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Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan2 Uzma Rahim Khan2 Uzma Rahim Khan2 2018 Aga Khan University

Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan2 Uzma Rahim Khan2 Uzma Rahim Khan2

Department of Anaesthesia

Objective:

Health care providers (HCPs) are at risk of occupational exposure to HIV infection. In developing world these exposure occur due to general lack of awareness, education and structured training of HCPs. The objective of the study was to asses if continuing medical education symposium can be used as an effective educational tool to improve attitude, awareness and knowledge regarding occupational exposure to HIV infection. This quasi-experimental study was conducted among HCPs from Karachi, Pakistan. After assessing the baseline knowledge, awareness, and attitude by means of pretest; HCPs were reassessed with posttest after an education symposium on occupational exposure to ...


Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan 2018 Aga Khan University

Occupational Exposure To Hiv In A Developing Country: Assessing Knowledge And Attitude Of Healthcare Professional Before And After An Awareness Symposium, Samina Ismail, Safia Awan, Rubaba Naeem, Sarfraz Siddiqui, Badar Afzal, Bushra Jamil, Uzma Rahim Khan

Department of Anaesthesia

Objective:

Health care providers (HCPs) are at risk of occupational exposure to HIV infection. In developing world these exposure occur due to general lack of awareness, education and structured training of HCPs. The objective of the study was to asses if continuing medical education symposium can be used as an effective educational tool to improve attitude, awareness and knowledge regarding occupational exposure to HIV infection. This quasi-experimental study was conducted among HCPs from Karachi, Pakistan. After assessing the baseline knowledge, awareness, and attitude by means of pretest; HCPs were reassessed with posttest after an education symposium on occupational exposure to ...


Haemodynamic Assessment And Support In Sepsis And Septic Shock In Resource-Limited Settings, David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W. Dünser, Arjen M. Dondorp, Marcus J. Schultz, Global Intensive Care Working Group†, of the European Society of Intensive Care Medicine (ESICM) and the Mahidol Oxford Tropical Medicine Research Unit (MORU) in Bangkok, Thailand 2018 Aga Khan University

Haemodynamic Assessment And Support In Sepsis And Septic Shock In Resource-Limited Settings, David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W. Dünser, Arjen M. Dondorp, Marcus J. Schultz, Global Intensive Care Working Group†, Of The European Society Of Intensive Care Medicine (Esicm) And The Mahidol Oxford Tropical Medicine Research Unit (Moru) In Bangkok, Thailand

Anaesthesiology, East Africa

Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking.

Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind.

Results: We suggest using capillary refill time, skin mottling scores and skin temperature gradients; suggest ...


Bladder Distension As A Cause Of Abdominal Compartment Syndrome, Muhammad Yasir, Muhammad Qamarul Hoda, Tauseef Ahmed 2018 Security Forces Hospital, Riyadh, Saudi Arab

Bladder Distension As A Cause Of Abdominal Compartment Syndrome, Muhammad Yasir, Muhammad Qamarul Hoda, Tauseef Ahmed

Department of Anaesthesia

Abdominal compartment syndrome (ACS) is increasingly identified in critically ill patient and its harmful effects are well documented. The disparity among the pressure, volume in abdominal cavity and its contents, results in ACS. The actual incidence of ACS is not known. However, it has been observed predominantly in patients with severe blunt and penetrating abdominal trauma, ruptured abdominal aortic aneurysms, retro- and intra-peritoneal hemorrhage, pneumoperitoneum, neoplasm, pancreatitis, ascites and multiple bone fracture. We present a case of 40-year female who underwent emergency cesarean section and developed abdominal compartment syndrome due to urinary bladder distension secondary to blockade of urinary catheter ...


