bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract No.: ABS0601: Patient Safety Incidents in Neuro-Anaesthesia “ A Prospective Analysis Over a One Year Period
Authors: Gangakhedkar Gauri
Published: September 2024

Background & Aims:

Reporting critical incidents and near misses is an established method of improving patient safety; which allows implementation of changes to prevent similar incidents from re-occurring. Our study aimed at identifying and analysing patient safety incidents in the neurosurgical patients.

Methods:

We conducted a prospective observational record-based study of all the patients receiving anaesthesia in the Neurosurgery OT over a period of 1 year. Any patient safety incidents occurring in the peri-operative period were noted down by the qualified anaesthetist on the table, which was recorded by the anaesthetists anonymously. Using a secondary database collection method, data already recorded in Anaesthesia register and the perioperative anaesthesia record was used to assess the validity of that data which was be confirmed by critical review.

Results:

1901 individuals received anaesthesia for neurosurgical procedures. Incidence of patient safety events was 24.14% (478). 22.59% (108) were near miss events. The incidence of patient safety incidents was the highest during “positioning”™ 19.66% (94). 76.15% (364) incidents were labelled as potentially preventable, 65.34% (312) were anticipated incidents. 68 patients recovered with deficit, 5 were successfully resuscitated, and 3 deaths were reported. A few uncommon incidents were also noted.

Conclusion:

Incidence of critical incidents was almost one for every four patients. The proportion of reported near misses was much lowerthan adverse events. The audit helped us establish policy guidelines in our institution and institute Patient safety training to promote voluntary reporting.
Abstract No.: ABS0738: Comparison of Analgesic Effect of Ropivacaine Versus Ropivacaine with Dexmedetomidine Used for Caudal Epidural Block in Patients Undergoing Lumbosacral Spine Surgery Under General Anaesthesia; A Randomised Double Blind Interventional Study
Authors: Kaur Kirandeep
Published: September 2024

Background & Aims:

Challenging aspect of spine surgery is to provide extended postop analgesia.In this study we aimed to determine the analgesic effects of Dexmedetomidine as an adjuvant to Ropivacaine versus Ropivacaine alone for caudal epidural block in patients undergoing lumbosacral spine surgery under general anaesthesia.

Methods:

Hospital based, prospective, randomized double blind interventional study. A sample of 30 cases in each group was adequateat 95% confidence and 80% power to verify the expected minimum difference of 0.8(Â±0.7) in VAS score at 8 hourspostoperative period in both groups. Patients were divided in two groups.Group A: (n=30):patients received 18 ml of 0.2% Inj. ropivacaine with 2 ml of normal saline in caudal epidural space.Group B: (n=30): patient received 18 ml of 0.2% Inj. ropivacaine with 2 mL (1 µg/kg) of Inj. dexmedetomidine in caudal epidural space.

Results:

There were no statistically significant difference observed with respect to demographic data (age, sex, weight), ASA, haemodynamic parameters, sedation and side effects in both groups.The time to first rescue analgesia was significantly prolonged(hours) (mean±SD) in Group B (25.00±4.33) as compared to Group A (15.13±1.74) with P value <0.001. Mean VAS scores were significantly lower in Group B as compared to Group A at 4,8 and 12 hours postoperatively with P value <0.001

Conclusion:

Inj. Dexmedetomidine 1 µg/kg added to 0.2% ropivacaine provided longer postoperative analgesia than 0.2% ropivacaine alone.Hence we concluded that Dexmedetomidine is an effective analgesic as an adjuvant to 0.2% ropivacaine in caudal epidural block

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Abstract No.: ABS1042: A Randomised Controlled Trial To Compare The Occurrence Of Postoperative Nausea And Vomiting In Early Versus Conventional Feeding In Children Undergoing Day Care Surgery Under General Anaesthesia
Authors: HULIGERI H SANTOSHKUMAR
Published: September 2024

Background & Aims:

Practice of postoperative fasting of 4-6 hours in children has no specific evidence. We planned this study to assess postoperative nausea vomiting (PONV) with early oral feeding as compared to conventional feeding in children undergoing day care surgery under general anaesthesia (GA)

Methods:

This was a randomised controlled trial, conducted after approval by Institutional Ethical Committee, registered in Clinical TrialsRegistry of India (CTRI No - CTRI/2020/01/022789). Three hundred children were randomised into group of early feeding (EF, n=150) or conventional feeding (CF, n=150). Standardised general anaesthesia was induced. Postoperatively, group EF received carbohydrate feed on demand, group CF received feed after 4-6 hours. Maximum feed given was 10 ml/kg body weight. Time, volume of first postoperative feed, incidence of PONV, postoperative pain [by Face,Legs,Activity,Cry,Consolability (FLACC Score)after the first feed, complications and parents satisfaction were recorded.

Results:

Time to first postoperative feed was 64.87 minutes in group EF and 273.28 minutes in group CF (p < 0.001). Incidence of PONV was comparable (EF vs CF = 12% vs 18.7%, p = 0.109). Difference in mean FLACC score were significant at 0 minutes, 30 minutes and 1 hour (p <0.001). Group EF had significantly shorter hospital stay (7.31 vs 11.13 hours, p =<0.001) and significantly better parental satisfaction score (p <0.001

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Conclusion:

Early postoperative feeding in children is safe and does not increase the incidence of PONV as compared to conventionalfeeding and is associated with shorter duration of hospital stay and improved parental satisfaction.

