RESUMO
INTRODUCTION: Urinary bladder tumors are one of the most common urological malignancies. Traditionally, it has been managed with trans-urethral resection of urinary bladder tumor (TURBT) for both diagnostic and therapeutic purposes. During TURBT of lateral wall tumors, there is risk of obturator nerve reflex (ONR), which can lead to serious complications such as inadvertent bleeding and urinary bladder perforation. To prevent this, obturator nerve block is given after spinal anesthesia. In this study, we have used the transvesical approach to block the obturator nerve. MATERIALS AND METHODS: In total, 60 patients were included in the study. In 30 of them, TURBT was performed under only SA and transvesical obturator nerve block (ONB). In the other 30 patients, TURBT was performed under SA and peripheral nerve stimulator (PNS) guided obturator nerve block (performed by anesthetists) was given. The patients underwent TURBT using conventional monopolar cautery. The procedure time and peri-operative complications were studied. In all patients, informed consent was taken. RESULTS: In this study, 30 ONBs (all bilateral) were performed transvesically. After confirming the location of the obturator nerve, transvesical ONB was given using local anesthetic. Two patients (6.67%) experienced adductor jerk during the operation. In the 30 patients who underwent peripheral nerve stimulator (PNS) guided ONB, 6 of the patients (20%) experienced adductor jerk during the operation and 1 of those (3.33%) suffered from urinary bladder perforation which was managed conservatively. CONCLUSION: Transvesical ONB is an easy method to prevent adductor jerk during TURBT of lateral wall tumors. The learning curve is less and it has a high success rate.
RESUMO
In the historical mysteries and present pandemic situation, the use of citrus fruits makes it rise high among other fruits. Citrus has a significant role in dietary and medicinal purposes from time immemorial and widely acknowledged for its therapeutic properties. Citrus megaloxycarpa Lush. is an unspecified sibling of the citrus family. The present work highlights the biochemical, antimicrobial, and anticancerous potential of cryptic species indigenous to Northeast India. The research was done on peel; P(L1) and pulp; Pu(L2) extracts of ripe large and peel; P(L1) and pulp; Pu(L2) extracts unripe small varieties respectively. The extract of the Pu(L2) has the highest total soluble sugar (9.174±0.006741 µg/ml) whereas the extract of P(S1) demonstrated high protein concentration (8.074±0.0567 µg/ml). The total carbohydrate content also varied in the extracts; the extract of P(L1) showed (8.326±0.003844 µg/ml). P(L1) have high free amino acid content (24.35±0.0225µg/ml) and high free fatty acid exhibited on P(L2) (0.3739±0.05774 µg/ml). The total DPPH scavenging activity was compared for the extracts, where the extract of Pu (S1) exhibits highest activity 73.80% and 0.6577 of logIC50 value. The highest total antioxidant capacity displays 150±0.333 in P(L1). The MIC value was calibrated (30%, 35%, 40%, 45%) (v/v) and found to be maximum in P(L2) (0.695) and minimum in P(L1) (0.163) against Salmonella typhi and Escherichia coli. MTT assay showed highest viability rate of 94.32% and toxicity rate of 8.56% achieved on mouse lung cancerous cell. It is quite obvious from the present research that Citrus megaloxycarpa Lush. has a great scope at industrial level for developing therapeutic drugs.
