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Uma,Shree Balaji Medical College and Hospital | Ramanan,Shree Balaji Medical College and Hospital
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2014

A 5 year old female child admitted with history of inability to walk for the past 6 months and deformity of back since birth. Baby was investigated and diagnosed as congenital kyphoscoliosis with D5 hemi vertebra. She was posted for scoliosis corrective surgery. Important anaesthetic implications in scoliosis surgery are management of massive surgical blood loss, Physiological effects of different positioning of the patient, need for intra operative wake up test to assess the motor function, somato sensory evoked potential monitoring, pain relief & proper planning regarding postoperative ventilation strategies.


Shanthi B.,Shree Balaji Medical College and Hospital | Mary Chandrika A.,Shree Balaji Medical College and Hospital | Manjula Devi A.J.,Shree Balaji Medical College and Hospital
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2015

Methemoglobin is an oxidized metabolite of hemoglobin, and its normal physiologic level is (< 1%). Abnormality occurs as methemoglobin levels increase. Methemoglobinemia occurs when red blood cells (RBCs) contain methemoglobin at levels higher than 1%. This may be from congenital causes, increased synthesis, or decreased clearance, and acquired causes. Increased levels may also result from exposure to toxins that acutely affect redox reactions, increasing methemoglobin levels. A 49 year old male a known chronic kidney disease patient, whose blood sample sent for biochemical analysis showed dark brown (chocolate brown) serum. On analysis the patient found to have methemoglobinemia. His arterial methemoglobin level of 22%. Going into detailed history he was found to be using Inj.metaclopromide for gastroesophageal reflux, though it is rarely reported to cause methemoglobinemia in adults compared to infants. He was treated with dialysis, cautious use of methylene blue and his clinical symptoms improved and the methemoglobin level returned to normal within 24 hours. By analysing this case we discuss the clinical features, diagnosis, cause and treatment of acquired methemoglobinemia induced by metoclopramide.


Madhusudhan K.,Shree Balaji Medical College and Hospital
Biomedicine (India) | Year: 2012

Background: To study Sero-prevalence of Hepatitis B virus in multitransfused children with β -thalassemia in comparison with non transfused children and healthy controls. Thalassemic children fail to thrive, with growth and developmental retardation and suffer from microcytic hypochromic anemia. Since regular blood transfusions are given to maintain Hemoglobin at a safe level, these children are at a high risk of acquiring Hepatitis B virus through transfusions. The carrier rate of HBV being more than 5% in South East Asia,adds to the risk. Methods: Study group (Group 1)-consisted of children 2-13 years with β- thalassemia and received more than 5 transfusions .Matched control group (Group 2)-consisted of 30 children with β- thalassemia and no transfusion. Control group (Group 3)-consisted of 30 normal healthy children. Serum samples from all three groups were tested for various Sero- markers for HBV using commercial ELISA Kits and their positivity in relation to age and number of transfusions studied. Results: Study showed,20% of Group I and 13% of Group II were positive for HBsAg. The incidence in Group III was nil. Out of 15 HBsAg positive cases in Group I, 4 were positive for HBeAg and 6 for anti-HBe; out of 4 HBsAg positive cases in Group II,1 was positive for HBeAg and 2 for anti-Hbe. In group I, it was found that HBsAg and anti-HBc were positive in 20% and 49% cases respectively and 17% were found to have combined positivity. In Group II, it was found that HBsAg and anti-HBc were positive in 13% and 27% respectively and 7% were found positive for both markers. In group III, none were positive for both markers. Study also showed, a significant increase in positivity of HBV markers in relation to age and no significant difference with number of transfusions received. Conclusion: This observation is of great concern as these children are at a risk of developing chronic hepatitis, cirrhosis and hepatocellular carcinoma, later in life. Since vaccination against Hepatitis B virus is available, all children with blood disorders who need transfusion therapies should receive the vaccine prophylactically before starting treatment. Highly sensitive and specific screening methods of donor blood for HBV including anti-HBc screening and DNA PCR testing should be included to ensure recipients safety, from transfusion transmitted HBV infection.

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