Journal of the Indian Medical Association
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Randomized Controlled Trial
Efficacy and safety of flupirtine maleate and tramadol hydrochloride in postoperative pain management--a prospective randomised double blinded study.
The study was conducted to evaluate the efficacy and safety of flupirtine maleate 100 mg thrice daily compared to tramadol hydrochloride 50 mg thrice daily as postoperative pain management for 5 days. A total of 113 postoperative patients were recruited for the study. Those who met the inclusion criteria (n = 104) were randomised into two treatment groups. ⋯ There was significant reduction in pain score (p < 0.001) in the flupirtine group with almost equal efficacy to that of tramadol group but the incidence of adverse effects were much less (7.4%) and didn't need discontinuation of the study. All drugs were assessed as good. Therefore it can be concluded that oral flupirtine can deliver the same analgesic efficacy as oral tramadol for postoperative pain relief, which might be beneficial for avoiding the adverse effects ofopioids and non-steroidal anti-inflammatory drug therapy.
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Blast lung is a clinical condition which is characterised by respiratory difficulty and hypoxia without obvious external injury to the chest in bomb blast cases. Two patients of the bomb blast episode were brought at emergency department at Chhattisgarh Institute of Medical Sciences, Bilaspur in a state of shock. After proper wound care, resuscitation and investigation both the cases proved to be that of blast lung. In bomb blast cases although there might not be any external injury over chest wall, it will be sensible to rule out blast lung in all cases with the help of computerised tomography.
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Randomized Controlled Trial Comparative Study
Evaluation of airway blocks versus general anaesthesia for diagnostic direct laryngoscopy and biopsy for carcinoma larynx.
A prospective randomised study of 100 patients divided into two groups was done to compare the effects of regional airway nerve blocks versus general anaesthesia to evaluate intra-operative haemodynamic changes and compare the level of postoperative analgesia and sedation in both the groups. In group I whole airway block including bilateral superior laryngeal nerve block with bilateral glossopharyngeal block and recurrent laryngeal nerve block was given and in group II general anaesthesia was given. The mean duration was 27 +/- 5 minutes in all cases, all patients were of ASA grade 3 or 4. ⋯ Whereas in group I there was a stability in mean arterial pressure and pulse rate peri-operatively. The postoperative analgesia was significantly higher in group I and lasted longer as compared to group II and patients were less agitated and calm as assessed by the sedation score, in group II most of the patients required postoperative nebulisation as compared to group I where no patient needed nebulisation. In conclusion we suggest that regional airway block for anaesthesia in the short procedures of upper airways and also in cases of predicting difficult airway cases for securing the safe airway can be very useful alternate to general anaesthesia.
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Kikuchi's disease, or histiocytic necrotising lymphadenitis, is an uncommon and unique form of self-limiting lymphadenitis and typically affects the head and neck regions. The most common clinical manifestation is cervical lymphadenopathy, with or without systemic signs and symptoms. ⋯ CT scan showed enlarged lymph nodes with hypodense centres and peripheral ring enhancement. As Kikuchi's disease can be cured by steroid, its diagnosis can prevent unnecessary surgery.
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Low back pain is very common complaint in all age groups. Paracetamol, non-steroidal anti-inflammatory drugs and muscle relaxants are commonly prescribed in combination for the treatment of back pain. The aim of the study was to evaluate efficacy and safety of fixed dose combination of aceclofenac + paracetamol + thiocolchicoside (acenac-MR) in the treatment of acute low back pain. ⋯ As per investigators' assessment about tolerability, 60 % of patients reported excellent, 36.66 % good and 3.33 % reported poor tolerability. None of the patients discontinued the therapy due to side-effects. Result of this study showed that aceclofenac + thiocolchicoside + paracetamol significantly reduced intensity of pain and improve the mobility of the patients.