ABSTRACT
Background: Basic life support (BLS) is a lifesaving skill which every health-care personnel must know. It has been added to the curriculum but still studies have shown poor knowledge and skill among them in India. Aims and Objectives: The aim of our study was to assess attitude and knowledge of BLS among healthcare personnel in a tertiary care center of Sikkim and to recommend training of BLS according to the finding of our study. Materials and Methods: A questionnaire based cross-sectional study was done among junior doctors, physiotherapists, and nursing staffs, who were willing to participate. The questionnaire collected data under the heading of demographics, attitude, awareness, and knowledge about various domains of BLS. Analysis was done with standard statistical software. Results: Among 208 completed surveys, 24 (11.5%) were males and 184 (88.5%) were females, majority of them (76.4%) were nursing staff and belonged to 20�-year age group (76%). Mean score of the participants were 13.43 � 3.725 with a range from 2 to 21. The necessity of BLS training and the requirement of mandatory renewal was strongly agreed by 77.4% and 33.2% participants respectively. Conclusion: We conclude that they all need the trainings at frequent interval to know about the importance of BLS, to gain confidence and to improve their skill which will help them in timely saving of many lives in as well as outside the hospital. This can be achieved if institutes help in conducting the BLS session regularly despite being already in curriculum.
ABSTRACT
Background: The improved understanding of origin of abdominal and shoulder pain after laparoscopic procedures led to the use of intra peritoneal and port site instillation of local anaesthetic to reduce post-operative pain. Combinations of intraperitoneal local anaesthetics with many opioids have been studied in past and it was proved that they provide additional analgesic benefits. Material and methods: 106 ASA grade I and II patients of age 20 to 60 years of either sex weighing 40 to 70 kg undergoing laparascopic cholecystectomy under general anaesthesia were enrolled for the present study after written informed consent and institutional ethical committee cleareance. Patients were randomized into two groups , Group I (n=53): Patients received 30ml of 0.5% ropivacaine with 2ml Normal Saline. Group II (n=53): Patients received 30ml of 0.5% ropivacaine with fentanyl 100 mcg (2 ml). General anaesthesia was standardized. VAS, VRS scores, hemodynamics, total amount of rescue analgesic and side effects were noted at regular intervals. Results: VAS and VRS score were significantly lower in ropivacaine plus fentanyl group in comparisons to ropivacaine alone group at most of the time intervals. Hemodynamics was comparable between the two groups. Total Rescue analgesic were also significantly ow in ropivacaine plus fentanyl group side effects were comparable between two group. Conclusion: Intraperitoneal instillation of ropivacaine with fentanyl reduces not only the intensity of visceral, parietal and shoulder pain but also the total rescue analgesic dose consumption.
ABSTRACT
Background: To evaluate the various factors associated with recurrence of Amblyopia. Methods:In this prospective observational study, 100 patient’s diagonised anisometropic and strabismic amblyopia. All patients were undergone squint workup and were treated with optical correction, occulusion therapy or penalization. Patients were divided three groups - group 1 age (4-7 year) , group 2 age(8-12 year), group 3 age(13-17 year) . Patients were followed upto 12 month and various factors assessed which could be responsible for amblyopia and compared between three group. Results:Recurrence of amblyopia was seen in 24% of patients which was more in group 1 & mixed amblyopia type (statically significant p < 0.05). Recurrence of amblyopia was found to be patients independent of binocular vision and mode of treatment. Recurrence and its relation with length and dose of occlusion therapy were significant those who were weaned off 6 hrs patching as compared 2 hrs patching. Recurrence of amblyopia was found to be more in those who improved five lines as compared to two lines with statistically significant p < 0.05. Recurrence was more in first 6 month as compared to last six month during follow up. Conclusion: Recurrence is more commonly seen between the ages of 4-7 yrs and those who with mixed amblyopia should be closely monitored during follow up. Occlusion therapy should be prescribed weaning off, it should not be abruptly stop. Since recurrence may occur even beyond 1 year hence, a longer follow up period would be advisable.
ABSTRACT
Background: POAG occurs in elderly, rarely seen earlier than 40 years of age and tends to run in families. Glaucoma is a neurodegenerative disease characterized by the slow, progressive degeneration of retinal ganglion cells. Aim: To study the changes, in retinal nerve fibre layer thickness in primary open angle glaucoma (POAG). Materials and methods: The present cross sectional study was carried out at a tertiary care hospital in North India. 100 patients of primary open angle glaucoma were matched with 100 controls and evaluated with the aim to assess their RNFL thickness and compare with each other. Results: The data distribution analysis of retinal nerve fibre layer thickness in different optic nerve head quadrants in POAG group in relation to overall severity of glaucoma shows that in superior quadrant maximum number of patients in preperimetric group 6 (50%) cases, in mild 9 (45%) cases and in moderate group 25 (44.6%) were in the range 100±10μm. But in severe glaucoma cases majority 7 (58.3%) cases had the RNFL thickness in the range of 60±10 μm. The temporal quadrant RNFL thickness was least in all grades of severity of glaucoma i.e. preperimetric 6 (50%), in mild cases 9 (45%), in moderate 25 (44.6%) cases and in severe 8 (66.7%) cases. Conclusion: Overall RNFL thickness variation, regardless of severity of glaucoma, follow the normal pattern of thickness being thicker in superior and inferior quadrant compared to nasal and temporal quadrant. It was interesting to note that the RNFL thickness in all the quadrants of optic nerve head area continues to become thinner as the severity of glaucoma increases.
ABSTRACT
The developing class III malocclusion is one of the most challenging problems for the practicing orthodontist to manage clinically. True class III malocclusion is rare in our region as compared to Class II and Class I malocclusion. With adults, orthognathic surgery and dental camouflage is the viable treatment option. A variety of treatment alternatives exists for patients in the developing stages of a Class III malocclusion. In the past much of the therapy has focused on restriction of mandibular growth with chin cups and functional appliances. This is based on the traditional thought that developing Class III malocclusions were the result of prognathic mandible. Recently, however, there has been a growing awareness that the majority of patients with a developing Class III skeletal pattern exhibit a maxillary deficiency with a normal or only slightly prognathic mandible. Therefore, considerable attention has been given to early treatment using maxillary protraction therapy. Using facemask therapy in conjunction with maxillary expansion has been shown in clinical reports to be a successful and predictable treatment option. Treatment should be carried out as early as possible with the aim to prevent it from becoming severe. A case treated with biphasic therapy – orthopaedic appliance followed by fixed orthodontic treatment is presented here.