ABSTRACT
Background: Objective of present study to determine that administration of Intravenous Lignocaine prior to propofol is as effective as topically on the posterior oropharynx for LMA insertion.Methods: 60 patients of age group 16-45years of both sexes, ASA Grade I and II undergoing elective surgeries. Group 1: (n=30) Patients receiving Lignocaine 1.5 mg/kg IV over 30 seconds. Group 2: (n=30) Patients receiving lignocaine aerosol 40 mg topically. Conditions of LMA insertion, gagging laryngospasm ,coughing noted at time of insertion, ECG, NIBP, SPO2 and ETCO2 were recorded according to scheduled times.Results: In Conditions of insertion, difference between groups reached significance, p<0.05. In groups at first min, rise in heart rate, fall in DSP, SBP and MAP was significant. At two and three minutes post LMA insertion these parameters change slightly but statistically not significant.Conclusions: Topical Lignocaine 10% aerosol prior to propofol induction provides excellent conditions for LMA insertion without the use of neuromuscular blockages.
ABSTRACT
Objective A short pre-hospital delay, from the onset of symptoms to rapid initiation of reperfusion therapy, is a crucial factor in determining prognosis of myocardial infarction (MI). The purpose of this study was to evaluate symptoms and presentation delay times in MI patients with and without diabetes. Methods This cross-sectional study was conducted in 3 tertiary care hospitals of Pakistan over a period of 6 months. The study sample consisted of 280 consenting individuals diagnosed with ST-elevation MI (STEMI) or Non-ST elevation MI (NSTEMI), out of which 130 were diabetic and 150 were non-diabetic. Data was collected using a standardized questionnaire, investigating MI symptoms along with causes and duration of pre-hospital delay within 72 hours of admission. Results No significant difference was found in the intensity of chest pain between diabetics and non-diabetics. Atypical symptoms of MI such as anxiety (p < 0.001), cold sweats (p = 0.034) and epigastric pain (p = 0.017) were more frequently reported in diabetics. MI patients with diabetes had a significantly longer presentation delay time with 75% of the patients presenting after elapse of 3 h. Only a few patients reported to the hospital within an hour of onset of symptoms (n = 23, 8.2%), out of which majority were non-diabetics (n = 18). A majority of patients (n = 146, 52%) in both groups did not use emergency medical services. Conclusion This study provides an incentive for further research, aiming to reduce pre hospital delay along with investigating the effectiveness of emergency medical services.
ABSTRACT
Background: Hepatitis C Virus [HCV] infection is diagnosed by antibody and RNA based methods. Anti HCV-RNA testing based methods are introduced to confirm viremia in seropositive samples. This study aimed to evaluate the relationship between quantitative anti-HCV [S/CO ratio] and HCV-RNA by PCR as a diagnostic test to identify viremic from non-viremic HCV patients received anti-HCV therapy in Egypt
Subjects and Methods: Patients serum samples used in this study were collected from Al Hussein University hospitals after they had completed their anti-HCV therapy. A total of 172 patients were included in this study 82 were positive RNA, 90 of them were negative RNA their serum samples were assessed for the presence of antibodies to HCV using ELISA method
Results: The results were expressed as the ratio between the signal detected on the sample and the cutoff value of the run [S/CO]. Patients with HCV-positive RNA were considered viremic. Receiver operator characteristic [ROC] curve was constructed by plotting sensitivity versus 1 - specificity, using HCV RNA and the S/CO ratio results respectively. Of the 172 patients with HCV infection the mean age was 51.9 +/- 7.2 years ranging 35-67 years, 111 [64.5%] were males while 61[35.5%] were females. In the present study there was significant difference in S/CO ratio between viremic and nonviremic subjects. The sensitivity, specificity, negative predictive value, and positive predictive value were 98.78%, 71.11%, 98.46%, and 75.70%, respectively in the S/CO ratio of 8. Area under ROC curve was estimated to be 0.982 [95% confidence interval 0.967 - 0.997]
Conclusion: by establishing 8 as cutoff value of the S/CO, it is possible to distinguish between viremic and non-viremic patients without need to use Anti HCV-RNA testing as a confirmatory test