AIM: To investigate the incidence of oculocardiac reflex (OCR) with two anesthetic regimens and its prevention using topical anesthetics in a rabbit model. We also investigated the effect of topical anesthetics on corneal healing.METHODS: Forty-eight clinically healthy adult New Zealand white rabbits of either sex were divided into two groups (Group A and B) and anesthetized with either ketamine (Group A, n=24) or propofol (Group B, n=24). In this study , the incidence of OCR was recorded in each group with a variety of ocular manipulation with or without the use of topical anesthetics (40g/L lignocaine, 5g/L proparacain, 5g/L bupivacaine). Corneal toxicity and healing following the use of each topical anesthetic was assessed one day after surgery and up to 7 days postoperatively by clinical examination of the eye, histopathology and collagen staining and transmission electron microscopy.RESULTS: No incidence of OCR was recorded with ocular manipulation under ketamine anesthesia, whereas significant reduction in heart rate (P<0.01) was recorded under propofol anesthesia. Topical anesthetics could successfully prevent the OCR without affecting the corneal healing.CONCLUSION: Topical anesthetics may be recommended for prevention of OCR without any local adverse effect.

Tuberculosis of skull is a rare disease, but its incidence is on rise in developing countries. Skull tuberculosis can have varied neurological presentations. Seizures are uncommon mode of presentation in these patients. We report a patient who presented with seizures and scalp swelling, which was found to be due to skull tuberculosis. Though uncommon, our patient indicates that any patient from tuberculosis endemic zone with skull swellings and neurological symptoms should be suspected and investigated for tuberculosis.

A multi-barrier antibiotics loaded biodegradable composite bone cement for resolving chronic osteo-myelitis has been studied to understand the physico-mechanical properties,drug loading/eluting effi-ciency,and different merits and demerits prior to clinical application.After successful induction of bone infection in 28 rabbits using methicillin-resistant Staphylococcus aureus(MRSA)strains,calcium sulfate/bioactive glass based composite cement was implanted in 12 defects to assess its performance over parenteral therapy with microscopic and radiological examination for 90 days.The composite cement revealed acceptable physico-mechanical properties and controlled drug elution kinetics.Furthermore,the antibiotics concentrations in bone up to 42 days were sufficient to kill MRSA without eliciting adverse drug reactions.The striking feature of platelets aggregation by composite cement could assist bone healing.The controlled degradation with simultaneous entrapment of composite cement within the osteoid tissues and complete repair of infected cortical defects(holes)in rabbit tibia at 6 weeks indicated the excellent anti-infective and osteoconductive properties of composite cement.Thus,the animal study demonstrated the superiority of composite over injectable antibiotic therapy based on infection reso-lution and bone regeneration.We thereby conclude that the composite cement can be effectively applied in the treatment of resistant cases of chronic osteomyelitis.