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Naaz S.,UPRIMSR | Bandey J.,HIMSR | Ozair E.,JNMC | Asghar A.,UPRIMSR
Journal of Clinical and Diagnostic Research | Year: 2016

Background: Dexmedetomidine, a selective alpha2 adrenoceptor agonist, has been used as adjuvant to spinal anaesthesia. Aim: To find out the optimum dose of dexmedetomidine to be used in lower abdomen surgery intrathecally. Materials and Methods: This was a randomized, controlled, double blinded study which included adult ASA I and II patients. They were allocated into five groups (n=20). Patients allergic to drugs to be used in the study and those with co-existing neurological disorders, coagulopathies, cardiac diseases, obesity and hypertension were excluded. Groups were designed as 2.5ml hyperbaric bupivacaine with 0.5ml saline (Control) or 0.5ml dexmedetomidine: 5mcg (D1), 10mcg (D2), 15 mcg (D3) and 20mcg (D4). Data were collected for 10 point VRS for pain, Bromage motor block, Ramsay sedation score, haemodynamics, time of first rescue analgesia (TRA) and any adverse effects and groups were analysed using one way analysis of variance (ANOVA) by SPSS16.0 (p-value <0.05 significant). Results: The mean duration of analgesia and need of first rescue analgesics are 201.5±29.1 mins in control group but in D1 group 259.1±15.2 mins, D2 310.7±48.1mins, D3 540.3±51.6 mins and D4 702.4±52 mins. p=0.003. The mean highest VRS score along with analgesic requirements were significantly reduced in dexemeditomidine groups, but D3 and D4 had hypotension which needed correction. Conclusion: Weighing the prolongation of anesthesia and analgesia and side effects we conclude that 10 mcg of dexmedetomidine is optimum intrathecal dose. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.

Uma B.,AIIMS | Kochhar A.,HIMSR
Indian Journal of Anaesthesia | Year: 2016

Purple glove syndrome (PGS) is a devastating complication of intravenous (IV) phenytoin administration. Anaesthetic management during the amputation of the limb for such patients is very challenging due to limited clinical experience. A 65-year-old woman developed PGS of left upper extremity after IV administration of phenytoin following generalised tonic-clonic seizures. The condition progressed rapidly leading to gangrene of left hand extending to the mid arm. Amputation was carried out under general anaesthesia with a supraglottic airway device. We discuss the prevention and alternate managements in PGS, which is a rare clinical entity with limited data in the literature. © 2016 Indian Journal of Anaesthesia.

Shobitha M.,HIMSR | Agarwal J.L.,Saraswati Institute of Medical science | Sadh K.,Saraswati Institute of Medical science
Indian Journal of Public Health Research and Development | Year: 2015

Introduction: Meditation is described as a family of self-regulation practices that focus on training attention and awareness in order to foster general mental well-being.1 Dynamic meditation is an awareness based meditation2, 3 Objective: 1. To evaluate the effect of dynamic meditation for 15 days on electroencephalographic wave patterns of healthy subjects. 2. To evaluate the effect of dynamic meditation for 15 days on blood pressure, heart rate and respiratory rate. Methodology: Electroencephalogram, electrocardiogram, blood pressure (BP) and respiratory rate were recorded before and after the practice of dynamic meditation for 15 days in 45 healthy subjects Results: After 15 days of sessions in dynamic meditation the subjects showed slow wave electroencephalographic patterns of high voltage theta and high voltage alpha waves. Resting heart rate, blood pressure and respiratory rate were reduced significantly (table1). Conclusion: Dynamic meditation is beneficial in improving the cardiorespiratory functions and produces high voltage slow wave electroencephalographic patterns indicating mind relaxation irrespective of gender. © 2015 Indian Journal of Public Health Research & Development. All Rights Reserved.

Husain M.,HIMSR | Hajini F.F.,HIMSR | Ganguly P.,HIMSR | Bukhari S.,HIMSR
BMJ Case Reports | Year: 2013

Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring in approximately 1 in 2200-12 500 live births. It is considered to be extremely rare in adults and poses a diagnostic challenge. We present a case of a young man who was diagnosed as a case of congenital Bochdalek's hernia and underwent laparoscopic mesh repair. Copyright 2013 BMJ Publishing Group. All rights reserved.

Sujata J.,HIMSR | Rana S.,HIMSR | Sabina K.,HIMSR | Hassan M.J.,HIMSR | Zeeba S.J.,HIMSR
Journal of Clinical and Diagnostic Research | Year: 2013

Background: Gall bladder carcinoma accounts for 98% of all the gall bladder malignancies and it is the sixth most common malignancy of the gastrointestinal tract worldwide. The incidence of incidental gall bladder carcinoma which is diagnosed during or after a laparoscopic cholecystectomy is reported to be around 0.19-3.3% in the literature. Aim: This study was aimed at detecting the incidence of gall bladder carcinomas which were diagnosed incidentally during or after laparoscopic cholecystectomies which were done for gall stone disease and cholecystitis. Materials and Methods: We analyzed the medical records of patients with symptomatic gallstone disease and acute or chronic cholecystitis, who underwent laparoscopic cholecystectomies at the Hakeem Abdul Hameed Centenary Hospital during the period from January 2007 to June 2012. Results: A total of 622 laparoscopic cholecystectomies were performed at our institute during the study period of five and a half years. In 6 (0.96%) cases, incidental carcinomas of the gallbladder were discovered. Conclusion: A laparoscopic cholecystectomy which is performed for benign gall bladder disease rarely results in a diagnosis of unexpected gallbladder cancer. The microscopic examination of the specimens, with special attention to the depth of invasion, range of the mucosal spread and the lymphovascular involvement, is critical in diagnosing the incidental malignancies as well as for the subsequent management of the cases.

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