Adductor Canal Block Versus Local Infiltration Analgesia for Postoperative Pain Management in Total Knee Arthroplasty.

BACKGROUND: Total knee arthroplasty (TKA) is a common surgical procedure for patients with knee osteoarthritis, often associated with postoperative pain. Effective pain management strategies are essential for improving patient outcomes and satisfaction. This study aimed to compare the efficacy of two analgesic modalities, local infiltration analgesia (LIA) and adductor canal block (ACB), in providing postoperative pain relief for patients undergoing TKA. METHODS: This prospective randomized comparative study included 60 patients undergoing TKA for knee osteoarthritis under subarachnoid block (spinal anaesthesia). Patients were divided into two groups: LIA group (local wound infiltration with periarticular injection of bupivacaine 0.125% + dexmedetomidine 1 mcg/kg) and ACB group (ACB with bupivacaine 0.125% + 1 mcg/kg dexmedetomidine). Pain relief was assessed using the Numerical Rating Scale (NRS) score, time to first rescue analgesic requirement (NRS > 3), and total amount of analgesic needed in the first 24 hours post-surgery. RESULTS: The time to first perception of pain with NRS > 3 was 11.30±0.8 hours in the ACB group and 9.40 ± 1.1 hours in the LIA group, with a statistically significant difference (p < 0.001). Additionally, the total number of rescue analgesic doses given in the first 24 hours post-operatively differed significantly between the two groups (p = 0.046). CONCLUSION: The study concludes that ACB is an effective postoperative analgesic modality, superior to local infiltration analgesia, for patients undergoing TKA.

Enhancing the biochemical growth of Haematococcus pluvialis by mitigation of broad-spectrum light stress in wastewater cultures.

In this study, the microalgae Haematococcus pluvialis were cultivated in wastewater inoculated into low-density polypropylene plastic air pillows (LDPE-PAPs) under a light stress. The cells were irradiated to different light stresses using white LED lights (WLs) as the control, and broad-spectrum lights (BLs) as a test for the period of 32 days. It was observed that the inoculum (70 × 102 mL-1 cells) of H. pluvialis algal cells increased almost 30 and 40 times in WL and BL, respectively, at day 32 coherent to its biomass productivity. Higher lipid concentration of up to 36.85 µg mL-1 was observed in BL irradiated cells compared to 13.215 µg L-1 dry weight of biomass in WL. The chlorophyll 'a' content was 2.6 times greater in BL (3.46 µg mL-1) compared to that in WL (1.32 µg mL-1) with total carotenoids being about 1.5 times greater in BL compared to WL on day 32. The yield of red pigment 'Astaxanthin' was about 27% greater in BL than in WL. The presence, of different carotenoids including astaxanthin was also confirmed by HPLC, whereas fatty acid methyl esters (FAMEs) were confirmed by GC-MS. This study further confirmed that wastewater alongwith with light stress is suitable for the biochemical growth of H. pluvialis with good biomass yield as well as carotenoid accumulation. Additionally there was 46% reduction in chemical oxygen demand (COD) in a far more efficient manner when cultured in recycled LDPE-PAP. Such type of cultivation of H. pluvialis made the overall process economical and suitable for upscaling to produce value-added products such as lipids, pigments, biomass, and biofuel for commercial applications.

Prevalence and pattern of congenital heart disease in school children of eastern Uttar Pradesh.

BACKGROUND AND AIM: The prevalence of congenital heart disease (CHD) is not known in our country. The aim of present study was to find out the prevalence of CHD in school children of eastern Uttar Pradesh. METHOD: A team consisting of a cardiologist, physicians and junior residents visited schools in the area. All the children were examined for presence of cardiac murmur or history of heart disease or any intervention. Those with murmurs or previous history of heart disease were called to the Medical College Hospital for evaluation by ECG, chest X-ray and echocardiography for confirmation of the lesion. RESULTS: Out of 118,212 children examined, 142 were found to have CHD. The prevalence was 1.3 per 1000 children and the commonest lesions were ventricular and atrial septal defects, aortic stenosis with or without regurgitation, and pulmonary stenosis. CONCLUSION: CHD prevalence is 1.3 per 1000 school children that is nearly two and a half times more than that of RHD. Knowing it is important for development of facilities for CHD care in our setup.

Prevalence of rheumatic heart disease in school-going children of Eastern Uttar Pradesh.

BACKGROUND: Rheumatic heart disease is a major health problem in our country. There is evidence from South India that its prevalence is declining. This study attempts to confirm whether this is so in North India as well. METHODS AND RESULTS: A total of 118,212 (68,357 males, 49,855 females) schoolchildren in the age group of 4-18 years were examined for the presence of heart disease. Evaluation, including echocardiography, confirmed that of a total of 389 suspected to have heart disease, 61 had rheumatic heart disease. Thus, the prevalence of rheumatic heart disease was found to be approximately 0.5 per 1000 children. CONCLUSION: In a fairly large school survey conducted by us, the prevalence of rheumatic heart disease turned out to be approximately 0.5 per 1000 children. This is the lowest figure reported from our country so far and confirms the decline of this disease in our country.