The scope of anesthesia has shifted from general anesthesia (GA) and spinal anesthesia (SA) for below-knee surgery to peripheral nerve blocks (PNB). Combined sciatic-femoral nerve block (SFNB) with ultrasound (USG) guidance can be a better format for use. ObjectivesThe primary objectives were to compare the duration of onset of sensory and motor blockade, total duration of sensory and motor blockade, and time of first analgesic requirement between both groups. MethodsA prospective, randomized comparative study was carried out at a tertiary care teaching hospital in Odisha, India, from April 2019 to April 2021 in the Department of Anaesthesiology. Patients admitted for elective below-knee surgeries with American Society of Anesthesiology (ASA) grade II or less were divided into two groups (Group A receiving USG-guided SFNB and group B receiving SA) by computer-generated sampling. The block randomization method was used to ensure equal samples in both groups. Data collection was done using the Magpi software (Magpi, Inc., Washington, D.C., United States) on android-based mobile phones. Data were analyzed using Stata Statistical Software: Release 12 (2011; StrataCorp LP, College Station, Texas, United States) for analysis. Relevant statistical tests were used to compare the results between the groups (independent sample t-test or Wilcoxson signed-rank test). Repeated measures ANOVA (RM-ANOVA) was used to check the hemodynamic stability within the groups. ResultsThirty-seven subjects were enrolled in each arm (Group A and Group B). Baseline parameters in both groups were comparable. The most common indication among the study subjects was single or multiple meta-tarsal fractures (20, 27.0%) followed by malleolus (15, 20.3%) and calcaneum fractures (13, 17.6%). Most of the study subjects were from ASA grade I (around 80%). The time of onset of sensory and motor block was found to be more for USG-guided SFNB (8.08±2.11 minutes and 11.35±1.84 minutes, respectively) as compared to the SA group (3.03±0.50 minutes and 4.89±0.52 minutes, respectively) (p<0.001). Total anesthesia and time to first analgesic requirement were, however, more in USG-guided SFNB (349.43±53.49 minutes and 339.73±54.24 minutes, respectively) as compared to the SA group (137.30±34.21 minutes and 137.30±34.21 minutes, respectively) (p<0.001). The mean time to first urination in USG-guided SFNB (178.92±20.92) was significantly less (p<0.001) compared to the SA group (419.19±40.30).There were no adverse events (0%) in USG-guided SFNB while 64.9% of the subjects in the SA group experienced adverse events (p<0.001). The most common adverse events were nausea/vomiting and hypotension (around 50% for both). Hemodynamic stability was present in both the groups of anesthesia subjects, though fluctuations in blood pressure may be seen more frequently in cases of SA. All the subjects in both the groups had achieved a Bromage score of 3 universally. The grand mean score of pain by SA (2.347±0.044) was more (p<0.001) in comparison to that in subjects with USG-gui...
Cytological investigations in forty-five species of Indian moths belonging to ten families (Tinaeidae, Limacodidae, Thyrididae, Pyralididae, Lasiocampidae, Saturnidae, Sphingidae, Noctuidae, Lymantriidae, Hypsidae) of Lepidoptera revealed haploid chromosome numbers varying from 12 to 31, the latter number being predominant (in 26 species). Their haploid chromosome numbers at metaphase I and II are stated in a table.
Congenital birth defects are major cause of poor health among infants affecting their survivability. Although such anomalies of the eyes are uncommon, the impact they have on the quality of life are more than significant. This study aimed to describe the clinical profile of congenital ocular anomalies with various epidemiological parameters in a tertiary health care center in western Orissa. The study screened 3674 patients, in the age group of 0 -14 years, who were delivered or attended the out-patient Department V.S.S. Medical College, Burla, Odisha and included 151 eyes of 99 cases of various types of congenital anomalies. Detailed history and other necessary data were collected by trained ophthalmologists and descriptive analyses performed. The incidence of congenital ocular anomalies was found to be 2.69%. Nasolacrimal duct anomalies (47 eyes) were the most frequently occurring congenital ocular anomaly (31.1%); followed by congenital cataract (41 cases; 27.3%) and coloboma eye (18 cases; 11.9%).There was a slight male preponderance, constituting 56.57% of the total cases. Majority of the patients were less than 5 years old (68 %) and the incidence of congenital ocular anomalies to be highest 11481 (68.69%) in the age group of 0 -5 years. Single eye involvement was seen in 47 cases (47.47%), whereas bilateral involvement was seen in 52 (52.53%) cases. History of consanguinity was found to be present in 13.13% of cases, with increased risk of bilateral involvement (84.6% cases). The most common presenting symptom was defective vision (38.4%), followed by watering from eyes (32.3%) and white pupillary reflex (14.1%). A total of 60 eyes (39.7%) required surgery. Congenital ocular anomalies are a common cause of ocular morbidity, comprising 2.7% of total cases in the paediatric age group. Early diagnosis, referral and appropriate intervention would help prevent majority of permanent sequelae in congenital ocular anomalies.
Background: Malaria is a major hindrance to economic development. It is caused due to infection with Plasmodium and transmitted to human by bite of female anopheles mosquito. Orissa contributes to about 20% of malaria cases to the national total, out of which 85% are P. falciparum cases. 40% of country's malarial deaths occur in the state. In Odisha out of 39,556 positive case and 9 deaths in year 2019. Material and Methods: This prospective case series study was conducted to understand the clinical profile of 60 complicated malaria cases presenting with jaundice out of 450 hospitalized patients diagnosed with acute severe malaria. All cases were treated with quinine dihydrochloride IV 600 mg 8 hourly for 3-4 days, then given orally for a total of 7 days. Results: In the present study forty five cases were males and 15 were females showing a male female ratio 3:1. Maximum cases around 39 (65%) belong to age group from 15-35 years. Fever was the presenting complaint in all cases in this study. The range of temperature varied between 100-103°F. Added to these the cerebral symptoms present in 24 (40%) cases would reasonably justify a clinical diagnosis of Falciparum infection.
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