Background: Transverses abdominis plane (TAP) block is a new regional anaesthetic technique for postoperative analgesia in abdominal surgeries, as a part of multimodal analgesia. We evaluated effect of two different doses of clonidine as an adjunct in TAP block in patients underwent unilateral inguinal hernioplasty. Methods: Sixty adult patients undergoing unilateral inguinal hernioplasty were randomized into two groups, Group A (n=30) received bilateral TAP block with bupivacaine 0.25% 38cc + clonidine (1cc) 150 microgram +1cc NS=40cc, Group B (n=30) received bupivacaine 0.25% 38cc+clonidine (2cc) 300 microgram=40cc, at the end of surgery. The postoperative pain was evaluated by visual analog score (VAS) for pain scoring at 2, 4, 6, 12 and at 24 hours. Subjective assessment of duration of analgesia was done. Results: The VAS score in patients who received clonidine 300 microgram Group B as an adjunct was significantly lower than who received 150 microgram Group A. Duration of analgesia was longer in Group B. 2 patients in Group B showed bradycardia treated with atropine. Sedation score was lesser in Group A. Conclusions: Clonidine showed dose dependant analgesia and adverse effect in TAP block for postoperative analgesia. Higher doses of clonidine may be used as an adjunct in TAP block.
Background: Peritonitis is a common emergency encountered by surgeons the world over. Despite a better understanding of pathophysiology, advances in diagnosis, surgery, antimicrobial therapy and intensive care support, peritonitis remains a potentially fatal affliction. Intra-abdominal sepsis is important causes of mortality and morbidity. The treatment is based on rapid fluid resuscitation, initiation of antibiotic therapy and surgical intervention. The antibiotic chosen must cover the most frequently expected bacterial species depending upon the site of perforation. Objectives of the study was done to identify the type of organism present in bowel perforation and their sensitivity pattern to different antibiotics. A guideline will be framed for advising antibiotics to be used for different kinds of perforation.Methods: This was a prospective study of one year on 50 patients of secondary peritonitis due to bowel perforation, conducted in Amaltas institute of Medical Sciences, Dewas.Results: This study included 50 patients with an average age of 36 years (range: 3 days-75 years). There were 40 males and 10 females. The mean duration of hospitalization was 10.6 days (range: 3-25 days) with predominant site of perforation was ileum. E. coli emerged as main pathogenic microbe even in site specific culture, was closely followed by Klebsiella. A combination of third generation cephalosporins with sulbactam and metronidazole has been the most promising therapy to treat secondary bacterial peritonitis due to bowel perforation. It needs to be emphasized that although the sensitivity studies reveal an edge for meropenem over cefaperazone sulbactam, yet the preference of cephalosporin with sulbactam over meropenem is justified, considering the economic constraints and with a suitable foresight, to keep meropenem as a reserve drug because trends indicate that our microbes are fast becoming resistant to the promising combination of third generation cephalosporin with sulbactam and metronidazole.Conclusions: This study suggests that the current recommended empirical antibiotics need to be reassessed.
Background: Acute Appendicitis forms an important emergency in the day-to-day surgical practice. It affects human beings irrespective of age, nationality and religion. Early diagnosis and prompt operative intervention is the key for successful management of acute appendicitis. However, the picture of acute appendicitis may not be classical, and in such situations, a policy of early intervention to avoid perforation may lead to high negative appendicectomy rates.Methods: A total of 80 patients were enrolled in the present cross sectional study. Their ages ranged from eleven to 72 years (mean 32.89 ± 15.87). A proforma containing general information about the patient plus eight variables based on the modified Alvarado scoring system was filled.Results: Histological examination confirmed appendicitis in 54 patients (67.5%). The remaining 26 patients were found to have normal appendix giving a negative appendicectomy rate of 32.5% being 36.8% and 28.3% for males and females respectively.Conclusions: This scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis. MASS can be used effectively in Indian setup to reduce the incidence of negative appendectomies. The patients are not unduly exposed to risks of delay in intervention or significant increase in number of false negative cases.
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Hip fractures in older patients are associated with impaired mobility, excess morbidity and mortality, and loss of independence. This study was aimed at evaluating the outcome of hemiarthroplasty, by assessing the quality of life and degree of function in the operated limb.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Out of 30 patients treated in this manner, all cases were available for follow-up period of 6 months. Patients of age 60 years and above, diagnosed with fracture neck of femur, were included in the study</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Majority of patients belongs to age group 60-69 years was 56.7% Females were more common 56.7% than males in the present study. About 13.3% patients sustained the injury due to a fall from a height and 23.3% due to a road traffic accident. About 20 patients (60%) had a stay of less than 20 days in hospital. In our study Harris hip score, at end of six month ranged from 35 to 94.6. At final 6 months follow-up by Harris hip scoring system, 53.33% had excellent result, 33.3% had good results, 16.67% had fair results and 6.67% had poor results. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">We conclude that hemiarthroplasty for fracture neck of femur is a good option in elderly patients. The mortality and morbidity are not high, operative procedure is simple, complications are less disabling. Early functional results are satisfactory.</span></p>
A system that combines dispersive infrared micro-spectroscopic imaging and thermography has been developed to study the effect of thermal radiation on the infrared absorption spectra of prostate biopsy samples. The system allows the distribution of thermal signal intensity as a function of emissivity to be interpreted from the integrated absorbance obtained by spectroscopic imaging. Biochemical differences between cancer and benign areas within the specimens are identified in the spectra. Side-by-side comparison of H&E stained adjacent tissue sections with infrared images constructed before and after removal of thermal effect showed that the latter strongly support differentiation of regions within tissues. The use of spectral bands at discrete wavelengths significantly reduced spectral acquisition time, making this technique promising as a future clinical diagnostic tool. A systemic methodology was implemented to process the data, firstly by k-means clustering on the second derivative spectra without a priori knowledge, followed by PCA analysis. Four distinct regions within the tissue samples were successfully classified based on the antisymmetric stretching mode of methylene functional group. Separation between data in clusters occurs when projecting spectra on a PCA score plot on a plane made by first two PCs. The significance of the disparity was verified with statistical test.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.