Journal of clinical and diagnostic research : JCDR
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Review
Mannitol an adjuvant in local anaesthetic solution: recent concept & changing trends (review).
Various adjuncts have been utilized with lignocaine to decrement tourniquet pain and prolong postoperative analgesia and its efficacy during dental extraction and various other restorative procedures in dentistry. An obligatory part of the dental process is to sanction a patient to feel comfortable and pain-free during operational and remedial dental procedures. The most popular local anaesthetic injection for lower teeth is the inferior alveolar nerve (IAN) block. ⋯ The goal of cumulating different drugs is to engender the best therapeutic effects with the fewest or no unpropitious effects. There are fewer researches and evidence present which recommend and promote the application and effectiveness of mannitol other than in the administration in decreasing raised intracranial pressure. It is paramount to know how the drug interacts with each other to minimize the unexpected or perilous effects.
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Spinal trauma is relatively more common in young active individuals. Although its mortality is low, it is an important cause of long term disability. Magnetic resonance imaging (MRI) can accurately depict presence and extent of spinal cord injury (SCI) in these patients. This study was aimed to look for various qualitative and quantitative MRI findings which are predictive of initial neurological deficit in patients with spinal trauma and final outcome on follow-up. ⋯ MRI is excellent imaging modality for detecting and assessing severity of spinal trauma. In our study, presence of cord haemorrhage, MCC and cord oedema were best predictors of baseline neurological status at presentation, whereas baseline ASIA score and cord haemorrhage were best predictors of final neurological outcome.
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Acute appendicitis is one of the most common surgical emergencies. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendicectomy rates. A number of scoring systems have been used for aiding in early diagnosis of acute appendicitis and its prompt management of which Alvarado score is the most popular. The accuracy of Alvarado score in the diagnosis of acute appendicitis is disappointingly low in Asian population and RIPASA scoring has been designed for the diagnosis of acute appendicitis in the Asian population. So we prospectively applied and compared Alvarado and RIPASA score in the diagnosis of acute appendicitis in Indian population. ⋯ RIPASA scoring system is more convenient, accurate, and specific scoring system for Indian population than Alvarado scoring system.
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Two standard approaches are described to block the ulnar nerve at wrist. These include a) the traditional Volar approach where the needle is inserted lateral to tendon of flexor carpi ulnaris (FCU) b) Medial approach where the needle is inserted posterior to the tendon of FCU. Caution must be exercised to avoid puncture of the ulnar artery and/or intraneural injection of the ulnar nerve in both the approaches. ⋯ The medial approach is safer compared to volar approach for peripheral block of ulnar nerve at wrist.
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Paracetamol is recommended as first line agent for pain management in osteoarthritis (OA) by various guidelines. The main problem associated with management of osteoarthritis is long term patient compliance to paracetamol due to its frequent dosing. ⋯ Patients with symptomatic OA of the knee showed a greater improvement in pain and functional capacity with PCM 650 dual release than PCM 500 IR with better tolerability.