Non invasive Management of Post Dural Puncture Headache –A Comparison.

Aim: To evaluate the efficacy of oral Theophylline for the management of post dural puncture headache (PDPH). Material and Method: Forty patients with PDPH, whose surgeries were done under spinal anaesthesia, were selected randomly and divided into two groups of 20 each. One group to receive conservative treatment and the other group Theophylline (400 mg) only orally. Intensity of headache was analysed using a visual analogue scale (VAS) of pain. Assessment was done immediately before (0 h) and at 8, 16 and 24th hr of drug administration. Result: Significantly better relief of PDPH was found in Theophylline (9.3±5.7) than the conservative group (56.7 ±10.2) (p<0.001). Recurrence of headache was found in 2 patients (10 %) at16th hr and 2 (10%) at 24th hr in the Theophylline group compared to 12 (60%) and 14 (70%) patients respectively in the other group. Conclusion: The study concludes that Theophylline in the management of post dural puncture headache may be considered the best choice over the conventional approach.

Control of Hazards in Operation Theater.

The operation theater (OT) environment is charged with multiple inherent risks. So, the team in the OT and the patient brought for surgical treatment may come across various hazards that can be classified as: (a) physical and accidental hazards, (b) chemical hazards, (c) biological hazards, (d) fire hazards, and (e) other hazards, such as organizational, psychological, and atmospheric. Inadequate safety measures thus can result in multiple ill effects. Constant vigilance, awareness with timely intervention, maintenance of a specific operative procedure, and an educated team culture can make the OT environment a safe haven for the patient as well as for the theater team. The aim of this article is to identify and categorize the hazards that occur in the OT during surgery, and the related precautionary measures taken thereof for the safety of both the operating team and the patients who have the right to be treated with dignity and respect.

Psychiatric Comorbidity in Cases Admitted for Alcohol Dependence.

Background – Alcohol dependence syndrome (ADS) is a medical disorder with some particular features resulting from a prolonged and heavy use of alcohol. When people with ADS present to a psychiatric service, they usually have developed other health problems. Objective – Since eastern Nepal has a heavy load of alcohol related problems, this hospital based descriptive study was carried out to observe psychiatric co-morbidity among inpatient-ADS cases. Method – In this cross sectional study of 60 consecutive inpatients, psychiatric co-morbidities were diagnosed according to the diagnostic criteria of ICD-10. Results – Mean age of the cases was 39.19 years, 75% were male and 90% were married. Three fourths used other substances besides alcohol; main being nicotine, opioid and cannabis. Eighty percent cases had one or other or more than one diagnosable psychiatric illness, including ICD-10 mental and behavioral disorders in 63% and personality problems severe enough to affect the course of substance use disorder in 48% of the total cases. The most common psychiatric disorder in ADS cases was anxiety disorders, followed by mood affective disorders, and psychotic illness. Among the personality problems, dissocial plus narcissistic, and anxious group were common. Conclusion – Psychiatric co-morbidity is common in people with alcohol dependence.

Fungal metabolites from Aspergillus niger AN27 related to plant growth promotion.

Two metabolites have been isolated from Aspergillus niger AN27, a biocontrol agent, and identified as 2-carboxymethyl 3-n-hexyl maleic acid (compound 1) and 2-methylene-3-hexylbutanedioic acid (compound 2). Their biological activities related to crop growth promotion have been assayed. Both the compounds increased germination and improved crop vigour. Compound 1 was more effective for increase in germination and shoot length, whereas compound 2 had relatively greater role in increasing the root length and biomass of cauliflower seedlings.