Research Ethics: The Bane of the unethical researcher.

Every human research creates generalizable information which is an integral part of health improvement & understanding of disease. It also causes some risk or inconvenience to research participants. Codes of conduct for physicians have existed since ancient period. Declaration of Helsinki ICMR, Human subjects’ protection; Animal care guidelines etc provide a policy for conduct of research involving research participants in India. The Why & the How in research are vital questions. The ‘Why’ is very clear to define as improvement of public health. What matters more is the ‘How’: while performing it is necessary to adhere to research ethics for promotion of knowledge, truth and avoidance of errors. Research being team work, involves principles of team work such as trust, mutual respect, even handedness, and accountability. Upholding confidentiality, data sharing policies, guidelines of authorship, peer review policies, copyright and patenting policy promotes security of intellectual property and gives confidence for collaborations. Ethical research outlines standard guidelines for institutions and professionals for their behavior towards the specified goals and helps to develop the trust of community further promoting funding.

Ultrasound Guided Popliteal Nerve Block For Various Ankle & Foot Surgeries

Background: Ankle& foot surgeries are very common surgeries in various age groups like young & geriatric as well as in patients with comorbidities. Popliteal nerve block is one of multimodal Anaesthesia & analgesia for same. we have used ultrasound guided block to prevent complications &precise volume at a site for improving Characteristics of block. Aims of study: To study the technique of giving popliteal nerve blocks with ultrasonographic guidance and evaluate it in terms of: No of attempts, Time required for sensory and motor blockade, Quality of Intra operative analgesia, Duration for post-operative analgesia, Supplementation required in form of sedo analgesia/general anaesthesia & Complications encountered. Methods: We performed ultrasonography guided popliteal nerve block in 60 adult patients of ASA grade I/II/III undergoing foot and ankle surgeries. The volume of drug used was 20ml consisting of Lignocaine (1.5%) 10ml and Bupivacaine (0.5%) 10ml; Results: The mean time taken to conduct the block was 4.3±1.4 mins. The mean time taken for sensory onset was 3.8±1.1 mins. The mean time taken for motor onset was 7.0± 1.4 mins. The mean time taken for completing the surgery was 39.2±5.0 mins. The mean time taken for complete motor regression was 143.8±13.5 mins. The mean time taken for complete sensory regression was 184.8± 16.8 mins. The patients first complained of pain at the mean time of 239±22.4 mins. The patients have stable haemodynamic parameters: pulse rate, SBP, DBP throughout the operation. Failure of block was seen in 4 patients where supplementation in the form of Injection Midazolam 1mg IV and Injection Fentanyl 50microgm IV was given in 2 patients and general anaesthesia was given in 2 patients. No other neurological complications were noticed in our study. Conclusion: ultrasound guided Popliteal nerve block is safe& effective block for various ankle &foot surgeries.

To Compare 0.25% Ropivacaine And 0.25% Bupivacaine In Tap Block For Postoperative Analgesia In Patients Undergoing Abdominal Surgeries.

INTRODUCTION Pain has been defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.1 Pain is the most dreaded problem which a person fears after any surgery. The transversus abdominis plane (TAP) block is an anaesthesia technique that provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall.4 Since the thoracolumbar nerves originating from the T6 to L1 spinal roots run into this plane and supply sensory nerves to the anterolateral abdominal wall5, the local anaesthetic spread in this plane can block the neural afferents and provide analgesia to the anterolateral abdominal wall. AIM AND OBJECTIVES Aim of study was to compare 0.25% Ropivacaine and 0.25% Bupivacaine in TAP block for postoperative analgesia in patients undergoing Abdominal Surgeries. The following parameters were compared: A. To study the effectiveness of transverses abdominis plane block for post-operative analgesia in Abdominal Surgeries. B. To compare the duration of analgesia and its effectiveness conferred by 0.25% Ropivacaine and 0.25% Bupivacaine. C. Total requirement of rescue analgesia. D. To watch for occurrence of side effects, if any MATERIALS AND METHODS A comparative clinical study was carried out on 60 adult patients belonging to ASA grade I or II, scheduled for elective Abdominal Surgeries. All patients were administered spinal anaesthesia with bupivacaine heavy 0.5%, 2.0-4.0 ml with 25 G spinal needle at L2-L3 or L3-L4 vertebral interspace. The patients were randomly allocated in two groups and study drug was injected at the end of surgery according to the group. The volume of administered drug kept constant (20 ml). Group I: Patients received TAP BLOCK on each side with 10ml 0.25% Ropivacaine. Group II: Patients received TAP BLOCK on each side with 10ml 0.25% Bupivacaine. CONCLUSION Transversus Abdominis Plane Block (TAP Block) provides better postoperative analgesia in various abdominal surgeries. 0.25% ropivacaine and 0.25% bupivacaine are equally effective in TAP block and provides effective postoperative analgesia but ropivacaine group shown longer duration of action compared to bupivacaine which was statistically significant without causing any increased adverse effects.

