An unusual fatal injury due to tyre burst: a case report

A 20 year-old male driver of a heavy duty crane, employed in an industry located in an industrial area on the outskirts of Delhi was fatally injured while repositioning an ill-fitted locking rim of a crane tyre (Fig. 1). The inner tube of the crane tyre had accidentally burst, dislodging the loose iron-locking rim, which hit the individual with a great force resulting in multiple injuries. He died on his way to the hospital.

Comparison of ondansetron, dexamethasone, ondansetron plus dexamethasone and placebo in the prevention of nausea and vomiting after laparoscopic tubal ligation

Laparoscopic tubal ligation is associated with an appreciably high rate of postoperative nausea and vomiting. This study was designed to compare the effectiveness of ondansetron, dexamethasone, ondansetron plus dexamethasone or placebo in the prevention of postoperative nausea and vomiting in patients after laparoscopic tubal ligation. In a prospective, randomised, double blind placebo controlled trial, 160 ASA I-II females received one of four regimens; ondansetron 4 mg, dexamethasone 8 mg, ondansetron 4 mg plus dexamethasone 8 mg or placebo (n=40 each) intravenously immediately before induction of anaesthesia. Patients were then observed for 24 hours postoperatively. The incidence of emetic episodes in the ondansetron with dexamethasone group was lower than in the placebo (p<0.001) and ondansetron (p=0.091) and dexamethasone (p=0.143) groups. A complete response (as no postoperative nausea and vomiting) was achieved in 60% of patients given ondansetron, 63% of the patients given dexamethasone, 78% of patients given ondansetron with dexamethasone and 37% of patients received placebo. The prophylactic use of ondansetron with dexamethasone is more effective in preventing postoperative nausea and vomiting.

Electrocution in South Delhi: a retrospective study

One hundred and fifty three unselected autopsy cases of electrocution received from South Delhi were studied during the period 1996-2001. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.98% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, season of the year, site of the body, time of day, place of occurrence and presence of entry and exit wounds on the body. Death occurred at the scene of the fatal event in 150 cases and three cases died in hospital. Three cases showed no electric burn marks on the body; the cause of death in one of these cases was polytrauma due to a fall from a height and one case had committed suicide.

Decapitation in road traffic accident--a case report

A 20-year-old girl along with four of her friends, all in their early 20s, met with a fatal accident in the early hours of the day. Their car was hit by a speeding truck at a crossing. All the occupants of the car sustained multiple injuries and died on the spot. The girl was decapitated in the accident. Her head was recovered outside the mangled remains of the vehicle and the rest of the body was extracted from the co-driver's seat of the damaged vehicle.

An unusual suicide by stabbing: a case report

A 50-year old cobbler, employed in a paramilitary unit, was found dead in a pool of blood in his shop inside the unit line in the morning. He had multiple stab wounds on his chest and was alleged to have committed suicide by repeated self-stabbing on the chest with a sharp iron chisel, which was found clenched in his right hand by the investigating officer. Fifteen wounds were communicating with the chest cavity, injuring the vital anatomical structures. The individual, according to the unit personnel, was not suffering from any physical or mental disorder and was not on any medication.

Comparison of granisetron and granisetron plus dexamethasone for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

BACKGROUND

Laparoscopic cholecystectomies are associated with an appreciably high rate of postoperative nausea and vomiting (PONV). This study was designed to compare the effectiveness of granisetron plus dexamethasone with granisetron alone for the prevention of postoperative nausea and vomiting in patients after laparoscopic cholecystectomy.

METHODS

In a randomized, double-blind study, 120 patients of both sexes received granisetron 40 micro g kg-1 alone or granisetron 40 micro g kg-1 plus dexamethasone 8 mg (n=60 of each) intravenously immediately before induction of anesthesia. Perioperative anesthetic care was standardized in all patients. Patients were then observed for 24 h after administration of the study drug.

RESULTS

A complete response (defined as no PONV and no need for another rescue antiemetic) was achieved in 83% of the patients given granisetron and in 95% of the patients given granisetron plus dexamethasone (P<0.05). The overall cumulative incidences (0-24 h) of PONV were 11 (18.3%) in the granisetron and three (5%) in the combination group. No difference in adverse events were observed in any of the groups.

CONCLUSION

The combination (granisetron plus dexamethasone) further increases the chance of complete response than granisetron alone. Therefore, the combination might be considered clinically relevant in a high risk setting.

Evaluation of mass-transfer coefficient of free fall--cascade-aerator

The mass-transfer coefficient of a free-fall cascade-aerator unit of 15 million litres per day was evaluated for its efficiency in the removal of a class of volatile organics, the trihalomethanes (THMs). These compounds are carcinogenic and occur as a result of chlorination of natural waters. Due to the volatile nature of the THMs, the efficiency of aeration as a potential technique for their removal has been studied. The principle behind aeration is gas-transfer, according to which the gas-liquid interface is hypothesized to consist of a gas and liquid film through which gas is transferred by molecular diffusion until equilibrium is attained. The overall mass transfer coefficient (K(L)) of the aerator considering oxygen as the reference compound, was found to be 29.3 hr(-1) for THMs.

