RESUMO
Background: Endotracheal intubation is routinely practiced in general anaesthesia, with potential hemodynamic effects on patients
Objective: The objective of this study was to compare the efficacy of single bolus intravenous lignocaine with magnesium sulphate to attenuate the haemodynamic response of laryngoscopy and intubation
Material and Methods: A total of 178 patients were included, randomly dividing them in two groups, 89 in each group. Group A, received intravenous 1% lignocaine 1mg/kg and group-B intravenous magnesium sulphate 10mg/kg. The data on heart rate, mean arterial pressure was compared among both groups and with baseline values, for the purpose of comparing efficacy. The data was entered and analyzed in SPSS version 14. Students t test was applied to compare means. AP-value of less than 5% was taken as significant. Study design: Double Blind Randomized Clinical Trial. Place and duration of study: Departments of Anesthesiology of CMH Multan, from 1[st] September, 2010 to 1[st] March 2011
Results: There was statistically significant difference between the two groups in terms of efficacy i.e. reduction of press or response to laryngoscopy and intubation. 20% reductions in Mean Arterial Pressure [MAP] from baseline values were observed in 54% of the patients in Group A and 36.69% in group B. Similarly, 25% reduction in heart rate [HR] from baseline values were observed in 11% of the patients in Group A and 6.23% in Group B. Incidence of > 20% increase in MAP was 4.2% in Group A versus 20.6% in group B and > 25% increase in HR 12.35% in group A versus 25.6% in Group B. Incidence of >20% increase in MAP was 4.2% in group A versus 20.6% in Group B and > 25% increase in HR 12.35% in group A versus 25.6% in Group B
Conclusion: There is statistically significant difference between two groups that is, lignocaine was more effective and efficacious than magnesium sulphate by preventing the increase in MAP and HR after laryngoscopy and intubation
RESUMO
Background: Endotracheal intubation is routinely practiced in general anaesthesia, with potential hemodynamic effects on patients
Objective: The objective of this study was to compare the efficacy of single bolus intravenous lignocaine with magnesium sulphate to attenuate the haemodynamic response of laryngoscopy and intubation
Material and Methods: Atotal of 178 patients were included, randomly dividing them in two groups, 89 in each group. Group A, received intravenous 1% lignocaine Img/kg and group-B intravenous magnesium sulphate lOmg/kg. The data on heart rate, mean arterial pressure was compared among both groups and with baseline values, for the purpose of comparing efficacy. The data was entered and analyzed in SPSS version 14. Students t test was applied to compare means. A P value of less than 5% was taken as significant. Study design: Double Blind Randomized Clinical Trial. Place and duration of study: Departments of Anesthesiology of CMH Multan, from 1[st] September, 2010 to 1[st] March 2011
Results: There was statistically significant difference between the two groups in terms of efficacy i.e reduction of pressor response to laryngoscopy and intubation. 20% reductions in Mean Arterial Pressure [MAP] from baseline values were observed in 54% of the patients in Group A and 36.69% in group B. Similarly, 25% reduction in heart rate [HR] from baseline values were observed in 11 % of the patients in Group A and 6.23% in Group B. Incidence of > 20% increase in MAP was 4.2 % in Group A versus 20.6 % in group B and > 25% increase in HR 12.35% in group A versus 25.6 % in Group B. Incidence of >20% increase in MAP was 4.2% in group A versus 20.6% in Group B and > 25 % increase in HR 12.35% in group A versus 25.6% in Group B
Conclusion: There is statistically significant difference between two groups that is, lignocaine was more effective and efficacious than magnesium sulphate by preventing the increase in MAP and HR after laryngoscopy and intubation
RESUMO
Underdeveloped countries are undergoing economic development at a rapid rate, which most often correlate with elevated urban air pollution in many cities. Pakistan is amongst those countries that are going through this industrialization phase and with a great increase in motorization and use of energy. According to the WHO[1], two third of the deaths in year 2000 were caused by exposure to urban air pollution in developing countries of Asia. To provide estimates of the quantitative relation between exposures and occurrences of diseases, epidemiologic studies together with toxicological and clinical investigations are required. Owing to limitations of the available epidemiologic and environmental studies in Pakistan, no authentic correlation among afore said factors can be made. This review is based upon peer-reviewed literature on the adverse health effects of air pollution in Pakistan and other major cities around the World. On the basis of this review it is possible to assess the status and to determine the trends in air pollution sources, emissions, concentrations, and exposures in four metropolitan cities [Karachi, Lahore, Rawalpindi, and Peshawar] of Pakistan. Environmental pollution in these cities is analyzed in terms of Particulate Matter [PM] and derived particle mass concentrations. Detected 24 hour averaged PM[10] and PM[2.5] concentrations in all four cities are up to 6 times higher than the maximum PM concentrations recommended by the WHO guidelines. The low PM[2.5]/PM[10] ratios revealed a high proportion of coarser particles, resulting in reduced visibility. The heavy metal concentrations from various studies are also presented for comparison with the standards set in the world
Assuntos
Saúde , Poluição do Ar , Material Particulado , Metais Pesados , Poluição AmbientalRESUMO
In the setting of Liver Transplantation as a new and emerging specialty in Pakistan the need has arisen for exact descriptions of the hepatic vascularization to avoid iatrogenic vascular damage. Exact knowledge of the arterial anatomy is required to plan the best resection as well as to minimize the risks of donor morbidity. We studied variations of extrahepatic arterial anatomy in forty six patients who underwent major hepatobiliary or pancreatic resections with complete exposure and/or skeletonization of the extrahepatic arterial anatomy. The extrahepatic arterial anatomy in twelve cadaveric dissections was also studied. The commonest arterial variant seen in our series was Type 1 i.e. 91.37% . The prevalence of anatomical variants was 8.63% . Knowledge of the variation in the hepatic arterial anatomy will help us in planning and performing the safe procurement of grafts from living donors with less risk of serious ischemic complications
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Intestinal parasitic infections cause significant morbidity in children of developing countries, where the vicious cycle of infections and malnutrition impairs their physical growth and development. A community based cross-sectional study on randomly selected children under 15 years of age was performed in two towns of Northern Pakistan. Information on hygiene, sanitation, waste disposal, water supply and maternal education was collected and the nutritional status of these children was assessed. Stool samples of the subjects were collected, immediately preserved and later examined for parasites, with severity of infection being quantified. Of the 89 samples examined, 91% contained one or more parasites. The lowest prevalence of infection was in children less than one year old. Majority of those infected in both towns were girls. Fifty-one percent of the infected children from Yasin and 38% from Singal suffered from malnutrition. Maternal education, family income and drinking water treatment did not affect the prevalence of infection in either town. The most frequent parasites isolated were Ascaris lumbricoides [66.3%], Entamoeba histolytica [27%], Blastocystis hominis [27%], Giardia lamblia [24.7%], and Trichuris trichiura [15.7%]. The results of this study indicate that parasitic infections in northern Pakistan have a high prevalence but low intensity. Programs for early detection and interventional strategies, along with improved hygiene, sanitation and waste disposal facilities are urgently needed to improve the health of these children