Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.030
Priyadarshini M. Bentur, R. Ravi
Background: To compare cervical epidural anaesthesia (CEA) technique with general anaesthesia in thyroid surgeries. Method: Fifteen patients were randomly selected to be operated under CEA for thyroid surgeries and their results were compared with 15 other patients who underwent the same surgery under conventional GA technique. Results: CEA was found to be comparable to GA in thyroid surgeries Conclusion: We conclude that cervical epidural anaesthesia can be safely used for thyroid surgery.
{"title":"A Study of Comparison of Cervical Epidural Anaesthesia with General Anaesthesia for Thyroid Surgery","authors":"Priyadarshini M. Bentur, R. Ravi","doi":"10.5958/J.2321-1024.1.2.030","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.030","url":null,"abstract":"Background: To compare cervical epidural anaesthesia (CEA) technique with general anaesthesia in thyroid surgeries. Method: Fifteen patients were randomly selected to be operated under CEA for thyroid surgeries and their results were compared with 15 other patients who underwent the same surgery under conventional GA technique. Results: CEA was found to be comparable to GA in thyroid surgeries Conclusion: We conclude that cervical epidural anaesthesia can be safely used for thyroid surgery.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126707212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.046
Seetha Panicker, T. Chitra, M. Priyadharshini, A. Chithra
Objectives: To correlate the fetal heart patterns in labour with the cord blood PH and perinatal outcome. Method: The study was carried out in the 104 women who required continuous electronic monitoring in labour. The CTG was assessed objectively using the Kerb's scoring system. Blood collection was done immediately after delivery from an isolated cord segment and PH was determined and correlated with the CTG scores and perinatal outcome. Results: The study group was divided into three groups based on the CTG. There was significant correlation between low CTG score up to two hours before delivery and acidosis at birth (P = 0.01). Conclusion: Application of a scoring system in interpretation of CTG increases the objectivity and reduces the intra&inter observer variation. Sensitivity of CTG with a poor score (zero to four) to predict acidosis was 55.81 % and the specificity was 77.04 %.
目的:探讨产程中胎儿心脏形态与脐带血PH值及围产期结局的关系。方法:对104例分娩时需要持续电子监护的产妇进行研究。CTG使用Kerb评分系统进行客观评估。分娩后立即从分离的脐带段采血，测定PH值，并将其与CTG评分和围产期结局相关联。结果:根据CTG将研究组分为三组。分娩前2 h CTG评分低与出生时酸中毒有显著相关性(P = 0.01)。结论:在CTG的解释中应用评分系统增加了客观性，减少了观察者内部和观察者之间的差异。CTG评分差(0 ~ 4分)预测酸中毒的敏感性为55.81%，特异性为77.04%。
{"title":"Correlation between Fetal Heart Patterns in Labour and Cord Blood pH and its Perinatal Outcome","authors":"Seetha Panicker, T. Chitra, M. Priyadharshini, A. Chithra","doi":"10.5958/J.2321-1024.1.2.046","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.046","url":null,"abstract":"Objectives: To correlate the fetal heart patterns in labour with the cord blood PH and perinatal outcome. Method: The study was carried out in the 104 women who required continuous electronic monitoring in labour. The CTG was assessed objectively using the Kerb's scoring system. Blood collection was done immediately after delivery from an isolated cord segment and PH was determined and correlated with the CTG scores and perinatal outcome. Results: The study group was divided into three groups based on the CTG. There was significant correlation between low CTG score up to two hours before delivery and acidosis at birth (P = 0.01). Conclusion: Application of a scoring system in interpretation of CTG increases the objectivity and reduces the intra&inter observer variation. Sensitivity of CTG with a poor score (zero to four) to predict acidosis was 55.81 % and the specificity was 77.04 %.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124636728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.018
M. Shah, Aakib Hamid Charag, S. F. Mir, K. Wani, Sameer H. Naqash, M. Wani
Echinococcosis (hydatid disease) is a zoonosis caused by the larval stage of Echinococcus granulosus. About seventy-five per cent of all hydatid cysts are found in the liver. Surgical management of hepatic hydatid cyst includes neutralization of the parasite, evacuation of cyst, removal of germinal lining and management of the residual cavity. Our study focussed on the management of the residual cavity in patients with cystobiliary communications. We divided the patients into two groups of 40 patients each. In both the groups the cystobiliary communications were ligated using sutures. After closing the cystobiliary communications, the residual cavity was left to drain externally using a polyvinyl chloride tube in group 1 whereas either capitonnage or omentoplasty was done in group 2. The results were studied in terms of the postoperative complications, mortality and hospital stay. In the patients managed by external tube drainage, average hospital stay was 6.95 ± 0.93 days while as patients in group 2 had an average post operative stay of 4.54 ± 0.76 days (p value = 0.0001). Bile leak was seen in 6 (15%) patients in group 1, while as only 1(2.5%) patient from group 2 developed an intra-abdominal bile collection. Wound infection and deep vein thrombosis was seen in one patient each in group 1, whereas no such complication was seen in group 2. One (2.5%) patient from each group had a recurrence of the disease during follow-up.
