Journal of Surgical Specialties and Rural Practice最新文献

{"title":"Comparison of Dexmedetomidine and Propofol for Sedation in Patients Undergoing Upper Limb Orthopedic Surgery under Regional Anesthesia with Brachial Plexus Block","authors":"Neha Padhi, Samir Hota, Mahendra Ekka, Siddhanta Choudhury, Smrutirani Mund, Jajati Keshari Panigrahi, Jyoti Prakash Samal","doi":"10.4103/jssrp.jssrp_35_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_35_23","url":null,"abstract":"\u0000 \u0000 \u0000 The search for the ideal sedative during regional anesthesia continues. Propofol is widely as a sedative intraoperatively. It may cause troublesome hemodynamic changes. Dexmedetomidine is an α2 agonist with sedative, anxiolytic, and analgesic properties. In this study, we compared dexmedetomidine with propofol as sedatives during surgeries under brachial plexus block.\u0000 \u0000 \u0000 \u0000 In our study, 70 American Society of Anesthesiologists I Class and II patients about to undergo upper limb surgeries under brachial plexus block were blinded and randomly allocated to receive either propofol (Group P) or dexmedetomidine (Group D) infusion. Brachial plexus block was performed, and after confirmation of adequate sensory and motor block, an initial loading dose of the drug was administered over 10 min, followed by a maintenance dose till the end of the surgery. Titration of the rate of infusion was done so as to maintain Ramsay Sedation Score (RSS) of 3–4 and Bispectral Index (BIS) of 60–80. Hemodynamic and respiratory parameters were monitored intraoperatively. Adverse effects such as hypotension, bradycardia, respiratory depression, and incidence of oversedation and undersedation were also noted. The collected data were evaluated using appropriate statistical tests in SPSS version 22®. P <0.05 was considered statistically significant.\u0000 \u0000 \u0000 \u0000 The RSS remained at 4 in Group P from 20 min onward and for Group D, RSS remained at 3 after 30 min. Post-induction, there was a reduction in BIS in both the groups, but patients in Group P showed statistically significant lower values of BIS when compared with Group D. The fall in mean arterial pressure was more in Group P as compared to Group D. Nine (25.71%) incidences of hypotension were seen in Group P and none in Group D. The decrease in heart rate was more profound in Group D as compared with Group P and one incidence of bradycardia observed in Group D. The respiratory rate was relatively stable in Group D as compared to Group P. The oxygen saturation (SpO2) values in the majority of the patients in both groups were above 92%, but three patients in Group P had SpO2 <92%. In Group P, 6 (17.14%) incidences of oversedation and 8 (22.85%) incidences of undersedation were observed. In Group D, 7 (20%) incidences of undersedation with no incidence of oversedation were observed.\u0000 \u0000 \u0000 \u0000 Dexmedetomidine at recommended doses has a better sedative property with less effect on hemodynamics and respiration as compared to propofol.\u0000","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"4 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Citation Cartels: A Hidden Menace in the Scientific Publication","authors":"G. Dharmshaktu","doi":"10.4103/jssrp.jssrp_3_24","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_3_24","url":null,"abstract":"","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140707445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural Health – Why and How","authors":"Sunil K Raina, Raman Kumar","doi":"10.4103/jssrp.jssrp_36_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_36_23","url":null,"abstract":"\u0000 With access a major issue on the supply side of the supply– demand chain of health care, reaching out to the rural population is not only needed but also imperative as part of delivering comprehensive primary health care.","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"20 S30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charnley’s Traction Unit in the Distal Leg: An Alternative Option for Closed Correction of the Lower Limb Deformities in Rural Settings","authors":"G. Dharmshaktu","doi":"10.4103/jssrp.jssrp_38_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_38_23","url":null,"abstract":"","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"92 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Fine-needle Aspiration Cytology in Guiding Clinicians for Lymphadenopathy","authors":"Saurabh Kumar, Sampa Choudhury, Vineeta Chadha, Suparna Dubey, Mhasisielie Zumu","doi":"10.4103/jssrp.jssrp_39_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_39_23","url":null,"abstract":"\u0000 \u0000 \u0000 Lymphadenopathy is a very common, routinely observed clinical finding which may be caused by a variety of pathological conditions, either a primary lymph node pathology or an underlying systemic disease. Fine-needle aspiration is a simple cost-effective diagnostic tool to screen these lesions, to enhance our knowledge, to understand lymph node pathology, as well as to assist clinicians for an effective management.