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<p class="abstract"><strong>Background:</strong> Osteoarthritis of knee is one of the most commonly affecting condition affecting the activities of daily living in the middle age group Indian and Asian population. Total knee arthroplasty (TKA) performed for pain relief and improvement in mobility of individuals is associated with significant post-operative pain. Ischemic preconditioning is one of the non-pharmacologic methods of reduction in postoperative pain using variable periods of tourniquet induced ischaemia which has limited data in literature.</p><p class="abstract"><strong>Methods:</strong> Sample size (n=30) was taken. A standard automatic pneumatic tourniquet was used while performing ischemic preconditioning of the limb prior to TKA and during surgery. Statistical analysis was performed with p values &lt;0.05 considered significant. Standard postoperative analgesia as per hospital protocol was given to patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean 6 hour postoperative and 48-hr postoperative visual analogue scale (VAS) score at rest is significantly higher compared to mean preoperative VAS score at rest (p&lt;0.01 for both). The distribution of mean preoperative and 24 hour postoperative VAS score at rest did not differ significantly (p&gt;0.05). The mean % change in postoperative period compared to preoperative VAS at rest was 47.06%.</p><p class="abstract"><strong>Conclusions:</strong> In this study, the effect of preconditioning over postoperative pain relief was not consistent. Although the patient reported pain scores were low at 6th and 24th postoperative hour, the effect at 48th postoperative hour was not satisfactory. Studies with larger sample size required for better understanding of ischemic preconditioning.</p>

Background: Tuberculosis is the most common co-infection among HIV Sero-Positive individuals. Radiological diagnosis of Pulmonary Tuberculosis is not a primary tool but having some importance in resource poor country like India, where there is lack of universal accessibility of molecular diagnosis. Radiographic presentation of tuberculosis differs in patients with HIV or without HIV infection. Objective: To compare radiological presentation in patients of pulmonary tuberculosis among HIV Sero-Positive and HIV Sero-Negative individuals. Methods: In this cross-sectional observational study we analysed the radiological manifestation of pulmonary tuberculosis among HIV Sero-Positive & HIV Sero-Negative patients at V.S.S. Medical College, Burla, Odisha, India from September 2013 to August 2015. Results: Unilateral infiltrative lesions are commonest form of radiological manifestation in both HIV Sero-Positive & HIV Sero-Negative groups. The prevalence of Cavitary lesion was statistically less (p < 0.001) in the HIV sero-positive groups than HIV Sero-Negative group. Hilar lymphadenopathy was observed only in the HIV Sero-positive group. Involvement of multiple chest radiological zone was statistically less (p =0.01) seen in HIV Sero-Positive groups than to HIV Sero-Negative groups. Minimal lesions were statistically more (p=0.001) seen in HIV Sero-Positive individuals & moderately advance lesion were statistically more (p<0.0001) in HIV Sero-Negative patients. Conclusion: In HIV Sero-Positive individuals, radiological manifestation of pulmonary tuberculosis is not similar to HIV Sero-Negative patients. Physicians should consider Pulmonary Tuberculosis when atypical radiological manifestation seen in HIV Sero-Positive cases for early diagnosis & treatment.

Background: Osteoarthritis (OA) of knee is a degenerative disorder characterized by the softening, ulceration and focal loss of articular cartilage, sclerosis of the subchondral bone, marginal osteophyte formation and a range of morphological and biochemical changes in the synovium & capsule of the knee joint. Total knee arthroplasty (TKA) has been the treatment of choice for advanced osteoarthritis of knee. TKA is associated with significant post-operative pain. The aim of this study is an evaluation of inflammatory markers (ESR, CRP, INR, TLC) following TKA with use of tourniquet in the perioperative period. Methods: Sample size (n=30) was taken A standard automatic pneumatic tourniquet was used during the surgery. Data on demographics, duration of surgery, Erythrocyte sedimentation rate (ESR), C-Reactive Protein (CRP), Total leukocyte count (TLC), Coagulation profile (INR) and limb circumference were analysed. P-values < 0.05 are considered to be statistically significant. The entire data was statistically analysed using Statistical Package for Social Sciences (SPSS version 21.0, IBM Corporation, USA). Results: The distribution of mean 6-hr post-op and 48-hr post-op ESR is significantly higher compared to mean pre-op ESR (P-value<0.001 for both). The mean% change at 48-hr post-op compared to pre-op in CRP is 1404.89% which was statistically significant. The change in preoperative INR versus postoperative 6 th hr INR is not significant (P value>0.05) as well as the preoperative versus 48 th hour. The mean% change at 48-hr post-op compared to pre-op in TLC is 96.24% with p value <0.001. Conclusions: In this study it was found that there is a significant increase in inflammatory markers (ESR, CRP, TLC) in the post-operative period which is consistent with studies in the past. Due to small sample size of the study, the data generated can be utilized as a baseline to study correlation between pain and inflammatory marker levels on a larger scale at multicentric levels.

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