ABSTRACT
Objective: To evaluate the efficacy of plain lignocain in attenuation of stress response to laryngoscopy and endotracheal intubation with impact on in-hospital mortality or morbidity
Study Design: A randomized control trial
Place and Duration of Study: Our study was carried out from December 2013-14, at tertiary-care hospital
Material and Methods: Patients [n=100 total] were randomized, using non-probability convenient sampling, dividing the population in two groups. Group A [n=50] as control, and in group B [n=50] Injection lignocain plain 2% 1.5 mg/kg was used 3 minutes prior to intubation. Both the groups were observed for changes in hemodynamic parameters i.e. heart rate [HR] systolic and diastolic blood pressure, Mean Arterial Pressure for every minute after baseline [0] and for 5 consecutive minutes [1, 2, 3, 4, and 5]. Deviation of >20% from baseline was considered significant. The mortality [death within hospital, irrespective of cause] and morbidity [defined as emergence of 4 condition as hypertensive encephalopathy, Acute Coronary Syndrome, Lab proven Myocardial Infarction and negative pulmonary edema] within 10 days of hospitalization were noted
Results: Statistically significant [p-value extremely significant at confidence interval of 98 degrees] results were obtained in the effect of study drug; however, 10 days of hospitalization remained inconclusive for emerging morbidity categories strictly due to the intubation reflexes. We consider few technicalities in peri-operative management resulted in such events
Conclusion: Lignocain is effective in blunting the pressor response towards laryngoscopy and intubation. However the impact on mortality/ morbidity for four conditions remained inconclusive
ABSTRACT
This study was to determine the frequency of retinopathy in newly diagnosed type-I1 Diabetics. Cross sectional descriptive study. It was conducted at Department of medicine, Military Hospital [MH], Rawalpindi from 1st Jan 2012 to 30 Jun 2012. We included 200 patients of type-I1 DM from both genders diagnosed in last 03 months from both outdoor and indoor departments in the age range of 40 to 70 years by consecutive sampling. All patients having co morbidities affecting retina were excluded. Informed written consent was taken before enrollment. Formal approval of the study was taken from hospital ethical committee. Ocular Fundoscopy was performed with WelchAllyn Ophthalmoscope [REF 11470] as per standard protocols and both eyes were elamined. The grade of DR [diabetic retinopathy] awarded as per highest changes in any of the two eyes. All tests were carried by a single person to avoid inter-observer variations. Findings of ocular fundoscopy were confirmed by ophthalmologist. All data was analyzed by using SPSS version 11. Out of 200 subjects 63.5% were male and 36.5% were female. Age ranged from 40 to 70 years with mean age of 51.05 + 6.910 years. 29 [14.5%] subjects had Diabetic retinopathy. Out of 29 patients, 24 [82.8%] had preproliferative and 5 [17.2%] had proliferative diabetic retinopathy. A significant proportion of diabetic patients have retinopathy at the time of diagnosis of their disease which is more common in males and with increasing age. It is recommended to thoroughly screen the newly diagnosed diabetics for early detection of diabetic retinopathy and its management involving early referral to eye specialist