ABSTRACT
With new advances in technology, intubation using video laryngoscopy has been gaining popularity, particularlyin patients with difficult airways or as rescue devices in failed intubation attempts. This study was done tocompare the effectiveness of King Vision video laryngoscope (KVL) and Macintosh laryngoscope whenperforming tracheal intubation under general anesthesia Eighty patients requiring endotracheal intubationduring general anaesthesia were randomly assigned into two groups to undergo tracheal intubation usingeither a King Vision video laryngoscope (n=40) or Macintosh laryngoscope (n=40). The primary outcomeswere the time of intubation and Cormack-Lehane grading and secondary outcomes were number of attemptsand optimisation manoeuvres required and complications related to laryngoscopy and intubation. King Visionvideo laryngoscope was found to be significantly better than the Macintosh laryngoscope in terms of Cormackand Lehane grading, requirement of optimisation manoeuvres and need of second attempt for intubationexcept time of intubation which was comparable between the two groups.
ABSTRACT
Background: In India a large number of patients have been suffering from breast cancer and with each passing year, the number is increasing. Fine needle aspiration cytology (FNAC) is an inexpensive, simple and highly accurate means of diagnosing both benign and malignant breast lesions. The procedure provides a rapid and non-morbid diagnosis before the operation which enables the patient and the surgeon to discuss and plan therapeutic alternatives in a rational atmosphere. Aims & Objective: To find out the common causes of breast lesions, to evaluate role of FNAC in the diagnosis of them, their risk categorization for development of cancer and to conduct cytohistological correlation wherever possible. In addition the sensitivity, specificity, positive & negative predictive value of FNAC in breast lesions are carried out. Material and Methods: The present study was carried out on 407 patients who presented with palpable lump in the breast in the Department of Pathology, Government Medical College, Ahmedabad over a period of one year. FNAC slides were examined under light microscope after H&E, Papanicolaou & May-Grunwald –Giemsa staining and were categorized as Unsatisfactory sample, inflammatory, Benign, Atypical probably benign, suspicious probably malignant and Malignant. Cytological Diagnosis was correlated with histological findings wherever possible. Results: Cytologically, the lesions were categorized in, Unsatisfactory 28 (6.87%), inflammatory 64 (15.72%), Benign 229 (56.26%), Atypical probably benign 8 (1.96%), suspicious probably malignant 8 (1.96%) and Malignant 70 (17.19%). Out of these 407 cases, 161 cases (39.55%) were available for histopathological examination. The most common benign lesion in this study was fibroadenoma 178/229 (77.72%) and the most common malignant lesion was infiltrating ductal carcinoma 51/70 (72.85%). The sensitivity and specificity of FNAC came out to be 98.08%, 98.86% respectively& positive & negative predictive value of FNAC were 99.35% &96.66% respectively. Conclusion: The FNAC of breast is cheap, safe and highly accurate preoperative method for diagnosis of breast lesions. Preoperative categorization of breast lesions is utmost important for management of the patient.
ABSTRACT
Background: To understand the incidence amongst the age groups and gender, correlation of this study with the clinical presentation, evaluate the adequacy of ventilation by detecting blood gases, the changes in acid-base balance & compensatory mechanism in chronic obstructive pulmonary disease (COPD) patients, COPD cases were evaluated. Materials And Methods: The retrospective study was carried out on the patients with chronic obstructive pulmonary disease who were admitted in Civil hospital, Asarwa, Ahmedabad from July 2000 to October 2003. Arterial blood gas analysis was used as a diagnostic test in 50 cases of chronic obstructive pulmonary disease. Results: out of total 50 cases, majority (50%) had emphysema, 30% had mixed clinical picture of chronic bronchitis and emphysema, where as 20% had clinical picture of chronic bronchitis. Mean age group in this study was 55.9+4.4 yrs. Majority (82%) of patients were male. 16% cases were oedematous. Mean partial pressure of CO2 & O2 were 50.76 and 66.9 mm of Hg respectively. Range of pH observed was 7.28 to 7.52. Conclusion: Smoking of cigarettes (82%), exposure to dust (44%) and urban residence (64%) were the major risk factors.