ABSTRACT
Background: Paraphenylenediamine [PPD], also known as Kaala pathar, has become an emerging and life threating source of poisoning in Pakistan as well as in many other Asian and African nations. The aim of this study is to recognize the etiological factors, poisoning
Methodology: This observational prospective analytic study included 32 patients who presented in ICU of Nishtar Hospital, Multan. Patients were first managed conservatively by IV fluids, diuretics, antihistamines and steroids; tracheal intubation or tracheostomy was performed only if needed. Univariate analysis was used to determine the independent variables of mortality after PPD poisoning and odds ratios were calculated
Results: Cervicofacial edema, oral erythema and sore throat were most common clinical presentation of patients at the time of admission in ICU, with incidence rates of 93.8%, 81.3% and 75.0%, respectively. Acute renal failure occurred in 34.4% patients and acute hepatitis in 18.75% patients. The independent predictors of mortality after PPD poisoning were: male gender [odds ratio 16.62], dysphagia [odds ratio 9.92], hyperkalemia [odds ratio 84.0], development of cardiogenic shock [odds ratio 36.75], acute renal failure [odds ratio 16.62] and acute hepatitis [odds ratio 27.50]. Tracheostomy was required in all 30 [93.7%], and 13 [40.6%] patients required mechanical ventilation support. In-hospital mortality was 9 [28.1%]. Mean stay of patients in ICU was 3.47+/- 2.04 days
Conclusion: Paraphenylenediamine [Kaala Pathar] poisoning has become one of the major means of suicide attempts with very high mortality rate. Male gender, dysphagia at the time of presentation, hyperkalemia, cardiogenic shock, acute renal failure and acute hepatitis are the independent predictors of mortality after PPD poisoning
ABSTRACT
It has been noticed in the past that some patients who had undergone surgeries under general anaesthesia regained conscience and complained of sore throat. This study is to determine the ratio of patients under general anaesthesia who will present with post-operative sore throat; and to attempt to reduce that ratio in order to provide a more comfortable recovery to the patients. Sixty four patients eligible to be considered for analysis had follow ups for the next three days and were asked to describe any sore throat feature they might be experiencing after they recovered from anaesthesia. The incidence of sore throat in the patients was 37.5%. An alternative to ETT has to be employed [e.g. LMA]
Subject(s)
Humans , Male , Female , Pharyngitis/epidemiology , Intubation, Intratracheal/adverse effects , Postoperative ComplicationsABSTRACT
To determine the efficacy of intravenous metoclopramide alone and in combination with dexamethasone in preventing postoperative nausea and vomiting [PONV] in patients undergoing strabismus surgery. Single blinded, randomized, interventional study. This study was conducted in the department of Anaesthesiology at Nishtar Hospital, Multan from October 2005 to October 2006. After the approval of the hospital's ethical committee, the study was conducted on 60 patients who were randomly divided into two groups, each group containing 30 patients. All of the patients were between 2-14 years of age and were A.S.A-I. Randomization was done by envelope draw method. The patients received either metoclopramide 150 micro g/kg or dexamethasone 150 micro g/kg with metoclopramide 150 micro g/kg combination IV, 30 minutes before the induction of anesthesia. General anesthesia was induced with thiopentone sodium, nalbuphine, succinylcholine and maintained with isoflurane and N[2]O+O[2] in both groups. PONV were evulated postoperatively. Patients in group II who received metoclopramide plus dexamethasone experienced significantly less PONV during the first 24 h after surgery. In this study, a single dose of metoclopramide plus dexamethasone [150 micro g/kg of each drug] produced better antiemetic effects after strabismus surgery than metoclopramide alone