{"title":"External Tube Drainage Versus no Drainage in Hepatic Hydatid Cysts with Cystobiliary Communications","authors":"M. Shah, Aakib Hamid Charag, S. F. Mir, K. Wani, Sameer H. Naqash, M. Wani","doi":"10.5958/J.2321-1024.1.2.018","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.018","url":null,"abstract":"Echinococcosis (hydatid disease) is a zoonosis caused by the larval stage of Echinococcus granulosus. About seventy-five per cent of all hydatid cysts are found in the liver. Surgical management of hepatic hydatid cyst includes neutralization of the parasite, evacuation of cyst, removal of germinal lining and management of the residual cavity. Our study focussed on the management of the residual cavity in patients with cystobiliary communications. We divided the patients into two groups of 40 patients each. In both the groups the cystobiliary communications were ligated using sutures. After closing the cystobiliary communications, the residual cavity was left to drain externally using a polyvinyl chloride tube in group 1 whereas either capitonnage or omentoplasty was done in group 2. The results were studied in terms of the postoperative complications, mortality and hospital stay. In the patients managed by external tube drainage, average hospital stay was 6.95 ± 0.93 days while as patients in group 2 had an average post operative stay of 4.54 ± 0.76 days (p value = 0.0001). Bile leak was seen in 6 (15%) patients in group 1, while as only 1(2.5%) patient from group 2 developed an intra-abdominal bile collection. Wound infection and deep vein thrombosis was seen in one patient each in group 1, whereas no such complication was seen in group 2. One (2.5%) patient from each group had a recurrence of the disease during follow-up.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"85 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114314224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.037
N. Shah, Quari Hasina, A. Asma, Para Maha, B. Tanveer, V. B. Gupta
Objective: "To study the etiology and various treatment modalities of liver abscess" a prospective study over a period of one year from November 2011 to October 2012 in the department of General surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu. (1) To study the etiology of liver abscess whether pyogenic or amoebic. (2) How many were treated conservatively and how many needed intervention either aspiration or pig tail catheter drainage or open surgical drainage. Materials and Method: The patients of this study were admitted from the emergency wing, indoor and outdoor department of surgery and medicine over a period of one year from November 2011 to October 2012 in the department of General surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu. Patients of all age groups and either gender who presented with clinical suspicion of liver abscess or already diagnosed were included in the study. Results: (1) Majority of the patients in our study had amoebic liver abscess (73.33%). (2) E.coli and Klebsella were the most common organisms cultured from the pyogenic abscess. (3) Majority of amoebic liver abscess patients were treated with drug therapy alone whereas all pyogenic liver abscesses required some form of drainage.