A Comparative Study Of Lateral Anal Sphincterotomy Versus Transfissure Sphincterotomy In Cases Of Fissure In Ano

OBJECTIVE The present study is designed to compare the effect of two most commonly used surgical procedure for anal fissure: Lateral Anal Sphincterotomy and Trans fissure Sphincterotomy with regards to fissure healing time, pain reduction, cessation of bleeding per rectum post operatively as well as the complications like flatus and feces incontinence post operatively in both surgical procedures. METHODOLOGY This hospital based prospective cohort study was undertaken at GCS hospital Ahmedabad (tertiary care hospital) from March 2019 to December 2019. 50 patients were enrolled in the study from which 25 patients were randomly assigned to lateral anal sphincterotomy group and 25 were assigned to trans fissure sphincterotomy group. RESULTS Our study establishes that although there is no statistically significant difference in pain alleviation and relief from bleeding per rectum post operatively in anal fissure between the Lateral Anal Sphincterotomy and Trans fissure Sphincterotomy, yet the fissure healing is earlier in Lateral Anal Sphincterotomy than in Trans fissure Sphincterotomy. There is also slight predominance of flatus incontinence rate in Trans fissure Sphincterotomy group as compared to Lateral Anal Sphincterotomy. CONCLUSION Thus, we can conclude from over all study that the lateral anal sphincterotomy is far better than the trans fissure sphincterotomy for the treatment of the fissure in ano by looking at various perspectives in areas of postoperative outcome.

Analysis And Clinical Study Of Surgical Management And Outcome Of Blunt Abdominal Trauma

INTRODUCTION: Trauma during Road Traffic Accident is a major public health problem in all countries. It causes death, disability or both. 50% die immediately at the time of accident. 25% die in golden hour (4–6 hours) of trauma. 25% may die late during treatment period due to sepsis and complications. AIMS AND OBJECTIVES: 1)To study the impact of blunt abdominal trauma on abdominal solid organs like spleen, liver and hollow viscera like stomach and intestine along with various mode of injuries and their different type of management and their outcomes. MATERIALS AND METHODS: This is a prospective study of blunt abdominal injuries during the period from June 2019 to January 2021 in Sheth Lallubhai Gordhandas Municipal General Hospital, Ahmedabad. Number of cases studied is 60. Clinical Data of admitted patient were collected by their detail history after stabilizing the patient, clinical examination with appropriate investigations. RESULTS AND DISSCUSION: In our Study majority of the patients belonged to 21-30 years age group, followed by 31-40 years age group. 46 cases were males, with females accounting for only about 14 cases. 35 patients were operated and 25 patients were selected for non-operative management. Road traffic accident was responsible for 48% of blunt abdominal trauma cases, while fall from heights accounted for 18% of cases and blow with blunt object was responsible for 34% of injuries. Majority of the patients presented with abdominal pain (100%) and abdominal tenderness (76%). Average latent period was between 12-18 hours. Majority of patients (50%) were taken for surgery between 6-10 hours of latent period. Associated extra abdominal injuries were found in 27 cases. Apart from routine investigations, abdomen x ray was done in all patients. Ultrasound of abdomen was done in 53 cases. CT scan was done in 21 cases. CONCLUSION: Propper clinical examination and appropriate investigations helps in management of patient either operative or non-operative which leads successful treatment in these patients. Other associated injuries greatly influence the outcome in morbidity and mortality.