ABSTRACT
Objective: A comparative study to evaluate the efficacy of dexmedetomidine to provide bloodless surgical field in comparison to midazolam in Functional Endoscopic Sinus Surgery (FESS). Methods: 60 patients ASA I or II scheduled for FESS were equally randomly assigned to receive either Inj. Dexmedetomidine in dose of 1 g/kg over 10 min in infusion or Inj. Midazolam 0.02 mg/kg. In both groups, the infusion rate was adjusted to maintain the mean arterial blood pressure (MAP) of 65-70 mmHg. The induction was done using propofol (2.5 mg/kg) and atracurium (0.5 mg/kg). After the intubation, maintenance was achieved with O (50%), N O 2 2 (50%), Inj. Atracurium infusion and Sevoflurane. Intraoperative bleeding was estimated by the surgeon using Boezzart's scale for the evaluation of operative field visibility during the surgery. Hemodynamic variables (MAP and HR) were recorded. Results: Better achievement of MAP control is achieved with Dexmedetomidine compared to Midazolam. Overall intra-operative blood loss was more in Midazolam group compared to Dexmedetomidine group. Conclusion: Both Dexmedetomidine and Midazolam are safe and effective in FESS for controlled hypotension, though Dexmedetomidine provides excellent surgeon's satisfaction without severe hemodynamic changes
ABSTRACT
Background: Abnormal uterine bleeding is one of the most frequent problems in life of an adult female. Accurate analysis of endometrium & localization of intrauterine lesion is the goal to effective management & better outcome of problem. Aims & Objective: To evaluate various histopathological features in D & C and/or hysterectomy in patients presenting with abnormal uterine bleeding and to find the efficacy of D & C as a better, cost effective and minimally invasive tool for screening in patients with AUB. Materials and Methods: The present study was conducted in Department of Pathology, tertiary care hospital, Ahmedabad, Gujarat, India over a period of one and half years. A total 320 patients aged 20 years & above, presenting with AUB were included. Endometrial samples were analysed, histopathological changes identified and classified. Results: Age of patients ranged from 21 to 70 years mean age being 42.6 ± 6.9 years, maximum patients (53.4%) belonged to 41-50 years of age group. Most common histopathological pattern was normal cyclical endometrium (47.3%) followed by endometrial hyperplasia (42.9%). Endometrial hyperplasia was most common (57.1%) in perimenopausal age group (41-50 years). The diagnostic accuracy of D &C was found to be 93.4%; amongst all histopathological patterns it was maximum for complex hyperplasia (typical and atypical) and simple atypical hyperplasia. Conclusion: Endometrial causes of AUB are age related therefore it is specially recommended in women of perimenopausal age group to rule out preneoplastic and neoplastic etiology. D & C is an accurate, minimally invasive outdoor procedure for detecting endometrial pathology especially hyperplasia.
ABSTRACT
Due to the rise over the years in patient emphasis on better esthetic outcomes, veneering the metal base of a restoration with composite resin or porcelain is widely used in dentistry. For the preservation of the opposing natural dentition and the potential for repair, the use of composite veneering materials has been suggested because of their resilience, low abrasive properties, and superior repair potential. Composites are not as popular as porcelain, but they are still widely used to cover metal because of low cost and because the laboratorial procedures are faster and simpler.
ABSTRACT
This case report discusses about a 50 years old female who had post atrophic rhinitis saddle nose deformity. The patient was first treated by a plastic surgeon who did “Inlay nasal grafting” and after that a temporary nasal stent was given which served mainly two purposes : 1) initially it maintained the graft in position and 2) secondly it prevented contracture of the graft. Also, a gumfit removable partial denture was given for replacing upper central incisors of the patient which greatly improved her esthetics.