Ultrasound-Guided Intercostal Nerve Block and Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Patients Posted for Open Cholecystectomy: A Randomized Controlled Trial.

BACKGROUND: Effective postoperative analgesia leads to early mobilization, fewer pulmonary complications, and shorter hospital stay. AIMS: We compared the analgesic effects of ultrasound-guided intercostal nerve (ICN) blocks, subcostal transversus abdominis plane (SCTAP) block, and a control group in open cholecystectomy. SETTINGS AND DESIGN: This was a prospective, randomized controlled, double-blind, multi-arm and parallel study. MATERIALS AND METHODS: The study was conducted on patients of American Society of Anaesthesiology Physical Status Classes I and II, either sex, 18-60 years of age, and body mass index 18-30 kg.m-2. Exclusion criteria were infection at the injection site, coagulopathy, thrombocytopenia, and allergy to the drugs used. Group I (n = 41) received ICN blocks, Group T (n = 41) SCTAP block, and Group C (n = 41) no postoperative block. The duration of analgesia was the primary outcome, and the analgesic consumption, the pain intensity, adverse events, and patient satisfaction were the secondary outcomes. STATISTICAL ANALYSIS: For the continuous data, analysis of variance was used for multiple group comparison and intergroup data were analyzed by Student's t-test. Kruskal-Wallis and Mann-Whitney U tests were applied for ordinal data. P = 0.05 or less was considered statistically significant. RESULTS: The duration of postoperative analgesia was significantly longer in the ICN (mean = 441.6 min; 95% confidence interval [CI], 407.71, 475.49) and SCTAP block (mean = 417.6 min; 95% CI, 390.94, 444.26) as compared to control (mean = 33.98 min; 95% CI, 26.64, 41.32) (P = 0.00) with no significant intergroup difference between the two intervention groups (P = 0.278). The cumulative analgesic consumption was not significantly different between the intervention groups but was significantly reduced in the study groups when compared with the control group (P < 0.001). No notable adverse events were observed. Patients with both the techniques were very satisfied in comparison with the control group (P = 0.00). CONCLUSION: Both the ICN and SCTAP blocks have similar results in terms of analgesia and patient satisfaction for cholecystectomy.

The lumbo-sacral transitional vertebra (LSTV) sacrum with negligible sacral kyphosis: a case report with an evolutionary review

Monkey and other hominids species have 5 sacral segments in 10% cases. The similar frequencies for each 6-segmented and 4-segmented sacra in human are known as lumbo-sacral transitional vertebra (LSTV). Achieving the erect posture in human has necessitated much skeletal modification, but these are more apparent in the lumbosacral region. Sacral kyphosis is a distinguishing feature of the human sacrum, which helps to differentiate them from the animal. The monkey has a sacral index near 80, and humans a sacral index is near 100. The sacral index was 88 in six-segmented sacra with negligible sacral kyphosis, having sacralisation of the 5th lumbar vertebra. Therefore, SI is 88 and lack of sacral kyphosis challenge its human origin. On the contrary, gross morphology, actual sacral index, and comparison with apes gave sufficient evidence of human origin. Later excluding 5th Lumbar vertebra, the sacral index is 107.34 and might belong to a male which corresponds with bone bank record

No disponible

Association of vitamin B12 mediated hyperhomocysteinemia with depression and anxiety disorder: A cross-sectional study among Bhil indigenous population of India.

BACKGROUND: Indigenous populations in India are amongst the poorest and most marginalized population groups experiencing severe health deprivation. AIM: The present study is the first study that aims to understand the association of micronutrient deficiencies (vitamin B12 and folate) and MTHFR C677T gene polymorphism with depression and generalized anxiety disorder (GAD) among the Bhil indigenous population of India. METHODS: A total of 303 participants aged 25-65 years of both sexes and unrelated up to first cousins belonging to Bhil indigenous population were recruited for the present study. Depression and generalized anxiety disorder were assessed using Patient Health Questionnaire and Generalized Anxiety Disorder scale, respectively. Biochemical analysis, DNA extraction and MTHFR C677T gene polymorphism analysis were done using standard protocols. RESULTS: Although, vitamin B12 and folate status was not found to be directly associated with depression and GAD, but hyperhomocysteinemia was posing more than three folds and six folds significant increased risk for depression and GAD, respectively. Further, it seems hyperhomocysteinemia was mediated by vitamin B12 deficiency among depressed and anxious individuals. T allele of MTHFR C677T gene polymorphism was posing increased risk for depression and anxiety disorder though not significant. CONCLUSION: The present study highlights the significance of micronutrient deficiencies in the causation of depression and anxiety disorder.

Screening of the growth of thymus of human fetuses / 대한해부학회지