POST OPERATIVE PAIN RELIEF IN CAESAREAN SECTION

Eighty female patients in the age group of 20-40 years, weighing 40 ± 15 Kg, in ASA physical status I and II, awaiting either elective or emergency caesarean delivery were selected for this study. Patients with cardiovascular disorders and those with significant systemic ailments were excluded from the study. They were randomly divided into two equal groups of 40 patients each. Group I was subdivided randomly into two equal sub-groups (1A and 1B) of 20 patients each and was selected for administration of epidural narcotics. Patients in sub-group 1A were given epidural morphine in the dose of 3-5 mg and those in subgroup 1B were given buprenorphine in the dose of 0.1-0.15 mg. Group II consisting of 40 patients, were again subdivided randomly into two equal subgroups (2A and 2B) of 20 patients each and were selected for administration of parenteral (intravenous) narcotics. Patients in subgroup 2A were given morphine in the dose of 5-7.5 mg I.V., and those in subgroup 2B were given 0.15-0.3 mg of buprenorphine intravenously. The degree of pain relief was assessed by applying numerical rating scale (NRS) and resulting complications were observed and recorded. It was found that 60-80% of patients with epidural narcotics, with various dosage schedules, experienced good to excellent analgesia as compared to 30-40% of patients with parenteral use of narcotics.KEY WORDS: Analgesia, Caesarean section, Epidural narcotics     

ANEURYSMAL BONE CYST IN THE MANDIBLE (A Case Report)

Aneurysmal bone cyst is commonly seen in the long bones and vertebrae and is rare in the jaws. Its association with other lesions of the bone has been stressed by many workers. Because of its variable radiological appearance, diagnosis of the lesion is established by histopathological examination. A case of aneurysmal bone cyst occurring in the mandible is reported.KEY WORDS: Aneurysmal bone cyst, Mandible     

Regulation of gamma-glutamylcysteine synthetase subunit gene expression in retinal Müller cells by oxidative stress.

PURPOSE: To study regulation of gamma-glutamylcysteine synthetase (GCS) heavy and light subunit gene expression in Müller cells under conditions of oxidative stress. METHODS: Experiments were carried out with an SV40 transformed cell line (rMC-1) that exhibits the phenotype of rat retinal Müller cells. Endogenous glutathione levels were modified by treating cells with diethyl maleate (DEM), D,L-buthionine sulfoximine (BSO), or tert-butylhydroquinone (TBH). In other experiments, cells were grown in either high (28 mM) or normal (5.5 mM) glucose medium for 1 week to examine the effects of hyperglycemia. Cells were processed for reduced glutathione (GSH) measurement, RNA extraction, cell count, and, in some cases, lactate dehydrogenase activity. The steady state mRNA levels of GCS heavy and light subunits were measured by northern blot analysis using specific cDNA probes. Changes in mRNA levels were normalized to beta-actin or 18S rRNA. RESULTS: Treatment with DEM for 30 minutes depleted cell GSH to 20% to 30% of the normal value. GSH content recovered completely 6 hours after returning to normal medium. BSO treatment for 12 hours followed by a medium change for 6 hours resulted in a cell GSH level that was 26% that of untreated cells. If cells were left in BSO for 18 hours, however, GSH levels were reduced to < 1%. Treatment with TBH for 12 hours led to a 77% increase in cellular GSH level. Treatment with DEM, TBH, or BSO for 18 hours led to a significant induction of the mRNA level of the GCS subunits, regardless of glucose concentration in the medium. Shorter BSO treatment exerted no effect. Prolonged hyperglycemia resulted in 30% lower GSH level, 55% lower GCS heavy subunit, and 30% lower GCS light subunit mRNA levels. CONCLUSIONS: Oxidative stress induced the gene expression of GCS heavy and light subunits in Müller cells. The effect of BSO on mRNA levels correlated with the degree of GSH depletion. Prolonged hyperglycemia lowered GCS subunit mRNA and GSH levels.     

Aplasia cutis congenita: a report of 12 new families and review of the literature.

Aplasia cutis congenita (ACC) is a heterogeneous group of disorders whose common characteristic is focal absence of skin. In the majority of instances this is limited to the scalp, although other areas of the body may also be involved. Other congenital malformations have been reported to occur with ACC; limb defects appear to be a specific association. Given our experience with ACC, we suggest a classification based on genetically distinct entities. Type I ACC is limited to the scalp. Type II involves body or scalp; IIA involves body or limb defects. Type III is limited to the scalp or limbs. Type IV is associated with epidermolysis bullosa; type IVA is Bart syndrome. Although most reported cases have been sporadic, there are many familial occurrences of all types of ACC. Most published pedigrees are consistent with autosomal dominant inheritance with reduced penetrance, or autosomal recessive inheritance. Careful examination of family members of affected individuals is warranted.