ABSTRACT
BACKGROUND AND AIMS: Multimodal analgesia comprising opioid, paracetamol, and non-steroidal anti-inflammatory drugs is used for managing postoperative surgical pain after ileostomy closure (IC). We investigated the efficacy of unilateral dual transversus abdominis plane (TAP) block to reduce morphine consumption in the first 24 hours along with a reduction in visual analogue score for pain and in postoperative nausea/vomiting. METHODS: This was a single-center, investigator-initiated, prospective, parallel-group, placebo-controlled randomized study involving patients undergoing IC under general anesthesia. We recruited 55 patients in two groups: 28 in a TAP group and 27 in a placebo group. The TAP group patients received 30 mL of 0.375% bupivacaine: 15 mL by a posterior TAP approach and 15 mL by a subcostal approach using ultrasonography. Patients in the placebo group received 30 mL normal saline (placebo) using the same approaches. Blocks were administered at the end of surgery before extubation. To monitor for the primary outcome-24-hour morphine consumption for both groups-patients were transferred to a high-dependency unit. The secondary outcome was to compare postoperative nausea/vomiting in both groups. RESULTS: The demographic data, gender distribution, ASA physical status, duration of surgery, and time of first morphine dose was comparable in both groups. The 24-hour morphine consumption was 3.29±2.78 mg and 9.23±2.94 mg for the TAP and placebo groups, respectively, which was statistically significant (P=0.001). CONCLUSION: Dual TAP block reduces opioid consumption in the first 24 hours after an IC and can facilitate early recovery with less adverse effects seen than with opioids and NSAIDs.
ABSTRACT
Curcuma neilgherrensis Wight is a folk medicinal plant used in the management of diabetes mellitus. The leaves of this herb are said to be successful in managing high blood glucose levels. This study is aimed at assessing the scientific appraisal of C. neilgherrensis in the course of pharmacognostical characters and phytochemical parameters, as these are not yet been done. Pharmacognostic study mainly covered the macroscopic and microscopic features of the leaves including powder microscopy, and revealed the presence of trichomes, spiral vessels etc. Phytochemical parameters such as pH, total ash value, water-soluble extract and MeOH extract values were assessed in the preliminary physicochemical screening. Qualitative analysis revealed the existence of certain chemical constituents such as flavonoids, tannins, organic acids and saponin glycosides. The crude extract of leaves was subjected to TLC and HPTLC for the separation of components.
ABSTRACT
Man has been in steady attempt to find the solutions for the life-threatening and distressing disorders, which afflict the human race. One of such condition is "Tamaka Shwasa," which is recognized by the name bronchial asthma in contemporary discipline, wherein episodic attacks are the characteristic features, leaving the patient in pathetic situation. Therefore management of this acute respiratory condition is the long mission in the medical society of all types. There is abundance of medicines explained for Tamaka Shwasa in Ayurveda, and it is mentioned that combined Shodhana and Shamana therapy is more effective. Hence the present study is designed to evaluate the role of Nithyavirechana followed by Shamana in the form of Nayopayam kashaya in patients of Tamaka Shwasa. This was a single blind clinical study with pre-test and post-test design where in 20 patients suffering from Tamaka Shwasa of either sex between the age group of 16 and 60 years were subjected to the trial. These patients were treated with Nithyavirechana with Eranda thaila (castor oil) followed by oral administration of Nayopayam kashaya in a dose of 50 ml twice a day. The therapeutic effect of the treatment was assessed based on specific subjective and objective parameters. Results obtained were analyzed for the statistical significance by adapting paired 't' test. Statistical analysis established that Eranda thaila and Nayopayam kashaya are highly effective in counteracting the symptoms of Tamaka Shwasa.
