Inhalational anesthetics have been used to induce and maintain general anaesthesia for more than 150 years. These anaesthetic agents are commonly used in the surgical and clinical practice solely and as a conjugant with other anaesthetics. Since inhalational anaesthetic agents develop amnesia, loss of awareness, and reduce reactions to painful surgical stimuli, they are an essential part of general anaesthesia. The choice of anaesthetic agent is based on the procedure's duration and type, patient characteristics, the attending anaesthesiologist’s preferences, and occasionally on institutional protocols. These medications are administered to the patient through the anesthetic circuit using a special vaporizer. The purpose of this research is to review the available information about inhalation anaesthetics: types, mechanism of action and adverse effects. Nitrous oxide is one of the earliest anaesthetic agents while isoflurane, sevoflurane, and desflurane are three commonly used inhalational anaesthetics. The low-solubility inhalation anaesthetics desflurane and sevoflurane have several clinical advantages over isoflurane, including rapid induction and faster recovery after prolonged treatment. However, isoflurane can sometimes be used effectively enough to match the induction and recovery times of other drugs. Inhalation anaesthetics work by suppressing inhibitory signals such as chloride channels and potassium channels and enhancing excitatory signals such as acetylcholine, muscarinic and nicotinic receptors, glutamate and serotonin in the central nervous system. Certain side effects including nausea, vomiting, malignant hyperthermia, post-operative cognitive impairment is associated with their use. More research is needed to further enhance the safety profile of available inhalation anaesthetics and can further lead to discovery of new, safe anaesthetics.
Gastric carcinoma is considered one of the most aggressive malignancies that is related to the late discovery of the disease. Feature of the disease is usually non-specific and can be misleading. Diagnosis is mainly depending on endoscopic biopsy, after that many steps should be done to assess the extent of the disease. Treatment will purely rely on the stage, since early disease is completely different from the metastasis one. The Medline, Pubmed, Embase, NCBI, and Cochrane databases were searched for studies of patients who developed gastric carcinoma symptoms. In regards to the inclusion criteria, the articles were selected based on the inclusion of one of the following topics: gastric carcinoma recent diagnosis and treatment. All other articles that did not have one of these topics as their primary endpoint were the exclusion criteria. The incidence, etiology, and management options were analyzed. Gastric carcinoma is a very wide topic, many aspects still unclear about it, and many needs more works to improve the outcome of the patient.
Background: Uncontrolled diabetes can cause many microvascular complications. Thus, early detection and appropriate treatment are essential to prevent diabetes complications that may cause disability and death. The main aim of the study is to test the effectiveness of a one stop screening clinic for retinopathy, nephropathy, and neuropathy for people with diabetes. Methods:A cross-sectional observational study, the study was done during a period of 3 months from February to March 2019. We used convenience sampling to select participants who attended the screening clinic of the Diabetes Care Center at King Salman Hospital, Riyadh, Saudi Arabia. A total of 260 diabetic patients participated in the study. Results:The study included 260 participants, around 61% were female participants. The mean age of the participants was 51 years. Most of the participants were type 2 diabetic patients (93.5%). Patients' acceptance and satisfaction rates of the one stop clinic were 100%. Non-proliferative diabetic retinopathy prevalence was 11%. Meanwhile, the prevalence of maculopathy was 1.5%. The prevalence of micro-albuminuria was 18.6% and macro-albuminuria was 1.9%. Also, the prevalence of chronic kidney disease stage 3 was 4.2% and stage 4 was 0.4%. We found that neuropathic symptoms were present in 40.7% of the participants. The prevalence of diabetic peripheral neuropathy (DNP) according to the neuropathy disability score, which is our gold standard test was 13.8% and using 10-g monofilament test was 19.5%. Meanwhile, the prevalence of DNP according to DPN-check was 40.9%, and according to Sudoscan was 73%. Conclusion:Having one clinic that combines retinopathy, nephropathy, and neuropathy screening is possible. A one stop clinic is also highly accepted, reduces clinical visits, and can detect microvascular disease.
Background: Of all organ injuries, the two most commonly encountered blunt abdominal injuries to organs are the spleen and liver. Splenic injury is historically managed by urgent laparotomy and subsequent removal of the spleen. This puts patients at lifelong postoperative risk of infections, and prophylactic vaccinations. Objectives: To review the literature on recent updates on splenic injury diagnosis and management. Methodology: PubMed database was used for article selection, papers on organ blunt trauma were obtained on the topic of splenic injury, and reviewed. Review: An updated outlook on splenic injuries shows that not all patients require an urgent splenectomy. In fact, many patients today could be managed conservatively under the supervision of the surgical team. Only patients who deteriorated and become hemodynamically unstable would fit the criteria for surgical intervention.Conclusion: In conclusion, splenic trauma used to be historically managed through emergency splenectomy. With the advancement of radiological technology, especially the CT scan, this blunt abdominal injury can now be staged and treated accordingly. Generally, hemodynamically stable patients can be managed conservatively, while those who are hemodynamically unstable are referred for operative management or interventional radiology.
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.