizes of 20 and 25 required significantly less time to reach the working length than size 15.

Role of delayed light polymerization of a dual-cured composite base on marginal adaptation of class II posterior composite open-sandwich restoration.

Objective: To determine the effect of delayed light polymerization of a dual-cured composite base material on the marginal adaptation of class II composite restoration. Materials and Methods: 35 extracted human molar teeth were used to prepare class II mesio-occlusal or disto-occlusal slot preparations with gingival margins at the CEJ. The teeth were restored using an open-sandwich technique with a 2mm base increment of dual-cured composite, and divided into 5 groups based on the mode of the polymerization of the dual-cured composite base: Group A - self-cured after placement (5 mins), Group B - light-cured immediately after placement, Group C - light-cured 30 seconds after placement, Group D - light-cured 60 seconds after placement, Group E - light-cured 120 seconds after placement. Then a top layer of a light-cured composite resin is placed to complete the restoration. The teeth were thermocycled and immersed in 1% aqueous solution of methylene blue for 24 hours. Sectioning of the teeth and scoring under stereomicroscope was done. Data will be statistically evaluated using the kruskal wallis 1-way ANOVA. Results: Statistical analysis using kruskal wallis 1-way ANOVA showed that the dual-cured composite light polymerized 1 minute after placement exhibited the least microleakage. Conclusion: Delayed light polymerization of the dual-cured composite base reduced the microleakage in class II open-sandwich restorations.

Genome inventory and analysis of nuclear hormone receptors in Tetraodon nigroviridis.

Nuclear hormone receptors (NRs) form a large superfamily of ligand-activated transcription factors, which regulate genes underlying a wide range of (patho) physiological phenomena. Availability of the full genome sequence of Tetraodon nigroviridis facilitated a genome wide analysis of the NRs in fish genome. Seventy one NRs were found in Tetraodon and were compared with mammalian and fish NR family members. In general, there is a higher representation of NRs in fish genomes compared to mammalian ones. They showed high diversity across classes as observed by phylogenetic analysis. Nucleotide substitution rates show strong negative selection among fish NRs except for pregnane x receptor (PxR), estrogen receptor (ER) and liver x receptor (LxR). This may be attributed to crucial role played by them in metabolism and detoxification of xenobiotic and endobiotic compounds and might have resulted in slight positive selection. Chromosomal mapping and pairwise comparisons of NR distribution in Tetraodon and humans led to the identification of nine syntenic NR regions, of which three are common among fully sequenced vertebrate genomes. Gene structure analysis shows strong conservation of exon structures among orthologoues. Whereas paralogous members show different splicing patterns with intron gain or loss and addition or substitution of exons played a major role in evolution of NR superfamily.