Abstract:Background: Background: Enhanced iron levels in patients afflicted with \(\beta\)-thalassemia induces oxidative stress, which restrains the secretion of gonadal and pituitary hormones. The associated severity level based on several hormones and oxidative stress biomarkers is not been demonstrated so far.
Method: The present study encompasses the employment of hierarchical clustering and different classifiers for determining the severity of the disease based on the analyzed clinical parameters in the study population. Furthermore, the hormonal parameters along with ferritin levels were used as input parameters for the prediction of the oxidative stress biomarkers ([Malondialdehyde (MDA) and protein carbonyl] through neural networks.
Result: A Significant negative correlation was observed between the oxidative stress biomarkers and the hormonal levels in both the female and male datasets of the case group. The clustering results depicted that the datasets corresponding to high oxidative stress biomarkers with very low gonadal hormones represented severe levels of the disease. Support vector machine outperformed the other classifiers in the case of the male dataset. The neural network efficiently predicted female and male models’ MDA and protein carbonyl values. High Fisher’s F-value (2042.035 to 6353.659) and low p-value (<0.001) established the significance of each model. Conclusion: The proposed framework can be used as a real-life decision tool for medical professionals to diagnose and treat \(\beta\)-thalassemia from a proper classification of the severity of the disease. Furthermore, the passive determination of some critical blood parameters may avoid the complex analytical procedure and its high cost.

Abstract:Background and Aim: Bilateral superficial cervical plexus block provides adequate analgesia in the neck region for thyroid surgery. Intermediate cervical plexus block can block all four cutaneous branches of the cervical plexus and sensory/ motor branches of the cervical plexus supplying the sternocleidomastoid muscle simultaneously so that provides adequate analgesia and anesthesia for neck surgeries that involve manipulation or resection of the sternocleidomastoid muscle. Along with general anesthesia, bilateral superficial cervical plexus block with intermediate cervical plexus block was given to reduce intraoperative opioid requirement and increase the duration of postoperative analgesia.
Material and Methods: A total of 56 patients aged between 18 to 65 years of either sex, ASA I and II, undergoing elective thyroid surgery were randomly allocated in two groups. Group S receives bilateral superficial and intermediate cervical plexus block with Inj. Ropivacaine 0.375% before induction of general anesthesia, and Group C receives no block. In both groups, intraoperative opioid requirement, intraoperative hemodynamics, time of rescue analgesia, total no. of rescue analgesic in 24 hours, total duration of analgesia, and complications were noted.
Results: Group S (\(25\pm0\) micrograms) had less mean fentanyl requirement intraoperatively than group C (\(35\pm14.43\) micrograms). Intraoperative hemodynamics were better in Group S compared to Group C. Total duration of analgesia was prolonged in group S (\(24.57\pm4.72\) hours) than in Group C (\(4.57\pm2.10\) hours). Total no. of rescue analgesic was reduced in group S (8 patients (28.57%)- 1 dose and 20 patients (71.42%)- no analgesic) as compared to group C (7 patients (25%)- 3 doses, 20 patients (71.42%)- 2 doses, one patient (3.57%)- one dose).
Conclusion: Combination of bilateral superficial cervical plexus block with intermediate cervical plexus block reduces intraoperative opioid requirement and increases postoperative analgesia with better intraoperative hemodynamic variables and fewer side effects.