Postoperative Analgesia in Ultrasound-Guided 3-in-1 Block versus Fascia Illiaca Compartment Block in Adult Patients Undergoing Lower Limb Orthopaedic Surgeries under General Anaesthesia: A Randomised Clinical Study

Introduction: Three-in-one block and Fascia Illiaca Compartment Block (FICB) are two peripheral nerve block techniques that target the femoral nerve, obturator nerve and lateral femoral cutaneous nerve in a single injection. Both nerve blocks are used to provide anaesthesia and analgesia to the lower limb for various surgical procedures. The use of ultrasonography in peripheral nerve blocks helps to visualise the nerve, needle, and the distribution of the drug in real-time. It, thus, shortens the time of onset of sensory block, decreases performance time, and lowers the required drug doses, and finally increases chances of a favourable outcome from the nerve block. Aim: To compare the postoperative analgesic efficiency of ultrasound-guided 3-in-1 block with FICB in patients undergoing lower limb orthopaedic surgeries under General Anaesthesia (GA). Materials and Methods: A randomised clinical study was conducted at a tertiary care hospital. One hundred and fifty patients were randomly allocated to two groups, 3-in-1 block group or FICB. Both groups received the respective blocks after surgery before extubation. Postoperatively, Visual Analog Scale (VAS) scores were evaluated hourly for first 6 hours and 2 hourly thereafter until rescue analgesia was instituted. Time period from giving the block to giving rescue analgesia was noted as duration of analgesia. Injection diclofenac 1.5 mg/kg Intravenous (IV) was given when VAS value reached ≥4. Results: On analysis of 150 patients, divided into 3-in-1 block group (N=75) and FICB Group(N=75); mean age: 53.29±8.69 years; the VAS scores at 2 to 18 hours, 20 hours, and 22 hours after performing the blocks were significantly less in the 3-in-1 block group compared to FICB group. Also, the mean time (hours) for first rescue analgesia in FICB group (3.49±0.53) was earlier compared with 3-in-1 block group (7.35±0.51). Conclusion: A 3-in-1 block provides effective and prolonged postoperative analgesia in comparison to FICB.

A Case-Control Study on Mucormycosis in Tertiary Care Hospital, Bhopal

BACKGROUND

The term mucormycosis refers to any fungal infection caused by fungi belonging to the Mucorales order. The disease often manifests in the skin and also affects the lungs and the brain. A large number of Mucormycosis cases were detected in Delhi, Maharashtra and Gujarat, and Madhya Pradesh.

OBJECTIVES

(1) To describe the epidemiology, management, and outcome of individuals with mucormycosis. (2) To evaluate the risk factors associated with cases and control.

METHODOLOGY

A case-control study, conducted in Hamidia Hospital, Bhopal, for 5 weeks. One hundred and sixty-eight patients diagnosed clinically with radiological or pathological findings was considered a case of Mucormycosis. Control was taken from March 2020 to May 28, 2021, the list of COVID-19-positive patients obtained from IDSP, MP.

RESULTS

Majority of the study participants were among the age group of 51-60 years and comprising 69.6% of males. Diabetes mellitus is the major comorbidity found in both cases (87.58%) and in controls (20.0%).

CONCLUSION

There is a need to stress to control hyperglycemia, and monitor blood glucose levels after discharge following COVID-19 treatment.

Highly effective and stable MWCNT/WO3 nanocatalyst for ammonia gas sensing, photodegradation of ciprofloxacin and peroxidase mimic activity

The present study discusses the ammonia (NH₃) sensing characteristics, photocatalytic degradation of emerging pollutants, and peroxidase mimic activity of multifunctional multi-walled carbon nanotube-tungsten oxide nanocomposite (MWCNT/WO₃) prepared by conventional solvothermal method. The prepared MWCNT/WO₃ nanocomposites were characterized by various analytical techniques like XRD, Raman, XPS, N₂ adsorption, FESEM with elemental analysis and diffuse reflection spectroscopy. The prepared 1% MWCNT/WO₃ nanocomposite showed better gas sensing performance for the NH₃ vapors at 10-100 ppm than the pristine WO₃ and the response and recover time of about 13 and 15s towards 20 ppm of ammonia (NH₃) was achieved. The photocatalytic activity of MWCNT/WO₃ towards organic dyes such as Rhodamine-B (Rh.B) methylene blue (MB) and pharmaceutical compound ciprofloxacin (CIP) were studied and achieved above 90% degradation at 160 min for CIP and 60 min for MB and Rho-B respectively. The radicle scavenging activity for MWCNT/WO₃ nanocomposite showed the predominant formation of hydroxyl (OH^•) and superoxide radicle (^•O^2-). Further, the MWCNT/WO₃ nanocomposite showed peroxidase mimic activity and exhibit the limit of detection (LOD) of about 321 nM. From the overall analysis, MWCNT/WO₃ hybrid seems to have potential characteristics that can be explored for multiple functional applications.

Comparison of the Modified Alvarado Score and Ultrasonography for Diagnosing Acute Appendicitis

Background: Acute appendicitis can be diagnosed much accurately by using Modified Alvarado score and Ultrasound together in the clinical setting. Objectives: Comparison of the diagnostic accuracy of Modified Alvarado score and Ultrasonographic findings in acute appendicitis. Materials and Methods: A total of 200 patients of age group ranging from 4-65 years, both male and female, who visited the tertiary health care center with clinical features suggestive of acute appendicitis were randomly selected. Data from the patients regarding their Modified Alvarado score, ultrasonographic findings and histopathological reports were collected for the study. Statistical analysis was performed for the results of both Modified Alvarado score and Ultrasonographic findings in contrast to the pathology reports.  Results: The study included 200 patients, with maximum incidence of acute appendicitis seen in males (70.5%) and among 21-30 age groups (40.5%). The sensitivity, specificity of Modified Alvarado Score was 89.47% and 73.33%, with Positive Predictive Value, Negative Predictive Value and diagnostic accuracy being 40%, 73.33% and 45% respectively. Ultrasonography revealed 89.58% sensitivity, 15.62 % specificity, Positive predictive value and NPV were 75.88% and 50%, and diagnostic accuracy was 72%. The negative appendectomies rates accounted to 15%. Conclusion: It is advised that both Modified Alvarado score and Ultrasound can be used to together to diagnose acute appendicitis. This can be useful in decreasing the negative appendectomies and hence reduce the morbidity and mortality.