Endometrial thickness (EM) is one of the strongest predictors of implantation rate and ongoing pregnancy success rate. The endometrial growth is dependent on the uterine blood flow and angiogenesis. Recently, some reports discussed the possible beneficial effects of sildenafil citrate on EM. Sildenafil citrate leads to smooth muscle relaxation and vasodilation. Because of these biological properties, it is a potential candidate for female infertility, especially in the management of thin endometrium, which leads to low implantation and pregnancy rates. An updated electronic search was performed through PUBMED, MEDLINE, and COCHRANE and focused on peer-reviewed, randomized controlled trials, and observational cohort or case-control studies for the role of sildenafil in thin endometrium. Systematic search through all the clinical studies showed favorable results. They documented the beneficial role of sildenafil citrate in the treatment of thin endometrium in failed in vitro fertilization-embryo transfer cycles, assisted intrauterine insemination cycles, or resistant endometrium, where it increased the uterine receptivity.

Introduction: UTI causes significant child morbidity and mortality. Enterobacteriaecae are most common uropathogens. Recently Enterococcus spp, yeast and Staphylococcus aureus have emerged as paediatric uropathogens. Understanding of local susceptibility pattern guides antibiotic therapy in UTI. This study describes demographic and susceptibility profile of uropathogens in children. Method: The urinary isolates were analysed retrospectively and data on age, sex, result of urine culture, etiological agent and susceptibility pattern were obtained from laboratory record books. Result: 315 urine samples analysed showed 34% significant bacteruria. Prevalence of UTI among male and female children was 62% and 37.9% respectively, statistically significant (P= .0329). Predominant uropathogens were Klebsiella spp. (66.6%), Escherichia coli (25.9%), Candida albicans (20.3%) and Enterococcus spp (15.7%). Bacteruria with pyuria was 26.03%. Sterile pyuria present in 9.52% of cases. A statistically significant correlation between Pseudomonas and pyuria was noted. Both Klebsiella spp and E coli were least susceptible to augmentin and cephalosporins (25%) and most susceptible to carbapenems. Proteus spp was most susceptible to aminoglycosides (75%) and Acinetobacter spp to Piperacillin-tazobactam (83.3%) while Pseudomonas to carbapenem (75%). Acinetobacter was most resistant with 100% resistance to augmentin, cephalosporins, aminoglycosides, fluoroquinolones and nitrofurantoin. All GNRs were 100% resistant to nitrofurantoin except E coli (39.2%) and Klebsiella spp (41.6% ) susceptible. Enterococcus were 100% sensitive while 87.5% of Staphylococcus aureus were sensitive to teicoplanin and linezolid. Conclusion: Ongoing monitoring should note any changes in paediatric uropathogens and their antibiotic resistance pattern to guide the clinicians for proper empirical management of UTI in children.

Background and Objectives: Surgical extraction of the third molars has been one of the widely performed procedures of all the minor oral surgical procedures in oral and maxillofacial surgery. Inflammation is a critical part of the normal sequence of healing as well as is an important cause for postoperative sequelae. They include pain, restriction of mouth opening, and swelling which are a few reasons for discomfort to the patient. There are various measures for the management of these complications including administration of nonsteroidal anti-inflammatory drugs. This study was done to compare the clinical efficacy of oral and sublingual piroxicam in the management of postoperative pain after surgical removal of the lower third molars. Methodology: The study comprised thirty selected patients with bilaterally impacted mandibular third molars. Split-mouth study design was implicated such that the patients served as their own control. Group 1 consisted of patients who were given piroxicam orally, and Group 2 consisted of patients who were given sublingual preparation postoperatively. Subjective evaluation (visual analog scale) and objective evaluation (validated landmarks) were carried out for pain, swelling, and trismus for the postoperative days 1 ^st , 3 ^rd , and 7 ^th . Results: The results showed no significant differences with respect to postoperative pain, trismus, and swelling when the two routes of drug delivery, namely, oral and sublingual were compared. Furthermore, the amount of rescue analgesics taken was slightly higher in the oral group but not statistically significant. Conclusion: Within the limitations of the study, it can be concluded both oral and sublingual formulations of piroxicam show comparable results and that both are equally effective in the postoperative management of pain, trismus, and swelling after surgical removal of the third molar.