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Abstract No.: ABS1180: A randomised comparative evaluation of ultrasound guided classical vs parasacral parallel shift (PSPS) technique of sciatic nerve block combined with femoral nerve block as a sole anaesthetic modality for orthopaedic lower limb surgeries
Authors: Nair Revathi
Published: September 2024

Background and Aims:

Sciatic nerve can be blocked in the gluteal region via anterior, posterior and a newly developed lateral/parasacral approach. Primary objective of the study was to compare success of sciatic nerve block using classical versus parasacral parallel shift approach (PSPS).

Methods:

This study was conducted in a tertiary medical college hospital from October 2020 to October 2021 after approval of Institutional Ethics Committee and written informed patient consent. Total 160 patients (80 in each group) aged 18-80 years with American Society of Anesthesiologists physical status I-III ,undergoing traumatic lower limb orthopaedic surgery were assessed for eligibility based on the inclusion and exclusion criteria. Ultrasonography was used for the blocks.

Results:

Successful block was administered in 98.61%(n=71) subjects via PSPS approach, compared to 90.27%(n=57) via classical approach(table1). Time between ultrasound localisation of nerve to drug administration was significantly higher with classical as compared to PSPS approach. Successful first needle pass was seen in 90.27%(n=65) of PSPS group compared to 45.54%(n=27) of classical group. Time to motor blockade was found to be 17.33+/-3.6 minutes with PSPS approach, significantly lower than classical (22+/-3.53 minutes) approach.

Conclusion:

Parasacral sciatic nerve block via PSPS approach is superior to classical approach in terms of time to administration of block, success of block, requirements of sedation intraoperatively, time to motor blockade and time to sensory blockade

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Abstract No.: ABS1786 : A prospective randomised double blinded conteolled study: impact of intrathecal magnesium sulfate as an adjuvant on perioperative shivering in parturients undergoing caeserean section
Authors: N Amulya
Published: September 2024

Background &Aims:

Incidence of shivering is 55% with neuraxial anaesthesia. It increases the metabolic rate by 400% ,with consequent oxygen consumption. This study was designed to assess the effectiveness of intrathecal magnesium sulphate as an adjuvant in preventing shivering in parturients undergoing caesarean section.

Methods:

After institutional ethical committee clearance, a prospective randomised double blinded study was conducted on 80 parturients of age 18-45 years of American Society of Anesthesiologists (ASA) grade II undergoing caesarean section. Parturients were randomised into two groups of 40 each by computer generated random numbers, allocation concealment was done by closed envelope technique, double blinding followed. Group M received 2ml 0.5% heavy bupivacaine+ 0.1ml 25mg MgSo4. Group P received 2ml 0.5% heavy bupivacaine + 0.1ml saline. Intraoperative Shivering score was assessed as primary outcome, Vital signs, temperature, sensory and motor blockade were recorded as secondary outcome, calculated using unpaired T test and chi square tests.

Results:

Overall incidence of shivering in Magnesium sulfate group was low, though during 10, 15, 20, 30, 40 minutes post spinal, it was statistically significant(p < 0.001%).

Core body temperature was significantly reduced in Magnesium sulfate group compared to the normal saline group30minutes post spinal (p <0.001%).

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Conclusion:

From the present study it can be concluded that Intrathecal Magnesium sulfate decrease the incidence and intensity of shivering during caesarean section under spinal anaesthesia, without having any serious side effects.
Abstract No.: ABS1828: A prospective randomised double blinded study to compare the analgesic efficacy of USG guided bilateral suprazygomatic maxillary nerve block(SMB) with 0.25% bupivacaineand 0.25% bupivacaine with dexmedetomidine in children undergoing cleft palate(CP)repair
Authors: S Prabavathi
Published: September 2024

Background & Aims:

The aim of this study was to assess the analgesic efficacy of dexmedetomidine as an additive to bupivacaine in childrenundergoing cleft palate (CP) repair with regional nerve block. OFC is one of the most common birth defects in India.

Methods:

Suprazygomatic maxillary nerve block (SMB) is a simple technique providing effective analgesia with decreased perioperative opioid consumption and complications. â€¢ 46 children fulfilling the inclusion criteria planned for CP repair with ultrasound guided (USG) SMB were randomised into Group A and B with comparable demographics and received 0.25% bupivacaine with saline and 0.25% bupivacaine with 1 µg/kg dexmedetomidine respectively. Postoperatively, pain was assessed by Children and Infants Postoperative Pain Scale (CHIPPS) score every 30 minutes for 2 hours and then every 2 hours until 24 hours. The pain control was considered insufficient if CHIPPS score was >3 for which Inj. fentanyl 0.5 µg/kg during first 2 hours and after 2 hours until 24 hours Inj. paracetamol 15 mg/kg were administered respectively and recorded.

Results:

The CHIPPS score was significantly lower in Group B than Group-A with p-value < 0.05. None of the children in Group-Brequired rescue fentanyl compared to 6 children in Group-A which was statistically significant (p value 0.032). 65.2% children in Group-A required rescue Paracetamol with more frequent administrations compared to only 26% in Group-B which wasstatistically significant (p value 0.048). No significant differences in haemodynamic parameters were noted between the groups intraoperatively.

