Pub Date : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4023
Deepak Kumar Meena, Pradeep Charan, Asha Sharma
Objective: Contemporary valvular cardiac surgery has evolved with the adoption of expedited postoperative recovery, known as fast-tracking. This paradigm shift results from advancements in anaesthetic agents, surgical techniques, and myocardial protection strategies. Fast-track anaesthesia aims to reduce intensive care unit (ICU) stays and overall hospital length of stay (LOS), optimizing resource utilization. Cardioprotective properties of volatile anaesthetic agents, especially in mitigating ischemic myocardial damage, have garnered attention. Methods: A hospital-based, randomized, comparative study was conducted at the Department of Anaesthesiology, S. M. S Medical College, Jaipur. 70 undergoing valvular heart surgery under general anaesthesia, were randomly assigned to two groups: Group A (Sevoflurane) and Group B (Isoflurane). Inclusion criteria encompassed ASA grade II to IV patients aged 20 to 50 y, with a body weight of 30-65 kg, and willingness to provide written consent. Anaesthesia induction and maintenance involved the administration of Sevoflurane or Isoflurane based on group allocation. Hemodynamic parameters were recorded at various surgical stages. Results: Heart rate, systolic blood pressure, and cardiac output were statistically insignificant between groups at different surgical stages (p>0.05). Intraoperative variables demonstrated no significant differences, except for a transient decrease in systolic blood pressure post-induction in both groups. Conclusion: The study underscores the comparable efficacy of Sevoflurane and Isoflurane in valvular cardiac surgery, supported by similar hemodynamic profiles. Understanding the nuances of volatile anaesthetic agents is crucial for their optimal clinical application, considering challenges like beta-blocker usage and perioperative hyperglycemia.
目的：当代心脏瓣膜手术随着术后快速恢复（即快速通道）的采用而不断发展。这一模式的转变源于麻醉剂、手术技术和心肌保护策略的进步。快速通道麻醉旨在缩短重症监护室（ICU）的住院时间和总体住院时间（LOS），优化资源利用率。挥发性麻醉剂的心脏保护特性，尤其是在减轻缺血性心肌损伤方面的特性，已引起人们的关注。方法：斋浦尔 S. M. S 医学院麻醉科进行了一项基于医院的随机比较研究。70 名在全身麻醉下接受瓣膜心脏手术的患者被随机分配到两组：A组（七氟烷）和B组（异氟烷）。纳入标准包括 ASA II 至 IV 级患者，年龄在 20 至 50 岁之间，体重在 30 至 65 公斤之间，并愿意提供书面同意书。麻醉诱导和维持根据分组情况使用七氟醚或异氟醚。在不同手术阶段记录血液动力学参数。结果心率、收缩压和心输出量在不同手术阶段的组间差异无统计学意义（P>0.05）。术中变量无显著差异，只是两组患者诱导后收缩压均出现短暂下降。结论该研究强调了七氟烷和异氟醚在心脏瓣膜手术中的疗效相当，并有相似的血液动力学特征作为支持。考虑到β-受体阻滞剂的使用和围术期高血糖等挑战，了解挥发性麻醉剂的细微差别对其最佳临床应用至关重要。
{"title":"COMPARATIVE EVALUATION OF SEVOFLURANE AND ISOFLURANE IN FAST TRACK ANAESTHESIA FOR VALVULAR CARDIAC SURGERY: A RANDOMIZED STUDY","authors":"Deepak Kumar Meena, Pradeep Charan, Asha Sharma","doi":"10.22159/ijcpr.2024v16i2.4023","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4023","url":null,"abstract":"Objective: Contemporary valvular cardiac surgery has evolved with the adoption of expedited postoperative recovery, known as fast-tracking. This paradigm shift results from advancements in anaesthetic agents, surgical techniques, and myocardial protection strategies. Fast-track anaesthesia aims to reduce intensive care unit (ICU) stays and overall hospital length of stay (LOS), optimizing resource utilization. Cardioprotective properties of volatile anaesthetic agents, especially in mitigating ischemic myocardial damage, have garnered attention. \u0000Methods: A hospital-based, randomized, comparative study was conducted at the Department of Anaesthesiology, S. M. S Medical College, Jaipur. 70 undergoing valvular heart surgery under general anaesthesia, were randomly assigned to two groups: Group A (Sevoflurane) and Group B (Isoflurane). Inclusion criteria encompassed ASA grade II to IV patients aged 20 to 50 y, with a body weight of 30-65 kg, and willingness to provide written consent. Anaesthesia induction and maintenance involved the administration of Sevoflurane or Isoflurane based on group allocation. Hemodynamic parameters were recorded at various surgical stages. \u0000Results: Heart rate, systolic blood pressure, and cardiac output were statistically insignificant between groups at different surgical stages (p>0.05). Intraoperative variables demonstrated no significant differences, except for a transient decrease in systolic blood pressure post-induction in both groups. \u0000Conclusion: The study underscores the comparable efficacy of Sevoflurane and Isoflurane in valvular cardiac surgery, supported by similar hemodynamic profiles. Understanding the nuances of volatile anaesthetic agents is crucial for their optimal clinical application, considering challenges like beta-blocker usage and perioperative hyperglycemia.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"94 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239652","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 : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4037
Priya Kumari, Premanand Panda, Rudra Panigrahi, Pragnya P. Mishra
