The Effect of Interleukin-1 Allele 2 Genotype (IL-1a−889 and IL-1b+3954) on the Individual's Susceptibility to Peri-Implantitis: Case-Control Study

2011 ◽  
Vol 37 (3) ◽  
pp. 325-334 ◽  
Author(s):  
Ahmed Abd El-Meguid Mostafa Hamdy ◽  
Mohamed Abd El-Moniem Ebrahem
Keyword(s):  
Interleukin 1 ◽  
Response To Treatment ◽  
Clinical Parameters ◽  
Tissue Destruction ◽  
Maintenance Program ◽  
Group I ◽  
Significant Difference ◽  
Polymerase Chain ◽  
Group Ii ◽  
Control Study

Abstract Individuals bearing the combination of interleukin (IL)-1 allele 2 at IL-1A−889 and IL-1B+3954 are referred to as being genotype positive and are susceptible to increased periodontal tissue destruction. The aim of this study was to assess the possible association of IL-1 allele 2 (IL-1A−889 and IL-B+3954) genotypes with the severity of peri-implantitis progression and the effect of this combination on treatment outcomes. Fifty patients with International Team for Implantology implants were studied; patients ranged in age from 35–55 years, and each patient had 1 implant. According to peri-implant tissue status, patients were divided into 2 groups: group I consisted of 25 patients with peri-implantitis, and group II comprised 25 patients with healthy peri-implant tissue. Clinical parameters were assessed at baseline and after 3 and 6 months. Epithelial cells were collected from the oral mucosa by plastic spatula and were used for IL-1 genotyping by the polymerase chain reaction technique. Group I patients were subjected to a peri-implantitis treatment and maintenance program. In all, 17 patients from group I and 5 patients from group II were genotype positive, with a statistically significant difference noted between the 2 groups. Group I genotype-positive patients presented with higher scores and measurements of clinical parameters with increased suppuration from peri-implant tissues compared with group II; differences were statistically significant (P < .05). In terms of response to treatment, genotype-negative patients demonstrated better response than genotype-positive patients. The combination of IL-1 allele 2 (IL-1A−889 and IL-1B+3954) in patients with inflamed periodontal or peri-implant tissues acts as a risk factor that leads to greater tissue destruction. IL-1 gene polymorphism at IL-1A−889 and IL-1B+3954 may affect outcomes of treatment for peri-implantitis in genotype-positive individuals.

Interleukin-1-beta concentration and neutrophil-lymphocyte ratio as possible predicting biomarkers of response to therapy with checkpoint inhibitors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3024-3024
Author(s):  
Rashida Orlova ◽  
Natalia V. Zhukova ◽  
Anna Malkova ◽  
Ekaterina Kaledina ◽  
Anna Gubal ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Immune Therapy ◽  
Interleukin 1 ◽  
Anticancer Therapy ◽  
Response To Therapy ◽  
Interleukin 1 Beta ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii

3024 Background: One of the discussed predictive markers of the immune therapy efficacy is the index of neutrophils to lymphocytes ratio in peripheral blood (NLr), which reflects the activity of adaptive immunity and correlates with the level of tumor-infiltrating lymphocytes (TILs). High NLr and low TILs are associated with disease progression. Interleukin-1-beta (IL-1β) is one of the main cytokines produced by the tumor microenvironment (TMO). Overexpression of the cytokine leads to a local immunosuppression. For some tumors, elevated serum IL-1β levels have been associated with a poor prognosis. The aim of this work is to analyze the serum IL-1β level as a marker of TMO activity and the NLr as a marker of adaptive immunity activity in relation to the response to therapy with checkpoint inhibitors in patients with various solid tumors. Methods: The study involved 63 patients with various solid tumors who were treated at the City Oncological Dispensary and were prescribed checkpoint inhibitors (nivolumab (n = 33), pembrolizumab (n = 23), ipilimumab + nivolumab (n = 7)). The determination of the level of IL-1β was performed using the ELISA method ("Interleukin-1-beta, ELISA-best", Novosibirsk), a clinical blood test was performed in a dispensary. The response to treatment was assessed 3-6 months after the start of therapy. Statistical analysis was carried out in GraphPad Prism. Results: Among the examined patients 49.21% (31/63) achieved partial regression or stabilization of the process (group I), and 50.79% (32/63) progressed (group II). The mean concentration of IL-1β before treatment in group I was 2.21±0.3 pg/ml, in group II - 0.98±0.2 pg/ml. NLr was increased in 7 patients from group I and in 9 patients from group II, with the mean index level being 2.9±0.39 and 3.2±0.5, respectively. There was no statistically significant difference in the concentration of IL-1β and the NLr between the studied groups. In group II, the number of patients undergoing systemic anticancer therapy before immune therapy (n = 18) was statistically significantly higher than in group I (n = 8), p = 0.033. There was no statistically significant difference in IL-1β concentration and NLr relative to previous treatment. Conclusions: Our study showed that the level of IL-1β corresponds to that of healthy donors and its isolated determination has no prognostic value. The NLr in most patients from the progression group was higher than normal, in contrast to group I, which is confirmed in the literature. The presence of previous systemic anticancer therapy was found to be associated with disease progression. The described feature can be explained by the fact that patients who received therapy before, already have a longer period of illness, a more severe clinical condition. The presence of systemic anticancer therapy does not affect the level of IL-1β and NLr.

