Red Light Absorption of [ReI(CO)3(α-diimine)Cl] Complexes through Extension of the 4,4'-Bipyrimidine Ligand's π-System.

Rhenium(I) complexes of type [Re(CO)3(NN)Cl] (NN = α-diimine) with MLCT absorption in the orange-red region of the visible spectrum have been synthesized and fully characterized, including single crystal X-ray diffraction on two complexes. The strong bathochromic shift of MLCT absorption was achieved through extension of the π-system of the electron-poor bidiazine ligand 4,4'-bipyrimidine by the addition of fused phenyl rings, resulting in 4,4'-biquinazoline. Furthermore, upon anionic cyclization of the twisted bidiazine, a new 4N-doped perylene ligand, namely, 1,3,10,12-tetraazaperylene, was obtained. Electrochemical characterization revealed a significant stabilization of the LUMO in this series, with the first reduction of the azaperylene found at E1/2(0/-) = -1.131 V vs. Fc+/Fc, which is the most anodic half-wave potential observed for N-doped perylene derivatives so far. The low LUMO energies were directly correlated to the photophysical properties of the respective complexes, resulting in a strongly red-shifted MLCT absorption band in chloroform with a λmax = 586 nm and high extinction coefficients (ε586nm > 5000 M-1 cm-1) ranging above 700 nm in the case of the tetraazaperylene complex. Such low-energy MLCT absorption is highly unusual for Re(I) α-diimine complexes, for which these bands are typically found in the near UV. The reported 1,3,10,12-tetraazaperylene complex displayed the [Re(CO)3(α-diimine)Cl] complex with the strongest MLCT red shift ever reported. UV-Vis NIR spectroelectrochemical investigations gave further insights into the nature and stability of the reduced states. The electron-poor ligands explored herein open up a new path for designing metal complexes with strongly red-shifted absorption, thus enabling photocatalysis and photomedical applications with low-energy, tissue-penetrating red light in future.

Double Effects of Interfacial Ag Nanoparticles in a ZnO Multipod@Ag@Bi2S3 Z-Scheme Photocatalytic Redox System: Concurrent Tuning and Improving Charge-Transfer Efficiency.

Distinct functional materials in their combined form in a well-designed hybrid architecture offer great possibilities for creating a highly active photocatalytic system. Herein, a uniform multipod-shaped ZnO is synthesized through a natural template assisted route and progressively integrated with Ag nanoparticles (NPs) and Bi2S3 to form a three-component (3C) ternary photocatalytic system by a facile, two -step wet chemical approach. Encapsulation of polycrystalline Bi2S3 and assimilation of Ag NPs in between the interface of ZnO and Bi2S3 in the ternary hybrid are confirmed from electron microscopy and X-ray photoelectron spectroscopy, which resulted in improved UV-vis absorption, charge separation efficiency, and photocurrent response evaluated from optical absorption spectroscopy, photoluminescence, and photoelectrochemical cell measurements. This ternary hybrid shows high photoredox activity toward the hydrogen evaluation reaction (HER) (218.7 µmol h-1 g-1) and methyl orange (MO) oxidation (k = 3.21 × 10-2 min-1) compared to their binary and single counterparts. Moreover, on the basis of the estimation of the predominant active species (O2•-, •OH) in the photoredox catalysis and band edge positions from the Mott-Schottky plot, it was determined that both binary ZnO multipod@Bi2S3 and ternary ZnO multipod Ag@Bi2S3 hybrids undergo a Z-scheme electron transfer mechanism under irradiation of light. Here, the Ag ingredient in the ternary hybrids acts as an interfacial charge-transfer mediator to accelerate the Z-scheme electron transfer between Bi2S3 and ZnO along with plasmonic photosensitization to trigger the generation of plasmon-induced hot electrons. Such a cooperative concurrent dual role of Ag NPs in the Z-scheme ternary hybrid system considerably boosts the photoredox performance compared to direct Z-scheme binary hybrids. This work will enlighten and uncover the essential roles of metal NPs along with their cooperative synergy in Z-scheme photocatalytic systems as a prototypical example for substantial solar energy conversion.

Fabrication of thiosemicarbazone-based Pd(II) complexes: structural elucidations, catalytic activity towards Suzuki-Miyaura coupling reaction and antitumor activity against TNBC cells.

