@article{Koti_2023c,

title = {A comparative study of effect of position (sitting versus lateral decubitus) during spinal anaesthesia on the incidence of postdural puncture headache in patients undergoing lower limb orthopaedic surgeries},

author = {Vijaya Rekha Koti and Heena Naaz},

url = {https://www.academicmed.org/Uploads/Volume5Issue3/57.%20[580.%20JAMP_MEDP]%20264-268.pdf},

issn = {2687-5365},

year  = {2023},

date = {2023-04-30},

urldate = {2023-04-30},

journal = {International Journal of Academic Medicine and Pharmacy },

volume = {5},

issue = {3},

pages = {264-268},

abstract = {Background: The most common method of anesthesia for Lower limb surgeries is spinal anesthesia, and postdural puncture headache (PDPH) remains a major complication of this procedure. Nowadays, postdural puncture headache is a major cause of morbidity in patients undergoing surgeries under spinal anesthesia. This headache is the most popular reason for claims against anesthesiologists. The position after spinal anesthesia has been evaluated as a contributory factor in the occurrence of postdural puncture headache, but the position before spinal anesthesia has not been evaluated much. Aim: To compare the incidence of Post-Dural Puncture Headache following spinal anaesthesia in lateral decubitus position and sitting position in patients who

underwent lower limb surgeries under spinal anaesthesia. Patients and Methods: This study is performed in Owaisi group of hospitals in 100 patients between the age 19 yrs and 35yrs undergoing lower limb surgeries. The intensity of post-dural puncture headache was assessed postoperatively using a Visual Analogue Scale (VAS) immediately on postoperative day (POD) one to POD 5. VAS is 10 point numeric scale with 0 considered as no pain and 10 considered as severe pain ever experienced. Results: The incidence of post dural headache is more in the sitting group compared to that of lateral decubitus position.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2023,

title = {Evaluation of dexmedotomidine and fentanyl as additives to ropivacaine for epidural anaesthesia and post operative analgesia in in lower abdominal and lower limb surgeries},

author = {Vijaya Rekha Koti and Syeda Saniya Shireen and Shaheera Rahman},

url = {https://medicopublication.com/index.php/ijphrd/article/view/19134/16533},

doi = {10.37506/ijphrd.v14i2.19134},

issn = {0976-0245},

year  = {2023},

date = {2023-03-15},

urldate = {2023-03-15},

journal = {Indian Journal of Public Health Research & Development },

volume = {14},

issue = {2},

pages = {370-376},

abstract = {Background: The regional anaesthesia has lot of benefits compared to general anaesthesia for lower abdominal and lower limb surgeries. Epidural anaesthesia is an ideal anesthetic technique for lower abdominal and lower limb surgeries. The additives are used with Anesthetics for Early onset of action, To prolong the duration of action, Analgesia and Improving the quality of block.Aims and Objectives: The aim of this study was to study the clinical efficacy of Dexmedetomidine versus Fentanyl as an additive to Ropivacaine for lumbar epidural anaesthesia and post-operative analgesia. Materials and Methods: This study is a prospective randomi ed controlled study involving 90 patients undergoing infraumbilical and lower limb surgeries who will be divided randomly into three groups Group R(n = 30): received 18 ml of 0.5% ropivacaine for epidural anaesthesia and 10 ml of 0.2% ropivacaine boluses for postoperative analgesia; Group RF (n = 30): received 18 ml of 0.5% ropivacaine with 25μg fentanyl for epidural anaesthesia and 10 ml of 0.2% ropivacaine with 10 μg fentanyl boluses for postoperative analgesia; and Group RD (n = 30): received 18 ml of 0.5% ropivacaine with 25 μg dexmedetomidine for epidural anaesthesia and 10 ml of 0.2% ropivacaine with 5 μg dexmedetomidine boluses for postoperative analgesia.Results: Addition of additives have enhanced the onset of action, prolong duration of analgesia. Quality and duration of epidural anaesthesia provided by ropivacaine with dexmedetomidine is more effective than fentanyl. Better efficacy of analgesia evidenced with Dexmedetomidine than with Fentanyl. Conclusion: It can be concluded that RD (Ropivacaine and Dexmedetomidine) when given epidurally can be a safe and effective combination for epidural blockade in lower abdominal and lower limb surgeries.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2023b,

title = {Comparison of chloroprocaine and bupivacaine for spinal anaesthesia in patients undergoing day care surgery: a double blind randomized controlled study},

author = {Vijaya Rekha Koti and Syeda Nehha and Rooma and Mohammed Asraruddin and Syeda Hafsa Fatima},

url = {https://medicopublication.com/index.php/ijphrd/article/view/19135/16534},

doi = {10.37506/ijphrd.v14i2.19135},

issn = {0976-0245},

year  = {2023},

date = {2023-03-15},

urldate = {2023-03-15},

journal = {Indian Journal of Public Health Research & Development},

volume = {14},

number = {2},

issue = {2},

pages = {377-383},

publisher = {Institute of Medico-legal Publications Private Limited},

abstract = {Background:In the last few years, the number of surgical procedures performed on day care basis has increased worldwide, nearly between 20% - 30% surgeries are being performed as outpatient procedures. Ambulatory surgery has become increasingly popular due to advantages for the individual patient and the positive economic impact for the health care system. In the near future, ambulatory surgery is likely to expand further.Objectives: The objectives of this study were to compare chloroprocaine and bupivacaine for spinal anaesthesia in patients undergoing day care surgery. Methods: Patients between 18-60 years’ age of either sex, belonging to ASA I and ASA II undergoing day care surgeries lasting 45-60 min were included in this study after approval of Institutional Review Board and obtaining informed consent. Preanaesthetic check-up was done one day before surgery patients were evaluated for any systemic diseases and laboratory investigation recorded the procedure of spinal anaesthesia was explained to the patients and written informed consents was obtained. Hundred patients were randomly divided into two groups of fifty each. Fifty patients received 0.5% heavy 10mg (2cc) bupivacaine. Fifty patients received 40mg (4cc)preservative free 2-chloroprocaine. The primary outcome of this study, I. e., the time to eligibility for discharge from hospital, was measured from the time spinal anaesthesia was performed to the time the patient attained all of the discharge criteria.Results : Intrathecal 1% 2-chloroprocaine 40 mg provides spinal anaesthesia of adequate duration for day care surgeries with the advantage of earlier onset and faster regression of spinal block resulting in earlier ambulation and earlier voiding with stable hemodynamic as compared to 0.5% hyperbaric bupivacaine 10 mg.Conclusion: Thus we conclude that 2-chloroprocaine can provide spinal anaesthesia with a shorter recovery profile than bupivacaine, permitting earlier discharge from hospital after day care surgeries.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Fatima_2022c,

title = {A clinical study on methods of anesthesia and its effects on peri-interventional morbidity following rigid bronchoscopy},

author = {Asiya Fatima and Naseeba Fatima and Mohammed Naseeruddin Mujahid and Arjun Peddapally},

url = {http://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue12,Article26.pdf},

issn = {0975-1556},

year  = {2022},

date = {2022-12-31},

urldate = {2022-12-31},

journal = {International Journal of Pharmaceutical and Clinical Research},

volume = {14},

issue = {12},

pages = {192-198},

abstract = {Background: Providing Anesthesia for rigid Bronchoscopy is a challenge to the Anesthetist and ENT surgeon as they both compete for the same Airway. Rigid Bronchoscopy is an interventional procedure requiring General anesthesia of course with different strategies. The range of complications includes both mechanical and systemic types, depending on the technique of anesthesia used. Aim of the study: To assess the Anesthetic strategies used for Rigid Bronchoscopy and their role in peri-interventional morbidity. Methods: 68 patients of rigid Bronchoscopy were included and divided into two groups. Group A included patients in whom Total Intravenous Anesthetics were used (TIVA group) and group B where patients were administered Gaseous anesthetics (Volatile group). In group A, 46 patients were included and in group B 22 patients were included. In comparison, group A patients (TIVA group) consisted of more Hypertensive patients than the group B. Foreign body removal was performed under inhalation anesthesia in 21/68 (30.88%) patients (TIVA group- 11 and 10

