Journal of clinical and diagnostic research : JCDR
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A suprascapular nerve entrapment can occur at the suprascapular notch or at the spinoglenoid notch. So, the size and shape of the suprascapular notch are associated with suprascapular entrapment neuropathy as well as with an injury to the suprascapular nerve in arthroscopic procedures. The knowledge on the variations along the course of the nerve is important in understanding the source of the entrapment syndrome. ⋯ Such studies may be useful in understanding the role of the notch in causing nerve entrapment and to prevent iatrogenic nerve injuries while posterior approaches are made to the shoulder joint.
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Laryngoscopy and tracheal intubation after the induction of anaesthesia, are nearly always associated with sympathetic hyperactivity. To 'blunt' this pressor response, various methods have been tried, but very few studies have been done to assess the effects of fentanyl orI.V. clonidine on the haemodynamic response during laryngoscopy and tracheal intubation. The purpose of this study was to compare these agents, to find the drug which was best suited for this purpose and the most favourable time for its administration. ⋯ Clonidine showed better attenuation of the sympathetic response, which is statistically highly significant and it remained so till the end of 10 minutes. Intravenous clonidine 2;g/kg which is administered 5 minutes before the laryngoscopy can be recommended to attenuate the sympathetic response to the laryngoscopy and the intubation.
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A clinical study on the management of inguinal hernias in children on the general surgical practice.
Inguinal and scrotal swellings are frequently encountered in the surgical practice, especially in children. It is also important to study the factors which are associated with inguinal hernia, especially in children, for its effective management. ⋯ Inguinal hernia is a common congenital condition in children. Difficulties are commonly encountered by the surgeons to identify and to confirm the presence of inguinal hernia. This study will help in a better management of hernia in the paediatric age group by understanding the features of inguinal hernia.
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The conventional hydrostatic reduction of an intussusception with barium enema or the pneumatic reduction of an intussusception is associated with considerable ionizing radiations and a risk of perforation; while the hydrostatic reduction of an intussusception under ultrasound guidance is a very safe method because the whole procedure is visualized with real time ultrasound. Also, being a non-invasive method with a high success rate, this procedure has emerged as a useful alternative to a surgical intervention. ⋯ We conclude that ultrasound with colour Doppler study is very useful for the diagnosis of intussusceptions, as well as for guided hydrostatic reductions by using normal saline enema. This is an optimal, simple, and a safe procedure for the treatment of intussusceptions in paediatric patients.
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Since central neuraxial analgesia cannot provide adequate post operative pain relief when it is used alone in patients who had undergone Total Knee Replacement Surgery (TKR), an alternative analgesic method is usually advised. The alternatives include either systemic analgesics (opioids, Non Steroidal Anti Inflamatory Drugs, [NSAIDs], etc) or peripheral nerve blocks. When complete analgesia is aimed in such patients, combining the sciatic nerve blocks along with the Femoral Nerve Blocks (FNBs) will be beneficial. But performing femoral and sciatic nerve blocks together in patients with regional or general anaesthesia will be too cumbersome and in this direction, the major clinical trials are yet to decide on their feasibility. Thus, in an attempt to keep the analgesia methods very simple and effective, the physicians may decide on doing a single nerve block when an ongoing epidural analgesia infusion is in situ. ⋯ A single injection femoral nerve block provides adequate analgesia for the patients who undergo TKR surgery, when an active epidural is in-situ on the day of the surgery. It keeps the analgesic mode as simple and comfortable and it achieves lower pain scores on the day of the surgery, also with least complications, in patients with an ongoing epidural local anaesthetic infusion.