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Objective: To compare the antiemetic effects of Metoclopramide and Ondansetron in female patients undergoing laparoscopic cholecystectomy. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anesthesia, Combined Military Hospital Rawalpindi, Pakistan, Feb to Jul 2022. Methodology: Female patients aged between 15-80 years, American Society of Anesthesiologists Grade I or II planned for laparoscopic cholecystectomy were included in the study. Using non-probability consecutive sampling technique 66 patients were assigned to two Groups with 33 participants in each Group i.e., Group-A (Metoclopramide) and Group-B (Ondansetron) Group. Patients from Group-A received 10mg Metoclopramide while patients from Group-B received Ondansetron 4mg as a part of premedication. Recorded variables were nausea, vomiting and requirement of antiemetic medication at recovery, during the first 06 hours and during 06-24 hours post-operatively. Results: Mean age of the patients was 44.61±12.74 years. ASA distribution of the patients in our study revealed 28(84.8%) patients from Group-A and 26(78.8%) patients from Group-B belonged to ASA I while 05(15.2%) and 07(21.2%) were from ASA II in Group-A and Group-B respectively. Both Metoclopramide and Ondansetron were effective, however results were significant only for nausea and the requirement of antiemetic medication in post-anesthesia care unit. Conclusion: Metoclopramide and Ondansetron both are effective in reducing nausea and vomiting after laparoscopic cholecystectomy in female patients. Ondansetron is superior to Metoclopramide in the reduction of nausea postoperatively however in case of vomiting there is no significant relationship between the two drugs. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of intravenous phenylephrine infusion versus boluses for blood pressure management in elective caesarean sections. Study Design: Quasi-experimental study. Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Jul 2022. Methodology: Three hundred ninety patients requiring elective caesarean section were divided into an Infusion Group (n=195) and a Bolus Group (n=195). The Infusion Group received phenylephrine with 100 mcg/ml titration immediately after spinal anaesthesia as per weight and height at a 1 ml/minute rate and continued for 5 minutes. Infusion stopped if MAP at 5 minutes was above baseline and restarted if dropped below baseline in subsequent readings. In the case of bradycardia, 600mcg of Glycopyrrolate was administered. Parameters recorded at 1, 5, 10 and 15-minute intervals. In the bolus group, total numbers of 100mcg boluses at the end of fifteen minutes were recorded. Protocol for bradycardia and data record intervals was the same. The primary variables were mean arterial pressure (MAP), heart rate(HR), the total dose of phenylephrine used, and nausea and vomiting. Results: Primary outcome variables showed consistent improvement in maintaining MAP in the Infusion Group versus the Bolus Group (p<0.05). A similar trend was seen with heart rate between both groups (p<0.05). However, the infusion group had an average fall in heart rate compared to the bolus group at all-time intervals. Conclusion: Phenylephrine infusion offers better hemodynamic stability, requiring less ephedrine support than when given in boluses. [ABSTRACT FROM AUTHOR]

Segmentation of the human eye retinal image is an essential step for proper examination and diagnosis by the ophthalmologists or eye care specialists. A technique for vessel segmentation of retinal images is proposed. Retinal images are mostly low‐light images, which are first processed for enhancement of light as well as for detail amplification. Illumination of low‐light images is enhanced, and details are amplified using content‐adaptive filters. For extraction of vessels from retinal images, after low‐light and detail enhancement, the B‐cosfire filter is modified by including extraction of details and small elements, which may otherwise be ignored. A modified B‐cosfire filter is used to extract vessels while minimizing false edges and halo artifacts. The morphological opening is performed to crop vessels that are falsely segmented. The technique is contrasted with other existing methods in terms of accuracy using publicly available datasets. The proposed technique is tested on STARE, CHASE‐DB1, and DRIVE databases. The outcome of the proposed procedure has better accuracy, preserved edges, minimum noise, and artifacts than the state‐of‐the‐art techniques. [ABSTRACT FROM AUTHOR]