Conclusion:

Dexmedetomidine when used as an adjuvant to 0.25% bupivacaine increased the duration of analgesia, reduced postoperative pain and need for rescue analgesics. It also provided stable haemodynamics throughout the intraoperative period with nil complications.

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Abstract No.: ABS1865: Effect of general anaesthesia and subarachnoid block on neutrophil to lymphocyte ratio (NLR) in paediatric patients undergoing infra-umbilical surgeries
Authors: Rahman Rushda
Published: September 2024

Background & Aims:

Neutrophil lymphocyte ratio (NLR) is a simple marker, of inflammatory response and physiological stress. Different systems are affected by the surgical stress and the anaesthetic method.

The aim of the study was to evaluate the effects of anaesthetic technique on neutrophil to lymphocyte ratio (NLR)

Methods:

After obtaining the institutional ethics committee approval and parental consent, a prospective randomised double-blinded study was conducted between October 2020 to January 2021, including 42,American Society of Anesthesiologists (ASA) class I and II patients, aged 3-12 years, scheduledfor infra-umbilical surgeries. The patients were divided randomly in two groups: group G (general anaesthesia) and group S (subarachnoid block) as per the standardised protocol. Differential count of leukocytes and NLR were obtained preoperatively (T0) and post-operatively at an interval of 6 hours (T6) and 24 hours (T24). The data analysis was done using Statistical Package for the Social Sciences (SPSS) 25.0. The independent t test was used to compare the ratio.

Results:

Baseline NLR(T0) was similar in both the groups. Mean in group G: 1.89Â±0.59 and in group S: 1.74Â±0.61, meandifference [ 95%CI] = 0.15 (-0.22-0.53), p < 0.42.Difference was statistically significant at T6. Mean in group G: 3.20Â±0.83 and in group S: 2.46Â±1.03, mean difference [95% CI] = 0.74(0.15-1.32), p < 0.014;

The difference became insignificant at T24. Mean in group G: 2.88Â±0.70 and in group S: 2.65Â±0.73, mean difference [95%CI] = 0.22 (-0.22-0.68), p < 0.303.

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Conclusion:

The demographic parameters were comparable between the groups. NLR was significantly higher in group G than in group S, postoperatively at 6 hours. However, at 24 hours postoperatively, the difference were insignificant.
Abstract No.: ABS2464 : Effect of propofol and isoflurane on immunoinflammatory profile of breast cancer patients undergoing modified radical mastectomy (MRM)
Authors: Das Deepanwita
Published: September 2024

Background & Aims:

Globally breast-cancer is the commonest female malignancy (24.5%) with surgery being the mainstay of management.). However both anaesthesia as well as surgery can have implications on metastasis as well as recurrence. The present study was a prospective-study aimed to compare immune-inflammatory response of isoflurane and propofol in breast-cancer.

Methods:

Peripheral blood-samples were collected [Pre (day before surgery), Intra (1 hour after incision), Post (48 hour postop)] to analyse immune-inflammatory markers. Total of 21 patients were randomised to receive either isoflurane (Iso; N,10) (in Isogroup, MAC 1) or propofol (Pro; N,11) (Pro group, with a target-controlled infusion of propofol, targeted at effect-site-concentration of 2-3 µg/mL) for maintenance of anaesthesia. All patients were induced with Injection thiopentone 3-5 mg/kg/intravenous titrated to loss of eyelash reflex and Injection fentanyl 2 mg/kg was used as analgesic. The trachea was intubated after muscle relaxation with Injection vecuronium 0.1mg/kg intravenous. All patients were reversed with neostigmine and glycopyrolate, Peripheral blood-samples were collected [Pre (day before surgery), Intra (1 hour after incision), Post (48 hour postop)] to analyse immune-inflammatory markers.

Results:

Analysis was done using advanced-statistics Mixed-Design ANOVA and power-analysis by G*Power. It was found that Propofol significantly upregulated both frequency (CD3-CD56+) and degranulation activity (CD3-CD56+CD107a+) of natural killer (NK)-cells than isoflurane(effect-size 0.164). Isoflurane significantly(p=0.006) suppressed helper-T-cells (Th, CD3+CD4+), aggravated CD4:CD8 greater than propofol. There was no significant difference on B-cells (CD3-CD19+), cytotoxic- cells (Tc, CD3+ CD8+), pro-inflammatory-mediators(IL-8, IFNï•¦, IL-6, TNFï•¡, IL-12, MMP-9) and anti-inflammatory-cytokines(IL-10). However, intra-operative and post-operative rise in IL-15 was significantly inhibited by propofol but not with isoflurane.

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Conclusion:

The present prospective-randomised-double-blinded-pilot study elucidates the superiority of propofol over isoflurane against NK cells and Th-cells anergy and sustained release of IL-15 in breast cancer surgery in terms of tumour recurrence and disease free survival.

