Is Ultrasound-Guided Transversus Abdominis Plane Block Superior to a Caudal Epidural or Wound Infiltration for Intraoperative and Postoperative Analgesia in Children Undergoing Unilateral Infraumbilical Surgery? A Double-blind Randomized Trial.

Background and Aim: Caudal block (CB) is the standard of care in pediatric surgeries. Ultrasound (USG) transversus abdominis plane (TAP) block has also been used as an effective regional anesthesia technique. We compared the duration of postoperative and intraoperative analgesia between TAP block, CB, and local wound infiltration (LI) in children undergoing unilateral infraumbilical abdominal surgery. Materials and Methods: One hundred and twenty children, 3-10 years old and American Society of Anesthesiologists Grade I and II, undergoing elective unilateral infraumbilical abdominal surgery were allocated to three groups. Group TAP: USG-guided TAP block with 0.5 ml/kg of 0.25% bupivacaine; Group CB: CB with 0.75 ml/kg of 0.25% bupivacaine; and Group LI: Local wound infiltration along the incision with 0.5 ml/kg of 0.25% bupivacaine. The primary outcome was the efficacy of postoperative analgesia using modified objective pain score (MOPS), and the secondary outcome was to determine intraoperative analgesia with fentanyl requirement and minimum alveolar concentration (MAC) hour of isoflurane among the three groups. Results: The MOPS was statistically better in Group TAP compared to group CB and group LI at 8 and 24 h postoperatively. The mean ± standard deviation duration of postoperative analgesia in groups CB, LI, and TAP was 6.84 ± 0.47, 2.3 ± 1.26, and 9.78 ± 1.02 h, respectively. The intraoperative requirement of fentanyl and MAC hour was least in Group CB. Conclusion: We found that USG-guided TAP block is a good alternative, with longer and effective postoperative analgesia compared to CB. However, the quality of intraoperative analgesia was best in group CB. Local infiltration was a poor alternative.

Spatiotemporal ecological vulnerability analysis with statistical correlation based on satellite remote sensing in Samara, Russia.

In the present global situation, when everywhere ecology is degraded due to the extreme exhaustion of natural resources. Therefore spatiotemporal ecological vulnerability analysis is necessary for the current situation for sustainable development with protection of fragile eco-environment. Remote sensing is a unique tool to provide complete and continuous land surface information at different scales, which can use for eco-environment analysis. A methodology constructed on the principal component analysis (PCA) to identify satellite remote sensing ecological index (RSEI) for ecological vulnerability analysis and distribution based on four land surface parameters (dryness, greenness, temperature and moisture) by using Landsat TM/ETM+/OLI/TIRS data in the Samara region Russia. The results were verified by the following four methods: location-based, categorization-based, correlation-based and city center to outwards distance-based comparisons. Results indicate that ecological condition was improved from 2010 to 2015 as RSEI increased from 0.79 to 0.98 and from 2015 to 2020 the ecological condition was degraded as RSEI decreased from 0.98 to 0.82 but overall it was improved in this decade. RSEI distribution curve shows moderate to good and excellent ecological conditions and degraded ecological condition was basically characterized by high human interference and socioeconomic activities in the study area. Such a technique is a baseline for highly accurate ecological conditions mapping, monitoring and can use for decision making, management and sustainable development.

Use of AMSR-E microwave satellite data for land surface characteristics and snow cover variation.

This data article contains data related to the research article entitled "Global land cover classification based on microwave polarization and gradient ratio (MPGR)" [1] and "Microwave polarization and gradient ratio (MPGR) for global land surface phenology" [2]. This data article presents land surface characteristics and snow cover variation information from sensors like EOS Advanced Microwave Scanning Radiometer (AMSR-E). This data article use the HDF Explorer, Matlab, and ArcGIS software to process the pixel latitude, longitude, snow water equivalent (SWE), digital elevation model (DEM) and Brightness Temperature (BT) information from AMSR-E satellite data to provide land surface characteristics and snow cover variation data in all-weather condition at any time. This data information is useful to discriminate different land surface cover types and snow cover variation, which is turn, will help to improve monitoring of weather, climate and natural disasters.

Satellite data for Singapore, Manila and Kuala Lumpur city growth analysis.

This data article presents satellite data related to city growth of Singapore, Manila and Kuala Lumpur cities. The data were collected from NASA and USGS websites. A method has been developed for city built-up density from city center to outward till 50 km by using satellite data. These data sets consists three decade Landsat images. A detailed description is given to show how to use this data to produce urban growth maps. The urban growth maps have been used to know the changes and growth pattern in the Southeast Asia Cities.

Urbanization data of Samara city, Russia.

A method has been developed for urbanization by using satellite data and socio-economic data. These datasets consists three decade Landsat images and population data. A detailed description using flow chart is given to show how to use this data to produce land use/cove maps. The land use/cove maps were used to know the urban growth in Samara City, Russia.

Clinical Evaluation of Success of Primary Teeth Pulpotomy Using Mineral Trioxide Aggregate(®), Laser and Biodentine(TM)- an In Vivo Study.

INTRODUCTION: Pulpotomy technique basically consists of removing the coronal pulp and fixing the radicular pulp with a medicament. It is the most widely accepted clinical procedure for treating primary teeth with coronal pulp inflammation caused by caries with no involvement of the radicular pulp. AIM: To evaluate the success and efficacy of Mineral Trioxide Aggregate (MTA), Lasers and Biodentine as pulpotomy agents both clinically and radiographically. MATERIALS AND METHODS: In the present study, 60 primary molars in children whose pulpal status warranted pulpotomy were selected and randomly assigned into three groups that included MTA, Laser and Biodentine allocating 20 teeth to each group. The pulpotomy procedure was then performed on all selected teeth followed by restoration with stainless steel crowns. Later the patients were recalled for 3 months and 6 months for clinical and radiographic evaluation. RESULTS: Statistical analysis was done using Fisher exact test to determine pair wise comparison of three agents with respect to clinical and radiographic criteria. Kruskal-Wallis ANOVA, Mc Nemars test was applied to evaluate the efficacy of each agent between 3 months and 6 months. The results showed that maximum success rate was found in MTA group. However, the comparison between three groups was statistically not significant (p<0.05). CONCLUSION: Pulpotomies performed with either MTA, Laser or Biodentine are equally efficient with similar clinical/radiographic success and hence can be considered as alternatives to Formocresol.

Dental Management of a 14-Year-Old with Cockayne Syndrome under General Anesthesia.

Cockayne's syndrome is a rare, autosomal recessive disorder characterized clinically by cachectic dwarfism, cutaneous photosensitivity, loss of adipose tissue, mental retardation, skeletal and neurological abnormalities, and pigmentary degeneration of the retina. Dental caries is a common finding. Dental rehabilitation of a 14-year-old male with Cockayne's syndrome is presented.

Pharmacotherapy of atrial fibrillation.

Atrial fibrillation is the most common sustained arrhythmia of clinical significance. Its prevalence rises with age. It is a significant cause of thromboembolic phenomena. We describe briefly the etiology and classification of atrial fibrillation, the risk factors for thromboembolism and stroke associated with it, the indications for hospitalization, and the therapeutic goal. We discuss in depth the management strategies for such patients and compare the impact of rate versus rhythm control in reducing morbidity and mortality attributed to arrhythmia, in light of past and present trials. A brief overview of the drugs used in the management of atrial fibrillation, their pharmacology and dosage, their effects and use in rhythm versus rate control with important side effects are also included. Finally, the prevention and treatment of thromboembolism in patients with atrial fibrillation, an important aspect of therapy, is revisited in light of recent advances.