Aim: To assess adherence on recommended guidelines for pre-operative routine investigations in ASA grade 1 and 2 by anaesthesiologists. Study Design: Cross-sectional study Place and Duration of Study: Tertiary Care Hospitals in the Province of Sindh from 17th April 2019 to 17th October 2019. Methodology: One hundred anaesthesiologists were enrolled. The laboratory investigations of the patients which were ordered by anaesthesiologists according to ASA Grade I & II and surgical grade I & II depending upon the age (16-60). The investigations were classified into three categories Good, Acceptable and Poor depending upon adherence to NICE guidelines. Results: Sixty six (66%) were males and 34 (34%) were female and the median age was 31 (29-35). Only 16% were positive adherence to the NICE guidelines when ordering pre-operative routine investigations which falls under category of poor adherence while none of positive adherence fall under category of good or acceptable adherence. Traditionally, there is no recommended test for ASA I, surgery grades I & II and ASA II, surgery grade I, but the result indicates that several insignificant tests were requested in these classes. Conclusion: Preoperative biochemical testing is widely used and enhance the effectiveness of surgery but it should be cost effective in range of the patients. Keywords: Tertiary care hospitals, Adherence, Routine investigations, Guidelines
L-carnitine (L-car) is a trimethylated amino acid required for the transformation oflong chain free fatty acids into acylcarnitine and their subsequent transport into the mitochondrialmatrix. It enhances the fatty acid oxidation for energy thus delaying the skeletal muscle fatigue.Objectives: Objectives of this study were to determine effect of L-carnitine supplementation onskeletal muscle lactate after fatigue, to observe effect of L-carnitine supplementation on forceof contraction in skeletal muscle and to estimate the time to onset of fatigue after L-carnitinesupplementation. Animals & treatment: In control group, the rabbit sedated and soleusmuscle was excised, Homogenized and centrifuged. Supernatant collected, was mixed withreagents of lactate test kit. Absorbance of light was read with the help of spectrophotometerand readings were noted. In experimental group, L-carnitine was given in a dose of 80mg / kg.The period of administration was two weeks. Soleus muscle was excised after giving the lastdose of L-carnitine.Lactate level was measured by using lactate test kit (Randox®). Readings forlactate measurement were noted after fatigue in both groups. Results: Statistically significantresults (p <0.05) were found in all three variables. Data was analyzed by applying “t” test in IBMSPSS Statistics - 20 soft ware. Conclusion: L -carnitine delays the onset of fatigue of skeletalmuscle. This was the stated alternative hypothesis.
Objective: To determine the frequency of patients having adequate knowledge regarding anaesthesia and the role of anaesthesiologists. Study Design: Cross-sectional study. Place and Duration of Study: Department of Anaesthesiology & Critical Care, The Indus Hospital Karachi, Pakistan from 1stJanuary 2017 to 31stMarch 2018. Methodology: Patients presented to the preoperative anaesthesia clinic and or admitted in the hospital for elective surgeries. A pre-coded performa in national language (Urdu) was used for the evaluation of information regarding anaesthesia. Results: 95.1% had correct knowledge about general anaesthesia, 40.6% about local anaesthesia and 43.6% about regional anaesthesia. 71.8% replied that surgeon will determine whether patient is fit for surgery or not. 53% of the patients responded that surgeon will be responsible for the wellbeing of patients during surgery as compare to 36.1% according to whom anaesthetist is responsible for this. Conclusion: Poor understanding of anaesthesiologist’s role both inside and outside the operating room. Educational efforts should be continued, with the goal of alleviating general public’s knowledge regarding this life saving specialty. Keywords: Anaesthesia, Anaesthesiologist, Adequate knowledge
Objectives: To determine the prevalence of controlled diabetes in registereddiabetic patients with Hemoglobin A1c (HbA1c) ≤ 7 or Fasting blood Sugar ≤ 130 mg/dl inthree primary Health Care Centers of Al- Ameer Ahmad Sector of Makkah. Methods: This studywas a descriptive study (cross sectional) started from 20 June 2012 to 30 September 2012. ThePrimary Health Care Centers randomly selected were AL-Zahir, Al-Hindavia and Kudai Al- Hijra.The sample size calculated was 320 patients with confidence level of 95% and confidenceinterval of 5. The cut of values adjusted for all diabetes mellitus patients was, haemogloblin A1c( HBA1c) ≤ 7 or fasting blood sugar (FBS) ≤ 130 mg/dl .Hypertension values were set as 140/90 mm of Hg. Results: Overall the age range was 25 – 87 (62) years and a mean of +/- SDof 58.66 +/- 11.97. Out of 320 diabetic patients selected (152 only diabetes + 168 patients ofdiabetes with hypertension) 21.25 % have disease under control. Most effected age range ofuncontrolled diabetes was 45-74 years. HbA1c test for study year was not done in 83.43 %cases. The age and Gender difference in two groups were not significant, however the resultsof controlled and non-controlled diabetic patients in three Primary Health Care Centers wassignificant (P <0.05 ). Conclusions: Diabetes Control programme at the level of Primary HealthCenters showed a very low level of success in study groups. There is a need to reconsider thecontrol strategy.
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