Objective: This study aims to evaluate the role of Lycopersicon esculentum in diethylnitrosamine (DEN)-induced and phenobarbital (PB)-promoted hepatocellular carcinoma. Materials and Methods: The hepatocarcinogenesis was induced in male Wistar albino rats by DEN (single injection, 200 mg/kg, i.p.); 2 weeks later, 0.05% w/v of PB was administered through drinking water for 16 weeks. The treatment group rats received a similar dosage as above along with enzymatic extract of L. esculentum (250 mg/kg body weight p.o.) at 3 ^rd week onward. The carcinogenesis was evaluated by estimating biochemical markers such as alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and bilirubin, DNA and RNA levels, liver protein, and cancer biomarkers as alpha-fetoprotein (AFP). Results: Treatment with enzymatic extract of L. esculentum significantly reduced DEN/PB-mediated elevation of ALT, AST, ALP, and bilirubin levels. A significant decrease in the levels of DNA, RNA, and AFP and increase in liver protein were observed when L. esculentum-treated rats were compared with DEN/PB-treated rats. Conclusion: The present study suggests that L. esculentum possesses chemopreventive activity against DEN-induced and PB-promoted liver cancer.

Background: India is witnessing an increase in diabetic cases as peoples' lifestyle change. This rapid increase of cases has led to an increase in the healthcare burden of the country with a considerable financial strain occurring due to the cost spent on diabetes treatment annually. Proper management of diabetes is based on good self-management behaviors (diet control, physical activity, glucose monitoring, and adherence to medication). Globally, studies have indicated the link between self-management behaviors and social support. Proper self-management behaviors could be the key to reducing the healthcare burden arising due to diabetes. Objective: The objective of this study was to estimate the prevalence of compliance to treatment among diabetes patients and to assess the influence of social support on the self-management behaviors of diabetes patients. Materials and Methods: A two-stage cluster sampling technique was employed to recruit 330 patients with Type 2 diabetes. A validated questionnaire was used to collect data on social support and self-management behaviors. Results: Prevalence of compliance to treatment among diabetic patients was found to be 82.1%. This study showed that diabetes patients received highest social support for glucose monitoring (69.4%) followed by diet control (46.7%) and physical activity (31.2%). Chi-square test showed a statistical association between social support and diet control (P < 0.001), social support and physical activity (P < 0.001), and social support and glucose monitoring (P = 0.001). Conclusion: Presence of good social support was found to positively influence the self-management behavior of diabetes patients. Higher level of evidence can be generated to place interventions in this regard.

Background: The aim of the present study was to develop a polyherbal formulation for epilepsy. Present polyherbal formulation (PHF) (containing Operculina turpethum (L.) Silva Manso, Mimosa pudica L., Uraria picta (Jacq.) DC., Cajanus cajan (L.) Millsp, and Lawsonia inermis L.) is based on an ayurvedic formulation " Brihad Panchagavya Ghrita" indicated for epilepsy. Materials and Methods: To establish the scientific basis of mechanism, we examined the effects of methanolic extract of PHF (100, 200, and 400 mg/kg, p.o.) on maximal electric shock (MES), pentylenetetrazol (PTZ), and isoniazid (INH)-induced convulsions as well as gamma-aminobutyric acid (GABA)-glutamate level in the brain tissues in PTZ-induced seizure model. Phenytoin (25 mg/kg, i.p.) for MES-induced seizure and diazepam (2 mg/kg, i.p.) for PTZ and INH-induced epilepsy were used as reference drugs, respectively. Results: The extract showed no toxicity and significantly prolonged the onset and reduced the duration of the seizures induced by MES. Phenytoin (25 mg/kg, i.p.) completely inhibited the seizures in this model. Similarly, in the seizures induced by PTZ and INH, the extract also prolonged the onset and reduced the duration of the seizures though not in a dose-dependent manner. Diazepam also inhibits the PTZ and INH-induced seizures. The plant extract however showed a significant anticonvulsant activity at 400 mg/kg in comparison with diazepam. The extract also attenuates the chemical (PTZ) induce oxidative stress in the brain. Moreover, the extract (400 mg/kg) also significantly decreases the GABA-transaminase enzyme activity in PTZ model. The PHF was also found to be capable in reversing the INH-induced decline in GABA level and increase in glutamate level in the brain. Conclusions: The results obtained from this work suggest that PHF has anticonvulsant activity, and this supports the use of the formulation traditionally in the treatment of convulsions.

