ABSTRACT
Introduction: The minimum volume of LA required toeffectively block the four main branches of the axillary brachialplexus is unknown. The main aim of the current study wasto determine the minimal volume of LA required to surroundeach branch of axillary brachial plexus and document its onsetand duration of sensory and motor effects.Material and methods: 20 patients with ASA I–II undergoinghand or forearm surgery were selected for this study. USG wasused to locate each of the 4 branches of axillary plexus. 1.5%of lignocaine with 1:200 000 of adrenaline was loaded into asyringe driver and deposited with a 22 G needle and injectioncommenced using the bolus function (600 ml h21).Results: The mean (95% of Confidence Interval) volumerequired for each nerve was: radial 3.32 (2.74–3.89) ml,median 2.65 (2.01–3.19) ml, ulnar 2.48 (2.04–2.93) ml, andmusculocutaneous 2.20 (1.86–2.54) ml. The mean (95% ofConfidence Interval) onset time for complete sensory blockwas: radial 21.5 (12.5–30.5) min, median 25.8 (17.5–34.0)min, ulnar 25.6 (16.8–34.4) min, and musculocutaneous 14.8(7.35– 23.2) min. The mean (95% of Confidence Interval) lastrecorded time with complete block was: radial 136.1 (104.6–158.7) min, median 143.7 (122.4–165.0) min, ulnar 182.2(157.1–207.2) min, and musculocutaneous 157.3 (130.8–183.9) min.Conclusions: We concluded that it is possible to deposit 2–4ml of local anaesthetic around each branch of axillary plexus.We also speculate that by increasing the amount of volumeof LA would produce anesthesia of quicker onset and withlonger.
ABSTRACT
OBJECTIVE@#To assess the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients.@*METHODS@#Close contacts of MDR-TB patients were traced in the cross-sectional study. Different clinical, radiological and bacteriological were performed to rule out the evidence of TB/MDR-TB.@*RESULTS@#Between January 2012 and December 2012, a total of 200 index MDR-TB patients were initiated on MDR-TB treatment, out of which home visit and contacts screening were conducted for 154 index cases. Of 610 contacts who could be studied, 41 (17.4%) were diagnosed with MDR-TB and 10 (4.2%) had TB. The most common symptoms observed were cough, chest pain and fever.@*CONCLUSIONS@#The high incidence of MDR-TB among close contacts emphasize the need for effective contact screening programme of index MDR-TB cases in order to cut the chain of transmission of this disease.
ABSTRACT
Objective To assess the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients. Methods Close contacts of MDR-TB patients were traced in the cross-sectional study. Different clinical, radiological and bacteriological were performed to rule out the evidence of TB/MDR-TB. Results Between January 2012 and December 2012, a total of 200 index MDR-TB patients were initiated on MDR-TB treatment, out of which home visit and contacts screening were conducted for 154 index cases. Of 610 contacts who could be studied, 41 (17.4%) were diagnosed with MDR-TB and 10 (4.2%) had TB. The most common symptoms observed were cough, chest pain and fever. Conclusions The high incidence of MDR-TB among close contacts emphasize the need for effective contact screening programme of index MDR-TB cases in order to cut the chain of transmission of this disease.
ABSTRACT
To compare the intraocular pressure [IOP] lowering effect of topical drug combination [Latanoprost and Timolol] with Latanoprost alone in patients of Primary Open Angle Glaucoma [POAG]. Randomized controlled Trials [RCT]. Armed Forces Institute of Ophthalmology [AFIO] Rawalpindi from December 2009 to May 2011. A total of 240 eyes of 120 patients [68 males and 52 females] were included in the study. The patients were randomized into two groups of 60 each using random numbers table. Group A [60 patients, 12Q eyes] were put on topical drug combination of Latanoprost and Timolol eye drops and Group B [60 patients, 120 eyes] were treated with topical Latanoprost eye drops alone. IOP assessments were done at baseline, 2 weeks, 4 weeks and 8 weeks intervals after initiation of treatment. Both the groups were age matched with mean age in Group A was 56.39 +/- 8.50 years and in Group B was 55.61 +/- 8.95 years [p=0.09]. Both groups showed significant IOP decrease from the baseline at each follow up interval. However after 8 weeks of start of treatment, pressure lowering effect in group A [14.73 +/- 2.50 mmHg] was significantly more as compared to Group B [9.10 +/- 2.51 mmHg] [p<0.001]. Combination therapy of Latanoprost and Timolol is more effective as compared to monoyherapy with Latanoprost in lowering IOP of patients with POAG
Subject(s)
Humans , Male , Female , Prostaglandins F, Synthetic , Timolol , Glaucoma, Open-AngleABSTRACT
This article presents patients with unilateral painful red eye refractory to recommended standard treatment regimes in which staining, culture and sensitivity reports were inconclusive. On ocular examination hazy cornea with central corneal abscess was common in all cases. Corneal biopsy was reserved for cases with inconclusive laboratory reports as well as poor response to standard treatment regime. The former revealed fungal hyphae in all cases. Patients mentioned had general predisposition e.g. diabetes mellitus, hot climate [Multan] as well as predisposing factors such as contact lenses, dry eye syndrome, poor ocular hygiene, agricultural background were more prone to fungal keratitis, hence better diagnosed and confirmed early by contemplating corneal biopsy