International Journal of Medical Sciences and Education (IJMSE)
Vol. 8 Issue: 4 (Oct-Dec 2021), Date of Publication: 01.01.2022

1.  EFFECT OF ADDITION OF DEXMEDITOMIDINE TO 0.5% ROPIVACAINE OR 0.5% ROPIVACAINE IN AXILLARY ROUTE BRACHIAL PLEXUS BLOCK IN HAND AND FOREARM SURGERY                                 1-8

 Dr Abeezar Hussain                                                                                                                         PDF FULL TEXT

ABSTRACT

Background- The present evidence supports the addition of  50mcg /kg Dexmedetomidine in moderate doses to potentiate the efficacy of peripheral nerve blocks without increasing risks of adverse events. Thus present study was designed to compare the role of  addition of  Dexmedetomidine to  Ropivacaine 0.5% or Ropivacaine 0.5%  alone  in axillary route brachial plexus block in hand & forearm surgery. Method- 60 study subjects scheduled to undergo hand & forearm surgery in ASA grade I & II were randomised into two groups Group R (n=30) and Group II (n=30).  In  Group I subjects were administered  Ropivacaine 0.5 %  15 ml, normal saline 5ml (Total 20 ml)  (n=30) and in Group II subjects were administered Ropivacine 0.5%  15 ml , normal saline 4ml + 50mcg /kg Dexmedetomidine 1 ml  (Total 20 ml)  (n=30) . Intergroup comparison  made for  hemodynamic parameters , onset of sensory block & motor block,duration of sensory & motor block,  total duration of analgesia and any untoward events.  Results- At baseline ,the demographics & hemodynamic parameters  were comparable(p>0.05). The onset of sensory block in Group RD (17±4.97 min)  was attained faster than Group R (21.4± 2.78 min) was statistically significant(p<0.001). The onset of motor block in Group RD (19±2.879 min ) was achieved faster than in Group R (24.21±.231min )  which was statistically significant (p<0.001). The duration of sensory block , motor block & duration of analgesia in Group RD statistically significantly prolonged (p<0.05). Intergroup comparison showed a significant decline in the HR in Group RD (p < 0.05). Conclusion -  Addition of 50mcg /kg Dexmedetomidine to long acting amide local anaesthetic Ropivacaine 0.5% hastens the onset of sensory & motor block, lengthens the duration of sensory block, motor block & analgesia. Thus can be effeciently used by anaesthetists in Ropivacaine in axillary route brachial plexus block in hand & forearm surgery with minimal adverse events which are transient & do not require treatemnt.
Keywords – Dexmedetomidine,  Ropivacaine , Axillary brachial plexus , nerve block

1.  ASSESSMENT OF HYPERURICEMIA AMONG TYPE 2 DIABETES MELLITUS PATIENTS                         9-13 
​     Dr. Sanjay Beniwal                                                                                                                       PDF FULL TEXT

ABSTRACT

Background- It is well known that insulin resistance at peripheral tissues (muscular tissue and adipose) plays a key role in the glucose metabolism disturbance in diabetes. Diabetes is a chronic disease in etiology and occurs when the pancreas does not produce enough amount of insulin or when there is resistance towards its action on the body. Various studies have been reported that elevated serum uric acid is found to be associated with diabetes mellitus. It is well known that Serum uric acid is formed in the body by the breakdown of purines. Material & Methods: The present observational prospective study was conducted at the department of Department general medicine of our tertiary care hospital. The study duration was of one year from January 2020 to December 2020. A sample size of 200 was calculated at a 90% confidence interval at a 10% acceptable margin of error by epi info software version 7.2. All newly diagnosed patients (diagnosed within 3 months) of diabetes mellitus were enrolled in the present study. Patients were enrolled from outdoor and from the ward by simple random sampling. Results. In the present study, the incidence of hyperuricemia among study participants was seen in 38 % of patients. Based on HbA1c levels and hyperuricemia, out of the total majority of study participants 34% patients had HbA1C levels 6.5-8 out of these 11% patients had hyperuricemia which was followed by 26% patients had HbA1C levels >11 out of these 12% patients had hyperuricemia which was followed by 25% patients had HbA1C levels 8.1-9.5 out of these 10% patients had hyperuricemia which was followed by 15% patients had HbA1C levels 9.6-11 out of these 5% patients had hyperuricemia. This difference was statistically non-significant.Conclusion: We concluded from the present study that hyperuricemia (serum uric acid levels) can be used as a sole and supplementary diagnostic marker for the progression and development of diabetes from prediabetes and its severity and complications. Patients who have high HbA1C levels (more than 6.5) should be tested for hyperuricemia (serum uric acid levels).
Keywords: Diabetics Mellitus, hyperuricemia,  uric acid levels.

1.  VITAMIN D AS A POTENTIAL MODULATOR OF INFLAMMATION IN TYPE 2 DIABETES: A REVIEW       14-26 
                                                                                                                                                                
​Dr. Jitendra Ahuja, Dr Deepandra Garg, Dr. Sunil Gupta                                                                PDF FULL TEXT

ABSTRACT

Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by hyperglycemia resulting from insulin resistance and impaired insulin secretion. In recent years, vitamin D has emerged as a potential modulator of T2D development and progression, with studies showing a link between vitamin D deficiency and an increased risk of developing the disease. In this review, we aim to provide a comprehensive overview of the current literature on the relationship between Vitamin D, inflammation, and type 2 diabetes. We will highlight the gaps in current knowledge and propose directions for future research to elucidate the role of vitamin D in the development and management of type 2 Diabetes and its underlying mechanisms. In conclusion, Vitamin D has been shown to have a beneficial effect on the regulation of glucose metabolism in the body. Therefore, a holistic approach to preventing and managing Type 2 Diabetes should involve a combination of strategies including regular physical activity, healthy eating habits, stress management, and medical interventions as necessary.
Keywords: vitamin D; inflammation; Insulin Resistance; Inflammatory Response; immune system