\u0000 \u0000 \u0000 \u0000 The aim of our study was to evaluate the patterns of pathological lesions on lymph node cytology and also to assess any particular trend of diseases in comparison with demographic variables, lymph node size, and consistency in this geographic area.\u0000 \u0000 \u0000 \u0000 In this retrospective study, we studied the reports of 131 lymph node cytology samples collected over a duration of 1 year. All parameters were entered in the Excel sheet and were analyzed for descriptive statistics.\u0000 \u0000 \u0000 \u0000 The mean age of the patients was 32 years. Reactive lymphadenitis was the most common (42%) pathology, followed by tubercular lymphadenitis, metastatic lymph nodes, and lymphomas. Infectious or inflammatory lesions were noted in younger age groups, whereas malignancies were prominent in elderly patients.\u0000 \u0000 \u0000 \u0000 This study threw light on diseases, whether infectious, inflammatory, or lymphoproliferative in etiology, which presented with lymphadenopathy in this coastal area and also unveiled the patterns of metastatic lymph nodes, their primary site, and predilection for a particular nodal site.\u0000","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"10 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of rural health care in India and digitalization of health care","authors":"Raman K Kumar, Alka S. Grover","doi":"10.4103/jssrp.jssrp_30_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_30_23","url":null,"abstract":"India is currently the most populous country in the world, with pressing unmet needs of the population living in rural and remote areas. Digitization of health care has opened a new window to solve public health challenges of the communities as it has the potential to remove the physical barrier between urban and rural areas. Several mHealth applications have been introduced in the recent 2–3 years in India. mHealth apps are being used to deliver health-care information, reminders, and support to rural communities. For health-care managers, digitalization makes their work of supply chain management easier in rural areas, ensuring that essential health-care resources are available to the communities in a more efficient manner.","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124598889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of POP boot traction in lower limb deformities","authors":"Sudhir Mishra, Dileep Kumar, Ganesh Yadav, A. Gupta, M. Srivastava","doi":"10.4103/jssrp.jssrp_33_22","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_33_22","url":null,"abstract":"Background: In India, postpolio residual paralysis (PPRP) patients, present with multiple deformities, which requires surgical intervention, and in rural setting, it poses a big challenge for doctors. Traction is one of the oldest treatments in fracture reduction and deformity correction. The objective of this study was to evaluate the clinical outcome of plaster of Paris (POP) boot traction for the correction of lower limb deformities in PPRP patients. Materials and Methods: This retrospective case series represents 14 cases of PPRP with hip and/or knee deformity treated with POP boot traction for deformity correction, followed by caliper application. Deformities were classified as mild, moderate, and severe and assessed weekly during treatment. Results: There were 8 females and 6 males. The mean age of participants was 22.21 ± 8.107 years, and the mean duration of traction was 5.21 ± 1.76 weeks. There were seven patients with unilateral knee deformity, two patients with bilateral knee deformity, two patients with unilateral hip and knee deformity, and three patients with bilateral hip and knee deformity. The mean baseline deformity angle was 37.41, and the mean postprocedure deformity angle was 15.89. Conclusions: POP boot traction is a low-cost intervention in PPRP patients and can give promising results in the correction of lower limb deformities.","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115971229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the effectiveness of percutaneous needle tendo Achilles tenotomy in congenital talipes equinovarus children","authors":"P. Madhuchandra, G. Sunilsanthosh, KP Raju","doi":"10.4103/jssrp.jssrp_15_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_15_23","url":null,"abstract":"Introduction: Congenital talipes equinovarus (CTEV) is one of the most common deformities that affects the human foot and ankle, and Ponseti method of correction is universally accepted procedure. Most of the patients need a percutaneous tenotomy of tendo Achilles for residual equinus deformity. Various methods of tenotomy such as cataract knife, No. 11 blade, and 21-G