Objectives: To evaluate the hemodynamic and recovery characteristics of dexmeditomidine and propofol in dilatation and curettage. Study Design: Randomized control trial. Setting: Department of ...Anaesthesia, DHQ Teaching Hospital Sargodha. Period: March 2016 to December 2017. Material & Methods: Patients undergoing dilatation & curettage were randomly divided into two groups, group P received IV propofol 1.5mg/kg slowly over 5 min and group D received dexmeditomidine at a loading dose of 1µg/kg followed by 0.5 µg/kg/h. During the procedure blood pressure and heart rate were compared in both groups. In the recovery room, recovery time was compared in both groups by using modified aldrete score. Results: In Group D, the decrease in heart rate was statistically significant when compared with group P. Both groups showed a decrease in MAP but results were not statistically significant when compared in both groups. Patients in group D were discharged earlier from recovery room than group P and results were statistically significant. Conclusion: Dexmeditomodine provides better recovery than propofol so it is a suitable drug for day care minor surgical procedures. Similarly dexmeditomidine is superior to propofol by providing less respiratory depression intraopertaively.
Objectives: In Laparoscopic surgery placement of primary port is an important step and is often associated with complications. Our objective is to compare the merits and demerits like safety, ...efficacy of the site, time of entry of the port, per-operative and post-operative complications of infrumbilical (IU) with transumbilical (TU) approach for placement of this port. So on the basis of best clinical evidence get a clinical direction for a better site for placement of primary port. Study Design: A prospective randomized controlled trial of 238 patients. Setting: Surgical unit II of DHQ Hospital/ Sargodha Medical College (University of Sargodha) Sargodha. Period: June 2015 to December 2017. Material & Methods: Patients aged 16-70 years, fit for surgery, under general anesthesia were included in this study after informed consent. Patients who were unfit for general anaesthesia, who were Imuno-compromised, diabetics, CLD, with ascites, patients with suspected malignancy, with previous surgery in the umbilical region like midline laparotomy scar, previous hernia repair in this region were excluded from this study. Permission was sought from and granted by institutional ethical committee. Results: A total number of 238 patients were included. Group A (Trans-Umbilical) and Group B (Infra-Umbilical) contained 119 cases each. There were 147 female and 91 male. (M: F ratio of 1: 1.615). Conclusion: Based on results from this study and previous literature, it may be concluded that Transumbilical (TU) placement of primary port for creation of pneumoperitoneum is superior to infrumbilical (IU) approach.
South Asia is an enigma for gastric cancer (GC) because it is a low risk region with a high prevalence of Helicobacter pylori (H. pylori) infections. We evaluated the trend of GC clinical ...presentation and risk factors in patients with dyspeptic symptoms.
The medical records of patients, coded by the international classification of diseases (ICD-10-CM, 2015, Diagnosis Code C16.9) for malignancies of stomach diagnosed by esophagogastroduodenoscopy (EGD) and histopathology, were studied.
394 GC cases with a mean age of 54±15 years, range of 18 to 88, were analyzed. 256 (65%) were male. Distal non-cardiac and cardiac tumors were 302 (77%) and 92 (23%) cases, respectively. The WHO classification of GC defined 222 (56%) cases as intestinal type adenocarcinoma, 68 (17%) cases as signet ring cell carcinoma (SRC), 62 (16%) cases as diffuse type and 42 (11%) cases as B cell non-Hodgkin lymphoma. The co-morbid conditions associated with GC were H. pylori infection (positive in 246 (62%) cases), diabetes mellitus type 2 (in 90 (23%) cases), and cigarette smoking (in 94 (24%) cases). Of the male patients, 88 (34%) (p<0.001) were smokers. Body mass index was abnormal in all age groups and in both sexes. Cardiac regions for GC were more common in the 46- to 60-year old age range and in males. Diffuse GC was seen in all age groups but there were significantly more common in the 18- to 45-year old age range. Gastric non-Hodgkin's lymphoma was seen at an early age of 18-45 years in 14(12%) and a later of 61-88 years in 20 (15%).
Intestinal type GC is common at all ages but SRC and diffuse GC are more common in patients less than 50 years old. SRC and diffuse GC were not specific to the elderly in our study population.
In order to mitigate the effects of disease spread, it is necessary to understand the Spatio-temporal dynamics of epidemic spread and response evaluation. For that purpose, an agent-based ...heterogeneous knowledge model is synthesized using a probabilistic approach that depicts population interactions. The approach can generate a baseline population synthesis for cities such as Lahore, Pakistan where the population is quite dense and agent-based modeling becomes quite complex. An agent-based Spatio-temporal model of airborne disease is analyzed (i.e., influenza) in a metropolitan area. Such diseases result in mass casualties’ events in the populous regions, every year. Using GIS shapefiles, prior knowledge of people activities and IPUMS data, the agent base model is synthesized and an epidemic spread scenario is simulated. The proposed model can be used by healthcare officials for disease spread simulation. The model is helpful when heterogeneity semantics in population bring complexity in computations. It brings different attributes like age, sex and social status under consideration while calculating the probability of being infected as the way of interaction between people is highly depend upon them. This proposed model takes spatial factor into account as the way an infection spreads depending upon spatial distribution of infected and susceptible ones.
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