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Objective: To compare the efficacy of Dexmedetomidine (Precedex) in addressing the mean haemodynamic stress response to laryngoscopy and endotracheal intubation (L&I). Study Design: Quasi-experimental study. Place and Duration of Study: Anesthesiology Department, Combined Military Hospital, Rawalpindi, from Jun 2019 Jun 2020. Methodology: The patients were divided into two groups. Group A was given Inj. Dexmedetomidine and group B (placebo). Operation theatre assistant randomly assigned the patients to either group A or group B each day. The second person administered the drug or placebo. The third person (researcher) recorded all the parameters mentioned in the proforma. Results: There were 100 patients with an age range of 18-60 years. The majority of the patients were ASA-I physical status. The main surgical procedure was laparoscopic cholecystectomy. Recording of heart rate and systolic blood pressure during laryngoscopy and intubation, after administration of drug or placebo, showed mean heart rate less than mean basal value in group-A and 22% above mean basal value in group-B, and it was statistically highly significant (p-value <0.001). Whereas mean systolic blood pressure in group-A was 122.42 ± 14.91 (less than the mean basal value) as compared to group B, 155.00 ± 18.32/min (20% above mean basal value). This change was also statistically highly significant (p-value <0.001). Conclusion: It is concluded that dexmedetomidine showed statistically significant stabilizing effects on the expected changes of the hemodynamic stress response. [ABSTRACT FROM AUTHOR]

Objective: To compare the pain relief efficacy of platelet rich plasma injection with corticosteroid injection in knee osteoarthritis using numeric rating scale. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia and Pain Management, Combined Military Hospital Peshawar, from Jan 2018 to Dec 2019. Methodology: Total of 310 patients who underwent knee injection for osteoarthritis were included in this study. Patients were divided into two groups; group A and group B comprising of 155 patients each. Patients in group ‘A’ received intra articular corticosteroid injection while patients in group ‘B’ received intra articular platelet rich plasma injection for knee osteoarthritis. Pain assessment via numerical rating score was done at the start of the treatment and at 6 months. Results: In group A female to male ratio was 2.69:1 while in group B the female to male ratio was 2.78:1. Mean age of ‘group A’ was 58.52 ± 11.87 years and that of ‘group B’ was 58.79 ± 11.15 years. Numerical rating score pre-treatment in ‘group A’ vs ‘group B’ was 8.35 ± 1.17 vs 8.42 ± 1.14. While numeric rating scale post treatment in ‘group A’ vs ‘group B’ was 5.74 ± 1.37 vs 4.06 ± 1.19, respectively with p-value of 0.001, which is statistically significant. Conclusion: Patients who received intra-articular platelet rich plasma had significantly more pain relief as compared to patients who received intra-articular steroid on numerical rating score. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and side-effects of 0.5% ropivacaine with that of 0.5% bupivacaine when used for single-shot epidural anaesthesia for orthopaedic surgery. Design: Randomized controlled trial. Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital Rawalpindi, over a period of eight months from June 2013 to January 2014. Patients and Methods: The study was carried out in 60 ASA physical status I, II or III patients undergoing elective lower extremity orthopedic surgery. Two groups of 30 patients each received single-shot epidural anaesthesia either with ropivacaine 0.5% (ropivacaine group) or bupivacaine 0.5% (bupivacaine group). Onset, time for maximum height and median height of sensory block was assessed as well as time to two segment recession. Modified Bromage scale was used for motor blockade. Total duration of motor block and common side effects were also recorded. Results: The patients in both groups were similar in age, height, weight, gender and ASA status. There was no significant difference in onset of sensory block and time for maximum height of sensory block. The median heighest level of sensory block was T6 (T5-T8) for ropivacaine group and T5 (T4-T7) for bupivacaine group. Time for two segment regression and duration of sensory block were also comparable for both groups. The total duration of motor block was significantly more in bupivacaine group (159 min vs 134.2 min, p< 0.001). Modified Bromage scale was also significantly higher in bupivacaine group (2.86 vs 1.96 min, p<0.001). Side effects like hypotension, bradycardia, nausea, vomiting and shivering were similar in both groups. Conclusion: Epidural administration of 0.5% ropivacaine provided effective and good quality anaesthesia. Motor blockade was of less duration as compared to equivalent dose of 0.5% bupivacaine, which may offer potential benefit of early patient mobilization after orthopaedic surgery. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of rapid and conventional methods of corneal collagen cross linking (CXL) on visual acuity (VA) and corneal parameters in Keratoconus. Study Design: Randomized control trial. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Feb 2012 to Apr 2013. Patients and Method: Thirty patients, fifteen in each group, were randomized by non probability consecutive sampling to rapid or conventional CXL group. Pre and post operative (6 months) best corrected visual acuity (BCVA), anterior and posterior keratometric (K) values and pachymetry were recorded. Intra and inter group comparison of all these parameters were statistically analyzed. Results: All thirty patients showed either stabilization or improvement in BCVA. Both groups showed comparable results in terms of improvement BCVA (p = 0.682), reduction in the corneal thickness at thinnest point (p = 0.062), anterior flat and steep K (p = 0.633, p = 0.443 respectively) and posterior flat and steep K values (p = 0.130, p = 0.068) at six months duration. Conclusion: Conventional and rapid methods of CXL are comparable in terms of their effect on VA and corneal parameters. [ABSTRACT FROM AUTHOR]