Propofol Alleviates Neuropathic Pain Induced by Chronic Contractile Injury by Regulating the Spinal glun2b-p38mapkepac1 Pathway

Background. Propofol acts as an intravenous anesthetic cure which is widely used as a therapy for the craniocerebral injury that comprised surgical anesthesia as well as the sedation done in the intensive care units. Propofol is one of the most commonly used and efficient anesthetics where the painful effects are followed by an injection of propofol. In many cases, patients experience pain followed by anxiety, boredom, fear, and even myocardial ischemia. Objective. This study was performed to investigate the underlying mechanism of propofol and its effect on regulating spinal glun2b-p38mapkepac1 pathways in chronic contractile injury. Material and Methods. Contractile injury was performed by ligation around the nerve of the thigh region postanesthesia. Rats were divided into three groups to analyze the changes like mechanical allodynia by the paw withdrawal threshold and histopathological analysis for assessing cellular degradation. L4-L6 from the spinal dorsal horns were isolated and harvested for studying protein expression, by the method of western blotting and immunofluorescence analysis. Results. The pain caused due to mechanical allodynia in the paw region was highest at 1 hour postinduction and lasted for three days postinjury. Pain was significantly less in the group receiving propofol when compared with the isoflurane group for the first two hours of injury. In the propofol group, EPAC1, GluN2B, and p38 MAP K were significantly lower. Conclusion. In the rat model of induced chronic contractile injury, postsurgery there was a suppression of the GluN2B-p38MAPK/EPAC1 signaling pathway in the propofol group. As the p38MAPK/EPAC pathway has a significant role in the postoperative hyperalgesia, thus our experiment suggests that propofol has analgesic effects.

A VARIATION IN ORIGIN OF BRANCHES OF PROFUNDA FEMORIS ARTERY IN RELATION WITH FEMORAL ARTERY: A CASE REPORT

Introduction – Profunda femoris is the main course of supply to the muscles of thigh area. It is the biggest part of femoral supply route in the thigh region. It gives out branches named medial circumex femoral and lateral circumex femoral and four perforating branches and proceeds as the fourth perforating branch in the mid of thigh. A variation regarding the branching pattern of profunda femoris artery was observed with an origin of medial and lateral circumex arteries is been seen in a formalin embalmed 55 years of age female cadaver during typical dissection procedure in the dissection hall. Methods - The study was undertaken on lower limb of a fully embalmed 55years old female cadaver in the department of anatomy, used for routine dissection for teaching undergraduate and post graduate medical students. Result - In this female cadaver on left side of lower limb, there was an uncommon origin of lateral circumex femoral artery directly from the femoral artery with a normal emergence of medial circumex femoral artery from profunda femoris artery. While on the right side of the same Cadaver, the profunda femoris artery arose at usual distance i.e., 3.7cm below inguinal ligament, from posterolateral aspect of femoral artery and then it bifurcates into lateral and medial circumex femoral artery. Conclusion - Current examination will assist the clinicians to bypass iatrogenic inconveniences during a surgical procedure and will likewise help them in methodology for interventional radiology around this region.

Analysis of Extended Resection of Limb Soft Tissue Leiomyosarcoma

Leiomyosarcoma is an uncommon soft tissue sarcoma that composed of malignant mesenchymal cells with distinct features of the smooth muscle lineage. Typically affects the uterus and gastrointestinal tract, it can rarely be seen in large blood vessels, lymphatic and glandular duts, the mesentery, the omentum, retroperitoneum, and limbs. Occurrence is particularly rare in the limb region. Retrospective study based on patient records and postoperative pathological histological features. Four patients with limb leiomyosarcoma that were operated between 2016 and 2020 were included, three of them arising in the subcutis of the thigh region and one in cubitus. Extend resection with satisfactory outcomes is reported. Pathological examination showed that masses were composed of a fascicular arrangement of hyperchromatic spindle-shaped cells, characterized by the proliferation of epithelioid cells with eosinophilic cytoplasm for epithelioid leiomyosarcoma. Leiomyosarcomas that arise in the soft tissue, although rare, should be differentiated from other lesions, such as neurilemoma, neurofibroma, liomyoma,lipomyoma, synoviosarcoma, rhabdomyosarcoma, malignant fibrous histiotoma, and malignant neurinoma.

A Case Study on Management of Tinea Cruris with Classical Vaman Karma

Tinea Cruris is the disease of fungal infection of groin by dermatophyte fungi. It is commonly seen in men, and also called as Jock Itch as the other name. It is the condition which shows characteristics of disease as erythema, itching, burning sensation, cracked skin, skin rashes which worsen by exercise, skin discoloration and important symptom like rashes does not clears but increases due to antifungal creams. The management of the condition can be done in Ayurvedic perspective. According to Ayurveda all the classified disease of skin are considered as in Kushta Roga (skin disease), where the conditions of fungal infections are correlated with the Dadru Kshudra Kushta (Tinea). Due the clinical features of itch, redness, circular patches. The disease having exaggerated state of Pitta and Kapha Dosha, moreover Kapha. The treatment principle in such conditions is Shodhan Purificaton therapy along with Shaman (Pacificatory) therapy, as both therapies are considered best in Kushta Roga according to Acharyas. This case report is of the female patient suffered from itching over left thigh region along with redness, pimples, and round patches since 3 months, the patient finds the relief after following the Ayurvedic treatment as Shodhan Karma and Shaman Karma with lifestyle changes. The symptoms were diminished by Vaman Karma (emesis). She got 80-90% relief after Shodhan Karma as if one can consider the best treatment for tinea cruris.

