High resolution C.T. cisternography with water-soluble contrast media was performed in eight patients with C.S.F. rhinorrhea and suspected C.S.F. fistula. This technique, aided by video fluoroscopy, proved successful in documenting the precise anatomical localisation of the fistulous track in all eight patients. Surgical exploration and correction was done in every case with confirmation of the radiological findings.
The human body is an amalgamation of many fundamental units put together. Amongst these hands have got a very distinct and important role. Injuries, diseases, and surgical interference therefore do much more harm than interfere with grip, touch, it expresses the personality itself. In disabilities of the Hands, the finest surgery and after care is more essential than in any other region of the body. JOSHI'S EXTERNAL STABILIZING SYSTEM, (JESS), provides a stable skeletal environment aiding rapid healing of soft tissue with establishment of microvascular circulation, immediate active and passive mobilization of the uninjured adjacent joints. It allows management and care of soft tissue injuries without disturbing the fracture site in compound injuries, which is not possible using other methods. AIMS AND OBJECTIVES: Evaluation of the role of Dr Joshi's external fixator in management of complex and compound mutilating injuries of hands and forearm. MATERIALS & METHODS: 40 cases of injuries of hand and forearm attending Orthopaedic OPD and Emergency Department of Orthopedics, M.L.B. Medical College, Jhansi between feb 2010 to feb 2012 were treated by Joshi's external stabilizing system. The patients were followed at regular interval and the results were evaluated clinically and radiographically. CRITERIA FOR SELECTION OF PATIENTS: All the patients of open/closed fractures of metacarpals and phalanges of hand irrespective of age and sex willing to undergo this procedure were selected with permission of ethical committee of medical college. PREOPERATIVE ASSESSMENT OF HAND: Done with 1. History 2. Routine investigations Results will be evaluated on the criteria's laid down:
BACKGROUND: Laparoscopic cholecystectomy is a relatively new surgical procedure which is enjoying ever increasing popularity and presenting new anesthetic challenges. Volatile anesthetics play an important role in the management of haemodynamic changes due to CO2 pneumoperitoneum during laparoscopic surgeries. The aim of the study is to evaluate Isoflurane Vs Halothane as an adjunct to obtund haemodynamic response due to CO2 pneumoperitoneum. MATERIALS & METHODS: 50 patients aged 20-60 yrs of either sex belonging to ASA grade I & II scheduled for elective laparoscopic cholecystectomy admitted in MLB Medical College, Jhansi were randomly divided into two group. Group I-O2: N2O + Inhalational agent (Isoflurane 1.5-2%) Group II-O2: N2O + Inhalational agent (Halothane 1.5-2%) RESULTS : Hypertensive response due to CO2 pneumoperitoneum was well suppressed by Isoflurane (1.5-2%) {Group-I} which maintained pulse rate at a relatively higher side than halothane, (1.5-2%){Group II} decreased mean arterial pressure more significantly than halothane without any difference in arterial oxygen saturation (SPO2) and end tidal CO2 concentration (ETCO2). CONCLUSION: This can be concluded from the study that Isoflurane (Group-I) more effectively attenuated the haemodynamic response due to CO2 pneumoperitoneum during laparoscopic cholecystectomy as compared to Halothane (Group-II) under balanced anesthetic technique.
BACKGROUND: Addition of α2 adrenergic agonists with local anaesthetics in bupivacaine spinal anaesthesia prolongs the duration of sensory and motor blockade and postoperative analgesia with minimal haemodynamic alterations. AIM AND OBJECTIVES: To compare and evaluate the efficacy of intravenous dexmedetomidine and clonidine as premedication on subarachnoid blockade duration, postoperative analgesia, and sedation score in patients undergoing lower limb orthopaedic surgeries in bupivacaine (0.5%) heavy intrathecal block.
MATERIALS AND METHODS:We carried out a prospective, randomized, double blind study in which 60 patients of ASA status I or II, scheduled for orthopaedic lower limb surgery under spinal anaesthesia, were randomly allocated into two groups of 30 each group A and group B. Group A received dexmedetomidine 0.5µg/kg IV and group B received clonidine 1µg/kg in 10 ml of normal saline intravenously as premedication over 10 min., before subarachnoid blockade with 3.0 ml. of 0.5% hyperbaric bupivacaine. Onset time and regression times of both sensory and motor blockade, haemodynamic parameters were recorded. Duration of postoperative analgesia and sedation score with adverse effects were also recorded. RESULTS: The sensory block level was higher (T5-T7) and earlier in onset (1.81±1.75min.) in dexmedetomidine group than clonidine with level (T6-T8) and onset (2.56±1.62min.). Dexmedetomidine also increased the onset (3.54±3.07min.) and duration (265.45±41.50min.) of motor block achieved as compared to clonidine. The Ramsay sedation score was also greater in dexmedetomidine group than clonidine group (P<0.0001).CONCLUSION: Single dose of premedication with intravenous dexmedetomidine is better than intravenous clonidine during bupivacaine spinal anaesthesia in orthopaedic lower limb surgeries for prolongation of sensory and motor blockade.
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