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OBJECTIVE: To compile epidemiological characteristics of traumatic spinal cord injury (TSCI) in the Northern Indian Himalayan regions and Sub-Himalayan planes. METHODS: The present study is a retrospective, cross-sectional descriptive analysis based on hospital data conducted at the Department of Physical Medicine and Rehabilitation and Spine Unit of Trauma Centre in a tertiary care hospital in Uttarakhand, India. People hospitalized at the tertiary care center between August 2018 and November 2021 are included in the study sample. A prestructured proforma was employed for the evaluation, including demographic and epidemiological characteristics. RESULTS: TSCI was found in 167 out of 3,120 trauma patients. The mean age of people with TSCI was 33.5±13.3, with a male-to-female ratio of 2.4:1. Eighty-three participants (49.7%) were from the plains, while the hilly region accounts for 50.3%. People from the plains had a 2.9:1 rural-to-urban ratio, whereas the hilly region had a 6:1 ratio. The overall most prevalent cause was Falls (59.3%), followed by road traffic accidents (RTAs) (35.9%). RTAs (57.2%) were the most common cause of TSCI in the plains' urban regions, while Falls (58.1%) were more common in rural plains. In both urban (66.6%) and rural (65.3%) parts of the hilly region, falls were the most common cause. CONCLUSION: TSCI is more common in young males, especially in rural hilly areas. Falls rather than RTAs are the major cause.
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CONTEXT: Chronic lower back pain (CLBP) and Vitamin D deficiency are two common conditions presenting to primary care physicians. AIMS: To study the vitamin D status in North Indians presenting with nonspecific CLBP and the correlation between vitamin D levels and pain severity by the Visual Analogue Scale (VAS). SETTINGS AND DESIGN: An observational study. Record of all CLBP patients presenting to the outpatient department in 2019, were analyzed, retrospectively. METHODS AND MATERIALS: All the patients of age 18 to 65 and either sex with nonspecific CLBP were included. Patients were divided into two: Vitamin D deficient (Group 1) and normal (Group 2) with cut off Serum Vitamin D values at 30 ng/mL. Demographic data and Visual Analogue Scale scores (VAS) of both groups were recorded. STATISTICAL ANALYSIS USED: Correlations between Vitamin D values and VAS scores were investigated using the Spearman coefficient, and the results with P of ≤ 0.05 were contemplated significant. RESULTS: Of total 376 patients with nonspecific CLBP, the majority were adults, females, married, vegetarians, overweight or obese, and had a mean sun exposure time of two hours. Vitamin D deficient Group 1 had 302 (80.32%) patients with significantly lower (P < 0.0001) mean vitamin D levels compared to Group 2 (74 patients i.e., 19.68%). Spearman's rho coefficient between vitamin D and VAS, showed a negative correlation (-0.554), with a P value < 0.00001. CONCLUSIONS: This study indicated a high probability of vitamin D deficiency in the nonspecific CLBP population and a negative correlation between vitamin D status and pain severity.
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BACKGROUND AND OBJECTIVES: Awake fiberoptic intubation (AFOI) is usually performed in patients with an anticipated difficult airway. Various sedation regimens are used during AFOI, however, most of them cause respiratory depression. The present study aims to compare the effectiveness of fentanyl with ketamine versus dexmedetomidine in search of a better sedation regimen which would achieve desirable intubating conditions and hemodynamic stability without causing respiratory depression. METHODS: This is a single centered randomized, double-blind clinical trial. Patients of both sexes between age 18-55 years and ASA (American Society of Anesthesiologists) physical status I-II with an anticipated difficult airway were randomly divided into two groups of thirty each. Group FK patients received intravenous fentanyl and ketamine, and group DX patients received dexmedetomidine, until Ramsay sedation scale ≥ 2. Heart rate (HR), mean blood pressure (MBP), oxygen saturation (SpO2), respiratory rate (RR), endoscopy time, intubation time, first end-tidal carbon dioxide (ETCO2) after intubation, endoscopist satisfaction score, and patient discomfort score were recorded during the study period. The level of recall was assessed on the next postoperative day. RESULTS: Endoscopist satisfaction score was better in group DX patients (p < 0.05). There was a smaller variation in HR and MBP from baseline with dexmedetomidine compared to fentanyl with ketamine. First ETCO2 after intubation was higher in group FK patients (p < 0.05). No significant difference was found in patient discomfort score, intubation time, RR, SpO2 and level of recall of the event. CONCLUSIONS: The use of dexmedetomidine in AFOI provides better intubating conditions and hemodynamic stability compared to fentanyl with ketamine.
