Medicine and Health Sciences Commons^™

Midazolam And Thiopentone Co-Induction: Looking For Improvement In Quality Of Anaesthesia, M A. Khan, F A. Khan

Department of Anaesthesia

Objective: To evaluate improvement in quality of anaesthesia induction using thiopentone and midazolam for co-induction of anaesthesia. An additional end point was taken as loss of response to a tetanic stimulation (50 Hz) delivered for 5 seconds after the loss of verbal contact and eyelash reflex.Methods: Ninety ASA I and II patients, within the age range of 20-60 years were studied. Patients were randomly divided into three equal groups; A, B and group C.Results: Onset of induction and loss of response to a tetanic stimulation was achieved earlier in group B as compared to the other study groups (p < 0.05).CONCLUSION: Co-induction with midazolam 0.02 mg x kg(-1) followed by thiopentone 3 mg x kg(-1) was superior to other two groups. Induction of anaesthesia in this group was found to be smoother and faster, provided better hemodynamic stability, better airway maintenance and with lesser incidence of untoward effects.

A Comparison Of Morphine And Nalbuphine For Intraoperative And Postoperative Analgesia, F N. Minai, F A. Khan

Department of Anaesthesia

Introduction: Short acting narcotics are not available in Pakistan and the supply of drugs like morphine and pethidine is short and erratic; therefore there is a need for investigating acceptable alternatives for analgesia, to be used for balanced anaesthesia.Objective: We studied the agonist-antagonist narcotic nalbuphine compared to morphine, for intra and postoperative pain relief in total abdominal hysterectomies.Methods: In a randomised double blind trial, fifty ASA I and II patients in two groups of twenty five each were given equianalgesic doses of morphine and nalbuphine. Hemodynamic stability, intraoperative analgesia, recovery profiles, incidence of side effects and need for postoperative supplements …

The Frequency Of Iga Nephropathy At A Single Center In Pakistan, S. Muzaffar, N. S. Azad, N. Kayani, Shahid Pervaz, A. Ahmed, S. H. Hasan

Department of Pathology and Laboratory Medicine

Objectives: To detect the prevalence of IgA nephropathy in Pakistani patients, as no significant published data from this part of the developing world is available in the international literature for reference.

Method: The study was conducted in a university hospital on 105 consecutive renal biopsy specimens. Direct immunofluorescence microscopy was performed using antibodies specific for the heavy chains of IgG, IgA, IgM, C3 and fibrinogen.

Results: Seventy-nine (79) cases were classified as glomerulopathies, out of which 10 cases (12.65%) were diagnosed as IgA nephropathy, among which one case was that of Henoch- Schonlein purpura. The age range was 6 to …

Effects Of Tensioning Errors In Split Transfers Of Tibialis Anterior And Posterior Tendons, Stephen J. Piazza, Matthew F. Moran, Neil A. Sharkey, Robert L. Adamson, James O. Sanders

All PTHMS Faculty Publications

Background: Split transfers of the tibialis anterior and posterior tendons are commonly performed to address hindfoot varus deformities in patients with cerebral palsy, stroke, or brain injury. Poor outcomes from these procedures are often attributed to a failure to tension the transferred tendon properly, but the mechanical effects of this aspect of the procedure have not been quantified, to our knowledge. The purpose of the present study was to use a cadaver model to examine changes in the actions of these muscles that occur when the tensions in the halves of the split tendon are intentionally balanced or unbalanced to …

A Computer Model Of Intracranial Pressure Dynamics During Traumatic Brain Injury That Explicitly Models Fluid Flows And Volumes, Wayne W. Wakeland, Brahm Goldstein, Louis Macovsky, James Mcnames

Systems Science Faculty Publications and Presentations

This report documents a computer model of intracranial pressure (ICP) dynamics that is used to evaluate clinical treatment options for elevated ICP during traumatic brain injury (TBI). The model uses fluid volumes as primary state variables and explicitly models fluid flows as well as the resistance, compliance, and pressure associated with each of the compartments (arteries and arterioles, capillary bed, veins, venous sinus, ventricles, and brain parenchyma). The model has been tested to assure that it reproduces a correct physiologic response to intra-and extra-parenchymal hemorrhage and edema, and to therapies directed at reducing ICP such as cerebral spinal fluid drainage, …

Effect Of Acupressure On Postoperative Nausea And Vomiting In Laparoscopic Cholecystectomy, K Samad, G Afshan, R Kamal

Department of Anaesthesia

Objective: To evaluate the effectiveness of acupressure applied at meridian P6 point for prevention of nausea and vomiting in patients undergoing laparoscopic cholecystectomy.METHODOLOGY: A randomized double blind study was performed in 50 ASA I and II patients scheduled for laparoscopic cholecystectomy. Patients were divided into two groups; control and placebo. In the control group acupressure was applied at P6 point half an hour before surgery while in the placebo group the acupressure band was tied on meridian P6 point but the plastic bead was placed on the dosum of right forearm away from meridian P6 point. Patients were assessed for …

Quality Assessment Of A Collaborative Approach For Decreasing Drug-Related Morbidity And Achieving Therapeutic Goals, Brian J. Issetts, Lawrence M. Brown, Stephen W. Schondelmeyer, Lois A. Lenarz

Pharmacy Faculty Articles and Research

Background Collaboration between physicians and pharmacists is one approach to address drug-related morbidity and achieve therapeutic goals. A collaborative practice of pharmaceutical care has been used in the Fairview Clinics System of Minneapolis-St Paul since 1999.

Methods The quality of therapeutic determinations made by pharmacists within this collaborative practice of pharmaceutical care was studied by a 12-member panel of physicians and pharmacists who used randomly selected patient records. This was a quality improvement and care process validation component of a study evaluating the effects of drug therapy management in patients receiving prepaid medical assistance. An implicit review process was used …