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Articles 1 - 20 of 20
Full-Text Articles in Medicine and Health Sciences
Breaking The Pain Cycle Successfully In A Child With Severe Pain Due To Recurrent Pancreatitis: A Case Report, Ali Sarfraz Siddiqui, Mansoor Chandio
Breaking The Pain Cycle Successfully In A Child With Severe Pain Due To Recurrent Pancreatitis: A Case Report, Ali Sarfraz Siddiqui, Mansoor Chandio
Department of Anaesthesia
Abdominal pain, due to pancreatic diseases like idiopathic recurrent pancreatitis and chronic pancreatitis, is difficult to manage with medications alone in some patients. The Coeliac plexus innervates abdominal organs including the liver, gallbladder, pancreas, etc. We are presenting a case of the successful pain man-agement of a 13-year-old boy with recurrent pancreatitis, by the application of coeliac plexus block. The patient was admitted to the hospital with severe abdominal pain in August 2019. Multimodal analgesia was provided to manage his pain, but he continued to have moderate to severe pain in the abdomen. So, he was scheduled for coeliac plexus …
Duration Of Cessation Of Smoking Before Elective Surgery: Impact On Intraoperative Hemodynamics And Early Postoperative Pain In Developing Country, Mohsin Nazir, Gauhar Afshan, Muslima Ejaz, Amir Raza
Duration Of Cessation Of Smoking Before Elective Surgery: Impact On Intraoperative Hemodynamics And Early Postoperative Pain In Developing Country, Mohsin Nazir, Gauhar Afshan, Muslima Ejaz, Amir Raza
Department of Anaesthesia
Aim and Background: It is estimated that up to 20% of patients coming for elective surgery are smokers and carry a risk of perioperative complications. Though smoking cessation and its impact on perioperative outcome are widely investigated worldwide we were unable to find any data in Pakistan. The objective of the study is to determine the impact of the duration of smoking cessation before elective surgery on intraoperative hemodynamics and postoperative pain in Pakistani population.
Methods: It was a prospective cohort study conducted at the Aga Khan University Hospital Karachi, Pakistan, for one-year duration. A total of 260 patients scheduled …
Comparison Of Perioperative Analgesia Between Intravenous Paracetamol And Fentanyl For Rigid Hysteroscopy: A Randomised Control Trial, Dileep Kumar, Kamal Kumar, Mohammad Hamid
Comparison Of Perioperative Analgesia Between Intravenous Paracetamol And Fentanyl For Rigid Hysteroscopy: A Randomised Control Trial, Dileep Kumar, Kamal Kumar, Mohammad Hamid
Department of Anaesthesia
Objective: To compare efficacy of intravenous paracetamol and fentanyl for intra-operative and post-operative analgesia in patients undergoing rigid hysteroscopy.
Method: The prospective randomised control trial was conducted at Aga Khan University Hospital, Karachi, from October 2016 to June 2017, and comprised patients aged 18-65 years with American Society of Anesthesiologists grade I or II undergoing hysteroscopy who were randomised into paracetamol group P and fentanyl group F. Anaesthesia induction technique was standardised and analgesia in group P was paracetamol 15mg/Kg administered 15-30 minutes pre-surgery, and in group F, it was fentanyl 2mcg/kg administered at induction of anaesthesia. Intra-operative pain was …
Anaesthetic Management Of Tracheal Injury Following Blunt Neck Trauma: An Unusual Late Presentation, Muhammad Saad Yousuf, Mohammad Bin Pervez, Saulat Fatimi, Khalid Samad
Anaesthetic Management Of Tracheal Injury Following Blunt Neck Trauma: An Unusual Late Presentation, Muhammad Saad Yousuf, Mohammad Bin Pervez, Saulat Fatimi, Khalid Samad
Department of Anaesthesia
Tracheal injuries, following blunt neck trauma, are life-threatening surgical emergencies with high risk of mortality. A high index of suspicion is necessary to avoid missing an occult injury because delays in diagnosis and definitive treatment are associated with poorer outcomes. We, herein, report a case of a 28-year man who presented in Emergency Department 15 days after blunt neck trauma from an accident involving electric cable. Anaesthetic challenges, airway management and importance of effective close loop communication, during repair of complex tracheal reconstruction, will be discussed in this case report.
Frequency Of Early Postoperative Adverse Events (Aes) In Adult Patients Undergoing Elective Neurosurgical Intervention At Tertiary Care Center In Pakistan, Mansoor Chandio, Faraz Shafiq, Ather Enam
Frequency Of Early Postoperative Adverse Events (Aes) In Adult Patients Undergoing Elective Neurosurgical Intervention At Tertiary Care Center In Pakistan, Mansoor Chandio, Faraz Shafiq, Ather Enam
Department of Anaesthesia
Objective: The postoperative period is critical in neurosurgical patients, where the incidence of postoperative AEs is significantly high. Most of events occurs during recovery phase and has got relation to anaesthetic management. The objective of study was to determine frequency of early AEs in elective neurosurgical patients.