Currently, there are many uses of metal complexes, especially in the fields of medicinal chemistry and catalysis. Thus, fabrication of new complexes which perform as a catalyst and chemotherapeutic drug is always a beneficial addition to the literature. Herein, we report three heterocyclic thiosemicarbazone-based Pd(II) complexes [Pd(HL1)Cl] (C1), [Pd(L2)(PPh3)] (C2) and [Pd(L3)(PPh3)]Cl (C3) having coligands Cl and PPh3. Thiosemicarbazone ligands (H2L1, H2L2 and HL3) and the complexes (C1-C3) were characterized methodically using several spectroscopic techniques. Single-crystal X-ray diffraction methods reveal that the structural environment around the metal center of C2 is square planar, while for C1 and C3 it is a slighty distorted square plane. The supramolecular network of compounds was built via hydrogen bonds, C-H⋯π and π⋯π interactions. Density functional theory (DFT) study of the structure of the complexes supports experimental findings. The application of these complexes as catalysts toward Suzuki-Miyaura coupling reactions has been examined with various aryl halides and phenyl boronic acid in PEG 400 solvent. The complexes displayed good biomolecular interactions with DNA/protein, with a binding constant value of the order of 105 M-1. C3 showed greater binding efficacy toward these biomolecules than the other complexes, which might be due to the cationic nature of C3. Furthermore, antitumor activity of the complexes was studied against the human triple-negative breast cancer (TNBC) cell line MDA-MB-231. It was found that C3 was more toxic (IC50 = 10 ± 2.90 µM) toward MDA-MB-231 cells than the other complexes. A known chemotherapeutic drug, 5-fluorouracil, was included as positive control. The programmed cell death mechanism of C3 was confirmed. Additionally, complex-induced apoptosis was confirmed and occurred via a mitochondria-dependent (intrinsic) pathway.

Facile synthesis of novel NNO-tethered copper(II) complexes: characterization details, theoretical studies, promising enzyme-like activities, and biomolecular interactions.

Given the ubiquitous and multifaceted role of copper ions in various biological processes, we report herein the one-pot facile synthesis, X-ray structure, Hirshfeld surface analysis, enzyme-like activities, and biomolecular interactions of three mononuclear copper(II) complexes, [Cu(L)(X)] (1-3) with a tridentate quinoline-based salicylaldimine Schiff base (LH) having an N2O donor set where X denotes NCS, N3, and NO3 for complexes 1, 2, and 3, respectively. Single-crystal X-ray study, spectroscopic techniques, DFT, and TD-DFT calculations were all used to fully characterize the complexes. The bio-inspired catalytic activities of the synthesized complexes were spectrophotometrically evaluated for the aerial oxidation of 3,5-di-tert-butylcatechol (3,5-DTBC) and 2-aminophenol (OAPH) in acetonitrile. The results of ESI mass spectrometry, EPR analysis of the reaction mixture, and DFT computations established that the aforementioned oxidation is metal-mediated and radical-driven, leading us to propose a viable mechanistic scheme. In complex 3, coordinated nitrate probably confers greater lability, allowing it to be the most effective enzyme for catecholase and phenoxazane-synthase activities. The biological activity of complexes 1-3 and the ligand LH towards calf thymus DNA and proteins (bovine serum albumin (BSA)) was explored using absorption and fluorescence spectral titrations, which affirmed that the compounds underwent avid binding with DNA, with high binding affinities (Kb) of approximately 104-105 M-1. The observed DNA binding constants and viscosity measurement data suggested an intercalative mode of DNA binding with the copper(II) complexes. Spectral evidence also supports the high binding propensity (on the order of approximately 105 M-1) of the complexes with the protein. They actively suppressed the protein's intrinsic fluorescence in a static quenching mode, as further determined by fluorescence lifetime titration of protein with the complexes. Circular dichroism and synchronous spectroscopic experiments supported the protein's conformational alterations mediated by copper(II) complexes (1-3) in the microenvironment of the tryptophan residue of the protein. The typical binding distance between BSA and complexes was also computed using fluorescence resonance energy transfer. Of the three complexes (1-3), complex 3 stands out as the most efficacious.

