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Background: Adjuvant analgesics are added to pain management regimen to reduce opioid consumption and minimise their side effect. Newer ones like dexmedetomidine and pregabalin have not been thoroughly researched. Objectives of the study to study the opioid sparing effect of dexmedetomidine and pregabalin using tail flick and hot plate method in male wistar rats.Methods: Forty two rats were grouped into seven groups with six in each group. Analgesic activity was tested using tail flick, where in the reaction time to flick its tail on a heated surface was noted. In the hot plate method, the reaction time to withdraw or lick the paws when placed on heated surface was noted.Results: The reaction time to flick its tail was prolonged with dexmedetomidine and pregabalin when combined with opioids even in sub therapeutic doses.Conclusion: Adjuncts like dexmedetomidine and pregabalin can be very useful in mutimodal pain management and also to reduce the opioid consumption.
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Background: Abnormal uterine bleeding (AUB) is the one of the most common problem among patients admitted for gynecological surgeries. There are various pathologies which can lead to AUB. History, blood investigations, ultrasonography, hysteroscopy and endometrial aspiration and those who failed to respond for medical management, underwent surgical profile and hysterectomies were done. Later on, FIGO proposed PALM-COEIN system for systematic and efficient management of AUB, which helps in better and successful management of AUB patients. Aim: To analyze the etiology of abnormal uterine bleeding in women who underwent surgical management. Materials and methods: It was a retrospective study done in Obstetrics and Gynecology Department of King George Hospital, Visakhapatnam from January 2017 to December 2018. A total of 143 cases who failed to respond for medical management and underwent surgeries like hysterectomies, myomectomies and polypectomies for AUB, were selected and hysterectomy specimens were evaluated in a structured proforma. Results: The most common age-group presenting with AUB was 45 to 49 years of age (30.06%). Dysmenorrhoea was found to be the most common associated symptom in AUB patients (68.3%). The most common surgical procedure done was Total Abdominal Hsterectomy (75%). As per PALMCOEIN classification, the most common type in our study was found to be AUBL (48.2%). Nissy G, Sujatha R, N. Uma, S. Sowmya, Pratyusha R. Analysis of etiology in women who underwent surgical management for abnormal uterine bleeding in a tertiary care centre, Visakhapatnam. IAIM, 2019; 6(10): 82-85. Page 83 Conclusions: Incidence and pattern of AUB varies according to the age of the patient. It is more common in perimenopausal age-group. Classification of AUB as per PALM-COEIN helps in better understanding of disease and successful management of patients.
ABSTRACT
Background: Cancer cervix is a leading cause of mortality and morbidity in developing countries like India most probably due to lack of proper screening facilities in the rural and suburban areas or due to the lack of awareness amongst the women of developing countries. Cervical cancer is the fourth most common cancer in the world. Developing countries accounted to about 80% of the global burden. This study was conducted to highlight the importance of Pap smear study in differentiating premalignant and malignant lesions. Materials and methods: This was a prospective study aimed to evaluate all pap smears examined at KGH over a period of 6 months i.e. from December 2016 to May 2017. Detailed clinical data and pap smear cytology reports were obtained and data noted in a structured proforma. All PAP smears reported as per THE BETHESDA System 2014. Women with abnormal smears were followed up by repeat pap smears or acetic acid guided cervical biopsy. Results: Total of 770 pap smears were examined in 6 months duration. Max no. of patients (around 40%) were of 31-40 years age group. Most of the patients (90.77%) were categorized into NILM (negative for intraepithelial lesion or malignancy). Among the five organisms, we found trichomonas were 38 (4.9%), and candida 38 (4.9%) cases of total NILM cases. Epithelial cell abnormalities in cytological examination were found in total 61 cases constituting 7.92%. Among epithelial cell abnormalities, LSIL was the commonest (27 cases, 3.57%). Conclusions: Cervical cytology by Pap smear is an important tool for early detection of premalignant and malignant lesions of cervix. Regular Pap smear screening should be conducted in vulnerable age group.
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Background: Caesarean section (CS) wound infections represent a substantial burden to the health system and the prevention of such infections should be a healthcare priority in developing countries. Aim and objectives: Prospective study aimed to evaluate all postoperative wound sepsis or fever cases at KGH, VSP during 6 months period of time January and June 2017. Materials and methods: All postoperative cases with wound sepsis were evaluated. Detailed clinical data, investigations, bacteriological evaluation, sensitivity to antibiotics noted. Results: A total no of 1000 cases with postoperative sepsis in a 6months period of time was followed and results were analyzed. Conclusion: All postoperative cases with wound sepsis and fever were analyzed for etiological factors, associated co morbid factors and their sensitivity to antibiotics noted.
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Objectives: To describe the clinical characteristics of obstetric patients requiring mechanical ventilation in a tertiary referral hospital and their maternal and perinatal outcome in order to identify their risk factors and clinical outcome and determine adverse prognostic factors in these patients. Study design: A prospective study was conducted in the Dept. of Obstetrics and Gynecology, Government Medical College, Kozhikode on all pregnant women up to 6 weeks postpartum from January 1, 2011 to December 31, 2013 and who subsequently required mechanical ventilation. Data was recorded in a predesigned proforma and was analyzed and frequency, and percentages were calculated. Results: In the 3-year period, 75 obstetric patients required mechanical ventilation. Majority were between 20-35 years (88%) and were primipara (53.3%). Eighty percent were admitted in the antepartum period and most were in the gestational age of 30-36 weeks (41.3%). Hypertensive disorder is an important antepartum complication (29.3%). Postpartum hemorrhage was the important cause (45.3%) of ICU admission. About 49.3% required mechanical ventilation for <24 hours and multiorgan failure was the important complication encountered (13.3%). Conclusions: Providing optimal prenatal care and improving the management of hemorrhagic complications and hypertensive disease can improve the morbidity and mortality of critically ill obstetric patients requiring mechanical ventilation.