Vitamin D deficiency - still a dilemma !

Vitamin D deficiency is a global pandemic, with some variations in the incidence from country to country. This vitamin has very important roles in the body physiological functions, and the deficiency has been linked to cancer, cardiovascular diseases, fractures and falls, cognitive disorders, Parkinsonism, auto-immune diseases, type 2 diabetes, and many other diseases, including uterine atony, which is the major cause of postpartum hemorrhage. Although the exact mechanism of vitamin D deficiency is not known, many ailments have been associated and supplement intake is recommended

Pediatric surgical patients; comparison of the effects of balanced salt solution with 1% dextrose and pead's solution on blood glucose and sodium levels intra operatively

Almost all the Pediatric surgeons and most of pediatric anesthetists are adhered to traditional paed's solution against recommendations due to fear of hypoglycaemia and not being aware of hyponatremia. To compare the effects of balanced salt solution with1% dextrose and Read's solution on blood glucose and sodium levels in pediatric surgical patients intra operatively. Interventional quasi experimental study. Department of Anesthesia, Intensive care and pain medicine in Sheikh Zayed Medical College/ Hospital Rahim Yar Khan [Pakistan]. December 2014 to February 2015. 60 patients were enrolled and divided into equal groups named after their respective iv fluids i.e.'Read's Solution' and [RLD1]. Patients aged between 1 month and 08 years, without gender discrimination, with ASA 1,2, fasted according to ASA guidelines undergoing elective surgical procedure general anesthesia were included in this study. Blood sampling for levels of serum sodium and glucose was done pre-operatively and 01 hour post-operatively. In immediate post-operative period incidence of hyperglycemia was statistically higher in 'Read's Solution' group [93.3%;28/30] vs 'RLD1' group [10%;3/30] p=0.000. Relative risk was 9.3 in 'Read's Solution' compared with 'RLD1' solution. Hyponatremia was statistically higher in 'Read's Solution' group [56.6%; 17/30] than in'RLDI' group [16.6%;5/30] p=0.001. Relative risk was 3.4 in 'Read's Solution' compared with 'RLD1' solution. Hypoglycemia and hypernatremia were not found in any patient in either group. Our results reflected that 'RLDI'is a better option than 'Read's Solution' as it is less likely to cause hyponatremia and doesnot cause hypoglycemia. However a large number of clinical trials in almost every teaching hospital are required to convince pediatric surgeons and anesthetists to use evidence based solutions

Comparison of LMA Classic and i-gel in anesthetized, spontaneously breathing patients during elective surgical procedures

The primary objective of this study was to compare two supraglottic airway devices regarding mean insertion time. Secondary objective was to assess the devices regarding first attempt success and ease of insertion. Tertiary objectives were to compare the post removal cough, laryngospasm and blood on device. Interventional quasi experimental study conducted in Department of Anesthesiology, ICU and Pain Management Sheikh Zayed Hospital, Rahim Yar Khan from April 2012 to October 2012. 100 adult patients aged 15 to 70 years, ASA-I and II, Mallampati I and II, who were scheduled for various elective surgical procedures under general anesthesia were taken. Study was conducted in anesthetized spontaneously breathing patients. The patients were divided into i-gel and LMA groups by draw method. SPSS 16 was applied for analysis. No statistically significant difference was reported between the groups, regarding mean insertion time, first attempt success, ease of insertion, cough and laryngospasm. Blood on LMA after removal had significantly greater incidence than on i-gel [10% on LMA group while none in i-gel group]. Both i-gel and LMA Classic can be used safely and effectively in selected patients under general anesthesia with spontaneous breathing