Statement of the Problem: Camper's plane is widely used to orient occlusal plane in edentulous patients, but the most reliable posterior reference point of Camper's plane is controversial. Purpose: The purpose of this study was to evaluate the most reliable posterior reference point of Camper's plane in relation with hamular notch-incisive papilla (HIP) plane with change in gender of edentulous subjects. Materials and Methods: The study was performed on 20 males and 20 females in the age group of 50-65 years. The conventional method of primary and secondary impression making was followed. The deepest point of the right hamular notch and the center of the incisive papilla was marked with an indelible marker on the master casts. Two spherical metal ball bearings of 3.1 mm were attached to the cast at the marked points, using cyanoacrylate resin. Autopolymerizing acrylic resin was adapted over the cast to construct the temporary denture base. Three spherical metal ball bearings were attached to superior, middle, and inferior part of the tragus and one at the ala of nose. A lateral cephalogram was made placing the temporary denture base in position intraorally. Cephalometric image analysis was done using Adobe Photoshop CS5. Results: Descriptive statistics of the data showed, in males, Camper's plane with superior point on tragus has a mean score of 8.71 ± 4.45, with middle point on tragus has 4.35 ± 3.17 and an inferior point on tragus has 4.01 ± 2.23. In females, Camper's plane with superior point on tragus has a mean score of 5.65 ± 2.64, with middle point on tragus has mean score of 2.71 ± 2.51, and inferior has 5.72 ± 3.09. Conclusion: Within the limitations of the study, it was concluded that in males, Camper's plane with posterior reference point as inferior border of tragus was the most parallel to HIP plane and in females, middle border of tragus was most parallel as the posterior reference point of Camper's plane in relation to HIP plane.

Objective: Most oral squamous cell carcinoma (OSCC) are preceded by premalignant conditions that demonstrate histopathologically as epithelial dysplasia and their malignant potential of a lesion is mainly determined using various grading systems. Loss of p120 catenin (p120) or its phosphorylation destabilizes E-cadherin; thereby it regulates cadherin stability and turnover which could affect the cell adhesive and migratory capacity. Therefore, p120 is related to invasiveness and progression of various human epithelial many tumor types, including OSCCs. Methodology: The immunoexpression of p120 in 60 selected cases were grouped into; oral epithelial dysplasia (OED) (n = 40) and OSCC (n = 20). The cases were assessed by two independent observers. The p120 immunolabeling was analyzed using the parameters intensity, percentage and the location of the epidermal growth factor receptor staining. Results: In OED, there was p120 expression observed in 100% of cases with 62.5% cases showing preserved expression, i.e., >50%, whereas 15% showed reduced/downregulation of p120 catenin levels. Further, a variation within the grades was also observed. The low-risk group of OED showed a preserved expression seen with most of the cases having >50% expression (95%) positivity and in the high-risk cases, there was a marked reduction with 70% of the cases showing reduced expression (P < 0.01). This reduction in expression was more prominent in OSCC with 60% showing reduced expression, whereas 20% showed loss of expression. Conclusion: The presence of strong reactivity was seen in oral dysplasia and most of the well-differentiated OSCC, the infiltrating areas of aggressive OSCC showed decreased and/or total lack of immunostaining. The abnormal staining pattern of p120 can reflect loss/reduction of adhesion and could be used to identify the malignant potential of OED and aggressiveness in OED.

