Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem world wide especially in developing countries where large percentage of the population lack specialized medical care, suffer from malnutrition and live in poor hygienic environmental conditions. It has been a general view that the hearing loss increases with the size of the perforation, more so if it is in the posterio inferior quadrant. It was found that the maximum average loss occurred at 250 Hz. The hearing loss is less in small perforations (less than 2 mm diameter) then in larger ones; less in perforations touching the manubrium than in those away from it, and also less in perforations of the anterioinferior quadrant than in those on posterio-inferior quadrant. A normally functioning eustachian tube is also an essential physiologic requirement for a healthy middle ear and normal hearing.
Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem world wide especially in developing countries where large percentage of the population lack specialized medical care. With a large number of patients frequently undergoing tympanoplasty for tubotympanic type of CSOM, it's important to assess the severity of the disease and predict the outcome of the surgical management whenever done. A normally functioning eustachian tube is an equally essential physiologic requirement for a healthy middle ear and normal hearing. In this study we have used the middle ear risk index (MERI) developed by Kartush which generates a numeric indicator of the severity of the middle ear disease to stratify patient groups according to the severity of the disease and to evaluate the efficiency of MERI score in predicting the outcome of tympanoplasty.
Introduction: Laryngoscopy and endotracheal intubation are the two essential procedures when general anaesthesia is administered to a patient. Adverse responses in the cardiovascular, respiratory, and other physiological systems can be provoked due to the noxious stimuli produced by laryngoscopy and intubation.1 During general anaesthesia maintenance of airway and ventilation can be done in various ways. Aims & Objectives: To assess the superiority of video laryngoscopy over direct laryngoscopy using baseline parameters like heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure. Materials And Methods: Interventional, Randomized study. Operation theatre of Durgapur Steel Plant Hospital, Durgapur, West Bengal. Adult males and females, ASA physical Grade 1 and 2 patients, scheduled for elective surgeries, under General Anesthesia, requiring or tracheal intubation. 1 year. From February 2018 to February 2019. Result And Analysis:In Group-A (MDL), 28(56.0%) patients had MPG 1 and 22(44.0%) patients had MPG 2. In Group-B (KVVL), 29(58.0%) patients had MPG 1 and 21(42.0%) patients had MPG 2. Association of MPG vs. group was not statistically signicant (p=0.8399). In Group-A (MDL), the mean time taken for intubation (mean±s.d.) of patients was 34.5600 ± 2.3661. In Group-B (KVVL), the mean time taken for intubation (mean±s.d.) of patients was 20.4000 ± 1.7728. Distribution of mean time taken for intubation vs. group was statistically signicant (p<0.0001). Conclusion: Also, Kingvision video laryngoscope offered less intubation time and reduced hemodynamic responses in patients with ASA grade 1and 2 as compared to Macintosh laryngoscope. So further study can be done on patients with difcult airways (III-IV) and with different co morbidities (ASA 3,4, E) to evaluate whether using Kingvision video laryngoscope can be advantageous in reducing intubation time and obtunding hemodynamic responses to laryngoscopy and intubation.
INTRODUCTION: Laparoscopic cholecystectomy decreases postoperative pain, decreases the need for postoperative analgesia, returns the patient to full activity within 1 week (compared with 1 month after open cholecystectomy), discharged the day after surgery. This study was conducted to compare the uctuations in hemodynamic changes using different intra- abdominal pressures with CO2 in laparoscopic cholecystectomy. MATERIALS AND METHODS: Thisrandomised, prospective, interventional study was conducted in Durgapur Steel Plant Hospital, Durgapur, West Bengal from November 2018 to January 2020. In our study, we attempted to compare the uctuations in hemodynamic changes using different intra- abdominal pressures. Present study included 90 cases undergoing laparoscopic cholecystectomy who were randomly divided into 3 groups with different intra-abdominal pressures, maintained during surgical intervention by CO2 insufation. RESULT: Mean VAS score was 2.83 in group Aafter 6 hours of laparoscopic cholecystectomy which decreased to 2.13 and 0.07 by the end of 12 and 24 hours respectively. The mean VAS scores for group B and C were 5.87; 8.03, 4.33; 7.10 and 2.40; 5.93 at 6, 12 and 24 hours post laparoscopic cholecystectomy respectively. Mean VAS score was signicantly lower in group A as compared to group B and lower in group B as compared to group C respectively at all time intervals (p<0.01). CONCLUSION: Low intra-abdominal pressures during surgical intervention by CO2 insufation leads to better hemodynamic control, better pain management and decreased hospital stay. Present study thus recommends use of low pressure pneumoperitoneum in all cases undergoing laparoscopic cholecystectomy.
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