ABSTRACT
Acute promyelocytic leukemia (APML) is considered to be sensitive to all-trans-retinoic acid (ATRA) which acts as a differentiating agent. ATRA is considered to be a well-tolerated agent and is known to achieve complete remission in acute promyelocytic leukemia. However, a few cases on long term all-trans-retinoic acid (ATRA) use can develop pseudotumor cerebri. Out of 32 patients with APML who were treated in our Centre over a 4-year-period, we encountered 6 patients who developed ATRA-related pseudotumor cerebri while on maintenance treatment. The patients ranged from 12 to 40 years of age. 3 patients complained of unbearable headache, 2 of diplopia and 1 of gross reduction in visual acuity. CT scans and MRI did not reveal any intracranial lesions. Cerebrospinal fluid (CSF) examination was normal with CSF manometry revealing a high CSF pressure (average of 345mmH2O). Fundoscopy revealed papilledema in 5 patients and optic atrophy in 1 patient. The patients were successfully managed with decrease dose/discontinuation of ATRA, use of acetazolamide, corticosteroids and therapeutic CSF drainage.
ABSTRACT
This study was undertaken to evaluate the incidence and severity of pain on Injection of Propofol and to find the efficacy of lignocaine pretreatment in reducing such pain. 150 patients undergoing different Maxillofacial Surgeries with American Society of Anesthesiologists class 1 and 2 [ASA 1 and 2] were randomly allocated in two groups, Group A [Saline group] and Group B [Lignocaine group] who received saline and lignocaine as pretreatment respectively. Another anesthetist who was blinded to study recorded pain on a 4-point pain scale. The incidence of pain on giving Propofol was 57.33%. There was reduction of pain by 32% in the patient group who received Lignocaine pretreatment. It was concluded that lignocaine is an effective measure to decrease the incidence and severity of pain on injection of Propofol