Composite of graphitic carbon nitride and TiO2 as photo-electro-catalyst in microbial fuel cell.

The widespread application of surfactants and their subsequent discharge in the receiving water bodies is a very common issue in developing countries. In the present investigation, a composite of graphitic carbon nitride (GCN) and TiO2 was used as a photo-electro-catalyst in a microbial fuel cell (MFC)-based hybrid system for bio-electricity production and simultaneous pollutant removal (organic matter and sodium dodecyl sulphate, SDS). The GCN: TiO2 composite with a ratio of 70:30 (by wt. %) revealed a better electrochemical response; thus, it was used as a photo-electro-catalyst in MFC. Additionally, the photochemical characterization indicated a decrease in the band gap and charge recombination of GCN-TiO2 composite compared to standalone TiO2, which indicated a conducive effect of GCN addition. Further, on the actual use as a photo-electro-catalyst, the GCN-TiO2 catalysed MFC attained 58.2 ± 9.6% and 86.5 ± 7.1% of COD and SDS removal; while simultaneously harvesting a maximum power density of 1.07 W m-3, which was higher than standalone TiO2-catalysed MFC. The follow-up treatment in the charcoal bio-filter and photo-cathodic chamber of the hybrid system further improved the overall COD and SDS removal efficiency to 92.1 ± 2.7 and 95.6 ± 1.5%, respectively. The electro-catalytic performance of the GCN-TiO2 can be attributed to the presence of nitrogen-active species in the composite. The results of this investigation demonstrated a potential MFC-based hybrid system for the simultaneous secondary and tertiary treatment of municipal wastewater. Consequently, the outcome of this investigation indicates an innovative research direction in the field of photo-electro-catalyst, which can fit into the role of a photo-catalyst as well as an electro-catalyst.

The effect of the lunar cycle on frequency of births: a retrospective observational study in Indian population.

For ancient period moon has been held responsible for many biological activities. That way, lunar cycle, by activity of moon, has been held responsible for increase in number of child birth. In this retrospective, observational study, we examined a total of 9890 full-term spontaneous deliveries as well as non-elective cesarean sections that occurred throughout 12 lunar months (February 7 th , 2008-January 25 th , 2009) in a rural medical college to evaluate the influence of the lunar position on the distribution of deliveries among Indian population. Student's 't' test and ANOVA were used for statistical analysis where each delivery was considered as a single measure. We found no significant differences in the frequency of births during various phase of lunar cycle regardless of route of delivery. Our observations do not support the hypothesis of a relationship between lunar cycle and the frequency of obstetric deliveries.

Differential tuning of the electron transfer parameters in 1,3,5-triarylpyrazolines: a rational design approach for optimizing the contrast ratio of fluorescent probes.

A large class of cation-responsive fluorescent sensors utilizes a donor-spacer-acceptor (D-A) molecular framework that can modulate the fluorescence emission intensity through a fast photoinduced intramolecular electron transfer (PET) process. The emission enhancement upon binding of the analyte defines the contrast ratio of the probe, a key property that is particularly relevant in fluorescence microscopy imaging applications. Due to their unusual electronic structure, 1,3,5-triarylpyrazoline fluorophores allow for the differential tuning of the excited-state energy DeltaE(00) and the fluorophore acceptor potential E(A/A(-)), both of which are critical parameters that define the electron transfer (ET) thermodynamics and thus the contrast ratio. By systematically varying the number and attachment positions of fluoro substituents on the fluorophore pi-system, DeltaE(00) can be adjusted over a broad range (0.4 eV) without significantly altering the acceptor potential E(A/A(-)). Experimentally measured D-A coupling and reorganization energies were used to draw a potential map for identifying the optimal ET driving force that is expected to give a maximum fluorescence enhancement for a given change in donor potential upon binding of the analyte. The rational design strategy was tested by optimizing the fluorescence response of a pH-sensitive probe, thus yielding a maximum emission enhancement factor of 400 upon acidification. Furthermore, quantum chemical calculations were used to reproduce the experimental trends of reduction potentials, excited-state energies, and ET driving forces within the framework of linear free energy relationships (LFERs). Such LFERs should be suitable to semiempirically predict ET driving forces with an average unsigned error of 0.03 eV, consequently allowing for the computational prescreening of substituent combinations to best match the donor potential of a given cation receptor. Within the scaffold of the triarylpyrazoline platform, the outlined differential tuning of the electron transfer parameters should be applicable to a broad range of cation receptors for designing PET sensors with maximized contrast ratios.