Intrathecal midazolam for postoperative pain relief in caesarean section delivery

Postoperative pain relief is a growing concern to an anaesthesiologist since no single analgesic is free from side-effects. Moreover, it becomes a challenge after caesarean section delivery to provide postoperative pain relief without much sedation, respiratory depression or problems like nausea, vomiting, so that early baby acceptance and care by mother is promoted. Antinociceptive effect of midazolam is well established by now and its safety is documented. This observation was made in a blind randomised study of 40 women of ASA I/II to evaluate postoperative pain relief using intrathecal midazolam in caesarean section delivery. Group A patients (n=20) received 1.5 ml of 5% lignocaine only and group B patients (n=20) received mixture of 1.5 ml 5% lignocaine with 2 mg midazolam (preservative free) through intrathecal route at L3.4 interspace; vital parameters were monitored intra-operatively and postoperatively and Apgar score of baby in 1st and 5th minute of deliverywas assessed. It was observed intrathecal midazolam produced highly significant (p<0.001) postoperative pain relief together with anti-emetic effect and tranquillity of patients of caesarean section delivery.

Isolation and characterisation of organochlorine pesticides residues from landfill sites

Organochlorine pesticides (OClPs) have been analysed in the soil samples collected from landfill site, which was abandoned for more than ten years. The most commonly used OClPs of the region were identified and analysed in the soil samples collected at various depths. The method involves extraction of OClPs by soxhlet assembly, concentration cleanup by alumina and florisil columns and gas chromatographic analysis. Among OClPs analysed, g-HCH concentration was found maximum at 5 m layer and minimum at the bottom layer. p,p'-DDT was not found in any of the layers, this could be due to its degradation into its metabolites like p,p'-DDE and p,p'-DDD. p,p'-DDE was detected in 2 m, 5 m and bottom (7 m) layer while p,p'-DDD was found only at 2 m level.

Comparison between two different modes of oxygen therapy during immediate postoperative period following mitral commisurotomy

Hypoxaemia is a common postoperative problem after thoracotomy. Oxygen therapy with continuous monitoring by pulse oximetry should be a routine practice. This study was conducted to compare the efficacy between nasal cannula and ventimask for post-thoracotomy oxygen supplementation on 20 patients divided into 2 groups of 10 each undergoing closed mitral commisurotomy. The study period was of 5 months duration from March to July, 1996. The mean oxygen saturation remained above 98% in both the groups receiving oxygen either by nasal cannula or ventimask. As there was adequate oxygenation, the cost benefit ratio favours the use of nasal cannula for routine postoperative oxygen supplementation in the closed mitral commisurotomy patients.

Experimental method for high-accuracy reflectivity-spectrum measurements

An experimental method for accurate measurements of the reflectivity spectrum of mirrors is presented. It combines the noise reduction obtained with multiple beam reflections on two identical mirrors; high-beam quality, owing to the use of single-mode optical fibers; and high immunity against intensity variations of the beam. This method is demonstrated for characterizing a 30-period GaAs/Al(0.65)Ga(0.35)As distributed Bragg reflector designed for long-wavelength vertical-cavity surface-emitting lasers. Its peak reflectivity is found to be 99.43 ? 0.04% at 1.562 mum, and an optical absorption coefficient of alpha = 36 ? 6 cm(-1) is derived. The peak internal reflectivity of this distributed Bragg reflector used as the top mirror in a wafer-fused vertical-cavity surface-emitting laser is calculated to be 98.87 ? 0.12%, and the transmission is 0.28%.

Role of epidural tramadol hydrochloride on postoperative pain relief in caesarean section delivery

Two groups comprising 25 patients in each went for caesarean section delivery under epidural anaesthesia. Group I patients received 50 mg (1 ml) of tramadol hydrochloride with 14 ml of 2% lignocaine with adrenaline (1:200,000) and group II cases received 15 ml of 2% lignocaine with adrenaline (1:200,000). Both the groups of patients were comparable in age and body weight. In both the groups, there were good operative conditions, insignificant changes in pulse and blood pressure. The neonatal status was also similar in both the groups. The patients belonging to group I showed longer duration (15.39 +/- 0.45 hours) of analgesia in comparison to group II patients (2.46 +/- 0.54 hours).

Study of circle system without absorber under controlled ventilation with limited fresh gas flow

A biphasic controlled randomised study was conducted to evaluate the differences in fresh gas flow with alterations in different anaesthetic parameters, on 15 adult female patients of American Society of Anesthetists grade I or II, who underwent elective gynaecological operations with identical premedication and anaesthetic technique in which absorber was by-passed. Intermittent positive pressure ventilation was maintained with a tidal volume of 10 ml/kg and fixed respiratory frequency of 16/minute with inspiratory:expiratory ratio of 1:2. N2O (67%) in O2, a non-depolarising muscle relaxant and a narcotic analgesic were used to maintain the anaesthesia, muscle relaxation and analgesia respectively. Phase I and II of the study were characterised by fresh gas flow of 81/minute and 5.61/minute respectively during steady state and data of both phases were collected every 30 seconds for 5 minutes. Arterial blood samples for arterial CO2 and O2 tension studies were taken towards the end of 5-minute period. In phase I a mean fractional concentration of end tidal CO2 of 3.43% +/- 0.42 (p less than 0.01) and a mean arterial tension of CO2 of 24.06 mm of Hg +/- 4.07 were obtained. In phase II mean fractional concentration of end tidal CO2 3.81% +/- 0.39 (p less than 0.01) and mean arterial O2 of 28 mm Hg +/- 2.32 were obtained. Mean arterial blood O2 saturation was above 99% and mean arterial O2 tension was above 160 mmHg in both the phases. The results were statistically significant.

Postoperative analgesia with extradural buprenorphine and pentazocine

A randomised study of the efficacy, duration of action and side-effects of two analgesic regimens following lower abdominal surgery is described. Patients received extradural pentazocine 30 mg or extradural buprenorphine 0.3 mg to provide postoperative analgesia. Interval for the next analgesia was significantly greater after extradural buprenorphine (18.96 hours) than after extradural pentazocine (8.39 hours) (p less than 0.001). No serious side-effects were reported.