ABSTRACT
Introduction: A lot of surgeries are now performed to reduce a number of physical ailments. Although these surgeries are done to reduce the sufferings these inevitably lead to a lot of pain for the patient. Material and Methods: Our study comprises of 60 patients who had undergone elective upper limb surgery in a tertiary care centre of central India. Patients of both genders, in age group 18-60 years with American Society of Anaesthesiology (ASA) grade I or II were included in our study and divided in two groups of 30 each. Results: Data was entered into MS-Excel sheet and analysed by SPSS version 20. Quantitative data was compared by using student t-test and qualitative data by using chi-square test and Fisher exact test, as applicable. P<0.05 was considered as statistically significant. Both the groups were similar in demographic and surgical characteristics. However, we found that the group given bupivacaine and fentanyl had longer duration of sensory and motor block and post-operative analgesia than ropivacaine and fentanyl group (p<0.001). Conclusion: Combination of bupivacaine with fentanyl provides longer duration of sensory block, motor block and postoperative analgesia without any major side effects than combination of ropivacaine with fentanyl with comparable haemodynamic in both groups.
ABSTRACT
Rudimentary horn is a developmental anomaly of the uterus. Pregnancy in rudimentary horn is rare occurrence with incidence of less than 1 in 150,000. Prerupture diagnosis of rudimentary horn pregnancy with USG is technically difficult, with sensitivity of 30%. It is often not diagnosed unless it terminates by rupture in the second trimester leading to catastrophic haemorrhage and hence high incidence of maternal mortality. Management of such cases is a challenge till today due to diagnostic dilemma. Expertise in ultrasonography and early resort to surgical management is life saving in such cases. Here we present a case of ruptured non-communicating rudimentary horn pregnancy at 15 weeks presenting in our emergency department as a case of pain abdomen. Laparoscopic resection of the rudimentary horn was performed for the patient.
ABSTRACT
Background: There is triad of hypoalbuminemia, edema, and hyperlipidemia in nephrotic syndrome patients. Management of nephrotic syndrome includes general measures like fluid restriction, emergency albumin transfusions and diuretics that provide symptomatic relief till steroids act. These measures require an assessment of body fluid volume to avoid circulatory failure which is very difficult in these patients because of edema. The objective of the study was to measure and compare the Inferior Vena Cava (IVC) Index and Inferior Vena Cava Collapsibility (IVCC) Index by ultrasound as a measure of body fluid volume status in children with nephrotic syndrome.Methods: The present observational study was conducted in all children of age more than 1 year up to 18 year. There were two groups; group 1 was nephrotic syndrome patients-Initial episode or in relapse and group 2 (Control) was age and sex-matched non-nephrotic children. IVC index and IVCC index were measured and compared in both the groups.Results: Mean value of minimum diameter of IVC during inspiration in cases was 5.91'1.60 mm as compared to 4.53'0.94 mm in controls which was significantly higher in case group {P ?0.0001}. Mean value of IVC index in cases was 0.88'0.20 cm/m2 as compared to 0.93'0.19 cm/m2 in controls which was non-significant. Mean value of IVCC index in cases (35.61'13.68) was significantly less as compared to controls (52.23'2.01) {P ?0.0001}.Conclusions: The present study concluded that IVCC index is better indicator of body fluid volume status in nephrotic patients as compare to IVC index.