ABSTRACT
Providing suitable analgesia following diagnostic and therapeutic arthroscopic surgeries, that are considered to cause some degree of postoperative pain, is a necessity in equine practice
The aim of the present study was to evaluate the equine synovial fluid biochemical and cytological changes as well as clinical assessments of the joint following intra-articular administration of ketamine. Six adult healthy donkeys were selected after clinical examination. Synovial fluid samples were taken from both middle carpal joints after routine preparation. Ketamine 2 mg/kg and 100 mg lidocaine 2% were administered to the right and left joints, respectively. Synovial fluid collection from the joints was performed at 12, 24, 48 and 192 h after medication. Cytological examination, total protein, glucose, specific gravity, alkaline phosphates [ALP], aspartate aminotransferase [AST], lactate dehydrogenase [LDH], viscosity and quality of mucin clot were measured. Joint circumference, flexion test and lameness examination, stimulation of the joint skin area and radiographic examination were performed as clinical evaluations. Comparison of treatments was performed by nonparametric sign test and Wilcoxon rank sum test. Significance level was set to P?0.05. In the ketamine group, increased joint circumference, positive flexion test and negative response to the ball-point pressure of the joint skin area were seen, unlike that of lidocaine. Mucin clot quality test and viscosity, the amount of total nucleated cell count [TNCC], mononuclear and neutrophil count, specific gravity, total protein content, ALP, AST and LDH of the ketamine treated joints revealed considerable differences between various sampling times compared to the 0 time and also between the ketamine and lidocaine groups [P>0.05]
It was concluded that intra-articular ketamine administration in equine carpal joint resulted in acute inflammatory changes, and failed to demonstrate analgesia; therefore, it is not safe to the joint environment and is not recommended as a local analgesic following arthroscopic surgeries?
ABSTRACT
The patient was a 35 Year old lady who underwent Caldwell-luc sinus surgery with the diagnosis of maxillary chronic sinusitis. Preoperative CT scan showed density and opacity in the right maxillary sinus. The pathologic report of the right maxillary sinus contents was consistent with invasive chronic fungulsinusitis and ASPERGILLUS as causing agent. Other C.T. scan and pathologic report paraclinical findings including CBC and biochemistry lab tests were normal. The patient had no history of previous disease and no evidence of having immunocompromised condition such as diabetes mellitus. Fungal sinusitis is an imprtant entity in different types of sinusitis. Early diagnosis and following treatment have an imporant role in reduction of mortality and morbidity especially in immunocompromised patients. CT scan and MRI are selective for diagnosis of fungal sinusitits and its extention. Most complications of fungul sinusitis are orbital and intracranially spread. Treatment is medical [systemic antifungal] and surgery