{"title":"To Study the Etiology and Various Treatment Modalities of Liver Abscess","authors":"N. Shah, Quari Hasina, A. Asma, Para Maha, B. Tanveer, V. B. Gupta","doi":"10.5958/J.2321-1024.1.2.037","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.037","url":null,"abstract":"Objective: \"To study the etiology and various treatment modalities of liver abscess\" a prospective study over a period of one year from November 2011 to October 2012 in the department of General surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu. (1) To study the etiology of liver abscess whether pyogenic or amoebic. (2) How many were treated conservatively and how many needed intervention either aspiration or pig tail catheter drainage or open surgical drainage. Materials and Method: The patients of this study were admitted from the emergency wing, indoor and outdoor department of surgery and medicine over a period of one year from November 2011 to October 2012 in the department of General surgery in Acharya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu. Patients of all age groups and either gender who presented with clinical suspicion of liver abscess or already diagnosed were included in the study. Results: (1) Majority of the patients in our study had amoebic liver abscess (73.33%). (2) E.coli and Klebsella were the most common organisms cultured from the pyogenic abscess. (3) Majority of amoebic liver abscess patients were treated with drug therapy alone whereas all pyogenic liver abscesses required some form of drainage.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125990916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.034
Prachi Kumar, R. Bhargava, Manjushri Kumar, Madaan Jyotsana
Purpose: To compare routine tear function tests and conjunctival impression cytology (CIC) in patients with dry eye syndrome, and to determine the sensitivity, specificity and positive predictive values of these tests, considering CIC as the gold standard? Material & method: A case control prospective study was done. The eyes of 276 patients with dry eyes, was compared with 216 eyes of controls. Patients were enrolled on basis of a questionnaire of common symptoms of dry eye. Tear film break up time (TBUT), Schirmer's-1, Rose Bengal scores (RBS) were compared with impression cytology scores. Results: The mean Schirmer's value in cases was 12.54 ± 4.73 and 16.32 ± 3.80 in controls (P=0.000). The mean tear film break up time in cases was 9.11 ± 2.90 and 14.21 ± 2.72 in controls (P=0.00). The mean goblet cell density in cases was 476 ± 238 and 1552 ± 598 in controls (P=0.000). 46.7% cases of dry eye had abnormal CIC as compared to 32.8 % controls. The sensitivity of tear function tests in diagnosing dry eye was TBUT>Schirmer's>RBS and specificity was Schirmer's>TBUT>RBS in decreasing order, taking CIC as gold standard. Conclusions: Dry eye diagnosis remains a diagnostic enigma. Routine tear function tests lack sensitivity and specificity. Therefore, they should be used in combination with tests like conjunctival impression cytology to improve diagnostic accuracy.
{"title":"Dry Eye Syndrome. A Diagnostic Enigma","authors":"Prachi Kumar, R. Bhargava, Manjushri Kumar, Madaan Jyotsana","doi":"10.5958/J.2321-1024.1.2.034","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.034","url":null,"abstract":"Purpose: To compare routine tear function tests and conjunctival impression cytology (CIC) in patients with dry eye syndrome, and to determine the sensitivity, specificity and positive predictive values of these tests, considering CIC as the gold standard? Material & method: A case control prospective study was done. The eyes of 276 patients with dry eyes, was compared with 216 eyes of controls. Patients were enrolled on basis of a questionnaire of common symptoms of dry eye. Tear film break up time (TBUT), Schirmer's-1, Rose Bengal scores (RBS) were compared with impression cytology scores. Results: The mean Schirmer's value in cases was 12.54 ± 4.73 and 16.32 ± 3.80 in controls (P=0.000). The mean tear film break up time in cases was 9.11 ± 2.90 and 14.21 ± 2.72 in controls (P=0.00). The mean goblet cell density in cases was 476 ± 238 and 1552 ± 598 in controls (P=0.000). 46.7% cases of dry eye had abnormal CIC as compared to 32.8 % controls. The sensitivity of tear function tests in diagnosing dry eye was TBUT>Schirmer's>RBS and specificity was Schirmer's>TBUT>RBS in decreasing order, taking CIC as gold standard. Conclusions: Dry eye diagnosis remains a diagnostic enigma. Routine tear function tests lack sensitivity and specificity. Therefore, they should be used in combination with tests like conjunctival impression cytology to improve diagnostic accuracy.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128437204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.040
U. Tayal, Aparna, Nishant, E. Chaudhary
Central nervous system involvement is the most common neurological complication in the course of tuberculosis. Lack of rapid and sensitive test delays the early diagnosis. Cytological study was carried out in cerebrospinal fluid of patients which were clinically suspected patients of tubercular meningitis. Purpose of this study is to determine the cytomorphological patterns in cerebrospinal fluid which will help in making the diagnosis of tubercular meningitis by providing the additional supportive evidence in clinically suspected cases. Technical aspect of this cytological study is rapid and simple therefore it can be applied for early diagnosis of tubercular meningitis particularly in which bacteriological methods did not demonstrate the presence of mycobacterium bacteria in cerebrospinal fluid.