Volatile group), Biopsy of Bronchogenic carcinoma was done in 11/68 (16.17%) patients (TIVA group- 06 and 05 Volatile group) and diagnostic Bronchoscopy was done in 14/68 (20.58%) of the patients (TIVA group- 06 and 08 Volatile group) to investigate the cause of hemoptysis. Both the groups of patients received similar ventilation irrespective of the indication for Bronchoscopy. Results: The hemodynamic showed the pre-operative and post-operative arterial blood gas, pulse oximetry and pulmonary function test data. The baseline values of these parameters were similar in the both groups. Post-operative estimation of arterial blood gas (7.42 ± 0.42 vs. 7.35 ± 0.17, P = 0.021) showed a lower PH in the patients who received volatile anesthesia than the TIVA group. But the volatile group patients were found to have a greater forced vital capacity (Volatile: 2.98 ±0.60 vs. TIVA: 2.19 ± 0.62, P = 0.034) than the TIVA group after rigid Bronchoscopy. The Volatile group patients showed greater incidence of systemic complications like Hypertension postoperatively, 14.25% in TIVA group than in Volatile group: 15.25%. Conclusion: The present study concluded that the two methods of anesthesia and ventilation used for rigid Bronchoscopy produced similar results and none of the both have shown to be superior over the other. Propofol and remifentanil combination used in TIVA group was better and appeared to be popular as it had attenuated haemodynamic response during the procedure. Both the groups showed improvement in spirometry mea- surements. The incidence of hypoxia or hypercapnia was also similar.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Fatima_2022d,

title = {Management of hypertension before, during and after general and orthopedic surgeries a pragmatic approach of anesthetists},

author = {Naseeba Fatima and Asiya Fatima and Arjun Peddapally and J. Hari Babu},

url = {http://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue12,Article10.pdf},

issn = {0975-1556},

year  = {2022},

date = {2022-12-31},

urldate = {2022-12-31},

journal = {International Journal of Pharmaceutical and Clinical Research},

volume = {14},

issue = {12},

pages = {78-89},

abstract = {Background: Among all the risk factors encountered before, during and after General and Orthopedic surgeries, Hypertension was considered as the foremost in the minds of all the Anesthetists. However, there is no definite and uniform protocol of using antihypertensive drugs in its management in the Indian literature. The situation such as this initiated the idea of conducting the present clinical trial. Aim of the Study: To study the peri-operative evaluation, care and management of the patient with hypertension undergoing general & orthopaedic surgeries. The objectives were to study the antihypertensive drug usage, types of anesthesia and their effects and side effects on hemodynamics during the surgery and their management strategies in peri-operative period. Methods: A tertiary care center where this cross-sectional, observational study was conducted

included patients from General Surgery and Orthopaedics Departments. Patients were examined by the Anesthetists before, during and after the surgeries up to 48 hours postoperative period. The variables included Initial blood pressure, Antihypertensive drugs used, Anaesthesia drugs used, Blood loss during surgery, Blood and Intravenous fluids used during the surgery. Statistical analysis done by using descriptive measures, mean, standard deviation and nonparametric tests and P < 0.05 was taken as significant in the study. Results: 93 Hypertensive patients undergoing General surgery and Orthopedics surgeries were included in this study. A Shpairo Wilk test was applied to test the normality of the subjects. There were 51/93 (54.83%) General surgery patients and 42/93 (45.16%) Orthopedic patients. There were 58 (54.83%) males (General Surgery- 38 (40.86%) and Orthopedic surgery- 20 (21.50%) and 35 (37.63%) female patients (General Surgery- 13 (13.97%) and Orthopedic surgery- 22 (23.65%) in the study. The male to female ratio was 1.28:1. The mean age was 34.85±6.15 years in General Surgery patients and 37.25±4.60 years in Orthopedic patients. Among The General Surgery patients the mean duration of history of Hypertension was 54.86±7.50 months. Among The

Orthopedics patients the mean duration of history of Hypertension was 52.31±2.75 months. Conclusion: Intraoperative hemodynamic changes were less in patients who used regularly Beta blockers than other antihypertensive drugs. They had lower heart rate also. Patients on diuretics on the morning of the surgery showed gross hemodynamic changes such as raised Systolic Blood Pressure and Diastolic Blood Pressure. Other antihypertensive drugs did not show significant hemodynamic changes intra-operatively.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Nelakurthi_2022,

title = {Comparison of intravenous morphine to unilateral erector spine block in postoperative analgesia following percutaneous nephrolithotomy},

author = {Rama Krishna Nelakurthi and Vinod Kumar V. S.},

url = {http://impactfactor.org/PDF/IJTPR/12/IJTPR,Vol12,Issue11,Article18.pdf},

issn = {0975-5160},

year  = {2022},

date = {2022-11-30},

urldate = {2022-11-30},

journal = {International Journal of Toxicological and Pharmacological Research},

volume = {12},

issue = {11},

pages = {143-148},

abstract = {Background: Acute postoperative pain is recently seen following PCNL where an ultrasound-guided block can be advantageous which manages pain along with reduced complication risks and better nerve visualization. Analgesic after PCNL can be delivered with ESP block without severe side effects. Aim: To comparatively assess the safety and efficacy of ultrasound-guided ESP block at the T8 level for intraoperative and postoperative analgesia in subjects undergoing PCNL (percutaneous nephrolithotomy) surgeries. Methods: 120 subjects of ASA-II were divided into 2 groups of 60 subjects each. Following general anesthesia induction, subjects were given an ultrasound-guided Erector Spinae plane (ESP) block before the surgical incision was given. Another 60 age and gender-matched subjects served as controls where general anesthesia without ESP block was given before surgical incision. Results: Intraoperative morphine use was significantly higher in controls compared to Group I subjects with p=0.001. VAS scores were significantly higher for Group II compared to Group I with

p<0.05. On assessing the consumption of analgesics and additional morphine in the study participants, analgesics consumption was 0 (0-1) for Group I and was significantly higher for group II with 1 (1-2). This was statistically significant with p=0.001. Overall morphine consumption was also significantly higher in Group II with 25.68±3.65 compared to Group I with ultrasound-guided erector spinae plane block with 15.01±5.27mg with p<0.001. Conclusion: The study concluded that satisfactory analgesic effects are seen with the ultrasound-guided ESP block at T8 transverse level in subjects undergoing PCNL (percutaneous nephrolithotomy). The postoperative pain was higher in controls and morphine was less used with ultrasound-guided ESP blocks.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2022,

title = {A clinical study on comparison of dexmedetomidine versus fentanyl as adjuvant to 0.5% bupivacaine in supraclavicular nerve block},

author = {Vijaya Rekha Koti and Asma Idris and Vamshi Bharadwaj},

url = {https://ejmcm.com/uploads/paper/2cc6e54bd2466c5615c82e673505853f.pdf},

issn = {2515-8260},

year  = {2022},

date = {2022-07-31},

urldate = {2022-07-31},

journal = {European Journal of Molecular & Clinical Medicine},

volume = {9},

issue = {7},

pages = {2391-2399},

abstract = {Supraclavicular approach of brachial plexus block has been popular technique in delivery of anesthesia in patients undergoing upper limb surgeries. Of various local anesthetics, bupivacaine is used most frequently for brachial plexus block. Any adjuvant to the local anesthetics for brachial plexus block prolongs its analgesic effect. Hence the present study was undertaken to compare the effect of dexmedetomidine and fentanyl as adjuvant to bupivacaine in supraclavicular nerve block for upper limb surgeries. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Prasad_2021b,

title = {Congenital pyloric atresia: experience with a series of 11 cases and collective review},

author = {G. Raghavendra Prasad and J. V. Subba Rao and Firdous Fatima and Fariha Anjum},

url = {https://www.jiaps.com/temp/JIndianAssocPediatrSurg266416-2971273_081512.pdf},