A rare association of familial exudative vitreoretinopathy and Turner's syndrome.

A 6-year-old girl presented with left divergent strabismus that had been noticed by her parents. She was known to have Turner's syndrome. On examination, she had tractional retinal detachment in the left eye and a temporal avascular area with neovascularization at the junction with the vascular area. Clinical features were characteristic of familial exudative vitreoretinopathy. This case is a rare and, to the authors' knowledge, the first reported association of familial exudative vitreoretinopathy and Turner's syndrome.

Recurrent neovascularization of the disc in sympathetic ophthalmia.

Sympathetic ophthalmia following parsplana vitrectomy is a known complication. We describe here a case of recurrent disc neovascularization in a patient of sympathetic ophthalmia. It promptly responded to steroids initially but later recurred with inflammation.

Synthesis of 2-substituted 9-oxa-guanines {5-aminooxazolo[5,4-d]pyrimidin-7(6H)-ones} and 9-oxa-2-thio-xanthines {5-mercaptooxazolo[5,4-d]pyrimidin-7(6H)-ones}.

Oxazolo[5,4-d]pyrimidines can be considered as 9-oxa-purine analogs of naturally occurring nucleic acid bases. Interest in this ring system has increased due to recent reports of biologically active derivatives. In particular, 5-aminooxazolo[5,4-d]pyrimidine-7(6H)-ones (9-oxa-guanines) have been shown to inhibit ricin. The preparation of a series of 2-substituted 5-aminooxazolo[5,4-d]pyrimidin-7(6H)-ones and related 5-thio-oxazolo[5,4-d]pyrimidines is described, including analogs suitable for further elaboration employing "click" chemistry utilizing copper-catalyzed Huisgen 1,3-dipolar cycloadditions. Two of the compounds prepared were found to inhibit ricin with IC(50)ca. 1-3 mM.

Strategic Synthesis of SiO2-Modified Porous Co3O4 Nano-Octahedra Through the Nanocoordination Polymer Route for Enhanced and Selective Sensing of H2 Gas over NO x.

In this work, a strategic synthesis of Co3O4 nano-octahedra was developed through the facile nanoscale coordination polymer (NCP) route, which was further modified by SiO2 to be used as a sensor for enhanced sensing of hydrogen. The Co(II)-NCP-derived Co3O4 octahedra and SiO2-modified Co3O4 octahedra were characterized using Fourier transform infrared, powder X-ray diffraction, Brunauer-Emmett-Teller, thermogravimetric analysis, field emission scanning electron microscopy, high-resolution transmission electron microscopy, X-ray photoelectron spectroscopy, and hydrogen temperature-programmed reduction (H2TPR) techniques. The SiO2-modified Co3O4 sensor exhibited a stronger and selective electrical response to H2 gas over NO x at 225 °C than Co(II)-NCP-derived Co3O4 octahedra and the conventional Co3O4 powder. The composite sensor shows faster recovery and significant repeatability than the other two. The enhancement in the sensing performance of the SiO2-modified Co3O4 octahedron was explained by the effectiveness of surface modification, controlled morphology, and combination of synergistic effect of Co3O4 and SiO2. Surface engineering of the as-prepared Co3O4 nano-octahedra with an exposed (111) surface plane and later SiO2 modification facilitates effective gas adsorption, resulting in enhancement in sensing and selectivity over NO x . The details of the synergistic effect and the plausible reasons for the improvement in gas-sensing parameters are discussed here. This study would offer new directions for development on the controlled synthesis of porous materials, in general, and in gas sorption or sensing, in particular.

Comparative evaluation of analgesic sparing efficacy between dexmedetomidine and clonidine used as adjuvant to ropivacaine in thoracic paravertebral block for patients undergoing breast cancer surgery: A prospective, randomized, double-blind study.