Systematic In Vivo Evaluation Of The Time-Dependent Inflammatory Response To Steel And Teflon Insulin Infusion Catheters., Jasmin R. Hauzenberger, Julia Münzker, Petra Kotzbeck, Martin Asslaber, Vladimir Bubalo, Jeffrey I. Joseph, Thomas R. Pieber 2018 Medical University of Graz

Systematic In Vivo Evaluation Of The Time-Dependent Inflammatory Response To Steel And Teflon Insulin Infusion Catheters., Jasmin R. Hauzenberger, Julia Münzker, Petra Kotzbeck, Martin Asslaber, Vladimir Bubalo, Jeffrey I. Joseph, Thomas R. Pieber

Department of Anesthesiology Faculty Papers

Continuous subcutaneous insulin infusion (CSII) catheters are considered the weak link of insulin pump therapy. Wear-time considerably varies between patients and the choice of catheter material is based on personal preferences rather than scientific facts. Therefore, we systematically assessed and quantified the inflammatory tissue response to steel versus Teflon CSII catheters over a maximum wear-time of 7 days in swine. Tissue surrounding catheters was analysed using histopathology and quantitative real-time PCR. The area of inflammation increased significantly over time independent of material which was confirmed by an increase in CD68 expression and an increase in mononuclear and neutrophil cell infiltrate ...


Use Of Caudal Epidural Catheter In A Child With Cerebral Palsy With Prior Posterior Spine (T1-Sacrum) Fusion., Divya Dixit, Mary C. Theroux, Kirk W. Dabney, Freeman Miller 2018 Thomas Jefferson University; Nemours/Alfred I. duPont Hospital for Children

Use Of Caudal Epidural Catheter In A Child With Cerebral Palsy With Prior Posterior Spine (T1-Sacrum) Fusion., Divya Dixit, Mary C. Theroux, Kirk W. Dabney, Freeman Miller

Department of Anesthesiology Faculty Papers

No abstract provided.


Fluid Choice During Perioperative Care In Children: A Survey Of Present‑Day Proposing Practice By Anesthesiologists In A Intertiary Care Hospital, Muhammad Faisal Khan, Khalid Maudood Siddiqui, Ali Asghar 2018 Aga Khan University

Fluid Choice During Perioperative Care In Children: A Survey Of Present‑Day Proposing Practice By Anesthesiologists In A Intertiary Care Hospital, Muhammad Faisal Khan, Khalid Maudood Siddiqui, Ali Asghar

Department of Anaesthesia

Background: Perioperative fluid therapy in pediatrics has always been a challenging avenue for anesthesiologists.

Inappropriate choice of fluid leads to multiple side effects, for instance iatrogenic hyponatremia. Our aim was to observe the

current practice of perioperative fluid therapy in pediatric population undergoing surgery in a tertiary care hospital.

Methods: After obtaining approval from the Departmental Research Review Committee, a survey form including questions

was emailed to anesthesiologists from January 2015 to June 2015. Individual responses were recorded and analyzed.

Results: Overall response was 100% from consultant and resident, and total 55 anesthesiologists were participated in

this survey. Majority of ...


Is Homocystinuria A Real Challenge For Anesthetist? Are We Making A Difference?, Muhammad Umar Slote, Karima Karam Khan,, Ausaf Ahmed Khan, Mohsin Nazir Butt 2018 Aga Khan University

Is Homocystinuria A Real Challenge For Anesthetist? Are We Making A Difference?, Muhammad Umar Slote, Karima Karam Khan,, Ausaf Ahmed Khan, Mohsin Nazir Butt

Department of Anaesthesia

No abstract provided.


A Reliable Alternative Of Fiberoptic Bronchoscope Inunanticipated Difficult Airway: Flexible Fiberoptic Cystoscope, Muhammad Sohaib, Khalid Maudood Siddiqui, Muhammad Faisal Khan 2018 Aga Khan University

A Reliable Alternative Of Fiberoptic Bronchoscope Inunanticipated Difficult Airway: Flexible Fiberoptic Cystoscope, Muhammad Sohaib, Khalid Maudood Siddiqui, Muhammad Faisal Khan

Department of Anaesthesia

No abstract provided.


Intravenous Lidocaine And Postextubation Laryngospasm, Muhammad Faisal Khan, Ullah Saleem 2018 Aga Khan University

Intravenous Lidocaine And Postextubation Laryngospasm, Muhammad Faisal Khan, Ullah Saleem

Department of Anaesthesia

No abstract provided.


