Journal of clinical and diagnostic research : JCDR
-
Retracted Publication
Comparison between Thoracic Epidural Block and Thoracic Paravertebral Block for Post Thoracotomy Pain Relief.
Postoperative pain after thoracotomy is being considered one of the most severe pain and if not treated well, can result in various respiratory and other complications. ⋯ Both the techniques, continuous thoracic epidural block and continuous thoracic paravertebral block were effective for post-thoracotomy pain relief; however, epidural block provides better pain relief. The incidence of sympatholytic complications was more in epidural group. The effect on respiratory mechanics was equivalent. Hence, paravertebral block can be used in post thoracotomy pain relief in those patients where thoracic epidural is contraindicated.
-
Continuous Positive Airway Pressure (CPAP) has an established role in the care of Very Low Birth Weight (VLBW) babies with respiratory distress. Bubble CPAP (BCPAP) is a cheap alternative for countries where resources are limited. However, data comparing efficacy of BCPAP with conventional ventilator derived (VCPAP) is limited. ⋯ The CPAP failure rates in VLBW babies with moderate respiratory distress were found to be similar whether bubble CPAP or ventilator CPAP was used. There was no difference in complication rates of IVH or mortality with either method of CPAP.
-
Acinetobacter baumannii (A.baumannii) is rapidly emerging as a potent organism causing a multitude of nosocomial infections. The organism also carries various resistance mechanisms to antibiotics, making treatment more difficult. Very few choices are left, as A.baumannii strains have begun to develop resistance against cephalosporins, aminoglycosides and even carbapenems. ⋯ Polymyxins (colistin - polymyxin E and polymyxin B) are the next choice for multidrug resistant serious nosocomial infections like those of A. baumannii, till newer antibiotics are discovered to treat such infections. Rifampicin resistance was found to be very high and hence, is not advised for monotherapy.
-
Case Reports
Acute Right Heart Failure in a Patient with Right Heart Thrombus and Pulmonary Thromboembolism.
Right Heart Thrombus (RiHT) management is really controversial, and appropriate guidelines are not present for the management. In patients referring with RiHT and Pulmonary Embolism (PE), there are three ways of managing these patients. Out of the three, one is thrombectomy, which is with high risk taking in mind the comorbidities these patients have. ⋯ Although recent Guidelines of European Society of Cardiology in management of acute PE stated that RiHT, particularly mobile, are associated with a significantly increased early mortality risk in patients with acute PE. Immediate therapy is mandatory, but optimal treatment is controversial in the absence of controlled trials. Thrombolysis and embolectomy are probably both effective while anticoagulation alone seems to be less effective.
-
Perioperative pain management is an integral part of anaesthesia and patients are most satisfied if there is minimal or no pain after surgery. Sciatic nerve block provides postoperative pain relief after below knee surgery and knee surgery. Many studies with different approaches for sciatic nerve block have been conducted to demonstrate the efficacy of sciatic nerve block with different local anaesthetic drugs over the past decade. ⋯ Single shot sciatic nerve block provided effective pain relief to majority of the patients upto 18 hours in below knee orthopaedic surgery and also decreased analgesic drugs requirement postoperatively. Sciatic nerve block was safe with no adverse effects.