ABSTRACT
Background and Objectives: To understand the benefi ts of dexamethasone and to compare the effect of submucosal versus intramuscular administration of dexamethasone in reducing post operative sequelae following impacted mandibular third molar surgery. Materials and Methods: The study was conducted on 90 patients, who were divided into three groups of 30 each. The two experimental groups were given dexamethasone 4 mg submucosally or intramuscularly(preoperatively), and the control group did not receive any form of corticosteroid. Measurement of facial swelling, maximal interincisal distance were made pre operatively and on the fi rst, third and seventh post operative day. Pain was evaluated from patients response to visual analogue scale (VAS) and recording the number of rescue analgesic tablets taken at the end of seventh postoperative day. Results: Both dexamethasone groups showed a signifi cant reduction in pain, swelling and trismus as compared with the control group at all intervals. There was a statistically signifi cant reduction in magnitude of swelling in submucosal dexamethasone group as compared to intramuscular dexamethasone group on the 1st post operative day, but there was no signifi cant difference among two experimental groups at other times and their effects were comparable for all variables. Conclusion: Dexamethasone 4 mg is an effective therapeutic strategy for reducing post operative sequelae following surgical removal of impacted third molars and submucosal dexamethasone is an effective alternative to dexamethasone given systemically.
ABSTRACT
Background: The undergraduate MBBS training in our country is still in the traditional mode. The main part of the curriculum consists of lecture, tutorial, practical and ward teaching classes with a limited number of problem based session. The objective of the study was undertaken to compare PBL with LBL in terms of students’ knowledge retention in the subject of Pharmacology in undergraduate medical training. Methods: The current survey was planned and executed by the Department of Pharmacology in collaboration with Medical Education Unit, MSDS Medical College, Fatehgarh in the batch currently posted in the Department of Pharmacology for practical classes. Fifty MBBS students posted were enrolled for the study and were divided in 2 groups. One of the topics was presented as LBL for the first group and as PBL for the second group. The other topic was presented as PBL for the first group and as LBL for the second group. Intervention and control groups were taken as those used PBL and LBL respectively. T test was used to compare mean scores obtained by students in the intervention and control groups. Results: Mean scores obtained by students in the intervention group (topics learnt with PBL) were higher (3.80 Vs 2.84) than mean scores obtained by students in the control group (topics learnt with LBL). Mean scores obtained by students in the intervention group were higher (3.72 Vs 2.96) than mean scores obtained by students in the control group. Conclusions: The current study indicates usefulness of Problem-based learning (PBL) over Lecture-based Learning (LBL) in terms of retention of knowledge. However further studies involving more number of students are warranted in order to generate stronger evidence on this tool for improving medical education in our setup.
ABSTRACT
Objective: To study the cardiovascular risk factors exposed to tobacco chewing and compare these findings with that of smokers and control subjects. Methods: This study was conducted at Jawaharlal Nehru Medical College, Aligarh. 180 subjects were included in this study. The subjects were divided in three groups. Group I (Tobacco chewers-chewed nicotine), Group II (Smokers-smoked nicotine) and Group III (control subjects). Each group consists of 60 subjects. Various anthropometric and cardiovascular parameters were recorded and compared among these three groups. Results: Significant difference was found for weight and body mass index (p<0.001) between smokers and control subjects. When compared to control subjects, tobacco chewers had significantly higher pulse rate (p<0.001), systolic blood pressure (p<0.011), diastolic blood pressure (p<0.004) and mean arterial pressure (p<0.001) but no significant difference was found between tobacco chewers and smokers.
ABSTRACT
The specialty of thoracic anaesthesia has emerged as a scientifically based discipline just 30 years back. At the start of the 20'1i century empyema and tuberculosis were the main indications for the thoracic surgery. Later on with the introduction of antibiotics lung malignancies were more commonly operated. Recent resurgence of tuberculosis and associated medical illnesses put these patients in high risk for surgery and anaesthesia, necessitating introduction of more skilful approach. The objective of this study was to evaluate the effectiveness of combined thoracic epidural anaesthesia and light general anesthesia in patients undergoing non-cardiac thoracic surgery. This study was conducted at the department of Anesthesia and Intensive care, Pakistan Institute of Medical Sciences, Islamabad from 1st Jan 2001 to 31st August 2002. Ten adult patients of both sexes of ASA grade I-III, < 68 years of age, who were undergoing non-cardiac thoracic surgery were included. Thoracic epidural and central venous lines were placed 20 to 30 minutes before the start of procedure. All patients received same premedication, induction agents, analgesics, inhalational agents and muscle relaxants. All patients were transferred to Surgical Intensive Care unit after completion of the procedure. Seventy% patients were operated on lungs, twenty% on mediastinum and one% for carcinoma of esophagus. Only one patient had co morbid disease of hypertension. One patient [10%] died of massive intraoperative hemorrhage. One patient [10%] developed superior vena caval obstruction, that was to be operated for mediastinal growth. Rest of eight [80%] patients were extubated in the operation theatre. All [100%] patients received intraoperative blood transfusion. 20 patients required additional analgesia in the postoperative period. 20% developed postoperative arrhythmias. Combined use of light general anaesthesia and thoracic epidural is effective in patients undergoing non-cardiac thoracic surgery