Normative Hand Strength Values for the Healthy Adult Trinbagonian Population and Comparison to International Data.

INTRODUCTION: It has been well established that grip strength measurements can be useful as a benchmark for comparing the efficacy of different treatment modalities as well as an aid in the assessment of the progress of disease and rehabilitation. Grip strength has also been shown to be a representative marker for sociodemographic factors. METHODS: Participants were selected from five different regions in a cross-sectional manner from the streets of Trinidad and Tobago, and a Jamar hand dynamometer was used to assess the metrics of hand grip, palmar grip, tip pinch, and key pinch across both hands. Data was analyzed comparing right and left as well as dominant and non-dominant hands, and participants were classified by occupation. RESULTS: We enrolled 1233 participants in this study, of which the majority were female (54.5%). 90% of participants were right-hand dominant. The mean hand strength of the dominant hand was significantly greater than the non-dominant for all four strengths assessed. Participants of Afro-Trinbagonian descent were shown to have the highest mean values overall. We found no significant relationship between occupational intensity and mean grip strengths. For the male population, it was found that height, age, and BMI were all significant predictors of hand strength. This was notably only so for a minority of the female population tested. CONCLUSION: This study serves to provide the normative data for the adult healthy Trinbagonian population. Further research to determine better predicative variables specific to the female population is needed.

Recurrent Hypoglycemia in a Non-diabetic Female: A Case Study on Doege-Potter Syndrome.

Solitary fibrous tumors (SFT) are mesenchymal cell tumors that may arise from any site throughout the body. A small percentage of patients with SFT develop non-islet cell tumor-induced hypoglycemia (NICTH), eponymously termed Doege-Potter Syndrome (DPS). DPS is characterized by severe, refractory hypoinsulinemic hypoglycemia. Diagnosis of SFT is dependent on histologic findings and immunohistochemistry (IHC). NAB2-STAT6 gene fusions are pathognomonic for SFT but may be difficult to identify in routine cytogenetic studies. STAT6 IHC is a highly sensitive and specific surrogate for the NAB2-STAT6 gene fusion. Total resection of the tumor remains the gold-standard definitive treatment of SFT of the pleura. Palliative tumor debulking is recommended if total resection is not feasible. We here report a case of DPS in a 73-year-old female, managed with palliative care.

Network Pharmacology, Molecular Docking, and Molecular Dynamics Simulation Analysis Reveal Insights into the Molecular Mechanism of Cordia myxa in the Treatment of Liver Cancer.

Traditional treatments of cancer have faced various challenges, including toxicity, medication resistance, and financial burdens. On the other hand, bioactive phytochemicals employed in complementary alternative medicine have recently gained interest due to their ability to control a wide range of molecular pathways while being less harmful. As a result, we used a network pharmacology approach to study the possible regulatory mechanisms of active constituents of Cordia myxa for the treatment of liver cancer (LC). Active constituents were retrieved from the IMPPAT database and the literature review, and their targets were retrieved from the STITCH and Swiss Target Prediction databases. LC-related targets were retrieved from expression datasets (GSE39791, GSE76427, GSE22058, GSE87630, and GSE112790) through gene expression omnibus (GEO). The DAVID Gene Ontology (GO) database was used to annotate target proteins, while the Kyoto Encyclopedia and Genome Database (KEGG) was used to analyze signaling pathway enrichment. STRING and Cytoscape were used to create protein-protein interaction networks (PPI), while the degree scoring algorithm of CytoHubba was used to identify hub genes. The GEPIA2 server was used for survival analysis, and PyRx was used for molecular docking analysis. Survival and network analysis revealed that five genes named heat shot protein 90 AA1 (HSP90AA1), estrogen receptor 1 (ESR1), cytochrome P450 3A4 (CYP3A4), cyclin-dependent kinase 1 (CDK1), and matrix metalloproteinase-9 (MMP9) are linked with the survival of LC patients. Finally, we conclude that four extremely active ingredients, namely cosmosiin, rosmarinic acid, quercetin, and rubinin influence the expression of HSP90AA1, which may serve as a potential therapeutic target for LC. These results were further validated by molecular dynamics simulation analysis, which predicted the complexes with highly stable dynamics. The residues of the targeted protein showed a highly stable nature except for the N-terminal domain without affecting the drug binding. An integrated network pharmacology and docking study demonstrated that C. myxa had a promising preventative effect on LC by working on cancer-related signaling pathways.