doi = {10.4103/jiaps.JIAPS_295_20},

issn = {0971-9261},

year  = {2021},

date = {2021-11-12},

urldate = {2021-11-12},

journal = {Journal of Indian Association of Pediatric Surgeons },

volume = {26},

issue = {6},

pages = {416-420},

abstract = {Introduction: Pyloric atresia is a rare cause of congenital gastric outlet obstruction. It is often associated with epidermolysis bullosa (EB). Rarity and experience with 11 cases are the reason for this publication. Aims and Objectives: The aim and objective of this study is to present our experience of 11 cases of congenital pyloric atresia and correlate with available literature. Materials and Methods: This was retrospective cohort of 11 cases correlative comparative study. Data of all the 11 cases from 1982 to 2019 were collected, reviewed, and analyzed. The parameters studied included age, gender, antenatal diagnosis, postnatal diagnosis, preoperative management, intraoperative findings, postoperative course outcome, associated anomalies, and any genetic studies if done. All these parameters were compared with published data. Results: There were 11 cases in the present series with six boys and five girls. Most of them presented at varying periods from birth to day 1 of life. Eight cases of type 1 pyloric atresia, two cases of type 2 pyloric atresia, and one case of type 3 pyloric atresia constituted the cohort. Five out of 11 cases were associated with EB. Two out of six cases with isolated pyloric atresia and four out of five cases with EB died. Discussion: Congenital pyloric atresia may be isolated or associated with EB. Three varieties of pyloric atresia were described. Association with EB increases the mortality. Conclusions: Review and analysis of 11 cases of pyloric atresia compared with published literature is being reported. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Prasad_2021,

title = {Abdominal cocoon: a diagnostic puzzle, multiple causes similar presentation– experience with 38 cases in search of a reliable imaging sign},

author = {G. Raghavendra Prasad and J. V. Subba Rao and Mahera Naureen and Gayatri Reddy Danda},

url = {https://journals.lww.com/kesg/fulltext/2021/27010/abdominal_cocoon__a_diagnostic_puzzle,_multiple.4.aspx},

doi = {10.4103/ksj.ksj_5_21},

issn = {0973-3051},

year  = {2021},

date = {2021-06-30},

urldate = {2021-06-30},

journal = {Kerala Surgical Journal},

volume = {27},

issue = {1},

pages = {8-12},

abstract = {Introduction: There are varied causes for abdominal cocoon. This study aims to present the varied causes of abdominal cocoon and definite pre operative indicator if any. Materials and Methods: A retrospective analysis of 38 cases of abdominal cocoon formed the cohort. An attempt was made to compare with the published cases of abdominal cocoon. Results: Giant cystic meconium peritonitis and para duodenal hernias were the most common non tubercular acute abdomen in children. Tubercular cocoon, cerebrospinal fluid CSF pseudocyst, ruptured ovarian cyst and idiopathic nonspecific sclerosing peritonitis were other causes. Imaging analysis showed clustering of bowel loops and well defined sac were the most reliable predictors. A comprehensive review of 38 cases of abdominal cocoon showed clustering of the bowel loops as the most reliable preoperative indicator of abdominal cocoon. Conclusions: Though there are varied causes for abdominal cocoon, clustering of bowel loops and well defined sac were the most reliable predictors.

},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Sirajuddin_2021,

title = {The attenuation of cardiovascular responses to tracheal extubation with lignocaine as compared with propofol},

author = {Mohammed Sirajuddin and Naseeba Fatima and Zara Batool and Mohd. Azam and Bushra Tarannum and Aisha Arif Ebrahim},

url = {https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_3411_v2.pdf},

doi = {10.21276/ijcmr.2021.8.4.7},

issn = {2393-915X},

year  = {2021},

date = {2021-04-30},

urldate = {2021-04-30},

journal = {International Journal of Contemporary Medical Research},

volume = {8},

issue = {4},

pages = {D6-D9},

abstract = {Introduction: With the introduction of endotracheal anaesthesia by Ivan W Magill, the father of endotracheal

anaesthesia (1914-1920) and the advent of balanced anaesthesia by John Lundy 1925, the use of controlled

ventilation technique has almost become universal. The study was conducted to know the Attenuation of Cardiovascular responses to Tracheal Extubation with Lignocaine as compared with Propofol at deccan college of medical sciences, Kanchanbagh, Hyderabad. Material and Methods: 75 patients belonging to ASA-1 and

2 of both the sexes (each group 25 patients n =25) undergoing surgery under general anaesthesia were randomly selected for the study. Patients of either sex with ASA grade 1 and 2 and the patients age ranged between 25 to 50 years were taken into study. Patients with history of respiratory problems, angina, palpitation, baseline systolic BP<100, coronary artery disease were excluded. Results: The pulse rate in test group showed a slight increase at 20 minutes followed by a insignificant decrease during the subsequent one hour period. But in control group the pulse rate decreased to about 12% below the preoperative level showing a statistically very highly significant change. Systolic blood pressure in test group fell by a maximum of 7.29% when compared to control group where it fell to a maximum of 19.18% and diastolic blood pressure in test group fell by a maximum of 3.69% as compared to control group where the decrease was 12.28%. Thus the difference was statistically very highly significant. Conclusion: It establishes the usefulness of an IV bolus dose of propofol 0.5 mg/Kg to attenuate the haemodynamic response to extubation. Propofol 0.5 mg / Kg is too superior to lignocaine 1 mg / Kg in prophylaxis of extubation response. When propofol and lignocaine were used in the study group by attenuation of cardiovascular responses to tracheal extubation no adverse side effects were encountered.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2021,

title = {Comparative study of perioperative blood glucose levels in various anaesthetic techniques (general, spinal and epidural) in non-diabetics and diabetics (controlled)},

author = {Vijaya Rekha Koti and Khaja Ali Hassan and Heena Naaz and Aejaz Ul Haq},

url = {https://www.medpulse.in/Anesthsiology/Article/Volume17Issue2/Anes_17_2_2.pdf},

doi = {10.26611/10151722 },

issn = {2579-0900},

year  = {2021},

date = {2021-02-07},

urldate = {2021-02-07},

journal = {MedPulse International Journal of Anesthesiology},

volume = {17},

issue = {2},

pages = {44-49},

abstract = {Background: Surgery produces a stress response resulting in various biochemical and hormonal changes. The most widely known metabolic disturbance is elevated blood sugar. Perioperative morbidity and mortality are affected by the inadequate glycaemic control. There are variations in hyperglycaemic response with various anaesthetic agents and techniques. Among the factors affecting genesis of hyperglycaemia Diabetes stands as a strong pillar. Aim: The aim of the study is to evaluate degree of rise of blood sugar levels as a measure of stress during anaesthesia and surgery, under various anaesthetic techniques between non-diabetics and diabetics (controlled). Patients and Methods: The study was conducted at Deccan college of medical sciences, Hyderabad in ninety adult patients (30 to 55 years age), undergoing various elective surgeries of 60 to 90 minutes duration under three aesthetic techniques (General Anaesthesia (GA), Epidural (EA), and spinal

Anaesthesia (SA)). 45 of these patients were not diabetic and 45 are controlled diabetics. Rise of blood sugar was compared among three techniques in each group and among similar techniques between both groups. For estimating blood glucose levels, preoperative,4 intraoperative and 2 postoperative venous blood samples were collected. Results: In diabetics and non-diabetics, the blood sugar fluctuation is less with regional techniques and furthermore, less under SA. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Fatima_2021b,

title = {Low dose of intravenous ketamine for prevention of hypotension after subarachnoid block},

author = {Naseeba Fatima and Mohammed Sirajuddin and Sumera Raheem and Aisha Arif Ebrahim and Syeda Rabia Fatima},

url = {https://ijhcr.com/index.php/ijhcr/article/view/860/749},

issn = {2590-3241},

year  = {2021},

date = {2021-02-07},

urldate = {2021-02-07},

journal = {International Journal of Health and Clinical Research},

volume = {4},

issue = {3},

pages = {11-17},

abstract = {Objectives  and  background:  The  study  was  conducted  to  know  the  efficacy  of  low  dose  i.v.  ketamine  for  prevention  of  hypotension  and  to compare   the   hemodynamic   changes   following subarachnoidblock   with   intrathecal   bupivacaine   heavy   with   or   without   low   dose   i.v. ketamine.Materials and Methods: 100 patients belonging to ASA-1 of both the sex (each group 50 patients n =50) undergoing General surgical and  orthopaedic  operations  were  randomly  selected  for  the  study.Results:The  pulse  rate  in  test  group  showed  a  slight  increase  at  20  minutes followed by a insignificant decrease during the subsequent one hour period. But in control group the pulse rate decreased to about 12% below the preoperative level showing a statistically very highly significant change. Systolic blood pressure in test group fell by a maximum of 7.29% when compared  to  control  group  where  it  fell  to  a  maximum  of  19.18%  and  diastolic  blood  pressure  in  test  group  fell  by  a  maximum  of3.69%  as compared to  control  group  where the  decrease  was 12.28%. Thus the difference  was  statistically  very  highly significant.Conclusion: Low  dose i.v. ketamine in doses of 0.3 mg/kg offers superior cardiovascular stability, and low dose i.v. ketamine in combination with midazolam, has good sedative and analgesic properties, reduces the volume of crystalloids required to maintain hemodynamic stability.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hussain_2021c,

