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Background:Systemic absorption of local anesthetics occurs due to its local vasodilator effects. This leads to inhibi-tory action on the heart which is represented in the form of a decrease in conduction rate, the excitability of myocardi-um and force of contraction. The aim of the present study was to evaluate the effects of Lignocaine and adrenaline combinations on electrocardiogram undergoing dental procedures. Methods:This was a prospective, observational clinical study done in collaboration with the Department of Oral & Maxillofacial Surgery. All patients scheduled for oral surgeries under local anesthesia with Lignocaine 2% and adrenaline (1:80000 or 1:200000) combination of age 18 years or above 150 patients were included in the study. Patients with a history of hepatic, renal, cardiovascular and thyroid disorders were excluded from the study. A standard 12-lead ECG (25 mm/s) was recorded for each patient before administration of drugs (Basal), during the dental procedure (Intraoperative) and immediately after completion of surgical procedure. Results:There was no statistically significant difference seen between the Group A (Lignocaine 2% with 1:80000 adrenaline) and B (Lignocaine 2% with 1:200000 adrenaline) when the age, gender, PR interval, RR interval, mean QT & QTc dispersion, and heart rate were compared. Statistically significant difference was seen in comparing the mean QT & QTc interval, which was higher in Group A. ECG parameters in Group A and B showed a statistically significant decrease in PR interval, RR interval, QT interval, QTc interval, QT dispersion and QTc disper-sion, with the basal, was compared with intraoperative and postoperative findings. The increase in heart rate although was statistically significant in both the groups, it was always within normal limits suggestive of no clinical signifi-cance. There was a statistically significant decrease in QT and QTc interval, QT and QTc dispersion. The change in all these parameters was within the physiologic range. All these relevant parameters for cardiac arrhythmias did not show any arrhythmogenic potential of lignocaine-adrenaline combination in both the groups. Both the combinations are comparable with each other in terms of ECG parameters with changes more with group A suggesting the effect of in-creased concentration of adrenaline. The change in the heart rate and ECG parameters in both the study group might be attributed to the presence of adrenaline in the combination. No cardiovascular morbidities were observed except palpitation. Conclusion:Thus it can be very well concluded that the effects of lignocaine-adrenaline combinations on electrocardiographic parameters are minimal and clinically irrelevant. Both the combination appears to be safe to use in healthy individuals.
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Background: Sickle cell disease (SCD) is the generic term for the group of inherited haemoglobinopathies caused by the occurrence of Haemoglobin S (HbS) in the homozygous or heterozygous form in combination of Hbs with another abnormal haemoglobin such as HbSC or beta-thalassaemias (HbS-thal). Sickle cell syndromes are remarkable for their clinical heterogeneity, including their presentations as sudden and unexpected deaths due to a sickle cell crisis. Less numbers of deaths are reported due to this cause because of ignorance of autopsy surgeon in considering this disease as a cause of death despite of its high prevalence. While doing autopsy in cases of deaths with no apparent cause and physical over activity medical officer must keep in mind the possibility of death due to vaso-occlusive crisis in sickle cell disease. Methods: The study covers a period of one year (January 2013 - December 2013) and it is a study of cases of autopsy carried out in a tertiary care hospital of South Gujarat. Results: A total of 607 cases examined, out of which sickled red blood cells were detected in 17 cases. The respective records were reviewed. Out of 17 cases, 13 cases were male and 4 cases were females. The youngest person was 15 years female and oldest was 70 years male. Conclusion: Sickle cell crisis is one of the causes of sudden unexplained deaths. The present study highlights the role of autopsy in such cases. Community awareness and marriage counseling programs are also helpful in preventing sickle cell disease.
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Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in women. Aims & Objective: To compare two different dose fractionation schedules in terms of overall treatment, locoregional control, acute and late toxicities and patient compliance. Material and Methods: Patients of postmastectomy non metastatic breast cancer were randomized in two arms: Arm A (45) Arm B (46) according to dose fractionation schedule of external radiation given to chest wall and draining lymphatics. Arm A was given 50 Gy in 25 fractions and Arm B was given 40 Gy in 17 fractions. After completion of radiation patients were kept on follow up. Results: Median follow up was 20 months. In arm A & B the median overall treatment time was 40 and 27 days with respective ranges of 36-47 days and 22-33 days .The patients in both the arms tolerated radiation well, skin reactions were most common followed by nausea and vomiting .Grade II and III acute reactions were comparable in both arms. There was non-significant increase in both late skin and subcutaneous skin toxicities in arm B. Result of treatment of both arms are, chest wall failure 5% v/s 9% (p> 0.05), nodal failure 8% v/s 7% (p> 0.05) and distant metastasis 25% v/s 28% (p> 0.05). Conclusion: Both the studied dose fractionation schedules are equally efficacious in terms of locoregional control, acute and late toxicities. The shorter schedules in Arm B gives an added advantage of decreased overall treatment time giving better compliance and reduces work load of overburdened department.
