iosr-JDMS   Volume-24 ~ Issue-11 ~ November 2025

Abstract: Background: Isoflurane has been a standard agent for CHA, but its sole use sometimes results in suboptimal hypotension and potential adverse effects. Dexmedetomidine is known for its sedative and sympatholytic effects, and it has been proposed as an adjunct to improve controlled hypotension and patient outcomes in surgeries. The study was conducted to assess and compare the efficacy of Isoflurane alone and the combination of Isoflurane and Dexmedetomidine for achieving controlled hypotension during middle ear surgeries. Materials and Methods: This....

Key Word: Middle ear surgery, Dexmedetomidine, Isoflurane, Controlled hypotensive anesthesia

[1]. Munhall CC, Warner BK, Nguyen SA, Guldan GJ 3rd, Meyer TA. Use Of Dexmedetomidine For Controlled Hypotension In Middle Ear Surgery: A Systematic Review And Meta-Analysis. Am J Otolaryngol. 2023;44(4):103917. Doi:10.1016/J.Amjoto.2023.103917
[2]. Degoute CS. Controlled Hypotension: A Guide To Drug Choice. Drugs. 2007;67(7):1053-1076. Doi:10.2165/00003495-200767070-00007
[3]. Hawkley TF, Patel P, Maani CV. Isoflurane. [Updated 2025 Apr 26]. In: Statpearls [Internet]. Treasure Island (FL): Statpearls Publishing; 2025 Jan-. Available From: Https://Www.Ncbi.Nlm.Nih.Gov/Books/NBK532957/
[4]. Reel B, Maani CV. Dexmedetomidine. [Updated 2023 May 1]. In: Statpearls [Internet]. Treasure Island (FL): Statpearls Publishing; 2025 Jan-. Available From: Https://Www.Ncbi.Nlm.Nih.Gov/Books/NBK513303/
[5]. Manuitt, María & Escamilla, Yolanda & Vallano, Antoni & Cardesin Revilla, Alda & Bernal-Sprekelsen, Manuel & Pontes, Caridad. (2017). Use Of Α 2 -Adrenergic Agonists To Improve Surgical Field Visibility In Endoscopy Sinus Surgery: A Systematic Review Of Randomised Controlled Trials. Clinical Therapeutics. 40. 10.1016/J.Clinthera.2017.11.010.
[6]. Pratyusha K, Managutti A, Tiwari RV, Tiwari HD, Das A, Dutta P. A RANDOMISED

Abstract: Background: Spinal anesthesia is a widely utilized regional anesthesia technique, particularly for infraumbilical surgeries. It provides effective sensory and motor blockade, minimal systemic side effects, and stable hemodynamics, making it a preferred choice in various surgical procedures, including lower abdominal, urological, and lower limb surgeries. Bupivacaine, a long-acting amide local anesthetic, is frequently used in spinal anesthesia.....

Key Word: Bupivacaine; Dexmedetomidine; Spinal Anaesthesia; Infraumbilical Surgeries

[1]. Brown DL, Neal JM, Butterworth JF. Spinal, Epidural, And Caudal Anesthesia. In: Miller RD, Editor. Miller’s Anesthesia. 9th Ed. Elsevier; 2020. P. 1553-1580.
[2]. Kalso EA, Poyhia R, Rosenberg PH. Spinal Antinociception By Dexmedetomidine, A Highly Selective A2-Adrenergic Agonist. Pharmacoltoxicol. 1991; 68:140–3.
[3]. Al-Mustafa MM, Badran I, Abu-Ali H, Darwish H, Al-Barazanchi M, Massad D. Effect Of Dexmedetomidine As An Adjuvant To Spinal Anesthesia: A Randomized Controlled Trial. J Anesth. 2009;23(2):187-193.
[4]. Bajwa SJ, Bajwa SK, Kaur J. Dexmedetomidine And Its Effects On Spinal Anesthesia: A Clinical Evaluation. Saudi J Anaesth. 2011;5(4):365-370.
[5]. Elia N, Culebras X, Mazza C, Schiffer E, Tramèr MR. Clonidine As An Adjuvant To Intrathecal Local Anesthetics For Surgery: Systematic Review Of Randomized Trials. Br J Anaesth. 2008;102(3):311-324

Abstract: Understanding root canal morphology is fundamental to successful endodontic treatment, yet anatomical variations often present unforeseen challenges that can compromise outcomes if not properly identified and managed. This case presentation explores the clinical significance of canal morphology variations and emphasizes the importance of adaptability, advanced diagnostic tools, and meticulous technique in navigating atypical anatomy. Through....

