Comparison of the analgesic efficacy of intra-articular steroid injections and its combination with suprascapular nerve block for adhesive capsulitis of the shoulder joint: a randomized clinical trial.

Background: Adhesive capsulitis is a distressing ailment that progressively limits the active and passive mobility of the shoulder joint. Physical therapy (PT) combined with intra-articular steroid (IAS) injection and suprascapular nerve block (SSNB) has shown improved functional outcomes. We aimed to assess whether providing both IAS injection and SSNB improved outcomes compared with IAS injection alone.

Comparison of Dexmedetomidine Versus Fentanyl-Based Anesthetic Protocols Under Patient State Index Guidance in Patients Undergoing Elective Neurosurgical Procedures with Intraoperative Neurophysiological Monitoring.

Objectives The study was designed to elucidate the effects of dexmedetomidine as an anesthetic adjunct to propofol in total intravenous anesthesia (TIVA) on anesthetic dose reduction, the quality of intraoperative neurophysiological monitoring (IONM) recordings, analgesic requirements, and recovery parameters in patients undergoing neurosurgical procedures with neurophysiological monitoring. Methods A total of 54 patients for elective neurosurgical procedures with IONM were randomized to group D (dexmedetomidine) and group F (fentanyl). A loading dose of the study drug of 1µg/kg followed by 0.

Comparison of two techniques of goal directed fluid therapy in elective neurosurgical patients - a randomized controlled study.

Background: Goal directed fluid therapy (GDFT) may be a rational approach to adopt in neurosurgical patients, in whom intravascular volume optimization is of utmost importance. Most of the parameters used to guide GDFT are derived invasively. We postulated that the total volume of intraoperative intravenous fluid administered during elective craniotomy for supratentorial brain tumours would be comparable between two groups receiving GDFT guided either by the non-invasively derived plethysmography variability index (PVI) or by stroke volume variation (SVV).

Comparison of Postoperative Analgesic Efficacy of Ultrasound-Guided Bilateral Rectus Sheath Block With That of Local Anaesthetic Infiltration in Patients Undergoing Emergency Midline Laparotomy Surgeries: A Randomised Controlled Trial.

Purpose Rectus sheath block (RSB) is increasingly utilised as a part of multimodal analgesia in laparotomy surgeries. We proposed this study to compare the analgesic efficacy of ultrasound-guided bilateral RSB with local anaesthetic (LA) infiltration. The primary outcome was the visual analogue scale (VAS) at rest and cough.

Comparison of the Analgesic Efficacy of Ultrasound-Guided Superficial Serratus Anterior Plane Block With Deep Serratus Anterior Plane Block in Patients Undergoing Modified Radical Mastectomy: A Randomized Clinical Trial.

Background Acute postoperative pain after breast cancer surgery adversely affects recovery and is an independent predictor of chronic postsurgical pain in these patients. Serratus plane blocks have been found to provide analgesia to the anterior hemithorax. However, trials comparing superficial serratus plane block and deep serratus block in breast cancer surgery patients are sparse.

Clinical utility of ultrasonography, pulse oximetry and arterial line derived hemodynamic parameters for predicting post-induction hypotension in patients undergoing elective craniotomy for excision of brain tumors - A prospective observational study.

Background: Hypotension, which is a common adverse effect of induction of anesthesia, may be especially detrimental in neurosurgical patients. Hence, it is important to investigate hemodynamic parameters which may be useful in identifying patients at risk of hypotension, following induction. Our study was designed to assess the utility of parameters derived from ultrasonography, pulse oximeter and arterial line for predicting post-induction hypotension.

Novel tricyclic small molecule inhibitors of Nicotinamide N-methyltransferase for the treatment of metabolic disorders.

Nicotinamide N-methyltransferase (NNMT) is a metabolic regulator that catalyzes the methylation of nicotinamide (Nam) using the co-factor S-adenosyl-L-methionine to form 1-methyl-nicotinamide (MNA). Overexpression of NNMT and the presence of the active metabolite MNA is associated with a number of diseases including metabolic disorders. We conducted a high-throughput screening campaign that led to the identification of a tricyclic core as a potential NNMT small molecule inhibitor series.

Preoperative Vascular Function Assessment and Perioperative Vascular Events in Patients Posted for Elective Non-cardiac Surgeries.

Background Coronary atherosclerosis is usually asymptomatic until a major cardiac event occurs. Surgery is one of the major stress factors that play a role in hastening vascular deterioration in susceptible patients. Non-invasive tests to detect atherosclerosis and endothelial dysfunction have started gaining popularity nowadays, and of the several options, carotid artery intima-media thickness (IMT) and radial artery flow-mediated dilation (FMD) are two promising tests for detecting cardiovascular impairment.

Evaluation of Cognitive and Psychomotor Functional Changes in Anesthesiology Residents after 12 hours of Continuous Work in Operation Theater: An Observational Study.

Background: Prolonged working hours in operation theater may impair cognitive and psychomotor function.

Aims: This study was done to evaluate the changes in cognitive and psychomotor changes in the anesthesia residents after 6 and 12 h of continuous work in operation theater.

Settings And Design: Sixty anesthesia residents whose working hours were expected to be longer than 12 h were recruited for this prospective, observational study.

Ease of lumbar epidural catheter insertion with prepuncture ultrasound as guidance compared with conventional palpatory technique when performed by anesthesiology residents: A randomized controlled trial.