Objective: Schwannoma is a benign peripheral nerve sheath tumour. Previously referred to as Neurilemmomas. It is a slow-growing tumour. The commonest site is the limb with a predilection to the upper limb. But, it has a 25–48% predilection for nerves of the head and neck. In the oral cavity, the commonest site is said to be the tongue. Methods: We report three cases of histopathologically diagnosed Schwannoma at unusual sites. The first case was a 52 y old lady with a palpable, firm, painless swelling in the occipital region of the scalp of size 2.0 x 1.0 x 1.0 cm. The second case was a 29 y old woman with a painless scalp swelling of 1 cm by 1 cm. The third case was a 23 y old boy who presented with a slow-growing and painless pedunculated swelling in the posterior pharyngeal wall for a year. All cases showed classical histopathologic pictures on microscopy. Results: All the patients were evaluated pre-operatively and subjected to an excisional biopsy. The post-operative period was uneventful and everything went according to plan for a full year. Conclusion: Schwannomas exhibit a slow growth rate, are present in all age groups, and are not specific to one gender. Extremities are the most common locations to occur, but some rare sites like the scalp, oral cavity, retroperitoneum, and internal viscera also exist. Magnetic resonance imaging (MRI) is helpful in those lesions, providing useful information about the location and nature of the lesion, eliminating differential diagnosis, and thus providing correct management plans.
目的：许旺瘤是一种良性周围神经鞘瘤。以前被称为神经瘤。它是一种生长缓慢的肿瘤。最常见的部位是肢体，好发于上肢。但是，25%-48%的患者好发于头颈部神经。在口腔，最常见的部位据说是舌头：我们报告了三例经组织病理学诊断为不同寻常部位的许旺瘤。第一例是一位 52 岁的女士，她的头皮枕部有一个可触及、坚实、无痛的肿物，大小为 2.0 x 1.0 x 1.0 厘米。第二个病例是一名 29 岁的妇女，头皮上有一个 1 厘米乘 1 厘米的无痛肿物。第三个病例是一名 23 岁的男孩，咽后壁有一个生长缓慢、无痛的蒂状肿物，已持续一年。所有病例在显微镜下均显示出典型的组织病理学图像：所有患者均接受了术前评估和切除活检。结果：所有患者均接受了术前评估，并接受了切除活检，术后一年一切顺利：结论：许万瘤的生长速度缓慢，存在于所有年龄组，且不分性别。四肢是最常见的发病部位，但也有一些罕见部位，如头皮、口腔、腹膜后和内脏。磁共振成像（MRI）对这些病变很有帮助，可提供有关病变位置和性质的有用信息，消除鉴别诊断，从而提供正确的治疗方案。
{"title":"SCHWANNOMA OF THE HEAD AND NECK REGION: A CASE SERIES IN A TERTIARY HEALTH CENTRE IN WESTERN ODISHA","authors":"Priya Kumari, Premanand Panda, Rudra Panigrahi, Pragnya P. Mishra","doi":"10.22159/ijcpr.2024v16i2.4037","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4037","url":null,"abstract":"Objective: Schwannoma is a benign peripheral nerve sheath tumour. Previously referred to as Neurilemmomas. It is a slow-growing tumour. The commonest site is the limb with a predilection to the upper limb. But, it has a 25–48% predilection for nerves of the head and neck. In the oral cavity, the commonest site is said to be the tongue.\u0000Methods: We report three cases of histopathologically diagnosed Schwannoma at unusual sites. The first case was a 52 y old lady with a palpable, firm, painless swelling in the occipital region of the scalp of size 2.0 x 1.0 x 1.0 cm. The second case was a 29 y old woman with a painless scalp swelling of 1 cm by 1 cm. The third case was a 23 y old boy who presented with a slow-growing and painless pedunculated swelling in the posterior pharyngeal wall for a year. All cases showed classical histopathologic pictures on microscopy.\u0000Results: All the patients were evaluated pre-operatively and subjected to an excisional biopsy. The post-operative period was uneventful and everything went according to plan for a full year.\u0000Conclusion: Schwannomas exhibit a slow growth rate, are present in all age groups, and are not specific to one gender. Extremities are the most common locations to occur, but some rare sites like the scalp, oral cavity, retroperitoneum, and internal viscera also exist. Magnetic resonance imaging (MRI) is helpful in those lesions, providing useful information about the location and nature of the lesion, eliminating differential diagnosis, and thus providing correct management plans.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241220","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 : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4030
Tatavarti Srinivasa Rao, T. D. P. Subbalakshmi, Helena Kanta
Objective: To assess the quality of services provided in Outpatient department (OPD), to the Inpatients (IP) and quality of Supportive services. Methods: This is a hospital-based cross-sectional study. Feedback was taken from the 150 patients after taking permission from the concerned authorities of the hospital, after taking Institutional ethical committee approval and after written consent from the patients. Feedback is taken from the patients attending 5 departments, namely (Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics and Paediatrics. Opinion from30 patients from each department covering 15 Outpatients and 15 inpatients were taken. Results: Most of the patients of Out Patient Department (OPD) and Inpatients (IP) have expressed satisfaction regarding the services they are receiving/received from the hospital. Conclusion: Utilizing the available hospital resources judiciously with wholehearted commitment from the available manpower with time to time needed budgetary support from the Government can improve the quality of services in the Government hospitals at par with the corporate hospitals.