The connectivity indices concept of neutrosophic graph and their application of computer network, highway system and transport network flow.

To address information ambiguities, this study suggests using neutrosophic sets as a tactical tool. Three membership functions (called T r , I n , and F i ) that indicate an object's degree of truth, indeterminacy, and false membership constitute the neutrosophic set. It becomes clear that the neutrosophic connectivity index (CIN) is an essential tool for solving practical problems, especially those involving traffic network flow. To capture uncertainties, neutrosophic graphs are used to represent knowledge at different membership levels. Two types of C I N s , mean CIN and CIN, are investigated within the framework of neutrosophic graphs. In the context of neutrosophic diagrams, certain node types-such as neutrosophic neutral nodes, neutrosophic connectivity reducing nodes (NCRN) , and neutrosophic graph connectivity enhancing nodes (NCEN) , play important roles. We concentrate on two types of networks, specifically traffic network flow, to illustrate the real-world uses of CIN. By comparing results, one can see how junction removal affects network connectivity using metrics like Connectivity Indexes (CIN) and Average Connectivity Indexes (ACIN) . A few nodes in particular, designated by ACIN as Non-Critical Removal Nodes ( N C R N s ) , show promise for increases in average connectivity following removal. To fully comprehend traffic network dynamics and make the best decisions, it is crucial to take into account both ACIN and CIN insights. This is because different junctions have different effects on average and overall connectivity metrics.

A Retrospective Study of Ocular Cancer in Saudi Arabia: 25-Year Analysis.

Background: Ocular malignancies are uncommon among eye diseases; however, they jeopardize both vision and life. The main objective of this study was to use to describe the epidemiology of eye and ocular adnexa malignancies across different ages and sex. Methods: The King Khaled University institutional review board approved this study. Data on ocular cancer were retrieved from the Saudi Cancer Registry between 1994 and 2018. The registry collected important patient information such as demographic information (age, gender, and nationality), clinical details, and tumor classification. Results: The total number of cases with ocular cancer diagnosed was 1051 cases. The highest number was recorded in Riyadh (35.39%, n=372), followed by Makkah (16.93%, n=178). The incidence was higher in the 0-4 years' age group (55.21%), and it got down as people got older. The data also revealed differences in the number of reported cases over time, as well as in the representation of eye cancer cases by gender and nationality. While many ocular cancer pathologies were seen, with "Retinoblastoma, not otherwise specified" being the most common (53.32%), the incidence rates for males and females remained largely stable over time. Conclusion: The study emphasizes the need for continued monitoring, research, and analysis of potential of epidemiology of ocular cancer occurrence in Saudi Arabia. Identifying the geographical distribution and age pattern of Ocular malignancies have the potential to assist healthcare authorities and policymakers in developing precise strategies to reduce, recognize at an early stage, and successfully manage this condition.

Knowledge assessment on cleft lip and palate among recently graduated dentists: a cross-sectional study.