title = {Effect of oral clonidine premedication on spinal anesthesia using levobupivacaine},

author = {Syed Asrar Hussain and U. Jayashree and Mohammed Asraruddin},

url = {https://www.iaimjournal.com/wp-content/uploads/2021/02/iaim_2021_0802_09.pdf},

issn = {2394-0026},

year  = {2021},

date = {2021-01-31},

urldate = {2021-01-31},

journal = {International Archives of Integrated Medicine},

volume = {8},

issue = {2},

pages = {63-68},

abstract = {Background: The duration of spinal analgesia can be prolonged by using different techniques including oral clonidine. This study was mainly undertaken in order to study the effect of oral clonidine in levobupivacaine spinal analgesia. Material and methods: A randomized controlled trial was undertaken in 80 patients. About 40

patients received 150 mcg of oral clonidine and 40 patients received placebo. The socio demographic

characteristics, hemodynamic parameters, sedation time, time to reach maximum sensory level and time to 2 segment regression were compared between the oral clonidine and placebo groups. Results: There was no statistically significant difference in the hemodynamic parameters between the oral clonidine and placebo groups. The mean sedation score was 1.1 in Oral clonidine group and 1.12 in the placebo group (p=0.728). The mean time to reach maximum sensory level was 9.92 minutes in oral clonidine group and 9.82 minutes in placebo group (p=0.753). The time to two segment regression in oral clonidine group was 108.85 minutes and 109.85 minutes in placebo group (p=0.496). Conclusion: This study had shown no significant difference in the hemodymaic parameters, sedation score, time to maximum sensory level and time to 2 segment regression between the oral clonidine and placebo groups.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Nazki_2020,

title = {Evaluation of serum uric acid levels in type 1 diabetes mellitus patients in association with glycemic control},

author = {Faizan I Asrar Nazki and Sara Mohammed and Syyeda Anees and Mohsin Wazir},

url = {https://www.worldwidejournals.com/international-journal-of-scientific-research-(IJSR)/fileview/evaluation-of-serum-uric-acid-levels-in-type-1-diabetes-mellitus-patients-in-association-with-the-glycemic-control_December_2020_7466102919_5722389.pdf},

issn = {2277-8179},

year  = {2020},

date = {2020-12-31},

urldate = {2020-12-31},

journal = {International Journal of Scientific Research},

volume = {9},

issue = {12},

pages = {65-66},

abstract = {AIMS: To evaluate the serum uric acid levels in Type 1 Diabetes Mellitus in association with the glycemic control. METHODOLOGY: 100 subjects were enrolled (50 controls and 50 type 1 diabetic patients) with age and sex matched. 50 Type 1 diabetic patients were grouped into 3 based on their glycemic status. Venous blood and urine is collected for the estimation of the serum uric acid, serum creatinine, fasting blood glucose and HbA1c. RESULTS: The present study received signicant correlations between SUA and HbA1c with their respective controls with p –value <0.005. The difference of mean values of SUA between Group 2 and Group 3 is not signicant, whereas between Group 1 and Group 3 is statistically signicant (p value <0.01). CONCLUSION: The present study stated that serum uric acid concentration was found to be higher in type 1 DM. The raised UA levels are found to be associated with poor glycemic control in Type 1 diabetes mellitus.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hussain_2020,

title = {Comparison of safety and efficacy of pethidine and tramadol in shivering patients for surgeries under regional anesthesia},

author = {Syed Asrar Hussain and U. Jayashree and Atif Mohammed},

url = {http://iaimjournal.com/wp-content/uploads/2020/03/iaim_2020_0703_11.pdf},

issn = {2394-0026},

year  = {2020},

date = {2020-03-31},

urldate = {2020-03-31},

journal = {International Archives of Integrated Medicine},

volume = {7},

issue = {3},

pages = {74-79},

abstract = {Background: Post-operative shivering is common complication of the regional anesthesia. This study was mainly undertaken to compare the efficacy of pethidine and tramadol in controlling the post-operative shivering.Materials and methods: A randomized controlled study was conducted among 80 patients undergoing different surgeries. All the patients were assessed for shivering grades, its disappearance,

hemodynamic status and complications if any. Sedation scores were recorded and shivering scores were also recorded.Results: There was no statistically significant difference in the age, weight, sex and ASA grades between the tramadol and pethidine groups. All the hemodynamic responses were same in both the groups. The shivering stopped at an earlier point of time in tramadol group when compared to the pethidine group which was statistically significant. Sedation characteristics are significant at 5 minutes and 10 minutes for pethidine. Pethidine causes more sedation tramadol at 5 and 10 minutes.Conclusion: Tramadol was shown to be superior in efficacy when compared with the pethidine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Jayashree_2020b,

title = {A prospective randomized double blind controlled clinical study comparing epidural butorphanol versus nalbuphine as adjuvants in abdominal hysterectomy},

author = {U. Jayashree and Syed Asrar Hussain and Henna},

url = {http://iaimjournal.com/wp-content/uploads/2020/03/iaim_2020_0703_12.pdf},

issn = {2394-0026},

year  = {2020},

date = {2020-03-31},

urldate = {2020-03-31},

journal = {International Archives of Integrated Medicine},

volume = {7},

issue = {3},

pages = {80-87},

abstract = {Background: Pain is abnoxius stimulus after surgery. This study was undertaken to evaluate the post-operative analgesic benefits in patients administered with epidural butorphanol and nalbuphine as adjuvants with local anesthetic post operatively for abdominal hysterectomy under epidural anaesthesia and to compare their post-operative efficacy.Material and methods: An RCT was conducted among 80 patients who were divided into two equal groups by computer generated random numbers. One group received Butorphanol and other received Nalbuphine. The sensory block, motor block, duration of analgesia, quality of analgesia and side effects were compared between the two groups.Results: There was no difference in the pulse rates of patients belonging to both the groups. Not much variation was recorded in systolic and diastolic blood pressures in both the groups. The mean onset of sensory block in Butorphanol group was 5.9 min and 4.6 min in Nalbuphine group. The mean pain score was 1.0 after three hours of injection in the butorphanol group and Nalbuphine group. The duration of analgesia was 7.85 hours in the Butorphanol and 7.88 hours in the Nalbuphine group. Nausea/ vomiting were the main complication among the Butorphanol group and also found in Nalbuphine group. In butorphanol group, the quality of analgesia was good in 93.3% and in Nalbuphine group in 90.0% of the cases. Conclusion: Both butorphanol and Nalbuphine had comparable efficacy and side effects as adjuvants in epidural anesthesia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Jayashree_2020,

title = {A comparative study to evaluate the efficacy of intranasal dexmedetomidine versus intranasal midazolam as pre medications in children},

author = {U. Jayashree and Syed Asrar Hussain and Humaira},

url = {http://iaimjournal.com/wp-content/uploads/2020/02/iaim_2020_0702_16.pdf},

issn = {2394-0026},

year  = {2020},

date = {2020-02-29},

urldate = {2020-02-29},

journal = {International Archives of Integrated Medicine},

volume = {7},

issue = {2},

pages = {94-100},

abstract = {Background: Pediatric surgery amounts for enormous stress due to anesthesia and surgery for the children. This study was mainly undertaken to assess the efficacy and safety of Midazolam and dexmedetomidine as premedicants in children.Material and methods: A randomized controlled trial was undertaken in 100 children belonging toASA Grades I and II posted for surgery in a Institute of Medical sciences hospital were dividedequally in to two groups. One group received Dexmedetomidine and other received Midazolam. A baseline heart rate, respiratory rate, systolic blood pressure and activity of the child were noted in the pre-operative room. The premedicant was administered and after 30 minutes, a standard general anesthesia procedure was administered. Results: About 36.7% of children in Dexmedetomidine group and 10% in Midazolam group had their eyes closed but verbally arousable, 33.3% of dexmedetomidine and 40% of the Midazolam group had their eyes closed but arousable with light physical stimulation. About 43.3% of the Dexmedetomidine group children and 46.7% of the Midazolam children had moderate fear of mask, co-operative reassurance and 36.7% of the children in Dexmedetomidine group and 30% in Midazolam group were combative, crying.Conclusion: Dexmedetomidine was shown to be effective than Midazolam in Parental separation, pre induction and sedation.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Prasad_2018b,