Methods: This cross sectional study was conducted at our tertiary care center. The duration of study was one year, from August 2017-July 2018. The data was collected using predesigned proforma. The assessment was done on arrival in recovery room (T1) and then at forty five minutes (T2), twenty-fourth hour (T3) and forty-eighth hour …
Essential Package Of Palliative Care For Women With Cervical Cancer: Responding To The Suffering Of A Highly Vulnerable Population, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa
Essential Package Of Palliative Care For Women With Cervical Cancer: Responding To The Suffering Of A Highly Vulnerable Population, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa
Department of Anaesthesia
Women with cervical cancer, especially those with advanced disease, appear to experience suffering that is more prevalent, complex, and severe than that caused by other cancers and serious illnesses, and approximately 85% live in low- and middle-income countries where palliative care is rarely accessible. To respond to the highly prevalent and extreme suffering in this vulnerable population, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an essential package of palliative care for cervical cancer (EPPCCC). The EPPCCC consists of a set of …
Safety And Effectiveness Of Ultrasound Guided Peripheral Nerve Blocks: Audit At Tertiary Care Hospital, Asma Abdus Salam, Riffat Aamir, Robyna Irshad Khan, Aliya Ahmed, Azhar Rehman
Safety And Effectiveness Of Ultrasound Guided Peripheral Nerve Blocks: Audit At Tertiary Care Hospital, Asma Abdus Salam, Riffat Aamir, Robyna Irshad Khan, Aliya Ahmed, Azhar Rehman
Department of Anaesthesia
Objective: To assess the safety and effectiveness of peripheral nerve blocks using ultrasound.
Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all patients who received peripheral nerve blocks as part of anaesthesia care between January 2015 and January 2017. The data included outcomes of peripheral nerve block effectiveness, complications and limb conditions after the block. Peripheral nerve block effectiveness was assessed by monitoring pain scores at rest and on movement, and the requirement of co-analgesia. Complications, like numbness, motor block, metallic taste, hypotension and respiratory depression, were also assessed. Data was …
Ratio Of Height To Thyromental Distance: A Comparison With Mallampati And Upper Lip Bite Test For Predicting Difficult Intubation In Pakistani Population, Saman Tauheed Ali, Khalid Samad, Syed Amir Raza, Muhammad Qamarul Hoda
Ratio Of Height To Thyromental Distance: A Comparison With Mallampati And Upper Lip Bite Test For Predicting Difficult Intubation In Pakistani Population, Saman Tauheed Ali, Khalid Samad, Syed Amir Raza, Muhammad Qamarul Hoda
Department of Anaesthesia
Objective: To compare the accuracy of three diagnostic tests in predicting difficult laryngoscopy using Cormack and Lehane grade as the gold standard.
Methods: The cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from August 2014 to August 2015, and comprised patients who required endotracheal intubation for elective surgical procedures. The primary investigator used ratio of height to thyromental distance, upper lip bite test and the modified Mallampati test for assessing the airway correlated with laryngoscopic view based on Cormack and Lehane grading. Data was analysed using SPSS 19.
Results: Of the 383 patients, 59(15.4%) were classified as …
Augmented Package Of Palliative Care For Women With Cervical Cancer: Responding To Refractory Suffering, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa
Augmented Package Of Palliative Care For Women With Cervical Cancer: Responding To Refractory Suffering, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa
Department of Anaesthesia
The essential package of palliative care for cervical cancer (EPPCCC), described elsewhere, is designed to be safe and effective for preventing and relieving most suffering associated with cervical cancer and universally accessible. However, it appears that women with cervical cancer, more frequently than patients with other cancers, experience various types of suffering that are refractory to basic palliative care such as what can be provided with the EPPCCC. In particular, relief of refractory pain, vomiting because of bowel obstruction, bleeding, and psychosocial suffering may require additional expertise, medicines, or equipment. Therefore, we convened a group of experienced experts in all …
Post-Operative Pain Management Modalities Employed In Clinical Trials For Adult Patients In Lmic; A Systematic Review, Gauhar Afshan, Robyna Irshad Khan, Aliya Ahmed, Ali Sarfraz Siddiqui, Azhar Rehman, Syed Amir Raza, Rozina Kerai, Khawaja Mustafa
Post-Operative Pain Management Modalities Employed In Clinical Trials For Adult Patients In Lmic; A Systematic Review, Gauhar Afshan, Robyna Irshad Khan, Aliya Ahmed, Ali Sarfraz Siddiqui, Azhar Rehman, Syed Amir Raza, Rozina Kerai, Khawaja Mustafa
Department of Anaesthesia
Background: Unrelieved postoperative pain afflicts millions each year in low and middle income countries (LMIC). Despite substantial advances in the study of pain, this area remains neglected. Current systematic review was designed to ascertain the types of clinical trials conducted in LMIC on postoperative pain management modalities over the last decade.