{"title":"Cytological Study of Cerebrospinal Fluid and Evaluation of its Role in the Diagnosis of Tubercular Meningitis","authors":"U. Tayal, Aparna, Nishant, E. Chaudhary","doi":"10.5958/J.2321-1024.1.2.040","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.040","url":null,"abstract":"Central nervous system involvement is the most common neurological complication in the course of tuberculosis. Lack of rapid and sensitive test delays the early diagnosis. Cytological study was carried out in cerebrospinal fluid of patients which were clinically suspected patients of tubercular meningitis. Purpose of this study is to determine the cytomorphological patterns in cerebrospinal fluid which will help in making the diagnosis of tubercular meningitis by providing the additional supportive evidence in clinically suspected cases. Technical aspect of this cytological study is rapid and simple therefore it can be applied for early diagnosis of tubercular meningitis particularly in which bacteriological methods did not demonstrate the presence of mycobacterium bacteria in cerebrospinal fluid.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127494976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.027
Pankaj Solanki, Shalabh K. Gupta, T. Bhagat, Atul Gupta, R. Verma, D. K. Sharma, Mamta Rai
Hemorrhoid disease is the most common reason patients seek evaluation by a colon and rectal surgeon. The majority of hemorrhoids can be managed nonoperatively with medical management or as day care procedures. Even though Milligan Morgan Hemorrhoidectomy(MMH) & Minimal Invasive Procedure for Hemorrhoid (MIPH) is the gold standard for hemorrhoids, but newer techniques like INFRA-RED Coagulation(IRC) for 1st, 2nd & 3rd degree hemorrhoids are showing promising results because of minimal complications, ease of procedure and a day care procedure most of the time. Besides that many patients are not ready for a definite surgical procedure and they can be benefitted by IRC.
{"title":"Comparative Study of Infra-red Coagulation Vs Haemorrhoidectomy in Patients of Haemorrhoids","authors":"Pankaj Solanki, Shalabh K. Gupta, T. Bhagat, Atul Gupta, R. Verma, D. K. Sharma, Mamta Rai","doi":"10.5958/J.2321-1024.1.2.027","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.027","url":null,"abstract":"Hemorrhoid disease is the most common reason patients seek evaluation by a colon and rectal surgeon. The majority of hemorrhoids can be managed nonoperatively with medical management or as day care procedures. Even though Milligan Morgan Hemorrhoidectomy(MMH) & Minimal Invasive Procedure for Hemorrhoid (MIPH) is the gold standard for hemorrhoids, but newer techniques like INFRA-RED Coagulation(IRC) for 1st, 2nd & 3rd degree hemorrhoids are showing promising results because of minimal complications, ease of procedure and a day care procedure most of the time. Besides that many patients are not ready for a definite surgical procedure and they can be benefitted by IRC.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122016534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.032
Rahil Muzaffar, O. Mattoo, R. Khurshid, S. Islam
Objective: Criteria for defi ning ‘severe septal deviation’ and to describe the clinical profi le of the same. Study: Retrospective study. Materials and methods: Hundred patients who were diagnosed with severe DNS and treated with extracorporeal septoplasty (ECSP) from September 2010 to December 2012, were retrospectively evaluated for this study. A review of their clinical charts formed the basis of this study. Results • In this study, majority of patients (96%) had nasal obstruction as their prime symptom followed by postnasal discharge in 60% cases, headache in 40% cases and anterior nasal discharge in 30% cases. External nasal deformity was reported by 22 patients. Snoring was seen in 24% of patients with same percentage complaining of altered sense of smell and throat discomfort. Epistaxis, sneezing and facial pain were seen in 14% patients. Epiphora was complained by only 8% of patients. • In this study, nasal endoscopy/anterior rhinoscopy was used to type the septal deformity. The commonest septal deviation was C-shaped cephalocaudal (48%), followed by S-shaped cephalocaudal (18%), C-shaped AP (16%), S-shaped AP (12%) and sharp septal deviation/angulation in 6% cases. • All but three patients (6%) had deviated nasal septum involving multiple Cottle’s areas. These three patients had sharp septal angulation involving Cottle’s area 2 only. • In this study, most common region involving DNS was area 1 + 2 + 3 (48%) followed by area 2 + 4 + 5 (28%) and 1 + 2 + 3 + 4 (18%). • Area 2 was invariably involved in 100% of cases. • NOSE (nasal obstruction symptom evaluation) scores. • Preoperatively, mean NOSE score was 67.60 ± 5.26 (65.34