scholarly journals Correlation between extraintestinal manifestations and clinical parameters with the histologic activity index in patients with inflammatory bowel diseases

2013 ◽  
Vol 70 (10) ◽  
pp. 947-952
Author(s):  
Milos Stulic ◽  
Djordje Culafic ◽  
Dragana Mijac ◽  
Goran Jankovic ◽  
Ivana Jovicic ◽  
...  
Keyword(s):  
Disease Activity ◽  
Clinical Laboratory ◽  
Inflammatory Diseases ◽  
Activity Index ◽  
Clinical Parameters ◽  
Extraintestinal Manifestations ◽  
Cross Sectional ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Bacground/Aim. Crohn's disease (CD) and ulcerative colitis (UC) are chronic, idiopathic, inflammatory diseases of the digestive tract. The aim of this study was to determine a possible correlation between the clinical parameters of the disease activity degree and the presence of extraintestinal manifestations with disease activity histopathological degree, in patients presented with CD and UC. Methods. This cross-sectional study included 134 patients (67 with CD and UC, respectively) treated at the Clinic of Gastroenterology, Clinical Center of Serbia, Belgrade. After clinical, laboratory, endoscopic, histopathologic and radiologic diagnostics, the patients were divided into two groups according to their histopathological activity. The group I comprised 79 patients whose values of five-grade histopathological activity were less than 5 (45 with CD and 34 with UC), while the group II consisted of 55 patients with the values higher than 5 (22 with CD and 33 with UC). The CD activity index (CDAI) and Truelove and Witts' scale of UC were used for clinical evaluation of the disease activity. Results. CD extraintestinal manifestations were present in 28.9% and 63.6% of the patients in the groups I and II, respectively (p < 0.05). Comparison of the mean CDAI values found a significant difference between these two patients groups (the group I: 190.0 ? 83.0, the group II: 263.4 ? 97.6; p < 0.05). No correlation of extraintestinal manifestations of the disease, Truelove and Witts' scale and histological activity was found in UC patients (p > 0.05). Conclusion. In the patients presented with CD, the extraintestinal manifestations with higher CDAI suggested a higher degree of histopathological activity. On the contrary, in the UC patients, Truelove and Witts' scale and extraintestinal manifestations were not valid predictors of the disease histopathological activity.

TRANSFUSION INDUCED ALLERGIC REACTIONS AMONG THE PATIENTS OF APLASTIC ANAEMIA - A CASE CONTROL STUDY FROM BANGLADESH..

2019 ◽  
pp. 1-6
Author(s):  
Bepasha Naznin ◽  
Md. Ashraful Hoque* ◽  
Daanish Arefin Biswas ◽  
Tamanna Afroz ◽  
Farida Parvin ◽  
...  
Keyword(s):  
Allergic Reaction ◽  
Aplastic Anaemia ◽  
Case Control Study ◽  
Platelet Concentrate ◽  
Transfusion Reaction ◽  
Group I ◽  
Multiple Unit ◽  
Group Ii ◽  
Control Study ◽  
Transfusion Reactions

