RESUMO
Peroneal neuropathy is the common mononeuropathy of the lower extremities in adults. The documented etiologies for peroneal nerve injury include trauma, traction, and external compression. Fibular neck is the most common site of common peroneal nerve (CPN) injury as the nerve lies superficial and vulnerable for injury. A 50-year-old male presented with foot drop in his left leg after working in squatting position for prolonged hours along with sensory disturbance in dorsum of left foot. Clinical examination showed poor dorsiflexion in both side ankle with preserved plantar flexion. Electrophysiological findings locate the site of lesion to be CPN at the level of fibular neck. We conclude that CPN is injured due to knee flexion in farmers repeatedly squatting for long hours. Superficial peroneal nerve may be spared due to their interfascicular arrangement at the level of fibular neck placing deep peroneal nerve near the fibula making them more susceptible to compression type of injury. Peroneal nerve may be damaged at multiple sites including ankle. The condition can be reversed with conservative treatment, primarily by avoiding the precipitating position.
RESUMO
Background: The knowledge and practice of exclusive breastfeeding has been prejudiced by demographic, social, cultural, biophysical, and psychosocial factors. About two-thirds of under-five deaths in India are associated with inappropriate infant feeding practices. Objective of this study was to assess the awareness, knowledge and practice of breastfeeding among the mothers attending to the tertiary care institute at Puducherry, India.Methods: This hospital-based, cross-sectional study was carried out among 150 postnatal mothers who attended immunization clinics, post-natal and paediatric wards at the tertiary care hospital at Puducherry collecting data about breastfeeding knowledge and practices using a structured interview.Results: The breastfeeding practices were significantly poorer in terms of initiation, feeding colostrums, timing and frequency of feeding and inclusion of pre-lacteal feeds among obese women compared to the normal weighted mothers. The breastfeeding knowledge and attitude was healthy among the mothers as depicted by the awareness of nutritive value of breast milk by majority (84%) of mothers.Conclusions: The mothers had poor knowledge regarding initiation of breastfeeding and administration of colostrum. There was a positive attitude about exclusive breastfeeding, frequency of feeding and social aspects of breastfeeding.
RESUMO
Background: Brachial plexus block has revolutionized the field of regional anesthesia for upper limb surgeries. Infraclavicular subcoracoid approach gives complete block without major complications. Aim: To compare the additives adenosine and magnesium sulphate with bupivacaine in infraclavicular infusion for upper limb surgeries and postoperative analgesia. Methods: 40 patients scheduled for elective unilateral upper limb surgeries involving distal arm/ elbow/ forearm/ hand divided into two groups A (n-20) and B (n-20) randomly. Group A - adenosine 6mgs with 28 ml 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 6mgs of adenosine (2ml) at a rate of 5ml/hr. Group B - magnesium sulphate 75 mgs (in 2ml) with 28ml of 0.5% bupivacaine bolus followed by infusion of 0.25% bupivacaine 28ml with 75mgs of magnesium sulphate (in 2ml) at a rate of 5ml/hr in USG guided placement of infraclavicular catheter. Results: Statistical analysis showed Group A had a faster onset time of sensory and motor block and faster recovery when compared to group B. Group A needed more rescue analgesia than group B. Though Group B had a higher incidence of sedation and vomiting than group A, it was not significant. Conclusion: Though the addition of adenosine and magnesium sulphate to bupivacaine as additive gives prolonged analgesia, magnesium sulphate exceeds adenosine in achieving prolonged postoperative analgesia and better pain score and may be a better choice than adenosine.