{"title":"QUALITY OF SERVICES PROVIDED TO THE PATIENTS IN GOVERNMENT GENERAL HOSPITAL, SRIKAKULAM–A CROSS-SECTIONAL STUDY","authors":"Tatavarti Srinivasa Rao, T. D. P. Subbalakshmi, Helena Kanta","doi":"10.22159/ijcpr.2024v16i2.4030","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4030","url":null,"abstract":"Objective: To assess the quality of services provided in Outpatient department (OPD), to the Inpatients (IP) and quality of Supportive services. \u0000Methods: This is a hospital-based cross-sectional study. Feedback was taken from the 150 patients after taking permission from the concerned authorities of the hospital, after taking Institutional ethical committee approval and after written consent from the patients. Feedback is taken from the patients attending 5 departments, namely (Medicine, Surgery, Gynaecology and Obstetrics, Orthopaedics and Paediatrics. Opinion from30 patients from each department covering 15 Outpatients and 15 inpatients were taken. \u0000Results: Most of the patients of Out Patient Department (OPD) and Inpatients (IP) have expressed satisfaction regarding the services they are receiving/received from the hospital. \u0000Conclusion: Utilizing the available hospital resources judiciously with wholehearted commitment from the available manpower with time to time needed budgetary support from the Government can improve the quality of services in the Government hospitals at par with the corporate hospitals.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"126 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140237668","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 : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4062
Vineela Kodi, Jayaprada Rangineni, Yamini Sharabu
Objective: The study aimed to estimate the prevalence of methicillin resistance of Staphylococcus aureus in various clinical samples received at tertiary care hospital. Initially, the Staphylococcus aureus and its antibiotic susceptibility tests is performed in clinical samples which are submitted to the department of Microbiology. And Methicillin Resistance Staphylococcus Aureus (MRSA) is determined by using cefoxitin (30 μg) as per CLSI guidelines. Methods: The prospective study was conducted in department of Microbiology in a tertiary care hospital. All Staphylococcus aureus organisms isolated in clinical samples were included in the study and processed as per the standard operating procedure. Methicillin susceptibility was tested by using cefoxitin (30μg) disks on Muller-Hinton agar plates that were inoculated with a suspension (equal to 0.5 McFarland standards) of the s. aureus. Results: In our study, amongst hundred staphylococcus aureus isolates, sixty isolates were shown resistance to cefoxitin (30µg), which indicates that percentage of methicillin-resistant s. aureus in our study is 60. Majority of s. aureus were isolated from blood samples 44% (n= 44) followed by pus samples 32% (n=32). Linezolid resistance reported was 3%. All isolates were sensitive to vancomycin and daptomycin by disc diffusion test as per CLSI guidelines 2021. Conclusion: To conclude, MRSA plays a significant role and it can be transmitted through endogenous, cross-infection and reinfections. Phenotypic methods like use of cefoxitin disc (30µg) can be considered for detection of methicillin resistance in S. aureus, as it consumes less time and easy to perform.
{"title":"DETECTION OF METHICILLIN RESISTANCE IN CLINICAL ISOLATES OF STAPHYLOCOCCUS AUREUS IN TERTIARY CARE HOSPITAL, TIRUPATI","authors":"Vineela Kodi, Jayaprada Rangineni, Yamini Sharabu","doi":"10.22159/ijcpr.2024v16i2.4062","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4062","url":null,"abstract":"Objective: The study aimed to estimate the prevalence of methicillin resistance of Staphylococcus aureus in various clinical samples received at tertiary care hospital. Initially, the Staphylococcus aureus and its antibiotic susceptibility tests is performed in clinical samples which are submitted to the department of Microbiology. And Methicillin Resistance Staphylococcus Aureus (MRSA) is determined by using cefoxitin (30 μg) as per CLSI guidelines. \u0000Methods: The prospective study was conducted in department of Microbiology in a tertiary care hospital. All Staphylococcus aureus organisms isolated in clinical samples were included in the study and processed as per the standard operating procedure. Methicillin susceptibility was tested by using cefoxitin (30μg) disks on Muller-Hinton agar plates that were inoculated with a suspension (equal to 0.5 McFarland standards) of the s. aureus. \u0000Results: In our study, amongst hundred staphylococcus aureus isolates, sixty isolates were shown resistance to cefoxitin (30µg), which indicates that percentage of methicillin-resistant s. aureus in our study is 60. Majority of s. aureus were isolated from blood samples 44% (n= 44) followed by pus samples 32% (n=32). Linezolid resistance reported was 3%. All isolates were sensitive to vancomycin and daptomycin by disc diffusion test as per CLSI guidelines 2021. \u0000Conclusion: To conclude, MRSA plays a significant role and it can be transmitted through endogenous, cross-infection and reinfections. Phenotypic methods like use of cefoxitin disc (30µg) can be considered for detection of methicillin resistance in S. aureus, as it consumes less time and easy to perform.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"24 59","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240323","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 : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4047