title = {Early enteral nutrition in neonates following abdominal surgery},

author = {G. Raghavendra Prasad and J. V. Subba Rao and Amtul Aziz and T. M. Rashmi and Saniya Ahmed},

url = {https://www.jneonatalsurg.com/ojs/index.php/jns/article/view/384/pdf},

doi = {10.21699/jns.v7i2.740},

issn = {2226-0439},

year  = {2018},

date = {2018-04-08},

urldate = {2018-04-08},

journal = {Journal of Neonatal Surgery},

volume = {7},

issue = {2},

pages = {21},

abstract = {Introduction: Nil per oral (NPO)/nil by mouth has been the most commonly practiced convention in post-operative period. Misplaced fear of aspiration led to routine prescription of “NPO.” Starvation leads to atrophy of the gut mucosa leading to decreased barrier effect of gut mucosa. This starvation-induced gut mucosal injury increases septic complications and mortality. The study aims at establishing the feasibility and effect of early enteral nutrition (EEN) in neonates following abdominal surgeries. Materials and Methods: A total of 260 cases formed the cohort of prospective cohort study, 79 in EEN - Group “A” and 181 in NPO - Group “B.” Effect of EEN was evaluated with regard to outcome, hospital stay, surgical site infections (SSI), stress markers such as C-reactive protein (CRP), procalcitonin, tumor necrosis factor alpha (TNF α), and neonatal-predisposition, insult/injury, response, organ failure (Neo-PIRO) scores, intra-abdominal pressure (IAP) grade, tolerance of feeds, and time to first stool. Chi-square was the statistical method used. Epi info version 7 was the software used. Results: Group B had higher mortality (20.09%) than Group A (P < 0.05). 33.7 in Group B developed SSI, of which 90% were deep and intracavitary (P < 0.05). Hospital stay was less in Group A (P < 0.05). CRP and Neo-PIRO scores were less in Group A compared to Group B (P < 0.05). TNF-α expression and IAP scores were not statistically significant (P > 0.05). Procalcitonin levels were higher in Group B. Feeds were better tolerated in Group A. First stool appeared earlier in Group A than B. There was no difference in anastomotic leak in both the groups. Conclusion: EEN in neonates following abdominal surgeries is feasible, well tolerated reduces the hospital stay and mortality, and reduces SSIs, and early gut motility could be established.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Prasad_2017b,

title = {"Neo-PIRO": introducing a novel grading system for surgical infections of neonates},

author = {G. Raghavendra Prasad and J. V. Subba Rao and Amtul Aziz and T. M. Rashmi},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615894/?report=reader},

doi = {10.4103/0971-9261.214455},

issn = {0971-9261},

year  = {2017},

date = {2017-12-31},

urldate = {2017-12-31},

journal = {Journal of Indian Association of Pediatric Surgeons},

volume = {22},

issue = {4},

pages = {211-216},

abstract = {Introduction: Quantification of surgical sepsis was never done beyond superficial, subfascial, and deep surgical site infection (SSI). Invasive surgical sepsis with systemic manifestation has not been tried to be quantified in general and pediatric surgery in particular. Hence, this attempts to develop a novel grading system to quantify neonatal surgical infections. Materials and Methods Predisposing factors, infection, response, and organ failure (PIRO) is being used in critical care institutions for medical sepsis; it was modified with neonate-specific surgical parameters. Authors have developed a grading of these parameters into Grade I, II, and III. Results: A blinded statistical test was performed and results were put to test. Extended Mantel–Haenszel Chi-square test validated linear relationship with grade and outcome, hospital stay, deep SSI, and organ dysfunction. Analysis of variance also showed the significant relationship of changing trends in grade and outcome. (1) Higher the grade indicated the probability of death. (2) Grade I patients had less duration of hospital stay compared to Grade II and III (P = 0.04). (3) The requirement of organ support and SSI were also more in Grade III. (4) Grade I patients had less increase in trends compared to Grade II and III (F = 4.86). Authors therefore feel Neo-PIRO seems to be the first scoring system that shows a linear relationship between scores and grade. Conclusion: Neo-PIRO is a novel grading system with surgical neonate-specific parameters. Future versions to include molecular parameters, as well as parameters selected by regression analysis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Prasad_2017,

title = {The role of routine measurement of intra-abdominal pressure in preventing abdominal compartment syndrome},

author = {G. Raghavendra Prasad and J. V. Subba Rao and Amtul Aziz and T. M. Rashmi},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473297/?report=reader},

doi = {10.4103/jiaps.JIAPS_222_15},

issn = {0971-9261},

year  = {2017},

date = {2017-09-30},

urldate = {2017-09-30},

journal = {Journal of Indian Association of Pediatric Surgeons},

volume = {22},

issue = {3},

pages = {134-138},

abstract = {Introduction: Abdomen, a closed compartment, is prone to raised intra-abdominal pressure (IAP) in the postoperative period. After a critical value of ≥ 15 cm of water, IAP produces abdominal compartment syndrome (ACS). ACS leads to reduced venous return, reduced cardiac output, and domino effect of organ dysfunction, leading to death. Hence, it is the need of hour to monitor IAP to pick up intra-abdominal hypertension (IAH) and ACS. This routine facilitates early institution of treatment measures. Aims and Objectives: To study IAP in abdominal operations in neonates, infants, and older children and to promote concept of routine measurement of IAP as standard care. Materials and Methods: Intravesical route was used to measure IAP in this prospective observational study. Seventy-nine pediatric abdominal surgeries met with criteria of availability of complete data for analysis and formed the cohort of the study. All major, infective, traumatic, tumor-related abdominal surgeries were included in the study. Outcome, C-reactive protein (CRP), procalcitonin, platelet counts, Simplified Sequential Organ Failure Assessment Score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were the parameters analyzed. The World Society of ACS grading was adopted in the study with subdivision of normal into low-normal and high-normal subgroups. Results: 

Extended Mantel–Haenszel Chi-square statistical tool when applied for linear relationship showed a linear relationship with outcome (P < 0.05), CRP (P < 0.05), procalcitonin (P < 0.05), Simplified Sequential organ failure Assessment Score, and APACHE II. Platelet counts (P > 0.05) were not significantly correlated. Decision for laparotomy was delayed in cases of ACS. Conclusion: Routine measure of IAP facilitates early recognition of IAH. This facilitates therapeutic measures to be initiated to reduce IAP. Early decision to decompress by laparotomy/laparostomy saves lives. Hence, routine IAP measurement should be a part of standard care in pediatric abdominal surgery.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Hassan_2017,

title = {A comparative study of different adjuvants to augment the effect of epidural bupivacaine for lower abdominal surgeries},

author = {Khaja Ali Hassan and Mahmood Mirza and Mazherullah Khan and Zara Batool and Mohammed Sirajuddin},

url = {https://www.medpulse.in/Anesthsiology/Article/Volume2Issue3/Anes_2_3_1.pdf},