INTRODUCTION: Thoracic paravertebral block (TPVB) is an effective method for intra- and post-operative pain management in thoracic surgeries. For a long time, various adjuvants have been tried for prolonging the duration of TPVB. OBJECTIVE: In this prospective study, we have compared the analgesic sparing efficacy of dexmedetomidine and clonidine, two α2 adrenergic agonists, administered along with ropivacaine for TPVB for breast cancer surgery patients. MATERIALS AND METHODS: Forty-four breast cancer surgery patients undergoing general anesthesia (GA) were randomly divided into Group C and Group D (n = 44 each) receiving preoperative TPVB at T3-5 level with 0.5% ropivacaine solution admixture with clonidine and dexmedetomidine, respectively. Cancer surgery was performed under GA. Intraoperative fentanyl and propofol requirement was compared. Visual analogue scale was used for pain assessment. Total dose and mean time to administration of first rescue analgesic diclofenac sodium was noted. Side effects and hemodynamic parameters were also noted. RESULTS: Intraoperative fentanyl and propofol requirement was significantly less in dexmedetomidine group than clonidine. The requirement of diclofenac sodium was also significantly less and later in Group D than Group C. Hemodynamics, and side effects were comparable among two groups. CONCLUSION: Dexmedetomidine provided better intraoperative as well as postoperative analgesia than clonidine when administered with ropivacaine in TPVB before breast cancer surgery patients without producing remarkable side effects.

Intravitreal bevacizumab for subfoveal idiopathic choroidal neovascularization.

OBJECTIVES: To evaluate the short-term visual and anatomical outcomes and safety of intravitreal bevacizumab in subfoveal idiopathic choroidal neovascularization. METHODS: Thirty-two eyes of 32 patients with idiopathic choroidal neovascularization received intravitreal bevacizumab (1.25 mg/0.05 mL) in this prospective, noncomparative, interventional case series. Injection was repeated if optical coherence tomography showed intraretinal edema, subretinal fluid, and/or pigment epithelial detachment at a 4-week interval. Ophthalmic evaluations included best-corrected visual acuity, optical coherence tomography, and fundus fluorescein angiography. Patients were followed up for at least 12 weeks. RESULTS: The mean follow-up period was 4.2 months. At 12 weeks, the mean best-corrected visual acuity improved from 20/133 (median, 20/200) to 20/50 (median, 20/40) (P < .001). The mean central macular thickness was reduced from 314.37 microm to 236.84 microm (P < .001). At the final visit, 19 eyes (59%) had an improvement of best-corrected visual acuity of 3 or more lines, 11 eyes (34%) remained stable, and 2 eyes (6%) lost 3 or more lines. No significant ocular or systemic adverse effects were observed. CONCLUSIONS: Short-term results suggest that intravitreal bevacizumab is safe and well tolerated in idiopathic choroidal neovascularization. Many patients showed marked improvement in visual acuity and a decrease in central macular thickness. Further evaluation with longer follow-up is needed to confirm long-term efficacy and safety.

Microincision cataract surgery in a vitrectomized eye.

Phacoemulsification after vitrectomy is associated with several intraoperative problems. We describe the use of bimanual microincision cataract surgery using an 18-gauge needle as the irrigating chopper combined with silicone oil removal in a vitrectomized eye. This technique may offer a safe alternative to standard phacoemulsification in such cases.

Safety and efficacy of intraoperative intravitreal injection of triamcinolone acetonide injection after phacoemulsification in cases of uveitic cataract.

PURPOSE: To evaluate the safety and efficacy of a single intraoperative intravitreal injection of triamcinolone acetonide after phacoemulsification in patients with chronic idiopathic anterior uveitis or intermediate uveitis. SETTING: Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. METHODS: This prospective randomized controlled study included 40 eyes (40 patients) with chronic idiopathic anterior uveitis or intermediate uveitis that had phacoemulsification with intraocular lens implantation. Twenty eyes received an intravitreal injection of triamcinolone acetonide (4 mg/0.1 mL) intraoperatively (triamcinolone acetonide group), and 20 received oral steroids (steroid group) postoperatively. Outcome measures were Early Treatment Diabetic Retinopathy Study best corrected visual acuity (BCVA), anterior chamber reaction, intraocular pressure (IOP) by applanation tonometry, and central macular thickness by optical coherence tomography. RESULTS: The mean BCVA (decimal) improved from a baseline of 0.13 +/- 0.14 to 0.64 +/- 0.32 in the triamcinolone acetonide group and from 0.05 +/- 0.06 to 0.61 +/- 0.36 in the steroid group (P = .74). There were no statistically significant differences between the 2 groups in postoperative anterior chamber reaction, IOP, or central macular thickness. Four patients in the triamcinolone acetonide group and 5 in the steroid group had recurrence of uveitis; 5 patients in the triamcinolone acetonide group had ocular hypertension. One patient in the triamcinolone acetonide group and 3 in the steroid group had cystoid macular edema postoperatively. CONCLUSION: A single intraoperative intravitreal injection of triamcinolone acetonide seemed to be a safe and efficacious route of steroid delivery during phacoemulsification in patients with chronic idiopathic anterior uveitis or intermediate uveitis and is recommended as a substitute for postoperative oral steroid administration.