Abhinav Chaudhary, Manish Yadav, Arvind Kanwar, P. Malhotra, UK Chandel
Objective: Stomach carcinoma, a complex challenge in oncology, necessitates refined staging for optimal therapeutic strategies. The comparative analysis of staging laparoscopy and contrast-enhanced computed tomography (CECT) emerges as a key exploration in this context. Methods: Conducted at Indira Gandhi Medical College and Hospital, Shimla, this prospective study spanned one year. Biopsy-proven gastric carcinoma patients meeting inclusion criteria underwent extensive investigations, including CECT, staging laparoscopy, and diagnostic lavage. The study employed specific protocols for each procedure, ensuring comprehensive data collection. Results: Analysis of 32 cases revealed a prevalence in the 61-70 y age group, predominantly affecting males. Diverse symptoms included pain (68.75%) and palpable mass (81.2%). Well-differentiated adenocarcinoma (43.8%) dominated, with distinct age-related patterns. The study showcased the intricate nature of gastric carcinoma, demanding tailored diagnostic approaches. Conclusion: This study unravels the interplay between staging laparoscopy and CECT in gastric carcinoma, offering a comprehensive staging approach. The nuanced insights gained through their synergy address individual limitations, contributing to more precise evaluations and tailored interventions. The collaborative use of these modalities promises to enhance precision, ultimately improving patient outcomes in gastric carcinoma management.
{"title":"COMPARATIVE ANALYSIS OF STAGING MODALITIES IN CARCINOMA STOMACH: UNRAVELING THE SYNERGY BETWEEN STAGING LAPAROSCOPY AND CECT ABDOMEN","authors":"Abhinav Chaudhary, Manish Yadav, Arvind Kanwar, P. Malhotra, UK Chandel","doi":"10.22159/ijcpr.2024v16i2.4047","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4047","url":null,"abstract":" \u0000Objective: Stomach carcinoma, a complex challenge in oncology, necessitates refined staging for optimal therapeutic strategies. The comparative analysis of staging laparoscopy and contrast-enhanced computed tomography (CECT) emerges as a key exploration in this context. \u0000Methods: Conducted at Indira Gandhi Medical College and Hospital, Shimla, this prospective study spanned one year. Biopsy-proven gastric carcinoma patients meeting inclusion criteria underwent extensive investigations, including CECT, staging laparoscopy, and diagnostic lavage. The study employed specific protocols for each procedure, ensuring comprehensive data collection. \u0000Results: Analysis of 32 cases revealed a prevalence in the 61-70 y age group, predominantly affecting males. Diverse symptoms included pain (68.75%) and palpable mass (81.2%). Well-differentiated adenocarcinoma (43.8%) dominated, with distinct age-related patterns. The study showcased the intricate nature of gastric carcinoma, demanding tailored diagnostic approaches. \u0000Conclusion: This study unravels the interplay between staging laparoscopy and CECT in gastric carcinoma, offering a comprehensive staging approach. The nuanced insights gained through their synergy address individual limitations, contributing to more precise evaluations and tailored interventions. The collaborative use of these modalities promises to enhance precision, ultimately improving patient outcomes in gastric carcinoma management.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241113","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 : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4024
Mantha Radha Sundari, T. D. P. Subbalakshmi, Tvvsv Prasad
Objective: To improve the quality of block in regional anaesthesia, several adjuvants are added to local anaesthetic drugs. The effects of clonidine and dexmedetomidine were compared with regard to the onset and duration of sensory and motor block as well as the length of analgesia when used as an adjuvant to bupivacaine in brachial plexus block by axillary approach. Objective: The present study was conducted to compare the onset time, duration and analgesic efficacy of clonidine vs dexmedetomidine when added as adjuvant to bupivacaine (0.5%) for USG guided brachial plexus by axillary approach. Methods: This is a prospective, randomized; comparative study conducted in elective unilateral upper limb forearm and hand surgeries. The study was conducted at Government General Hospital, Srikakulam, between March 2023 to September 2023 after obtaining permission from the Institutional Ethics Committee and from the patients. Group BC received 30 ml of 0.5% bupivacaine with Clonidine 1µg/kg (n=30) and Group BD received 30 ml of 0.5% bupivacaine with dexmedetomidine 1µg/kg (n = 30). The onset and duration of sensory and motor block total duration of analgesia were studied in both groups. Results: The mean time for onset of sensory block in Group BD was 4.7 min, which was lower than Group BC 8.47 min. The mean time for onset of motor block in Group BD was 9.63 min the mean time for total duration of sensory block in Group BD was 537.8 min. This was higher than the Group BC 319.1 min. The total duration of analgesia in Group BD was 666.27 min. This was higher than in Group BC 375.23 min. Bupivacaine dexmedetomidine group had better quality analgesia than the bupivacaine clonidine group. Conclusion: The addition of Dexmedetomidine (1μg/kg) to bupivacaine (0.5%) in brachial plexus block by USG-guided axillary approach results in a shorter onset time for sensory and motor blockade, prolongs the duration of sensory and motor blockade and also total duration of analgesia.
