Medical journal, Armed Forces India
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Med J Armed Forces India · Oct 2004
Maxillofacial Injuries in Counter Proxy War Posture of the Armed Forces.
Various maxillofacial injuries, sustained in counter insurgency operations in the counter proxy war posture (CPWP) of the Armed Forces in the Kashmir valley are being treated at various maxillofacial surgical centres. ⋯ Proper primary reconstruction (soft tissue and skeletal tissue) of the facial region goes a long way in reducing subsequent disfigurement and morbidity. Improving the structural design of the combat head gear for safety and comfort will go a long way in preventing majority of maxillofacial injuries or can at least reduce the severity of these injuries.
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During a period of one year, from Jan 99 to Dec 99, 60 cases of missile injuries were treated at our centre. 59 were males and one was a female and their average age was 25 years. 43 patients had suffered splinter injuries, 12 had gunshot wounds and 5 had suffered injuries by improvised explosive devices. Glasgow coma scale was < 5 in 8 patients, 5-8 in 14, 8-12 in 30 and 13-15 in 8 patients. Extensive comminution of skull bones was found in 10 patients. 35 patients had more or less clear penetration of the skull and the rest had orbito-cranial or facio-cranial wounds. ⋯ Two patients developed wound sepsis, one each developed aspiration pneumonia, septicemia, deep vein thrombosis and post-traumatic hydrocephalus. On follow up at 6 months, outcome as per Glasgow outcome scale was as follows: good outcome - 42, moderate disability in 7, severe disability in 6 and death in 5 patients. Retained bone fragments were found in 40% on follow up CT scan but none had brain abscess.
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Med J Armed Forces India · Jan 1994
DOSE RESPONSE RELATIONSHIP OF NEUROMUSCULAR BLOCKADE, INTUBATION CONDITIONS AND CARDIOVASCULAR CHANGES WITH CHANDONIUM IODIDE.
One hundred and forty ASA physical status I and II patients undergoing general or gynaecological surgery were the subjects of this study. Patients were randomly assigned into five groups receiving 100, 150, 180, 200 and 250 µg/kg I. V. of chandonium iodide after induction of general anaesthesia with thiopentone. ⋯ Intubation conditions also improved with increasing doses of chandonium iodide, so that, although intubation was possible in all the patients, grading of good intubation conditions were achieved in 64, 80, 88, 100 and 100% of patients in groups I to V respectively. 200 µg/kg of chandonium iodide produced ideal intubation conditions. Recovery to spontaneous ventilation was rapid and smooth, further facilitated with neuromuscular antagonists. Short lasting increase in heart rate and blood pressure was seen which was neither dose dependent nor outlasting the duration of neuromuscular blockade.