BACKGROUND: The complex presentation, associated co-morbidities and multi-disciplinary requirements dictate the requirement for in-depth knowledge in order to effectively manage patients with cleft lip and palate (CLP). We aimed to develop a validated questionnaire for cleft lip and palate knowledge assessment and to evaluate the knowledge of cleft lip and palate among a group of recently-graduated dentists. MATERIALS AND METHODS: A multiple-site, cross-sectional questionnaire-based study was conducted. The study population included recently graduated dentists involved in a dental internship program. A bespoke questionnaire was developed and validated, with internal consistency assessed using Cronbach's alpha and factor analysis performed. A 47-item prototype was distilled into a 15-item questionnaire. This was distributed to the participants with a response rate of 67% obtained. RESULTS: The overall proportion of correct responses among dental interns was moderate (73%). The best results were found in relation to CLP treatment including the effect of unfavorable surgical outcomes on speech (89.5%) and the impact of CLP on the occlusion (87.6%). The lowest rate of correct responses (26.7%) was identified in relation to the association between CLP and smoking. CONCLUSION: A validated CLP questionnaire was developed, permitting evaluation of the knowledge of cleft lip and palate and its management among recently graduated dentists. There is limited appreciation among dental interns of the risk factors for CLP as well as post-surgical complications. Given that general dentists are often the gatekeepers for the management of patients with cleft lip and palate, it is important that the findings of this survey are used to inform the curriculum and teaching of cleft lip and palate.

Regulation of iron metabolism is critical for the survival of Salmonella Typhimurium in pasteurized milk.

Salmonella is known to survive in raw/pasteurized milk and cause foodborne outbreaks. Lactoferrin, present in milk from all animal sources, is an iron-binding glycoprotein that limits the availability of iron to pathogenic bacteria. Despite the presence of lactoferrins, Salmonella can grow in milk obtained from different animal sources. However, the mechanism by which Salmonella overcomes iron scarcity induced by lactoferrin in milk is not evaluated yet. Salmonella employs the DNA binding transcriptional regulator Fur (ferric update regulator) to mediate iron uptake during survival in iron deplete conditions. To understand the importance of Fur in Salmonella milk growth, we profiled the growth of Salmonella Typhimurium Δfur (ST4/74Δfur) in both bovine and camel milk. ST4/74Δfur was highly inhibited in milk compared to wild-type ST4/74, confirming the importance of Fur mediated regulation of iron metabolism in Salmonella milk growth. We further studied the biology of ST4/74Δfur to understand the importance of iron metabolism in Salmonella milk survival. Using increasing concentrations of FeCl3, and the antibiotic streptonigrin we show that iron accumulates in the cytoplasm of ST4/74Δfur. We hypothesized that the accumulated iron could activate oxidative stress via Fenton's reaction leading to growth inhibition. However, the inhibition of ST4/74Δfur in milk was not due to Fenton's reaction, but due to the 'iron scarce' conditions of milk and microaerophilic incubation conditions which made the presence of the fur gene indispensable for Salmonella milk growth. Subsequently, survival studies of 14 other transcriptional mutants of ST4/74 in milk confirmed that RpoE-mediated response to extracytoplasmic stress is also important for the survival of Salmonella in milk. Though we have data only for fur and rpoE, many other Salmonella transcriptional factors could play important roles in the growth of Salmonella in milk, a theme for future research on Salmonella milk biology. Nevertheless, our data provide early insights into the biology of milk-associated Salmonella.

Multifocal malignant peripheral nerve sheath tumor in patients with neurofibromatosis type I: Report of two cases and review of literature.

Background: Malignant peripheral nerve sheath tumors (MPNSTs) are one of the rarest soft-tissue sarcomas with a prevalence of 0.001% in the general population. It is closely associated with a unique neurocutaneous stigmata under the spectrum of the dermatological manifestations of neurofibromatosis type 1 (NF1). Almost 81% of MPNST arises from a precursor neuroma, and multifocality of these lesions is extremely rare, making up to 0.001% of cases. Moreover, spinal cases are extremely uncommon with only four cases reported internationally. Here, we present the fifth and sixth spinal MPNST cases with a brief review of literature. Case Description: We describe two unusual cases of multifocal MPNST in relation to NF1 occurring in the spinal cord. Both patients presented with local pain and myelopathic symptoms. The two patients underwent wide surgical resection, followed by neoadjuvant radiotherapy and reported immediate postoperative improvement of the presented complaint; however, one patient suffered from rapid recurrence and metastasis. Conclusion: Due to the scarcity of spinal cases related to MPNST, no clear guidelines regarding the management of these cases are set in the literature. Histopathological diagnosis remains as the most pivotal diagnostic tool as they can mimic other peripheral nerve sheath lesions, such as neuromas and schwannomas, in imaging. Cases that were managed by early surgical intervention in addition to neoadjuvant radiotherapy reported the best outcome. However, cases of MPNST in concomitance with NF1 were found to be resistant to both chemo and radiotherapy and have high recurrence rate.

