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Background & Objective: Spinal anesthesia (SA) has been preferred for transurethral resection of prostate (TURP) due to various advantages over general anesthesia. The most commonly used drug for SA is bupivacaine, but recently ropivacaine has been introduced with better hemodynamic profile. Dexmedetomidine is sedative-analgesic, and can be used through multiple routes. We compared low dose ropivacaine plus dexmedetomidine vs. low dose bupivacaine for SA in TURP. Methodology: This comparative, cross-sectional study was conducted at Anesthesia Department of Combined Military Hospital, Lahore, from December 2021 to June 2022. A total of 197 patients, planned to undergo TURP under SA were included in the study. The patients were randomly allotted to one of the two groups by lottery method and using concealed envelops. Group RD took low dose ropivacaine (7.5 to 10 mg) plus dexmedetomidine (5 µg) and in Group B low dose bupivacaine (7.5 to 10 mg) was used for spinal anesthesia. Parameters of efficacy and safety were compared in both groups during and immediately after the surgery to look for better option among the two regimes. Results: Out of 197 patients randomized into two groups, Group RD, 99 (50.2%) took low dose ropivacaine (7.5 to 10 mg) plus dexmedetomidine (5 µg) and 98 (49.8%) took low dose bupivacaine (7.5 to 10 mg) for spinal anesthesia. Mean age of patients who underwent TURP in our study was 61.66 ± 7.88 y. Hemodynamic instability and requirement of opiate analgesia was not significantly different in both the groups (P > 0.05) while all other efficacy parameters were better in patients who took low dose ropivacaine plus dexmedetomidine (P < 0.05) as compared to those who only took low dose bupivacaine. Conclusion: Both groups showed no difference in safety parameters related to hemodynamic stability but the anesthesia profile was better in patients who took low dose ropivacaine plus dexmedetomidine as compared to the bupivacaine group. [ABSTRACT FROM AUTHOR]

Objective: To assess the risk of acquiring cutaneous leishmaniasis (CL) in tribal areas of Pakistan. Study Design: A cross sectional observational study. Place and duration of study: Combined Military Hospital, Okara, from Oct 2014 to Mar 2015. Material and Methods: A total of 4500 persons between the ages of 22 to 50 years, who were moved from central areas of Punjab to Waziristan on duty, were studied for the occurrence of CL. All cases was developed cutaneous lesions and were confirmed as having CL were included in the study. During the same period, 4300 persons living at Okara, who did not have any exposure to the Federally Administered Tribal Area in same age group, were also observed and studied as control group. Results: A total of 36 patients suffered from CL in the study population, while one case from the control group developed the disease (p<0.05). This patient was resident of Sindh and had repeated visits to his home station. The risk of developing CL was greater in Waziristan as compared to central Punjab as odds ratio (OR) was calculated as 30.79. Conclusion: There is substantial risk of developing CL in persons exposed to tribal areas of Pakistan. [ABSTRACT FROM AUTHOR]