ABSTRACT
The occurrence of tuberculosis of the upper respiratory tract including oral cavity has become uncommon. Isolated tuberculosis in the absence of active pulmonary tuberculosis is very rare clinical entity. Here is a report of primary tuberculosis of tonsil, presented with complaints of sore throat.
ABSTRACT
Postoperative nausea and vomiting (PONV) is common after anaesthesia and surgery. In patients undergoing laparoscopic cholecystectomy (LC) without antiemetic prophylaxis, the incidence can be as high as 76% which would cause unexpected delay in hospital discharge. This study was designed to compare the efficacy of the ondansetron alone with combination of ondansetron and dexamethasone the given as prophylaxis for PONV in patients undergoing laparoscopic cholecystectomy. One hundred patients undergoing elective laparoscopic cholecystectomy were selected and randomly divided into 2 groups of 50 each. Group I received 4mg of ondansetron intravenously (iv), whereas Group II received ondansetron 4mg and dexamethasone 4mg just before induction of anaesthesia. Postoperatively, the patients were assessed for episodes of nausea, vomiting and need for rescue antiemetic. Complete response defined as no nausea and vomiting during first 24 hours, was noted in 76% of patients in Group I and in 92% of patients in Group II. Rescue anti emetic requirement was less in Group II (4%) than Group I (20%). So it can be concluded that the combination of ondansetron and dexamethasone is more effective in preventing PONV in patients undergoing laparoscopic cholecystectomy than ondansetron alone.
ABSTRACT
Pheochromocytoma is a rare catecholamine secreting tumour originating usually from adrenal medulla and produces signs and symptoms due excessive catecholamine secretion from tumour. A young female patient of 21 year age presented with paroxysmal attacks of hypertension causing palpitation, dizziness, blurring of vision and headache for last 06 months. Clinical suspicion of pheochromocytoma was confirmed by 24 hour urinary catecholamine level, transabdominal USG and CT scan of abdomen. After having two weeks of preoperative preparation with phenoxybenzamine and propanolol, open surgical removal of pheochromocytoma was done. Peroperative fluctuation of BP was well managed by IV fluid overload, intravenous phentolamine, intravenous esmolol and intravenous ephedrine. Postoperative recovery was uneventful and BP regains to normal range from 1st postoperative day. Pheochromocytoma is a rare cause of hypertension. If the diagnosis of pheochromocytoma is overlooked, the consequences could be disastrous, even fatal; however, if a pheochromocytoma is identified, it is potentially curable, as being one of the cause of surgically correctable hypertension.
ABSTRACT
Haemodynamic stability is an integral and essential goal of any anaesthetic management plan. Laryngoscopy and intubation can cause striking changes in haemodynamics. Increase in blood pressure and heart rate occurs most commonly from reflex sympathetic and vagal discharge in response to laryngotracheal stimulation, which in turn leads to increased plasma norepinephrine concentration. This study was designed to compare efficacy of esmolol and lignocaine for attenuating haemodynamics response due to laryngoscopy and endotracheal intubation. The aim of this study was to compare the effects of Esmolol with that of Lignocaine to attenuate the detrimental rise in heart rate and blood pressure during laryngoscopy and tracheal intubation. One hundred and twenty adult patients randomized into group-L and group-E, were received lignocaine 1.5 mg/kg and Esmolol 1.5 mg/kg I.V. respectively. Heart rate and blood pressure in each minutes for the 10 minutes after intubation was recorded. Time span around intubation up to 4 minutes has been looked specifically to isolate the effect of the study drugs at the time of intubation. For statistical analysis Student's 't' test was used for comparing means of quantitative data and chi-square test was used for qualitative data. Difference was considered statistically significant if p<0.05. The mean heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product before starting anesthesia were similar in group-L (Lignocaine group) and in group-E (Esmolol group) (p>0.05). The mean values of heart rate, systolic, diastolic, and mean blood pressure, and rate-pressure product at 2, 3 and 4 minutes after intubation were significantly lower in group-E than group-L (p<0.05). In conclusion, esmolol 1.5 mg/kg is superior to lignocaine (1.5 mg/kg) for attenuation of haemodynamic response to laryngoscopy and endotracheal intubation.
ABSTRACT
Improvement of maternal health care services is regarded as an important component for achieving targets of MDGs by the year 2015. A cross-sectional community based study was carried out to find out the status and utilization of maternal health care services in Pangsa Upazilla of Rajbari District among 517 mothers who had at least one child up to 1 year of age. The study was conducted from June to August in the year 2008. Data were collected through face-to-face interview using purposive sampling technique. Most of the respondents were in the age group of 20-29 years (69.05%) and 35.01% of them had received primary education. Sixty seven percent of them had average monthly income of Taka 3001-5000. Eighty percent of the respondents were at the age group of 15-19 years when they got married. Most of the mothers (71.57%) got antenatal care during their last pregnancy and more than 80% of them had completed their TT vaccination schedule during pregnancy period. More than 80% of the deliveries were taken place at home. Eighty five percent of the deliveries were normal delivery and most of them (77.76%) were attended by the untrained traditional birth attendants (TBA). Hemorrhage was found to be the highest reported obstetric complication (37.50%). This study offered a picture of the maternal health care services in rural Bangladesh and detected the need for future work in this area.