Evaluation Of Delivery Methods Of Chemical Dependency And Wellness Education, marissa coggin 2017 The University of Southern Mississippi

Evaluation Of Delivery Methods Of Chemical Dependency And Wellness Education, Marissa Coggin

Doctoral Nursing Capstone Projects

Anesthesia practice is learned in a stressful environment, and these stressors may lead to the students’ development of maladaptive coping mechanisms. Despite significant improvements in our understanding of addiction and our approaches to combat this problem, the risk of substance misuse remains high in nurse anesthesia students. Education and intervention are imperative when taking preventative measures. The purpose of this Doctor of Nursing Practice (DNP) project was to determine whether delivery method of chemical dependency/wellness educational program effects the level of understanding of anesthesia providers and substance misuse and the development of healthy coping mechanisms.

In determining whether the ...


Subanesthetic Ketamine For Postoperative Analgesia: An Evidenced-Based Project, Jeremy Vance 2017 University of Southern Mississippi

Subanesthetic Ketamine For Postoperative Analgesia: An Evidenced-Based Project, Jeremy Vance

Doctoral Nursing Capstone Projects

Roughly 100 million surgical procedures are performed in the United States (U.S.) each year and more than 80% of these patients experience acute postoperative pain. Pain costs the U.S. an estimated $560 to $635 billion annually and is a significant contributor to national rates of mortality, morbidity, and disability. Despite these findings, patients continue to receive suboptimal postoperative pain relief.

The adjunct administration of subanesthetic ketamine is opioid-sparing and can improve the effectiveness of a multimodal pain management approach. This project used an exploratory descriptive design to examine how an evidence-based presentation impacted the clinical practice of certified ...


Efficiency Of Spinal Anesthesia Versus General Anesthesia For Lumbar Spinal Surgery: A Retrospective Analysis Of 544 Patients., John T. Pierce, Guy Kositratna, Mark A. Attiah, Michael J. Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, MD, Paul J. Marcotte, W. Andrew Kofke, William C. Welch 2017 University of Pennsylvania

Efficiency Of Spinal Anesthesia Versus General Anesthesia For Lumbar Spinal Surgery: A Retrospective Analysis Of 544 Patients., John T. Pierce, Guy Kositratna, Mark A. Attiah, Michael J. Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, Md, Paul J. Marcotte, W. Andrew Kofke, William C. Welch

Department of Anesthesiology Faculty Papers

BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons.

MATERIALS AND METHODS: A retrospective analysis was performed by querying the electronic medical record database for surgeries performed by a single surgeon between 2007 and 2011 using procedural codes 63030 for diskectomy and 63047 for laminectomy: 544 ...


Right Ventricular Perforation: A Rare Complication Of Pulmonary Artery Catheterization, Khalid Ahsan, Mohammad Hamid, Saulat H. Fatimi, Ijaz Hidayat 2017 Aga Khan University

Right Ventricular Perforation: A Rare Complication Of Pulmonary Artery Catheterization, Khalid Ahsan, Mohammad Hamid, Saulat H. Fatimi, Ijaz Hidayat

Saulat Fatimi

A 70 years old male underwent Coronary Artery Bypass and Graft (CABG) surgery. After induction, a Pulmonary Artery Catheter (PAC) was inserted via right IJV with some difficulty in achieving PA tracing. During distal RCA anastomosis, surgeon noticed PAC tip coming out of Right Ventricular (RV) surface. Resistance was felt on trying to pull PAC, so it was left there. Cardiac surgeon then opened the Right Atrium (RA) and pulled out the catheter. Multiple attempts during insertion of PA catheter should always raise the suspicion of PAC tip slipping back into the RV. It should be closely monitored during surgery ...


Dilemma During Ultrasound-Guided Internal Jugular Venous Catheterization, Sanjay Dwarakanath, Monica Cheriyan, Annette Rebel 2017 University of Kentucky

Dilemma During Ultrasound-Guided Internal Jugular Venous Catheterization, Sanjay Dwarakanath, Monica Cheriyan, Annette Rebel

Anesthesiology Faculty Publications

The presence of Internal Jugular Valves can pose a diagnostic and procedural challenge during ultrasound-guided cannulation. After ruling out dissection, thrombus, or ultrasound artifacts, it can still be accessed and successfully cannulated with appropriate precautions including use of Live ultrasound, positioning, use of soft-tipped catheters, and minimizing duration of catheter placement.


