scholarly journals A Study of the Haemodynamic Response to Oral Clonidine as Pre–Medication in Laparoscopic Surgeries

2014 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Alka Koshire ◽  
Rupesh Sinha ◽  
Utkarsh S. Rayakar
Keyword(s):  
Laparoscopic Surgery ◽  
Preoperative Evaluation ◽  
Haemodynamic Response ◽  
Controlled Study ◽  
P Value ◽  
Health Care Centre ◽  
Group V ◽  
Medical College ◽  
Oral Clonidine ◽  
Anaesthetic Procedure

<strong>Introduction:</strong> Laparoscopic surgery is a boon for surgeons as it reduces tissue trauma, post-operative morbidity, hospital stay and healthcare costs. However, it is not possible to perform a laparoscopic procedure unless a proper anaesthetic procedure is available to combat the additional haemodynamic stress of pneumoperitoneum with CO<sub>2</sub> insufflation and the patient's position<sup>1,2</sup>. Use of an alpha-2 against tablets such as clonidine helps in blunting the adverse haemodynamic response during laparoscopy<sup>3,4</sup>. <strong>Aims of this study were:</strong> To study haemodynamic response to oral clonidine tablet during endotracheal intubation in laparoscopic surgery. To study haemodynamic response to oral clonidine tablet in the intraoperative period in laparoscopic surgery. To study side-effects of clonidine. <strong>Materials and Methods:</strong> This prospective placebo controlled study was conducted in the Department of Anaesthesiology, in a tertiary health care centre attached to a medical college. A total of 60 patients scheduled for laparoscopic surgery in the age group of 18-60 years belonging to ASA grade 1 &amp; 2 were included in the study. After appropriate preoperative evaluation they were divided into 2 groups. Group C (n = 30) received Tab. Clonidine 150 mcg orally. Group V (n = 30) received a placebo Vitamin tablet. After appropriate premedication, patients were given general anaesthesia. Various parameters like pulse rate, Non-Invasive Blood Pressure (NIBP) including systolic, diastolic and mean arterial pressure, ETCO<sub>2</sub> were measured pre-operatively, during intubation and at various points intraoperatively. Statistical analysis was done using statistical package for Social Sciences Ver. 18. The results was expressed in mean and standard deviation. Independent t-test was used to compare mean of the two groups. For the purpose of this study, 95% confidence limit was chosen and corresponding p-value &lt;0.05 was taken as statistically significant. <strong>Conclusion:</strong> We found that pre-medication with oral clonidine provides haemodynamic stability and protection against the stress response triggered by laryngoscopy, intubation and pneumoperitoneum with CO<sub>2</sub> in patients undergoing laparoscopic surgery. It also was found to reduce nausea, vomiting and shivering post-operatively.

scholarly journals THYROID DISORDERS AND POLYCYSTIC OVARY SYNDROME Dr. B S Meena1, Dr. Neeta Meena2

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
B S Meena ◽  
Neeta Meena
Keyword(s):  
Polycystic Ovary ◽  
Control Group ◽  
P Value ◽  
Thyroid Disorders ◽  
Free T4 ◽  
Androgen Excess ◽  
Group V ◽  
Medical College ◽  
High Prevalence ◽  
Pcos Group

Background: Polycystic ovarian syndrome (PCOS) is the most common form of chronic anovulation associated with androgen excess; perhaps occurring in 5-10% of reproductive women.  Methods: Observational study done in the Department of Obstetrics & Gynaecology, SMS Medical College, Jaipur. Forty cases of women with PCOS based on Rotterdam’s criteria and an equal number of age-matched controls (women without PCOS) were included in the study. Results: T4 level was significantly lower in PCOS group with mean free T4 level 0.87 ± 0.75 ng/ml in PCOS group v/s 1.92 ± 0.84 ng/ml in control group (p-value = 0.001). TSH level was significantly higher in PCOS group with mean TSH  level 8.86  ± 7.57 mU/L in PCOS group v/s 3.40 ± 1.21 mU/L in control group (p-value = 0.001) Conclusion: High prevalence of thyroid disorders in PCOS patients thus points towards the importance of early correction of hypothyroidism in the management of infertility associated with PCOS. Keywords: T4, T3, TSH, PCOS

scholarly journals COMPARISON OF PRE AND POST INDUCTION BISHOPS SCORE IMPROVEMENT IN INTRACERVICAL FOLEY’S CATHETER AND PGE2 GEL

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
B.S. Meena ◽  
Mohinee Dhaka ◽  
Sunita Garhwal ◽  
K.P. Banerjee ◽  
Reena Pant
Keyword(s):  
Foley Catheter ◽  
Cervical Ripening ◽  
Controlled Study ◽  
P Value ◽  
Medical College ◽  
Score Improvement ◽  
Efficacy Parameter ◽  
Successful Induction ◽  
Foley’S Catheter ◽  
Group B