doi = {10.26611/1015231},

issn = {2579-0900},

year  = {2017},

date = {2017-06-12},

urldate = {2017-06-12},

journal = {MedPulse International Journal of Anesthesiology},

volume = {2},

issue = {3},

pages = {46-49},

abstract = {Background: The technique of epidural anesthesia and analgesia have become widespread following their introduction and acceptance by the patients in surgical and obstetric practice. Adjuvants to bupivacaine have been used to enhance good quality perioperative and postoperative anesthesia and analgesia. The aim of the study is to evaluate the effect of extradural administration of bupivacaine, bupivacaine with fentanyl (2microgram/kg), ketamine (1mg/kg) and dexmeditomedine (1.5microgram/kg). Aim: The aim of the study is to evaluate the effect of extradural administration of bupivacaine, bupivacaine with fentanyl(2 microgram/kg), ketamine(1mg/kg) and dexmeditomedine (1.5microgram/kg). Methods: The prospective, comparative, single blind study includes 100 patients of ASA grade 1 and 2 for lower abdominal surgeries. Each group was given loading dose of 20ml of 0.5% bupivacaine with various adjuvants-fentanyl(2microgram/kg), or ketamine (1mg/kg) or dexmeditomedine (1.5microgram/kg) Result: Time of onset was earlier in group with ( bupivacaine +fentanyl) and (bupivacaine+dexmeditomedine). It was delayed in group of plain bupivacaine. The total power regained was delayed in bupivacaine+dexmeditomedine-260.8±18.77,bupivacaine+fentanyl-241.70±24.98 ,bupivacaine+ketamine-234.232±9.66 when compared to plain bupivacaine of 183.07±14.53(P <0.05).Demand of analgesia is earlier in plain bupivacaine and (bupivacaine+ketamine) when compared to (bupivacaine + fentanyl) and (bupivacaine+dexmeditomedine) requiring an early top up of epidural .Similarly two segment regimen is also significantly early in group (plain bupivacaine) and (bupivacaine+ketamine) (P<0.001). It is also observed that patients are hemodynamically stable with bupivacaine + fentanyl > bupivacaine + dexmeditomedine >plain bupivacaine>bupivacaine +ketamine. Conclusion: Fentanyl and dexmeditomedine were effective and superior as compared to plain bupivacaine(bupivacaine+ketamine) as an adjuvant to enhance effect of bupivacaine for epidurals.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Khan_2017c,

title = {Anaesthetic management of Bochdalek hernia in a 72-year-old patient- a rare case report},

author = {Basheer Ahmed Khan and Zara Batool and Unaiza and Mohammed Sirajuddin},

url = {https://www.jebmh.com/articles/anaesthetic-management-of-bochdalek-hernia-in-a-72yearold-patient-a-rare-case-report.pdf.pdf},

doi = {10.18410/jebmh/2017/498},

issn = {2349-2562},

year  = {2017},

date = {2017-05-22},

urldate = {2017-05-22},

journal = {Journal of Evidence Based Medicine and Healthcare},

volume = {4},

issue = {41},

pages = {2518},

abstract = {A 72-year-old female was admitted to the hospital with the complaints of difficulty in breathing and chest discomfort after food intake since 7 months. She also complained of reflux vomiting after a regular meal for the same duration. Other complaints included weight loss, cough after taking even water and recurrent upper respiratory tract infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2017b,

title = {Effect of intrathecal ketamine as an adjuvant on the dose of intrathecal bupivacaine},

author = {Vijaya Rekha Koti and Saratbabu Chevuri and Mohammed Umer Majid and Syeda Huma Gulbadeen},

url = {https://www.medpulse.in/Anesthsiology/Article/Volume2Issue1/Anes_2_1_3.pdf},

doi = {10.26611/1015213},

issn = {2579-0900},

year  = {2017},

date = {2017-04-12},

urldate = {2017-04-12},

journal = {MedPulse International Journal of Anesthesiology},

volume = {2},

issue = {1},

pages = {12-16},

abstract = {Background: A randomized control study was done to evlauate the effect of ketamine on the dose of bupivacaine when added as an adjuvant to intrathecal bupivacaine. Materials and Methods: 90 patients were divided randomly into 3 groups of 30 each. Group - 1 received 0.5% heavy Bupivacaine 3cc, Group 2 received 0.5% heavy Bupivacaine +preservative free ketamine 25mg. Group 3 received 0.5% heavy Bupivacaine 2.5cc + 0.5cc normalsaline. All patients after thorough checkup, after obtaining informed consent, recording basal parameters were shifted to O.T. Spinal anaesthesia was given in sitting position in L3-L4 space with 25G Quincke spinal needle, group specific drug was injected and immediately made supine. Monitoring was done by another person. Time of onset of T12 blockade, height of blockade, onset and duration of motor and sesory blockade and haemodynamic parameters were noted down. Observations and Results: Onset of sensory block, motor block were fast with Gr 2 then Gr 1 lastly with Gr3. Intensity of motor block (assessed by modified Bromage scale) is good with Gr1, then with Gr 2 and last with Gr 3. Haemodynamics are better maintained with Gr 2 than Gr 1. Recoveryfrom block (2 segment regression) was early in Gr 3 then Gr 2 last with Gr 1 motor block. Conclusion: When preservative free ketamine 25mg is added to bupivacaine 2.5 cc (0.5% heavy) produces early and good analgesia, adequate relaxation for infraumbilical surgeries compared to 2.5cc of

Bupivacaine alone and better maintained haemodynamics and early recovery from block than 3cc of Buppivacaine so that dose of intrathecal dose of Bupivacaine can be reduced. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2017,

title = {Dexmedetomidine an adjuvant in anesthesia for functional endoscopic sinus surgery (FESS)},

author = {Vijaya Rekha Koti and Saratbabu Chevuri and Syed Abdul Wasiq and Bashirunnisa},

url = {https://www.rfppl.co.in/subscription/upload_pdf/Vijayarekha%20Koti_5128.pdf},

doi = {10.21088/ijaa.2349.8471.4217.28},

issn = {2349-8471},

year  = {2017},

date = {2017-04-07},

urldate = {2017-04-07},

journal = {Indian Journal of Anaesthesia and Analgesia},

volume = {4},

issue = {2},

pages = {532-536},

abstract = {Introduction: Dexmedetomidine can provide controlled hypotension, analgesia, and sedation. The present study

aimed to evaluate advantages of dexmedetomidine as an adjuvant in anesthesia for FESS(Functional Endoscopic Sinus Surgery). Materials and Methods: Study was conducted in 50 patients form April -2015 to March -2016 after obtaining approval from ethical committee and informed consent from the patients. who were ASA grade I/II, aged between 18-55years scheduled for FESS. Patients were randomly allocated into two groups of Group D(n=25)which received injection Dexmeditomidine as loading dose of 1mcg/kg intravenously followed by maintenance infusion of 0.6mcg/kg intravenously and Group NS(n=25) received normal saline in similar volume. Results: The baseline mean systolic blood pressure was lower during surgery in patients of group D, but not statistically significant . At the end of surgery and after recovery, blood pressure is significantly lower in group D (114± 11 vs. 131 ± 9 mmHg; P < 0.05). Baseline values of the mean heart rate intraoperatively was significantly reduced compared with the baseline value in group D (P < 0.05), After extubation, the heart rate was found to be higher in patients of the Group-NS (98 ± 4 vs. 86 ± 3 beats/minutes). Blood losses were

lower in group D as compared to group NS (p= 0.03).The Visual Analogue Scale (VAS) scores in the immediate

postoperative periods were also significantly lower in the group D (p =0.03). The only side effect noted was bradycardia in 3 patients in group D. Isoflurane requirement was also reduced in the maintenance of anaesthesia. Conclusion: Dexmedetomidine as an adjuvant for hypotensive anaesthesia is effective and decreases bleeding thus providing relatively bloodless field during FESS. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Chevuri_2017,

title = {The impact of verapamil addition to ketamine and lidocaine intravenous regional anesthesia: a randomized controlled study},

author = {Saratbabu Chevuri and Vijaya Rekha Koti },

url = {https://www.iaimjournal.com/storage/2017/04/iaim_2017_0404_06.pdf},

issn = {2394-0026},

year  = {2017},

date = {2017-03-31},

urldate = {2017-03-31},

journal = {International Archives of Integrated Medicine},

volume = {4},

issue = {4},

pages = {27-34},

abstract = {Background: The use of adjuncts along with Lidocaine during intravenous regional anesthesia (IVRA) decreases tourniquet pain and prolongs post-operative analgesia. Addition of ketamine reduces the time for onset of block, delays the onset of tourniquet pain and reduces postoperative analgesic requirement. Verapamil potentiates the effect of neuromuscular blocking agents. This study was designed to evaluate the effect of adding Verapamil (2.5 mg) to Lidocaine plus Ketamine (0.5mg/kg) in comparison with lidocaine plus ketamine IVRA. Materials and methods: Hundred and twenty patients, aged 18–50 years, ASA physical status I and