Background:Allergic transfusion reactions (ALTR) are very common complication of blood transfusion. Advances in transfusion medicine have significantly decreased the incidence of ALTR; however, ALTR continue to be burdensome for transfusion dependent patients. It increases their existing sufferings. Allergic reaction is more common in platelet concentrate transfusion because stored platelet concentrate supernatants (PCSNs) accumulate striking levels of biological response modifiers (BRMs) during storage. Objective: To determine the risk factors of allergic reactions in platelate concentrate transfusion. Method: It is a case control study enrolled a total of 64 diagnosed case of aplastic anaemia receiving transfusion of platelet concentrate at Department of Transfusion Medicine, BSMMU, Dhaka, from May 2015 to April 2016. Among them 32 case of aplastic anaemia having allergic reaction due to transfusion of platelet concentrate was considered as group I (case) and rest 32 patients not developed allergic transfusion reaction due to transfusion of platelet concentrate was considered as group II (control). Patients age belong to 5 - 50 years and both sex and also patients getting transfusion of plate late concentrate were enrolled in this study. Statistical analysis: Statistical analyses were carried out by using the Statistical Package for Social Sciences version 20.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Chi-Square test, Odds ratio with 95% CI used to analyze the categorical variables, shown with cross tabulation. Student ttest used for continuous variables. Significant value of 'p' was decided to be at a level of 0.05 in two tailed tests. Result: The mean age was found 22.1±11.58 years in group I and 23.5±3.8 years in group II. Twenty four (75.0%) patients were male in group I and 17(53.1%) patients in group II. Almost twenty (62.5%) patients come from urban area in group I and 19(59.4%) in group II. In group I, thirty two (100.0%) patients had urticarialrash, 100.0% had itching, 37.5% had angioedema, 3.1% had cough, 3.1% had chest pain, 3.1% had respiratory distress, 3.1% had fever and 3.1% had vomiting. Almost twenty(62.5%) patients had tachycardia (>100 bpm) in group I and all patients had normal pulse in group II.Thirty two (100.0%) patients had normal blood pressure in both group. In group I, 31(96.9%) patients developed mild allergic reaction, 3.1% moderate allergic reaction. Majority (40.6%) patients belonged to age 16-30 years in present allergic transfusion reaction and 11(34.3%) in absent allergic transfusion reaction. Most (40.6%) of the patients was found blood group B in present allergic transfusion reaction and 11(34.4%) in absent allergic transfusion reaction. Multiple unit of PC transfusion increases 3.69 times risk to develop allergic transfusion reactions with 95% CI 0.99 to 14.44%.Platelet concentrate storage>3daysincreases 5.95timesrisktodevelopallergic transfusionreactionwith95%CI1.75to21.09%. Conclusion: Multiple unit (≥2) transfusion and Platelet concentrate storage >3 days were significantly (p<0.05) associated with allergic transfusion reactions but no significant association was found between allergic transfusion reactions with age and Blood group

scholarly journals Impact of hemodialysis on the wellbeing of chronic kidney diseases patients: a pre-post analysis

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Perceived Social Support ◽  
Kidney Diseases ◽  
Chronic Kidney Diseases ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Impact

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.

Role of Cord Blood Carboxyhemoglobin in Detecting Significant Hyperbilirubinemia in Term Neonates with ABO Alloimmunization

2021 ◽  
Author(s):  
Mahir Tıraş ◽  
Emrah Can ◽  
Şahin Hamilçıkan
Keyword(s):  
Cord Blood ◽  
Total Serum ◽  
Healthy Controls ◽  
Term Neonates ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Positive Direct ◽  
Severe Hyperbilirubinemia

Objective This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates with Coombs-positive ABO hemolytic disease than among those with Coombs-negative ABO incompatibility and higher than that of ABO-compatible control neonates. Study Design This cross-sectional descriptive study of 198 term neonates comprised three subgroups: group I featured 68 DCT-positive ABO-incompatible neonates (ABO + DCT), group II featured 60 DCT-negative ABO-incompatible neonates with hyperbilirubinemia (ABO–DCT), and group III featured 70 healthy controls. COHb was determined by an OSM3 hemoximeter. Results Group I differed from groups II and III for cord blood bilirubin, cord blood hemoglobin, and cord blood hematocrit. Groups I and II had higher mean total serum bilirubin (TSB) levels than group III, while there was no difference in the mean TSB levels between groups I and II. There was no significant difference between the COHb group means for groups I, II, and III (p = 0.98). The area under the receiver operating characteristic curve calculated for group I/group III and group II/group III were found to be 0.62 and 0.54, respectively. Conclusion COHb levels did not prove to be superior to the DCT for predicting the risk of developing severe hyperbilirubinemia in term neonates. Key Points

scholarly journals AB1119 U9: A NOVEL CLINICALLY ORIENTED ULTRASONOGRAPHIC SCALE AS A USEFUL MARKER FOR MONITORING THERAPEUTIC RESPONSE IN RHEUMATOID ARTHRITIS (MULTI CENTERS STUDY)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1848.2-1849
Author(s):  
M. A. Mortada ◽  
H. Eitta ◽  
R. Elmallah ◽  
A. Radwan ◽  
A. Elsaman
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Clinical Laboratory ◽  
Pearson Correlation ◽  
Response To Treatment ◽  
P Value ◽  
Clinical Parameters ◽  
Biologic Dmards ◽  
Das 28 ◽  
Significant Difference