{"title":"Criteria for Defining Severe Septal Deviation","authors":"Rahil Muzaffar, O. Mattoo, R. Khurshid, S. Islam","doi":"10.5958/J.2321-1024.1.2.032","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.032","url":null,"abstract":"Objective: Criteria for defi ning ‘severe septal deviation’ and to describe the clinical profi le of the same. Study: Retrospective study. Materials and methods: Hundred patients who were diagnosed with severe DNS and treated with extracorporeal septoplasty (ECSP) from September 2010 to December 2012, were retrospectively evaluated for this study. A review of their clinical charts formed the basis of this study. Results • In this study, majority of patients (96%) had nasal obstruction as their prime symptom followed by postnasal discharge in 60% cases, headache in 40% cases and anterior nasal discharge in 30% cases. External nasal deformity was reported by 22 patients. Snoring was seen in 24% of patients with same percentage complaining of altered sense of smell and throat discomfort. Epistaxis, sneezing and facial pain were seen in 14% patients. Epiphora was complained by only 8% of patients. • In this study, nasal endoscopy/anterior rhinoscopy was used to type the septal deformity. The commonest septal deviation was C-shaped cephalocaudal (48%), followed by S-shaped cephalocaudal (18%), C-shaped AP (16%), S-shaped AP (12%) and sharp septal deviation/angulation in 6% cases. • All but three patients (6%) had deviated nasal septum involving multiple Cottle’s areas. These three patients had sharp septal angulation involving Cottle’s area 2 only. • In this study, most common region involving DNS was area 1 + 2 + 3 (48%) followed by area 2 + 4 + 5 (28%) and 1 + 2 + 3 + 4 (18%). • Area 2 was invariably involved in 100% of cases. • NOSE (nasal obstruction symptom evaluation) scores. • Preoperatively, mean NOSE score was 67.60 ± 5.26 (65.34","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125179936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.026
O. Nazir, M. Wani, B. Kapoor
Study Design: Prospective study. Materials and method: This study was conducted in the Department of Anaesthesiology, Govt Medical College, Jammu 2011-2012. In this study, 75 adult patients of age 18 -60 years of either sex belonging to ASA I&II, admitted in surgical ward for elective lapraoscopic cholcystectomy were taken for this study. Patients were randomly divided into three groups. • Group I - Patients who received normal saline 20ml at the end of surgery. • Group II - Patients who received bupivacaine with adrenaline at the end of surgery. • Group III- Patients who received bupivacaine with adrenaline and clonidine at the end of surgery. Anaesthesia was standardized, consisting of glycopyrrolate 0.2 mg and ranitidine 50mg as premedication i.v 30min before induction. Induction was done with thiopentone sodium 5mg/kg and atracurium 0.5mg/kg IV, followed by maintenance with isoflurane and nitrous oxide 60-70% with oxygen. Pain assessments were made using 'Visual Analogue Scale' first in recovery ward after surgery and then 15, and 30 minutes and 1, 2, 4, 6, 8, 10, 12, 14, 16 hours after injection till effect lasts. Systolic and diastolic blood pressures and heart rate were recorded before injection and at 15, and 30 minutes, 1, 2, 4, 6, 8, 10, 12, 14 and 16 hours after injection. Results: Onset of analgesia was 15min in group III where as it was 30min in group II and control group do not show any analgesia. Quality of analgesia was much better in group III. Mean duration of analgesia was 14.5hrs in group III and it was 8.2hrs in group II. Conclusions: To conclude, clonidine is a good adjuvant to 0.5% bupivacaine in interpleural block for postoperative analgesia in cases of laparoscopic cholecystectomy.
