Background:Various adjuvants have been used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine.Materials and Methods:Sixty patients classified in American Society of Anesthesiologists classes I and II scheduled for lower abdominal surgeries were studied. Patients were randomly allocated to receive either 12.5 mg hyperbaric bupivacaine plus 5 μg dexmedetomidine (group D, n = 30) or 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl (group F, n = 30) intrathecal.Results:Patients in dexmedetomidine group (D) had a significantly longer sensory and motor block time than patients in fentanyl group (F). The mean time of sensory regression to S1 was 476±23 min in group D and 187±12 min in group F (P<0.001). The regression time of motor block to reach modified Bromage 0 was 421±21 min in group D and 149±18 min in group F (P<0.001).Conclusions:Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand for rescue analgesics in 24 h as compared to fentanyl.

A comparative study of roentgenograms of the paranasal sinuses between 37 patients with cleft lip and palate and 37 control subjects of the same age group was done using a planimeter. The results indicate that there is no statistical difference in the sizes. The paranasal sinuses increased in size with age in patients as well as in control subjects.

Background:Stress has touched almost all professions posing threat to mental and physical health. India being the Information Technology (IT) hub with lakhs involved as IT Professionals, there is a need to assess prevalence of professional stress, depression and problem alcohol use and understand their association.Objectives:(1) To screen for the prevalence of professional stress, risk for depression and harmful alcohol use among software engineers. (2) To study the association between professional stress, risk for depression and harmful alcohol use.Materials and Methods:This is a cross-sectional online study conducted using screeing questionnaires like professional life stress scale, centre for epidemiological studies depression scale and alcohol use disorders identification test. This study was conducted specifically on professionals working in an IT firm with the designation of a software engineer.Results:A total of 129 subjects participated in the study. 51.2% of the study sample was found to be professionally stressed at the time of the interview. 43.4% of the study population were found to be at risk for developing depression. 68.2% of those who were professionally stressed were at risk for developing depression compared with only 17.5% of those who were not professionally stressed. Odds ratio revealed that subjects who were professionally stressed had 10 times higher risk for developing depression compared to those who were not professionally stressed. Subjects who were professionally stressed had 5.9 times higher prevalence of harmful alcohol use compared to those who were not professionally stressed. Subjects who were at risk for developing depression had 4.1 times higher prevalence of harmful alcohol use compared with those who were not at risk for developing depression.Conclusion:Such higher rates of professional stress, risk for developing depression and harmful alcohol use among software engineers could hinder the progress of IT development and also significantly increase the incidence of psychiatric disorders.

SummaryBackgroundPosterior reversible encephalopathy syndrome (PRES), also called the acute hypertensive encephalopathy and reversible posterior leukoencephalopathy syndrome (RPLS), is a neurotoxic syndrome of cerebral vasoregulation classically characterized by bilaterally symmetrical parieto-occipital edema. However, the imaging findings are variable and may occur in other locations such as the frontal lobes, thalami, basal ganglia and brainstem. Most commonly, PRES presents with hyperintense signals on T2 and FLAIR sequences. Restricted diffusion and hemorrhage are rare. This study presents the typical and atypical manifestations of PRES on 3T MR images.Material/MethodsIt is a retrospective study analyzing a radiology report database and MR images of 92 patients with a clinical and radiological diagnosis of PRES. The brain MRI images of these patients were evaluated. The regions involved and the signal intensity of the affected areas on T1, T2, FLAIR and DW sequences were recorded. The location of the abnormal signal intensity as well as the presence or absence of atypical features such as diffusion restriction and hemorrhage were also recorded.ResultsThe most commonly affected region was the parieto-occipital lobes (100%), however, other atypical regions involved were the frontal lobes (30.4%), temporal lobes (8.69%), basal ganglia (22%), cerebellum(17.39%), brainstem(9%) and thalamus(4%). Some of the cases showed restricted diffusion (43%) and hemorrhage (9%).ConclusionsThe involvement of the parieto-occipital, frontal and temporal lobes is common in PRES. Occasionally, there may be an involvement of the basal ganglia, cerebellum and brainstem, with or without hemorrhage and restricted diffusion. Radiologists should be aware of the typical and atypical imaging manifestations of PRES in order to make an accurate diagnosis.