Journal of clinical and diagnostic research : JCDR
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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.
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Improved pain management for blunt trauma to the lower extremity has shown to reduce morbidity, induce early ambulation and improve long-term outcomes. Dexmedetomidine; a selective α-2 agonist; has recently been used intrathecally in different doses to prolong spinal anaesthesia. We evaluated the effect of adding two different doses of dexmedetomidine to hyperbaric bupivacaine for spinal anaesthesia. The primary endpoints were the onset and duration of sensory, motor block and duration of analgesia. ⋯ Spinal dexmedetomidine increases the sensory, motor block duration and time to first analgesic use, and decreases analgesic consumption in a dose-dependent manner.
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The aim of this prospective study was to see whether LD-1227, a quality-controlled marine nutraceuticals shown to protect experimental stress-induced hyppocampal degeneration, could beneficially modulate BDNF, as measured in the serum, in otherwise healthy but work-stressed individuals. ⋯ The present data suggest that LD-1227 is beneficially affecting neuromodulation and related symptoms during common stressful life conditions and may have the potential as tools in a neuroprotective clinical strategy.