ABSTRACT
Introduction:Spinal anesthesia is one of the most commonly used techniques in modern anesthesia. Spinal needles have evolved over time to increase efficacy and decrease complications. Fine gauge spinal needles technically consume more time but are advisable in certain clinical conditions such as raised intracranial pressure and when patient well‑being and comfort are the priorities. Hence, we undertook this study to compare the effects and complication of transverse insertion of Quincke’s spinal needle 26 G (gauge) and 29 G. Materials and Methods: Hundred patients of age 18–40 years posted for lower abdominal and lower limb surgeries were allocated into two groups of 50 each to receive spinal anesthesia with 3 ml of 0.5% bupivacaine using 26 G or 29 G Quincke’s spinal needle. All the patients were evaluated for the time of drug administration, number of attempts, time to attain sensory blockade up to T8 level, time to attain motor blockade up to bromage Grade 3, and incidence of post‑dural puncture headache (PDPH) and post‑dural puncture backache. Results: Demographic data were comparable in both groups. The PDPH incidence on 3rd day for 29 G Quincke’s was 0% while for 26 G Quincke’s was 12%. There was statistically significant difference when 26 G Quincke’s was compared with 29 G Quincke’s for number of attempts, time of drug administration, time to attain motor and sensory block. Conclusion: 29 G Quincke’s spinal could be used to provide spinal anesthesia in young adult patients owing to adequate sensory and motor blockade with no incidence of PDPH and backache.
ABSTRACT
Background: Identification of alcohol dependence is crucial in preventing adverse health effects and social consequences of excessive alcohol consumption. The blood tests used traditionally as markers of excessive drinking are the liver enzymes, gamma glutamyltransferase (GGT), aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and the red blood cell volume (mean corpuscular volume; MCV). Here, we evaluate the usefulness of these markers, their association with pattern of alcohol consumption and their practical application in management and treatment of alcohol dependent individuals. Methods: This was a longitudinal study on 50 alcohol dependent individuals and 50 healthy controls. Detailed information about socio-demographic characteristics and alcohol consumption was recorded through psychiatric interview performa. CAGE questionnaire was applied as a screening tool. Diagnosis of alcohol dependence was confirmed as per ICD-10 criteria. All the subjects underwent laboratory testing for biochemical markers which were estimated by semi automated analyzer. The data thus generated was statistically analyzed by using chi-square test, t-test, ANOVA and Pearson product moment correlation analysis. Results: The values for GGT, MCV and AST were significantlyhigh (p<0.001) in study group than control group. GGT was found to be significantly related to the amount of alcohol consumption (<0.001). The correlation of GGT was also found to be highly significant with the increasing frequency of alcohol consumption (r= .488, p<0.001). GGT was found to be most sensitive marker i.e., 64% while HDL-c was found to be having more specificity (100%). Diagnostic accuracy of GGT was found to be highest of all markers(77%). Conclusion: These biochemical markers tests are widely available and relatively inexpensive. While having limited sensitivity and specificity in detection of excessive drinking, they also provide valuable data on complications of drinking, comorbid conditions that may be affected by drinking and, in some cases, prognosis
ABSTRACT
Background:Shift work is common in modern society, and includes several professions responsible for the health and safety of others e.g. health care, police, and fire response. Perceived stress in Health Professionals could be regarded as being of special concern. Indeed, it is thought that level of psychological stress may be higher in Health Professionals than in other occupational groups. Objectives- To compare Perceived stress in shift duty health professionals. Methods: This was an observational, cross sectional study conducted at Rajindra Hospital, Patiala. The socio demographic profile of subjects was recorded and they were subjected to perceived stress scale. The observations and data obtained were statistically analysed using the software statistica 7.0 and SPSS 20. Results andConclusion: Results revealed that junior residents had more perceived stress as compared to staff nurses, interns, pharmacists and other health professionals. Our study has concluded that periodic assessment and evaluation of health professionals is essential to know their perceived stress.