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Background and Aims: Ultrasound is a safe and non-invasive method for detecting numerous pathologies. Pediatric patients are often uncooperative which leads to decreased quality and increased time of scan. We compared the conventional means alone and combination of oral midazolam for the above cited purpose. Material and Methods: This double blind prospective study (CTRI/2016/06/007030) was conducted after obtaining due approval from institutional ethical committee. One hundred Children aged 2-6 years belonging to ASA class 1 or 2, posted for high resolution ultrasonography of abdomen were included in the study. They were randomised to receive midazolam 0.3 mg/kg mixed in 20 mL of apple juice (Group I) or 20 mL of apple juice alone (Group II) 20 minutes prior to the procedure. The parameters assessed were level of cooperation, sonologist's satisfaction, total scan time, heart rate and SpO2. Results: Out of 100 patients, 44 patients of group I and 42 of group II were analysed. The cooperation score was significantly higher in Group I (35%) than Group II (19%). Likert scale revealed very satisfied and satisfied rating in 61.3% (Group I) and 21.4% (Group II). The time taken by sonologist and number of attempts were significantly less in Group I than Group II. There was no difference in discharge time between the groups. There was no reportable adverse event in either group. Conclusion: Oral midazolam is a safe and effective agent to aid routine abdominal ultrasonography in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic cholecystectomy is the most commonly performed laparoscopic procedure. The goal of anesthetic management is to minimize stress response and early discharge. Dexmedetomidine, and pregabalin have been used successfully to attenuate laryngoscopy and intubation response in various surgical procedures. Aim: To compare efficacy of pregablin and dexmedetomidine in attenuating hemodynamic and stress response. Setting and Design: A prospective, double blind randomized trial comprising 130 ASA physical status class I and II patients posted for laparsoscopic cholecystectomy. Materials and Methods: Patients were randomized in to Group A and Group B. Group A received intravenous dexmedetomidine in a dose of 1ug.kg-1, through an infusion pump 20 min prior to induction of anaesthesia. Group B subjects received oral pregabalin 150 mg. Parameters observed were vitals, discharge time, cortisol level, side effects if any. Results: Post intervention heart rate got reduced significantly in Group A and it remained low in comparison to baseline during whole peri-operative period. In Group B, immediate post-pneumoperitoneum heart rate, and post exubation heart rate was higher than baseline. Blood pressure (BP) decreased significantly post intervention in Group A which persisted till pneumoperitoneum. In Group B there was statistically significant rise in systolic, diastolic and mean blood pressure postpneumoperitoneum as compared to baseline blood pressure. Post-operative cortisol level was significantly higher than baseline values and the level is more in Group B. Conclusion: Intravenous dexmedetomidine is more effective than oral pregabalin in attenuating perioperative stress response. [ABSTRACT FROM AUTHOR]

Severe hypertriglyceridemia (HTG) is associated with an increased risk of cardiovascular disease and acute pancreatitis. We report the case of a 34-year-old female admitted with complaints of recurrent pancreatitis and triglyceride (TG) levels above 995 mg/dl. The patient was started on therapeutic plasma exchange (TPE) to achieve a rapid fall (78%) in serum TG levels. We conclude that TPE is a safe and quick therapeutic treatment modality for patients with HTG-induced recurrent acute pancreatitis who fail to respond to conventional therapy. [ABSTRACT FROM AUTHOR]

Ultrasonic power generated by an ultrasonic transducer must be measured and declared for the ultimate safety of patients. According to IEC-61161 radiation force balance is internationally recommended primary method for measurement of total, time averaged ultrasonic power radiated by transducer. In a manual RFB system, the output of microbalance is recorded manually at no radiation force and after transducer excitation. Manual technique suffers from various errors, such as overshoot due to momentum of target, disturbance due to small tilt in target and buoyancy change of target. The developed automated system provides scope to visualize these effects and enables us to considerably reduce effects of above sources and hence improves uncertainty. In this article developmental details and the functionality of an improved automated system is described. [ABSTRACT FROM AUTHOR]