A variety of medications have been studied to reduce the hemodynamic response to laryngoscopy and intubation. Dexmedetomidine has been used intravenously in many studies to reduce the hemodynamic response to laryngoscopy and intubation. In high-risk patients, this pressor response can increase morbidity and mortality. As dexmedetomidine has a good bioavailability via the nebulisation route, we formulated this study to evaluate the effect of nebulised dexmedetomidine on the hemodynamic response to laryngoscopy and endotracheal intubation. This is a prospective, randomised controlled trial conducted on 100 patients with the American Society of Anesthesiologists grade I and II. The primary objective of the study was to see if nebulised dexmedetomidine at a dose of 1 microgram/kg could reduce the stress reaction to laryngoscopy and intubation. The secondary objective was to study the dose sparing effect of nebulised dexmedetomidine on the amount of propofol used during induction of general anaesthesia. The study population was randomly divided into two groups: group A (n = 50) included patients nebulised with dexmedetomidine 1 microgram/kg and group B (n = 50) included patients nebulised with 5 ml saline 30 minutes before induction of anaesthesia in a sitting position. The demographics were similar in both groups. Following laryngoscopy and intubation, the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate showed a significant increase in the control group B as compared to the treatment group A. In group A, there was attenuation in SBP (one minute = 113.2 ± 14.503, P < 0.001; five minutes = 109.86 ± 8.342, P < 0.001; 10 minutes = 114.24 ± 7.797, P = 0.010), DBP (one minute = 73.72 ± 10.986, P = 0.011; five minutes = 71.62 ± 9.934, P = 0.005; 10 minutes = 76.1 ± 8.006, P = 0.009), MAP (one minute = 86.80 ± 11.86, P = 0.001; five minutes = 84.44 ± 8.97, P = 0.006; 10 minutes = 88.72 ± 7.44, P = 0.018), and heart rate (one minute = 83.34 ± 12.325, P = 0.001; five minutes = 81.56 ± 13.33, P = 0.003; 10 minutes = 80.16 ± 14.086, P = 0.013) following laryngoscopy and intubation. Induction dose of propofol was significantly lower in the dexmedetomidine group (73 ± 19.509, P < 0.001). Nebulised dexmedetomidine effectively blunts the hemodynamic response to laryngoscopy and intubation and also has a dose sparing effect on the induction dose of propofol.

Background: Transfusion Transmitted Malaria is a major concern among blood donors in endemic countries. The Drugs and Cosmetic Act 1940 in India mandated testing of all blood donations for Malaria. Regular screening of malaria prevents severe transfusion-transmitted malaria, and shows its prevalence and enables its control among the population. Material and Methods: This is a 09-year retrospective observational study from 1 ^st August 2014 to 31 ^st July 2023 among apparently healthy blood donors in Blood Centre of Rajendra Institute of Medical Sciences, Jharkhand, a tertiary health care centre in tribal population-dominant region of India. Every donor’s sample is subjected to a malaria antigen test both for Plasmodium falciparum and Plasmodium vivax by One step, rapid, immunochromatographic test. Positive result by rapid diagnostic Antigen card tests were also analysed by microscopy (peripheral blood smear). Results: In the present study, the total number of blood units collected was 246,147. On screening of the total blood donors, 62,225 (25.27%) were voluntary donors and 183,942 (74.72%) were replacement donors. There were 2,27,731 (92.51%) male donors and 18,416 (7.48%) female donors. Among all the donors, only 61 (0.024%) malaria-positive donors were seen, all male. Conclusion: Malaria transmission is strictly monitored and controlled by governments in endemic regions. In addition to the direct spread by mosquito bites, malaria can also be transmitted by transfusion as blood is transfused mainly as whole blood in developing countries. The transmission by transfusion of blood remains a challenge to blood centres because of carriers of malaria in the population in endemic regions like Jharkhand, India. This is first long retrospective observational study of prevalence of malaria among apparently healthy blood donors in a tertiary care centre in Northeastern tribal region of India. It gives a rough idea of the effectiveness of various malaria control programs in remote, malaria-endemic regions.

Antibiotic resistance in pathogens like E. coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa poses a major threat to global health, with limited treatment options. This study systematically evaluated the efficacy of bacteriophage therapy in vitro and in vivo against multidrug-resistant strains. Phage treatment led to significant bacterial reduction (up to 4.5 log₁₀ CFU/mL) and improved survival rates in mice (up to 85%). Synergistic effects with antibiotics and preservation of gut microbiota were observed without adverse reactions. These findings highlight phage therapy as a promising, targeted, and safe alternative for managing resistant infections.

Background: Ultrasound-guided quadratus lumborum block (QLB) is used for intraoperative and postoperative pain relief in laparoscopic total and partial nephrectomy. The analgesic efficacy of QLB in nephrectomy remains under-explored and needs evaluation. Methods: A comprehensive literature search was done to assess the effectiveness of preoperative QLB for nephrectomy. The primary objective was to evaluate postoperative opioid consumption following laparoscopic total and partial nephrectomy. In total nephrectomy, the opioid requirement was recorded at 24 h interval. In partial nephrectomy patients, postoperative opioid requirement was recorded at 6–12 h, 12–24 h and 24–48 h. The secondary objective was to assess the incidence of nausea and vomiting in both the groups. Results: Single-shot QLB was compared with no block or sham block in laparoscopic total and partial nephrectomy. In total laparoscopic nephrectomy, significant reduction of postoperative opioid consumption in patients with QLB (weighted mean difference [WMD]: −549.11, 456.07; P = 0.004) than the control group seen. Nausea was 35% lower in the QLB group than the control group (risk ratio [RR]: 0.65, 95% confidence interval [CI]: 0.39–1.10). In partial nephrectomy, QLB group had less opioid use at 6–12 h (WMD: −6.23, 95% CI: −9.76–−2.70), 12–24 h (WMD: −5.40, 95% CI: −10.10–−0.70) and 24–48 h (WMD: −1.12, 95% CI: −6.52–4.29). Partial nephrectomy group QLB showed 28% decrease in the vomiting than the control group (RR: 0.72, 95% CI: 0.3–1.50). Conclusion: Significant reduction in the requirement of postoperative opioid, nausea and vomiting in group receiving single-shot QLB in laparoscopic nephrectomy patients was seen. The results suggest that QLB can serve as an important part of multimodal analgesia strategies.