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Biradar P.A.,Bldeus Shri B M Patil Medical College And Research Institute | Kaimar P.,Kasturba Medical College Mangalore | Gopalakrishna K.,Yenapoya Medical College
Indian Journal of Anaesthesia | Year: 2013

Background: Different additives have been used to prolong brachial plexus block. We performed a prospective, randomised, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of supraclavicular brachial plexus block as this is the most common type of brachial block performed in our institute. Methods: Sixty American Society of Anaesthesiologist's physical status I and II patients undergoing elective hand, forearm and elbow surgery under brachial plexus block were randomly allocated to receive either 1.5% lidocaine (7 mg/ kg) with adrenaline (1:200, 000) and 2 ml of normal saline (group C, n=30) or 1.5% lidocaine (7 mg/ kg) with adrenaline (1:200, 000) and 2 ml of dexamethasone (8 mg) (group D, n=30). The block was performed using a nerve stimulator. Onset and duration of sensory and motor blockade were assessed. The sensory and motor blockade of radial, median, ulnar and musculocutaneous nerves were evaluated and recorded at 5, 10, 20, 120 min, and at every 30 min thereafter. Results: Two patients were excluded from the study because of block failure. The onset of sensory and motor blockade (13.4±2.8 vs. 16.0±2.3 min and 16.0±2.7 vs. 18.7±2.8 min, respectively) were significantly more rapid in the dexamethasone group than in the control group (P=0.001). The duration of sensory and motor blockade (326±58.6 vs. 159±20.1 and 290.6±52.7 vs. 135.5±20.3 min, respectively) were significantly longer in the dexamethasone group than in the control group (P=0.001). Conclusion: Addition of dexamethasone to 1.5% lidocaine with adrenaline in supraclavicular brachial plexus block speeds the onset and prolongs the duration of sensory and motor blockade. Source

Prasad K.C.,Kasturba Medical College Mangalore | Prasad S.C.,Kasturba Medical College Mangalore
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2011

To estimate the average operative blood loss in tonsillectomy and adenotonsillectomy and the various factors affecting it. A prospective study of estimation of blood loss in 100 patients who underwent tonsillectomy and adenotonsillectomy. Data collected included the age, sex, operative indication, clotting time, Hb levels and usage of pre-operative antibiotics. Cold knife dissection method for tonsillectomy and curettage method for adenoidectomy were used. Measurement by calorimetric method of estimation being simple and accurate was used for estimation. Study undertaken at a tertiary referral hospital catering to an urban, semi-urban and rural populace. Blood loss was more in males and increases as age advances both in adenotonsillectomy and tonsillectomy. Blood loss was more in fibrosed tonsils, at lower hemoglobin levels and at higher clotting times. It was less in cases who received pre-operative antibiotics. The average blood losses in males and females during tonsillectomy were 106. 91 and 96. 26 ml respectively. In adenotonsillectomy, the average blood losses in males and females were 81. 44 and 76. 82 ml respectively. In our series we found that blood loss in tonsillectomy and adenotonsillectomy depended on various factors like age, sex, the type of tonsillitis, method of dissection, hemoglobin concentration, clotting time and the use of antibiotics. All these factors must be taken into consideration while taking up patients especially those who cannot tolerate blood loss, for surgery. © 2011 Association of Otolaryngologists of India. Source

Chakraborti S.,Kasturba Medical College Mangalore | Kini H.,Kasturba Medical College Mangalore | Pai K.G.,Kasturba Medical College | Upadhyaya V.,K S Hegde Medical Academy
Journal of Pediatric Neurosciences | Year: 2012

Sacrococcygeal location of myxopapillary ependymoma (MPE) is uncommon. Local recurrence and metastases are on record inspite of its benign characteristics. We report a rare case of sacrococcygeal MPE in an 11-month-old female child who showed typical myxopapillary ependymal histology along with anaplastic ependymal component. Ki-67 labeling index in the myxopapillary component was 4-5% and in the anaplastic component was 70%. Six weeks after gross total resection of the tumor, the child presented with local recurrence and metastasis in the right inguinal lymph nodes and was treated with chemotherapy. The present case of sacrococcygeal MPE with anaplastic ependymoma component is the second case on record in the medical literature, and the first case without any syndromic features. Metastasis in this case can be explained because of the anaplastic component, with mitotic count of 5-6/high power field and high Ki-67 labeling index. Source

Nair V.,Kasturba Medical College Mangalore | Nair V.,All India Institute of Medical Sciences | Mohan L.,Kasturba Medical College Mangalore | Rao U.S.C.,Kasturba Medical College Mangalore | Gopalakrishna H.N.,Kasturba Medical College Mangalore
Evidence-based Complementary and Alternative Medicine | Year: 2011

The present study investigates the anxiolytic activity of NR-ANX-C, a standardized polyherbal formulation containing the extracts of Withania somnifera, Ocimum sanctum, Camellia sinensis, Triphala, and Shilajit in ethanol withdrawal- (EW-) induced anxiety behavior in rats. Ethanol dependence in rats was produced by substitution of drinking water with 7.5v/v alcohol for 10 days. Then, ethanol withdrawal was induced by replacing alcohol with drinking water, 12 hours prior to experimentation. After confirming induction of withdrawal symptoms in the alcohol deprived animals, the anxiolytic activity of the test compound in graded doses (10, 20, and 40mg/kg) was compared to the standard drug alprazolam (0.08mg/kg) in the elevated plus maze and bright and dark arena paradigms. In our study, single and repeated dose administration of NR-ANX-C reduced EW-induced anxiety in a dose-dependent manner. Even though the anxiolytic activity was not significant at lower doses, NR-ANX-C at the highest dose tested (40mg/kg) produced significant anxiolytic activity that was comparable to the standard drug alprazolam. Based on our findings we believe that NR-ANX-C has the potential to be used as an alternative to benzodiazepines in the treatment of EW-induced anxiety. Source

Goel G.,Kasturba Medical College Mangalore | Rai S.,Kasturba Medical College Mangalore | Gupta A.,Kasturba Medical College Mangalore | Naik R.,Kasturba Medical College Mangalore | Baliga P.,Kasturba Medical College Mangalore
Journal of Clinical and Diagnostic Research | Year: 2011

Introduction: Multiple myeloma (MM) is a neoplastic plasma cellproliferation involving the bone marrow and extraosseous tissueswhich usually occurs in the elderly, (aged, 60 to 70 years), whilepatients younger than 30 or 40 years account for only 0.3 and2.2 %,of all myelomas, respectively.Materials and Methods: The present study analyzed 7 patientsyounger than 40 years among 87 patients of MM who presentedto our hospital from 2005 to 2008. Complete diagnostic workupwas carried out for all the patients.Results: The youngest of the 7 patients included in the study wasa 30 year old female. All the patients had marrow involvement byneoplastic plasma cells.Conclusion: The survival of patients younger than 40years withMM is longer than observed in other series of patients of all ageswith MM. Source

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