Journal of clinical and diagnostic research : JCDR
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Orthopaedic anaesthesia plan requires customi-zation as per patient's need for safe outcome. Sequential Combined Spinal Epidural Anaesthesia (Sequential CSEA) and Unilateral Single Shot Spinal anaesthesia (Unilateral SA), both have advantages over conventional spinal anaesthesia that they provide longer lasting block with less hypotension. ⋯ Thus, our study concludes that unilateral SA is a cost-effective and rapidly performed anaesthetic technique. Unilateral SA with 10 mg bupivacaine and sequential CSEA with 5 mg spinal and incremental epidural top up, both provide good quality sensory and motor block for lower limb orthopaedic surgery but sequential CSEA provides significantly more stable haemodynamics with feasibility to prolong block. Thus sequential CSEA should be preferred over unilateral SA in high risk patients especially for major lower limb orthopaedic surgeries.
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Prevention and treatment of postoperative pain is a major challenge in postoperative care and well-being of the surgical patient. The multimodal analgesic method has been recommended as an alternative treatment for the management of postoperative pain. ⋯ Combination of 300 mg gabapentin plus 200 mg celecoxib twice a day is a good alternative in multimodal analgesia, effective in pain control with lesser side effects seen with gabapentin alone.
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Choosing the correct Endotracheal Tube (ETT) size is important in paediatric anaesthesia. The subglottic diameter being the narrowest diameter of the paediatric upper airway plays an important role in appropriate ETT size selection. ⋯ Ultrasonographic estimation of subglottic diameter is useful for optimal paediatric ETT size selection. USG is effective in estimating the appropriate sized ETT both for cuffed and uncuffed tubes.
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Multidetector Computed Tomography (MDCT) provides clinically and surgically important information in bowel obstruction. It can depict the severity, level and cause of obstruction. ⋯ SBO is more common than LBO with adhesive bands being the most common cause of SBO. MDCT is very useful for depicting site and cause of obstruction and any associated complications.
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MicroRNAs (miRNAs) are short (~22 nucleotides) regulatory RNAs that can modulate gene expression and are aberrantly expressed in many diseases, including cancer. It has been suggested that, the presence of single nucleotide polymorphisms in precursor miRNAs (pre-miRNAs) can alter miRNA processing, expression and binding to target mRNA and represents another type of genetic variability, that can contribute to the susceptibility of human cancers. ⋯ The results of the present study demonstrate that, miRNA 499 T/C polymorphism is significantly associated with genetic susceptibility to cervical cancer and may have a role in its pathogenesis.