JPMA. The Journal of the Pakistan Medical Association
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A fifty seven years old female patient came to operating room for coronary artery bypass grafting (CABG) surgery. After induction, invasive monitoring lines were placed. Pulmonary artery catheter (PAC) floated after three attempts and it was wedged at 60cm. ⋯ Knotting usually occurs due to excessive advancement of the pulmonary artery catheter beyond the normally expected distance. The removal of a catheter should never be forced when resistance is encountered. PA catheter knotting is a rare complication but it should be suspected whenever there is excessive length of catheter required to reach pulmonary artery.
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Randomized Controlled Trial Comparative Study
Excision with or without primary closure for pilonidal sinus disease.
To evaluate the outcome of excision with or without primary closure in the management of chronic pilonidal sinus (PNS) disease. ⋯ Excision and primary closure is recommended, as a preferred procedure in the management of chronic PNS disease. It has the advantages of early wound healing, rapid return to work and comparable recurrence rate with excision and open wound.
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Our objective was to determine the trends of providing intraoperative analgesia for day-care surgery among the various anaesthesiologists at our university hospital. All patients having surgical procedures under general anaesthesia in the Surgical Day Care Unit (SDC) of the Hospital were included. ⋯ Of the 22% patients who received pethidine intraoperatively needed rescue analgesia in recovery room, while 12% of those receiving a combination of pethidine and ketorolac needed rescue analgesia. Pethidine was found to be the most commonly used analgesic agent while a combination of pethidine and ketorolac was found to provide a superior quality of analgesia with a lesser need of additional analgesia.
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To examine clinical variables and outcomes in patients with out-of-hospital (unwitnessed) and emergency department (ED; witnessed) cardiac arrests at a tertiary care hospital in Karachi. ⋯ Out of hospital arrest was associated with dismal survival at hospital discharge, emphasizing the need for development of pre-hospital care services for our country.
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To evaluate need of elective neck dissection in patients with early oral tongue cancer, and to see the pattern of involvement of different lymph node levels. ⋯ The overall micrometastases rate in our patients (32%) warrants elective neck dissection in early cases also. The incidence of metastases to level IV and V from T1-T2 oral tongue cancer is low so these lymph nodes should be removed only when there is intraoperative suspicion of extensive metastases in levels I, II or III., otherwise supraomohyoid neck dissection is sufficient.