Unplanned Prolonged Postanaesthesia Care Unit Length Of Stay And Factors Affecting It, Khalid Samad, Mueenullah Khan, Hameedullah, Fauzia A. Khan, Mohammad Hamid, Fazal Hameed Khan 2017 Aga Khan University

Unplanned Prolonged Postanaesthesia Care Unit Length Of Stay And Factors Affecting It, Khalid Samad, Mueenullah Khan, Hameedullah, Fauzia A. Khan, Mohammad Hamid, Fazal Hameed Khan

Fazal Hameed Khan

Objective: To identify the factors that prolong the length of stay in the post anaesthesia care unit (PACU). Methods: This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded. Data was collected for 20 months by a designated recovery nurse for all included patients including those admitted outside the ...


Respiratory Arrest In A Child After Flushing Of Pancuronium From The Dead Space Of Intravenous Cannula, R. I. Khan, Fazal Hameed Khan, H .I Naqvi 2017 Aga Khan University

Respiratory Arrest In A Child After Flushing Of Pancuronium From The Dead Space Of Intravenous Cannula, R. I. Khan, Fazal Hameed Khan, H .I Naqvi

Fazal Hameed Khan

It is common practice for patients admitted to Intensive Care Units to have indwelling intravenous cannulae. Sometimes these cannulae are used only for the administration of drugs and are closed otherwise. Residual drugs in the deadspace of these intravenous cannulae as well as connected stoppers or 3-way stopcocks can later be flushed unknowingly. We would like to report a case in which inadvertent flushing of residual pancuronium caused complete muscle paralysis and respiratory arrest in a young child.


To Compare The Accuracy Of Prayer's Sign And Mallampatti Test In Predicting Difficult Intubation In Diabetic Patients, Mirza Mudassir Ali Baig, Fazal Hameed Khan 2017 Aga Khan University

To Compare The Accuracy Of Prayer's Sign And Mallampatti Test In Predicting Difficult Intubation In Diabetic Patients, Mirza Mudassir Ali Baig, Fazal Hameed Khan

Fazal Hameed Khan

Objective: To determine the accuracy of Prayer's sign and Mallampatti test in predicting difficult endotracheal intubation in diabetic patients. Methods: The cross-sectional study was performed at Aga Khan University Hospital, Karachi, over a period from January 2009 to April 2010, and comprised 357 patients who required endotracheal intubation for elective surgical procedures. Prayer's sign and Mallampatti tests were performed for the assessment of airway by trained observers. Ease or difficulty of laryngoscopy after the patient was fully anaesthetised with standard technique were observed and laryngoscopic view of first attempt was rated according to Cormack-Lehan grade of intubation. SPSS ...


Haemodynamic Response To Tracheal Intubation Via Intubating Laryngeal Mask Airway Versus Direct Laryngoscopic Tracheal Intubation, Naveed Tahir Siddiqui, Fazal Hameed Khan 2017 Aga Khan University

Haemodynamic Response To Tracheal Intubation Via Intubating Laryngeal Mask Airway Versus Direct Laryngoscopic Tracheal Intubation, Naveed Tahir Siddiqui, Fazal Hameed Khan

Fazal Hameed Khan

Objective: To compare the haemodynamic response to tracheal intubation using either direct larygoscopy or Intubating Laryngeal Mask Airway. Methods: This was a prospective randomized controlled trial. One hundred adult ASA-I and ASA - II patients coming to the Anaesthesia Department of Aga Khan University Hospital were randomly divided into two groups. In group- I endotracheal intubation was done with the help of Macintosh laryngoscope while in group-II patients were intubated with the help of the Intubating Laryngeal Mask Airway. Systolic, diastolic, mean arterial blood pressure and heart rate were recorded at baseline, at laryngoscopy and at 1 minute interval for 10 ...


Anaesthetic Management Of A Pregnant Patient For Aortic Valve Replacement, Khalid M Siddiqui, Fazal Hameed Khan 2017 Aga Khan University

Anaesthetic Management Of A Pregnant Patient For Aortic Valve Replacement, Khalid M Siddiqui, Fazal Hameed Khan

Fazal Hameed Khan

Cardiac disease can be encountered during pregnancy with the frequency being 1% to 2% of all pregnant women. Because of the high foetal and relative maternal mortality during surgery, medical management is the first line of treatment. Nevertheless, when medical treatment fails, cardiac surgery becomes necessary. We present the anaesthetic management of a case of Aortic valve disease in a pregnant woman undergoing surgery.


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