Journal of the Indian Medical Association
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Lumbar disc prolapse as a cause of back and leg pain is quite common and results in significant disability. This is a prospective uncontrolled study done on 40 patients with signs and symptoms of lumbar disc prolapse, in whom conservative treatment of at least 6 weeks had failed. The aim of the present study was to study the effect of caudally administered epidural steroids in the treatment of such patients. ⋯ After 6 months, symptomatic improvement was seen in 67.5% of the cases with good results in 47.5% and fair results in 20% of the patients. No major complications were observed. It is concluded that caudally administered epidural steroid injections are a safe and effective modality of treatment in lumbar disc prolapse with good results in short term and possibly long term in some patients.
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A 30-year-old male presented with accidental injury with an arrow which referred to us from a peripheral village hospital. It was found that the arrow was penetrating through the nasal bones. ⋯ As the patient had no clinical evidence of neurological or vascular injury, he was immediately operated upon and the arrow was removed. Patient was discharged in good condition and a 3-month follow-up was normal.
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Forty-nine cases of electric burns with various factors responsible for accidents were studied. The stress was given on the study of disability after electric burns. Different complications of electric burns including morbidity and mortality were noted. ⋯ Hence, the major problem in electrical burns is due to permanent disability because of amputations, ultimately giving rise to the problem of rehabilitation mostly in young working people. Upper limb was burnt in 96% of patients. Hence, it further aggravates the severity in electrical burn injury because it is a working limb.
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The incidence of postdural puncture headache, its severity, time of onset and duration following spinal anaesthesia in female subjects using 25 gauge Quincke needles are discussed in this paper. Postdural puncture headache was seen in only 3% of the cases. The headache appeared mainly on the 1st postoperative day and was associated with nausea and vomiting in one case; and it disappeared by the 2nd to 3rd day following administration of mild analgesics and anti-emetics.
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It is generally agreed that it is important to control blood glucose levels during the peri-operative period. However, there have been controversies surrounding the appropriateness of each regimen, as well as ideal glucose targets during surgery. This review focuses on a simple and practical strategy to control glucose during surgery, and sets out simple guidelines on instituting an insulin infusion protocol. ⋯ In the ICU, it is best to use an insulin infusion protocol for glucose control. The ideal regimen should be individualised for each patient. The success of peri-operative glucose control requires teamwork between the various medical personnel involved in patient care.