BACKGROUND Mandibular fracture treatment includes restoration of anatomic form and function with establishment of occlusion. Different methods are used to provide stable fixation like metallic compression plates, mini plates, locking plates, 3D plates and bioresorbable plates, etc.The present study compared the effectiveness of bioresorbable plates to the conventional titanium miniplates. MATERIALS AND METHODSNon-randomised controlled trial conducted on patients aged between 16 -56 years of either gender with clinical and radiographical evidence of mandibular fractures requiring open reduction and internal fixation, visiting dental department for the period of one year were enrolled for the study. They were intervened with either Bioresorbable Plates or Titanium Miniplates for the management of mandibular fractures under general anaesthesia. The patients were allotted in 2 groups. Group-I was treated with 2.5 mm Bioresorbable plates and screws; Group-II was treated with 2.0 mm Titanium miniplates and screws. Clinical and radiographic outcome parameters such as stability of occlusion, mobility of fracture fragments, need for intermaxillary fixation, wound healing, stability of fixation, displacement of fracture fragments and healing of fracture site were evaluated. RESULTSIn Group-I 6 patients showed unstable occlusion, 4 patients showed fracture mobility, 6 patients required intermaxillary fixation, whereas in Group-II only 3 patients had unstable occlusion, none of the patients showed fracture mobility (p < 0.05), only 3 patients required IMF during 1 st week post-operatively. There was no abnormality in wound healing/ soft tissue dehiscence and post-operative healing was satisfactory in both the groups. CONCLUSIONThe use of 2.0 mm titanium miniplates is a viable and better option as compared to bioresorbable plates for fixation of mandibular fractures. The stability of titanium plates is significantly higher than the bioresorbable plates for early function of mastication.

Background: Various adjuvants have been used in intrathecal anesthesia to avoid intraoperative visceral and somatic pain and prolong postoperative analgesia. Clonidine, partially selective α2-agonist, is being evaluated as a neuraxial adjuvant with intrathecal bupivacaine. The objective of the study was to evaluate and compare safety and efficacy of intrathecal clonidine as adjuvant to bupivacaine with control normal saline.Methods: American Society of Anesthesiologist grade 1 and 2 patients (60 patients) were randomly divided into two groups of 30 patients each for lower limb surgeries. Study group injected with intrathecal 3ml of 0.5% Bupivacaine heavy (15mg) + 1µg/kg of clonidine and control group injected with 3ml of 0.5% Bupivacaine heavy (15mg) + equivalent dose of normal saline. The onset and duration of sensory and motor block, duration of analgesia, and the incidence of side effects in both groups were observed and compared.Results: Time for 2 segment regressions in study group was 186.17±25.92 minutes compared to control was 103.20±19.15 minutes (p value<0.001). Total duration of analgesia in control was 226.50±35.69 minutes and in the study group was 465.67±100.37 minutes (p value<0.001). The average duration of motor block in control group was 181.17±26.12 minutes compared to study group was 217.80±41.51 minutes (p value<0.001). The small dose of intrathecal clonidine is not significantly associated with systemic side effects such as bradycardia and hypotension.Conclusions: Clonidine added to bupivacaine for intrathecal anesthesia effectively increases the duration of sensory block, duration of motor block and duration of analgesia and does not produce any significant hemodynamic changes. No significant side effects are associated with it.

Background: In developing countries 2–3 million people are acutely poisoned by organophosphorus (OP) pesticides every year. There is a pressing need for new affordable antidotes and in this context clonidine which has central effect (α2 agonist) has been evaluated in the albino rats presenting with signs or symptoms of acute malathion poisoning. And compared with atropine for the acte malathion poisoning in albino rats.Methods: This was a preclinical study conducted on albino rats of either sex weighing 100-150 grams were randomly divided into 4 groups (6/group). Malathion was given at the lethal dose of 54 mg/kg body weight (BW) by gavage to each group. Group 1: normal saline intraperioneal (i.p). Group 2: Post treated with atropine 1.5 mg/kg BW (i.p). Group 3: Pre treated with clonidine 1mg/ kg BW (i.p), 10 minutes priore malathion. Group 4: Pre treated with clonidine and post treated with atropine. The above groups were observed for straub tail, muscle fasciculation, piloerection, lacrimation, defecation/ urination; salivation, tremors, gasping and convulsion and were recorded at time 0, 15, 30, 45 and 60 minutes after poisoning. The latency of onset of tremors, loss of righting reflex and tremors were recorded. Results were presented as percentage occurrence and Mean ± SEM. Repeated measure one way ANOVA and Fisher’s Least Significant Difference post hoc test for comparison between groups. P-value of 0.05 or less was considered for statistical significance.Results: The central effects namely straubs tail and whole body tremors are significantly improved compared to control and atropine with clonidine group (p<0.05). However convulsion shows improve in atropine alone and atropine with clonidine groups. The overall survival time has significantly increased compared to control and atropine and atropine with clonidine (P<0.05).Clonidine has not shown any effect on survival time.Conclusions: Clonidine has some central protective effect in malathion poisoning. And it has not shown any effect on survival time. This issue needs further controlled studies.