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Background: Most of the patients suffering from malaria shows reduced Red cell count, leukopenia and varying degree of thrombocytopenia but it is rarely associated with haemorrhagic manifestations. Aims & Objective: This study was undertaken to correlate the incidence and severity of thrombocytopenia with the prevalent species of malaria. Material and Methods: Total 1480 Patients were included in this study after positive identification on PSMP. Platelet count was done by haematology analyser (Sysmax Kx 21). Results: Incidence of thrombocytopenia was seen in 83.80% and 74% cases of P. falciparum and P. vivax malaria respectively. Severe thrombocytopenia in P. falciparum was found in 7.70% cases while in P. vivax 3.67% cases. No difference was observed in incidence of thrombocytopenia in both age groups in relation to both prevalent species. In paediatric age group, significant leukopenia was found in 22.22% Cases of P. falciparum in comparison to P. vivax (14.96%). Hb less than 10 mg/dl was found in 66.11% cases in P. Falciparum while in P. vivax it was found in 40.13% cases. In adults leukopenia was found in 27.46% Cases of P. falciparum in comparison to P. vivax 22.61% cases. Hb less than 10 mg/dl was found in 41.28% cases in P. falciparum while in P. vivax it was found in 28.57% cases. Conclusion: Severe thrombocytopenia is commonly associated with P. falciparum malaria however severe thrombocytopenia also observed in P. Vivax malaria. In both species of malaria significant number paediatric patients present with low Hb level compared to adults. In P. vivax malaria significant number of adult patients presented with leukopenia as compared to paediatric patients.
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Introduction: Malaria is one of the most common infectious diseases of tropics. It presents with varied clinicopathological manifestations. Most of the complication in malaria occurs due to various hematological abnormalities. Present study was aimed to find out abnormalities in WBC and platelet counts in patients with malaria. Methods: A total 135 patients either hospitalized or treated on an outpatient basis were included in the study after positive identification for malarial parasites on Giemsa stained PSMP smears. WBC and platelet count was carried out on 3 part hematology analyzer (Sysmax KX 21). WBC count less than 4000/cumm was considered as leucopenia and platelet count less than 150000/cumm was considered as thrombocytopenia. Results: The present study includes 135 patients with malaria from which 72.59% of subjects were male and 27.41% of subjects were female. P. falciparum was present in 68.89% of cases, P. vivax in 28.15% of cases. Majority of patients had normal leucocyte count (97.03%). Neutrophilia with lymphopenia was observed in both species of malaria in our study. Thrombocytopenia was observed in89.62% of cases in malaria. Thrombocytopenia in P. falciparum was found in 92.48% of cases and in P. vivax it was 81.57% of cases. Conclusion: Present study did not show any significant change in WBC count. Present study showed neutrophilia with relative lymphopenia in both group of malaria. Incidence of thrombocytopenia was observed in both species of malaria without any statistical significance.
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Background: In Transfusion Medicine, screening for suitable donor for platelet aphaeresis is difficult and time consuming procedure. This might lead to delayed supply of life saving Single Donor Platelet to critically bleeding patient. Aims & Objective: The aim of this study was to analyse the effect of various donor and procedure related parameters on the yield of single donor platelet so that the transfusionist as well as clinician can screen blood donors effectively in less time. Pre-donation platelet count, haemoglobin, haematocrit & weight were included as donor related variables. Processing time and blood volume processed were assessed as procedure related variables. Material and Methods: A total number of 265 platelet aphaeresis procedures were performed on CS 3000 plus with AMS cell separator (Fenwal, USA) using closed & open system aphaeresis kits & studied with respect to donor’s, procedure’s & patient’s related data. The statistical analysis used in this study was Pearson Correlation (‘r’ value). Results: The mean pre-donation platelet count was 286 ± 55 x 103/cu mm & mean platelet yield of all procedures was 3.3 ± 0.68 x 1011. Conclusion: Platelet yield correlated positively with pre-donation platelet count (r = 0.302, P < 0.0001). Donor’s weight, haemoglobin & haematocrit were not correlated with the yield & did not affect the yield of single donor platelets.
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Background: Malaria is a major health problem and infects many individuals despite of various efforts to control it. The present study was aimed to observe characteristics of malaria, seasonal variation and prevalence of malaria in our region. Methods: This retrospective study was conducted in our institute from period of January 2012 to December 2012. All the fever cases undergone investigations for malarial parasites were included in present study for defined time period. All the laboratory data of the patients having fever were retrieved from the Pathology Laboratory of our institute. Results: out of total 32674 reports studied 4907(15.01%) were positive for malaria with overall Slide positivity rate and slide falciparum rate were 15.01% and 38.29% respectively. Incidence of malaria occurs throughout year with increased incidence of P. falciparum in monsoon. Conclusion: In the present study incidence of malaria was higher in monsoon in comparison to other seasons. But throughout the year no declining trends in incidence of malaria was observed. P. vivax malaria was more commonly observed in our study but incidence of P. falciparum increased in monsoon.