Is Stylet Use During Intubation Associated with Post Intubation Complications

Objective: The basic objective is to evaluate the impacts of placing stylet during tracheal intubation on the post-operative pharyngeal pain in anesthetized patients. Methodology: This randomized control trail was conducted in the department of Anesthesia and ICU, Ch. Pervaiz Ellahi Institute of Cardiology and  Nishter Hospital Multan from   May 2017 to December 2018. All these patients were divided into two groups group S (stylet group) and group C (control group) by lottery method. All the data was entered and analyzed by the computer software SPSS version 23.2. Results: A total number of 100% (n=386) patients were included in this study, both genders. Gender distribution showed that there were more males than females i.e. 56.2% (n=217) and 43.8% (n=169) respectively. The main outcome variables of this study were pharyngeal pain, airway maintenance and sore throat. It was also noted that group (S) showed easy airway maintenance in 95.9% (n=185) patients. It was observed that, in group (S), 63.2% (n=122) patients were complained from sore throat and 67.4% (n=130) were complained about pharyngeal pain.  While on the other hand, in group (C), only 8.3% (n=16) patients were complained about sore throat and 11.4% (n=22) were complained about pharyngeal pain Conclusion: Use of stylet during endotracheal intubation decreases the incidences multiple attempts and make the airway maintenance easy for the anesthetist but on the other side it have complications like sore throat and post intubation pharyngeal pain than those patients in which stylet was not usede. Keywords: Pharyngeal pain, Tracheal Intubation, Stylet, Post-operative. DOI: 10.7176/JMPB/53-05 Publication date:March 31st 201

Results of traction followed by hip spica cast for closed fracture shaft of femur in children from 2 years upto 10 years of age: experience from a remote centre in North India

Background: Fracture shaft of femur is a common fracture in children, with treatment from conservative in form of skin traction to intramedullary nailing depending on age. Conservative treatment is mostly used upto six years of age, while for children more than 12 years surgery is usually preferred. We extended conservative in form of hip spica cast till 10 years of age. This study evaluates results of skin traction followed by spica cast in children upto 10 years of age.Methods: Study was done in GMC Doda from April 2019 to March 2022. 47 patients were enrolled for study, patients were initially given skin traction to get alignment which was followed by spica cast. Patients were evaluated at 3, 6, 9 and 12 weeks, final follow up was done at 6 months.Results: Out of 47 children, 4 patients were lost to follow up. Average age of children was 5.83 years. Mode of trauma was mostly RTA or fall from height. Average duration of traction was 9.14 days and average stay in hospital was 11.5 days. Average union time was 8.36 weeks. We had significant limb length discrepancy or angulation in 6 (13.9%) of our patients.Conclusions: skin traction followed by spica cast gives good results in fracture shaft femur in children upto 10 years of age

A pituitary carcinoma secreting TSH and prolactin: a non-secreting adenoma gone awry

To our knowledge, only one case of a TSH-secreting carcinoma has previously been reported. We describe here a second patient with a pituitary carcinoma producing TSH and prolactin (PRL). A 37-year-old male underwent a left frontotemporal craniotomy in 1996 for a sellar mass. Except for mildly increased PRL and elevated alpha-subunit, hormone evaluation was normal. Pathologic examination revealed a chromophobe adenoma with increased mitotic forms. The patient completed a course of external beam radiation to the pituitary and was prescribed l-thyroxine, bromocriptine, and hydrocortisone. He was lost to follow-up but did well for 6 years, until 2002, when he presented with TSH-dependent thyrotoxicosis and hyperprolactinemia. The patient was started on bromocriptine and propylthiouracil and was, again, lost to follow-up. In 2004, 9 years after his initial presentation, he presented after falling. Magnetic resonance imaging showed two brain masses with associated midline shift. Emergent resection of the larger mass revealed a pituitary cancer with positive staining for PRL, but not for TSH. Nine months later, the patient underwent further debulking of metastatic disease. Although development of a carcinoma from a pituitary adenoma is very rare (<0.5%), macroadenomas that become hormonally active should be suspect for transformation into pituitary cancer

Phytogenic Synthesis of Nickel Oxide Nanoparticles (NiO) Using Fresh Leaves Extract of Rhamnus triquetra (Wall.) and Investigation of Its Multiple In Vitro Biological Potentials

Chemically nickel oxide nanoparticles (NiONPs) involve the synthesis of toxic products, which restrict their biological applications. Hence, we developed a simple, eco-friendly, and cost-efficient green chemistry method for the fabrication of NiONPs using fresh leaf broth of Rhamnus triquetra (RT). The RT leaves broth was used as a strong reducing, capping, and stabilizing agent in the formation of RT-NiONPs. The color change in solution from brown to greenish black suggests the fabrication of RT-NiONPs which was further confirmed by absorption band at 333 nm. The synthesis and different physicochemical properties of RT-NiONPs were investigated using different analytical techniques such as UV-Vis (ultraviolet&minus;visible spectroscopy), XRD (X-ray powder diffraction), FT-IR (Fourier-transform infrared spectroscopy), SEM (scanning electron microscopy), TEM (transmission electron microscopy), EDS (energy-dispersive X-ray spectroscopy), DLS (dynamic light scattering) and Raman. Further, RT-NiONPs were subjected to different in vitro biological activities and revealed distinctive biosafe and biocompatibility potentials using erythrocytes and macrophages. RT-NiONPs exhibited potential anticancer activity against liver cancer cell lines HUH7 (IC50: 11.3 &micro;g/mL) and HepG2 (IC50: 20.73 &micro;g/mL). Cytotoxicity potential was confirmed using Leishmanial parasites promastigotes (IC50: 27.32 &micro;g/mL) and amastigotes (IC50: 37.4 &micro;g/mL). RT-NiONPs are capable of rendering significant antimicrobial efficacy using various bacterial and fungal strains. NiONPs determined potent radical scavenging and moderate enzyme inhibition potencies. Overall, this study suggested that RT-NiONPs can be an attractive and eco-friendly candidate. In conclusion, current study showed potential in vitro biological activities and further necessitate different in vivo studies in various animal models to develop leads for new drugs to treat several chronic diseases