Journal of clinical and diagnostic research : JCDR
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The supplementation of local anaesthetics with adjuvants to improve the efficacy of subarachnoid block has been recognised since long. The most preferred drug has been opioids, but newer drugs like dexmedetomidine has also been introduced and investigated as an effective adjuvant. ⋯ Intrathecal dexmedetomidine when compared to intrathecal buprenorphine causes prolonged anaesthesia and analgesia with reduced need for sedation and rescue analgesics.
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Clavicular injury is common in active and younger age group with male preponderance (male-female ratio is 2:1). Purpose of this study was to analyze the outcome of surgically treated displaced fracture midshaft clavicular fracture using Intra-medullary fixation by titanium elastic nail. ⋯ Titanium elastic intra-medullary nailing is a promising surgery with excellent functional outcome, safer percutaneous method with less invasive nature and rapid healing tendency with fewer complications in contrast to plate osteosynthesis.
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Functional Endoscopic Sinus Surgery (FESS) is associated with significant post-operative pain. Intravenous (iv) paracetamol provides pain relief in most patients who have undergone FESS. In some studies, it was found to be inadequate. It has been observed from previous studies conducted on patients undergoing other surgeries like abdominal surgeries that the analgesic efficacy of iv paracetamol improves when used Pre-emptively. There are no studies done previously on use of iv paracetamol Pre-emptively in FESS. ⋯ Pre-emptive iv paracetamol in comparison to intra-operative paracetamol, provided effective and reliable post-operative analgesia after FESS.
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Day care gynaecological surgeries mandate use of hemodynamically stable combination of commonly used intravenous agents, propofol & ketamine. Hence we proposed to evaluate the hemodynamic profile of different dose combination of propofol & ketamine as induction agents in ambulatory gynecological surgeries. ⋯ We conclude that the combination of 1mg Propofol and 1mg ketamine produced better hemodynamic stability in comparison to other Groups.
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Ventilator-associated pneumonia (VAP), an important form of hospital-acquired pneumonia (HAP), specifically refers to pneumonia developing in a patient on mechanical ventilator for more than 48 h after intubation or tracheostomy. Despite the advancements in antimicrobial regimes, VAP continues to be an important cause of morbidity and mortality. VAP requires a rapid diagnosis and initiation of appropriate antibiotic treatment, as there is adverse effect of inadequate antibiotic treatment on patients' prognosis and the emergence of multidrug-resistant (MDR) pathogens. ⋯ Due to the increasing incidence of multidrug-resistant organisms in our ICU, early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment and cure. Hence, knowing the local microbial flora causing VAP and effective infection control practices are essential to improve clinical outcomes.