Operative management and outcomes in patients with myxomas: A single-center experience.

Background: Cardiac myxoma is a rare cardiac tumor that may be asymptomatic or can cause embolization or intracardiac obstruction, leading to heart failure, sudden cardiac death, and arrhythmia. This study aims to report an 11-year experience of a single center in the management of cardiac myxoma. Method: This study is a single-center retrospective case series. Eighty cases of cardiac myxoma were collected in Ibn Albitar's specialized center for cardiac surgery. Transthoracic echocardiography was used to make the preoperative diagnosis in all patients. The surgeries were undertaken through the standard approach of a median sternotomy. All four cardiac chambers were thoroughly explored for additional myxomas. The major objective of the operations was complete tumor resection. Result: The mean age of the patients was 46.3 years. Females (67.5%) were predominant over males (32.5%). Shortness of breath was the most common symptom (86.25%). The left atrium was the most affected site (83.75%), followed by the right atrium (13.75%). Coronary artery bypass grafting was required as the secondary or associated intervention in 19 (23.75%) cases. The recurrence rate was 11.25%, with a mortality rate of 3.75%. Conclusion: Recurrence and tumor embolism are risks of surgical intervention for myxoma. Good preparation using transthoracic echocardiography as a diagnostic tool and standard median sternotomy to complete resection of the tumors can decrease the rate of recurrence, embolism, and even mortality.

Endovascular Biopsy of an Inferior Vena Cava Mass: A Case Report.

We describe the case of an 82-year-old female referred to the vascular clinic for further evaluation and management of suspected inferior vena cava (IVC) thrombosis. She had previously presented to the general practitioner with a one-week history of vague abdominal pain in the right and left loins. Contrast-enhanced magnetic resonance imaging (MRI) of the abdomen and magnetic resonance angiography/magnetic resonance venography (MRA/MRV) revealed a 10 cm filling defect in the IVC, with the inferior margin of ≈5.8 cm proximal to the aortic bifurcation and its superior margin in the intrahepatic portion of the IVC. The filling defect had a transverse diameter of 2.6 cm and displayed heterogenous enhancement with contrast. We performed an endovascular biopsy with fluoroscopy (anteroposterior {AP} and lateral views) being utilized throughout the procedure to locate the mass and position the forceps in the tumor bed. The IVC was accessed via the right common femoral vein with a 10F catheter sheath. The sheath was advanced using the Seldinger technique to within ≈1 cm of the mass; then, a biopsy forceps (Micro-Tech single-use 8.5 mm biopsy forceps, Nanjing, China) was inserted, and six tissue samples were obtained. We report this case to add to the growing evidence that endovascular biopsy of IVC tumors can be performed safely and effectively.

Acute gastroenteritis-related acute kidney injury in a tertiary care center.

