Lupine Publishers Group

Bikash Khadka*

DOI : 10.32474/GJAPM.2020.03.000165

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otherwise useful agent such as propofol for short cases and day care surgeries. Lidocaine and ketamine both are used as pretreatment to decrease propofol related injection pain. The aim of this study is to compare effectiveness of ketamine injection to decrease propofol induced pain in comparison to lidocaine injection. Method: This is a cross sectional comparative study. 89 cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) as pre-treatment medication after venous occlusion with rubber tourniquet. 1/4th dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1 and 2 minutes of propofol injection with verbal response and behavioural signs. Chi square test and paired T test was used and p value less than 0.05 was con..... ReadMore

Rajeev Nair and Satish Kumar Mishra*

DOI : 10.32474/GJAPM.2020.03.000164

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Bleeding is a frequent complication during surgery. The intraoperative administration of blood products, including packed red blood cells, platelets, and fresh frozen plasma (FFP), is often lifesaving. Complications of blood transfusions contribute considerably to perioperative costs and blood product resources are limited. The aim of the present study was to evaluate and compare the usage of INR guided vis a vis clinician discretion based component replacement therapy which will optimize the use of FFP and may even result in less blood loss during surgery. Materials and Method: This study was conducted in surgical patients in a large tertiary care centre. Ethical clearance was taken from the local ethics committee at the proposal stage itself. Patients consent was taken after providing all necessary information prior to surgery. Th..... ReadMore

Kalpana Rajendra Kulkarni* and Rajendra Madhukar Kulkarni

DOI : 10.32474/GJAPM.2020.03.000163

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Background: Peripheral vascular diseases (PVDs) associated with atherosclerosis, hypertension, diabetes, thromboembolism, chronic regional pain syndrome or Berger’s disease, presents with ischemic manifestations of cold limbs, claudication, ulcers, or gangrene. Chemical lumbar sympathetic block (LSGB) with alcohol/ phenol and radiofrequency ablation (RF) are well-established methods to improve the circulation. Methods: We conducted prospective observational study in 150 cases of PVDs who underwent chemical LSGB using 5ml of phenol 8% at two levels L2 and L3 under guidance of fluoroscopy (Group CH, n=50), RF ablation of lumbar sympathetic ganglions at L2 and L3 level (Group RF, n=50) and combined RF with chemical LSGB using phenol 5ml 8% at L2and L3level following RF(Group RF+CH, n=50). Results: There was significant difference i..... ReadMore

Tong Zheng Hong*

DOI : 10.32474/GJAPM.2020.03.000162

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This unique and newly developed acupoint protocol composed of Yuan-Source and Luo-Connecting acupoints was conducted to the patient with thalassemia for knee pain. Therapeutic effects of acupuncture for the knee pain were observed and rated by the patient on the Wong-Baker Faces Pain Scale from 6 to 2 with the first treatment, the pain did not reoccur, and the patient could fall asleep easily and soundly, which shows this protocol is effective to reduce the pain and deserve attention..... ReadMore

Nasibova EM*

DOI : 10.32474/GJAPM.2020.03.000161

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Propofol (diprivan) is the drug of choice in one-day surgery in children. The use of the drug provides rapid awakening (due to rapid redistribution and short half-life) and a minimum incidence of postoperative complications. Total intravenous anesthesia with propofol infusion or bolus administration is an easily managed anesthesiologist, anesthesia comfortable for the patient..... ReadMore

Bikash Khadka* and Prajjwal Raj Bhattarai

DOI : 10.32474/GJAPM.2020.03.000160

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Background: Continuous spinal anaesthesia (CSA) is an underutilized technique in modern aesthesia. It allows incremental intermittent dosing of an intrathecal local anaesthetic via an intrathecal catheter which allows titration of block level, block of indefinite duration and better hemodynamic stability than single-shot spinal anaesthesia (SSA)...... ReadMore

Nasibova EM* and Pashaev CN

DOI : 10.32474/GJAPM.2020.03.000159

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Decades have passed since the first reports of the successful use of mask non-invasive ventilation (NIV) in the treatment of respiratory failure. The aim of the study is determining the benefits of NIV in acute respiratory failure in patients with COVID-19. The study included patients admitted to the intensive care unit of the surgical clinic of the AMU from April 1 to May 1, 2020. NIV has visible advantages over mechanical ventilation...... ReadMore

