ABSTRACT
Introduction: Thyroid hormones regulate numerousmetabolic processes. Therefore, any alteration in theirsynthesis or function has important health implications. Aims:Study done on clinical and laboratory profile of patients withprimary hyperthyroidism.Material and methods: Descriptive and cross-sectionalStudy done amongst the in-patients with a proven PrimaryHyperthyroidism. 60 Patients with newly diagnosed PrimaryHyperthyroidism above the age of 18 years. Diagnostichormone levels i.e. increased SERUM T3,T4 levels withdecreased TSH levels.Results: out of 60 patients of Hyperthyroidism, 60% wereGrave’s disease, 28.3% were Toxic multinodular goiter and1.7% was toxic solitary nodule. Majority of TSH values wereless than 0.01. In all most all cases both T3 and T4 wereelevated (predominantly T4). There was no difference inT3, T4 and TSH values among the three common causes ofHyperthyroidism. Wayne’s clinical Diagnostic index had goodcorrelation with T3 (p value of 0.024), T4 and TSH. When theWayne’s index was high, T3 & T4 were also high and TSHwas low.Conclusion: Wayne’s clinical index correlate quite well withthe thyroid function tests particularly raised T3 and the scorecould be a useful tool for follow up of hyperthyroid patients
ABSTRACT
Background: Various adjuvants that can be added to local anesthetics and administered in central neuraxial blockade are Opioids, α2 agonists, benzodiazepines. Knowledge and use of adjuvant drug therapy has rendered neuraxial analgesia more effective in the management of both acute and chronic pain conditions. α-2 adrenergic agonists have both analgesic and sedative properties when used as adjuvant in regional anaesthesia. Aim: To study the effects of intrathecal dexmedetomidine added to ropivacaine for surgeries under spinal anesthesia. Materials and methods: Clinical study conducted on 50 patients of ASA PS 1 and 2 in the age group of 18-50 years of either sex posted for elective lower limb orthopaedic and lower abdominal surgeries under spinal anaesthesia. Results: Subjects among the age groups and the mean age of study population was 40 years (SD: ±11.5). 66% (n=33) of study population were male and 34% (n=17) were female. Most of the study population had healthy BMI. 76% (n= 38) of subjects belonged to ASA grade 1 and 34% (n=12) subjects belonged to ASA grade 2. The average duration of surgery was 94.4 min ± 34.4 min. Level of sensory block was T6 in 24 (48%) of subjects, T4 in 17 (34%) of subjects, T8 in 6 (12%) and T2 in 3 (6%) of subjects. The mean duration for onset of Sensory block was 4.12 minutes (SD: ± 1.69) and the mean duration for onset of motor block was 10.12 minutes (SD: ± 2.89). Hypotension was Swetha Ambati, Mukesh Kumar B. Study of dexmedetomidine as an intrathecal adjuvant to ropivacaine for hemodynamic stability and for postoperative analgesia. IAIM, 2017; 4(11): 27-36. Page 28 observed in 3 patients after SAB (Fall in SBP > 20%) after 4 to 6 min. The mean RSS was 2.08 with SD 0.27. Side effects observed were mainly hypotension, nausea and shivering. Conclusions: 5 microgram dexmedetomidine is alternative as an adjuvant to spinal ropivacaine in surgical procedures. It has excellent quality of postoperative analgesia with minimal side effects.