Introduction: The cause of pain in abdominal surgeries, is Somatic and Visceral. Out of many ways to reduce Post laparoscopic pain one way is Intra peritoneal instillation of local anaesthesia. Intra peritoneal instillation of local anaesthesia is a simple, cheap and safe method of providing post operative analgesia after laparoscopic cholecystectomy. Aim of this study was to compare the analgesic efficacy of intraperitoneally instilled bupivacaine and ropivacaine and Placebo (Normal saline) in relieving postoperative pain after laparoscopic cholecystectomy. Prospective Randomized Open Label study was conducted in 9 Methods and methodology: 0 patients posted for laproscopic cholecystectomy divided into three groups each containing 30 patients according to computer generated numbers: Group Saline (S) received 35 ml of 0.9% normal saline, Group Bupivacaine (B) received 35 ml of 0.25% bupivacaine (87.5 mg), Group ropivacaine (R) received 35 ml of 0.375% ropivacaine (131.25 mg). Post operative pain and analgesia,Time until use of first rescue analgesic and its total dose, Post operative hemodynamic changes like pulse rate, Blood pressure (Systolic BP, Diastolic BP, Mean BP) ,Post operative nausea and vomiting and post operative complication if any was studied. VAS Score in different time interval of Bupivai Results: caine and Ropivaicaine group was lower than saline group with p < 0.0001, a significant fall in rescue analgesia dose with p value <0.05. Intra Peritoneal Instillation of Conclusion: Local Anaesthetic Drug is useful for Post operative Pain relief and better control of postoperative Nausea and Vomiting for Patients undergoing Laproscopic Cholecystectomy.
Airway management in emergency room or operating room (OR) in patients with facial injury, especially following road traffic accidents (RTA) needs preparedness, planning, multidisciplinary availability and approach with experienced hands. This enables decision-making and handling the situation in an effective manner. Here, we are presenting a case with open distorted faciomaxillary injury following RTA and successful management of airway in OR with fibreoptic-guided intubation.
Introduction: Endotracheal intubation is frequently referred to as the "gold standard" for airway management in an emergency. The present study is an attempt to compare the BlockBuster LMA with I-Gel regard to first-attempt success rate of blind tracheal intubation. We also have tried to study Time of insertion, Ease of insertion, Number of attempts, Success of device placement. The patients who were fulfilling the inclusion criteria were randomly divided into two gr Methodology: oups -Group B (BlockBuster LMA) and Group I (I-GEL), with 40 patients in each group.The appropriate size of LMA was selected according to body weight as per the manufacturers' guidelines. Time required for insertion of LMA is defined as time in seconds from removal of face mask where adequate ventilation as established through LMA with normal square wave capnogram. Soon after the insertion, LMA cuff was inflated with air.ETT intubation was done through blockbuster LMA/I-gel. Results: First attempt success rate was 90% in Group B and 70% in Group I respectively. Mean (SD) of time of insertion (in seconds) was 14(±1.4) and 36(±1.5) among group1 and Group I respectively. And insertion was difficult in 15% of group1 and 65% of Group I respectively. This is found to be significant (p value <0.05) And insertion was difficult in 15% of group1 and 65% of Group I respectively. Mean (SD) of time of insertion (in seconds) was 14(±1.4) and 36(±1.5) among group1 and Group I respectively. Conclusion: The present study was able to prove that the mean time of insertion of ET tube is much lesser in groupB compared Group I, Mean (SD) of time of insertion (in seconds) was 14(±1.4) and 36(±1.5) among groupB and Group I respectively.First attempt success rate was 90% in BlockBuster LMA and 70% in I-Gel.
Rheumatoid arthritis (RA), axial spondylarthritis (axSpA) and psoriatic arthritis (PsA) significantly impact global health, causing chronic pain and inflammation. Despite effective treatments like adalimumab (ADA), high costs limit its use in India. Moreover, the absence of India-specific guidelines creates subjective biases for effective treatments. To address this lacuna, the RAPID-India steering committee, comprising experienced academic rheumatologists, used a three-phase Delphi process to create a nationwide consensus for ADA treatment for RA, axSpA and PsA. A 22-question survey was sent to 32 rheumatologists nationwide who rated statements on a 5-point Likert scale, with consensus being defined as ≥75% agreement. ADA was recommended for treatment of aggressive early RA and established RA, axSpA and PsA with axial, peripheral and extra-musculoskeletal manifestations. ADA was also recommended for co-morbid conditions like chronic kidney disease (CKD), cardiovascular diseases, fatty liver, osteoporosis and metabolic syndrome (MetS). For patients achieving six consecutive months of remission, a slow tapering of ADA was advised over instant discontinuation to avoid disease flares. ADA is also recommended during pregnancy, right up to the end of the second trimester and during lactation. Furthermore, ADA biosimilars are cheaper and affordable for a larger number of patients in India. This consensus provides evidence-based recommendations to optimise disease outcomes by guiding healthcare professionals with special emphasis and focus only on ADA use in inflammatory arthritis.
The majority of current research on dance injuries has been on ballet, leaving a void in recent data on musculoskeletal injuries in Indian classical [IC] dance. The prevalence of injuries among IC dancers remains unclear, stressing the importance of injury epidemiology research for improved diagnosis, treatment, prevention, and injury burden reduction. Through a thorough examination of published literature, this study sought to critically evaluate existing research on the epidemiology of musculoskeletal pain and injury in IC dancers. Using Google Scholar and PubMed, a systematic evaluation of the online literature published in English was carried out from inception up to December 31, 2021 following PRISMA guidelines. For studies estimating injury prevalence, the Joanna Briggs Institute Prevalence Critical Appraisal Tool and the Risk of Bias Tool (RoBT) were used to evaluate the studies’ quality. Of 3,917 studies identified, 6 studies, all cross-sectional, of low quality, with a high risk of bias, and featuring young Bharatanatyam and Kathak dancers, were determined to be admissible. Because of the studies’ heterogeneity, severe study limitations, and methodological variability, a meta-analysis could not be carried out. The evidence from the current review is severely constrained, lacking generalizability to IC dancers as a whole and Bharatanatyam in particular. Since injury epidemiology is essential to the whole injury-prevention puzzle, there is a need for standardization in future research, particularly with active and prospective injury surveillance, injury assessment, and injury reporting.
