Indian Journal of Public Health Research & Development

Sharad Goel ¹, Ritu Goyal ¹, Sanjay Lal ¹, Shailja Sharma ¹

Affiliations
1 Department of Anaesthesia, Sarswathi Institute of Medical Sciences, NH-24 Anwarpur, Hapur, Ghaziabad 245304, IN

Abstract

Intrathecal neostigmine had been used in various doses to produce analgesia without neurotoxicity in both animal and human studies. The present study was conducted using 50μg intrathecal neostigmine methylsulphate with 12.5mg bupivacaine (0.5% heavy) for optimum duration of post-operative analgesia with minimal side effects. In this study 100 patients belonging to ASA physical status I and II, age 20-70 years of either sex scheduled for elective lower abdominal and lower limb surgeries under spinal anaesthesia were included. Patients were randomly allocated in two groups: group I (n=50, control) received 2.5ml bupivacaine + 0.5ml of normal saline and group II (n=50, test) received 2.5ml bupivacaine +0.5ml of neostigmine (50μg). Time of onset of sensory and motor block, highest level of block, duration of analgesia and side effects like hypotension, bradycardia, nausea, vomiting, etc were recorded. Onset time of sensory and motor block was much faster In bupivacaine and neostigmine group as compared to bupivacaine group. Patients were pain free for average 6-7 hours with bupivacaine and neostigmine as compared to 3-4 hours with bupivacaine. It was concluded that intrathecal neostigmine in the dose of 50μg provide post-operative analgesia for a period of 6-8 hours with lesser incidence of side effects of nausea and vomiting.

Keywords

Anaesthesia, Spinal Anaesthesia, Drugs, Bupivacaine, Neostigmine

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Shailja Sharma ¹, Arati Srivastava ¹, Sharad Goel ¹, Vikrant Sharma ², Ashutosh Niranjan ³

Affiliations
1 Department of Anaesthesiology, Saraswathi Institute of Medical Sciences, Hapur, IN
2 Department of Ophthalmology, Saraswathi Institute of Medical Sciences, Hapur, IN
3 Department of Surgery, Saraswathi Institute of Medical Sciences, Hapur, IN

Abstract

Intraocular pressure is the pressure exerted by the contents of the eye against its containing wall. During general anaesthesia, the intraocular pressure can increase, rendering problems in ophthalmic surgery especially surgery on the eye bulb. Pre-treatment with non-depolarising muscle relaxant prevents fasciculation and so the intraocular pressure does not rise. This is a prospective randomized study of 100 patients divided into two equal groups, where we have compared the effect of vecuronium bromide and atracurium besylate on intraocular pressure. The intraocular pressure was measured before surgery, at the time of intubation and at every 10 minutes interval during surgery. All the data were analysed statistically using unpaired student t test. We concluded that vecuronium bromide has better control over intraocular pressure as compared to atracurium besylate.

Keywords

Vecuronium Bromide, Atracurium Besylate, Intraocular Pressure

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Pankaj Saini ¹, Varsha A. Singh ², Kunal Sharma ³, Gunjeet Singh ³, Abhishek Chauhan ⁴, Shailja Sharma ⁵

Affiliations
1 Junior Resident, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
3 Junior Resident, Department of Pharmacology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
5 General Physician, Baghpat, Uttar Pradesh, IN

Abstract

Non-tuberculous mycobacterium (NTM) has been identified in human pulmonary and extra pulmonary diseases and is of great concern for clinicians and microbiologists because of their increasing global incidence. They are now increasingly recognized as important pathogens in both immunocompromised and immunocompetent population. They should be identified rapidly and should be carefully differentiated as contamination, colonization ordisease. Cultures were made on conventional LJ and LJ with PNB media. Growth was confirmed as AFB (acid fast bacilli) by ZN staining. NTM were identified by growth on LJ with PNB media, colony morphology, rate of growth, pigmentation, catalase activity and confirmed by MPT 64 antigen rapid test (using SD Bioline TB Ag MPT 64 test kit) . Data was analysed statistically using SPSS software. Out of total 500 processed samples (250 pulmonary & 250 extrapulmonary), 12(21.05%) and 7(21.8%) NTM were isolated from pulmonary and extrapulmonary samples respectively. Maximum pulmonary NTM (41.7%) were isolated from > 60 years age of patients in contrast to extrapulmonary NTM isolates which were more in 20-40 years of age group. There was 16.7% previously treated patients in pulmonary while 100% were newly diagnosed patients in extrapulmonary TB cases. This study highlights the importance of early diagnosis and differentiation among Mycobacterium tuberculosisand NTM so that these NTM are not underestimated in routine diagnostic procedures merely as environmental or laboratory contaminants.

Keywords

Non-tuberculous mycobacterium, p-nitrobenzoic acid, Pulmonary TB, extrapulmonary TB, MPT64 antigen.

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