Journal of the Indian Medical Association
-
Randomized Controlled Trial Comparative Study
Comparative study of heart rate responses to laryngoscopic endotracheal intubation and to endotracheal intubation using intubating laryngeal mask airway under general anaesthesia in patients with pure mitral stenosis for closed mitral commissurotomy.
The various drugs and methods studied in an attempt to curb the haemodynamic stress response associated with conventional laryngoscopic endotracheal intubation have not been found to be ompletely satisfactory. The rise in heart rate can be detrimental to patients with mitral stenosis. This study was aimed to compare the heart rate responses to endotracheal intubation using conventional laryngoscope and with the help of intubating laryngeal mask airway (ILMA) in patients with isolated mitral stenosis. ⋯ On applying statistical tests, it was found that the median heart rate values in group A at 2, 3, 4 and 5 minutes postintubation were significantly higher than in group B (p<0.05). Although use of both laryngosope and ILMA for endotracheal intubation was associated with rise in heart rate, the rise was less with ILMA compared to laryngoscope. Hence, it can be concluded that use of ILMA may be a preferable device for endotracheal intubation laryngoscopy in patients with isolated mitral stenosis.
-
Randomized Controlled Trial
Tranexamic acid used before caesarean section reduces blood loss based on pre- and postoperative haemoglobin level: a case-control study.
The objective of the study was to find out the efficacy and safety of tranexamic acid in reducing blood loss during and after the lower segment caesarean section based on pre- and postoperative haemoglobin level. A prospective randomised, case-control, study was conducted on 100 women undergoing lower segment caesarean section. Fifty of them were given tranexamic acid immediately before the surgery and compared with 50 others to whom tranexamic acid was not given. ⋯ No adverse neonatal outcome was also noted. Therefore tranexamic acid significantly reduced the amount of blood loss during and after the lower segment caesarean section and its use was not associated with any side-effects or complications. Tranexamic acid can be used safely and effectively in women undergoing lower segment caesarean section.
-
A prospective observational study was performed to know the profile and outcome of paediatric Intensive care unit admitted patients. Paediatric intensive care unit admitted patients are mostly male (65%), suffering from critical respiratory (36%) and CNS diseases (35.4%). The survival at paediatric intensive care unit was 37.5% (25% were mechanically ventilated). ⋯ Commonest organism Isolated from blood was Klebsiella pneumoniae (38%). Most Gram-negative organisms were sensitive only to carbapenems, some were sensitive only to polymyxin B. All staphylococci were resistant to vancomycin.
-
In India, institutionalisation of deliveries is happening at a fast pace. Evaluating the knowledge and practices of healthcare providers in these institutions is a priority in this current scenario. The objective of this study was to assess the knowledge and practices regarding essential newborn care and resuscitation among healthcare providers in Panchkula district of Haryana. ⋯ However, kangaroo mother care was rarely advised to mothers of preterm babies. It was found that majority of healthcare personnel had good awareness about breastfeeding and clean practices while conducting delivery. In contrast, knowledge about neonatal resuscitation and some aspects of essential newborn care was poor.
-
A two-year-old child presented with history recurrent attacks of stridor. Initially he was thought to have laryngomalasia and treated accordingly but the symptoms did not improve with age. The child was symptomatic only during episodes of respiratory tract infection. ⋯ CT angiography showed an incomplete double aortic arch. As the child was symptomatic only during intercurrent infections and there was no feeding difficulty, respiratory distress and growth problems conservative management was opted. Parents were advised to observe the patient and review after six months.