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Indore, India

Gurulingappa,MRMC | Aleem M.A.,MNR Medical College | Awati M.N.,MRMC | Adarsh S.,MRMC
Journal of Clinical and Diagnostic Research | Year: 2012

Background and objectives: Laryngoscopy and tracheal intubation is invariably associated with a reflex sympathetic pressor response resulting in elevated heart rate and blood pressures. This may prove detrimental in high risk patients. Objective of this study is to compare the effects of lignocaine and fentanyl in attenuation of this pressor response to laryngoscopy and tracheal intubation. Methods: Seventy five ASA I and II status normotensive patients scheduled for elective surgical procedures were selected randomly and divided into three groups of 25 each. All patients received premedication with pentazocine 0.05mg/kg i.v., atropine 0.01mg/ kg intramuscularly and midazolam 0.01mg/kg i.v. half an hour prior to induction. Induction of anesthesia was standardized for all patients who received, thiopentone 5 mg/kg i.v. and and were relaxed with succinylcholine 2mg/kg i.v. The first group received fentanyl 4micrograms/kg i.v bolus, the second group received lignocaine 1.5mg i.v bolus and then third group received placebo (normal saline), 5 minutes before laryngoscopy and intubation. HR, systolic, diastolic blood pressure were recorded noninvasively one day priorly B, Before induction 0 postinduction, 1,2,3,4 and 5 minutes from the onset of laryngoscopy. Results: After intubation incidence of tachycardia (HR>100/min) was significantly greater in placebo and lignocaine group than in fentanyl group (p<0.05). Rise in SBP and DBP were also statistically significant in placebo and lignocaine group than in fentanyl group (p<0.05). Conclusion: Attenuation of pressor response is seen both with lignocaine and fentanyl. Of the two drugs fentanyl 4mgicrogram i.v. bolus provides a consistent, reliable and effective attenuation as compared to lignocaine 1.5mg/kg iv. bolus. Source


Reddy A.K.,GHR Micro Diagnostics | Brahmaiah U.,MNR Medical College | Narayen N.,Maxivision Eye Center | Reddy R.K.,Medivision Eye and Health Care Center | And 9 more authors.
International Ophthalmology | Year: 2013

To compare the blood agar (BA), sabouraud dextrose agar (SDA) and chocolate agar (CA) for the isolation of fungi in patients with mycotic keratitis. Corneal Scrapings of 229 patients with clinically diagnosed microbial keratitis were inoculated on BA, SDA, CA. The culture media were evaluated for the rate and time taken for the fungal growth. Seventy six of 229 patients had fungal keratitis. Fungus grew on BA in 60/76(78.9 %), on SDA in 76/76 (100 %), on CA in 40/76(52.6 %) patients. The fungi which grew on BA (60/76) also grown on SDA at the same time. The colony morphologies of different fungi were better on SDA than BA/CA. Among the different culture media, SDA is essential for the isolation fungi in patients with mycotic keratitis. © 2012 Springer Science+Business Media Dordrecht. Source


Mukhopadhyay B.K.,MNR Medical College
World Journal of Laparoscopic Surgery | Year: 2013

Knots are very important in the general and laparoscopic surgery. Knots are of two types, extracorporeal and intracorporeal. Intracorporeal knots are difficult while extracorporeal knots are comparatively easy to make, as we make it outside. This new knot (Dilip-Sarbani knot) is an extracorporeal knot. We shall take 20 cm length suture material of prolene, vicryl or catgut. Then we shall take three simple rounds in left index finger. Then we shall mark it as no 1, 2 and 3. Then we shall take no 1 over no 2 and again no 2 over no 3 and lastly no 3 over no 1. Then we shall pull it tightly. The knot is prepared. Finally push the above portion of knot to the target organ for making it tight. If we want to be more secure then we can give one more simple knot. This knot can be used in tubal ligation, in appendectomy or where tubular structure and stump ligation. Source


Patil T.B.,MNR Medical College | Paithankar M.M.,Government Medical College
Annals of Tropical Medicine and Public Health | Year: 2012

Aims: This study was aimed to study the clinical and radiological profile of neurocysticercosis and outcomes of treatment in neurocysticercosis. Settings and Design: A prospective observational study in a tertiary care hospital. Methods and Material: A total of 40 patients coming under definitive or probable diagnosis of neurocysticercosis as per the revised diagnostic criteria for neurocysticercosis were included in this study. Clinical history, physical examination, and neuroimaging (CT or MRI) studies were done at the beginning. Patients were treated with albendazole, corticosteroids, and antiepileptic drugs. They were followed up clinically for 3 months and neuroimaging study was repeated 3 months after albendazole therapy. Results: Definitive cases were 28 (70%) and probable cases were 12 (30%). Male: female ratio was 2.07. Mean age of 29.62 9.08 years. The commonest presentation was seizures in 38 (95%). Twenty-nine (72.5%) patients had a single lesion and 11 (27.5%) had multiple lesions in initial imaging study. Commonest site of lesion was parietal lobe (45%). Most common stage of presentation was colloidal (55%). Thirty-seven (92.5%) patients were free of seizures at the end of three months. At the end of 3 months, 23 (57.5%) patients had radiological resolution (Complete resolution + partial resolution + calcification). Conclusions: Neurocysticercosis usually affects young persons, mostly in third decade, being equally common among vegetarians. Most common clinical manifestation is seizures. Single lesion is more common than multiple lesions, commonly presenting in colloidal. Clinical and radiological response to 4-week therapy with albendazole is quite satisfactory. All cases of young-and adult-onset epilepsy in tropical countries should be investigated for neurocysticercosis. Source


Amane H.S.,SDM Medical College and Hospital | Burte N.P.,MNR Medical College
Indian Journal of Pharmacology | Year: 2011

Objective: To compare the efficacy and safety profile of dalteparin, a low-molecular-weight heparin with a standard unfractionated heparin in patients with unstable angina pectoris. Materials and Methods: This was a 6-month, prospective, parallel, randomized and open-labeled study. Patients of angina pectoris were randomized to receive either unfractionated heparin or dalteparin for 5 days. They were followed for 21 days during three visits on 1 st, 5 th and 21 st days. A series of resting electrocardiogram were undertaken in all patients on each visit. Results: The frequency of the combined clinical outcome of death, myocardial infarction and recurrence of angina was similar during 21 days of follow-up with either dalteparin or intravenous unfractionated heparin. In patients who received dalteparin 2.43% patients developed minor bleeding in the form of epistaxis and 2.5% patients who received unfractionated heparin developed minor bleeding in the form of macroscopic hematuria. Conclusion: Dalteparin is as effective and safe as unfractionated heparin in the treatment of unstable angina. Dalteparin does not require routine laboratory monitoring as with unfractionated heparin. Source

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