An Alternative Technique for Transumbilical Single-Port Laparoscopic Percutaneous Precise Closure of the Inguinal Hernia Sac in Children: A 3-Year Single-Centre Study

Objective. To evaluate the safety and reliability of a novel technique of single-port laparoscopic-assisted percutaneous precise closure of the inguinal hernia sac in children. Methods. From September 2016 through September 2019, children with inguinal hernia(s) treated with single-port laparoscopic-assisted percutaneous extraperitoneal closure using a guide wire were enrolled in this study. Operative time, surgical complications, recurrence rate, and cosmetic results were collected. Results. A total of 917 cases with inguinal hernia(s) were collected. Among them, there were 886 (96.61%) boys and 31 girls. Their mean age was 5.2 ± 3.7 years. There were 693 (75.57%) cases with unilateral hernia. There were 224 cases with bilateral hernias or patent processus vaginalis, including 135 (14.72%) cases with an open contralateral ring which was confirmed intraoperatively. Twenty-three (2.51%) needed another port to complete the hernia sac separation. The operation time was 24.7 ± 5.2 min and 14.6 ± 3.8 min in bilateral and unilateral ones. Three cases complained of numbness in the thigh region or groin pain which subsided without medication in the 2nd postoperative month. There was no recurrence, and the incision scars were nearly invisible. Conclusion. Single-port laparoscopic-assisted percutaneous extraperitoneal closure using a guide wire is a safe, less cost, and reliable technique in the treatment of inguinal hernia in children.

A Case Report of Urusthambha Vyadhi

Ayurved is the science of good long health and vitality. All possible vyadhis (disease) and their treatments classified under vata, pitta and kapha (tridosha) types. There have been mentioned 80 types of vata vyadhis (type of diseases) as per classical texts of ayurved. Uruthambha vyadhi (disease) is the type of vata vyadhi explained by acharya charak separately in Charak samhita other than mentioned 80 types. Urusthambha is caused due to avrodh (obstruction) of vata (type of dosha) by aama (indigested food) and meda dhatu (fat). It obstructs the natural karya (function) of vata in urupradesh (femoral region) due to which the patient has restricted or no movements of thighs. Hence it’s the avran (covering) of aama & meda dhatu to prakruta vata (normal vata)which produces difficulty in walking along with symptom as sthambha (stiffness) in uru Pradesh (thigh region) and hence known as urusthambha. Urustambha cases are very uncommonly seen and diagnosed in routine clinical practice and hence we thought to present the case which diagnosed & successfully treated with only ayurveda. A male patient aged 39 yrs was reported for OPD by us at Shree gajanan ayurvedic chikitsalay and panchakarma centre, panvel, navi mumbai, Maharashtra (Registration no- 2166) with complaints of difficulty in walking with extreme pain and stiffness in uru pradesh (thigh region).We diagnosed and treated for urusthambha with classical treatment mentioned as per charak samhita (ayurvedic text) and was recovered completely after the regular treatment. Patient showed progressive improvement with complete cure in the period of 1 year & 2 months with abhyantara (internal) and bahya chikitsa (external treatment).

The Influence of Negative Pressure and of the Harvesting Site on the Characteristics of Human Adipose Tissue-Derived Stromal Cells from Lipoaspirates

Background. Adipose tissue-derived stromal cells (ADSCs) have great potential for cell-based therapies, including tissue engineering. However, various factors can influence the characteristics of isolated ADSCs. Methods. We studied the influence of the harvesting site, i.e., inner thigh (n=3), outer thigh (n=7), and abdomen (n=9), and of negative pressure, i.e., low (-200 mmHg) and high (-700 mmHg), on the characteristics of isolated ADSCs. We counted initial yields of attached cells after isolation. In subsequent passage, we studied the number, viability, diameter, doubling time, mitochondrial activity, and CD surface markers of isolated ADSCs. Results. We revealed higher initial cell yields from the outer thigh region than from the abdomen region. Negative pressure did not influence the cell yields from the outer thigh region, whereas the yields from the abdomen region were higher under high negative pressure than under low negative pressure. In the subsequent passage, in general, no significant relationship was identified between the different negative pressure and ADSC characteristics. No significant difference was observed in the characteristics of thigh ADSCs and abdomen ADSCs. Only on day 1, the diameter was significantly bigger in outer thigh ADSCs than in abdomen ADSCs. Moreover, we noted a tendency of thigh ADSCs (i.e., inner thigh+outer thigh) to reach a higher cell number on day 7. Discussion. The harvesting site and negative pressure can potentially influence initial cell yields from lipoaspirates. However, for subsequent in vitro culturing and for use in tissue engineering, it seems that the harvesting site and the level of negative pressure do not have a crucial or limiting effect on basic ADSC characteristics.