RESUMO
Background: Central venous cannulation is a commonly performed procedure in neurosurgical patients to maintain the hemodynamic stability in the intraoperative period. It is used for infusion of intravenous fluids, vasopressors central venous pressure monitoring and detection of air embolism. Subclavian vein is commonly performed as there are minimal effects of positioning on it. Supraclavicular approach to subclavian vein cannulation is not as frequently employed as the infraclavicular approach. The purpose of this study was to compare the supraclavicular approach versus the infraclavicular approach in terms of number of attempts, success rate of catheterization and complications associated with the procedure.Methods: About 150 patients undergoing various neurosurgical procedures were enrolled in the study. They were divided into two groups. 75 patients underwent right supraclavicular catheterization of subclavian vein while as 75 patients underwent right infraclavicular catheterisation of the subclavian vein. The number of attempts for cannulation, success or failure of catheterization and any complications associated with the procedure or in the postoperative period were noted in each group. The data was compared between the two groups by using Chi-square test and Student’s Independent Samples T-test.Results: The right supraclavicular vein was successfully cannulated in 90.66% while as the right infraclaviclar vein was successfully cannulated in 96% of the patients (p >0.05). Malpositioning of catheter (threaded in contralateral subclavian) was noted in 4 patients in Group S and ipsilateral internal jugular vein in 2 patients. Pneumothorax was encountered in 1 patient in the group S undergoing supraclavicular subclavian vein cannulations while as subclavian arterial puncture was seen in 4 patients who underwent infraclavicular arterial puncture.Conclusions: There was no difference in successive cannulations between right the supraclavicular and right infraclaviclar veins. The rate of complications between the two approaches was comparable.
RESUMO
Background: Obesity is a major modifiable cardiovascular risk factor as studied by American Heart Association. Aim of present study was to determine the prevalence of generalised and central body obesity among Medical Students and association of obesity measured by body mass index (BMI) and waist circumference (WC) with health risk factors. Material and methods: The present study was conducted on 200 medical students including 102 males and 98 females in the age group of 18-23 years in the Department of Physiology, Govt. Medical College, Amritsar. For generalised obesity (BMI> 25 kg/m2 and abdominal or central obesity (WC 94>cm in males and 80 >cm in females) were used. Results: The prevalence of generalised obesity in males and females was 75.51% (males 50.0%, females 25.51%) and abdominal or central obesity 82% (males 14% and females 68%). Isolated generalised obesity (BMI increased and WC normal) in males and female was 62.96% and 37.04% and isolated abdominal obesity (WC increased and BMI normal) in males and females 17.28% and 82.72%. Combined obesity (BMI and WC both increased) in males and females 40.12% and 59.88%. Conclusion: Prevalence of combined obesity was found high among both sexes. While isolated generalised obesity was more common in males and isolated abdominal obesity more common in females. However, these prevalence rates vary markedly depending on cut points used. WC is a better marker of obesity related risk than BMI.