{"title":"Comparison of Analgesic effects between Interpleural Bupivacaine with Adrenaline and Interpleural Bupivacaine with Adrenaline & Clonidine in Laparoscopic Cholecystectomy","authors":"O. Nazir, M. Wani, B. Kapoor","doi":"10.5958/J.2321-1024.1.2.026","DOIUrl":"https://doi.org/10.5958/J.2321-1024.1.2.026","url":null,"abstract":"Study Design: Prospective study. Materials and method: This study was conducted in the Department of Anaesthesiology, Govt Medical College, Jammu 2011-2012. In this study, 75 adult patients of age 18 -60 years of either sex belonging to ASA I&II, admitted in surgical ward for elective lapraoscopic cholcystectomy were taken for this study. Patients were randomly divided into three groups. • Group I - Patients who received normal saline 20ml at the end of surgery. • Group II - Patients who received bupivacaine with adrenaline at the end of surgery. • Group III- Patients who received bupivacaine with adrenaline and clonidine at the end of surgery. Anaesthesia was standardized, consisting of glycopyrrolate 0.2 mg and ranitidine 50mg as premedication i.v 30min before induction. Induction was done with thiopentone sodium 5mg/kg and atracurium 0.5mg/kg IV, followed by maintenance with isoflurane and nitrous oxide 60-70% with oxygen. Pain assessments were made using 'Visual Analogue Scale' first in recovery ward after surgery and then 15, and 30 minutes and 1, 2, 4, 6, 8, 10, 12, 14, 16 hours after injection till effect lasts. Systolic and diastolic blood pressures and heart rate were recorded before injection and at 15, and 30 minutes, 1, 2, 4, 6, 8, 10, 12, 14 and 16 hours after injection. Results: Onset of analgesia was 15min in group III where as it was 30min in group II and control group do not show any analgesia. Quality of analgesia was much better in group III. Mean duration of analgesia was 14.5hrs in group III and it was 8.2hrs in group II. Conclusions: To conclude, clonidine is a good adjuvant to 0.5% bupivacaine in interpleural block for postoperative analgesia in cases of laparoscopic cholecystectomy.","PeriodicalId":113416,"journal":{"name":"International journal of contemporary surgery","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127219952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-10DOI: 10.5958/J.2321-1024.1.2.023
M. Baba, B. Mir, M. Halwai, A. Shikari, Shakir Rasheed, Omar Khursheed, Qazi Manan
Background: The purpose of the study was to evaluate the most frequently missed fractures by primary care physicians and identify the most difficult areas of radiographic interpretation and suggest measures to avoid these in future. Materials and Method: A retrospective study was carried on hospital based data of a period of three years from 2009 to 2012 of all patients with fractures which were initially missed by primary care physicians and presented late to the hospital. Results: A total of 50 fractures where confirmed to have been missed by primary care physicians during this period from the hospital records. Out of these 34 (68%) cases where seen in children less than 14 years of age (average 7.6 years) and 16 (32%) in adults. The most frequently missed fractures where around the elbow 14 (28%), wrist and hand 12 (24%), around hip 11 (22%), ankle 8 (16%) and 5 (10%) in other regions including 2 in foot, 1 each in spine, shoulder and knee. Conclusion: This study revealed that majority of missed injuries are seen around the elbow and the hip. If missed and not treated properly can lead to serious complications. So it is suggested that all primary care physicians should undergo a specifically directed educational program in these areas to suspect and diagnose such injuries in time to avoid any complications related to such injuries.
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