Journal of the Indian Medical Association
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Seven cases of intercondylar fractures of the distal humerus were treated by a mini-external fixation technique. The average range of motion was 30 degrees to 110 degrees. ⋯ Open wound sites healed in 6 cases. There were no evidence of any nerve palsies.
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A 75-year-old male diagnosed to be a case of intractable asthma resistant to all conventional therapies requiring ventilatory support, was successfully weaned off the ventilator after treatment with subanaesthetic dose of intravenous ketamine.
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The instant axis of rotation (IAR) is an important kinematic property to characterise of lumbar spine motion. The goal of this biomechanical study on cadaver lumbar spine was to determine the excursion of the IAR for flexion (FE), lateral bending (LB) and axial rotation (AR) motion at L4-5 segment. Ten cadaver lumbar spine specimens were tested in a 6 degrees-of-freedom spine tester with continuous clyclical loading using pure moment and follower pre-load, to produce physiological motion. ⋯ The IAR excursion was faster and larger during neutral zone motion in FE and LB, but uniform for AR motion. This is the first published data on the continuous excursion of IAR of a lumbar motion segment. The methodology is accurate and precise, but not practicable for in vivo testing.
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Randomized Controlled Trial Comparative Study
Comparative clinical study of effect of neostigmine and ketamine for postoperative analgesia.
The purpose of the study was to evaluate and compare the role of neostigmine and ketamine as an additive to epidural bupivacaine to prolong the duration of postoperative analgesia. A double-blind randomised study was done on 60 adult patients, of both sexes, between 18 and 50 years, belonging to ASA grades I and II, undergoing below umbilical surgeries under epidural anaesthesia. All the patients were divided into three groups of 20 each to receive 20 ml of 0.5% bupivacaine with either 1 ml of normal saline, 100 mg of neostigmine or 50 mg of ketamine (both diluted with 1 ml normal saline). ⋯ Both neostigmine and ketamine demonstrated better haemodynamic stability with less incidence of hypotension. There was no increased incidence of nausea and vomiting or any other side-effects. In conclusion, it can be said neostigmine is a good adjuvant to epidural block to produce adequate pain relief without increased incidence of adverse effects.