BACKGROUND: Acute gastroenteritis (AGE) can cause acute kidney injury (AKI) via hypoperfusion mechanisms. Early detection of AKI caused by AGE can significantly decrease mortality rates. In Saudi Arabia, studies investigating the association between AGE and AKI are limited; thus, we aimed to fill this knowledge gap. OBJECTIVES: Analyze all cases of AGE reported in tertiary-care hospitals to assess the prevalence of AKI among AGE patients. DESIGN: Retrospective cohort SETTINGS: Single tertiary-care center PATIENTS AND METHODS: The study included patients treated for AGE between October 2017 and October 2022. Stool culture was used to diagnose AGE. Inclusion criteria were infective diarrhea and/ or vomiting, and availability of data (demographics, comorbidities, malignancies, length of hospital stay, vital signs at the time of diagnosis, dehydration, causative agents of diarrhea, hemodialysis status, and laboratory data. MAIN OUTCOME MEASURES: Prevalence of AKI among AGE patients and factors associated with development of AKI. SAMPLE SIZE: 300 patients diagnosed with AGE. RESULTS: Of the 300 patients with AGE, 41 (13.6%) had AKI, those older than 60 years were more likely to develop AKI. The most frequent cause of AGE was Salmonella spp. (n=163, 53.3%), whereas AKI was most common in Clostridium difficile AGE patients (n=21, 51.2%). Furthermore, the most common comorbidity in the present study was malignancy, especially leukemia and lymphoma the risk of AKI was independently associated with mild dehydration, higher serum urea concentrations and low GFR values. CONCLUSIONS: Patients hospitalized for diarrheal disease are at an increased risk of developing AKI due to dehydration and comorbid conditions. It is crucial to keep kidney function in mind for AGE patients as this is associated with a high mortality rate and poor prognosis. LIMITATIONS: The main limitation of this study was its retrospective design. Another limitation is that it is limited to a single center. CONFLICTS OF INTEREST: None.

Bentall procedure as a lifesaving surgery: A single center experience.

The Bentall procedure is a surgical technique used in the management of aortic root abnormalities with ascending aorta and aortic valve issues. The present study aimed to evaluate the outcomes of 18 patients treated with the Bentall procedure in a single center. The present study was a single-center retrospective case series conducted over a period of 3 years. The patients had either acute ascending dissection and/or dilated ascending aorta with aortic valve dysfunction. The Bentall procedure was performed via standard median sternotomy. St. Jude Medical composite grafts with a valve were applied in all cases. A total number of 18 patients with either acute ascending dissection and/or dilated ascending aorta with aortic valve dysfunction were included in the study. The age of the participants ranged from 27-60 years. The ratio of males to females was 16:2 (males, 88.8%). The symptoms developed 3-4 days prior to hospital admission. Chest pain was the most common presenting symptom (n=10, 55.5%). Hypertension was the most common risk factor (n=12, 66.6%). In total, 14 cases underwent emergency surgery (77.7%). The emergency surgery was performed in 9 patients within 24 h of arrival owing to the association of aortic root dissection with tamponade. For the other cases, the surgery was performed within 2 and 7 days (n=5, 27.7% and n=4, 22.2%) respectively. Early post-operative complications occurred in 5 patients (27.7%). On the whole, as demonstrated herein, the modifications of the Bentall procedure have a notable impact on decreasing the overall mortality rates. Raising the awareness of clinicians and the general population as regards aortic dissection may aid in the early referral of patients to specialized centers and may thus decrease the overall mortality rate.

Osteoporosis treatment by mesenchymal stromal/stem cells and their exosomes: Emphasis on signaling pathways and mechanisms.

Osteoporosis is the loss of bone density, which is one of the main problems in developed and developing countries and is more common in the elderly. Because this disease is often not diagnosed until a bone fracture, it can become a life-threatening disease and cause hospitalization. With the increase of older people in a population, this disease's personal and social costs increase year by year and affect different communities. Most current treatments focus on pain relief and usually do not lead to bone tissue recovery and regeneration. But today, the use of stem cell therapy is recommended to treat and improve this disease recovery, which helps restore bone tissue by improving the imbalance in the osteoblast-osteoclast axis. Due to mesenchymal stromal/stem cells (MSCs) characteristics and their exosomes, these cells and vesicles are excellent sources for treating and preventing the progression and improvement of osteoporosis. Due to the ability of MSCs to differentiate into different cells and migrate to the site of injury, these cells are used in tissue regenerative medicine. Also, due to their contents, the exosomes of these cells help regenerate and treat various tissue injuries by affecting the injury site's cells. In this article, we attempted to review new studies in which MSCs and their exosomes were used to treat osteoporosis.