{"title":"A COMPARATIVE STUDY BETWEEN CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN BRACHIAL PLEXUS BLOCK THROUGH USG-GUIDED AXILLARY APPROACH","authors":"Mantha Radha Sundari, T. D. P. Subbalakshmi, Tvvsv Prasad","doi":"10.22159/ijcpr.2024v16i2.4024","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4024","url":null,"abstract":"Objective: To improve the quality of block in regional anaesthesia, several adjuvants are added to local anaesthetic drugs. The effects of clonidine and dexmedetomidine were compared with regard to the onset and duration of sensory and motor block as well as the length of analgesia when used as an adjuvant to bupivacaine in brachial plexus block by axillary approach. \u0000Objective: The present study was conducted to compare the onset time, duration and analgesic efficacy of clonidine vs dexmedetomidine when added as adjuvant to bupivacaine (0.5%) for USG guided brachial plexus by axillary approach. \u0000Methods: This is a prospective, randomized; comparative study conducted in elective unilateral upper limb forearm and hand surgeries. The study was conducted at Government General Hospital, Srikakulam, between March 2023 to September 2023 after obtaining permission from the Institutional Ethics Committee and from the patients. Group BC received 30 ml of 0.5% bupivacaine with Clonidine 1µg/kg (n=30) and Group BD received 30 ml of 0.5% bupivacaine with dexmedetomidine 1µg/kg (n = 30). The onset and duration of sensory and motor block total duration of analgesia were studied in both groups. \u0000Results: The mean time for onset of sensory block in Group BD was 4.7 min, which was lower than Group BC 8.47 min. The mean time for onset of motor block in Group BD was 9.63 min the mean time for total duration of sensory block in Group BD was 537.8 min. This was higher than the Group BC 319.1 min. The total duration of analgesia in Group BD was 666.27 min. This was higher than in Group BC 375.23 min. Bupivacaine dexmedetomidine group had better quality analgesia than the bupivacaine clonidine group. \u0000Conclusion: The addition of Dexmedetomidine (1μg/kg) to bupivacaine (0.5%) in brachial plexus block by USG-guided axillary approach results in a shorter onset time for sensory and motor blockade, prolongs the duration of sensory and motor blockade and also total duration of analgesia.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241170","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 : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4031
K. S. Bai, D. Jayasree, Bharathi Uppu, S. C.
Objective: Chronic low back pain is a global health problem with significant medical and economic burden. Vitamin D deficiency and obesity are its risk factors. The objective was to determine efficacy of oral vitamin D formulations in patients with chronic low back pain with vitamin D deficiency. Methods: A prospective analytical cohort study was conducted. Patients with self-reported chronic low back pain and with vitamin D concentrations ≤30 ng/dl were identified and randomized into 3 groups namely Granule, Nano syrup and soft gel capsule group. Vitamin D supplementation of 60,000 IUs per dose for ten consecutive days was given in the form of granule (1 g sachet), Nano syrup (5 ml bottle) and soft gel capsule. We measured (25-hydroxyvitamin D [25(OH)D]) concentrations and to assess pain, Visual analogue scale and Modified Oswestry low back pain disability questionnaire (MODQ) were used before and 12 w after the intervention. Results: After 12 w 25(OH)D levels increased significantly with vitamin D supplementation in all the groups but more in the Nano syrup group. There was also significant reduction in back pain intensity in all the groups after vitamin D supplementation. However in Nano syrup group, there was a significantly greater reduction in back pain compared with other groups. Conclusion: Our findings suggest that vitamin D supplementation in vitamin D deficient adults may improve chronic low back pain. Hence, testing for vitamin D deficiency in those with chronic low back pain may be warranted.
