scholarly journals COMPARISON OF INTRAVENOUS LIGNOCAINE VS NALBUPHINE IN ATTENUATION OF HEMODYNAMIC RESPONSE TO AWAKE TRACHEAL EXTUBATION IN ENT SURGERIES

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S37-41
Author(s):  
Liaquat Ali ◽  
Amim Akhter ◽  
Muhammad Saeed ◽  
Usman Khalid ◽  
Jawad Rehmani
Keyword(s):  
Tracheal Extubation ◽  
Ethics Committee ◽  
Military Hospital ◽  
P Value ◽  
Hemodynamic Parameters ◽  
Operation Theatre ◽  
Duration Of Surgery ◽  
The Mean ◽  
Randomized Control ◽  
Classification Evaluation

Objective: To compare intravenous lignocaine vs. intravenous nalbuphine in terms of mean change in heart rate and mean arterial pressures (MAP) during awake tracheal extubation. Study Design: Randomized control trial. Place and Duration of Study: Main Operation Theatre, Combined Military Hospital Rawalpindi, from May 2016to Dec 2016. Methodology: After approval of the study by the institution’s research ethics committee, the patients meetinginclusion criteria were assigned randomly to one of the two groups by lottery method. On return of spontaneous ventilation, patients in group L received intravenous lignocaine 1.5 mg/kg while group N patients received intravenous Nalbuphine 0.2mg/kg. Data recorded immediately (T1) and 5min after (T2) extubation. Results: After stratification of data in terms of age, gender, duration of surgery and ASA classification, evaluation of hemodynamic parameters (HR and MAP) between the two groups was done. The mean change in HR in group L was 6.66 ± 1.53 bpm and in group N was 4.43 ± 1.35. The mean change in MAP in group L was 4.90 ± 1.49 mm of Hg and in group N was 3.23 ± 1.33. p-value in both parameters was found to be less than 0.05 and thus declared significant.Conclusion: We concluded that intravenous nalbuphine, in the dose of 0.2mg/kg, is a better attenuator ofhemodynamic response to extubation as compared to intravenous lignocaine and provides better stability ofHeart rate and Mean arterial Pressure.

scholarly journals INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

scholarly journals Application of platysma muscle suture after thyroidectomy

2020 ◽  
pp. 147-150
Keyword(s):  
Postoperative Pain ◽  
Wound Infection ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Platysma Muscle ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Mean ◽  
Length Of Hospitalization

Introduction: Thyroidectomy is a common surgery in the neck area, in which the application of platysma muscle suture after thyroidectomy is still being discussed. This study was conducted to compare the application (currently common) or non-application of suture for platysma muscle. Methods: In this retrospective cross-sectional study, 117 patients underwent thyroidectomy, among which 63 cases without suturing platysma (control group) and 54 subjects with suturing platysma (Intervention group ) were examined in terms of postoperative pain based on visual analogue scale score measured 24 h post-operation. The samples were also investigated regarding hematoma and seroma, wound infection, length of hospitalization, scarring (1 year after surgery), duration of surgery, and the number of cases using opioids during the hospitalization. Patients with diabetes, previous neck surgery, coagulopathy, and radiation history were excluded from the study. The gathered data were analyzed statistically in SPSS software (version 18) using the Chi-square test and the Mann–Whitney U test. A p-value of less than (0.05) was considered significant. Results: Based on the findings, the mean age of the patients in the Intervention group was calculated at 51 years, of which 41 and 13 cases were females and males, respectively. In the Intervention group, 34 patients underwent complete thyroidectomy and 20 patients had hemithyroidectomy. The mean age score of subjects in the control group was calculated at 50 years, of which 44 and 19 patients were respectively female and male. No significant difference was revealed considering wound infection, length of hospitalization, created scarring, the amount of opioid use (opioids), and postoperative pain. However, only the length of surgery was different between the groups (P-value<0.05). Conclusions: There was no difference between wound and surgical complications and cosmetic results between both groups; nevertheless, due to the duration of the surgery and other benefits, such as consuming less thread, not suturing the platysma is recommended.

