Background: We examined the effect of preoperative combination of different analgesics and the role of each individual analgesic compared to control regarding postoperative pain,

Methods: patients were randomly allocated into either control; multiple treatment, perfalgan, opioid and voltaren group. The time for first request for analgesia and visual analogue score were compared by analysis of variance and tuckey Kramer test.

Results:There was a main effect of treatment p>0.0001 in favor of multi-analgesia and opioid groups. Multi-analgesia group was better than opioid group p=0.016. There was a little improvement with paracetamol (perfalgan) but no effect of voltaren on duration of analgesia nevertheless;both have reduced VAS relative to control.

Conclusion: Combination ofnon-opioid analgesicsDiclofenac Na (voltaren),

Paracetamol (perfalgan) with low dose morphine and dexamethasone have greatly prolonged duration of analgesia and reduced pain intensity without displaying notable side effects.

Web 2.0 is an important name in today’s age of Advance Communication. Web 2.0 is actually a platform which is responsible for advance communication among the author and group of people. Though web 2.0 supported or enriched website any one can join and share their views, information, videos, audios and other content depending upon need. Commonly web 2.0 websites are popular as social networking site. Application ad integration of web 2.0 was the reason of creation for some more web 2.0 dimension; out of which Medical and Health 2.0 treated as most popular. Virtually, Medical 2.0 is a wonderful name for proper medical information sharing and medical treatment. This paper is talks about Medical 2.0 and Health 2.0 which includes their characteristics and values, contemporary role of medical 2.0 in medical world and so on. Paper also compares some aspects between medical 2.0 and health 2.0, briefly.

Type 2 diabetes mellitus (T2DM) is a common metabolic disorder in India. It is recognised that the low testosterone level is associated with reduced insulin

sensitivity and type 2 diabetes(T2DM)1.Testosterone level is comparatively lower in diabetic2-5.But data in this relation is lacking particulaly in rural india. So the aim of this study wastoevaluate the prevalence of hypogonadism among T2DMpatients in rural India with an objective to assess and compare serum total Testosterone (TT), Folicle Stimulating Hormone(FSH) and Luteinizing Hormone(LH) level of male T2DM patients and age matched healthy control group. Methods and Material:It was an open label observational descriptive cross sectional study. Fifty male type 2 diabetic patients and 50 healthy control subjects were selected randomly following inclusion and exclusion criteria for this study. Blood sample was collected aseptically and properly for assessment TT,FSH, LH, and glycosylated haemoglobin.Results: Hypogonadism(TT<12nmol/l) was found in 68% of diabetic subjects and in 20% of healthy control group.Of those with diabetes 72.72% of diabetic whose serum TT level <12nmol/l had LH level<10nmol/l.Conclusion: Testosterone levels were frequently low in men with T2DM compare to the healthy normal individuals of the same age group.Majority of them were suffering from hypogonadotrophichypogonadism (HH).

Context: sepsis is associated with severe oxidative stress. During sepsis, there

are several potential sources of reactive oxygen species, including the respiratory burst associated with neutrophil activation. Aim: We try to monitor the kinetics of the scavengers’ antioxidant enzymes, erthrocyte superoxide dismutase (SOD), whole blood glutathione peroxidase (GPX) and serum catalase in the pathogenesis of neonatal sepsis and the effect of

antibiotics therapy on their levels. Study Design: This study was carried out on blood samples from children suffering from sepsis proved by positive blood culture in addition to 11 healthy children. Blood samples were subjected for determination of antioxidant enzyme activities including red blood cell superoxide dismutase (SOD), whole blood glutathione peroxidase (GPx) and serum catalase Results; There was highly significant decrease in erythrocyte superoxide dismutase (RBC SOD) (P<0.001) and whole blood glutathione peroxidase (GPx) (P=0.01) at admission and after 48 hours of start of antibiotics therapy (P<0.001, for each) in patients compared with controls. There was highly significant increase in serum catalase level in patients at admission (P<0.001) and after 48 hours of antibiotics therapy compared with controls. The commonest isolated organism from blood culture was Staphylococci species (66.7%) with Staphylococcus aureus (40.0%)

and Staphylococci epidermidis (26.7%). There was significant decrease of SOD (P1=.0001) and GPx (P1=.049) at start of sepsis associated with Staphylococcus aureus infection. After 48 hours from clinical response to antibiotics therapy, both SOD and GPx had significant decrease with all types of bacteria isolated. 

Conclusion: Our study suggests that children with sepsis are susceptible to high oxidative stress which may play a role in the pathogenesis of sepsis. The

administration of antibiotics therapy was not associated with the improvement of level of superoxide dismutase and glutathione peroxidase, so the utility of

supplementation of antioxidant enzymes in neonates with septicemia needs further evaluation.

Cytomegaloviral infection is an important cause of disease in immunocompromised patients e.g chronic renal failure. Laboratoty diagnosis of active stage of infection remains problem if based upon serological tests. Therefore detection of CMV antigens in peripheral leucocytes by immunohistochemical stain and PCR are mandatory in diagnosis of CMV infection dialysis patients.In this study 29 dialysis patients were assessed for the presence of cytomegalovirus by direct immunohistochemical staining of early CMV antigen (P65) in blood leucocytes, quantitative PCR detection of DNA in blood and by serology (IgG,IgM). CMV antigen was detected in 14 (48.3%) of patients, CMV PCR was positive in 10 (34.5%) patients, IgG was positive in 21 (72%) and 5 (17%) were positive for IgM. There was significant correlation (P<.0001) between PCR method and direct

staining of CMV early antigen (P65) in peripheral leucocytes.

These results suggest that direct detection of CMV antigen in peripheral leucocytes is as sensitive as PCR technique. Antigen detection is more valuable than serology in actual diagnosis of active CMV infection.