Context: People affected by eye injury often have to face loss of career opportunities, major lifestyle changes, and occasionally permanent disfigurement. Aims: (1) To find the prevalence of ocular trauma in patients attending our hospital. (2) To find the clinical profile of ocular trauma patients and the cause of trauma in them. Settings and Design: This was a cross-sectional study conducted at KLE Hospital, Belagavi, Karnataka. Subjects and Methods: The present 1-year study was conducted in the Department of Ophthalmology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi, on 2308 trauma patients presenting to the ophthalmology outpatient department and casualty from January 1, 2014, to December 31, 2014. Out of 2308 patients, 217 patients were identified to have ocular trauma and were examined in a systematic fashion. Statistical Analysis Used: None. Results: The prevalence rate of ocular trauma was found to be 9.40%. Maximum patients (27.19%) were in the age group of 21-30 years. A total of 182 (83.87%) patients were male and 35 (16.13%) patients were female. Conclusions: Most common cause of ocular trauma was found to be road traffic accidents (RTAs), seen most commonly among males in the age group of 21-30 years. Males are commonly injured in RTA which is probably related to both exposure and risk-taking behavior. Several human and environmental risk factors were found to be associated with increased risk of RTA. Apart from RTA, occupational hazard was the next major cause of ocular trauma. Certain laws and legislations and their strict enforcement can curb these two major causes of ocular trauma.

Context: Surgically induced astigmatism (SIA) is the cause of poor postoperative vision even after uneventful cataract surgery. Aims: (1) To evaluate the effect of SIA after phacoemulsification clear corneal incision in the steepest meridian on the magnitude of preexisting astigmatism (PEA). (2) To map the magnitude of SIA by incisions in superior (S) and temporal (T) positions. Settings and Design: KLES Dr. Prabhakar Kore Hospital and Medical Research Centre (MRC), Belagavi, Karnataka. Longitudinal study. Subjects and Methods: The present 1-year study was conducted in the Department of Ophthalmology, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi, on patients undergoing cataract surgery during the period of January 1, 2014,-December 31, 2014. The patients undergoing phacoemulsification with PEA ranging from 0.5 D to 1.5 D were selected for the study to evaluate SIA after phacoemulsification clear corneal incision in the steepest meridian on the magnitude of the PEA. Statistical Analysis Used: Paired t-test was used to calculate mean SIA. Results: The result showed average SIA recorded was 0.54 ± 0.34 D with P < 0.001 (statistically significant). The SIA through temporal incision was 0.70 ± 0.35 D and through superior incision was 0.84 ± 0.49 D. This difference of SIA comparison between temporal and superior incision was not statistically significant (P = 0.145). On taking temporal incision, the mean keratometric difference was 1.03 ± 0.96, which was statistically significant. On taking superior incision, the mean keratometric difference was 0.92 ± 0.95, which was statistically significant. Conclusions: Choosing the clear corneal incision site based on the preoperative steepest meridian significantly decreased keratometric astigmatism at the temporal and superior locations. As well as, temporal incision is evidently better than superior incision in minimizing SIA.

Background: Women who are homemakers represent a vulnerable group regarding dental health, given the traditionally low importance placed on their health and preventive behavior, especially in the developing countries. Objective: To study the dental health-related behaviors among the homemakers in a region of Delhi, India, and its association with socioeconomic status (SES). Materials and Methods: A community-based cross-sectional study done in four selected residential colonies in a region of Delhi. Seven hundred and fifty-four homemakers residing in the colonies participated in the study. Results: Of the women, only 45.5% brushed their teeth twice daily while just 5.2% flossed their teeth at least once a day as recommended. The large majority (92.2%) never visited a dentist for preventive checkup. The most common reason cited for never having visited was "will go to a dentist only if some dental problem" (87.4%). Only 1.2% women were undertaking all the three major preventive health behaviors (brushing, flossing, and dental checkup). A significant direct association was observed between SES and the adoption of positive dental behaviors. Conclusion: The current study found specific lacunae in the behaviors related to dental health among the homemakers and an association with low SES. Dentistry practitioners and primary care managers need to be cognizant of the importance of promoting positive dental health behaviors in this sizeable constituency of homemakers, especially those who are socioeconomically deprived.

Background and Objectives: Early childhood caries (ECC) is one of the most prevalent diseases of childhood. Pediatric dentists must make conscious efforts to prevent this condition for optimal oral health. Normal salivary function is considered critical for the maintenance of a healthy oral cavity. Saliva provides an easily available, noninvasive medium for the diagnosis of wide range of diseases and clinical conditions. The objective of the present study was to estimate and compare salivary nitric oxide (NO) levels in caries-free children and children with ECC. Methodology: The children were divided into two groups. Group I comprised thirty caries-free children and Group II comprised thirty children with ECC. Saliva was collected by suction method. Griess reaction was used to estimate the NO levels. Unpaired t-test was used for comparing and evaluating the NO levels in both the groups. Results: Mean salivary Nitric Oxide level is significantly higher in caries free children as compared to that of children with early childhood caries (ECC). Interpretation and Conclusion: The present study clearly indicates a significant increase in salivary NO levels in caries-free children as compared to children with caries. This may be attributed to the antimicrobial action of NO.

