ABSTRACT
Objective: To observe the efficacy of blind obturator nerve block by Labat technique for prevention of obturator jerk during transurethral resection of bladder tumor performed under spinal anesthesia
Study Design: Descriptive Study
Material and Methods: This was a single center based study conducted at tertiary care military hospital for a period of thirty months. Fifty five patients were recruited in the study, after identifying the location of bladder growth in the lateral wall on ultrasound USG and confirming its exact site on cystoscopic examination. Those eliciting obturator jerk during transurethral resection of bladder tumor [TURBT] were included and ONB was performed using 2% lidocaine via blind technique of Labat. TURBT was restarted and presence of obturator jerk was recorded if evoked [primary outcome]
Results: Median age was 67.3 +/- 8 years with majority [72.7%] in the age group between 61 to 80 years. Male female ratio was 7:1. Fifty [90%] patients presented with solitary growth. Mean operating time was 28.8 +/- 12 minutes. ONB was successful in 52 [94.54%] of the cases while failure in 3 [5.45%] resulted in conversion to general anesthesia for the completion of TURBT
Conclusion: Blind obturator nerve block [ONB] by using Labat technique for obturator nerve block has proven to be simple, reliable and easily replicable in any set up and it does not require any time consuming steps or sophisticated equipment
ABSTRACT
Objective: To compare the mean time duration of patient's first request for analgesic for pain relief after open cholecystectomy with preoperative use of pregabalin or gabapentin. Study Design: Randomized controlled trial. Place and Duration of Study: Department of anesthesia, Combined Military Hospital [CMH] Peshawar during a period of six months, from May 2014 to Nov 2014
Material and Methods: This study included a total of 126 patients with clinical and ultrasound diagnosis of acute cholecystitis. Patients were distributed randomly into two groups equally [63 patients in each group]. Group A was given 300mg pregabalin and group B was given 900mg gabapentin one hour before surgery by mouth
Results: Mean age was 46.68 +/- 8.074 years for group A and 46.33 +/- 8.046 years for group B. In group A, there were 49.2% males and 50.8% females while in group B, there were 42.9% males and 57.1% females. Weight of patients was 68.54 +/- 6.283 kg in group A and 69.75 +/- 5.778 kg in group B respectively. Mean time duration score was 37.48 +/- 7.175 minutes and 18.27 +/- 3.366 minutes in group A and B, respectively [p<0.001]
Conclusion: Preoperative use of pregabalin provides significantly prolonged postoperative analgesia compared to gabapentin after open cholecystectomy
ABSTRACT
To compare laparoscopic and conventional open appendectomy in terms of operative time, hospital stay and frequency of surgical site infection [SSI]. Quasi-experimental study. Combined Military Hospital, Quetta from 6[th] Jun 2010 to 1[st] Sep 2011 and Combined Military Hospital, Multan, Pakistan from 2[nd] Sep 2011 to 5[th] Jun 2012 over a period of 2 years. A total of 417 patients underwent appendectomy during this period. 137 patients underwent laparoscopic appendectomy [group A] while 280 patients had open appendectomy [group B]. The sample includes all patients who were operated upon, between the time-span of June 2010 to September 2011. A chi square-test was performed to compare the data for statistical significance. Mean operative time for group A was 79.21 +/- 23.42 minutes whereas in group B, the mean operative time was 41.49 +/- 20.86 minutes. Group A patients had a shorter hospital, 1 stay [3.6 +/- 1 day] but in group B, it was [5.2 +/- 3 days]. Seven patients [5.1%] developed surgical site infection [SSI] in group A and 34 patients [12.14%] developed postoperative SSI in group B [p < 0.05]. Laparoscopic appendectomy is superior to open appendectomy because of shorter hospital stay and lesser post-operative SSI, but requires longer operative time
ABSTRACT
Background: Endotracheal intubation is routinely practiced in general anaesthesia, with potential hemodynamic effects on patients
Objective: The objective of this study was to compare the efficacy of single bolus intravenous lignocaine with magnesium sulphate to attenuate the haemodynamic response of laryngoscopy and intubation
Material and Methods: A total of 178 patients were included, randomly dividing them in two groups, 89 in each group. Group A, received intravenous 1% lignocaine 1mg/kg and group-B intravenous magnesium sulphate 10mg/kg. The data on heart rate, mean arterial pressure was compared among both groups and with baseline values, for the purpose of comparing efficacy. The data was entered and analyzed in SPSS version 14. Students t test was applied to compare means. AP-value of less than 5% was taken as significant. Study design: Double Blind Randomized Clinical Trial. Place and duration of study: Departments of Anesthesiology of CMH Multan, from 1[st] September, 2010 to 1[st] March 2011
Results: There was statistically significant difference between the two groups in terms of efficacy i.e. reduction of press or response to laryngoscopy and intubation. 20% reductions in Mean Arterial Pressure [MAP] from baseline values were observed in 54% of the patients in Group A and 36.69% in group B. Similarly, 25% reduction in heart rate [HR] from baseline values were observed in 11% of the patients in Group A and 6.23% in Group B. Incidence of > 20% increase in MAP was 4.2% in Group A versus 20.6% in group B and > 25% increase in HR 12.35% in group A versus 25.6% in Group B. Incidence of >20% increase in MAP was 4.2% in group A versus 20.6% in Group B and > 25% increase in HR 12.35% in group A versus 25.6% in Group B