scholarly journals Considering the hypothesis of the pathophysiology of cellulite in its treatment

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
José Maria Pereira de Godoy ◽  
Ana Carolina Pereira de Godoy ◽  
Maria de Fatima Guerreiro Godoy
Keyword(s):  
Clinical Trial ◽  
Medical Records ◽  
Ethics Committee ◽  
Clinical Treatment ◽  
P Value ◽  
Lymph Drainage ◽  
The Mean ◽  
Cervical Stimulation ◽  
Alpha Error ◽  
Paired T Test

The aim of this study was to evaluate perimetric reductions in the clinical treatment of cellulite (aesthetics) using the Godoy method in a randomized retrospective clinical trial. The medical records of 150 patients treated for cellulite in the period from 2006 to 2011 in the Clinica Godoy were revisited. Treatment comprised manual and mechanical lymph drainage and cervical stimulation for one hour per day over 10 days. The paired t-test was used for statistical analysis, with an alpha error of 5% (P-value <0.05) being considered acceptable. This study was started after being approved by the Research Ethics Committee of the Medicine School in São José do Rio Preto (FAMERP - no. 395- 2010), Brazil and after being registered as a clinical trial. The mean reduction of the 150 patients was 3.81±2.76 g (P-value <0.0001; 95% confidence interval: 3.408-4.223). A significant reduction in size was seen with the clinical treatment of cellulite giving an improvement in the physical appearance. Pathophysiological mechanisms such as regional skin lymphostasis seem to be involved in the formation of cellulite.

scholarly journals Comparison between dissection method and coblation technique in tonsillectomy

2019 ◽  
Vol 5 (6) ◽  
pp. 1607
Author(s):  
Shreyas S. Joshi ◽  
Vinayak Raikar
Keyword(s):  
Chronic Tonsillitis ◽  
P Value ◽  
Safe Procedure ◽  
Duration Of Surgery ◽  
The Mean ◽  
Operative Recovery ◽  
Dissection Technique ◽  
Cold Dissection ◽  
Dissection Method

<p class="abstract"><strong>Background:</strong> The objective of the present study was to compare the dissection method and coblation technique in tonsillectomy in patients of chronic tonsillitis.</p><p class="abstract"><strong>Methods:</strong> This is prospective study in which 40 patients of chronic tonsillitis in age group of 5-12 years were selected in this study. Patients were blinded with regards to technique used to remove tonsils. 20 patients underwent tonsillectomy by cold dissection method and 20 with coblation method. In both techniques, duration of surgery and amount of blood loss were recorded and compared.  </p><p class="abstract"><strong>Results:</strong> In our study, the mean operative time from giving incision to achieving complete haemostasis for dissection method was 42.9 minutes and that for coblation technique was 34 minutes. The amount of blood lost on an average by dissection method was 51.8 ml, and by coblation technique was 22.3 ml. This difference was found to be statistically significant. Pain was evaluated by visual analogue scale. The data recorded from two groups was put to statistical analysis and ‘p’ value was calculated using independent t-test. The mean pain score for coblation technique averaged over 10 days was 2.72 and was 4.84 for dissection technique.</p><p class="abstract"><strong>Conclusions:</strong> We can conclude that coblation tonsillectomy is an easy to learn safe procedure with significant advantages in terms improving the quality of post-operative recovery compared to that following the cold dissection technique. But cost effectiveness of dissection method outweighs benefits of coblation at present in Indian scenario.</p>

scholarly journals DURATION OF SURGERY OF LAPAROSCOPIC NEPHRECTOMY -AN INITIAL EXPERIENCE IN IGMC, SHIMLA

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Bhartendu Nagesh ◽  
D.K Verma ◽  
R S Jhobta ◽  
Sanjiv Sharma ◽  
Mehar Chand
Keyword(s):  
Operating Time ◽  
Standard Of Care ◽  
Laparoscopic Nephrectomy ◽  
P Value ◽  
Dense Adhesion ◽  
Medical College ◽  
Duration Of Surgery ◽  
The Mean ◽  
Gandhi Medical College ◽  
Hydronephrotic Kidney

