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Preterm neonates and sick full-term neonates are at risk for brain injury. Although advances in neonatal intensive care have greatly improved the survival and outcome of these 'micro' patients, brain injury remains of major concern. Early diagnosis is important for optimal treatment, and neurological outcome.
Cranial ultrasonography (cUS) is the preferred modality to image the neonatal brain. The advantages of cUS are numerous: it can be performed at the bedside with little disturbance to the infant, it is relatively safe, and can be repeated whenever needed, enabling visualization of ongoing brain maturation and the evolution of lesions. However, cUS also has several limitations: quality of imaging depends on the skills and experience
of the ultrasonographer, some areas of the brain are difficult to visualize, and several abnormalities remain beyond its scope. In this paper, we discuss the applications and indications of neonatal cUS. We briefly describe the standard procedure and general informations.

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This study compared the hypoglycaemic effects of the increasing dosages of A. cepa, A.
sativum and Z. officinale aqueous extract on alloxan –induced diabetic Rattus novergicus for possible use in the management of diabetes mellitus. Diabetes mellitus was induced in 108 out of a total of 117 adult Rattus novergicus using 150mg/kg b wt of alloxan monohydrate. Increasing dosages (200, 250 and 300mg/kg bw ip) of A. cepa, A. sativum and Z. officinale aqueous extracts were given to the diabetic rats for six weeks while the
control rats got either normal saline (1ml) or increasing dosage of glibenclamide (2.5, 3.8 and 5.0mg/kg b wt ip) during the same period. Blood glucose level from each treatment was evaluated using o – toluidine method. F-LSD was employed to test significant differences (P < 0.05) among treatment means. Increasing dosages of plants aqueous extracts produced a dose-dependent significant (P < 0.05) reductions in the blood glucose
levels of diabetic rats after 6 weeks of treatment when compared with that of the control rats. Among the extracts studied, A. sativum at 300mg/kg bw ip gave the best hypoglycaemic effect (79.7% from 314.1±40.4 to 63.9±2.9), A. cepa followed with 75.4% (297.8±37.5 to 73.4±3.0) and Z. Officinale with 56.7% (303.3±35.8 to 147.2±2.3). From the experimental findings, it is possible to conclude that the three plant extracts studied
exhibited promising hypoglycaemic activity in alloxan-diabetic rats. The hypoglycaemic effects could represent a protective 2 mechanism against the development of hyperglycaemia common in diabetes mellitus.

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The present study was aimed to evaluate the antidiabetic activity of leaf extract of Aloe vera on forty adult male albino rats weighing 200-300 mg body weight (BW) which were divided into four groups (A, B, C and D), Group A served as control, Group B included normal rats treated with Aloe vera leaf extract (0.5 ml/100 gm BW), Group C and D were made diabetic by alloxan injection (65 mg/100 gm BW). Group C served as diabetic control while Group D was given Aloe vera leaf (AVL) extract at the same dose to Group B for 30 days. After 30 days the blood serum was analyzed for serum glucose level in all the four Groups. Twenty rats were randomly taken from these 40 rats for a follow up study and were not given AV extract. The serum glucose level was significantly (P •0.05) decreased in AVL extract feeded rats in Group B and D indicating its hypoglycemic effect.

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There is uncertainty as to whether addition of steroids or narcotics to epidural local anesthetics improves pain control in spine surgery. The aim of the current placebo-controlled, double blind study was to assess the postoperative pain score using a single epidural administration of bupivacaine alone, bupivacaine plus triamcinolone or bupivacaine plus pethidine after wound closure in patients underwent lumbar discectomy.
108 patients were included in this study. After closure of wound, patients were randomly assigned to receive bupivacaine 0.25% (group A), bupivacaine 0.25% plus triamcinolone 40 mg (group B), bupivacaine 0.25% plus pethidine 50 mg (group C) or saline (group D) via epidural catheter. 5 or 10ml of prepared medication was infiltrated in epidural space based on one or two segment procedures. Additional postoperative pain relief was provided using morphine. Patients were assessed with respect to pain score by visual analog scale (VAS), cumulative morphine requirement (mg), ambulation time (hour) and discharge time (day), at the postoperative period. Data were analyzed using chi-square, kruskal wallis, and ANOVA tests.
Mean pain scores were higher in group D at recovery time, 6 and 24 hours postoperatively (P<0.05). The mean total morphine consumption up to 48 hours after operation in groups A, B, C, and D were 1.4±1.5, 1.4±1.3, 1.4±1.3 and 4.6±2.1 mg, respectively (P<0.05). The ambulation time and discharge time were higher in group D (P<0.05). There were not any statistically differences between group A, B and C in order to above variables. In conclusion, epidural administrations of bupivacaine 0.25% results in lower pain scores, opioid consumption and ambulation time and also discharge time when compared with placebo. Triamcinolone or pethidine added to bupivacaine could not improve these parameters.

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To investigate whether neurodevelopmental outcome at age one year might be different after early versus late rescue surfactant treatment in preterm infants.
In 54 preterm infants, having gestational age between 25-30 weeks who were enrolled in a controlled trial of early versus late selective surfactant treatment (45 vs.70 min respectively), a standardized follow up of medical history, neurodevelopmental outcome using the Bayley Scales of Infant and Toddler Development, Second Edition at 9-12 months corrected age.scales were carried out.
Median Mental developmental index (MDI) score was 107 for early group and 111 for late group. Median Psychomotor developmental index (PDI) score was 82 for early group and 93 for late group. Although median MDI and PDI scores were slightly higher in late poractant treatment group and neurodevelopmental impairment was higher in early rescue group than the late rescue group, this was not statistically significant.
Our results demostrated that both early and late poractant treatment had similiar effects on the neurodevelopmental outcomes of preterm infants with RDS. In terms of neurodevelopmental outcomes there is no obvious advantage of an immediate surfactant administration in preterm infants according to our results.

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We present 45 old male patient presented to the hospital with low back pain and non specific
abdominal discomfort of 2 weeks duration, no urinary or other GI complication, no feature of GI or GU obstruction, abdominal CT show retroperitoneal Para aortic mass at lower aortic root before bifurcation and, elevated C-RP (unfortunately patient has refused to do biopsy), patient has history of amlodipine, patient has very high suspicion of idiopathic retroperitoneal fibrosis.

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