Background and Aims: As a part of the Global Polio Eradication program by the World Health Organization (WHO, 1988), surveillance of acute flaccid paralysis (AFP) was an important public health activity in many countries. With nearing eradication of poliomyelitis, other causes of AFP are gaining importance in both children and adults. Our study was designed to know the clinical characteristics and differential diagnosis of causes of AFP, including distribution by age, gender, and time. This was a prospective observational study. Methods: AFP cases were diagnosed on history and physical examination. The underlying etiology was ascertained by appropriate laboratory investigations such as arterial blood gas analysis, urinary pH, electrolytes, thyroid profile, electrophysiological studies, cerebrospinal fluid (CSF) analysis, and imaging. Results: Between July 2010 and September 2012, 106 cases of AFP were enrolled in the study. The mean age of males was 40.2 years (standard deviation [SD] 17.1) and the mean age of females was 33.4 years (SD 14.1). Of 106 patients, 61 (57.5%) were male and 45 (42.5%) were female. Out of 106 patients, 58 (54.7%) were suffering from Guillain-Barre' syndrome (GBS), 15 (14.2%) from hypokalemic paralysis, 8 (7.5%) from myasthenia gravis, 8 (7.5%) from thiamine deficiency, 5 (4.7%) from transverse myelitis, and 2 (1.9%) from cord compression. Other diagnoses include acute motor axonal neuropathy 3 (2.8%), acute disseminated encephalomyelitis 2 (1.9%), meningoencephalitis 2 (1.9%), diabetic polyneuropathy 2 (1.9%), and chemotherapy-induced neuropathy 1 (0.9%). Of 106 patients, 42 (39.6%) were admitted during the spring season. Conclusion: GBS was the most common cause of AFP in all age groups. Most AFP cases occurred during the spring season. No case of poliomyelitis was found.

Background: Lung cancer is the second most leading cause of cancer mortality throughout the world. It is an imperative requirement to find reliable markers which can be used effectively to assess the initial analysis and predict the risk of lung cancer. The cytokinesis-blocked micronucleus (CBMN) assay is one of the well-developed methods to measure the proficiency of genomic instability in peripheral blood lymphocytes of individuals with different types of cancer. In our present study, we used the CBMN assay to investigate chromosomal aberrations in lung cancer patients. Materials and Methods: Peripheral blood was collected from lung cancer patients (n = 12) and healthy subjects (n = 10). The blood samples were cultured with RPMI-1640, fetal bovine serum, stimulated with phytohemagglutinin, and incubated at 37°C. The cells were blocked by adding cytochalasin-B at 44 ^th h and analyzed for micronuclei, nucleoplasmic bridges, and nuclear buds (NBUD) in binucleated cells. Results: The frequency of micronuclei, nucleoplasmic bridges, and NBUD were found to be significantly (P < 0.001) higher in cases, indicating escalated genetic damage in cancer patients than controls. This study also revealed a correlation between the age, duration of smoking, number of cigarettes, and chromosomal aberration present in the study subjects. Conclusion: The CBMN assay is a valuable tool that can be employed to screen lung cancer cases for its simplicity, rapidity, and sensitivity.