Background: Laparoscopic nephrectomy has been established as the standard of care for the management of benign non-functioning kidneys and has gained worldwide popularity over the past decade. Methods- This study was conducted in the Department of General surgery, Indira Gandhi medical college, Shimla on 20 selected patients of benign non functional kidney admitted for elective Laparoscopic Nephrectomy between July 2018 to June 2019 Results: In this study, the mean operating time in success full laparoscopic nephrectomies was 103.7 + 20.6 min in lap converted to open it was    165 .7 +26.99 min and in hand-assisted tame taken was 150 min which is statically not significant with p value =0.1317. Conclusion: The mean time taken for completion of laparoscopic nephrectomy in first 4 cases was 105 min and in next 4 cases was 108 min and in last 4 cases it was 97 min there was definitive learning curve as in last 4 cases operating time was less as compared to initial cases but operating time also depends on other factors like in hydronephrotic kidney due to well maintained plane dissection take less time ,but in  pyonephrotic kidney ,tubercular kidney,previously intervension like PCN, there were dense adhesion resulting in more time for disection. Keywords: Laparoscopy, Nephrectomy, Duration of surgery

scholarly journals ROLE OF GINKGO BILOBA IN TINNITUS BASED ON TINNITUS HANDICAP INVENTORY

2021 ◽  
Vol Volume 9 (upjohns/volume9/Issue2) ◽  
pp. 32-36
Author(s):  
Monica Manhas
Keyword(s):  
Informed Consent ◽  
Ginkgo Biloba ◽  
Ethics Committee ◽  
P Value ◽  
Inclusion Criteria ◽  
Tinnitus Handicap Inventory ◽  
Institutional Ethics ◽  
The Mean ◽  
Pre Treatment

ABSTRACT AIMS AND OBJECTIVES To evaluate whether there is role of Ginkgo biloba in treatment of tinnitus or not, using Tinnitus Handicap Inventory MATERIAL METHODS: The present prospective study, after approval by Institutional Ethics Committee, was conducted in Department of ENT, GMC Jammu from January 2019 to January 2020 on 90 patients with primary complaint of tinnitus. Inclusion criteria- Age: 20 years or above, Duration of tinnitus > 3 months. Informed consent was taken and all patients were asked to complete the THI-Tinnitus Handicap Inventory. All patients were given 50mg of Ginkgo biloba standardized extract LI 1370 (containing 25% flavonoids, 3% ginkgolides and 5% bilobalides). Patients were advised to take three tablets daily for 12 weeks. RESULTS The mean pre-treatment THI score was 43.6 and mean post-treatment THI score (at 12 weeks) was 39.4; the mean change in THI score was 4.2, the result being statistically insignificant (p-value= 0.43). Out of 90 patients, 51 reported unchanged severity of tinnitus, 27 patients reported improvement in severity of tinnitus and 12 patients reported worsening of condition. CONCLUSION According to our study, Ginkgo biloba has no significant therapeutic role in tinnitus. However, the aetiology of tinnitus is multifactorial and Ginkgo biloba could benefit patients with ischemic aetiology. KEYWORDS Ginkgo, biloba, handicap, inventory, tinnitus

