Background and Aims: Perfusion index, which assesses perfusion dynamics is used as a non‑invasive method in spinal anesthesia cases to detect the occurrence of hypotension. A Perfusion Index value after which hypotension is common can be assessed. Methods: In this prospective double-blind observational study, 100 parturients were included. Baseline Perfusion Index was recorded and spinal anesthesia was carried out with Injection bupivacaine 0.5% (hyperbaric), 10 mg at L3 - L4 / L2 - L3 intervertebral space. Fall in Systolic Blood Pressure < 20 % of baseline was defined as hypotension. Chi-Square test and independent sample t-test was used for the statistical analysis. Spearman’s rank correlation coefficient was applied to assess the correlation between baseline PI and hypotension. The receiver operating characteristic (ROC) curve was mapped for PI and the occurrence of hypotension. Results: The occurrence of hypotension in parturients with PI < 4.25 was 40.9% compared to 94.6% in parturients with PI > 4.25. There was a remarkable association between baseline PI > 4.25, the number of episodes of hypotension 53/100 (p-value < 0.0001) and the total dose of phenylephrine used 53/100 (p-value 0.02). T
Background:To evaluate the role of EEG and Magnetic resonance imaging (MRI) in first episode of unprovoked afebrile seizure in a child. Subjects and Methods: Data was collected retrospectively from case records of patients admitted with seizures during the period between January 2016 to December 2018. All children with first episode of unprovoked afebrile seizure (1-15 years of age) were included in the study. Results: Case records of 108 patients with first episode of unprovoked afebrile seizures were reviewed . Out of these , 65 patients were investigated with MRI and EEG.54 children (83.1%)had generalized tonic clonic seizures(GTCS), 11 had partial seizures (16.9 %) . EEG abnormalities were seen in 21 children, predominantly in GTCS type. The most common EEG abnormality observed was sharp and spike wave discharges .7 children (10.7 %) had abnormal (MRI). The accuracy of MRI detecting the abnormality when EEG was abnormal was 33.3 % (p < 0.05). Conclusion: This study illustrates that routine neuroimaging for all children with first episode of unprovoked afebrile seizures is gratuitous. Neuroimaging can be reserved for those patients with recurrence of seizures or those children with clinical findings suggestive of intracranial pathologies.
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