目的：慢性腰背痛是一个全球性的健康问题，给医疗和经济带来沉重负担。维生素 D 缺乏和肥胖是其风险因素。目的：确定口服维生素 D 制剂对缺乏维生素 D 的慢性腰背痛患者的疗效。研究方法进行了一项前瞻性队列分析研究。研究人员确定了自述患有慢性腰背痛且维生素 D 浓度≤30 ng/dl 的患者，并将其随机分为 3 组，即颗粒剂组、纳米糖浆组和软胶囊组。以颗粒剂（1 克袋装）、纳米糖浆（5 毫升瓶装）和软胶囊的形式连续十天补充维生素 D，每次剂量为 60,000 IUs。我们在干预前和干预后 12 天测量了维生素 D（25-羟基维生素 D [25(OH)D]）的浓度，并使用视觉模拟量表和改良奥斯韦特里腰痛残疾问卷（MODQ）评估疼痛。结果显示12 个月后，所有组的 25（OH）D 水平都随着维生素 D 的补充而明显提高，但纳米糖浆组的提高幅度更大。补充维生素 D 后，所有组的背痛强度都有明显降低。不过，与其他组相比，纳米糖浆组背部疼痛的减轻幅度更大。结论我们的研究结果表明，缺乏维生素 D 的成年人补充维生素 D 可改善慢性腰背痛。因此，有必要对慢性腰背痛患者进行维生素 D 缺乏检测。
{"title":"A PROSPECTIVE COMPARATIVE STUDY ON EFFICACY OF ORAL VITAMIN D FORMULATIONS IN PATIENTS WITH CHRONIC LOW BACK PAIN WITH VITAMIN D DEFICIENCY AT A TERTIARY CARE HOSPITAL","authors":"K. S. Bai, D. Jayasree, Bharathi Uppu, S. C.","doi":"10.22159/ijcpr.2024v16i2.4031","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4031","url":null,"abstract":"Objective: Chronic low back pain is a global health problem with significant medical and economic burden. Vitamin D deficiency and obesity are its risk factors. The objective was to determine efficacy of oral vitamin D formulations in patients with chronic low back pain with vitamin D deficiency. \u0000Methods: A prospective analytical cohort study was conducted. Patients with self-reported chronic low back pain and with vitamin D concentrations ≤30 ng/dl were identified and randomized into 3 groups namely Granule, Nano syrup and soft gel capsule group. Vitamin D supplementation of 60,000 IUs per dose for ten consecutive days was given in the form of granule (1 g sachet), Nano syrup (5 ml bottle) and soft gel capsule. We measured (25-hydroxyvitamin D [25(OH)D]) concentrations and to assess pain, Visual analogue scale and Modified Oswestry low back pain disability questionnaire (MODQ) were used before and 12 w after the intervention. \u0000Results: After 12 w 25(OH)D levels increased significantly with vitamin D supplementation in all the groups but more in the Nano syrup group. There was also significant reduction in back pain intensity in all the groups after vitamin D supplementation. However in Nano syrup group, there was a significantly greater reduction in back pain compared with other groups. \u0000Conclusion: Our findings suggest that vitamin D supplementation in vitamin D deficient adults may improve chronic low back pain. Hence, testing for vitamin D deficiency in those with chronic low back pain may be warranted.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"11 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238796","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 : 2024-03-15DOI: 10.22159/ijcpr.2024v16i2.4045
Abdul Hareesh, Sharanabasappa Haseeb, Malashetty, Sharanabasappa Malashetty
Objective: This comparative analysis explores the feasibility and reliability of the Pediatric Index of Mortality 3 (PIM 3) Score in contrast to traditional scoring systems within the context of a single institution. The study delves into the intricate landscape where the contemporary PIM 3 score converges with the time-honored methodologies of conventional scoring systems, offering valuable insights into prognostic evaluation. Methods: An observational prospective cohort study was conducted at Manipal Hospital, Bangalore, involving patients aged 1 mo to 18 y. The study focused on children admitted to the Pediatric Intensive Care Unit (PICU) for at least 1 hour, studying the feasibility of obtaining PIM 3 scores within the first hour. Exclusion criteria included neonates, infants less than one-month-old, and children requiring elective procedural sedation. Feasibility was assessed, and logistic regression was employed to evaluate PIM 3's ability to discriminate between survivors and non-survivors. Results: The training dataset comprised 2,534 patients with a mean age of 8.2 y. Patient characteristics, including age, gender, race, patient type, and origin, were well-distributed. Trauma and variables like elective admission and mechanical ventilation in the first hour were infrequent. The mortality rate across datasets was 1.0%. The PIM 3 risk of mortality and PICU medical length of stay were calculated, forming a comprehensive overview of patient profiles. Conclusion: The comparative analysis unfolds as a cerebral sojourn, revealing the intricate dance of perplexity and burstiness in the juxtaposition of PIM 3 score against traditional scoring systems. The study contributes nuanced insights, portraying each word and concept as integral notes in the composition of knowledge. This singular institutional perspective offers a profound understanding into the intricacies of prognostic evaluation, creating a narrative that transcends conventional methodologies.