scholarly journals EVALUATION OF DEXMEDETOMIDINE ON HEMODYNAMIC STRESS RESPONSE DURING LARYNGOSCOPY AND INTUBATION

2021 ◽  
Vol 71 (6) ◽  
pp. 2126-30
Author(s):  
Abdul Raafeh Jamal ◽  
Bilal Yaseen ◽  
Mohammad Saeed ◽  
Rao Ali Shan Khan ◽  
Syed Hamid Ali Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Systolic Blood Pressure ◽  
Military Hospital ◽  
P Value ◽  
Hemodynamic Stress ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Dexmedetomidine (Precedex) in addressing the mean haemodynamic stress response to laryngoscopy and endotracheal intubation (L&I). Study Design: Quasi-experimental study. Place and Duration of Study: Anesthesiology Department, Combined Military Hospital, Rawalpindi, from Jun 2019 Jun 2020. Methodology: The patients were divided into two groups. Group A was given Inj. Dexmedetomidine and group B (placebo). Operation theatre assistant randomly assigned the patients to either group A or group B each day. The second person administered the drug or placebo. The third person (researcher) recorded all the parameters mentioned in the proforma. Results: There were 100 patients with an age range of 18-60 years. The majority of the patients were ASA-I physical status. The main surgical procedure was laparoscopic cholecystectomy. Recording of heart rate and systolic blood pressure during laryngoscopy and intubation, after administration of drug or placebo, showed mean heart rate less than mean basal value in group-A and 22% above mean basal value in group-B, and it was statistically highly significant (p-value <0.001). Whereas mean systolic blood pressure in group-A was 122.42 ± 14.91 (less than the mean basal value) as compared to group B, 155.00 ± 18.32/min (20% above mean basal value). This change was also statistically highly significant (p-value <0.001). Conclusion: It is concluded that dexmedetomidine showed statistically significant stabilizing effects on the expected changes of the hemodynamic stress response.

scholarly journals Investigating the effect of Sesame Ointment on Wound healing of Episiotomy

2018 ◽  
Vol 9 (3) ◽  
pp. 182-184
Author(s):  
Najmeh Amani Babadi ◽  
Masoomeh Kheirkhah ◽  
Faraz Mojab ◽  
Hamid Haghani
Keyword(s):  
Wound Healing ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
The Mean ◽  
Randomized Control ◽  
Spss Software ◽  
And Control

Episiotomy is one of the most common midwifery interventions method for preventing injuries to the pelvic floor during the delivery process. Traditional medicine has a special place in improving the quality of postpartum care. Sesame is one of the herbs with anti-inflammatory, anti-bacterial and antioxidant activity.  This study was evaluate the effect of sesame ointment on episiotomy healing. Methods: This randomized control clinical trial was performed on 104 eligible women. The samples were block randomly assigned to one of the groups Intervention and control. Samples were used sesame and placebo ointment for epizootics from 4 hours after delivery for ten days every 8 hours. Clinical evaluation of episiotomy ulcer was performed 4 hours, 7 and 10 days after delivery with using REEDA tool. SPSS software version 16 was used for data analysis. P value less than 0.05 was considered significant. Results: The average of wound healing rate was 7 days after episiotomy in the intervention group 0.09 ± 0.29 and in the control group was 0.73 ± 0.44. Independent t-test showed that the two groups had a significant difference (p <0.001).Healing of the wound 10 days after episiotomy showed that the mean scores in the control group (0.4 ± 0.49) and in the intervention group (0.02 ± 0.13), healing in the intervention group significantly decreased from the control group (p <0.001). Conclusion: Sesame ointment can be used as a pain relief and accelerator for episiotomy healing.  

scholarly journals Association of Hyperuricemia With Hypertension In Pakistani Population

2021 ◽  
Vol 10 (02) ◽  
pp. 98-101
Author(s):  
Attia Khaliq ◽  
Abdul Moueed Tariq ◽  
Abdul Latif Khattak ◽  
Karamat Ali ◽  
Shahzeb Ahmad Satti ◽  
...  
Keyword(s):  
Uric Acid ◽  
Study Design ◽  
Case Control Study ◽  
Military Hospital ◽  
P Value ◽  
Control Groups ◽  
Pakistani Population ◽  
The Mean ◽  
And Control ◽  
Control Study