needle are available. We studied the effectiveness of percutaneous needle tenotomy of the Achilles tendon in CTEV children for residual equinus deformity. Materials and Methods: Forty-three patients of serially manipulated and casted CTEV patients were subjected to a percutaneous needle tenotomy at our institute, followed by cast and orthosis. Tenotomy and regeneration were confirmed ultrasonologically and complete tenotomy was demonstrated by animal cadaver study. Results: All the patients were followed up regularly and an average of 25° of passive dorsiflexion was achieved at an average of 2-year follow-up. No cases of skin scarring, neurovascular compromise, stiffness, or cast complications were noted in our series. Conclusion: We conclude that percutaneous needle tenotomy for residual equinus deformity in a serially casted CTEV patient is a simple, effective, and safe method in giving a functionally and cosmetically good plantigrade foot.","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117231285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of screen time and its determinants in under-five children in a rural Indian population","authors":"AJenit Osborn, S. Gayathri, T. Satheesh, Karthikeyan Shanmugam","doi":"10.4103/jssrp.jssrp_24_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_24_23","url":null,"abstract":"Background: Excess screen viewing can deteriorate the well-being of under-five children. Identifying the modifiable screen determinants can pave the way to develop strategies for optimization. Objectives: The objective of the study was to study the profile of screen time among children between 12 and 59 months of age and to determine the risk factors associated with increased screen time. Materials and Methods: A community-based cross-sectional study was done in rural villages of Tamil Nadu among 418 children aged 12–59 months by universal sampling method during August 2021 to January 2022. Parents of the children were interviewed using a predesigned semi-structured questionnaire. Results: The prevalence of screen viewing among the study population was 96.9% and their average screen time was 106.85 ± 77.95 min/day. The prevalence of excess screen time (nonadherence to the WHO recommendations) was estimated to be 70%. The most common reason for offering screen time to children was feeding/mealtime (45.7%). The risk determinants identified for higher screen time were access to multiple gadgets (P < 0.001), first screen exposure before 1 year of age (P < 0.001), having erratic screen-viewing hours (P = 0.002), snacking during screen time (P < 0.001), screen time before bed (P < 0.001), and those who were overweight (P = 0.027). Maternal screen time and children's screen time had a positive association (r = 0.367, P < 0.001), whereas children's screen time and sleep duration were negatively associated (r = −0.139, P = 0.004). Conclusions: This study reiterates the high prevalence of excess screen time among the study population. Multiple risk determinants identified can be utilized to plan interventions and awareness programs to regulate screen time in under-five children.","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"209 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115562818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise and sleep affect blood pressure and blood sugar of hypertensive patients","authors":"Kusum K. Rohilla, Sonia Gulia, C. Kalyani","doi":"10.4103/jssrp.jssrp_4_23","DOIUrl":"https://doi.org/10.4103/jssrp.jssrp_4_23","url":null,"abstract":"Aim: Hypertension is a major worldwide health issue because of its great prevalence. This study's aim was to check the effects of exercise and sleep on blood pressure (BP) and blood sugar among hypertensive patients. Materials and Methods: The study was a descriptive study that was conducted on 545 hypertensive patients at the All India Institute of Medical Sciences, Rishikesh, using validated self-structured questionnaire tools. Results: Hypertensive patients bio-demographic characteristics, sleep, exercise, and physical activity were examined and presented as frequency and percentage. Majority of hypertensive patients were male (55%), illiterate (25%), and their sleeping were OK during the night (38%). Their mean systolic BP (SBP) was 156.17 ± 15.83 mmHg, the diastolic BP was 91.81 ± 12.93 mmHg, and random blood sugar was 127.27 ± 6.06 g/dl, respectively. Among hypertensive patients doing regular exercise (0.009*) and a good sleep pattern (0.000*) help in the reduction of SBP at 0.05 level of significance. Conclusion: The prevalence of hypertension is significant and regular exercise and good sleep habits can help hypertensive patients to lower their SBP.","PeriodicalId":355285,"journal":{"name":"Journal of Surgical Specialties and Rural Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130479230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}