II undergoing elective hand or forearm surgery under Bier’s Block lasting one to one and half hours were included in this double-blinded, randomized and controlled study. Patients were divided into two groups of 60 patients each. Group- I (control group) received 40 ml of 0.5% Lidocaine plus ketamine (0.5 mg/kg) and Group- II received an addition of 2.5 mg of verapamil IVRA. Sensory and motor block onset and recovery time were noted. After the tourniquet deflation: pain, sedation values, time to first analgesic requirement and side effects were evaluated over a period of 12 hours. Results: Significant postoperative hemodynamic changes, sedation score, pain score and delayed first request for analgesia was observed in-group II when compared to group I. Sensory and motor block characteristics were significant in-group II as against group I. The side effect profile of verapamil (2.5mg) was minimal with a few episodes of hypotension and bradycardia, which were clinically

managed by ephedrine and atropine respectively. Conclusions: Adding verapamil 2.5 mg to Lidocaine plus ketamine (0.5 mg/kg) for IVRA proved to be an effective and safe adjuvant for acute pain after surgery.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Khan_2017b,

title = {Comparative study of pressor responses after tracheal extubation and LMA (laryngeal mask airway) removal in controlled hypertensive patients: a randomised clinical trial},

author = {Basheer Ahmed Khan and Mohammed Sirajuddin and Zara Batool and Unaiza},

url = {https://www.ijhsr.org/IJHSR_Vol.7_Issue.3_March2017/3.pdf},

issn = {2249-9571},

year  = {2017},

date = {2017-02-11},

urldate = {2017-02-11},

journal = {International Journal of Health Sciences and Research},

volume = {7},

issue = {3},

pages = {14-21},

abstract = {Background and objectives: Airway management using endotracheal intubation and laryngeal mask airway (LMA) are known to induce hemodynamic changes. The predominant response is tachycardia and systemic hypertension. The present study was undertaken to compare the hemodynamic responses after tracheal extubation and LMA removal in controlled hypertensive patients. Methodology: The study was conducted on 70 patients in age group of 35-65 yrs, ASA Grade II scheduled for elective surgical procedures. Patients were allocated in randomized manner in two groups, one undergoing endotracheal tube intubation (Group T) and other undergoing laryngeal mask airway insertion (Group L). Each group had 35 patients. The hemodynamic data included pulse rate and blood pressure that were recorded at time intervals: baseline before intubation, at 1, 2, 3, 5 and 10 min after extubation or LMA removal. Rate pressure product was calculated. Results: Extubation caused significant increase in mean pulse rate in Group T, which failed to reach baseline level after 10 minutes. LMA removal in Group L was associated with significant increase in mean pulse rate however it returned back to baseline at 5minutes after removal. Significant rise in MAP after extubation and LMA removal was observed in Group T and L, it did return to baseline values after 5 min in Group L and no such effect observed even after 10 min in Group T. Rise in mean pulse rate and mean arterial pressure was significantly higher when compared between group T and group L. Similar observations were made for rate pressure product in Group L and T respectively. Interpretation and conclusion: Both endotracheal extubation and laryngeal mask airway removal were associated with a statistically significant rise in pulse rate, rate pressure product and MAP. The rise was

significantly higher in Group T as compared to Group L. LMA removal was found to be accompanied with lesser pressor response as compared to endotracheal tube extubation in controlled hypertensive patients. Use of Laryngeal mask airway is quite advantageous and hence is desirable in hypertensive patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Khan_2016e,

title = {Comparative study on various adjuvants used during spinal anaesthesia in infraumbilical surgeries},

author = {Basheer Ahmed Khan and Mohammed Mohib Hussain and Jaweed Zaheer Siddique and Naseeba Fatima and Santosh Singh},

url = {http://www.jcmad.com/admin/pdf/435.pdf},

issn = {2347-4513},

year  = {2016},

date = {2016-12-06},

urldate = {2016-12-06},

journal = {Journal of Contemporary Medicine and Dentistry},

volume = {4},

issue = {3},

pages = {27-32},

abstract = {This prospective randomized double-blind study was conducted to evaluate the onset and duration of sensory and motor block as well as perioperative analgesia and adverse effects of various adjuvants like dexmedetomidine, magnesium sulphate, fentanyl given during spinal anaesthesia with 0.5% hyperbaric bupivacaine for central neuraxial block. A total of 120 patients were randomly allocated into four groups to receive intrathecally either 15 mg hyperbaric bupivacaine plus 10 μg dexmedetomidine (group A, n =30) or 15 mg hyperbaric bupivacaine plus 50 mg magnesium sulfate (group B, n =30) or 15 mg hyperbaric bupivacaine plus 25 μg fentanyl (group C, n =30) or 15 mg hyperbaric bupivacaine plus 0.1 ml saline (group D, n =30) as control. The onset time to reach peak sensory and motor level, the regression time for sensory and motor

block, hemodynamic changes and side-effects were noted. The Ɵme of onset to reach T10 dermatome level and to reach peak sensory level as well as the onset time to reach modified Bromage 3 motor block were significantly different in all the four groups. The onset time to reach peak sensory and motor level was shorter in group A as compared with the control group C, and it was significantly prolonged in group B. It was also found that patients in group A had significant longer sensory and motor block times when compared to patients in group B, which was greater than in the fentanyl group C and control group D. In this study it was found that onset of anaesthesia was rapid and of prolonged duration in the dexmedetomidine group (A).

However, in the magnesium sulfate group (B), although onset of block was delayed, the duration was significantly prolonged as compared with the fentanyl group (C) and control group (D), but to a lesser degree than in the dexmedetomidine group (A). All the groups were similar with respect to hemodynamic variables and there were no significant side-effects in either of the groups. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2016,

title = {Attenuation of haemodynamic response to intubation with oral clonidine and oral atenolol},

author = {Vijaya Rekha Koti and Saratbabu Chevuri and Sunil Pulla and Varunchander G},

url = {https://www.ijca.in/journal-article-file/2002},

doi = {10.5958/2394-4994.2016.00046.9},

issn = {2394-4781},

year  = {2016},

date = {2016-01-31},

urldate = {2016-01-31},

journal = {Indian Journal of Clinical Anaesthesia},

volume = {3},

issue = {2},

pages = {251-256},

abstract = {A comparative study is done between oral Atenolol and oral Clonidine in the attenuation of cardiovascular response during laryngoscopy and intubation. 50 adult patients undergoing various elective surgeries of ASA grade 1, Mallampatigrade 1 were selected and informed consent was taken for all the cases. Patients were of both sexes and age ranging from 18 to 60 years. The study was done in two groups. Group 1 consisted of 25 patients where atenolol 0.75mg per kg body wt was given orally 3 hrs before the scheduled time of the surgery. Group 2 consisted of 25 patients where clonidine 3 micrograms per kg body wt was orally given 90min before schedules time of surgery. The drugs given in premedication were inj.glycopyrollate 10mcg/kg, inj. midazolam 40mcg/kg and inj.ondansetron 0.08mg/kg. Induction of anesthesia was achieved by inj. thiopentone in a dose of 5mg/kg iv. Tracheal intubation was facilitated with inj. suxamethonium 2 mg/kg iv.Hemodynamic parameters (BP, HR, MAP) were recorded at the  intervals of  Pre induction, After induction, During laryngoscopy and intubation, 1 min, 3 min, 5 min after intubation. Data was compared between the two groups of patients. Group 1 did not show a significant increase in various hemodynamic parameters. Group 2 showed higher increase in hemodynamic parameters compared to oral atenolol. Hemodynamic parameters returned to the baseline at the end of 5 min in the atenolol group whereas it took more than 5 min to return to the basal value and it has less effect on the heart rate in clonidine group compared to atenolol group. The following conclusion can be drawn from our study. Oral atenolol attenuates the increase in heart rate to laryngoscopy and intubation more effectively than oral clonidine. Oral atenolol blunts the increase in systolic, diastolic and mean arterial pressure effectively and values returned to basal value within 5 min of intubation compared to oral clonidine. No side effects were noted in atenolol and clonidine groups in our study. Hence oral atenolol in a dose of 0.75 mg/kg given 3 hrs before induction of anaesthesia is effective in attenuating hemodynamic response to laryngoscopy and endotracheal intubation when compared to oral clonidine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Prasad_2015c,

