Dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia for appropriate surgical field visibility during modified radical mastectomy with i-gel®: a randomized control study / 대한마취과학회지

BACKGROUND: Modified radical mastectomy is associated with appreciable blood loss, while endotracheal intubation leads to elevated hemodynamic responses. The present study aimed to evaluate the clinical efficacy of dexmedetomidine infusion as an anesthetic adjuvant to general anesthesia during modified radical mastectomy with I-Gel. METHODS: Sixty adult consenting female patients, of American Society of Anesthesiologists physical status 1 to 2 and aged 4,065 years, were blindly randomized into two groups of 30 patients each. The patients in Group I received intravenous dexmedetomidine at a loading dose of 1 µg/kg over 10 min, followed by maintenance infusion of 0.4 to 0.7 µg/kg/h, while patients in Group II were administered an identical amount of saline infusion until 15 min prior to the end of surgery. The primary end point was bleeding at the surgical field and hemodynamic changes; requirement of isoflurane, intraoperative fentanyl consumption and recovery time were assessed as secondary outcomes. RESULTS: The patients receiving dexmedetomidine infusion showed significantly less bleeding at the surgical field (P < 0.05). A statistically significant reduction was also observed in the percentage of isoflurane required (0.82 ± 0.80%) to maintain the systolic blood pressure between 100 and 110 mmHg in patients receiving dexmedetomidine infusion compared with the Group II (1.50 ± 0.90%). The mean intraoperative fentanyl consumption in patients in the Group I was also significantly lower compared with that of the Group II (38.43 ± 5.40 µg vs. 75.12 ± 4.60 µg). The mean recovery time from anesthesia did not show any clinically significant difference between the groups. CONCLUSIONS: Dexmedetomidine infusion can be used safely to decrease the bleeding at the surgical field with smooth recovery from anesthesia.

impact of body mass index on oral hygiene practices of adolescents in Bhopal City, India

Objective: To assess the impact of Body Mass Index [BMI] on oral hygiene practices of adolescents in Bhopal City, India

Study Design: Cross-sectional study

Place and Duration of Study: Arts College, Bhopal, from February to March 2014

Methodology: A convenience sample of 17 - 23 years college-going adolescents from Arts College, Bhopal city was selected for the study. Self-reported questionnaire for adolescents to assess BMI and oral hygiene attitude, knowledge and practices was used. Descriptive statistics and chi-square test were applied

Results: Out of the total study population, 53.54% [n=166] were males and 46.45% [n=144] were females. Two hundred and six [66.45%] were of optimal weight, 27.74% [n=86] were underweight and only 4.52% [n=14] were overweight. There was a significant association between BMI and oral hygiene practice of toothbrushing [p < 0.001] and mouth rinsing [p=0.001] among both male and female subjects

Conclusion: Hence, BMI is significantly associated with the oral hygiene practices of adolescent population. There is growing interest in the relationship between BMI and oral health because both are significant public health concerns. These public health problems are related to common lifestyle factors such as unhealthy eating habits and smoking among children. These maladapted habits track into later life as predictors of increased BMI and oral health problems. Hence, it is required that the dentists are aware of the influence of body mass Index and lifestyle on oral health practices among children and adolescents

Comparison of opinion referendum of medical and dental postgraduates towards plagiarism in Bhopal - central India

To evaluate awareness and attitude towards plagiarism of postgraduates of health fraternity in Bhopal, Central India. A cross-sectional survey. People's University, Bhopal, Madhya Pradesh, India, from January to March 2014. A total of 164 postgraduates, medical [n = 80] and dental postgraduates [n = 84] were included in the study. A standard pre-tested self-administered questionnaire assessing positive, negative and subjective norms towards plagiarism was the assessing tool. Data was captured through distribution of the instrument and collected as scheduled from the study participants. The distribution of scores based on the responses to the individual questions in each dimension between the groups were compared using Mann-Whitney U-test. Among dental and medical postgraduates the median values for the questions under positive attitude was 34.0 and 32.0, negative attitude was 21.5 and 19, subjective norms was 29.0 and 27.5 respectively. The difference in the opinion regarding positive attitude was found to be statistically significant in between the groups [p < 0.05]. Overall plagiarism was favored more by dental students as compared to medical students. Moreover, inadequate level of knowledge and awareness was observed in both the streams. Efforts should be undertaken to motivate health professionals to instill honest behavior in order to preserve the intellectual property right

Dexmedetomidine premedication for fiberoptic intubation in patients of temporomandibular joint ankylosis: a randomized clinical trial

Fiberoptic intubation is the gold standard technique for difficult airway management in patients of temporomandibular joint. This study was aimed to evaluate the clinical efficacy and safety of dexmedetomidine as premedication with propofol infusion for fiberoptic intubation.Consent was obtained from 46 adult patients of temporomandibular joint ankylosis, scheduled for gap arthroplasty. They were enrolled for thisdouble-blind, randomized, prospective clinical trial with two treatment groups - Group D and Group P, of 23 patients each. Group D patients had received premedication of dexmedetomidine 1microg/kg infused over 10 min followed by sedative propofol infusion and the control Group P patients were given only propofol infusion to achieve sedation. Condition achieved at endoscopy, intubating conditions, hemodynamic changes and postoperative events were evaluated as primary outcome. The fiberoptic intubation was successful with satisfactory endoscopic and intubating condition in all patients. Dexmedetomidine premedication has provided satisfactory conditions for fiberoptic intubation and attenuated the hemodynamic response of fiberoptic intubation than the propofol group. Fiberoptic intubation was found to be easier with dexmedetomidine premedication along with sedative infusion of propofol with complete amnesia of the procedure, hemodynamic stability and preservation of patent airway

Electrolyte changes: an indirect method to assess irrigation fluid absorption complications during transurethral resection of prostate: a prospective study

Fluid absorption is inevitable complication of transuretheral resection of prostate and serum electrolytes changes can indirectly assess the irrigation fluid absorption. To monitor the extent of 1.5% glycineirrigation fluid absorption during transurethral resection of prostate [TURP], by measuring the changes of serum sodium and potassium levels peri-operatively. This is a randomized prospective cohort observational study. The 86 male patients of ASA grades I to III in the age group of 50 to 80 years, scheduled for elective TURP surgery under central neuraxial block, were studied. Their preoperative and post-operative serum sodium, potassium and calcium levels were measured. When duration of surgery exceeds 60 min, serum sodium and potassium levels were done intra-operatively with venous blood samples by using blood gas analyser. The height of irrigation fluid column was kept constant at 60 cm. These changes were correlated with the volume of irrigating fluid used, duration of procedure and the volume of prostate gland resected. The values of pre and postoperative sodium, potassium and calcium serum levels were compared and statistical significance of the difference in values was assessed using Student's paired t test. Statistically significant reduction of serum sodium levels [hyponatremia] and elevation of serum potassium levels [hyperkalemia] were observed post-operatively, which was directly proportional to volume of irrigating fluid used, duration of procedure and volume of prostate gland resected. No significant changes in serum calcium level were observed. To measure serum electrolytes changes during TURP surgery, it is simple and economical method for indirect assessment of fluid absorption for early identification of TURP syndrome