Background: Aim-The success of labor induction depends on the cervical status at the time of induction. Objective- For effective cervical ripening both foley catheter and a dinoprostone gel are used. The aim of this study was to compare the efficacy and safety of the intracervical Foleys catheter and dinoprostone gel in cervical ripening for successful induction of labor. Methods: It was a randomized controlled study conducted in the obstetrics department at SMS Medical College, Jaipur. 100 Women were enrolled with a bishops score <5with various indication for induction of labour. They intracervical Foleys catheter insertion and group B received Dinoprostone gel 0.5mg instilleted intracervical. Maximum of 2 doses dinoprostone gel could be administered 6 hours apart. Primary efficacy parameter was change in Bishops score as compared to baseline. Results: The groups were comparable with respect to maternal age, gestation age, indication of induction and initial Bishop's score. Both the groups showed significant change in the Bishop's score  at 12 hr,8.02 ± 3.22 and 7.1 ± 4.48 in Foleys catheter and Dinoprostone gel, respectively, But p value was not statistically significant(0.242). Conclusion- This study shows that both Foleys catheter and Dinoprostone are equally effective in cervical ripening.  

scholarly journals Effect of oral clonidine on perioperative haemodynamic response and post-operative requirement of analgesic for patients undergoing laparoscopic surgery

2021 ◽  
Vol 4 (2) ◽  
pp. 19-22
Author(s):  
Dr. Dimple K Pandya ◽  
Dr. Tirth S Patel ◽  
Dr. Krupal Patel ◽  
Dr. Manisha Sharma ◽  
Dr. Karan A Batavia
Keyword(s):  
Laparoscopic Surgery ◽  
Haemodynamic Response ◽  
Oral Clonidine

scholarly journals Sublingual versus vaginal use of Misoprostol for induction of labor

2019 ◽  
Vol 8 (12) ◽  
pp. 4960
Author(s):  
Mamta Bansal ◽  
Indu Sharma ◽  
Jyoti Lagoo ◽  
Harish Jadhav
Keyword(s):  
Neonatal Outcome ◽  
Obstetric Care ◽  
Induction Of Labor ◽  
Controlled Study ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Sublingual Misoprostol ◽  
Chi Square Test ◽  
Vaginal Misoprostol

Background: Induction of labor is one of the great challenges for obstetric care provider. Misoprostol is used for induction of labor by various routes with the advantages in being cheap and stable at room temperature and widely available even in resource-poor settings.Methods: A randomized controlled study was conducted in the obstetrics and gynecology department of Govt. Medical College and associated Maharani Hospital, Bastar, Chhattisgarh, India over a period of 1.75 years from September 2014 to May 2016. Study has comprised of 200 pregnant women admitted in the department for induction of labor fulfilling the inclusion and exclusion criteria. Data was collected and analyzed by SPSS 16.0. z-test and chi-square test to compare the safety and efficacy of both the routes of misoprostol use for IOL.Results: There were insignificant differences in number of doses required for induction with satisfactory maternal and neonatal outcome but shorter (12 hours) induction delivery interval with sublingual Misoprostol induction. Most of the cases of both the groups were delivered by vaginal route (86% and 62%) within 12 hours of induction(58% and 42%) yet significant (p value < 0.001) number of cases had undergone caesarean in group of vaginal misoprostol administration (29%) with major indications of meconium stained liquor (3% and 12%) and non assuring fetal heart rate (1% and 10%).Conclusions: Although both the routes of induction by Misoprostol are well tolerated by the women with satisfactory neonatal outcome, sublingual Misoprostol has an added advantage of quicker delivery, less caesarean and ease of administration indicates better safety and effectiveness.

Evaluation of pre-operative clinical finding and per-operative assessment of carcinoma stomach in tertiary settings of Bangladesh

2020 ◽  
Vol 22 (1) ◽  
pp. 43-46
Author(s):  
Mst Jesmen Nahar ◽  
Md Mahiuddin Matubber ◽  
Md Mahbubur Rahman ◽  
Md Mahbubur Rahman ◽  
Syed Muhammad Baqul Billah ◽  
...  
Keyword(s):  
Lymph Node ◽  
Clinical Picture ◽  
Preoperative Evaluation ◽  
Lymph Node Involvement ◽  
Lesion Detection ◽  
Clinical Feature ◽  
P Value ◽  
Operative Finding ◽  
Node Involvement ◽  
Carcinoma Stomach

