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Background & Objectives: Laryngeal, tracheal and bronchial receptors are stimulated by mechanical and chemical irritants during laryngoscopy, intubation and extubation. The reflex increases in sympathoadrenergic activity caused by these manipulations leads to an increase in catecholamine release, arterial blood pressure and heart rate. The aim of present study was to evaluate the efficacy of Fentanyl (2 mcg/kg), Esmolol (1mg/kg) and their combination in half the dose(fentanyl 1 mcg/kg +esmolol 0.5mg/kg) in attenuating the pressure response during laryngoscopy and tracheal intubation. Methods: This is a prospective double blind study comprising ninety patients between 21-60 yrs and ASA grade I and II scheduled for elective surgery under general anesthesia. Patients were randomly divided into group E (injection Esmolol 1mg/kg iv), group F (inj.Fentanyl 2mcg/kg iv) and group C (inj.Esmolol 0.5mg/kg and inj.Fentanyl 1mcg/kg). The study drug was given 2 minutes before induction of anaesthesia. All the vital parameters of patients were observed during intra operative and postoperative period .Values of heart rate and mean blood pressure were recorded at preinduction, after giving study drug, after induction, immediately after intubation and at 1 min, 3 min, 5 min, 7 min and 10 min. after intubation. Results: Inter group comparison of groups E, F & C showed greater attenuation of heart rate in group F as compared to group C and group E. Inter group comparison of groups E, F & C in attenuating increase in MAP showed greater attenuation of MAP in group F as compared to group E (p=0.880) and group C (p=0.0005). Conclusion: Among the fentanyl (2 mcg/kg), esmolol (1 mg/kg) and their combination drug in half doses, injection fentanyl is best in attenuating haemodynamic responses to laryngoscopy and tracheal intubation. [ABSTRACT FROM AUTHOR]

In the the present study patients were divided into three study groups of thirty patients each, group 1 included Infertility patients, group 2 comprised of patients undergoing laparoscopy for ovarian cyst, chronic pelvic pain, fibroid uterus, adnexal mass etc. and group 3 had patients undergoing laparoscopic sterilization without any symptoms. Prevalence of endometriosis was found to be 12.2%.Highest being in Group 1(23.3%), followed by Group 2 (13.3%) and no cases of endometriosis were detected in Group 3. Peritoneum was involved in maximum cases with commonest lesion being subtle red lesion (71.4%).On comparing ultrasound with laparoscopy in endometriosis diagnosis, sensitivity of ultrasound was only 9%. Thus it is recommended that diagnostic laparoscopy in gold standard for the diagnosis of endometriosis. [ABSTRACT FROM AUTHOR]

Spontaneous pregnancy in patients with Sheehan's syndrome is very rare, even after ovulation induction in such patients' pregnancy outcome is poor. We report a case of women with Sheehan's syndrome who became pregnant without ovulation induction with successful outcome of pregnancy. [ABSTRACT FROM AUTHOR]

Background Propofol is the most common induction agent used in current anesthesia practice. Patients receiving propofol injections commonly experience varying degrees of pain, creating an unpleasant anesthesia experience. Methods Seventy-two patients, aged between 18 and 70, scheduled for elective laparoscopic cholecystectomy under general anesthesia were randomized into two groups. Group D received 8 mg of dexamethasone, and Group O received 8 mg of ondansetron intravenously before induction. After five seconds, mid-arm venous occlusion was applied for one minute using a tourniquet. Propofol (0.5 mg/kg) was administered intravenously over five seconds, and patients rated the injection pain over the next 15 seconds. The primary outcome was pain intensity using the Verbal Rating Scale during propofol injection. Secondary outcomes included intraoperative hemodynamic changes and postoperative nausea and vomiting (PONV). Normally distributed variables were compared using the Student's t-test, non-normally distributed variables using the Mann-Whitney U-test, and qualitative data using the chi-square or Fisher's exact test. Statistical significance for the study was set at p < 0.05. Results In Group D, 30 out of 36 patients (83.3%) experienced no pain, while four patients (11.1%) reported mild pain, two patients (5.6%) reported moderate pain, and no patients (0.0%) reported severe pain. In contrast, in Group O, only 15 out of 36 patients (41.6%) experienced no pain, with 12 patients (33.3%) experiencing mild pain, seven patients (19.4%) experiencing moderate pain, and two patients (5.6%) experiencing severe pain. Overall, six out of 36 patients in Group D (16.7%) experienced some level of pain, compared to 21 out of 36 patients in Group O (58.3%), a statistically significant difference (p < 0.05). Regarding postoperative nausea, 16 out of 36 patients in Group Dexamethasone (44.44%) experienced nausea, whereas 23 out of 36 patients in Group Ondansetron (63.88%) reported this symptom, with the difference being statistically significant (p = 0.0372). Additionally, postoperative vomiting occurred in nine out of 36 patients in Group Dexamethasone (25%), compared to 18 out of 36 patients in Group Ondansetron (50%), with this difference also reaching statistical significance (p= 0.026). Conclusions Intravenous dexamethasone before propofol administration reduces injection pain and PONV in laparoscopic cholecystectomy more effectively as compared to ondansetron., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Rajendra Institute of Medical Sciences Institutional Ethics Committee issued approval 184/IEC. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Aditya et al.)