title = {A study of impact of early diagnosis in the management of choledochal cysts of infancy and childhood– experience and analysis of 205 cases},

author = {G. Raghavendra Prasad and Kasha Aishwarya and J. V. Subba Rao},

url = {https://medicalresearchjournal.org/index.php/GJMR/article/view/100518/5702},

issn = {0975-587X},

year  = {2015},

date = {2015-07-14},

urldate = {2015-07-14},

journal = {Global Journal of Medical Research},

volume = {15},

issue = {2},

pages = {9-15},

abstract = {Introduction: Choledochal cyst not an uncommon encountered pediatric surgical practices. Advances in technology have impacted timing of diagnosis. Advances in instrumentation and surgical access have added yet another way of excion. But the exact impact of early diagnosis on surgery of choledochal cysts have not been analysed and reported. Hence this attempt to analyse the three periods of choledochal  cyst, namely 1. PTC   (Percutaneous Trans-hepatic Cholangiography) and ERCP (Endoscopic Retrograde Cholangio Pancreatography),   2. USG (Ultrasonography) and CT Scan (Computerised Tomography era, and 3 .Period of MRCP (Magnetic Resonnace Cholangio Pancreaticography) with regards to impact of early diagnosis in the management of Choledochal cysts. Materials and Methods: A total of 205 cases of choledochal cysts treated by the team were analyzed. The data retrieval was from a self developed Microsoft Access based software used by senior pediatric surgeon. The parameter studied was actual impact on surgical aspects of the three main components of surgery of choledochal cysts, namely 1. Approach to cyst excision per se, 2. Management of distal end, 3. Restoration biliary drainage. Results: The advances in imageology have lead to early diagnosis and early surgery before complications develop. This has impacted in disappearance of delayed presentation with complications as  seen by the number of cases diagnosed in neonatal period. Neonatal, perinatal, rarely antenatal detection of choledochal cysts was possible due to advances in imaging choledochal cysts. All children underwent excision of cyst and common hepaticodochojejunostomy. The safety of excision particularly when dealing inflamed, adherent choledochal cysts was better with open conventional excision. Similarly the confidence of handling the distal end was more with open surgery. Laparoscopy and Robot assisted have added another surgical access to choledochal cysts. Minimal access and magnification added to better visual appreciation, but ergonomics, cost, and availability, approach to distal end remain still to be validated. Conclusions: The present series clearly show the increase in the incidence of Choledochal cyst due to advances in imageology. Also has impacted early diagnosis is early surgical removal and there by delayed presentation, and with complications like stone, recurrent cholangitis, pancreatitis, biliary cirrhosis. This technological anatomical detailing has not reflected any significant change in the surgical management of Choledochal cyst. The advances in instrumentation and minimal access surgery and Robot assisted surgery still needs to validated as safe and can be used as standard surgical option for excision of choldochal cyst.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kehkashan_2015,

title = {Spontaneous rupture of right uterine artery in a pregnant women- a rare entity},

author = {Anjum Kehkashan and Shanti Sree and Khaja Ali Hassan},

url = {https://www.jemds.com/data_pdf/Anjun%20kekhashan.pdf},

doi = {10.14260/jemds/2015/1116},

issn = {2278-4748},

year  = {2015},

date = {2015-06-01},

urldate = {2015-06-01},

journal = {Journal of Evidence Based Medicine and Healthcare},

volume = {4},

issue = {44},

pages = {7684-7688},

abstract = {CASE: A 30 years old female G4P2L2A1 at 34 wks of pregnancy with complains of acute pain abdomen more on right side and constipation, fever on & off & vomiting. After through investigations exploratory laparotomy was done which reveled spontaneous rupture right sided uterine artery with 1000ml of haemoperitoneum. Hysterectomy was performed after delivering the baby due to uncontrolled bleeding & difficult homeostasis. Because of maternal vital signs become unstable & homeostasis was difficult hysterectomy was performed & blood transfusion administered. Although very rare, hemoperitoneum should be included in the differential diagnosis when a pregnant women experiences acute onset, severe abdominal pain, even without an episode of abdominal trauma. BACKGROUND: Spontaneous rupture of uterine artery during pregnancy is rare,

presenting symptom include acute onset abdominal pain & maternal hypovolemic collapse due to

hemoperitoneum. A typical case of subculture uterine artery rupture @ 34wks. of gestation occurred in a women. CONCLUSION: Spontaneous rupture of the uterine vessels during pregnancy is a rare complication & may lead to maternal & fetal morbidity & mortality. Diagnosis and treatment are based on the clinical symptoms of actuate abdominal pain & laboratory test of hypovolemic shock signs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Khan_2014b,

title = {Cardiovascular collapse following intramyometrial injection of prostaglandin},

author = {Basheer Ahmed Khan and Vijaya Rekha Koti and Murtuza Khan and Syed Asrar Hussain and Mohammed Mohib Hussain and M. Aleemuddin Naveed},

url = {http://www.jcmad.com/admin/pdf/239a17.pdf},

doi = {10.18049/jcmad/239a17},

issn = {2347-4513},

year  = {2014},

date = {2014-12-31},

urldate = {2014-12-31},

journal = {Journal of Contemporary Medicine and Dentistry},

volume = {2},

issue = {3},

pages = {80-82},

abstract = {A 21 year old female gravida 2, para 1, live 1 with previous lower segment cesaerian section (LSCS), hypothyroid on tablet Eltroxin 12.5mcg, was posted for LSCS. Spinal anaesthesia was given and the effect was patchy, hence general anaesthesia was supplemented. Intramyometrial prostaglandin was given by surgeon for persisting uterine atony following which patient developed hypertension, tachycardia, pulmonary edema and later on cardiac arrest.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Koti_2023d,

title = {A study on efficacy of unilateral spinal anesthesia with low dose hyperbaric bupivacaine},

author = {Vijaya Rekha Koti and Nooruddin Owaisi and Mohammed Asraruddin and Syed Asrar Hussain},

url = {https://www.lcebyhkzz.cn/article/view/2023/4960.pdf},

issn = {1001-1781},

journal = {Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery},

volume = {27},

issue = {1},

pages = {4960-4966},

abstract = {Background and Objectives: Unilateral spinal anaesthesia is a promising alternative to traditional, widely used techniques of central neuraxial blocks, as it restricts markedly the anaesthetized area thereby, decreases the risk of adverse events and complications. The present study was taken up to assess the hemodynamic effects of low dose 1.5 ml (7.5 mg) of 0.5% hyperbaric Bupivacaine and also to assess the level achieved and duration of block. Methods: The present one year clinical trial was conducted in the Department of Anesthesiology, during the period of one year at Deccan College of Medical Sciences, affiliated to Owaisi Hospital and Princess Esra Hospital, Hyperabadon 100 ASA II and III patients undergoing unilateral lower limb surgery under unilateral spinal anaesthesia with bupivacaine. 1.5 ml of (7.5 mg) 0.5% bupivacaine heavy was injected with patient in lateral position with the limb to be operated on the lower side. Results: In this study out of 100 patients studied 72 (72%) were males with male to female ratio of 2.57:1. Majority of the patients (45%) were aged between 46 to 60 years. Overall mean age was 47.79 years and mean weight was 57.90 Kgs. The SBP, DBP and MBP showed a gradual fall with maximum fall noted at 40 minutes and gradually increased, subsequently reaching the baseline levels at 90 minutes. The maximum increase in HR was seen at 40 minutes after giving spinal and it gradually reduced coming to baseline levels at 90 minutes. Maximum sensory level of L1 was achieved. The block remained unilateral in 74.8% of the cases. Motor blockade was adequate in the limb to be operated. Conclusion: Subarachnoid block with 1.5 mL (7.5 mg) of 0.5% hyperbaric bupivacaine used in this study does not produce any adverse hemodynamic changes and lasts for short duration that is 90 minutes and can be used in surgeries of shorter duration.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}