Mymensingh medical journal : MMJ
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Randomized Controlled Trial Comparative Study
Postoperatve pain relief in children after subumbilical surgeries-a comparison between caudal bupivacaine and bupivacaine-clonidine.
In a randomised case control study in children undergoing elective subumbilical surgery, we have assessed the clinical value of bupivacaine and bupivacaine-clonidine mixture for caudal analgesia. Sixty children aged 2-10 years, were allocated randomly to two equal groups (n=30) to receive 0.25% bupivacaine 1ml/kg (Group I) and 0.25% bupivacaine 1ml/kg with clonidine 2μg/kg (Group II). The baseline haemodynamic parameters, heart rate and blood pressure were recorded. ⋯ There was no significant difference in the incidence of side effects between the two groups. Group I received more doses of diclofenac suppository in first 24 postoperative hours. We conclude that, when added to bupivacaine, clonidine improves the duration of caudal analgesia in children undergoing subumbilical surgery.
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Randomized Controlled Trial Comparative Study
Blood conservation strategies for reducing peri-operative blood loss in open heart surgery.
Defects in hemostasis are frequently seen in open heart surgery. Strategies should be reviewed about the peri-operative blood loss and conservation of blood here. In this study, comparison among three agents (Aprotinin, Tranaexaemic Acid & Epsilon Amino Caproic Acid) is done to reduce the peri-operative blood loss in open-heart surgery. ⋯ Peri-operative blood loss is significantly reduced (p<0.05) both in the Aprotinin and Tranexamic acid groups. Renal dysfunction was reported in 20% of aprotinin patients, 14.29% of tranexaemic acid patients and 18.51% of EACA patients. A conclusion was drawn from the study that Tranexamic acid can significantly reduce the peri-operative blood loss in open heart surgery cases and that it can be preferred as an agent of choice in blood conservation strategy in these cases.
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Comparative Study
Comparison between ultrasound and plain X-ray in evaluating the cause of shoulder pain.
Painful shoulder is a common painful condition among patients. Apart from acute traumatic lesions such as fractures, dislocations, contusions, sprains and ruptured tendons, 85 to 90% of painful shoulders are due to adhesive capsulitis, acute or chronic calcific tendinitis, bursitis, bicipital tendinitis and lesions of the musculotendinous cuff. Arthritis is the cause of less than 5% of painful shoulders. ⋯ On Ultrasonography (USG) 12.5% patients had displaced long head of biceps, 21.9% had biceps tendinitis, and 3.1% had bursitis. In the assessment of shoulder pathology, USG had a sensitivity of 73.3%, specificity of 88.2%, Positive predictive value (PPV) of 84.6%, Negative predictive value (NPV) of 78.9% and an accuracy of 81.3%. USG is a useful modality for evaluation the shoulder joint in case of painful shoulder even plain X-ray is non conclusive.
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Comparative Study
Comparison between bipolar diathermy tonsillectomy and cold dissection tonsillectomy.
A prospective study was carried out in the department of otolaryngology-Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh Medical college Hospital, Dhaka. From January, 2007 to January, 2009 to compare between Bipolar Diathermy Tonsillectomy and Cold Dissection Tonsillectomy. Two hundred patients were divided equally into two groups- bipolar diathermy tonsillectomy and cold dissection tonsillectomy. ⋯ No significant difference (p>0.05) was noted between the two groups in terms of postoperative activity and postoperative blood loss. Operative blood loss & time was significantly less in bipolar diathermy tonsillectomy. So it is a safe technique and can be used safely with less morbidity & complication.