A comparative study to evaluate the efficacy of intranasal midazolam and intranasal dexmedetomidine as pre-medication in paediatric patients

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 432 – 439 Open Access Full-Text PDF
Monika Gandhi, Gireesh Tyagi, Shailendra Singh and K. K. Arora

Abstract:This study aimed to compare the efficacy of Midazolam and Dexmedetomidine as premedication agents in pediatric patients administered via the intranasal route. 100 children in ASA physical status I and II, aged 2-8 years, planned for surgery under general anesthesia, were randomly assigned to Group D, which received 1 mcg/kg of Intranasal dexmedetomidine, or Group M, which received 0.2 mcg/kg of Intranasal midazolam for premedication. The patients’ sedation status, separation anxiety, and mask acceptance were evaluated using UMSS, PSAS, and MAS, respectively, along with hemodynamic parameters and side effects. The mean sedation score was higher in Group D than Group M, and the mean parental separation anxiety score and mean mask acceptance score were also higher in Group D than Group M. All hemodynamic parameters were comparable and stable in both groups. In conclusion, intranasal dexmedetomidine was found to provide better sedation, relieve preoperative anxiety, make parental separation easier, and promote better mask acceptance, without any significant side effects.

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The efficacy of USG-guided transversus abdominis plane block for abdominal surgeries: A comparative study

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 423 – 431 Open Access Full-Text PDF
Srishti Chandrawanshi, K. K. Arora, Pooja Vaskle, P. S. Tripathi and Prem Krishnan V

Abstract:The study aimed to compare the analgesic efficacy of USG-guided versus landmark-based transversus abdominis plane (TAP) block using 0.25% bupivacaine in abdominal surgeries. A total of 100 patients undergoing elective abdominal surgery were included in the study, with 50 patients receiving USG-guided TAP block and the other 50 patients receiving landmark-guided TAP block. The patients were evaluated post-operatively for up to 24 hours for their VAS score, amount of analgesic required, and time for the first rescue analgesia. The results showed that the USG-guided TAP block group had a significant decrease in pain at 4 and 8 hours following surgery compared to the landmark group, with a lower total analgesic demand in the postoperative period. The study concluded that USG-guided TAP block is an efficient and safe addition to multimodal post-surgical analgesia compared to landmark-guided block. The study was conducted at the Department of Anesthesiology of the M. G. M. Medical College and M. Y. Hospital in Indore, Madhya Pradesh, and was approved by the Institutional Ethical and Scientific Review Committee.

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A study to evaluate the effect of oral melatonin on patient’s anxiety scores and the dose requirement of propofol by bispectral index guided induction of general anaesthesia

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 416 – 422 Open Access Full-Text PDF
Monika Gandhi, Neha Vaishanav, Arpit Agrawal and K. K. Arora

Abstract:Preoperative anxiety is a common occurrence in patients undergoing surgery, and it can lead to a range of negative effects, including an increased requirement for anesthetic agents, hemodynamic instability, and delayed recovery. Melatonin has been shown to have an anxiolytic and hypnotic effect with fewer side effects. This study aimed to explore the potential of oral melatonin to reduce preoperative anxiety levels and the dose requirement of propofol for the induction of general anesthesia. The study included 150 patients who were equally divided into two groups: Group M and Group C. Group M received oral melatonin 6mg and vitamin B complex tablets, while Group C received a sip of water and vitamin B complex tablets 90 minutes before the surgery. Anxiety levels were measured using the VAS score preoperatively and 90 minutes after drug administration. Propofol was given until the BIS value was sustained for 1 min at 48\(\pm\), and the total dose was measured in both groups. Postoperative pain was assessed using the VAS score just after extubation and every hour for the next 4 hours, with Inj. Diclofenac given if the score was \(\geq\)4. The time of first rescue analgesia was noted. Results showed that Group M had a significantly reduced VAS score and required a lower dose of propofol for induction compared to Group C (p\(\leq\)0.0001). The time of first rescue analgesia was also prolonged in Group M compared to Group C (p\(\leq\)0.0001). Therefore, oral melatonin is an effective premedicant that reduces preoperative anxiety, the required induction dose of propofol, and provides postoperative analgesia.