{"title":"COMPARATIVE ANALYSIS OF FEASIBILITY AND RELIABILITY OF PIM 3 SCORE VS. TRADITIONAL SCORING SYSTEMS: INSIGHTS FROM A SINGLE INSTITUTION","authors":"Abdul Hareesh, Sharanabasappa Haseeb, Malashetty, Sharanabasappa Malashetty","doi":"10.22159/ijcpr.2024v16i2.4045","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4045","url":null,"abstract":"Objective: This comparative analysis explores the feasibility and reliability of the Pediatric Index of Mortality 3 (PIM 3) Score in contrast to traditional scoring systems within the context of a single institution. The study delves into the intricate landscape where the contemporary PIM 3 score converges with the time-honored methodologies of conventional scoring systems, offering valuable insights into prognostic evaluation. \u0000Methods: An observational prospective cohort study was conducted at Manipal Hospital, Bangalore, involving patients aged 1 mo to 18 y. The study focused on children admitted to the Pediatric Intensive Care Unit (PICU) for at least 1 hour, studying the feasibility of obtaining PIM 3 scores within the first hour. Exclusion criteria included neonates, infants less than one-month-old, and children requiring elective procedural sedation. Feasibility was assessed, and logistic regression was employed to evaluate PIM 3's ability to discriminate between survivors and non-survivors. \u0000Results: The training dataset comprised 2,534 patients with a mean age of 8.2 y. Patient characteristics, including age, gender, race, patient type, and origin, were well-distributed. Trauma and variables like elective admission and mechanical ventilation in the first hour were infrequent. The mortality rate across datasets was 1.0%. The PIM 3 risk of mortality and PICU medical length of stay were calculated, forming a comprehensive overview of patient profiles. \u0000Conclusion: The comparative analysis unfolds as a cerebral sojourn, revealing the intricate dance of perplexity and burstiness in the juxtaposition of PIM 3 score against traditional scoring systems. The study contributes nuanced insights, portraying each word and concept as integral notes in the composition of knowledge. This singular institutional perspective offers a profound understanding into the intricacies of prognostic evaluation, creating a narrative that transcends conventional methodologies.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"121 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140238049","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}
Objective: Acute Bacterial Meningitis (ABM) is associated with a high mortality rate and morbidity in paediatric population despite recent advances in diagnostic methods, antimicrobial and supportive treatments and monitoring. This study is therefore undertaken to aid in rapid diagnosis of ABM by latex agglutination test (LAT) and to comparatively evaluate Gram stain, Culture and LAT in the diagnosis of ABM along with antibiotic susceptibility pattern of the isolates. We undertake this study in children with symptoms of meningitis to isolate and identify the pathogens in CSF and blood and to determine their antibiotic susceptibility pattern. We will compare and evaluate the three methods Gram stain, culture and Antigen detection. Methods: A hospital-based prospective study conducted at Government General Hospital, Kakinada during December 2018–August 2020. A total of 50 clinically suspected cases of bacterial meningitis in the paediatric age group were taken. The CSF sample was collected and subjected to Gram stain, culture and antigen detection tests using PASTOREX TMMENINGITIS kit. Results: Out of 50 samples collected, 15 cases were declared as laboratory confirmed cases as per WHO criteria. Gram stain was positive in 6 cases. CSF culture could identify 8 cases of ABM. CSF LAT was positive in 12 cases. Group B Streptococcus was the most common etiological agent in neonates, while S. pneumoniae in children. The isolates were 100% sensitive to cefoperazone, cefuroxime, cefepime and gentamicin. Conclusion: Although Gram stain is simple and CSF culture is the gold standard, LAT has an advantage over Gram stain in terms of species identification. It was found to be more sensitive, rapid, easy to perform and could identify fastidious organisms like S. pneumoniae, N. meningitidis and Group B Streptococcus.
目的：尽管近年来诊断方法、抗菌药和支持性治疗以及监测手段不断进步，但急性细菌性脑膜炎（ABM）在儿科人群中的死亡率和发病率仍居高不下。因此，本研究旨在通过乳胶凝集试验（LAT）帮助快速诊断 ABM，并比较评估革兰氏染色法、培养法和 LAT 在诊断 ABM 中的作用以及分离物的抗生素敏感性模式。我们在有脑膜炎症状的儿童中开展这项研究，以分离和鉴定 CSF 和血液中的病原体，并确定其抗生素敏感性模式。我们将对革兰氏染色、培养和抗原检测三种方法进行比较和评估。研究方法2018 年 12 月至 2020 年 8 月期间，在卡基纳达政府综合医院开展了一项基于医院的前瞻性研究。共抽取了 50 例儿科细菌性脑膜炎临床疑似病例。采集 CSF 样本并使用 PASTOREX TMMENINGITIS 试剂盒进行革兰氏染色、培养和抗原检测试验。结果：在采集的 50 份样本中，根据世界卫生组织的标准，15 个病例被宣布为实验室确诊病例。6 例革兰氏染色呈阳性。脑脊液培养可确定 8 例 ABM 病例。12 个病例的 CSF LAT 呈阳性。新生儿最常见的病原体是 B 群链球菌，而儿童最常见的病原体是肺炎链球菌。分离出的菌株对头孢哌酮、头孢呋辛、头孢吡肟和庆大霉素 100%敏感。结论虽然革兰氏染色简单，而 CSF 培养是金标准，但 LAT 在物种鉴定方面比革兰氏染色更有优势。研究发现，LAT 更敏感、更快速、更容易操作，并能识别肺炎双球菌、脑膜炎双球菌和 B 群链球菌等快速致病菌。