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Abstract No. : ABS2584: Incidence of different phenotypes of neuropathic pain in cancer patients coming to tertiary care centre in North India over a period of one year -An observational study .
Authors: Singh Shipra
Published: September 2024

Background and Aims:

Neuropathic pain can present as characters(phenotypes) based on specific etiology, which can be grouped together to form phenotypic clusters. This study aimed to find out the incidence of different phenotypes amongst cancer patients and form phenotypic clusters.

Methods:

Institutional Ethics Committee clearance and clinical trial registration registration were obtained. After written and informed consent, patients aged between 18-80years, registering in Pain and palliative out-patient department or Radiotherapy department with complaint of pain and noton any anti-neuropathic pain medications, were enroled. They were assessed using the Leeds assessment of neuropathic symptoms and signs(LANSS) pain score and a score of >12 was eligible for assessment of neuropathic pain phenotypes.

Results:

Out of 261 patients ,73 had LANSS>12 (28%). The incidence of various characters of neuropathic pain has been shown in figure 1. The phenotypes were clustered in 3 groups based on spontaneous pain(cluster I), stimulus evoked positive pain(cluster II) and stimulus evoked negative pain(cluster III) and they were correlated with different organ systems. Most of the patients had combined phenotypic sensory profile of cluster I+II.

Conclusion:

Careful patient assessment can reveal different phenotypic combinations of pain and hence guide targeted therapy. Individuals’ sensory profiles should be used to select the patients who are most likely to benefit from treatment with drugs used for neuropathic pain.
Abstract No. : ABS2592: Medial branch block versus medial branch radiofrequency ablation in patients with lumbar facet joint pain
Authors: Gupta Disha
Published: September 2024

Background and Aims:

Lumbar facet joint related pain is reported to have a prevalence of 15-45%.This prospective study was conducted to compare the efficacy of medial branch block with medial branch radiofrequency(RF) ablation in patients with lumbar facet joint pain.

Methods:

Forty-six participants were randomised to Group-I (n=24) or Group-II (n=22). In Group-I, patients received fluoroscope guided medial branch block with 2ml drug solution comprising of 0.25% bupivacaine plus 10mg of triamcinolone and in Group-II, patients received fluoroscope guided medial branch radiofrequency ablation at a temperature of 80°C for 90 seconds using a RF generator. Patients were followed up for a period of three months. Numeric Rating Scale (NRS) Oswestry Disability Index (ODI) and Roland-Morris Questionnaire (RMQ) score were compared between the groups.

Results:

NRS and ODI scores were found comparable between the two groups at all the time intervals (p>0.05). Significant reduction (RMQ score was found in Group-II at two weeks (p=0.003) and at one month (p=0.01) ; whereas, at two months and three months the scores were found comparable between the groups(p>0.05). Pain at injection/RF site was significantly less in Group-II (p=0.006). None of the patients reported any serious complications.

Conclusion:

Both medial branch block and medial branch radiofrequency ablation provide good pain relief and improvement of disability in patients with lumbar facet joint pain. However, improvement in disability is early with medial branch radiofrequency ablation.
Abstract No. : ABS2870: Continuous positive airway pressure versus differential lung ventilation during one lung ventilation for thoracic surgery
Authors: P P Aswathi
Published: September 2024

Background & Aims:

The primary objective of the study was to observe the changes in oxygenation, ventilation and the surgeons’ perception of the surgical field using continuous

positive airway pressure (CPAP) or single lung ventilation (SLV) to the non-ventilated lung during the period of one lung ventilation (OLV) in patients undergoing thoracic surgery.

Methods:

In this single centre study, each patient acted as his own control as well as the two study groups. Patient were crossed over from SLV to CPAP or vice versa with an interval period during which only OLV was used (control period).

Results:

The study revealed that oxygenation was significantly better while using SLV to the non-ventilated lung during the period of OLV. However, the surgeon found significantly better surgical field when CPAP was applied.

Conclusion:

The study showed that using SLV to the non-ventilated lung during the period of OLV was superior in terms of oxygenation,although it interfered more with the surgical field.

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Abstract No.:ABS3030: The effect of pre-operative gastric ultrasound examination on the choice of general anaesthetic induction technique in paediatric patients posted for surgery- A prospective cohort study
Authors: Adhyapak Neha
Published: September 2024

Background & Aims:

Ultrasonographic assessment of the gastric antrum, is a non-invasive reliable tool for gastric content estimation in both adultsand children. This study aimed to determine the most appropriate induction technique and assessment of gastric contents by aspiration of nasogastric tube.

Methods:

80, American Society of Anesthesiologists (ASA)I and II paediatric patients aged 6 months to 16 years were considered. Ultrasonography (USG) was performed preoperatively in semi-recumbent and right lateral decubitus position to assess the gastric contents. Perlas’s grading 0-2 was used to determine the gastric volume. A final induction plan (Routine or rapid sequence induction-RSI) was made based on this assessment. Immediately after tracheal intubation, gastric contents were suctioned through a nasogastric tube; these were defined as above risk threshold for regurgitation and aspiration if there was clear fluid >0.8 ml/kg, and/or the presence of thick fluid and/orsolid particles.

Results:

Out of 80 patients examined, RSI was performed in 23 after assessing by ultrasonography. p value was highly significant (<0.0001) for appropriate technique of induction based on Perlas grade. Confirmation of gastric volume by nasogastric tube aspiration was also highly significant (p<0.0001).