Keywords: Radix Entomolaris, C-shaped, CBCT, canal configuration, magnification, case report

[1]. Vertucci FJ. Root Canal Anatomy Of The Human Permanent Teeth. Oral Surgery, Oral Medicine, Oral Pathology. 1984 Nov 1;58(5):589-99.
[2]. Weine FS, Healey HJ, Gerstein H, Evanson L. Canal Configuration In The Mesiobuccal Root Of The Maxillary First Molar And Its Endodontic Significance. Oral Surgery, Oral Medicine, Oral Pathology. 1969 Sep 1;28(3):419-25.
[3]. Gulabivala K, Aung TH, Alavi A, Ng YL. Root And Canal Morphology Of Burmese Mandibular Molars. International Endodontic Journal. 2001 Jul;34(5):359-70.
[4]. Patel S, Dawood A, Whaites E, Pitt Ford T. New Dimensions In Endodontic Imaging: Part 1. Conventional And Alternative Radiographic Systems. International Endodontic Journal. 2009 Jun;42(6):447-62.

Abstract: Background: Uterine scar complications following cesarean delivery represent significant obstetric challenges with potentially severe maternal and neonatal consequences. Objective: To evaluate the incidence, risk factors, and outcomes of uterine scar dehiscence and rupture in post-cesarean pregnancies.
Materials and Methods: A prospective observational study of 120 women with previous cesarean sections was conducted at a tertiary care center, Department of Obstetrics and Gynecology at Katihar medical college, Katihar, Bihar from July.....

Key Word: Uterine rupture, Scar dehiscence, Cesarean section, Pregnancy complications, Ultrasonography, Maternal outcomes, Neonatal outcomes

[1]. Abbas A MA. Maternal And Perinatal Outcomes Of Uterine Rupture In A Tertiary Care Hospital: A Cross-Sectional Study. J Matern Fetal Neonatal Med. 2019;32(20):3352–3356. Doi: 10.1080/14767058.2018.1463369.
[2]. Astatikie G, Limenih M A, Kebede M. Maternal And Fetal Outcomes Of Uterine Rupture And Factors Associated With Maternal Death Secondary To Uterine Rupture. BMC Pregnancy Childbirth. 2017;17(01):117. Doi: 10.1186/S12884-017-1302-Z.
[3]. Motomura K, Ganchimeg T, Nagata C, Ota E, Vogel J P, Betran A P. Incidence And Outcomes Of Uterine Rupture Among Women With Prior Caesarean Section: WHO Multicountry Survey On Maternal And Newborn Health. Sci Rep. 2017;7:44093. Doi: 10.1038/Srep44093.
[4]. Kieser K E, Baskett T F. A 10-Year Population-Based Study Of Uterine Rupture. Obstet Gynecol. 2002;100(04):749–753. Doi: 10.1016/S0029-7844(02)02161-0.
[5]. Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal–Fetal Medicine Units Network . Landon M B, Grobman W A. What We Have Learned About Trial Of Labor After Cesarean Delivery From The Maternal-Fetal Medicine Units Cesarean Registry. Semin Perinatol. 2016;40(05):281–286. Doi: 10.1053/J.Semperi.2016.03.003.

Abstract: Background: Glaucoma is a leading cause of irreversible blindness worldwide, characterized by progressive optic neuropathy. Early detection and monitoring are crucial, as structural damage often precedes functional vision loss. Traditional methods like intraocular pressure measurement and standard automated perimetry have limitations in sensitivity and subjectivity. This review synthesizes the current evidence on new imaging technologies that offer potential for earlier, more objective diagnosis and monitoring of glaucomatous changes. Materials and Methods....

Keywords: Glaucoma; Optical Coherence Tomography; Adaptive Optics; Retinal Nerve Fiber Layer; Optic Nerve Head; Diagnostic Imaging

[1]. Weinreb RN, Aung T, Medeiros FA. The Pathophysiology And Treatment Of Glaucoma: A Review. JAMA. 2014 May 14;311(18):1901-11.
[2]. Rodriguez-Una I, Azuara-Blanco A. New Technologies For Glaucoma Detection. Asia Pac J Ophthalmol (Phila). 2018 Nov-Dec;7(6):394-404.
[3]. Kotowski J, Wollstein G, Folio LS, Ishikawa H, Schuman JS. Clinical Use Of OCT In Assessing Glaucoma Progression. Ophthalmic Surg Lasers Imaging. 2011 Oct;42 Suppl:S6-S14.
[4]. Chen AX, Conti TF, Hom GL, Greenlee TE, Raimondi R, Briskin IN, Et Al. Functional Imaging Of Mitochondria In Retinal Diseases Using Flavoprotein Fluorescence. Eye (Lond). 2021 Jan;35(1):74-92.
[5]. Jun TJ, Eom Y, Kim D, Kim C Et Al. Trk-CNN: Transferable Ranking-CNN For Image Classification Of Glaucoma, Glaucoma Suspect, And Normal Eyes. Arxiv Preprint Arxiv:1905.06509. 2019.