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Role of transvaginal ultrasound of endometrium in females with abnormal uterine bleeding

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 401 – 408 Open Access Full-Text PDF
Rakesh Vijaywargiya, Diksha Ramteke and Aksha Tanwani

Abstract:This prospective observational study aimed to assess the role of transvaginal ultrasound (TVS) in diagnosing the cause of abnormal uterine bleeding (AUB) and characterizing benign and malignant lesions. 130 patients were included and underwent TVS and histopathological examination. TVS showed sensitivity of 59%, specificity of 93%, positive predictive value of 81%, negative predictive value of 82%, and accuracy of 58% for diagnosing malignant lesions. The study provided TVS imaging features for early identification, characterization, and extent of uterine pathologies, as well as relevant information for clinicians to make reasonable decisions. TVS is a good primary imaging modality due to its non-invasiveness, low cost, and wide availability.

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Study of prevalence of cytomegalovirus in male partner of infertile couple and its impact on seminal analysis in a tertiary care hospital of Kolkata

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 397 – 400 Open Access Full-Text PDF
Sagar Das and Bosumita Sinha

Abstract:Introduction: Cytomegalovirus (CMV), a double-stranded DNA virus belongs to a family called herpesviridae or human herpesviruses (HHVs). CMV is spread by direct contact with infectious body fluids such as nasal secretions, saliva, tears, urine, genital secretion or breast milk. After contamination, the virus initially replicates in the epithelial cells at the site of entry, followed by hematogenous spread to numerous organs and cell types.
Aims: to estimate prevalence of CMV in a population of male partners of infertile couples attending a tertiary care hospital of Kolkata and also to determine the impact of CMV infection on sperm parameters.
Materials and method: The proposed study is an observational and descriptive study of cross-sectional study was conducted in department of Physiology, R.G. Kar Medical College & Hospital, Kolkata. The study period was One year January 2021 – January 2022. 56 patients were included in this study.
Result: We showed that, lower number of patients had Normal Morphology in with Cytomegalovirus [4 (100.0%)] this was not statistically significant (p=0.6895). Association of Addiction with Cytomegalovirus was statistically significant (p=0.0059) and Infertility DX with Cytomegalovirus was not statistically significant (p=0.6088). It was found that, higher number of patients had Height in without Needed Mechanical Ventilation [29 (65.9%)] compared to with Needed Mechanical Ventilation [4 (44.4%)] It was not statistically significant (p=0.0504).
Conclusion: we concluded that cytomegalovirus was associated with in male partner of infertile couple and its impact on seminal analysis a tertiary care hospital.

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Impact of after completion therapy assistance on pediatric oncology patients: A study from a tertiary care center from Jammu & Kashmir

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 391 – 396 Open Access Full-Text PDF
Faisal R Guru, Shumail Bashir, Sadaf Shafi Wani, Saquib Zaffar Banday, Syed Nisar Ahmad, Mohmad Hussain Mir, Ulfat Ara Wani and Aiffa Aiman

Abstract:Background: Advances in all fields of oncology have resulted in five-year survival rate approaching 80% among pediatric /AYA survivors which has led to increased focus on psychosocial relationship care, identification of late effects and improving quality of life. For this growing population of cancer survivors with a whole life ahead of them, more concrete support structures have been directed towards the evaluation and improvement of post-treatment care. Medical care complemented with non-medical (psychosocial relationship) care increases awareness with respect to many psychosocial relationship aspects such as educational, employment, post treatment distress and coping which need to be addressed for the survivor to lead a normal productive life. Recent studies have shown that regular psychosocial relationship follow ups have resulted in timely identification of late effects followed by appropriate rehabilitation services being provided to survivors.
Method: The study is based on project PICASSO (partnership in cancer survivorship optimization) initiated by Indian Cancer Society which aims at providing holistic care for childhood cancer survivors. The qualitative analysis was performed by using the quality-of-life scale (WHOQoL-BREF). Non probability purpose sampling pediatric/AYA oncology survivors were taken from the act clinic and potential survivors participated who have completed the treatment till June 2022. (n=100).
Results: The Significant difference is seen between ACT and non-ACT survivors as far as psychological well-being health and physical health domain is considered and insignificant difference is seen as far as social relationship and environment wellbeing is considered.
Conclusion: The Study revealed that ACT survivors have good psychological well-being and physical health then non-ACT survivor.