Background: Mucositis persists throughout radiation therapy. As radiation therapy continues mucositis worsens. It contributes to poor nutrition, low quality of life. Even though on one side radiation helps as a treatment, on the other side it has its complications that are making an issue in the developing countries. The aim of the study to assess the effectiveness of 0.2% chlorhexidine mouthwash as compared to 1% povidone-iodine mouthwash on radiation-induced oral mucositis among patients with head and neck cancer. Materials and Methods: Simple random sampling technique through lottery method was used to select the sample for study. The experimental group and control group consisting of 50 subjects were advised to rinse their mouth with 15 ml of 1% povidone-iodine mouthwash and 0.2% chlorhexidine mouthwash respectively for 30 s, 15 min before radiation therapy, after 15 min and 4 h after radiation therapy. Postintervention assessments were made on day 1, 7, 11, and 15 after intervention with 1% povidone and 0.2% chlorhexidine mouthwash iodine mouthwash in the experimental and control group, respectively. Results : The result showed that in the experimental group the mean oral mucositis grades obtained during I ^st , II ^nd , III ^rd , and IV ^th interventional assessment (1 ^st , 7 ^th , 11 ^th , and 15 ^th day) were 0, 0.64, 1.34, and 2.5 whereas in the control group were 0, 0.14, 0.80, and 1.6, respectively. This proved that there is a significant reduction in the oral mucositis in the control group (0.14-0.80) when compared to experimental group (0.64-2.5). Conclusion: Study findings revealed that both mouthwashes were effective in controlling radiation induced oral mucositis however 0.2% chlorhexidine fared better

Statement of the Problem: The distance between the canines is usually measured around the curvature of the wax occlusal rim; however, most manufacturer's mold charts provide the measurements of the artificial six anterior teeth as if they were on a straight line. Purpose: To assess the correlation between combined mesiodistal width (CW) of six maxillary anterior teeth and curved distance (CD) from distal surface of one canine to the other measured on the occlusal rim for Indian and Malaysian population. Materials and Methods: Seventy maxillary dentate casts were used (35 Indians and 35 Malaysians). The width of each maxillary anterior tooth was measured using modified Vernier caliper. The CW of six anterior teeth corresponded to the sum of the width of each anterior tooth. Putty indexes were made on the labial surface of anterior teeth, and the casts were made partially edentulous by trimming the six anterior teeth. Occlusal rims were prepared with the help of index. The CD between the distal surface of one canine to the other was measured on the rim by ligature wire adapted across the center of the rim and measured using the Vernier caliper. Unpaired t-test/Pearson correlation and linear regression analysis were used to find out the correlation. Results: Pearson correlation test for CW and CD was statistically significant for both the groups (Indians [r = 0.820] and Malaysians [r = 0.941]) linear regression equations were obtained: Indians (CD = 1.1 [CW] − 12.4) and Malaysians (CD = 1.1 [CW] − 11.0). Conclusion: The CD can be related to the CW of six anterior teeth for both (Indians and Malaysians) and can be used in the clinical practice for selecting the comparatively accurate mold size. In broader sense, the CD for Indians will be 6-8 mm greater than the combined width, while for Malaysians, it will be 5-7 mm greater than the combined width.

Objective: Bisphosphonates represent the first choice in the treatment of osteoporosis, and no data are available concerning their effects on comorbid behavior alterations. There are some contradictory reports regarding these drugs with respect to antidepressant activity in humans. Hence, the present study was planned to investigate the effects of etidronate in male Wistar rats and Swiss albino mice using depression paradigms, namely, forced swimming test (FST) and tail suspension test (TST). Materials and Methods: Eighteen male Wistar rats and 18 male Swiss albino mice were brought and acclimatized 10 days prior to experimentation. Then, they were randomized into three groups: (1) control (distilled water), (2) standard (amitriptyline), and (3) test (etidronate). After treatment, the Wistar rats were subjected to FST while Swiss albino mice were subjected to TST to evaluate the antidepressant activity. Results: Etidronate showed significant decrease in the immobility time in both FST and TST when compared to that of control group. There was no significant decrease in the immobility time when compared between the standard amitriptyline and etidronate groups. Locomotor performance was tested using actophotometer for all the three groups taken in the study. Effects on locomotor activity showed no significant difference among all three groups. Conclusion: From the results, it is concluded that etidronate can have antidepressant activity. Based on experimental and observational studies, there appears to be a role of etidronate in depression.