Conclusion:

Ultrasonography is a useful guide to assess the gastric volume to aid for the choice of general anaesthetic technique that can reduce risk of pulmonary aspiration

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Abstract No.: ABS3221: Comparison of Fentanyl and Dexmedetomidine as adjuvants to 0.2 % Ropivacaine Epidurally in Labour Analgesia
Authors: Dhumal Shital
Published: September 2024

Background & Aims:

Childbirth being the most exciting event in the life of a female gets ruined because of cruciating and intolerable labour pain. This study compared quality of labour analgesia by using fentanyl and dexmedetomidine as adjuvants to 0.2% ropivacaine epidurally .

Methods:

Institutional Ethical Committee approval and patient consent was obtained. 60 enroled patients were divided into 2 groups Group RF: 0.2% ropivacaine + fentanyl 15µg (15ml) Group RD: 0.2% ropivacaine + dexmedetomidine 7.5 µg (15ml) Epidural catheter was inserted at the L2-L3 space and drug was administered. VAS, sensory, motor levels were assessed. Maternal and foetal adverse effects were noted. Maternal satisfaction was evaluated after 24 h. The results were expressed as mean Â± standard deviation for continuous variables while frequency and percentage for discrete data. Continuous variables were analysed by using unpaired two-tailed Student t- test. Discrete data was analysed using Chi-square test. P<0.05 considered as statistically significant.

Results:

The demographical data like age, weight and height were comparable and had no influence on outcome of the study. Quality of analgesia was comparable in both groups (p>0.05) with no patient having poor quality. Early onset and longer duration of analgesia, less epidural top-ups, shorter duration of labour, less incidence of instrumental delivery and adverse effects were observed in Group RD compared with Group RF (p<0.05). Neonatal APGAR score was comparable between the groups.

Conclusion:

Both fentanyl and dexmedetomidine with 0.2% ropivacaine epidurally provide safe, effective and excellent quality of labour analgesia and equal foetal well-being and neonatal outcomes. Dexmedetomidine as adjuvant prolongs labour analgesia and shortens duration of labour.

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Abstract No. : ABS3228: Perfusion index - a novel and objective parameter to predict successful lumbar sympathectomy: a case series.
Authors: Arora Prateek
Published: September 2024

Background and Aims:

Lumbar sympathectomy interrupts the sympathetic system of the lower limb, thereby augmenting the flow in microcirculation. This block is assessed by resolution of symptoms, reduced nociception, decreased sweating, and rise of local temperature. Perfusion index(PI) can objectively predict a successful block. complex regional pain syndrome

Methods:

The trend of perfusion index from the ipsilateral great toe of ten patients undergoing diagnostic lumbar sympathectomy for CRPS (6 patients) and peripheral vascular disease (4 patients), was observed and recorded using Mindray Beneview T8 monitor. The PI at zero and thirty minutes was plotted and the percentage of change was calculated.

Results:

The trend and behaviour of perfusion index in all patients, irrespective of the chronicity and underlying pathology, was consistent. The rise in PI in the lower limb can be taken as an objective marker of a successful lumbar sympathectomy. Further controlled studies are needed to pin down an absolute percentage rise in PI to predict a successful blockade.

Conclusion:

PI is a novel and promising parameter which is readily available in operating rooms and can objectively demonstrate a successful lumbarsympathectomy.

Perfusion index, lumbosacral plexus, sympathectomy, complex regional pain syndrome
Abstract No.: ABS2191 : Comparative study between perfusion index and sensory function tests for determination of successful supraclavicular brachial plexus block
Authors: Joshi Priyanka
Published: September 2024

Background & Aims:

Conventional tests are time consuming, subjective and require patient’s cooperation. The aim was to compare perfusion index with tactile stimulation in both blocked and unblocked arm to determine onset and more reliable indicator for PNS guided supraclavicular block success.

Methods:

Comparative study conducted in MY hospital Indore over 1 month included 30 patients undergoing elective upper limb procedures under supraclavicular block. After local anaesthetic instillation, perfusion index (PI) readings by pulse oximeter and tactile stimulation by cold sensation in both arms were noted. They were graded as 2= normal,1= reduced, 0=absent. These were noted at baseline, 1,3,5,10 and 20 min. Graphs were constructed for comparison.

Results:

PI was higher in blocked limb at all time points and tripled at 3 min while tactile stimulation showed a mean absent grade at 4 min

45 sec PI showed 100% sensitivity and specificity for block success at and after 3 mins when compared with tactile stimulation in both blocked and unblocked limbs. Comparison between both parameters was statistically significant (p value<0.001) at 3 min stating PI was faster and reliable indicator.

Conclusion:

Perfusion index is a faster and more accurate parameter of successful supraclavicular brachial plexus block than sensory function test. A tripling of PI around 3 min is a good predictor.
Abstract No.: ABS3251: A comparative study of oral clonidine and oral midazolam as premedication in paediatric surgery.
Authors: Dhalwani Karishma
Published: September 2024

Background & Aims:

Premedication plays animportant role in allowing smooth parent-child separation. Oral midazolam 1hour before surgery,as a premedication in children-is considered safeandeffective at separation and induction. Oral clonidine 1hour before surgery-providessedation, anxiolysis, analgesia. The aim of the study was to access the parent-separation anxiety score and mask acceptance score.