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A cross-sectional study on morphometry of pterion and its relation with middle meningeal artery

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 386 – 390 Open Access Full-Text PDF
Sanjay Singh, Hasmatullah, Hina Fatima, Pradeep Bokariya and Akherez Zaman Ahmed

Abstract:Introduction: The frontotemporal type is characterised by a pterional sutural configuration between the frontal and temporal bones. The stellate kind of suture is formed by the fusion of the flat sphenoid, frontal, parietal, and temporal bones.
Methods: The kind of pterion based on sutural pattern was determined using Murphy’s classification into sphenoparietal, frontoparietal, stellate, and epipteric kinds on both the left and right sides of each skull. The centre of the circle, which connects the four bones that make up the pterion, is thought to be the centre of the pterion. Distance between the pterion’s centre and the external auditory meatus’s anterosuperior margin, P-PM: the distance between the pterion’s centre and the lateral margin of the optic canal, P-AM.
Results: The current investigation was carried out using 115 dried adult skull bones that were gathered from the central Karnataka region. On the right side, there were 115 pterions, and on the left, there were 115. The most frequent type of pterion was sphenoparietal (82.1%), followed by epipteric (26.1%), stellate (18.6%), and frontotemporal (17.8%).
Conclusions: The findings of this study may be useful for forensic pathologists, neurosurgeons, anatomists, and anthropologists in the region of the population under study.

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Motor nerve conduction, auditory evoked potential, and visual evoked potentials in severely malnourished children vs healthy controls: An electrophysiological study

TCMS-Special issue: Recent developments of medical and surgical research (2023), pp. 379 – 385 Open Access Full-Text PDF
Anju Agarwal, Anita Pal, Shrishty Tomar, Yashvardhan Raghuvanshi, Gaurav Bhatnagar, Ajit Singh Rajput and Virendra Verma

Abstract:Background: Severe acute malnourishment (SAM) is a significant public health problem in India and many developing countries. The World Health Organization (WHO) defines – Severe acute malnutrition (SAM) as very low weight-for-height or a mid-upper arm circumference (MUAC) of less than 115 mm or the presence of nutritional edema. According to the most recent NFHS-5 survey (2019- 2021) covering 36 states and union territories (UTs), the prevalence remains at an alarming 7.7%. Malnutrition slows down the myelination process, thus preventing the increase in the calibre of myelinated nerve fibres. Motor nerve conduction, auditory evoked potential and visual evoked potential changes caused by severe acute malnutrition can be evaluated clinically and electrophysiologically. These changes are produced mainly due to a deficiency of micro and macronutrients like vitamins, minerals, protein, fat & Carbohydrates.
Aim: Severe acute malnutrition affects the myelination and growth of the central and peripheral nervous systems. This study aimed to assess the effects of severe acute malnutrition on peripheral motor median and ulnar nerve conduction, auditory evoked potential and visual evoked potential in children.
Materials & Methods: The study group included 50 severely acute malnourished children (SAM) of 6 – 59 months of age, recruited from SMTU, J.A. Group of the Hospital, G.R.M.C. Gwalior (M.P.), based on WHO classification for severe acute malnutrition. The Control group consisted of 50 normally nourished healthy children of the same age group. The case-control study period was extended from January 2021 to December 2021. Ethical clearance from the Institutes and written informed consent were taken from the parents/guardians of SAM patients. The family, immunization, birth, metabolic, endocrinal disorder, and history of neuromuscular disease were taken in detail. The study was performed using the four-channel RMS – EMG EP MARK- II. The electrophysiological parameters were evaluated for velocity, distal latency, and amplitudes. Results were analyzed statistically using the unpaired student’s t-test.
Results: This study showed decreased motor nerve conduction velocity ( p < 0.05 ) and delayed distal latencies in the median and ulnar motor nerves of both upper limbs in children with severe acute (SAM) malnutrition. There were significant differences in the mean latencies of the waves I to V and the mean interpeak latencies (IPLs) of the waves I-III and I-V on the right and left ears between the study and control groups (P < 0.05). We observed significant alteration in mean latencies of wave p 100 in VEP.
Conclusion: The present study shows a statistically significant alteration in electrophysiological parameters in children with severe acute malnutrition. This may be due to nutritional deficiency affecting the myelination of peripheral nd central nerves depending on the duration and severity of malnutrition.

