Role of Oral Pregabalin as Premedication in Attenuation of Hemodynamic Responses to Laryngoscopy, Intubation, and Extubation in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Clinical Trial
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:6] [Pages No:1 - 6]
DOI: 10.5005/jp-journals-10057-0094 | Open Access | How to cite |
Background and aim: Direct laryngoscopy, tracheal intubation, and extubation contribute to augmentation in heart rate and blood pressure. This can precipitate serious complications in patients with coronary artery disease, intracranial neuropathology, or reactive airways. Attenuation of hemodynamic stress response to laryngoscopy, intubation, and extubation is essential for better anesthetic outcome. The aim of this study was to evaluate the effect of oral pregabalin as premedication in attenuation of hemodynamic stress response to laryngoscopy, intubation, and extubation. Materials and methods: This prospective randomized double-blinded placebo controlled study was conducted with 60 patients of American Society of Anesthesiologists (ASA) physical status class I/II, undergoing elective laparoscopic cholecystectomy. Patients were allocated randomly into two groups receiving either oral placebo or oral pregabalin 150 mg, 120 minutes before induction of anesthesia. Hemodynamic parameters such as heart rate, systolic, diastolic, and mean blood pressures were compared at various time points. Results: Pregabalin showed a significant attenuation of hemodynamic stress response to laryngoscopy, tracheal intubation, and extubation compared with that of placebo. The pregabalin premedicated patients remained hemodynamically stable perioperatively without any significant side effects. Conclusion: Pregabalin is effective in attenuating hemodynamic stress response to laryngoscopy, tracheal intubation, and extubation.
Unusual Swelling in the Head and Neck Region
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:7] [Pages No:7 - 13]
DOI: 10.5005/jp-journals-10057-0098 | Open Access | How to cite |
These are case series with six patients who presented unusual neck swelling. Worldwide, the most common swelling in the neck region is a enlargement of cervical lymph nodes. Each country has a different etiology and geographical distribution for cervical lymphadenopathy. Tuberculosis, metastatic cancers, and lymphomas are the commonest causes. However, in clinical practice, we encounter rare neck swelling. Such swellings are due to their less common and unusual presentation, and its clinical diagnosis is rarely attained. In such cases, proper diagnosis and management are required to attain the desired results. Materials and methods: In our tertiary healthcare center, we encountered such case in ENT OPD. Five cases were evaluated in this article along with their management. Such rare causes of neck swellings are therapeutically challenging, as they cause diagnostic dilemmas. Results: Histopathology and immunohistochemistry were the mainstay of diagnosis, and surgery was curative in most cases.
A Rare Case of Arteriovenous Malformation of Mandible: A Case Report
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:4] [Pages No:14 - 17]
DOI: 10.5005/jp-journals-10057-0100 | Open Access | How to cite |
Arteriovenous malformation (AVM) is a congenital disorder of the veins and arteries that makeup the vascular system. This report presents a case of AVM in the body and ramus region of left side of mandible in a 22-year-old male. The case presents with diffuse swelling present on left region of the body and ramus area of mandible since 8 months. Malformation was diagnosed with the help of detailed patient history, clinical evaluation, radiographs, and computed tomography (CT) scans. The definitive diagnosis was made by CT angiography. Later hemimandibulectomy with simultaneous reconstruction by a titanium plate was done.
Endodontic Management of External Apical Root Resorption: A Case Report
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:3] [Pages No:18 - 20]
DOI: 10.5005/jp-journals-10057-0101 | Open Access | How to cite |
Resorption is the combination of either physiological or pathological factors that results in the loss of dentin, cementum, and the alveolar bone of tooth structure due to the action of polynuclear giant cells. The most frequent causative factor for resorption is local factors, notably excessive pressure and inflammatory process. Different types of resorption have been classified depending upon its etiology and site, and different treatment regimens have been proposed based on the type of resorption present. External apical root resorption is usually pathological. The case in this article demonstrates external root resorption managed with nonsurgical root canal therapy with the use intracanal medicament of calcium hydroxide, with 1 month follow-up revealing arrest of resorption. Subsequent follow-up at 6 months shows complete repair of periradicular and furcation area.
