Evidence-based Medicine: Time for a change? - Journal of Medical ...

More documents

Recommendations

Info

ORIGINAL ARTICLE 15) Kaul R, Plummer FA, Kimani J, et al. HIV- 1-specif ic mucosal CD8+ lymphocyte responses in the cervix of HIV-1-resistant prostitutes in Nairobi. J Immunol.2000;164(3):1602–1611. 16) Kaul R, Rowland-Jones SL, Kimani J, et al. Late seroconversion in HIV-resistant Nairobi prostitutes despite pre-existing HIV-specific CD8+ responses.[comment]. J Clin Invest.2001;107(3):341–349. 17) Liu HW, Hong KX, Ma J, et al. Identification of HIV-1 specific T lymphocyte responses in highly exposed persistently seronegative Chinese. Chin Med J (Engl). 2006 Oct 5;119(19):1616-21. 18) Thomas SM, Tse DB, Ketner DS, et al. CCR5 expression and duration of high risk sexual activity among HIV-seronegative men who have sex with men. AIDS. 2006 Sep 11;20(14):1879-83. 19) Chaudhary O, Rajsekar K, Ahmed I,et al.Polymorphic variants in DC-SIGN, DC- SIGNR and SDF-1 in high risk seronegative and HIV-1 patients in Northern Asian Indians. J Clin Virol. 2008 Oct;43(2):196- 201. 20) Michael NL.Genetic Restriction of AIDS Pathogenesis by an SDF-1 Chemokine Gene Variant. JAMA 1998:279;389-393. 21) Songok EM, Osero B, McKinnon L, et al .CD26/dipeptidyl peptidase IV (CD26/ DPPIV) is highly expressed in peripheral blood of HIV-1 exposed uninfected female sex workers. Virol J. 2010 Nov 25;7:343. 24 JMS * JMS Vol 25 * Vol * No. 25 3 * No. * September, 1 * June, 2010 2011
ORIGINAL ARTICLE Preloading versus prophylactic intravenous ephedrine in the prevention of hypotension following subarachnoid block in patients undergoing caesarean section 1 N. Anita Devi 2 L. Chaoba Singh 3 Prof. L. Kameshwar Singh, 1 Th. Rupendra, 2 L. Eshori Abstract Objective: The primary objective of this study was to compare the efficacy of preloading with ringer lactate and prophylactic intravenous ephedrine in prevention of hypotension following subarachnoid block in patients undergoing caesarean section. Methods: One hundred parturient of ASA I &II undergoing caesarean section in RIMS hospital during the period of 2006- 2008 were enrolled for the study. They were randomly divided into two groups of fifty each. Group I (preloading) – patients were preloaded with ringer lactate at the dose of 20ml/kg, 30 mins before the spinal anaesthesia Group II (ephedrine) – patients were given inj ephedrine 10 mg intravenously just before the induction of spinal anaesthesia . Heart rate, systolic blood pressure , peripheral oxygen saturation were recorded at baseline and thereafter every 2min interval for the first 10min and than at every 5min till the end of the study. Results: Preloading with ringer lactate did not absolutely prevent hypotension and the incidence of hypotension was 44% in the preloading group and 32% in the ephedrine group. This finding was not significant statistically between the groups. Conclusion: Preloading with crystalloid administration was a safe procedure, its 1. Assistant Professor 2. Registar. 3. Prof. and Head. Dept. of Anaesthesia RIMS Address for correspondence Prof. L. Kameshwar Singh, Prof. & Head, Dept. of Anaesthesiology RIMS Imphal. effectiveness in preventing hypotension in parturient undergoing caesarean section under spinal anaesthesia was questionable. And at the same time prophylactic ephedrine had limited efficiency for the prevention of hypotension. Key words: Hypotension, preloading, ephedrine, spinal anaesthesia Introduction: Spinal anesthesia is commonly used for caeserian section as it has got rapid onset, profound sensory and motor blockade and avoidance of side