Frequency of Stroke and Factors Associated With It Among Old Age Hypertensive Patients in Karachi, Pakistan: A Cross-Sectional Study.

INTRODUCTION: Worldwide, stroke has become the major cause of mortality and morbidity among the old age population. Hypertension is one of the factors associated with stroke. Individuals with hypertension are at high risk of developing stroke. This study was conducted to determine the frequency of stroke factors associated with it among old-age hypertensive patients in Karachi, Pakistan. METHODS: It was a cross-sectional study conducted in outpatient departments (OPD) of two tertiary care hospitals of Karachi, Pakistan, including Jinnah Postgraduate Medical Center (JPMC) and Ziauddin Hospital. Eligible patients were invited to be a part of the study, and informed consent was taken from them before data collection. RESULTS: Multivariable logistic regression analysis showed that age (adjusted odds ratio [AOR]: 1.06, 95% CI: 1.03-1.11), smoking (AOR: 1.76, 95% CI: 1.14-2.72), lack of physical activity (AOR:2.57, 95% CI: 1.60-4.14), medication adherence (AOR: 4.22, 95% CI: 2.69-6.62), and dyslipidemia (AOR: 1.98, 95% CI: 1.23-3.21) were significantly related to prevalence of stroke in hypertensive population over 60 years or above. CONCLUSION: The prevalence of stroke was high in the hypertensive population aged above 60 years and above. The study found that factors significantly associated with stroke among the hypertensive population aged 60 years or above, included age, smoking, lack of physical activity, medication adherence, BMI, and dyslipidemia.

Determinants of Hypertension Among Patients With Type 2 Diabetes Mellitus in Karachi, Pakistan: A Cross-Sectional Study.

INTRODUCTION: Hypertension is the persistent rise of systemic arterial blood pressure. Among diabetic patients, hypertension is one of the important public health challenges. The frequency of hypertension among diabetic patients is almost twice than that of non-diabetic patients. This study aims to determine the determinants of hypertension among type 2 diabetes patients in Karachi, Pakistan. METHODOLOGY: This was a cross-sectional study conducted in diabetic clinics of a tertiary care hospital from August 2020 to August 2021. The source population included all adult patients with type 2 diabetes at the follow-up clinic of Liaquat National Hospital and Aga Khan Hospital. Data collection was done using a structured interviewer-administered questionnaire. REDCap software (Vanderbilt University, Nashville, TN) was used for the data collection. RESULTS: A total of 610 patients were included in the study. The mean age of participants was 57.37 (±11.32) years. The overall prevalence of hypertension among diabetic patients was 39.84%. Age, physical activity, family history of hypertension, smoking status, BMI, sedentary lifestyle, stress level, and serum creatinine were independent determinants of hypertension among people with type 2 diabetes mellitus. CONCLUSION: In this study, age, physical activity, family history of hypertension, smoking status, BMI, sedentary lifestyle, stress level, and serum creatinine are independent determinants of hypertension among type 2 diabetes patients. The findings of the study call for strategies that can target these predictors, and clinicians need to start educating their patients about hypertension and ways to prevent it.

Changes in antioxidant activity, phenolic compounds, fatty acids, and mineral contents of raw, germinated, and boiled lentil seeds.

