Background:The challenging task of postoperative pain relief comes within the realm of the anesthesiologist. Combined spinal epidural (CSE) anesthesia can be used as the sole technique for carrying out surgical procedures and managing postoperative pain using various drug regimes. Epidural administration of opioids in combination with local anesthetic agents in low dose offers new dimensions in the management of postoperative pain.Aims:Comparative evaluation of bupivacaine hydrochloride with nalbuphine versus bupivacaine with tramadol for postoperative analgesia in lower limb orthopedic surgeries under CSE anesthesia to know the quality of analgesia, incidence of side effects, surgical outcome and level of patient satisfaction.Settings and Design:A prospective, randomized and double-blind study was conducted involving 80 patients of American Society of Anesthesiologists physical status I and II coming for elective lower limb orthopedic surgeries carried under spinal anesthesia.Materials and Methods:Anesthesia was given with 0.5% of 2.5 ml bupivacaine intrathecally in both the groups. Epidurally 0.25% bupivacaine along with 10 mg nalbuphine (group A) or tramadol 100 mg (group B) diluted to 2 ml to make a total volume of 10 ml was administered at sensory regression to T10.Statistical Analysis:The data were collected, compiled and statistically analyzed with the help of MS Excel, EPI Info 6 and SPSS to draw the relative conclusions.Results and Conclusions:The mean duration of analgesia in group A was 380 ± 11.49 min and in group B was 380 ± 9.8 min. The mean sedation score was found to be more in group B than group A. The mean patient satisfaction score in group A was 4.40 ± 0.871 and in group B was 3.90 ± 1.150 which was found to be statistically significant (P < 0.05). We concluded that the addition of nalbuphine with bupivacaine was effective for postoperative analgesia in terms of quality of analgesia and patient satisfaction score as compared to tramadol.

We hypothesized that the ventilatory threshold and sensitivity to carbon dioxide in the presence of hypoxia and hyperoxia during wakefulness would be increased following testosterone administration in premenopausal women. Additionally, we hypothesized that the sensitivity to carbon dioxide increases following episodic hypoxia and that this increase is enhanced after testosterone administration. Eleven women completed four modified carbon dioxide rebreathing trials before and after episodic hypoxia. Two rebreathing trials before and after episodic hypoxia were completed with oxygen levels sustained at 150 Torr, the remaining trials were repeated while oxygen was maintained at 50 Torr. The protocol was completed following 8-10 days of treatment with testosterone or placebo skin patches. Resting minute ventilation was greater following treatment with testosterone compared with placebo (testosterone 11.38 +/- 0.43 vs. placebo 10.07 +/- 0.36 l/min; P < 0.01). This increase was accompanied by an increase in the ventilatory sensitivity to carbon dioxide in the presence of sustained hyperoxia (VSco(2)(hyperoxia)) compared with placebo (3.6 +/- 0.5 vs. 2.9 +/- 0.3; P < 0.03). No change in the ventilatory sensitivity to carbon dioxide in the presence of sustained hypoxia (VSco(2 hypoxia)) following treatment with testosterone was observed. However, the VSco(2 hypoxia) was increased after episodic hypoxia. This increase was similar following treatment with placebo or testosterone patches. We conclude that treatment with testosterone leads to increases in the VSco(2)(hyperoxia), indicative of increased central chemoreflex responsiveness. We also conclude that exposure to episodic hypoxia enhances the VSco(2 hypoxia), but that this enhancement is unaffected by treatment with testosterone.

Energy needs, depleting fossil fuel supplies and demanding sustainable energy alternatives is ever-increasing process. In the future energy network, power storage systems are one of the indispensable devices to buffer the irregular energy generation and renewable energy supplies. Therefore, it is important to design an innovative and efficient modern electrochemical storage system, combine with resource abundance, eco-efficient industrial methods, and life-cycle analysis. These issues are currently being addressed by few existing technologies but there are still theoretical and technical challenges in each case that needs to be talked again. Among these technologies Metal Air Battery (MAB) is a prominent solution and has recently been again into research these days. A metal air battery comprises a metallic anode in an appropriate electrolyte, and an embedded air cathode. The metals that can be used as anode may be first group metals such as sodium lithium, potassium etc. in second group other elements like magnesium, calcium etc. and third group aluminium and a few transition metals like Fe and Zn. Metal-air batteries are actually the combination of the design and working of traditional and fuel cell batteries. These have a high energy efficiency that is 5 to 30 times greater than lithium-ion batteries and are often considered a sustainable alternative. MABs considered are as eco-friendly, non-toxic, low cost and viable alternative as metals are abundant in nature. Metal-air batteries now a days are the most promising power storage systems with high power densities. A metal air battery comprises a metallic anode in an appropriate electrolyte, and an embedded air cathode. Metal-air batteries (MABs) combine the design features of traditional and fuel cell batteries. Some of the most common metal-air batteries include LAB (lithium air battery), SAB (sodium air battery), MABs (magnesium-air battery), AAB (aluminium air battery) and ZAB (zinc-air battery) etc.

No abstract