Bilateral lens subluxation in a case of lipoid proteinosis.

We report a patient who presented with pain, redness, and diminution of vision in the right eye and low vision in the left eye. Ophthalmologic examination showed characteristic eyelid lesions, anterior dislocation of the crystalline lens in the right eye, and nasal subluxation in the left eye. The patient's voice was hoarse, and he had skin lesions. After histopathologic examination of the skin biopsy, lipoid proteinosis (LP) was diagnosed. Bilateral pars plana lensectomy was performed. The ophthalmic manifestations of LP are discussed.

Comparison of anterior segment optical coherence tomography and ultrasound biomicroscopy for assessment of the anterior segment.

PURPOSE: To compare anterior segment parameters using quantitative imaging by anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM). SETTING: Tertiary-care glaucoma research center. METHODS: Sixty-three eyes of 63 subjects had anterior segment evaluation by AS-OCT (Visante-Zeiss) and UBM (Paradigm). Central corneal thickness (CCT), anterior chamber depth (ACD) (measured from the central corneal endothelium to the anterior lens capsule), and the peripheral iridocorneal angles (temporal and nasal) were assessed and compared. RESULTS: There was an excellent correlation between AS-OCT and UBM measurements for the nasal angle (r = 0.84; P<.0001), temporal angle (r = 0.86; P<.0001), ACD (r = 0.97; P<.0001), and CCT (r = 0.91; P<.0001). There was no significant difference (paired t test) between the mean ACD, CCT, and angle parameters measured by AS-OCT or UBM. The mean values of the parameters measured by AS-OCT and UBM were, respectively, as follows: nasal angle, 26.25 degrees +/- 11.0 (SD) and 28.27 +/- 11.3 degrees (P = .3); temporal angle, 25.1 +/- 11.4 degrees and 28.3 +/- 13.5 degrees (P = .15); ACD, 2.85 +/- 0.5 mm and 2.78 +/- 0.5 mm (P = .2); and CCT, 512 +/- 46 microm and 502 +/- 46 microm (P = .25). The AS-OCT images showed sharper definition of the scleral spur than the UBM images. CONCLUSION: Anterior segment optical coherence tomography and UBM can both be used for anterior segment measurements and yielded comparable results.

Perineural Nalbuphine in Ambulatory Upper Limb Surgery: A Comparison of Effects of Levobupivacaine with and without Nalbuphine as Adjuvant in Supraclavicular Brachial Plexus Block - A Prospective, Double-blinded, Randomized Controlled Study.

BACKGROUND AND AIMS: Various opioid additives have been trialed to prolong brachial plexus block. We evaluated the effect of adding nalbuphine hydrochloride to levobupivacaine for supraclavicular brachial plexus blockade. The primary end-points were the onset and duration of sensory and motor blocks and duration of analgesia. MATERIALS AND METHODS: Seventy-eight patients (aged 25-45 years) posted for ambulatory forearm and hand surgery under supraclavicular brachial plexus block were divided into two equal groups (Groups LN and LC) in a randomized, double-blind fashion. In Group LN (n = 39), 30 ml 0.5% levobupivacaine + 10 mg (diluted in 2 ml 0.9% saline) nalbuphine hydrochloride, and in Group LC (n = 39), 30 ml 0.5% levobupivacaine + 2 ml normal saline (0.9%) were administered in supraclavicular block. Sensory and motor block onset times and block durations, time to first analgesic use, total analgesic need, postoperative visual analog scale (VAS), hemodynamics, and side effects were recorded for each patient. RESULTS: Although with similar demographic profile and block (sensory and motor) onset time, sensory and motor block duration and time to first analgesic use were significantly longer and the total need for rescue analgesics was lower in Group LN (P < 0.05) than Group LC. Postoperative VAS value at 24 h was significantly lower in Group LN (P < 0.05). Intraoperative hemodynamics was comparable between two groups, and no any appreciable side effect was noted throughout the study period. CONCLUSION: It can be concluded that adding nalbuphine hydrochloride to supraclavicular brachial plexus block increases the sensory and motor block duration and time to first analgesic use, and decreases total analgesic use with no side effects.