Cassandra Gerhart*

DOI : 10.32474/GJAPM.2020.03.000158

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Review Topic: Use of Regional Anesthesia in Patients with Multiple Sclerosis Background: This article will focus on patients who have traditionally been considered contraindicated for the use of regional anesthesia. Specifically, patients with autoimmune mediated neurologic disorders. The selected pathophysiology of multiple sclerosis and regional anesthesia and their considerations via evaluation of research studies will be presented. Furthermore, suggestions for anesthesia care for these patients will be provided...... ReadMore

Joanne Lusher*, Alexandra Murrell, Betty Changa, Christopher Mafuva, Eddy Awire and David Chapman Jones

DOI : 10.32474/GJAPM.2020.03.000157

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Pain is a subjective experience and one that the medical healthcare profession will never fully be able to understand because the pain belongs to the patient. Ultimately, pain is whatever the patient experiences it to be, yet the traditional medical model approach is one that views the patient’s pain as something to be managed by the ‘professional’ [1,2]...... ReadMore

Zaily Fuentes Díaz*, Gonzalo Fabián Orga García, Orlando Rodríguez Salazar, Jorge Lozano Casanova, Tania Puerto Pérez5

DOI : 10.32474/GJAPM.2020.03.000156

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Introduction: the physiological response to the aggression produced by the surgical trauma provides the effective treatment capacity in case of complications. Surgical intervention causes endocrine, metabolic, autonomic, immunological, and hematological changes...... ReadMore

Yasser Mohammed Hassanain Elsayed*

DOI : 10.32474/GJAPM.2020.03.000155

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Background: Arrhythmias are one of the most serious disorders in cardiovascular and clinical medicine. Understanding the pathogenesis and mechanisms of arrhythmias is very advantageous to the appropriate management and treatment of all arrhythmia types. The “Graded phenomenon” is a novel directory phenomenon for understanding the arrhythmia. The principal of “Graded phenomenon” is based on catching the graded changes in serial ECG tracings or even single one regarding the arrhythmias...... ReadMore

Behzad Saberi*

DOI : 10.32474/GJAPM.2020.03.000154

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Early management of ventilation and oxygenation in the patients with traumatic brain injury, can be of importance to reduce secondary injury risks and improve outcomes. Increasing in the intracranial pressure of the patients with traumatic brain injury is an important risk which these patients are faced with. Hypocapnia due to hyperventilation and vasoconstriction in the brain’s blood vessels as the result, causes reduction in blood flow. Therefore, the risk of secondary injury due to hypoperfusion and ischemia would increase. It is recommended to keep PaCO2 levels in the range between 35 and 40 in these settings. Minimizing the bag-ventilating of the patients with traumatic brain injury who have been intubated, is an important note which should be kept in mind to reduce the risk of hyperventilation in such patients. These..... ReadMore

Behzad Saberi*

DOI : 10.32474/GJAPM.2020.03.000153

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There are some terms related to mechanical ventilation which the healthcare professionals who deal with the patients who are placed on the ventilator for various reasons, should have knowledge about them. Based on the selected mode of mechanical ventilation there are “Control “variables like volume or pressure-controlled ventilation modes. Mechanical ventilation’s dependent variables are “ Conditional “ variables. “ Trigger “ initiates the inspiration. As a matter of fact, one breath can be time, pressure or flow triggered. End of inspiration and beginning of exhalation determinant would be the “ Cycle “. The mechanical ventilator can be time, volume and pressure cycled. Mechanical respiratory cycle’s resistive forces are named “ Airway resistance “ which its normal range is equal to or lower than 5 cm..... ReadMore

Seun Ayoade*

DOI : 10.32474/GJAPM.2020.03.000152

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S.A.M.S. is an acronym for Seun Ayoade’s Medical System [1], an alternative form of therapy based on the Germ Terrain Duality theory of disease. The Germ-Terrain duality theory of disease states that the etiology of certain diseases/diseased states is better explained as a complex interplay between germs and the inherent anatomical/physiological integrity of the body cells...... ReadMore

