The role of warmed intravenous fluid on intraoperative hypothermia and postoperative shivering during prolonged oral and maxillofacial surgery

Background: Under general anaesthesia, the core temperature may drop up to 6°C. Patients undergoing prolonged maxillofacial surgery frequently experience unintentional hypothermia that causes postanaesthetic shivering which is a common complication of anaesthesia that should be prevented. This study aimed to evaluate the role of warmed intravenous fluid in preventing intraoperative hypothermia and postoperative shivering. Methods: Between January 2022 and December 2022, 322 patients with American Society of Anesthesiologists (ASA) physical status I, II and the age group of 18 to 45 years old scheduled for elective major oral and maxillofacial surgery were evaluated under the Department of Anaesthesiology in Dhaka Dental College and Hospital. The patients were grouped into Room Temperature Group and Warmed Fluid Group. Results: 162 patients received warmed fluid, whereas 160 patients received fluid at room temperature. In Room Temperature Group, there were 89 male and 71 female patients, whereas Warmed Fluid group had 88 male and 74 female patients. At the end of the procedure, the basal core temperature was 36.7±0.2°C in the group receiving warmed fluid versus 35.9±0.2°C in the group receiving fluid at room temperature. The incidence of hypothermia (<36 °C) was much lower in Warmed Fluid Group (n=28, 17.28%) than Room Temperature Group (n=86, 53.75%). Shivering was more common in Room Temperature Group (n = 67, 41.86%) than in Warmed Fluid Group (n = 19, 11.73%) in the postanaesthetic care unit (PACU). Conclusions: The results of this study suggested that intraoperative hypothermia and postoperative shivering are less common when warmed fluid is infused.

Review on diagnosis and molecular characterization of Toxoplasma gondii in humans and animals

@#Toxoplasma gondii is an obligate intracellular protozoon which causes toxoplasmosis, an important zoonotic disease that is endemic worldwide. Common sources of T. gondii infection in humans are food or water contaminated with oocysts and raw or undercooked meat with cysts. In animals, common sources of infection include feed, water, or litter contaminated with oocysts. The diagnosis and molecular characterization of T. gondii infection in humans and animals is crucial due to public and veterinary health importance. Various traditional and serological methods have been used in clinical practice for toxoplasmosis diagnosis, but interpreting the results remains a challenge. Several molecular techniques have also been used for the detection and genetic characterization of T. gondii, but primarily in research settings. In this paper, we review the techniques that are currently used for the diagnosis and genetic characterization of T. gondii in humans and animals, along with their advantages and disadvantages. The techniques reviewed have laid the groundwork for the future development of more effective and precise detection and characterization of T. gondii. These advances will contribute to a better understanding of epidemiology, prevention and control of toxoplasmosis. Thus, this review would be of particular interest to clinical physicians, veterinarians and researchers.

Plant stature of aromatic rice genotypes in the environment of Bangladesh.

Plant stature of a rice crop is an important selection criterion. As plant height is a quantitative trait it is influenced by environmental conditions. A field experiment was conducted with 40 rice genotypes to assess the fluctuation and stability of plant height in a series of 16 environmental situations. The effects of genotype (G), environment (E) and all the components of G×E interaction were highly significant. Among the genotypes, Jamai sohagi was extremely sensitive (bi = 1.37) to environmental changes, and indicating lowest adaptability over the environments. Plant height of seven genotypes viz. Basmati PNR346, Benaful, BRRIdhan28, BRRIdhan38, BRRIdhan39, Gandho kasturi and Neimat, having the bi values between 0.59 and 0.72, showed high stability against environmental changes. The other seven genotypes viz. Badshabhog, Basmati Tapl-90, Kamini soru, Khazar, Laljira, Sarwati and Ukni madhu expressed only nonlinear sensitivity (S2 di = 90 – 181)) and thus unpredictable fluctuation. Twenty one genotypes indicated their average stability (bi = 0.91 -1.15) over the environments.

Rare Case of Ruptured Sinus of Valsalva: Ruptured Into Left Ventricular Cavity.

Rupture sinus of Valsalva is a relatively rare condition. We report a rare case of ruptured left sinus of valsalva with aneurysm, presenting with acute left ventricular failure. Transthoracic echocardiography showed an aneurysmal dilatation of the base of interventricular septum and part of the aortic root and a marked turbulent flow from the aortic root to the left ventricle with a continuous systolodiastolic shunting. The patient underwent successful repair of ruptured sinus of valsulva with closure of fistula. During Ventriculotomy the defect was repaired using pledgeted 5/ 0 prolene interrupted sutures and pericardial patch.

Pheochromocytoma with hypertensive crisis due to glucocorticoid administration: a case report and review of the literature.

We report a patient who presented with single episode of severe hypertension after intramuscular injection of betamethasone which was given to treat acute exacerbation of bronchial asthma. Episode of severe arterial hypertension was associated with pulmonary edema, acute renal failure and hyperkalemia. Further evaluation by appropriate diagnostic tests revealed that the patient is a case of phaechoromocytoma. This neoplasm was excised successfully and the patient is presently asymptomatic.We believe that this episode was initiated by glucocorticoid injection.

Male urethral cancer.

A 55 years old man presented with long standing voiding obstructive symptoms like poor stream, frequency of micturition, straining at micturition and a sense of incomplete evaluation since 2002. He was clinically diagnosed a case of stricture urethra. Later he developed a swelling in the penoscrotal region with retention of urine in March 2005 and was treated by dilatation. But on removal of the catheter he developed retention again for several times and ultimately for gross periurethral sepsis, urinary diversion was required in May 2005. In October 2005, biopsy from the scrotal abscess wall established the diagnosis of urethral carcinoma. In November 2005 extensive penoscrotectomy was done followed by chemo-radiotherapy. But the prognosis was so bad that the patient died in November 2006. Urethral carcinoma is a rare disease diagnosed in the department of urology, Mymensingh Medical College Hospital, the prognosis of which is also poor even after extensive operations.