{"title":"STUDY OF ACUTE BACTERIAL MENINGITIS IN CHILDREN BY GRAM STAIN, CULTURE AND ANTIGEN DETECTION","authors":"Kosanam Ramyasri, Gunti Rajyalakshmi, Aravadurga Rani, Murthy Ds","doi":"10.22159/ijcpr.2024v16i2.4029","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4029","url":null,"abstract":"Objective: Acute Bacterial Meningitis (ABM) is associated with a high mortality rate and morbidity in paediatric population despite recent advances in diagnostic methods, antimicrobial and supportive treatments and monitoring. This study is therefore undertaken to aid in rapid diagnosis of ABM by latex agglutination test (LAT) and to comparatively evaluate Gram stain, Culture and LAT in the diagnosis of ABM along with antibiotic susceptibility pattern of the isolates. We undertake this study in children with symptoms of meningitis to isolate and identify the pathogens in CSF and blood and to determine their antibiotic susceptibility pattern. We will compare and evaluate the three methods Gram stain, culture and Antigen detection. \u0000Methods: A hospital-based prospective study conducted at Government General Hospital, Kakinada during December 2018–August 2020. A total of 50 clinically suspected cases of bacterial meningitis in the paediatric age group were taken. The CSF sample was collected and subjected to Gram stain, culture and antigen detection tests using PASTOREX TMMENINGITIS kit. \u0000Results: Out of 50 samples collected, 15 cases were declared as laboratory confirmed cases as per WHO criteria. Gram stain was positive in 6 cases. CSF culture could identify 8 cases of ABM. CSF LAT was positive in 12 cases. Group B Streptococcus was the most common etiological agent in neonates, while S. pneumoniae in children. The isolates were 100% sensitive to cefoperazone, cefuroxime, cefepime and gentamicin. \u0000Conclusion: Although Gram stain is simple and CSF culture is the gold standard, LAT has an advantage over Gram stain in terms of species identification. It was found to be more sensitive, rapid, easy to perform and could identify fastidious organisms like S. pneumoniae, N. meningitidis and Group B Streptococcus.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140239280","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}
Objective: The lumbar spine undergoes degenerative changes with age, leading to lumbar canal stenosis (LCS). Surgical interventions, including transforaminal lumbar interbody fusion (TLIF), become essential when conservative measures fail. Understanding complications associated with TLIF is crucial for informed decision-making and improved patient outcomes. Methods: A study involving 40 LCS patients undergoing TLIF was conducted at Indira Gandhi Medical College, Shimla. Records were retrospectively evaluated for 15 patients (pre-May 2016) and prospectively for 25 patients (May 2016-May 2017). Surgical indications, inclusion/exclusion criteria, preoperative preparation, and TLIF procedures were outlined. Postoperative care and follow-up assessments were detailed. Statistical analysis utilized SPSS 17.0 with a significance level of 0.05. Results: Age and sex distribution demonstrated a significant association (p=0.0049), with a male predominance (57.5%). Occupation analysis revealed 32.5% farmers, 15% laborers, 5% drivers, and 47.5% 'others.' Neurological deficits were present in 75% of cases, while facet joint arthropathy affected 67.5% of patients. Preoperative Oswestry Disability Index indicated severe disability in 62.5% of cases. Conclusion: This study provides critical insights into TLIF complications for LCS, emphasizing male predominance, occupation-related considerations, and significant preoperative disability. Findings contribute to refining surgical protocols, minimizing risks, and optimizing patient safety in TLIF for LCS, essential for advancing spinal surgery standards.
{"title":"ANALYSIS OF COMPLICATIONS IN PATIENTS UNDERGOING TRANSFORAMINAL LUMBAR INTERBODY FUSION: A CRITICAL EXAMINATION OF SURGICAL INTERVENTIONS FOR LUMBAR CANAL STENOSIS","authors":"Rahul Kumar Singh, Priyank Deepak, Chhewang Topgia","doi":"10.22159/ijcpr.2024v16i2.4036","DOIUrl":"https://doi.org/10.22159/ijcpr.2024v16i2.4036","url":null,"abstract":"Objective: The lumbar spine undergoes degenerative changes with age, leading to lumbar canal stenosis (LCS). Surgical interventions, including transforaminal lumbar interbody fusion (TLIF), become essential when conservative measures fail. Understanding complications associated with TLIF is crucial for informed decision-making and improved patient outcomes. \u0000Methods: A study involving 40 LCS patients undergoing TLIF was conducted at Indira Gandhi Medical College, Shimla. Records were retrospectively evaluated for 15 patients (pre-May 2016) and prospectively for 25 patients (May 2016-May 2017). Surgical indications, inclusion/exclusion criteria, preoperative preparation, and TLIF procedures were outlined. Postoperative care and follow-up assessments were detailed. Statistical analysis utilized SPSS 17.0 with a significance level of 0.05. \u0000Results: Age and sex distribution demonstrated a significant association (p=0.0049), with a male predominance (57.5%). Occupation analysis revealed 32.5% farmers, 15% laborers, 5% drivers, and 47.5% 'others.' Neurological deficits were present in 75% of cases, while facet joint arthropathy affected 67.5% of patients. Preoperative Oswestry Disability Index indicated severe disability in 62.5% of cases. \u0000Conclusion: This study provides critical insights into TLIF complications for LCS, emphasizing male predominance, occupation-related considerations, and significant preoperative disability. Findings contribute to refining surgical protocols, minimizing risks, and optimizing patient safety in TLIF for LCS, essential for advancing spinal surgery standards.","PeriodicalId":13875,"journal":{"name":"International Journal of Current Pharmaceutical Research","volume":"31 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140240115","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}
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