Methods:

A total of 60 children, aged 2 to 10 years and American Society of Anesthesiologists (ASA) physical status classification of I–II, were included after random allocation into two groups. Group C- oral clonidine 3 µg/kg, Group M- oral midazolam (0.5 mg/kg) were given as premedication 1 hour before surgery. Patients were assessed for parent separation anxiety score (PSAS) and mask acceptance score. Patients were monitored for pulse, blood pressure, saturation at regular intervals. Statistical analysis was done using Pearson chi square test.

Results:

There was a significant association between the groups and PSAS (P=0.001). Lower PSAS was seen in clonidine as compared to midazolam. Significant association was found between the groups and Mask acceptance scale (MAS) (P=0.001). Excellent maskacceptance was seen in clonidine as compared to midazolam group.

Conclusion:

From our observations and data analysis. we concluded that clonidine is better than midazolam when used as premedication and provides better parent separation score and mask acceptance in paediatric patients undergoing surgery.
Abstract No. : ABS3567: The feasibility and impact of acute normovolaemic haemodilution in on-pump cardiac surgery: a descriptive study
Authors: Soni Richa
Published: September 2024

Background & Aims:

Cardiac surgeries have the potential of perioperative blood loss, allogenic blood transfusion, prolonged postoperative hospitalstay and thus increase the load on the blood bank in the hospital. We evaluated the feasibility and impact of acute normovolaemic haemodilution (ANVH) in on-pump cardiac surgery.

Methods:

The data of 195 patients undergoing on-pump cardiac surgeries (coronary artery bypass graft surgeries, single/double valve repair surgeries) was retrospectively retrieved. Pre-operative haemoglobin >12 gm % was taken as criteria for ANVH. The amount of blood withdrawn was replaced withcrystalloid in a 1.5:1 ratio. The noradrenaline 4 µg/ml bolus was used to maintain the haemodynamics if required. The bloodwas re-transfused after protamine administration. The threshold for autologous blood transfusion was taken as <8 gm/dl.

Results:

In 75.38% (147) patients, ANVH was carried out. The mean pre-operative haemoglobin of patients who underwent ANVH was 13.5 gm%. An average of 1.44 units of blood was withdrawn. Allogenic blood transfusion was required in 23.40% of patients.Six patients were re-explored for surgical cause and excluded from the analysis. Mean 0.5 units of packed red blood cells (PRBC) were transfused in the post-operative period. The haemodynamics were maintained during ANVH.

Conclusion:

ANVH is feasible in the majority of patients, drastically reduces the requirement of allogenic blood transfusion in patients undergoing on-pump cardiac surgeries without much problem in maintaining haemodynamics.
Abstract No. : ABS3660: Comparative study of perioperative effect of premedication with melatonin versus pregabalin total hip arthroplasty under spinal anaesthesia.
Authors: Mishra Akash
Published: September 2024

Background & Aims:

The aim of the present study was to compare the efficacy of melatonin and pregabalin in reducing perioperative anxiety and postoperative pain along with effects on onset and duration of spinal anaesthesia and level of sedation in patient undergoing total hip arthroplasty under Spinal anaesthesia

Methods:

The present study was a randomised double blind placebo controlled studyand included96 American society of Anesthesiologists (ASA) I and II patients of either sex, aged between 30 to 60 years scheduled for total hip replacement under spinal anaesthesia. The patients were randomly allocated to one of three groups of 32 each to receive placebo (group 1), melatonin 6 mg (group 2), pregabalin 150 mg (group 3) orally 2 hours before spinal anesthesia. Perioperative anxiety using Beck anxiety inventory, postoperative pain along with onset and duration of spinal anaesthesia and sedation were assessed at multiple time points in the first 24 hours after surgery.

Results:

Perioperative anxiety scores was significantly decreased in group 2 (11.08) and group 3 (7.26) when compared to group1(17.25) and significant decrease in group 3 when compared to group 2. Post operative Visual analogue scale VAS scores were decreased in group 2 and 3 when compared to gropup1. Request for rescue analgesic during the first post operative 24 hour were lower among groups 2 and 3. The duration of sensory and motor blockade was prolonged in groups 2 and 3.

Conclusion:

Premedication with single dose of melatonin 6mg and pregabalin 150mg 2 hours before surgery decreases perioperative anxiety and postoperative pain in patients undergoing total hip arthroplasty under spinal anaesthesia and pregabalin has an added advantage of anxiolysis when compared to melatonin.

