Journal of clinical and diagnostic research : JCDR
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Arterial punctures for monitoring respiratory problems are one of the most painful procedures in hospitalized patients. The knowledge regarding non-pharmacologic methods of pain management, including cold application is limited. ⋯ Cold pack is a simple, non-invasive and inexpensive technique for pain management before the arterial puncture. However, there is a need for further research regarding this topic.
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Functionality of the hands is the major determinants of the quality of life in burns survivors. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and there by the economic status of the patient suffer. ⋯ Most of the cases can be resurfaced with skin grafting and few cases have clear indication for flap coverage which needs to be planned and executed cautiously. Z plasties with proper planning gives maximum length gain with no donor morbidity as other procedures. Postoperative physiotherapy and splinting is must for better outcome in all cases.
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Percutaneous nephrolithotomy (PCNL) is done under general anaesthesia in most of the centres. Associated complications and cost are higher for general anaesthesia than for regional anaesthesia. Present study is designed to compare the efficacy of epidural block versus spinal anaesthesia with regards to intraoperative mean arterial pressure, heart rate, postoperative pain intensity, analgesic requirement, Postoperative complications and patient satisfaction in patients undergoing PCNL. ⋯ For PCNL, segmental epidural block is better than spinal anaesthesia in terms of haemodynamic stability, postoperative analgesia, patient satisfaction and reduced incidence of PONV. Epidural anaesthesia is difficult to execute and takes longer time to act as compared to spinal block which limits its use.
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Thoracic injury and its complications are responsible for as much as 25% for blunt trauma mortality. Pulmonary contusion occurs in 30%-75% of these cases. Despite advances in pulmonary care and intensive care management pulmonary contusion still contributes to higher mortality and morbidity for patients with severe injuries. ⋯ The risk factors that were associated with higher mortality in patients with pulmonary contusions following chest trauma were APACHE II score, SAPS II score, SOFA score, paO2/Fio2 ratio and ventilator days. Close monitoring to improve the gas exchange and better fluid management will help in improving the survival in these patients.