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     

Changes in regional meningeal immunity in local immunomodulating therapy in patients with acute traumatic intracranial hematomas

A clinicomorphological study of 660 patients with acute traumatic intracranial hematomas has shown that pneummonia develops in 56% of cases, intracranial complications (purulent meningitis) in 14%.Pyoinflammatory complications were 1.5-1.7 times less common in small-sized hematomas, their total rate and the rate of pneumonias was twice higher in left cerebral hemispheric lesion. On the contrary, intracranial complications were twice more common in right cerebral hemispheric lesion. The structural bases of the regional meningeal immunity system were as follows: the pathways of blood and spinal fluid circulation and dural arachnoidal intercellular fluid; cellular cooperation of the meninx and tissue of the brain; the network of lymph vessels of the dura mater encephali and adventitia of large blood vessels and middle and inferior jugular (regional) lymph nodes. Morphodunctional changes in the local meningeal immunity system in patients with hematomas point to the development of secondary immunodeficiency. Inclusion of regional immunotherapy with T-activin into multimodality treatment decreases the incidence of extra- and intracranial pyoinflammatory complications and mortality.     

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