JOURNAL/ijana/04.03/01762628-202203001-00048/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff
KERATOPROSTHESIS - CLASSIFICATION, INDICATIONS AND COMPLICATIONS; HOW IT REVOLUTIONISED VISUAL REHABILITATION
Authors: Aftab Naila , Sinha Prerna , Nanda Jayadev , Raj Amit
Published: September 2024

Visual rehabilitation in cases of profound visual impairment due to end-stage ocular diseases saw a beautiful dawn with the advent of keratoprosthesis (KPro). Ever since its inception, KPro devices have been a boon for those with debilitating ocular surface diseases or chemical injuries. It is basically an artificial cornea which is a replacement for diseased and opacified cornea. Long-term anatomical and functional outcomes support the use of KPro for the treatment of patients with corneal blindness and poor prognosis for penetrating keratoplasty. This article deals with a description of various KPro devices available till date and description of commonly used KPro and their surgical techniques. Most commonly performed is Boston KPro. - over 19,000 implantations have been done till January 20191 It also entails a comprehensive approach to understanding the available KPro devices, and their uses, indications and complications. To avail the benefits of KPro, its user must have a thorough understanding of its functionality and usability. Through this article, which has a thorough review of literature on the topic, we wish to provide the readers with all that is available on KPro devices till date.
Exploring Pathways from Community Involvement to Empowerment in Sexual and Reproductive Health: A Public Health Perspective
Authors: Tohit Nor Faiza Mohd. , Rashid Siti Athirah Zafirah Abd. , Fakuradzi Wan Farizatul Shima Wan Ahmad , Zaidi Nur ‘Adnin Ahmad , Haque Mainul
Published: September 2024

The intersection of community involvement and empowerment in sexual and reproductive health (SRH) initiatives represents a critical area in public health. This scoping review aimed to explore the pathways from community involvement to empowerment within SRH initiatives, providing a comprehensive understanding of how public health strategies engage and build the capacity of communities. The literature from databases such as PubMed, Scopus and Web of Science were reviewed systematically, focusing on studies published between 2000 and 2023. The review identified various public health interventions that initially engage communities through participation, consultation and collaboration. These interventions often serve as the foundation for subsequent empowerment, characterised by capacity building, autonomy and advocacy. Key findings highlight that effective SRH initiatives involve community members in programme activities and foster environments where they can gain the skills, knowledge and confidence needed to take control of their health outcomes. Our analysis revealed that successful pathways from involvement to empowerment are multifaceted, requiring sustained commitment, resources and culturally sensitive approaches. The review underscores the importance of integrating community involvement and empowerment in designing and implementing SRH programmes to ensure sustainable and impactful health outcomes. This scoping review contributes to the existing literature by mapping the relationship between community involvement and empowerment, offering insights for public health practitioners and policymakers aiming to enhance SRH initiatives. Future research should focus on longitudinal studies to better understand the long-term impacts of these pathways on community health and well-being.
Assessment of Immunoreactivity Patterns in the Excised Cervical Lymph Nodes of Oral Squamous Cell Carcinoma
Authors: Jadeja Nileshwariba , Parikh Neelampari , Nandini C , Gohil Raviraj
Published: September 2024

Introduction:

Epidermoid carcinoma (oral squamous cell carcinoma [OSCC]) comprises approximately 80% of the malignancies of the oral cavity, which is also responsible for the morbidity and mortality due to the distant spread of the neoplastic cells. The regional draining lymph node has been considered an anatomic barrier to the systemic dissemination of malignant cells. It has been postulated that the microscopic architectural pattern of a regional lymph node (RLn) represents the immunologic reactivity in that node and the host response. Morphological assessment of the regional nodes aids in a better understanding of the immune response and its correlation with the stage of the tumour.

Materials and Methods:

A total of 51 head-and-neck dissection cases were assessed for immunomorphological patterns and the degree of tumour involvement in positive lymph nodes. 49 lymph nodes were in the early stage (TNM Stage l and ll) and 71 lymph nodes were in the advanced stage(TNM stage lll and lV). A total of 595 lymph nodes were histologically evaluated and were categorised into metastatic and non-metastatic nodes showing four different patterns: lymphocyte predominance (LP) pattern, germinal centre predominance (GCP) pattern, sinus histiocytosis (SH) pattern and lymphocyte-depleted pattern.

Results:

The most frequently encountered pattern of lymph nodes was of LP (436 nodes), followed by GCP (61 nodes), SH (36 nodes) and lymphocyte depleted (18 nodes), respectively. Out of 595, 120 nodes were positive for metastasis, indicating that as the stage advances, the GCP type predominates (the predominant immunomorphological pattern shifts from LP to GCP), facilitating metastasis.

Conclusion:

Immunomorphological changes in the RLns of OSCCs seem to be pivotal factors that serve as an important prognostic indicator. Whereas the cell-mediated immune response represented by LP and SH appears to resist the metastasis process, the humoral response reflected by GCP favours metastasis.
Retention of Candida Species on Plastic and Bamboo Toothbrushes. A Comparative Study
Authors: Avaneethram A R , Peedikayil Faizal C. , Chandru T. P. , Kottayi Soni , Aparna T. P. , Ismail Shabnam
Published: September 2024

Background:

Tooth brushing is the basic mode of oral hygiene practice. Various studies have shown that microorganisms can colonize on the tooth brush heads. Newer tooth brushes which are biodegradable are available in the market. This study compares the fungal colonization of plastic brush head and bamboo brush head.

Materials and Methods:

Fifty patients were randomly allocated into two groups with 25 each in both groups. Group 1 was given toothbrush with plastic brush head and group 2 was given toothbrushes with bamboo head. After 30 days, toothbrushes were collected. The bristles of the brush was removed from its base and put on to the petri dishes with sabouraud dextrose agar and, incubated at 28°C, with chloramphenicol and cycloheximide for 5 days. After growth was identified, pure colonies were transferred on Chromagar for the identification of Candida species.