Unusual Severe Superolateral Dislocation of Right Condyle Associated with Sagittal Split of Articular Eminence in Pan-facial Trauma Managed with Inverted L-plate: A Case Report
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:6] [Pages No:21 - 26]
DOI: 10.5005/jp-journals-10057-0106 | Open Access | How to cite |
Head and neck trauma is a challenging case for a maxillofacial surgeon because not only preinjury anatomy needs to be achieved but also esthetic has to be improved. Management of such patients is quite challenging and also requires a frequent multidisciplinary team intervention. One of the cause of such trauma is unprotected driving or high-velocity collision.1 Pan-facial trauma not only disrupts normal facial anatomy but also hinders normal functions like vision (dystopia, diplopia, enophthalmos), respiration (airway) and olfactory senses, mastication and natural occlusion and intercuspation, deglutition, and overall asthetic of the patient. Restoring and rehabilitation of preinjury contour of facial skeleton in such patient of trauma requires artistic work of the operating maxillofacial surgeon. The treatment modality in case of trauma is open reduction and internal fixation (ORIF) under general anesthesia (GA). Various approaches have been suggested to achieve near normal anatomy. Past research suggested “top to bottom” or “bottom to top” along with “outward to inward” or “inward to outward,” The main aim being restoring horizontal and vertical facial pillars.
Urethral Stricture Reconstruction by Buccal Mucosal Graft Technique
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:2] [Pages No:27 - 28]
DOI: 10.5005/jp-journals-10057-0091 | Open Access | How to cite |
Introduction: A prospective study of 39 cases with stricture urethra who underwent buccal mucosal graft urethroplasty from January 2018 to June 2019 in Department of Urology in Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India. Aim and objective: To establish the outcome of urethral stricture reconstruction by a buccal mucosal graft technique. Materials and methods: The prospective study will be carried out in the Department of Urology, Mahatma Gandhi Medical College and Hospital, Jaipur, for the period of one and half year from January 2018 to June 2019. Inclusion criteria were that all male patients with diagnosis of urethral stricture disease will be included in the study. Exclusion criteria were old fragile medical unfit patients on supra pubic catheter, patient with bleeding dyscrasia, and all females. Results: In our study, we found that balanitis xerotica obliterans (BXO) is the most common cause of stricture urethra. It is the most common from 31 to 40 years. After the procedure, no donor site complications were seen. Medium and long strictures got excellent outcome. Out of 39 grafts, no graft loss is seen till date in follow-up of 3 and 6 months. Conclusion: In our study, we found that dorsal onlay is the preferred form of graft placement. Buccal mucosal graft is the ideal substitute for urethra, especially in medium and long segment urethral stricture. Buccal mucosal graft has good graft properties for graft survival. The donor site had no significant complications. Dorsal onlay graft is the preferred type as it has good support better outcome. Nil failure in respect to graft function urine flow patients satisfaction till date. Longer follow-up is need (keeping attrition over a period of time for substitution urethroplasty in mind before coming to definite conclusion).
Management of Sodium Hypochlorite Accident: A Case Report
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:3] [Pages No:29 - 31]
DOI: 10.5005/jp-journals-10057-0095 | Open Access | How to cite |
Root canal treatment, or endodontic treatment, is a procedure frequently done to debride, disinfect, and remove residual microorganisms found in infected root canals of teeth. Certain chemicals have been found to be effective in disinfecting the root canal system with different success rates. Sodium hypochlorite (NaOCl) is a common irrigation solution and disinfectant used in root canal treatment. It has strong antibacterial and tissue-dissolving properties. Although it is a potential irrigant, but severe complications can occur when it comes into contact with soft tissue especially due to its cytotoxic features, some of which are life-threatening. This case report documents successful management after accidental extrusion of NaOCl into the periapical area and explains precautionary management protocols for such cases.
Tongue-tie Management: A Case Report
[Year:2019] [Month:January-April] [Volume:4] [Number:1] [Pages:3] [Pages No:32 - 34]
DOI: 10.5005/jp-journals-10057-0096 | Open Access | How to cite |
Tongue-tie or ankyloglossia is a rare congenital anomaly. It is a short, thick, and fibrosed lingual frenulum which causes restriction in function of the tongue and also in speech. Tongue is an accessory organ, and it helps in deglutition, mastication, and speech. Tongue-tie also causes lingual recession of the teeth. So, it is necessary to treat at the right time. In this case, the patient has a lingual tongue-tie which has been treated by using a diode laser.