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  • 1
    Online Resource
    Online Resource
    Anaesthetic Management of Post Polio Scoliotic Patient for Fracture Femur Reduction
    Rajiv Gandhi University of Health Sciences ; 2022
    In:  RGUHS Journal of Medical Sciences Vol. 12, No. 2 ( 2022)
    Details
    In: RGUHS Journal of Medical Sciences, Rajiv Gandhi University of Health Sciences, Vol. 12, No. 2 ( 2022)
    Abstract: Kyphoscoliosis in a patient posted for incidental surgery is a challenge not only due to the presence and consequences of the disease but also for the anaesthetic implications. Central neuraxial blocks may risk erratic spread of the local anaesthetic agents. Airway and restrictive lung disease may add to the challenges in long standing cases. We report anaesthetic management of 39-year-old male with fracture of mid shaft of left femur with alleged history of self-fall from tricycle bike which he had been using due to post-polio weakness of the lower limbs. He successfully underwent closed reduction with Titanium Elastic Nailing System TENS under spinal anaesthesia.
    Type of Medium: Online Resource
    ISSN: 2231-1947 , 2581-7248
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.26463/rjms.12_2
    DOI: 10.26463/rjms
    DOI: 10.26463/rjms.12_2_2
    Language: English
    Publisher: Rajiv Gandhi University of Health Sciences
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Study of Urinary Glycosaminoglycans among Essential Hypertensive Patients
    JCDR Research and Publications ; 2021
    In:  JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH ( 2021)
    Details
    In: JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, JCDR Research and Publications, ( 2021)
    Abstract: Introduction: Essential hypertension is a systemic disease which affects endothelial basement membrane. Changes in Glycosaminoglycans (GAG) distribution pattern on glomerular basement membrane has been noted in hypertension. Hence it seems likely that an increase excretion of GAG levels may be an indicator of reduction in renal function. The qualitative or quantitative determination of urinary GAGs may be of value and could constitute a non invasive marker to assess the renal damage in essential hypertension. Aim: Differential analysis of urinary GAGs in essential hypertensive patients. Materials and Methods: This analytical case-control observational study which was conducted from November 2014 to June 2016 in Department of Biochemistry, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India. The study group included 50 male patients with age group of 30-60 years, clinically diagnosed with essential hypertension. Control group included 50 healthy male individuals with age group of 30-60 years, blood donors visiting to hospital blood bank. Random urine sample was collected. Urine creatinine was estimated by Jaffe’s method, urine GAGs by Dimethyl methylene blue (DMMB) dye method and urine microalbumin by particle enhanced Turbidimetric inhibition immunoassay method. Correlation was tested with Spearman’s correlation coefficient. Level of significance was set for p-value 〈 0.05 with confidence interval of 95%. Results: In present study, urinary GAGs levels in essential hypertensive study group was 14.57±10.16 mg/dL and in control group was 10.09±6.04 mg/dL. Urinary GAGs levels in essential hypertensive group was significantly high (p-value=0.890) when compared with normotensive control group. But no statistical significant correlation was found between urine GAGs and urine microalbumin in hypertensive study group. Conclusion: Estimation of urine glycosaminoglycans in essential hypertensive patients is a simple, rapid and cost effective test which asseses the glomerular function. It can be used as one of the early marker for diagnosis of nephropathy before microalbuminuria sets in.
