This study was undertaken to evaluate the effect of a bolus dose of dexmedetomidine on haemodynamic, recovery responses and airway reflexes during extubation. MATERIAL AND METHODSSixty patients aged 20-45 yrs. of either sex of ASA grade I/II scheduled for elective general surgical, ENT, orthopaedics and gynaecological surgeries were studied after randomisation into two groups; 5 minutes before anticipated end of surgery, group A and B received either dexmedetomidine 0.5 µg/kg or placebo (Saline) respectively intravenously over 2 minutes. Anaesthesia technique was standardised for both groups. Heart rate, systolic, diastolic, mean arterial pressures were recorded at the start of a bolus drug injection and thereafter 1, 2 and 3 minutes after injection during extubation; at 1, 3, 5 minutes after extubation for 15 minutes. Quality of extubation was evaluated immediately after extubation based on cough using a 5-point rating score. Postoperative sedation was evaluated on a 6-point scale (Ramsay sedation scale). Side effects like laryngospasm, bronchospasm, respiratory depression, desaturation, vomiting, hypotension, bradycardia and undue sedation were noted. RESULTSHeart rate, systolic, diastolic, mean arterial pressure were significantly lower in study group. Extubation quality score in majority of cases was score 1 in study group and score 3 in control group. Sedation score in most of the cases was 3 in study group and 2 in control group. Bradycardia and hypotension were more in study group. Vomiting incidence was comparable in both the groups. CONCLUSIONOur study concludes that single dose of dexmedetomidine 0.5 µg/kg administered 5 minutes before extubation attenuates the haemodynamic and airway reflexes during emergence from anaesthesia without causing undue sedation. KEYWORDSDexmedetomidine, Haemodynamic Responses, Airway Reflexes, Extubation. HOW TO CITE THIS ARTICLE:Vankayalapati SD, Ramsali MV, Dumpala S, et al. Effect of dexmedetomidine on haemodynamic and recovery responses during tracheal extubation: a randomized comparative study.
Background: Clinical training is a part of curriculum for the dental students. They are trained in dental procedures, where there is a chance of exposure to HIV infection. Hence this study was conducted with an objective to assess their knowledge, attitude to treat these patients.Methods: An institutional based study was carried out among 145 dental students at Malla Reddy Dental College for Women. A questionnaire with 29 questions on knowledge, attitude and willing to treat the HIV/AIDS patients which was already used in other study was adapted. Primary outcome- knowledge and attitude was measured in percentages, proportions using SPSS version 20 and Chi-square.Results: Total subjects who had good knowledge were 71 (48.9%) and 137(94.5%) viewed needle stick injury can transmit HIV virus. 138 (98.1%) agreed that it is their moral responsibility to treat HIV/AIDS patients and risk of HIV transmission is high, hence special precautions have to be followed to treat them. Positive attitude towards HIV/AIDS patients was reported among 129(89%) of students. Chi square test showed an association between knowledge and attitude among study subjects which was statistically significant at p <0.05 level.Conclusions: Active student’s collaboration for treatment compliance of HIV/AIDS patients should be directed towards comprehensive training in the dental colleges which forms a basis for provision of appropriate, optimal dental care improving oral health related quality of life in people living with HIV.
Background: An outbreak of fever with joint pains occurred at Proddutur village, Nalgonda District, Telangana state, India. Methods: We investigated the outbreak ; attempted to identify the agent, source, mode of disease transmission, study clinico-epidemiological factors and recommend control measures during the period 11 th-15 th , February 2014. A rapid fever survey was conducted by using pre-tested, pre-designed epidemiological case sheets. Seventeen serum samples were collected for laboratory analysis. Entomological survey was conducted to identify and study the vectors. Results: The outbreak was observed to be a seasonal disease which started on 12 th January, 2014 and continued till 18 th February, 2014. Out of the total population of 1365 in the village, 259 cases were identified to have chikungunya fever as per case definition. Overall attack rate was 19%. Maximum cases occurred (24.1%) in the age group of 21-30 years and the least (1.9%) in the age group of less than one year and greater than 70 years (2.8%). Proportion of cases of Chikungunya was higher in females (51.9%) compared with males (48.2%). Fever (100%) and Joint pains (92.6%) were the most common clinical manifestations; 61% had severe disability and needed family help to do daily normal activities. Out of seventeen serum samples sent for laboratory confirmation, 5, 2 and 2 were positive for Chikungunya, dengue and both Chikungunya and dengue together respectively. No mortality was reported. Conclusions: The occurrence of this outbreak stresses the need for carrying out continuous surveillance for vector borne diseases so that appropriate remedial measures are initiated.
Background: Overweight/obesity is a critical public health problem in both developed and developing nations, has nearly tripled since 1975. In 2016, more than 1.9 B were overweight and 650 M obese. Studies from different parts of India have reported a rise in prevalence of obesity (11 to 37.5%). To date, there are not many studies on the prevalence of obesity among medical students in India. Hence this study was conducted with an objective to assess the prevalence of overweight/obesity and its associated factors among young medical students.Methods: VI Semester MBBS students of the year 2013 batch of Malla Reddy Medical College for Women were interviewed in March and April 2016.Results: Out of 150 participants, 125 responded (83%). Overall prevalence of obesity/overweight was 45%. Mean age of the sample was 20 years (±0.75); more belonged to upper than lower strata (61.6% vs. 38.4%); 86.4% were from nuclear family, means better food and care. Chi-squared test revealed significant differences for age, higher socio-economic status, diet, physical inactivity and co-morbidities associated with obesity/overweight (p<0.05). There was significant positive correlation values between BMI and waist circumference at p<0.01 level. The correlation of BMI with waist circumference is (r=0.675).Conclusions: It is crucial to establish cost-effective strategies like promotion of healthy foods, introducing extra-curricular activities at institutional level, avoiding junk food are likely to have a major effect in reducing obesity among these young medicos. This would also enable them to maintain normal weights, avoid immediate and long-term complications associated with overweight/obesity.
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