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Background:Polycystic ovary disease (PCOD) isacommon endocrine disorder, whichis mainlycharacterized by infertility,anovulation, hyperinsulinemia, dyslipidaemia, biochemical imbalance. In our present study we have evaluated the effect of NAC in womensuffering from PCOD in terms oftheir clinical, metabolic and hormonal parameters. Material And Methods:We conducted this prospective study for a period of 5 months on 60 women who are affected with PCOD (diagnosed by Rotterdam criteria) of age group 18–30 year, visiting OPD of obstetrics and gynaecology department of Acharya Vinobha Bhave Rural Hospital (AVBRH) Jawaharlal Nehru Medical College (J.N.M.C) located in Sawangi (Meghe), Wardha. Patients who had oligo/amenorrhoea, hirsutism (hyperandrogenism) and ultrasound finding (Polycystic ovaries) were included in this study. Clinical, metabolicparameter and hormonal profile were measured pre and post treatment with NAC. Result:Fifty-six patients who received tab N acetylcysteine 600 mg three times a day, shown improvement in BMI, waist circumference, WHR, fasting glucose, fasting insulin and total testosterone level after a period of 3 months but no significant reduction in weight. Conclusion:It has been concluded that longer treatment with N-acetyl cysteine may result in more desirable outcomes and more effective control of clinical symptoms of PCOS, hyperandrogenism, and carbohydrate parameters. So, NAC can be used as a insulin sensitizer drug for PCOS women.
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Background:About 52% of patients who undergo Cesarean delivery under spinal or epidural anesthesia will experience shivering, which may interfere with the monitoring of vital signs. Recent studies have shown that dexmedetomidine could potentially help to mitigate shivering associated with anesthesia. In accordance with them we decided to investigate the capability of dexmedetomidine, an alpha 2-adrenergic agonist, in reducing the duration of shivering associated with spinal anesthesia during Cesarean delivery. Material And Methods:Forty parturient going through Cesarean delivery under spinal anesthesia and experiencing shivering were included in this randomized, double-blind, prospective trial. After delivery, the intervention group (n = 20) was administered a single intravenous bolus of dexmedetomidine (20 microgram) while the control group (n =20) was given normal saline. Randomization and allocation were based on a computer-generated list. The primary outcome parameter was the time required for an observable reduction in shivering after the intervention. Result:Eighty patients were recruited, 40 of whom presented with shivering and underwent randomization. Our study recorded that dexmedetomidine alleviated the mean duration of shivering after a single intravenous bolus to 2.2 (2.07) min after dexmedetomidine from 18.9 (12.72) min after saline (95% confidence interval [CI],). The effect of dexmedetomidine was sustained 15 min after the bolus was administered, and shivering had completely stopped in 90% of the patients in the intervention group vs. 22.6% in the control group. No adverse effects were recorded. Conclusion:Our study found that a single intravenous bolus of dexmedetomidine reduced the duration of shivering for up to 15 min during Cesarean delivery under spinal anesthesia when compared against a placebo.
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Background:Central venous catheterization is a vital intervention in critically ill patients. The purpose of this study was to compare the procedural parameters and complications associated with anterior and posterior approaches of IJV catheterization under real timeultrasound guidance in critically ill patients. Material And Methods:In this prospective randomised study, 90 patients admitted in various ICUs were randomly allocated two groups of 45 each, including both males and females aged between 18 to 80 years ofage requiring central venous catheterization for various indications. Result:The first attempt success rates were comparable between both the groups. The venous visualization time was 38.52 seconds in Group A and 14.65 seconds in Group P (p<0.001). The venous puncture time and the duration of catheterization was found to be 47.60 sec & 2 minutes in Group A respectively and 24.16 sec & 1 minute 32 sec in Group P respectively (p<0.001). No statistically significant differences were found between the two groups in terms of incidence of carotid arterial puncture, haematoma formation and catheter displacement.Conclusion:It was observed that the posterior approach is better than anterior approach of USG guided IJV catheterization as it improves the accuracy, reduces the access time and duration of catheterization & leads to fewer incidences of immediate complications like carotid arterial puncture & subseque nt haematoma formation.