Results:

Fungal growth was observed in 48% of plastic brush heads and 76% in bamboo brush heads. Candida Albicans was the most common species isolated from both plastic and bamboo tooth brushes, followed by Candida tropicalis. C. Albicans were seen as light green-colored smooth colonies; Candida tropicalis appeared as metallic blue-colored raised colonies. Candida tropicalis, Candida glabrata, Candida krusei and Candida guilliermondii were also observed.

Conclusion:

Fungal growth was more in bamboo tooth brushes than in plastic tooth brush even though it is statistically insignificant C. albicans is most predominant species found in the tooth brush head.
Comparative Assessment of Width of Neutral Zones Recorded Using Two Neutral Zone Impression Methods (Phonetic and Swallowing) and Two Different Materials (Tissue Conditioner and Polyether)
Authors: Parab Manjita M. , Aras Meena A. , Chitre Vidya , Qanungo Anchal
Published: September 2024

Statement of Problem:

Medium body polyether impression material has been recently used as neutral zone recording material. However, there is a lack of studies comparing it with routinely used material.

Purpose:

The purpose of the study is to compare neutral zone width of phonetic (PNZ) and swallowing (SNZ) neutral zone impression techniques with a tissue conditioner and a polyether impression material within the same subjects.

Materials and Methods:

Assessments of neutral zone width were carried out in ten completely edentulous patients with advanced mandibular resorption. On each patient, four neutral zone impressions were recorded as follows: SNZ with tissue conditioner material, PNZ with tissue conditioner material, SNZ with polyether impression material, PNZ with polyether impression material. Putty indices were made of each neutral zone and traced on graph paper. The buccolingual measurements were made at five different locations, midline, right first premolar, left first premolar, right first molar, and left first molar. Statistical analysis was done using Mann–Whitney U test.

Results:

There was no significant difference observed when comparison was done either between materials or techniques.

Conclusion:

Medium body polyether can be a viable alternative to conventional tissue conditioner material and can be used with both swallowing and phonetic techniques with equal efficacy.
Multiple perianal papules and nodules in a child: an intriguing entity
Authors: Rokade Pallavi R. , Chopkar Apoorva D. , Supekar Bhagyashri B. , Mukhi Jayesh I.
Published: September 2024

Anogenital papules in children can be attributed to various infectious and noninfectious causes. Perianal pseudoverrucous papulo-nodules (PPPN) is a severe manifestation of skin irritation from urine and feces, the diagnosis of which is primarily based on history and clinical examination. This condition resolves when the underlying condition is treated. We report a case series of three patients with PPPN.
Percutaneous Nephrolithotomy as Minimally Invasive Treatment of Urinary Calculi
Authors: Bellos Themistoklis Ch. , Makris Georgios S. , Chatzikrachtis Nikolaos A. , Chrisofos Michael
Published: September 2024

The management of urolithiasis has radically changed over the past two decades. Open surgery has been almost completely replaced by minimally invasive procedures. Percutaneous nephrolithotomy (PCNL) is considered to be the first line of treatment for large renal stones. Its use is associated with a multitude of complications. A thorough bibliographic search was performed for this review. Although PCNL comes with higher morbidity, its efficacy is unbeaten by other minimally invasive modalities. Improved skills and modifications of the procedure may reduce the probability of adverse outcomes. However, it is still associated with complications, even life-threatening ones. Since its introduction more than 30 years ago, PCNL has claimed its position as the minimally invasive procedure of the first choice for the treatment of large and complex renal stones. PCNL numbers are rising in recent years.
Schwannoma of the Nasal Septum: A Rare Clinicopathological Case Report in an 18-Year-Old Female
Authors: Kaushik Nupur , Rani Deepa , Kumar Lalit , Singh Akhil Pratap
Published: September 2024

Schwannoma, a benign tumor, arise from schwann cells of myelin sheath; occur anywhere in the body but commonly occur on flexor aspect of extremities. Nasal septum being the rarer site. We report a case of nasal septum schwannoma in an 18-year-old female presented with intermittent epistaxis and progressively increasing nasal obstruction for 2-year duration. The differential diagnosis of juvenile angiofibroma, pyogenic granuloma, and pleomorphic adenoma was made and complete surgical excision was done. Histopathological examination revealed ciliated stratified columnar epithelium, underlying tumor area with two distinct patterns, mainly hypercellular and few hypocellular areas. The cells have spindle shaped pointed basophilic nuclei with abundant eosinophilic cytoplasm. Overall feature was suggestive of nasal septum schwannoma. For confirmation, immunohistochemical staining with S-100 was done and tumor was found positive. Herein, we report the clinicopathological features of nasal septum schwannoma in an 18-year-old female.
Dental Aberrations
Authors: Madhavan Souparna , Haifa B.
Published: September 2024

Oral health-care services provided by the dentist have to follow certain standards to avoid any kind of negligence during treatment. Patient safety is an important aspect of quality in health care system. In the present time, all dentists need to be cautious about the general perception and the high cost involved in the treatment and to avoid any serious injury to the patient. The best way to prevent being involved in a litigation is to follow a good clinical practice patterns. This article emphasizes on common clinical mishap and dental patient incidents in a clinical practice.