International journal of surgery
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Evidence suggests that switch from spinal/general anaesthesia (SA/GA) to perianal block (PAB) may prove advantageous for proctologic surgeries. This study evaluates the practicability of this evidence based switch. ⋯ Perianal block is a safe, feasible, reliable, and reproducible mode of anesthesia for ano-rectal surgeries. Its evident efficacy justifies its adoption as anesthesia of choice.
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Severe blast injuries of large tyres are similar to those resulting from landmine explosions with neither thermal nor chemical effects. Little has been written about the destructive nature of these blasts. ⋯ The high energy produced by large tyre blasts may cause severe injuries leading to high morbidity and mortality. Preventive occupational methods should be adopted and implemented at the work place.
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Mortality and morbidity in trauma remain a major problem in developing countries. Organized emergency response systems for transfer of trauma patients to hospitals are absent and the consequent delays could cause significant complications. ⋯ Transfer and delay in admission to a tertiary care center does not affect in-hospital mortality of trauma patients in a setting with no emergency response system. This may be due to self selection of patients who survive long enough to reach the hospital.
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The effect of vasopressors on the healing of gastrointestinal anastomoses is still controversial. The purpose of our study was to research the relationship between dose of dopamine, which is used generally as a vasopressor in shock status, and anastomotic leak in colonic surgery. ⋯ Although vasopressors appeared to increase the risk of anastomotic leakage as a result of splanchnic vasoconstriction, deterioration of microcirculation, and local hypoxia, we found that BPA were increased with high doses of vasopressor. We speculated that the use of vasopressors without shock might increase blood supply to the anastomotic line by increasing cardiac output.