    Type of Medium: Online Resource
    ISSN: 2249-782X
    URL: Article
    DOI: 10.7860/JCDR/2021/51777.15695
    Language: Unknown
    Publisher: JCDR Research and Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2775283-5
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  • 3
    Online Resource
    Online Resource
    Efficacy of Prophylactic Norepinephrine and Phenylephrine Infusions against Spinal Hypotension during Lower Segment Caesarean Section- A Randomised Clinical Study
    JCDR Research and Publications ; 2023
    In:  JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH ( 2023)
    Details
    In: JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, JCDR Research and Publications, ( 2023)
    Abstract: Introduction: Hypotension after Subarachnoid Block (SAB) can affect mother and foetus and can be prevented by prophylactic use of vasopressors. Phenylephrine (PE) has been a popular and effective drug as prophylaxis against hypotension. Norepinephrine (NE) is recently tried for this purpose. Aim: To compare PE infusion with NE infusion prophylactically against SAB induced hypotension during Lower Segment Cesarean Section (LSCS). Materials and Methods: This randomised clinical study was conducted in the Department of Anaesthesiology at a Tertiary Care Hospital, Ballari, Karnataka, India. The duration of the study was 12 months, from December 2018 to November 2019. A total of 156 primigravida and multigravida with singleton term pregnancy, posted for caesarean section under SAB received prophylactic infusions of either NE 5 μg/minute (group NE) or PE 50 μg/minute (group PE) immediately after SAB till end of the surgery. The primary outcome of the study was to assess the incidence of hypotension. The secondary outcomes included incidence of nausea, vomiting, hypertension, tachycardia, bradycardia and the neonatal outcomes. Related categorical and numerical variables were subjected to suitable statistical tests and analysed using Statistical Package for Social Sciences (SPSS) version 20.0. Results: The mean age of the study participants of group NE was 24.47±2.52 years and group PE was 23.91±2.63 years, respectively. The age, parity and surgical duration was comparable between the groups. The incidence of hypotension was 17.9% in group NE and 26.8% in group PE (p-value=0.182). No significant differences in total doses of vasopressors used were noted. The incidence of bradycardia in group NE was 3.8% and 21.8% in the group PE (p=0.053). No adverse events or neonatal outcomes were observed. Conclusion: The incidence of hypotension and the total dose of vasopressors administered were similar in the two groups receiving prophylactic infusion doses (NE or PE). Incidence of bradycardia was greater in the parturients receiving PE infusion.
    Type of Medium: Online Resource
    ISSN: 2249-782X
    URL: Article
    DOI: 10.7860/JCDR/2023/64470.18138
    Language: Unknown
    Publisher: JCDR Research and Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2775283-5
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  • 4
    Online Resource
    Online Resource
    Efficacy of Apnoeic Oxygenation by Nasal Prongs in Preventing Desaturation during Airway Management in Infants Undergoing General Anaesthesia: A Randomised Controlled Study
    JCDR Research and Publications ; 2023
    In:  JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH ( 2023)
    Details
    In: JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, JCDR Research and Publications, ( 2023)
    Abstract: Introduction: Neonates and infants are more prone to desaturation during the apnoeic period of laryngoscopy and intubation. Various options exist to reduce this risk beyond conventional preoxygenation. Aim: To assess whether continuous apnoeic oxygenation via nasal prongs during intubation can extend the safe apnoea period compared to standard management with preoxygenation alone. Materials and Methods: A randomised controlled, two-group parallel clinical study was conducted at the Department of Anaesthesiology, Vijayanagar Institute of Medical Sciences, Ballari, Karnataka, India, from July 2019 to November 2020. The study involved 63 infants aged one day to six months undergoing elective or emergency surgeries under general anaesthesia. Preoxygenation via a mask was followed by sevoflurane induction and vecuronium-induced muscle relaxation. Conventional laryngoscopy and intubation were performed in 32 infants in Group-C (Control group), while 31 infants in Group-O (Apnoeic Oxygenation group) also received oxygen (O2 ) via nasal prongs at 4 L/min in addition to preoxygenation. The primary outcome parameter was the time taken for desaturation by 1%. The time taken to desaturate by 2%, 3%, 4%, and 5%, as well as their incidences, lowest observed saturation, safe apnoea period, and Heart Rate (HR) trends, were also noted. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0 and OpenEpi version 3.01. Results: Demographic and clinical parameters were comparable between the groups. The mean time for 1% desaturation was 18.33±4.3 seconds in Group-C, while all Group-O cases maintained 100% saturation during the study period. No significant difference was found in the safe apnoea period between the groups (p=0.503). The average lowest O2 saturation observed in Group-C was 98.81±1.28%, while it was 100% in Group-O. Only one infant in Group-C showed desaturation down to 95%. Both groups exhibited similar HR trends. Conclusion: Apnoeic oxygenation by nasal prongs in healthy infants helps prolong the time to desaturation and can be beneficial for those at risk of desaturation and hypoxia.
    Type of Medium: Online Resource
    ISSN: 2249-782X
    URL: Article
    DOI: 10.7860/JCDR/2023/65714.18381
    Language: Unknown
    Publisher: JCDR Research and Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2775283-5
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