Methods: A comprehensive search was performed in June 2019 on PubMed, Cochrane Library, CINAHL Plus, and Web of Science databases to identify relevant trials on the management of postoperative pain in LMIC. Out of 1450 RCTs, 108 studies were reviewed for quality evidence using structured form of critical appraisal …
Cervical Cancer-Associated Suffering: Estimating The Palliative Care Needs Of A Highly Vulnerable Population, Eric L. Krakauer, Xiaoxiao Kwete, Khadidjatou Kane, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa, C R Beena Devi C R Beena Devi
Cervical Cancer-Associated Suffering: Estimating The Palliative Care Needs Of A Highly Vulnerable Population, Eric L. Krakauer, Xiaoxiao Kwete, Khadidjatou Kane, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa, C R Beena Devi C R Beena Devi
Department of Anaesthesia
Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.
Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying …
Thyrotoxic Hypokalemic Periodic Paralysis: A Success Story Of A Diagnostic Challenge, Mohsin Nazir, Malika Hameed, Rizwana Shehzad
Thyrotoxic Hypokalemic Periodic Paralysis: A Success Story Of A Diagnostic Challenge, Mohsin Nazir, Malika Hameed, Rizwana Shehzad
Department of Anaesthesia
Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare but life-threatening complication of hyperthyroidism seen predominantly in males. It is generally characterized by hypokalemia and skeletal muscle paralysis requiring intensive care admission. Hypokalemia occurs due to the massive intracellular shift of potassium because of the hyperactivity of the sodium-potassium adenosine triphosphates pump (Na+ K+ ATPase). Its differential diagnosis from the other common causes of hypokalemic paralysis is essential to provide targeted therapy. We present a rare case of THPP in a female patient with no prior history of thyroid disease. THPP in this patient was precipitated by trauma and …
Efficacy And Safety Of Dotinurad In Hyperuricemic Patients With Or Without Gout: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Ayman Iqbal, Kinza Iqbal, Eisha Farid, Ali Ishaque, Muhammad Hasanain, Taha Bin Arif, Shajeea Arshad Ali, Sawai Singh Rathore, Mehreen Malik
Efficacy And Safety Of Dotinurad In Hyperuricemic Patients With Or Without Gout: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Ayman Iqbal, Kinza Iqbal, Eisha Farid, Ali Ishaque, Muhammad Hasanain, Taha Bin Arif, Shajeea Arshad Ali, Sawai Singh Rathore, Mehreen Malik
Department of Anaesthesia
Introduction: A systematic review and meta-analysis of the available randomized controlled trials (RCTs) were conducted to investigate the efficacy and safety of dotinurad in hyperuricemic patients with or without gout. Dotinurad is a novel selective urate reabsorption inhibitor (SURI) that increases uric acid excretion by selectively inhibiting urate transporter 1 (URAT1). To the best of our knowledge, this is the first meta-analysis conducted to gauge the efficacy and safety of dotinurad.
Methods: Electronic databases (PubMed, the Cochrane Library, and ClinicalTrials.gov) were searched from inception till March 2, 2021, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis …
Incidence And Risk Factors Of Delirium In Surgical Intensive Care Unit, Muhammad Asghar Ali, Madiha Hashmi, Waqas Ahmed, Syed Amir Raza, Muhammad Faisal Khan, Bushra Salim
Incidence And Risk Factors Of Delirium In Surgical Intensive Care Unit, Muhammad Asghar Ali, Madiha Hashmi, Waqas Ahmed, Syed Amir Raza, Muhammad Faisal Khan, Bushra Salim
Department of Anaesthesia
Background: To evaluate the incidence and modifiable risk factors of delirium in surgical intensive care unit (SICU) of tertiary care hospital in a low-income and middle-income country.
Methods: We conducted a single cohort observational study in patients over 18 years of age who were admitted to the SICU for >24 hours in Aga Khan University Hospital from January to December 2016. Patients who had pre-existing cognitive dysfunction were excluded. Intensive Care Delirium Screening Checklist was used to assess delirium. Incidence of delirium was computed, and univariate and multivariable analyses were performed to observe the relationship between outcome and associated factors. …
Persistent Post-Surgical Pain Following Breast Cancer Surgery: An Observational Study In A Tertiary Care Hospital, Ali Sarfraz Siddiqui, Sana Zeeshan, Aliya Ahmed, Shaista Khan
Persistent Post-Surgical Pain Following Breast Cancer Surgery: An Observational Study In A Tertiary Care Hospital, Ali Sarfraz Siddiqui, Sana Zeeshan, Aliya Ahmed, Shaista Khan
Department of Anaesthesia
Objective: To determine the frequency of persistent pain in patients after breast cancer surgery, and to assess the distribution and characteristics of pain in such patients.
