JPMA. The Journal of the Pakistan Medical Association
-
Tramadol, an analgesic with a low affinity to opioid receptors, inhibits the reuptake of norepinephrin and serotonin. It is also abused by opioid addicts. Tramadol overdose can induce CNS and respiratory depression, tachycardia, and seizures. ⋯ He experienced frequent seizures, confusion, myosis, and dramaticrise of CPK, LDH and Creatinine. Improvement was had in the following days by administering fluids, NaHCO3 and chlordiasopoxide and routine management. He was discharged with no further sequelae.
-
To study the awareness on Basic Life Support (BLS) (CPR) in undergraduate medical students. ⋯ Most of the medical students although had not attended the course, still they had some knowledge about BLS. Inclusion of this course in the undergraduate curriculum will increase awareness and application of this valuable life saving maneuver.
-
Clinical Trial
Haemodynamic response to induction, laryngoscopy and tracheal intubation in diabetic and non-diabetic patients.
Presence of autonomic neuropathy in diabetic patients can alter the haemodynamic response to induction and tracheal intubation. This trial was conducted to compare this response in 30 non-diabetic (control group) and 30 diabetic patients including both insulin and non-insulin dependent. ⋯ The systolic, diastolic and mean blood pressure response was similar in the two groups. A greater fall in SAP was observed post intubation in the DB group. A significant difference was observed in the heart rate response which was less in the diabetic group.
-
Neuropathic pain, a form of chronic pain initiated and sustained by an insult to the peripheral or central nervous system, is a challenge to clinicians as it does not respond well to traditional pain therapies. However exact pathophysiology is not known but considering similarities between epilepsy models and in neuropathic pain models justify the rationale for use of anticonvulsant drugs in the symptomatic management of neuropathic pain disorders. The role of anticonvulsant drugs in the treatment of neuropathic pain is evolving and various clinical trials have used these anticonvulsants and shown positive results in the treatment of trigeminal neuralgia, painful diabetic neuropathy and postherpetic neuralgia. ⋯ Gabapentin has the most clearly demonstrated analgesic effect for the treatment of neuropathic pain, specifically for treatment of painful diabetic neuropathy and postherpetic neuralgia. Pregablin is a newer drug and will soon gain popularity in clinical practice. There is a need for further advances in our understanding of the neuropathic pain syndromes to establish the role of anticonvulsants in the treatment of neuropathic pain.