Conclusion: There is statistically significant difference between two groups that is, lignocaine was more effective and efficacious than magnesium sulphate by preventing the increase in MAP and HR after laryngoscopy and intubation
ABSTRACT
Background: Endotracheal intubation is routinely practiced in general anaesthesia, with potential hemodynamic effects on patients
Objective: The objective of this study was to compare the efficacy of single bolus intravenous lignocaine with magnesium sulphate to attenuate the haemodynamic response of laryngoscopy and intubation
Material and Methods: Atotal of 178 patients were included, randomly dividing them in two groups, 89 in each group. Group A, received intravenous 1% lignocaine Img/kg and group-B intravenous magnesium sulphate lOmg/kg. The data on heart rate, mean arterial pressure was compared among both groups and with baseline values, for the purpose of comparing efficacy. The data was entered and analyzed in SPSS version 14. Students t test was applied to compare means. A P value of less than 5% was taken as significant. Study design: Double Blind Randomized Clinical Trial. Place and duration of study: Departments of Anesthesiology of CMH Multan, from 1[st] September, 2010 to 1[st] March 2011
Results: There was statistically significant difference between the two groups in terms of efficacy i.e reduction of pressor response to laryngoscopy and intubation. 20% reductions in Mean Arterial Pressure [MAP] from baseline values were observed in 54% of the patients in Group A and 36.69% in group B. Similarly, 25% reduction in heart rate [HR] from baseline values were observed in 11 % of the patients in Group A and 6.23% in Group B. Incidence of > 20% increase in MAP was 4.2 % in Group A versus 20.6 % in group B and > 25% increase in HR 12.35% in group A versus 25.6 % in Group B. Incidence of >20% increase in MAP was 4.2% in group A versus 20.6% in Group B and > 25 % increase in HR 12.35% in group A versus 25.6% in Group B
Conclusion: There is statistically significant difference between two groups that is, lignocaine was more effective and efficacious than magnesium sulphate by preventing the increase in MAP and HR after laryngoscopy and intubation
ABSTRACT
Leishmaniasis is quite commonly encountered in Balochistan. Of all the known treatment modalities, only a few are available at our hospital. We carried out this study in search of an effective and easily available agent. This quasi-experimental study was carried out at Combined Military Hospital Sibi in Balochistan from May to Nov 2010. The gross appearance of non healing ulcers and demonstration of parasite in Giemsa stained smears were used to confirm the diagnosis. Thirty nine patients were enrolled and divided into two groups by non- probability convenience sampling. Eighteen patients [having 30 ulcers] received meglumine antimoniate and 21 patients [having 32 ulcers] received 0.2% ciprofloxacin intralesionally every fifth day till re-epithelialization started, up to a maximum of five doses. Side effects of therapy were checked at every visit. Patients were followed up at one week and subsequently one month after completion of treatment to assess complete clinical healing and regression in size of the scar. Two ulcers in meglumine antimoniate and five ulcers in ciprofloxacin group did not heal [response rate 93.33% vs. 84.38%, p: 0.273]. Those treated with meglumine antimoniate required a lesser number of doses [mean 3.83 and 4.27; p: 0.039]. Reduction in scar size was equal in both groups [58.46% and 57.21%; p: 0.087]. Intralesional ciprofloxacin is an effective, cheap and safe treatment for cutaneous leishmaniasis
Subject(s)
Humans , Male , Ciprofloxacin/administration & dosage , Meglumine , Injections, Intralesional , CiprofloxacinABSTRACT
Arteriovenous malformation [AVM] is an anomaly characterized by abnormal vascular communications between arteries and veins in the different organs of the body. It may be congenital or acquired. Microsurgical resection, endovascular embolization and radiosurgery [irradiation] are the three effective modes of treatment currently available. However, no objective criteria have been established for which mode[s] of treatment should be selected for individual patients with AVMs
Subject(s)
Humans , Arteriovenous Malformations/therapy , Magnetic Resonance Imaging , Ultrasonography, Doppler, Duplex , Embolization, Therapeutic , RadiosurgeryABSTRACT
To assess the role of serum C-reactive protein in the rapid diagnosis of neonatal sepsis, a prospective study has carried out on pediatric patients. The study was carried out at the neonatal ICU of CMH Sialkot from July 2000 to March 2001. All patients were assessed by a thorough history and examination and then segregated into various groups. Their intravenous blood samples were taken and then subjected to battery of investigations. Statistical analysis of the observations was carried out in the form of sensitivity, specificity, positive predicative value and negative predicative value. Significance of the tests was also computed in form of p value. Serum CRP has got the highest sensitivity and negative predictive value when compared with total leukocyte count, platelet count and erythrocyte sedimentation rate From this study, it was inferred that serum CRP helps in the early and rapid diagnosis of neonatal sepsis