Methods: The prospective observational single cohort study was conducted at the Department of Anaesthesiology and in the Breast Clinic of the Department of Surgery, Aga Khan University Hospital, Karachi, from August 2016 to January 2017, and comprised adult female patients with biopsy-proven carcinoma of breast who were scheduled for elective definitive breast cancer surgery. The patients were followed up for up to three months post-surgery and those with persistent pain were followed up for …
Management Of Difficult Airway In A Pregnant Patient With Severely Reduced Mouth Opening, Faisal Shamim, Aly Bahadur, Dinaz Ghandhi, Anum Aijaz
Management Of Difficult Airway In A Pregnant Patient With Severely Reduced Mouth Opening, Faisal Shamim, Aly Bahadur, Dinaz Ghandhi, Anum Aijaz
Department of Anaesthesia
Pregnancy is associated with a wide variety of oral and dental changes ranging from gingivitis to odontogenic infections. If left untreated, severe dental abscess can progress to Ludwig's angina, which is a potentially lethal cellulitis that rapidly extends to the neck region and may lead to life-threatening upper airway obstruction. We report the case of a pregnant woman who presented with intense throbbing pain, trismus and severely reduced mouth opening due to dental abscess for the last one week. She required incision and drainage of abscess with extraction of third molar under general anaesthesia. There are some significant challenges to …
Quality Assurance Audit In Adult Cardiac Anaesthesia, Syed Shabbir Ahmed, Mohammad Hamid, Faisal Junejo
Quality Assurance Audit In Adult Cardiac Anaesthesia, Syed Shabbir Ahmed, Mohammad Hamid, Faisal Junejo
Department of Anaesthesia
Objective: To assess different anaesthesia-related quality indicators during adult cardiac surgery.
Methods: The prospective clinical audit was conducted at the Aga Khan University Hospital, Karachi, from October 2016 to March 2017, and comprised all adult patients scheduled for cardiac surgery. Different anaesthesia-related quality indicators were observed during the pre-induction phase, before the cardiopulmonary bypass, during the procedure, and post-surgery till the transfer from the operating room to the cardiac intensive care unit. Data was analysed using SPSS 19.
Results: Of the 264 patients, 217(82.2%) had complete record; 160(73.7%) males and 57(26.3%) females. The overall mean age was 56.56±12.46 years. In …
Epidemiological Characteristics, Ventilator Management, And Clinical Outcome In Patients Receiving Invasive Ventilation In Intensive Care Units From 10 Asian Middle-Income Countries (Provent-Imic): An International, Multicenter, Prospective Study, Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Seyed Mohammadreza Hashemian, Madiha Hashmi
Epidemiological Characteristics, Ventilator Management, And Clinical Outcome In Patients Receiving Invasive Ventilation In Intensive Care Units From 10 Asian Middle-Income Countries (Provent-Imic): An International, Multicenter, Prospective Study, Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Seyed Mohammadreza Hashemian, Madiha Hashmi
Department of Anaesthesia
Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [V T] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, …
Enhancing The Efficiency Of Bag Mask Ventilation: New Method, Muhammad Irfan Ul Haq
Enhancing The Efficiency Of Bag Mask Ventilation: New Method, Muhammad Irfan Ul Haq
Department of Anaesthesia
No abstract provided.
Post Operative Sore Throat: Comparison Between Macintosh Versus Video Laryngoscope In Patients Intubated By Trainee Anaesthetists - A Randomised Control Trial, Amin Ahmed Kapadia, Faraz Shafiq, Amir Raza
Post Operative Sore Throat: Comparison Between Macintosh Versus Video Laryngoscope In Patients Intubated By Trainee Anaesthetists - A Randomised Control Trial, Amin Ahmed Kapadia, Faraz Shafiq, Amir Raza
Department of Anaesthesia
Objectives: Postoperative sore throat (POST) is a common complication related to endotracheal intubation. The aim of this study was to compare the incidence of POST in patients intubated by trainee anaesthetist using Video Laryngoscope™ (VDL) or Conventional Macintosh Laryngoscope (CL).
Methods: Total 110 patient scheduled for elective laparoscopic cholecystectomy were included from main operating room of Aga Khan University Hospital between June 2017-2018. The standardized perioperative protocol was used for general anaesthesia. Selected patients were randomly allocated into conventional laryngoscopy (CL) group or video laryngoscopy (VDL) group. The evaluation of sore throat was done at 1st, 12th and 24th hour …