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On the uniqueness of the Laplacian spectra of coalescence of complete graphs

ODAM-Vol. 6 (2023), Issue 1, pp. 25 – 39 Open Access Full-Text PDF
Gerhard Kling

Abstract:Using coalescence and cones, this study defines three types of graphs formed by amalgamating vertices of disjoint unions of complete graphs. The three types include the cone over a disjoint union of two complete graphs (C1), the cone over a disjoint union of \(k\) complete graphs (C2), and the \(l\) cone over a disjoint union of two complete graphs (C3). Coalescence of complete graphs (C1, C3) and the \(l\) cone (C3) are determined by their Laplacian spectra, a novel finding. Their Laplacian spectra reveal the size of the vertex cutset. Applications include the analysis of corporate networks, where individuals form coalescence of complete graphs through joint membership of two or more company boards.

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A note on extremal intersecting linear Ryser systems

ODAM-Vol. 6 (2023), Issue 1, pp. 21 – 24 Open Access Full-Text PDF
Adrián Vázquez-Ávila

Abstract:A famous conjecture of Ryser states that any \(r\)-partite set system has transversal number at most \(r-1\) times their matching number. This conjecture is only known to be true for \(r\leq3\) in general, for \(r\leq5\) if the set system is intersecting, and for \(r\leq9\) if the set system is intersecting and linear. In this note, we deal with Ryser’s conjecture for intersecting \(r\)-partite linear systems: if \(\tau\) is the transversal number for an intersecting \(r\)-partite linear system, then \(\tau\leq r-1\). If this conjecture is true, this is known to be sharp for \(r\) for which there exists a projective plane of order \(r-1\). There has also been considerable effort to find intersecting \(r\)-partite set systems whose transversal number is \(r-1\). In this note, we prove that if \(r\geq2\) is an even integer, then \(f_l(r)\geq3r-5\), where \(f_l(r)\) is the minimum number of lines of an intersecting \(r\)-partite linear system whose transversal number is \(r-1\). Aharoni \emph{et al.,} [R. Aharoni, J. Barát and I.M. Wanless, \emph{Multipartite hypergraphs achieving equality in Ryser’s conjecture}, Graphs Combin. {\bf 32}, 1–15 (2016)] gave an asymptotic lower bound: \(f_l(r)\geq3\).\(052r+O(1)\) as \(r\to\infty\). For some small values of \(r\) (\(r\geq2\) an even integer), our lower bound is better. Also, we prove that any \(r\)-partite linear system satisfies \(\tau\leq r-1\) if \(\nu_2\leq r\) for all \(r\geq3\) odd integer and \(\nu_2\leq r-2\) for all \(r\geq4\) even integer, where \(\nu_2\) is the maximum cardinality of a subset of lines \(R\subseteq\mathcal{L}\) such that any three elements chosen in \(R\) do not have a common point.

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