Background:Musculoskeletal Ultrasonography (MSUS) is now a widely used tool for monitoring of rheumatoid arthritis (RA). Although there are many proposed sets of composite scores, a fixed set of joints may not be an ideal tool to assess a disease like RA, which affects many joints and tendons in different presentations. In previous study (1) U9 score was proven to be correlated with disease activity parameters.Objectives:To determine whether US assessment using U9 score is useful for monitoring response to treatment for RA or not?Methods:A prospective, multicenter study were conducted in period from July 2019 to December 2019. All recruited RA patients were subjected to: Disease activity assessment by clinical disease activity indices (CDAI and DAS28 ESR). Functional status assessment by (HAQ) and ultrasonographic assessment using U9 score which include 8 joints (bilateral wrists,2ndMCP,3RDMCP and knees) plus most clinically affected joint or tendon (one joint or one tendon). Most clinically affected joints from 48 joints. Any affected tendons could be choosing. All targeted joints were evaluated according to EULAR guidlines and by EULAR/ OMERACT combined score (0-3). Targeted tendons were scored (0-3).All patients received their treatment (biologic and non biologic DMARDs) according to the decision of the treating physicians. No specific therapy is needed. CDAI and DAS28 ESR, HAQ and U9 score were repeated after 3 months to detect the response to change after receiving the therapy.Results:One hundred and forty patients (23.6% were male) with mean age 39.26±11.30 were recruited from 4 tertiary referral university hospitals.There was a significant difference (<0.001) between the first and second visits as regards clinical, laboratory and ultrasonographic parameters. DAS 28 decreased form (5.29±1.21) to (3.95±0.99), ESR decreased from (42.12±15.24) to (26.84±12.32), HAQ2 improved from (0.652±0.350) to (0.510±0.237) and U9 total US score decreased from (13.56±5.18) to (8.02±4.28).There was significant correlation between U9 ultrasonographic score and clinical parameters at both visits (table 1).Table 1.correlation between U9 ultrasonographic score and clinical parameters.U9 at 1stvisitU9 at 2ndvisitDAS-28Pearson Correlation(P value)0.806<0.0010.790<0.001CDAIPearson Correlation(P value)0.787<0.0010.773<0.001HAQPearson Correlation(P value)0.431<0.0010.317<0.001We found that the most suitable cut-off value of U9 score to predict high disease activity was 11.5 (sensitivity 85.7% and specificity 80.6%), cut off value for moderate disease activity was 5.5(sensitivity 83.2% and specificity 88%) and cut off value for low disease activity was 3.5 (sensitivity of 83.3% and specificity 57.1%). These results are summarized in the following table:Conclusion:U9 ultrasonographic score is very useful method for evaluating the monitoring the response of treatment.References:[1]Mortada, et al. Annals of the Rheumatic Diseases 2019;78:1009.Disclosure of Interests:None declared

scholarly journals Experimental Study on a Prediction Model of the Shrinkage and Creep of Recycled Aggregate Concrete

2019 ◽  
Vol 9 (20) ◽  
pp. 4322 ◽  
Author(s):  
Lv ◽  
Liu ◽  
Zhu ◽  
Bai ◽  
Qi
Keyword(s):  
Substitution Rate ◽  
Recycled Aggregate Concrete ◽  
Recycled Aggregate ◽  
Creep Model ◽  
Aggregate Concrete ◽  
Ordinary Concrete ◽  
Group I ◽  
Significant Difference ◽  
Shrinkage And Creep ◽  
Group Ii