Objective: The present study was designed to evaluate the cardioprotective potential of Acorus calamus (AC) on doxorubicin (DOX)-induced myocardial toxicity. Materials and Methods: Albino Wistar rats were used in this study. DOX was administered intraperitoneally in six equal injections (each containing 2.5 mg/kg DOX at 48 h interval) to a total cumulative dose of 15 mg/kg over 2 weeks to produce cardiotoxicity. Control and treated group animals were used for the estimation of lipid and cardiac biomarkers. Animals were sacrificed and heart tissue was used for the assay of glutathione (GSH), malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD) and also for the membrane-bound enzymes namely Na ⁺ -K ⁺ -ATPase, Ca ⁺² -ATPase, and Mg ⁺² -ATPase. The remaining portion of the heart tissue was used for histopathological studies. Results: Pretreatment with AC decreases serum enzyme levels and lipid profiles brought to the near normal values, and it significantly protected the myocardium from the toxic effect of DOX, by increasing the levels of antioxidant enzymes such as GSH, SOD, and CAT toward normal and decreasing the increased level of MDA. AC (200 mg/kg) + DOX showed significant increase in Na ⁺ -K ⁺ -ATPase and Mg ⁺² -ATPase and decrease in Ca ⁺² -ATPase compared to DOX-treated groups. Conclusion: The results of this study indicated that the cardioprotective effect of AC might be attributed to its antioxidant property.

Background and Aims: Dexmedetomidine is a selective α₂ agonist used as an adjuvant to attenuate sympathetic response to laryngoscopy and tracheal intubation in general anesthesia. Recent studies have shown that dexmedetomidine decreases brain flow and cerebrospinal fluid pressure without cerebral ischemia. Hence, it is beneficial in neurosurgical procedures. This study was undertaken to analyze the efficacy of dexmedetomidine in neurosurgery for good perioperative hemodynamic stability with blunt sympathetic response to laryngoscopy and intubation. Materials and Methods: Sixty, American Society of Anesthesiologists grades II-IV patients between 18 and 50 years of age undergoing craniotomy under general anesthesia were divided randomly into two groups (thirty patients in each group). Group D: Dexmedetomidine was given as a bolus dose of 1 μg/kg diluted to a total volume of 20 ml with normal saline (0.9%) for 10 min before the induction of anesthesia. Group C: The patients received a similar volume of normal saline. Results: We observed a decrease in blood pressure and heart rate (HR) after intubation by dexmedetomidine, and they were highly significant on comparison (P < 0.0001). During intraoperative period, the patients in Group D had lower HR and blood pressure than baseline value as compared to Group C (P < 0.0001). We also observed decreased requirement of sevoflurane (33%) and fentanyl (45%) in Group D compared to Group C. Data were expressed as mean values ± standard deviation. P <0.05 was considered to be significant. Conclusion: Dexmedetomidine blunted the hemodynamic stress response due to laryngoscopy and intubation and perioperative hemodynamic stability in patients undergoing neurosurgery.

Background: Many preoperative airway assessment tests to predict a difficult intubation (DI) have been developed and documented, but we have no published data on how frequently these tests are used or how useful they are perceived by anesthetists in Nigeria. This survey was done among physician anesthetists in Nigeria to document practices related to the use of bedside airway predictive tests in adults. Methods: The following tests were compiled into a questionnaire and administered to physician anesthetists in training. Effective mandibular length, inter-incisor gap (IIG), Mallampati classification (MC), sternomental distance, thyromental distance, hyomental distance (HMD), range of neck motion (ROM), upper lip bite test (ULBT), mandibular protrusion test, and prayer sign (PS). A 5 and 4-level Likert item was used to assess the frequency of use and perceived importance of each test during the preoperative period. Results: A total of 81 (90%) participants completed the questionnaires. Of the 10 predictive tests listed; MC and ROM were "always" and "very often" used in 80 (98.8%) and 67 (82.7%) of participants, while PS, ULBT, and HMD is "rarely" or "never used" in 42 (51.9%), 41 (50.6%), and 39 (48.2%) of participants, respectively. MC, ROM, and IIG assessments were considered "very useful" and "useful" in 76 (93.8%), 69 (85.2%), and 69 (85.2%) of participants respectively in predicting DI, while HMD and PS were considered to be of "little use" by 7 (8.6%) and 7 (8.6%) of participants, respectively. MC, ROM, and IIG measurement (28%) were perceived as the best combination for high predictive value for DI. Conclusion: There is a tendency towards the use of MC and ROM more frequently than other tests during bedside preoperative airway assessment in adults by physician anesthetists in Nigeria. This practice may be insufficient for the prediction of DI in view of the current evidence.