Objective: To find an association between Hyperuricemia and Hypertension in patients presenting in outpatients department for regular check-up. Study design and Setting: Case Control Study design conducted at Pak Emirates Military Hospital Rawalpindi (PEMH), Medical Outpatient department (OPD) from 4th Feb, 2017 to 4th Aug, 2017. Methodology: A total of 200 patients, with 100 cases and 100 controls fulfilling the selection criteria were included in the study, which were selected from Medical OPD of PEMH. An informed written consent was taken. The Demographic such as age, gender were obtained. Veriable upon selection into study group, the blood samples were taken and two groups of patients were made on the basis of normal or raised uric acid levels. The Serum Uric Acid (SUA) was measured in the patients. Then blood pressure was measured by using sphygmomanometer by researchers themselves. If BP level was >140/90mmHg on 2 separate occasions, or patient is already a known case of hypertension, then hypertension was labeled. Results: The mean age (years) in the study was 54.79 + 8.96. There were 136 (68%) male and 64 (32%) female patients. The frequency and percentage of hypertension in cases and control groups was (84%) and (41%) patients respectively which was statistically significant with a p-value of 0.000. The Odds ratio was found to be 7.55. Conclusion: It was concluded that there was an association found between Hyperuricemia and Hypertension

P253 Withdrawal of beta- blockers and ACE inhibitors after left ventricular systolic function recovery in patient with dilated cardiomyopathy randomized control trial

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
A Bakhsh ◽  
G Thanassoulis ◽  
J C Engert ◽  
E Elstein ◽  
T Huynh ◽  
...  
Keyword(s):  
Dilated Cardiomyopathy ◽  
Medical Therapy ◽  
Primary Endpoint ◽  
Ace Inhibitors ◽  
Systolic Function ◽  
Treatment Withdrawal ◽  
P Value ◽  
The Mean ◽  
Randomized Control ◽  
Lv Systolic Function

Abstract Funding Acknowledgements The Rosenfeld Heart Fund Introduction recovery of left ventricle (LV) systolic function with normalization of ejection fraction (LVEF) occurs in 10 - 27% of patients with 80% maintaining recovery. However, the need for medical therapy after recovery is often questioned. Previous randomized studies of treatment withdrawal were small, not selected for non-ischemic dilated cardiomyopathy (DCM) and had a reference of improved or recovered EF to &gt; 40% or &gt; 10% change from LVEF at time of diagnosis.  Hypothesis: In patients with DCM with recovery of the LV systolic function to an EF (&gt;50%), medical therapy withdrawal is possible without rebound LV systolic dysfunction. Method: This was a pilot randomized control open-label trial with 2:1 randomization for withdrawal of b-blockers and ACE inhibitors in patients with recovered LV systolic function. Patients’ medication discontinuation occurred in 2 phases with a six-month interval and patients were followed for one year. The primary endpoint was LVEF reduction (&lt; 40%). Results: There were 22 patients (10 females) enrolled. The mean age was 60 ± 12y. The mean LVEF at enrollment was 58 ± 5% with no significant difference in the mean LVEF in both groups. Sixteen patients were assigned to the withdrawal group and 6 assigned to the control group. The primary endpoint occurred in 31% of the withdrawal group compared to none of the control. The rate of 1ry outcome after withdrawal of medical therapy was 19%, p-value 0.15. The mean LVEF at 1 year for the treatment withdrawal group was 46.8 ± 12% and control 55 ± 6%, p-value 0.15. In the medication withdrawal group, the mean LVEF reduction was 10.6 ± 11% and the difference between the mean LVEF at enrollment and at 1 year was 10.6 ± 11% with 95% CI (4.6,16.49), p-value 0.0017. Conclusion: In DCM patients with recovery of LV systolic function, we observed worsening of LVEF after withdrawal of b-blockers and ACE inhibitors. Abstract P253 Figure.

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