The significant difference between recycled aggregate and natural aggregate is the content of the attached mortar layer. With the increase of the replacement rate of recycled aggregate, the shrinkage and creep of recycled aggregate concrete is significantly increased. In this paper, 180-day shrinkage and creep tests of recycled aggregate concrete with different water–cement ratios were designed in order to analyze the effect of the substitution rate and water–cement ratio on shrinkage and creep properties. The results show that the shrinkage strain of recycled aggregate concrete with a substitution rate of 50% and 100% at 180 days is 26% and 48% higher than that of ordinary concrete, respectively, and the growth of group II is 22% and 47%, respectively. When the load was 180 days old, the creep coefficient of recycled aggregate concrete with a substitution rate of 50% and 100% in group I increased by 19.6% and 39.6%, respectively compared with ordinary concrete, and group II increased by 23.6% and 44.3%, respectively. Based on the difference of adhering mortar content, the creeping increase coefficient and shrinkage increase coefficient of the attached mortar were proposed, and a shrinkage and creep model of recycled aggregate concrete was established. When compared with the experimental results, the model calculation results met the accuracy requirements.

Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri
Keyword(s):  
Virtual Reality ◽  
Pain Perception ◽  
Dental Treatment ◽  
Immersive Virtual Reality ◽  
Dental Procedures ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Chi Square Analysis

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

Effect of using smart phones on balance functions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
N Hazzaa ◽  
DM Hassan ◽  
Sh Mahmoud
Keyword(s):  
Healthy Subjects ◽  
Smart Phone ◽  
Balance Function ◽  
Visual Fatigue ◽  
Vestibular Disorder ◽  
Dynamic Posturography ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Composite Scores

Abstract Objective To investigate the effect of visual fatigue caused by smart phone on the balance function. Subjects and Methods Forty subjects divided into 2 groups were included in the present study . Group I, twenty normal healthy subjects with mean age of 28.8 years. Group II, twenty subjects with a clinical diagnosis of peripheral vestibular disorder with mean age of 38.85years. They were subjected to a computer vision syndrome questionnaire (CVS-Q) , occulomotor tests of videonystagmography (VNG) and sensory organization test (SOT) of computerized dynamic posturography (CDP) before and after visual fatigue induction. Results Significant differences existed between C5, 6 and composite scores in group I and in C4 and composite scores in group II after visual fatigue induction. However, there was no significant difference between occulomotor tests in both groups after visual fatigue induction. Conclusions The smart phone use can affect the balance function in healthy subjects and augment the deficit in those with balance problem. Reducing visual fatigue should be considered through various procedures as taking proper rest, adjusting the brightness of screen, avoid any wrong posture and using filters if possible.

scholarly journals Caudal tramadol bupivacaine combination for postoperative pain releif in subumbilical paediatric surgery

2014 ◽  
Vol 23 (2) ◽  
pp. 42-46
Author(s):  
Md Shafiqul Islam ◽  
Md Tajul Islam ◽  
Dilip Kumar Bhowmick ◽  
Moinul Hossain ◽  
AKM Akhtaruzzaman ◽  
...  
Keyword(s):  
Postoperative Nausea And Vomiting ◽  
Paediatric Population ◽  
Paediatric Surgery ◽  
Physical Status ◽  
Anaesthetic Agents ◽  
Group I ◽  
Caudal Analgesia ◽  
Group Ii ◽  
To Receive ◽  
Control Study

Background Regional anaesthesia in children provides the advantage of reduced requirements of other anaesthetic agents and of excellent analgesia introduction. Rational use of adjuvant with local anaesthetic in caudal route for prolonged optimal analgesia in paediatric population. Objectives To evaluate the quality and duration of postoperative analgesia in children undergoing subumbilical surgeries with caudally administered mixture of tramadol and bupivacaine. Methods Sixty children of ASA physical status I & II scheduled for elective subumbilical surgery were included in this prospective case-control study. Children were randomly assigned to receive caudal analgesia with plain bupivacaine (Group-I) and a mixture of tramadol-bupivacaine (Group-II) respectively. Blood pressure, heart rate, oxygen saturation and duration of analgesia were recorded postoperatively. Results Study revealed that mean duration of caudal analgesia in Group-I and Group-II were 245.67 ± 6.94 and 612.05 ± 16.49 minutes respectively which was significantly longer (P<0.001) in Group-II. Mean number of postoperative analgesics were 2.97±0.50 and 1.78±0.50 in Group-I and Group-II which was statistically highly significant (P=0.000). Postoperative nausea and vomiting was significantly high in Group-II (P=0.019). Conclusion Combination of tramadol with bupivacaine results in prolonged analgesia when administered in caudal route. In addition, tramadol is more useful in young children considering less respiratory depression than other opioids. DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18172 Journal of BSA, 2009; 23(2): 42-46

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