Background: Carcinoma stomach, a major killer cancer all over the world, is still presenting late in developing countries due to delay in early diagnosis, lack of awareness, infrastructure etc. Objectives: To establish the importance of preoperative evaluation on operability of carcinoma stomach. Methods: Sixty clinically and histopathologically diagnosed ca stomach cases who underwent surgery in department of Bangabandhu Sheikh Mujib Medical University, Dhaka, and Dhaka Medical College Hospital, Dhaka in 2011 were assessed with clinical picture, investigations, preoperative evaluation and peroperative findings were recorded. Z test for proportion was used to assess clinical decision predictability with a p value of :s;0.05 as significant. Results: Male (73.33%) predominant with 2.75:1 male:female ratio was observed. Mobility, fixity and abdominal lymphadenopathy were not well detected through clinical assessment (p=0.001) while ascites, metastasis and Shelf of Slummer were similar in both clinical and operative finding. The endoscopy of upper GIT finding gave a unique picture as the findings were almost same as were found during operation. USG detected a lesser proportion of the clinical condition compared to peroperative condition whereas CT performed better than the USG except for the lesion detection. Though Computed Tomography (CT) detected higher percentage of lesion, metastasis, ascites and lymph node involvement compared to ultrasonogram (USG), it was significantly higher only for lesion detection (p=0.002) and lymph node involvement (p=<0.001). In the similar manner USG assessment of lesion detection (p=<0.001) and lymph node involvement (p=0.003) was significantly low compared to operative finding. When we looked between CT and operative finding only lesion detection was significantly low (p=0.01) indicating CT to be most effective predictor of clinical picture for operative decision. Preoperative plan were mostly not in accordance with peroperative decision except for total gastrectomy. Conclusion: The study indicates weakness in clinical detection and pre-operative plan compared to per-operative finding. Hence combination of clinical feature and investigation tools especially endoscopy of upper GIT combined with CT is recommended to predict a better operative decision. Journal of Surgical Sciences (2018) Vol. 22 (1): 43-46

e-Learning: Practices Among Undergraduates of a Medical College of Khyber Pakhtunkhwa

2020 ◽  
Keyword(s):  
Information Technology ◽  
Medical Students ◽  
Background Information ◽  
P Value ◽  
Undergraduate Medical Students ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical College ◽  
Learning Practices ◽  
E Learning

Background: Information technology (IT) is a new way of teaching and learning. One of the promising media of information technology is e-Learning, which is used to enhance knowledge and skills among users. A student gains better and deep knowledge through a useful tool. This survey aimed to determine practices among medical students for e-Learning. Methods: This cross-sectional survey was conducted on 184 students amongst the 500 students currently enrolled in medical college. Data was collected using questionnaires and were analyzed through SPSS version 22. Chi-square was used for qualitative values. Results: Majority 90.80% (n=167) students were aware of e-Learning and were statistically high in first year students (p-value: 0.018). The student did not show statistically significant results for content learned through e-Learning with a p-value of 0.063. Different resources were used for e-Learning in which videos had the highest percentage (87.60%) and audios were used as the least resource for e-Learning (29.20%). Daily, 56% of the students use e-Learning for 1 hour or less and only 3% of the students used it for more than 4 hours. Conclusion: Majority of undergraduate medical students were aware of the use of e-Learning and most of them preferred e-Learning for their course work and studies showing a significant increase in understanding and use, compared to studies conducted earlier. Participants found e-Learning useful and effective tool in increasing knowledge and understanding of their subject. Keywords: e-Learning; Practices; Students.

scholarly journals A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3826
Author(s):  
Sharmistha Sarkar ◽  
Dhruba Prasad Paul ◽  
Jayanta Ray
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Comparative Evaluation ◽  
P Value ◽  
Contraceptive Device ◽  
Government Medical College ◽  
Expulsion Rate ◽  
Medical College ◽  
Significant Difference ◽  
Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

scholarly journals Validity of the Diabetes, Hypertension and Hyperlipidaemia (DHL) Knowledge Instrument among Medical Students of Karachi

2016 ◽  
Vol 9 (1) ◽  
pp. 265
Author(s):  
Muhammad Bilal ◽  
Abdul Haseeb ◽  
Aleena Zehra Merchant ◽  
Muhammad Ahad Sher Khan ◽  
Arsalan Majeed Adam ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Knowledge Score ◽  
Educational Status ◽  
Educational Programs ◽  
P Value ◽  
Medical College ◽  
Knowledge Based ◽  
The Mean ◽  
Knowledge Levels

BACKGROUND: While there have been a number of studies on DM, hypertension and hyperlipidaemia, an instrument which assesses knowledge based on all three conditions has neither been established nor authorized in Pakistan. Hence, the focus of this study was to establish a pre- tested extensive questionnaire to evaluate medical students’ understanding of DM, hypertension, hyperlipidaemia and their medications for use.METHODS: A pre-validated and pre-tested DHL instrument was employed on 250 students of Dow Medical and Sindh Medical College and on 45 physicians working in a leading teaching hospital of Karachi. The DHL knowledge instrument was then distributed a second time to the very same set of students, after a period of 2 months, at the end of the foundation module, once they had received some basic formal medical education including diabetes and CVS diseases.RESULTS: The overall internal consistency for the DHL instrument failed to comply with the set standard of more than or equal to 0.7 as our results yielded Cronbach’s α of 0.6. Overall the average difficulty factor of 28 questions is 0.41, which highlighted that the instrument was moderately tough. The mean scores for all domains were substantially lower in the students section in comparison to that of the professional section, which had remarkable impact on the overall mean(SD) knowledge score (40.58 ± 14.63 vs. 63.49 ± 06.67 ; p value = 0.00).CONCLUSION: The instrument can be used to recognize people who require educational programs and keep an account of the changes with the passage of time as it could help in differentiating the knowledge levels among its participants based on their educational status.

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