The use of tranexamic acid (TA) in total knee arthroplasty is well documented. However, there is limited evidence to suggest the use of TA in simultaneous bilateral computer assisted total knee arthroplasty (CATKA). We, therefore, studied the effect of TA, in simultaneous bilateral computer assisted total knee arthroplasty, in terms of blood transfusion, routes of administration and complications. We divided 90 patients into three groups. Group I patients received intravenous normal saline alone (IVNS group). Group II received intravenous TA alone (IVTA group). Group III received intraarticular TA alone (IATA group). Our study confirms that there is significant benefit of using TA but no difference between the intravenous or intraarticular routes of administration.

Simultaneous Bilateral Computer Assisted Total Knee Arthroplasty: The Effect of Intravenous or Intraarticular Tranexamic Acid

. This systematic review and meta-analysis examined the effects of selected root plants (curcumin, ginseng, ginger and garlic) on markers of muscle damage and muscular performance measures ...

Selected root plant supplementation reduces indices of exercise-induced muscle damage: A systematic review and meta-analysis.

Background: Burns remain a major public health issue all over the world, especially in developing countries. Pseudomonas aeruginosa is a major cause of infection and death in patients with severe burns.  So, there is a need to develop drugs which will decrease complications and prevent infections more effectively than the presently used drugs.Methods: Ocimum sanctum, ointment silver sulfadiazine and 24 Rabbits were used in this study. Animals were acclimatized and divided randomly into 04 groups of 06 animals each. After producing partial thickness burn wound ointment silver sulfadiazine was applied daily on the burn wound and Ocimum sanctum was administered orally once daily. Healing was assessed by wound contraction and Oxidative stress and Antioxidant Activity were measured by Malondialdehyde and Superoxide dismutase respectively. Results were analysed by student’s ‘t’ test, one way ANOVA followed by Dennett’s test. P values <0.05 were considered statistically significant.Results: At the end of treatment (After 28th Day) Group treated with ointment silver sulfadiazine+Ocimum sanctum showed  maximum Percentage of wound contraction (93.17±4.34), maximum decrease of MDA percentage (0.30±0.02 nmol/ml) and maximum increase of SOD percentage (0.0045±0.0002 IU/gm of Hb).Conclusions: Most effective treatment for burn wound healing in this study was ointment silver sulfadiazine+Ocimum sanctum.

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Assessment of antioxidant activity of Ocimum sanctum in healing of thermal burn wound with and without supportive treatment of silver sulfadiazine in rabbits

The process by which a therapeutic agent or drug is administered to the body for achieving desired effects is known as drug delivery. In the transdermal route, the drug is delivered topically through the skin. It is one of the most patient-friendly drug delivery routes favoring instant local effect. The intended drug is released at regular intervals and gradually reaches the systemic circulation. The stratum corneum of the epidermis becomes the main hindrance to effective delivery of the drug which becomes one of the drawbacks of this drug delivery route. The ethosomes were therefore conceptualized for providing an appropriate mechanism for the delivery of intended drugs directly to the targeted area through the transdermal route. Ethosomes are soft, malleable vesicles which are primarily composed of phospholipids (phosphatidylcholine/phosphatidylserine/phosphatidic acid), ethanol, and water. The barrier function of the stratum corneum is disrupted by the collective action of ethanol and phospholipid. Being a penetration enhancer, ethanol disturbs the arrangement of the lipid bilayer in the stratum corneum, thereby facilitating the soft and malleable ethosomal vesicles to squeeze and fuse with the inner lipid bilayer. Hence, the drug is subsequently released to the deeper layer of the skin for intended therapeutic application. 

Ethosomes for Dermal and Transdermal Drug Delivery Systems

The nonsurgical cosmetic arena continues to grow, with more people consistently seeking minimally invasive procedures for facial rejuvenation However, although these prospective patients are not seeking surgical correction to obtain their results, there is still the potential for nonsurgical procedures to yield adverse events posttreatment Patients often do not realize that their dietary regimens may affect their nonsurgical cosmetic outcomes For example, many patients desiring these types of treatments are often found to be taking prescription medications, herbs, and spices on a daily basis that may have the capacity to potentiate adverse outcomes such as bleeding and/or bruising For these reasons, it is important for clinicians to be inclusive while taking health histories and to properly educate their patients so that administered treatments have the best chance of yielding the desired results The focus of this article is to provide health care providers information on many of the herbs and spices that have the potential to negatively impact nonsurgical cosmetic outcomes

A Recipe for Improved Nonsurgical Cosmetic Outcomes: Know Your Herbs and Spices.

The use of herbal medicines has increased dramatically over the past few years. The United States alone noted a 380% increase in the consumption of these products. Although the common practice of taking over-the-counter herbal soups, herbal teas and other such prepacked preparations was not associated with adverse events at large, still, some herbs are known to cause problems, especially when large doses are taken. The American Society of Anaesthesiologist (ASA) has taken a conservative stance and recommended that it is prudent to stop these products at least 2-3 weeks prior to anaesthesia and surgery. This advice may be difficult to implement as most preoperative evaluations occur only a few days prior to surgery. Some of the Ayurvedic preparations have shown to improve the patient outcome when taken during the perioperative period. Hence, the conservative stance by ASA may not always benefit the patient. More scientific studies are needed to have more targeted recommendations. This article puts forward the facts that need to be addressed by researchers in the future.

Priya S Pradhan

Papers

Ayurvedic medicine and anaesthesia

Area of foramen magnum as a tool for sex determination