Postoperative Sore Throat Prevention in Ambulatory Surgery: A Comparison between Preoperative Aspirin and Magnesium Sulfate Gargle - A Prospective, Randomized, Double-blind Study.

BACKGROUND: Postoperative sore throat (POST) frequently hampers the positive feedback of ambulatory surgery in spite of so many measures. This study was carried out to compare the efficacy of preoperative magnesium sulfate and aspirin gargle in preventing POST after ambulatory surgery. MATERIALS AND METHODS: It was a prospective, randomized, and double-blinded study. Fifty-six adult patients of either sex, aged 25-50, of American Society of Anesthesiologists physical status I-II, scheduled for day care surgery, were randomly allocated to Group A ([n = 28] receiving aspirin gargle [325 mg tablet]) and Group M ([n = 28] receiving magnesium sulfate [20 mg/kg] gargle). In both groups, the medications were made into 20 mL of (5% dextrose) solution. Patients were asked to gargle with this mixture for 30 s, 15 min before induction of anesthesia. Episodes of POST were measured at 0, 2, 4, 6, 9, 12, and 16 h postoperatively with a four-point scale. RESULTS: Both groups had a similar demographic profile with comparable oxygen saturation, hemodynamics, and consciousness status at immediate postoperative period. Number of patients with sore throat was significantly lower in magnesium group compared to aspirin group at 0 h (P = 0.0376), 2 h (P = 0.0429), 4 h (P = 0.0394) after the operation. POST pain score (visual analog scale) was significantly (P < 0.05) lower in magnesium group compared to aspirin group after the operation at 0, 2, 4 h after operation. CONCLUSION: It is evident that preoperative magnesium sulfate gargle significantly attenuated the incidence and severity of POST, especially in the early postoperative period, with no adverse effects in patients undergoing day care surgery under general anesthesia.

Effect of Clonidine as Adjuvant in Thoracic Paravertebral Block for Patients Undergoing Breast Cancer Surgery: A Prospective, Randomized, Placebo-controlled, Double-blind Study.

BACKGROUND AND AIMS: Postoperative pain after breast cancer surgery is unavoidable. Thoracic paravertebral block (TPVB), a locoregional anesthetic technique, has been proven successful for postoperative pain management in different thoracic surgical procedures, such as thoracotomy, breast cancer surgeries. Clonidine, an adjuvant, in TPVB may enhance the quality and prolong the duration of analgesia. This prospective study was to evaluate the effectiveness of clonidine; administered with TPVB; in addition to conventional local anesthetic solution. MATERIALS AND METHODS: Fifty-two patients (25-55 years) scheduled for breast cancer surgery under general anesthesia were randomly divided into Group A (n = 26) receiving preoperative TPVB at T3 with clonidine added to local anesthesia solution and Group B (n = 26) receiving identical TPVB with local anesthesia but without any adjuvant. This was followed by balanced general anesthesia. A visual analog scale was used to assess pain postoperatively up to 48 h. Meantime to administration of the first dose of rescue analgesic was noted. Total dose of fentanyl consumption, hemodynamic parameters, and side effects were all recorded for each patient. RESULTS: The dosage of fentanyl required in the intraoperative period was significantly lower in Group A. Mean time to administration of rescue analgesic was found to be significantly longer in clonidine group. Hemodynamics and side effects were quite comparable among two groups. CONCLUSION: Clonidine as adjuvant in TPVB provided profound analgesia for up to 48 h postoperatively for patients undergoing breast cancer surgery without any appreciable side effects.