No abstract

No abstract

Lack of awareness about isolated tubercular osteomyelitis of the sternum resulted in a delay in diagnosing the condition in an eleven-year-old girl who presented with a gradually increasing swelling over the sternum. Radiological, histological, and microbiological investigations helped diagnose the condition and the child responded well to antitubercular therapy (ATT) and surgical debridement. The report provides a brief description about the various management options available.

Background: Various adjuvants have been used with local anaesthetics in spinal anaesthesia for lower segment caesarean section (LSCS) to provide better haemodynamics & prolonged postoperative analgesia. The aim of this study was to compare onset & duration of sensory & motor block with haemodynamic stability of intrathecal ketamine and fentanyl added to Bupivacaine in spinal anaesthesia for two different group of patients posted for LSCS Method: Sixty patients of age between 18-35 years and ASA grade I and II were included and randomly divided in to two groups of 30 each. Group K received injection bupivacaine 10 mg with 10 mg Ketamine and Group F received injection Bupivacaine 10 mg with 12.5 mcg Fentanyl. The sensorimotor characteristics, haemodynamic parameters, neonatal outcome and side effects were noted and compared between two groups. Results: Group K showed higher sensory level (<0.05), rapid sensory (P<0.05) and motor (P<0.05) onsets, prolonged sensory (P<0.05) and motor (P<0.05) blocks as compared to group F.Hyperbaric bupivacaine-Ketamine had better haemodynamic stability and significantly reduced incidence of hypotension (P<0.05) and bradycardia (P<0.05). Apgar scores at 1 and 5 min were comparable in both groups (P = 0.2734 and 0.6731 respectively).Tachycardia was found in 16.66% cases in group K, whereas no patient developed tachycardia in group F. Conclusion:The combination of hyperbaric bupivacaine (0.5%) 10mg with ketamine (10mg) can be used as a safe and effective alternative to hyperbaric bupivacaine (0.5%) 10mg with fentanyl 12.5mcg for spinal anaesthesia in LSCS.

Background: Since many years, CT-scan of the temporal bone is a widely accepted investigation in preoperative evaluation of patients with cholesteatoma in the middle ear. Aim: To compare the preoperative HRCT findings with intraoperative findings in the patients with atticoantral CSOM Study design: Comparative cross-sectional study Setting: Department of ENT Sir Ganga Ram Hospital Lahore Duration: February 1st 2022 to January 31st 2023 Methods: After taking approval from board of studies, IRB & ASRB of FJMU, 50 patients fulfilling inclusion criteria were admitted in Department of ENT, Sir Ganga Ram Hospital Lahore. Firstly patients were seen in outdoor, history and otoscopy followed by examination under microscope was done, then the diagnosis of atticoantral CSOM was established. HRCT temporal bone of the cases diagnosed as atticoantral type CSOM was done. The patients were then admitted for mastoid exploration. Informed consent was obtained. Demographic information was recorded. HRCT temporal bone was reported by consultant radiologist from Department of Radiology, Sir Ganga Ram Hospital in all cases. Intraoperative findings like soft tissue mass, dural& sinus plate, ossicular status, status of semicircular canal, facial canal and scutum was noted and compared with the preoperative HRCT findings. Then the data was collected in accordance to patients Proforma. Results: The mean age of patients was 22.32±10.42 years. Among patients 56% were male and 44% were female. HRCT was closely in agreement with intraoperative findings for detection of soft tissues mass in middle ear [HRCT:92% & IOF: 100%], dural plates [HRCT:98% & IOF: 98%], Sigmoid sinus plates [HRCT:92% & IOF: 92%], erosion of malleus [HRCT:56% & IOF: 62%], Incus [HRCT:56% & IOF: 26%], stapes [HRCT:60% & IOF: 66%], ;lateral semicircular canal [HRCT:96% & IOF:96%], facial canal nerve [HRCT:96% & IOF: 94%] and scutum [HRCT:70% & IOF: 74%] respectively. This would be of great help to the otologists in anticipating the possible complications, developing treatment strategy, counseling the patient regarding the procedure and in taking consent about expected complications. Conclusion: In patients of atticoantral CSOM HRCT effectively helps in preoperative assessment of the site & extent of the disease process, Ossicular erosion and status of various important anatomical structure. Keywords: Preoperative, HRCT, Intraoperative, Atticoantral, CSOM, Mastoidectomy, Ossicular necrosis.

It is unknown whether social presence in internet-based MBA courses enhances students’ career success. This study examined general self-efficacy and goal orientation mediation models to determine what strengthens MBA students’ social presence and their career planning self-confidence. Data included 278 online MBA students in an AACSB-accredited college of business. The regression analyses demonstrated that perceived general self-efficacy and goal orientation related to students’ career planning self-confidence. The mediation analyses revealed that internet self-efficacy, perceived general self-efficacy, and goal orientation had an indirect mediating effect on social presence and career planning. Implications are offered for business communication educators.

No abstract

No abstract