effects of general anaesthesia. But hypotesion complicates spinal anaesthesia in about 80% of the parturient and if left untreated it produces foetal acidosis and a poor neonatal outcome. Hypotension is universally treated with preloading with either crystalloid like ringer lactated at a dose of 10-30ml/kg body weight before induction of spinal anaesthesia or with colloids like gelatine and starch. However rapid infusion of fluid causes pulmonary oedema in patients with heart diseases, hypothermia or dilutional coagulopathy 1, 2 . There is increase used of vasopressors 3,4 like ephedrine, phenylephrine with no preloading or minimal loading. Of the available vasopressors, ephedrine is most commonly used. IM ephedrine has been described, but its efficacy has been inconsistent 5,6 , and its use may be associated with unacceptable hypertension, particularly if spinal anesthesia is unsuccessful 7 . As an alternative, IV ephedrine given immediately after the induction of spinal anesthesia has been described 8,9 .The present study was conducted to compare the JMS * Vol 25 * No. 13 * June, September, 2010 2011 25
Page 1 and 2: EDITORIAL Evidence-based Medicine:
Page 3 and 4: EDITORIAL are depraved of the much-
Page 5 and 6: ORIGINAL ARTICLE described by Schue
Page 7 and 8: ORIGINAL ARTICLE in two cases of op
Page 9 and 10: ORIGINAL ARTICLE Introduction : As
Page 11 and 12: ORIGINAL ARTICLE associated with HI
Page 13 and 14: ORIGINAL ARTICLE renal disease, inc
Page 15 and 16: ORIGINAL ARTICLE Clinical profile o
Page 17 and 18: ORIGINAL ARTICLE factors HIV (2 cas
Page 19 and 20: ORIGINAL ARTICLE 4. WHO media centr
Page 21 and 22: ORIGINAL ARTICLE discordant couples
Page 23: ORIGINAL ARTICLE the HIV vaccine. C
Page 27 and 28: ORIGINAL ARTICLE Figure 2: The mean
Page 29 and 30: ORIGINAL ARTICLE The effect of intr
Page 31 and 32: ORIGINAL ARTICLE Table 3. Compariso
Page 33 and 34: ORIGINAL ARTICLE adjuvant to plain
Page 35 and 36: ORIGINAL ARTICLE consent, 105 adult
Page 37 and 38: ORIGINAL ARTICLE 8. Liaw WJ, Pang W
Page 39 and 40: ORIGINAL ARTICLE for thyroid lesion
Page 41 and 42: ORIGINAL ARTICLE References : 1. Ht
Page 43 and 44: ORIGINAL ARTICLE Bone and joint inf
Page 45 and 46: ORIGINAL ARTICLE Among the gram-neg
Page 47 and 48: ORIGINAL ARTICLE permanent, however
Page 49 and 50: ORIGINAL ARTICLE 3. National Instit
Page 51 and 52: ORIGINAL ARTICLE High causes may be
Page 53 and 54: ORIGINAL ARTICLE leads to positive
Page 55 and 56: ORIGINAL ARTICLE there is hardly an
Page 57 and 58: ORIGINAL ARTICLE Table 2: Effect of
Page 59 and 60: ORIGINAL ARTICLE glucose induced hy
Page 61 and 62: ORIGINAL ARTICLE Trends in blood co
Page 63 and 64: ORIGINAL ARTICLE References: 1. The
Page 65 and 66: ORIGINAL ARTICLE availability of su
Page 67 and 68: ORIGINAL ARTICLE Table 2 Cox’s re
Page 69 and 70: ORIGINAL ARTICLE Clinical profile o
Page 71 and 72: Table 5: CT finding showing relatio
Page 73 and 74: CASES SERIES A profile of renal tub
Page 75 and 76:
CASES SERIES 5 . Hypercalciuria wit
Page 77 and 78:
CASES SERIES 14) Rao N, John M, Tho
Page 79 and 80:
CASES SERIES acts directly as an on
Page 81 and 82:
REFLECTED ARTICLES OF PREVIOUS ISSU
Page 83 and 84:
CASE REPORT logical test was perfor
Page 85 and 86:
CASE REPORT Fibrocalculus pancreati
Page 87 and 88:
CASE REPORT 4. Absence of other cau
Page 89 and 90:
CASE REPORT CECT-abdomen/ MRangiogr
Page 91 and 92:
CASE REPORT Hypokalemic periodic pa
Page 93 and 94:
CASE REPORT Giant condyloma acumina
show all

Evidence-based Medicine: Time for a change? - Journal of Medical ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?