Background And Aims: Lumbar epidural catheter insertion is conventionally performed by anesthesia residents by palpation of anatomical landmarks with relatively blind localization of epidural space which may lead to an increase in failure rate. We aim to compare the ease of lumbar epidural catheterization using prepuncture ultrasound as guidance with that of conventional palpatory technique. Comparisons were made with reference to number of insertion attempts, total time taken for the procedure, frequency of dural puncture, and overall satisfaction score as assessed by Likert's scale.

Comparison of total intravenous anesthesia vs. inhalational anesthesia on brain relaxation, intracranial pressure, and hemodynamics in patients with acute subdural hematoma undergoing emergency craniotomy: a randomized control trial.

Background: The major goals of anesthesia in patients with severe traumatic brain injury (TBI) are-maintenance of hemodynamic stability, optimal cerebral perfusion pressure, lowering of ICP, and providing a relaxed brain. Although both inhalational and intravenous anesthetics are commonly employed, there is no clear consensus on which technique is better for the anesthetic management of severe TBI.

Methods: Ninety patients, 18-60 years of age, of either gender, with GCS < 8, posted for emergency evacuation of acute subdural hematoma were enrolled in this prospective trial, and they were randomized into two groups of 45 each.

Evaluation of Neuromuscular Blockade with Vecuronium during General Anesthesia with Oxygen, Nitrous Oxide, Isoflurane versus Oxygen, Air, Isoflurane: A Randomized Controlled Study.

Background: The use of air oxygen mixture with isoflurane has become more common in the place of nitrous oxide, especially in laparoscopic and abdominal surgeries. With a varied mixture of gases and isoflurane used in general anesthesia, the exact dosing requirement and time duration of action have not been precisely studied with vecuronium when given as a bolus, as is given routinely.

Purpose: This study was undertaken to evaluate and compare the neuromuscular effect of vecuronium during anesthesia with oxygen, nitrous oxide and isoflurane versus oxygen, air and isoflurane.

A small molecule inhibitor of Nicotinamide N-methyltransferase for the treatment of metabolic disorders.

Nicotinamide N-methyltransferase (NNMT) is a cytosolic enzyme that catalyzes the transfer of a methyl group from the co-factor S-adenosyl-L-methionine (SAM) onto the substrate, nicotinamide (NA) to form 1-methyl-nicotinamide (MNA). Higher NNMT expression and MNA concentrations have been associated with obesity and type-2 diabetes. Here we report a small molecule analog of NA, JBSNF-000088, that inhibits NNMT activity, reduces MNA levels and drives insulin sensitization, glucose modulation and body weight reduction in animal models of metabolic disease.

Anaesthetic Implications of Severe Hyperthyroidism Secondary to Molar Pregnancy: A Case Report and Review of Literature.

Pregnant women with gestational trophoblastic disease have an increased likelihood to develop hyperthyroidism secondary to increased secretion of human chorionic gonadotropin. Most of these cases of hyperthyroidism remain undiagnosed and may present as a thyrotoxic crisis during the perioperative period. Pregnant patients with gestational trophoblastic disease should be always evaluated for hyperthyroidism, and in cases of severe hyperthyroidism, antithyroid treatment should be initiated before evacuation of the mole.

Crystal structures of monkey and mouse nicotinamide N-methyltransferase (NNMT) bound with end product, 1-methyl nicotinamide.

Nicotinamide N-methyltransferase (NNMT) is a S-adenosyl-l-methionine (SAM)-dependent enzyme that catalyzes N-methylation of nicotinamide (NA) and other pyridines to form N-methyl pyridinium ions. Here we report the first ternary complex X-ray crystal structures of monkey NNMT and mouse NNMT in bound form with the primary endogenous product, 1-methyl nicotinamide (MNA) and demethylated cofactor, S-adenosyl-homocysteine (SAH) determined at 2.30 Å and 1.

Comparison of ease of administration of intranasal midazolam spray and oral midazolam syrup by parents as premedication to children undergoing elective surgery.

Background: The efficacy of midazolam as premedication in children for providing pre-operative sedation and reducing parental separation anxiety has been well established. Many studies have compared the effectiveness and medication acceptance of midazolam via oral and intranasal routes. In this study, we have compared the ease of administration of oral midazolam syrup and intranasal midazolam spray as premedication, administered by parents to children.

Co-crystal structures of PTK6: With Dasatinib at 2.24 Å, with novel imidazo[1,2-a]pyrazin-8-amine derivative inhibitor at 1.70 Å resolution.

Human Protein tyrosine kinase 6 (PTK6)(EC:2.7.10.

Crystal structure of the kinase domain of human protein tyrosine kinase 6 (PTK6) at 2.33 Å resolution.

Human Protein tyrosine kinase 6 (PTK6) (EC:2.7.10.

Fractured tracheostomy tube presenting as a foreign body in a paediatric patient.

Tracheostomy tube fracture and aspiration into the tracheobronchial tree leading to airway obstruction is a dangerous complication after tracheostomy. We report a case of a fractured tracheostomy tube in a 6-year-old child who had been maintained on a tracheostomy tube for the past 5 years. The tracheostomy tube got fractured at the junction of the tube and neck plate, and impacted in the trachea and right main bronchus.

Anaesthesia ventilators.

Anaesthesia ventilators are an integral part of all modern anaesthesia workstations. Automatic ventilators in the operating rooms, which were very simple with few modes of ventilation when introduced, have become very sophisticated with many advanced ventilation modes. Several systems of classification of anaesthesia ventilators exist based upon various parameters.