Rejected

Objective To assess the effect of intravenous dexmedetomidine on subarachnoid anesthesia with the help of hyperbaric bupivacaine when administered as a bolus or as an infusion. Materials and methods This randomized control trial was conducted at the Department of Anesthesia, Nishtar Hospital, Multan, Pakistan, from January 2017 to December 2018. Seventy patients were enrolled in the study. Patients were segregated into three groups. At the T10 level, a sensory blockade was noted. The motor blockade was also periodically measured until a modified Bromage score of three was achieved. The depth of sedation was measured with the help of the Ramsay Sedation Scale score. Oxygen saturation and other factors were also measured and recorded. Nausea, vomiting, diarrhea, and pruritus were the adverse effects noted during the study. To check and compare the statistical differences among the variables from different groups, the Chi-square test and analysis of variance test were performed. A probability (p) value of <.05 was considered statistically significant. Results The duration of the sensory blockade was shortest in the control group receiving only bupivacaine (Group B) and longest in the group receiving bupivacaine plus dexmedetomidine as a single bolus (Group BDexB; p: <.001). The time of complete sensory and motor recovery was longest in Group BDexB and shortest in Group B. The difference was statistically significant (p: <.001). The Ramsay score was >2 (i.e., 3 or 4) in five patients from Group B, 19 from Group BDexB, and 17 from the group receiving intrathecal bupivacaine plus dexmedetomidine as an infusion (Group BDexI). Between these groups, a statistically significant difference was found (p: <.001). Conclusions Intravenous administration of dexmedetomidine as either a bolus or infusion prolonged the duration of the sensory and motor blockade.

Controlling postoperative pain and improving outcomes after total hip arthroplasty (THA) remain an important challenge, which affects the functional recovery of the hip.

Total pancreatectomy may improve symptoms in patients with severe end-stage chronic pancreatitis. This might be achieved whilst preserving both the duodenum- and spleen-(DPSPTP). Mature clinical outcomes of this approach are presented.

The medial patellofemoral ligament is the primary static restraint to lateral patellar translation. It is injured in 96% to 100% of patellar dislocations that affect approximately 6 to 29 of 100,000 patients and is more common in patients younger than 20 years of age. Risk factors for patellar dislocation include patella alta, trochlear dysplasia, genu valgus, increased Q angle, and hyperlaxity. The treatment for patellar instability depends on the clinical and radiographic findings and can be nonoperative for first-time dislocations (bracing, proximal strengthening, and progressive return to sport) or operative for recurrent dislocations. It is critical for medial patellofemoral ligament reconstruction to reproduce the anatomy and isometry of the native ligament. Graft choice and methods of fixation are less critical to achieve successful outcomes. Studies have reported successful outcomes and improved Kujala scores, with recurrent instability ranging from 1% to 5%. Careful surgical technique can avoid complications, including fracture, graft failure, loss of range of motion, persistent anterior knee pain, medial instability, and recurrent instability. The role of the medial quadriceps tendon femoral ligament also should be considered more in future research.

Allergic rhinitis is a global cause of disability, characterized by airway inflammation. Sumatriptan is a 5-hydroxytryptamine 1B/1D (5HT1B/1D) agonist used as a treatment for migraine headaches. Activation of 5HT1B/1D receptors can inhibit the release of neuropeptides and inhibit the inflammation cascades. This study investigated the effect of sumatriptan on ovalbumin-induced allergic rhinitis model in mice and the role of nitric oxide.

Ketamine and magnesium sulphate showed synergic interaction in the tail-immersion test and additive interaction in the rat formalin test. Aim of study was to evaluate the influence of serotonergic and opioidergic system of this combination in the formalin test in rats.

Alcohol consumption often leads to hangover, a condition characterized by several symptoms, characteristically headache, nausea, fatigue and drowsiness. Hangover may be alleviated by altering the rate of alcohol metabolism and facilitating elimination of acetaldehyde by affecting the activity of alcohol dehydrogenase (ADH) and/or aldehyde dehydrogenase (ALDH) enzymes. In the present study, several food commodities like fruits, vegetables, cereals, pulses, dairy products, spices and other miscellaneous products (ascorbic acid, cocoa sample, tea, coffee, egg yolk and date samples) were investigated for their effect on the activities of the enzymes and their antioxidant properties. Of the many screened food commodities, few showed an increase in the activity of either one or both the enzymes, ADH and ALDH. Studies showed no correlation between ADH and ALDH enzyme activities and antioxidant property of the selected food commodities for anti-hangover effect. Further, an anti-hangover (AHO) product was developed using pear (65%), sweet lime (25%) and coconut water (10%) and, validated for ADH and ALDH enzyme activities. AHO product was found to enhance ADH and ALDH activities by 23.31% and 70.02%, respectively.

The following material was presented to an esteemed group of colleagues, Chinese physicians and stomotologists, friends and fellow panelists from around the globe at the Core China Conference, Nanjing China. Modern medicine accepts that a dichotomy exists between the mind, psyche and emotions and the rest of the body as if they function independently, having little downward up upward influence, one on the other. However, history teaches a different lesson. The influence of the emotional state of the patient plays a significant role effecting hormonal, neuroimmunological and peripheral modulatory factors influencing the pain experience. This brief discussion reviews the roots of modern Western Medicine in Traditional Chinese Medicine, and how we have come back to the realization of the mind-body concept in treating the patient as a single entity and not as a collection of systems.

Atopic dermatitis is a common chronic inflammatory disease characterized by severe pruritus with its symptoms occurring in phases. Associated with a genetic disposition, it is a complex immune and autonomic dysfunction with different symptoms based on a barrier disorder and a dysbalance of the skin microbiome. Its pathogenesis is determined by a Th2 mediated inflammation. This article is protected by copyright. All rights reserved.