Lipid contents of lentil seeds were determined between 1.02% (germinated) and 1.23% (boiled). Total phenolic and flavonoid amounts of processed lentils were detected between 45.32 mgGAE/100 g (germinated) and 68.02 mgGAE/100 g (control) to 70.95 mgQE/100 g (germinated) and 199.52 mgQE/100 g (control), respectively. Also, antioxidant activity values of lentil seeds were detected between 0.70 mgTE/kg (germinated) and 3.35 mgTE/kg (boiled). The major phenolic compounds of raw, germinated, and boiled lentil seeds were gallic acid, 3,4-dihydroxybenzoic acid, and catechin. While oleic acid amounts of lentil oils vary between 33.22% (control) and 47.72% (germinated), linoleic acid amounts of lentil oils were detected between 26.40% (germinated) and 40.91% (boiled). In addition, linolenic acid amounts of lentil oils were determined between 4.12% (germinated) and 6.97% (boiled).The key minerals of raw, germinated, and boiled lentil seeds were P, K, Mg, and S. However, according to the results, it was determined that lentils are a good source of potassium. PRACTICAL APPLICATION: Lentil is one of the oldest known food products used only in human food. Lentils are an excellent source of phytochemical nutrients. Lentils are widely used in salads, casseroles, and soups as well as in vegetarian cuisine. Lentil is considered a good source of energy along with high fiber content. Germination plays an important role in reducing nonnutritive compounds in legumes.

Transversus Abdominis Plane Block Versus Local Anesthetic Wound Infiltration for Postoperative Analgesia in Adult Patients Undergoing Hernia Repair in Daycare Procedure: A Randomized Control Trial.

INTRODUCTION: Various modalities are now being used to manage postoperative pain, such as regional nerve blocks techniques, continuous epidural analgesia, patient-controlled analgesia, opioids, and systemic non-steroidal anti-inflammatory drugs. This study compared the mean postoperative pain score between ultrasound-guided transversus abdominis plane (TAP) block and a local anesthetic wound infiltration at the surgical incision site. METHODOLOGY: A prospective, comparative, randomized controlled trial (RCT) was carried out from February 2021 to September 2021. The study was conducted in the anesthesia department of Dow University of Health Sciences, Karachi, Pakistan. Patients aged 18-80 years presenting with elective surgery of (both direct and indirect) inguinal hernia repair were enrolled in the study. Participants were randomly assigned into one of the two groups that are local anesthetic wound infiltration (Group A) and TAP block (Group B). The mean pain score was assessed using a visual analog scale and compared between the two groups. RESULTS: The study included 168 patients grouped in two different groups. The mean age in Group A was 43.87 (+17.21), and Group B was 47.01 (±15.37). Mean pain scores in groups A and B were 6.36±1.94 vs 4.51 ± 1.99 (p-value=0.001). The pain rescue medications were given to 57.14% of patients in Group A and 34.52% of patients in Group B, and it was significantly different in the two groups (p-value=0.003). It was found that patients in Group A reported more severe pain (41.67%) than patients in Group B (10.71%). CONCLUSION: When compared to local anesthetic wound infiltration, ultrasound-guided TAP block had better analgesic activity compared to local anesthetic wound infiltration.

Coblation Versus Cold Dissection Tonsillectomy: A Comparative Study.

Tonsillectomy is the most frequently performed surgery in the recent years. Many techniques have been advocated to improve surgical efficacy and decrease postoperative morbidity. Probably the most update was coblation tonsillectomy. This is a comparative study which was conducted on 50 patients (23 females and 27 males) who underwent tonsillectomy operations, 25 patients using cold steel dissection method whereas coblation technique was used for the rest 25 patients. Follow up was done at day 1, 3, 7 and 14 and the related parameters were calculated. The mean age of patients was 11.6 years with a mean of 2.2-40 years. There were 27 (54%) males out of 50 and 23 (46%) were females. Male to female ratio was 54%:46% ≈ 1.17:1. The current study revealed significant difference between coblation versus cold dissection tonsillectomy. Postoperative pain was significantly less at day 3 and day 7 using coblation technique. Moreover, there were less intraoperative bleeding, less time in days to return to normal diet and less time to return to normal activities. We believe that coblation tonsillectomy carries less morbidity than cold steel dissection, hence we recommend it to be applied at our hospital.