This study was undertaken to determine shear bond strength of different sizes 01 commercially available gauze mesh, which were spot•welded on the base of the bracket. There after they were bonded to freshly extracted premolar teeth to determine the bond strength. The debonded brackets were rebonded to determine the shear rebond strength.The shear strength of the four type of gauze mesh were compared and correlated with that 01 a control Edgewise and 8egg bracket, having built•in base. II was concluded that. (I) the coarser size of gauze mesh (422 J.Jrn mesh diameter and 190 $lm wire diameter) was found to provide maximum shear bond strength, (2) bond failure was mostly (77%) found in the interface, between gauze mesh and bonding agent, (3) the rebonded strength was insignificantly effected, and (4) bond area played insignificant role in shear bond strength.

Background: Brachial plexus block utilizing ultrasound imaging has now become either adjuvant to general anaesthesia (GA) or as a mainstay anaesthesia modality. There are fewer studies comparing the effects of ropivacaine and levobupivacaine for supraclavicular brachial plexus block. The aim of this study was to do a prospective randomized study to compare 0.5% Levobupivacaine and 0.5% Ropivacaine in patients undergoing forearm orthopaedic surgeries under Ultrasound-Guided Supraclavicular Brachial Plexus Block. Materials and Methods: A total of 56 patients were enrolled and randomized into two groups. Group R with 28 patients was given 30mL of 0.5% Ropivacaine and Group L with 28 patients were given 30 mL of 0.5% Levobupivacaine, drugs were used for giving supraclavicular block under ultrasound. Parameters assessed were onset and duration of sensory and motor block, duration of analgesia, and any adverse events. After administration of block, the block characteristics were assessed every 5mins till the onset of the complete blockade, then hourly till the effect of the block. Data between the groups were analysed using SPSS 25.0 software. Results: Demographically both the groups were comparable in the study. The study shows that there was a statistically significant difference in onset of sensory block in Levobupivacaine and Ropivacaine (7.54 mins ± 2.10 vs 8.55 mins ± 2.08), similarly there was the difference in onset of motor block in Levobupivacaine 12.95 mins ± 2.30 vs Ropivacaine 14.07 mins ± 2.22. The duration of analgesia was more in the group of patients Levobupivacaine (9.98 hours ± 4.88) Ropivacaine (8.03 hours ± 3.58) Conclusion: the onset of action of sensory and motor was early in Levobupivacaine group with faster recovery of motor function as compared to the equivalent dose of Ropivacaine. Levobupivacaine has a better profile in terms of duration of analgesia. Keywords: Brachial plexus block, ropivacaine, levobupivacaine, supraclavicular brachial plexus block, ultrasound guidance

No abstract

Extended-spectrum β-lactamases (ESBLs) are a group of plasmid-mediated, diverse, complex and rapidly evolving enzymes that are posing a major therapeutic challenge today in the treatment of hospitalized and community-based patients. Enterobacteriaceae group is the main cause of bacterial infection and in this family Escherichia coli and Klebsiella species are the most common causes of nosocomial infections. ESBLs represents a major threat among multidrug-resistant (MDR) bacteria isolates. These ESBL producing pathogens are now recognized globally as major causes of nosocomial and community-acquired infections. ESBL detection is important from a therapeutic point of view and for infection control purposes. Carbapenems are often used to treat infections caused by ESBL producing E. coli and Klebsiella. This study was conducted in indoor patient department of Teerthanker Mahaveer Medical College & Research Centre, Moradabad, U.P., which is a tertiary care hospital. This study was conducted during the period from April 2015 to December 2017.A total no. of 350 gram negative Enterobacteriaceae were isolated in 800 no. of samples. They were screened for the beta-lactamase production. Among the 350 isolates 210 strains were ESBL producers. The major ESBL producers were E.coli (32%) followed by Klebsiella, Enterobacter, Citrobacter, Proteus. Multidrug resistance to Fluoroquinolones and Aminoglycosides were observed in the ESBL producing organism. The most common ESBL producing organism were from ICU.

Background: Modified Electroconvulsive therapy (MECT), is evidence based, safe and established treatment for varieties of psychiatric diseases that includes acute mania, major depressive disorder, schizophrenia, suicidal tendency and many more conditions. Government of India and world health organization has mandated use of sedative / anesthetic drug to make MECT acceptable method of treatment. MECT is administered under anesthesia to control acute cardiovascular, cerebrovascular and musculoskeletal changes occurring subsequent to delivery of electric current across the cerebral cortex. This also prevents respiratory and traumatic complications. Subjects and Methods: In the present clinical observational study we analyzed 113 MECT administrations for evaluating suitability of thiopentone sodium, propofol and midazolam with succinyl choline chloride; on 45 patients belonging to ASA grade II with no associated systemic diseases. Results: We observed the induction characteristics, induction and recovery time, associated changes in hemodynamic parameters during and after procedure, duration and energy required to induce muscular convulsions and changes in serum potassium level. Our observations indicates that induction was quicker with propofol than with thiopentone 43.67 ± 9.13v/s 61.31 ± 15.58 seconds and recovery time was also quicker with propofol than thiopentone 518.73 ± 69.67 v/s 595.25 ± 112.68 seconds. Only on one occasion in thiopentone group induction was turbulent. Acute but short lasting changes in heart rate, systolic, diastolic and mean arterial pressure was observed in both thiopentone and propofol groups. The energy requirement was less than 100 joules on 34 sittings in thiopentone group while in propofol group it was observed on 47 sittings. In thiopentone group on 17 occasion energy required were more than 100 joules and 5 sittings in propofol group. There was transient elevation of mean serum potassium of 0.55 mEq/lit after MECT in all patients. Midazolam did not produce satisfactory condition in dose of 5 mg and needed thiopentone supplement on 10 occasions. Conclusion: The findings allowed us to conclude that both thiopentone and propofol along with subparalytic dose of succinyl choline chloride produced satisfactory conditions for MECT sittings without complications. However propofol provided quick induction and recovery and lesser energy requirement.