Harsh Rajeev Mehta*, Payal Salvi1, Sarojini P Jadhav and Suresh R Harbade

DOI : 10.32474/GJAPM.2020.03.000151

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Lipomas are the most common mesenchymal tumours. They arise from primordial adipocytes and gradually increase in size with age. They usually develop as well-circumscribed, encapsulated masses that are freely mobile beneath the skin. Lipomas can occur in many locations all over the body, but most commonly in the subcutaneous tissue of the head, neck, shoulders and back. Lesions that are larger than 5 cm are termed as giant lipomas [1]. Giant lipomas of the upper extremity are rare and require an appropriate workup. This should be followed by adequate open surgical excision and repeat examination over time to monitor for recurrence...... ReadMore

Miranda Nava Gabriel*, Gallo Frias Luis Gilberto, Pimentel Diaz Alejandro Yami and Ginger Ramirez Diana Guadalupe

DOI : 10.32474/GJAPM.2020.02.000150

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Mucoepidermoid carcinomas are rare and comprise 5% of head and neck malignancies and are seen in 2.6 cases for every 100,000 people. We report the case of a 49 year old blacksmith from Guadalajara, Mexico who presents to office and who is later diagnosed with a mucoepidermoid carcinoma located in the left side of the submandibular gland, tumor was treated with two surgery for removal of the mass with patient now being seen under periodic moments..... ReadMore

Yasser Mohammed Hassanain Elsayed*

DOI : 10.32474/GJAPM.2020.02.000149

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Rationale: Serum potassium concentration is usually elevated in the cases of diabetic ketoacidosis. Coronary artery spasm is recognized after the hematological chemical disturbance. Hyperkalemia is a rare cause of junctional tachycardia. Insulin decreases potassium levels in the blood by redistributing it into cells via increased sodium-potassium pump activity.Patient concerns: A young housewife female patient presented to the emergency department with diabetic ketoacidosis, coronary artery spasm, and junctional tachycardia. Diagnosis: Hyperkalemia-induced coronary artery spasm and junctional tachycardia in diabetic ketoacidosis. Interventions: Electrocardiography, oxygenation, central venous pressure monitoring, and echocardiography. Lessons: Electrolytes disturbance especially hyperkalemia is a significant serious..... ReadMore

Eman M Kamal Abo Seif, Walid Y Kamel and Amr M Hilal Abdou*

DOI : 10.32474/GJAPM.2020.02.000148

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Background and Aim: Breast surgeries are associated with post-operative pain and restricted shoulder mobility, so the aim of this study is to assess the analgesic efficiency and safety of Continuous Pectorals II (PECS) block by adding magnesium to bupivacaine as an adjuvant versus bupivacaine as a sole agent in cases of simple mastectomy. Patients and Methods: This randomized double blinded study designed to compare the analgesics efficacy and safety of continuous PECS II using bupivacaine versus continuous PEC II using bupivacaine plus magnesium in patients undergoing simple mastectomy and postoperative period. We enrolled 40 adult females ASA I-II patients’ candidates for simple mastectomy without axillary clearance. All patients were randomly distributed into two groups. Control group: prior to surgica..... ReadMore

Jbili N*, Bibiche L, Jebbar N, Maaroufi A, Diai A, Chkoura K, Kechna H and Laoutid J

DOI : 10.32474/GJAPM.2020.02.000147

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We report the observation of a 56-year-old female patient, with no specific medical history, operated on for acute cholecystitis. One week after the intervention, she presented a fatal fulminant hepatitis in less than two weeks, associating a deterioration of the general state with jaundice cutaneous mucosal frank, cytolysis and cholestasis important in addition to a deep hypo albuminemia and a very low prothrombin level. The toxicity of halothane has been incriminated due to the negativity of the etiological balance. Like the literature and this clinical case, the still frequent use of halothane in several countries must be reviewed...... ReadMore

Jamal Hasoon*, Amnon AB, Ivan Urits, Vwaire Orhurhu, Omar Viswanath

DOI : 10.32474/GJAPM.2020.02.000146

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Spinal epidural abscess (SEA) is a rare suppurative infection of the spinal cord. SEAs are formed in the true spinal epidural space between the dura and vertebral wall. They are the result of direct spread from adjacent structures, hematogenous spread or iatrogenic inoculation of bacteria into the spinal canal...... ReadMore