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Evaluation of Pediatric Appendicitis Score in Predicting Appendicitis

Iraqi Postgraduate Medical Journal, 2018, Volume 17, Issue 3, Pages 255-260

ABSTRACT:
BACKGROUND:
The diagnosis of acute appendicitis carries significant difficulties, particularly in very young ages on which the history and physical examination are difficult. The clinical challenge is to diagnose appendicitis early enough to prevent perforation, while minimizing the number of negative appendicitis that are performed. The diagnosis of acute appendicitis is primarily clinical and the clinical scoring systems have been investigated as alternatives or adjuncts to diagnostic imaging.
OBJECTIVE:
Is to establish the accuracy and applicability of using pediatric appendicitis scoring system (PAS) in evaluating acute appendicitis in pediatric age group.
METHODS:
A prospective cohort study was conducted in Al-Khansaa Teaching Hospital and Children Welfare Teaching Hospital, from January 2014 till November 2015. The study includes 143 patients aged from (3-13) years old referred from pediatric emergency unit or outpatient clinic with suspicion of acute appendicitis. All the obtained data were analyzed using pediatric appendicitis score (PAS) system which classifies the patients into 3 groups: Group (1): Patients with scoring (1-3) includes 38 patients, Group (2): Patients with scoring (4-6) includes 20 patients, while Group (3): Patients with scoring (7-10) includes 85 patients. Surgery was done to all patients of group 3 and thirteen patients of group 2. All removed appendices were sent for histopathological study.
RESULTS:
The median age of the 98 operated on patients was (8.9 years ± 2.6). The histopathological results of appendicitis were confirmed in 89 patients underwent surgery (five patients of group 2 and 84 patients of group 3), while negative histopathological result of appendicitis is seen in nine (9.2%) patients. There is significant association of positive histopathological findings with high PAS (≥7) scoring (p<0.0001). The 8 parameters of PAS system shows accuracy as following: the right lower quadrant tenderness, anorexia and hop tenderness shows accuracy of 90.8%, 87.8% and 86.7% respectively, while leukocytosis, fever and nausea/vomiting shows accuracy of 83.7%, 80.6% and 63.3% respectively. Migration of pain and PMN neutrophilia shows the lowest accuracy rate. The sensitivity of PAS system was 94.4%, the specificity was 88.9%, the PPV was 98.8%, the NPV was 61.5% with overall accuracy of PAS system was 93.9%.
CONCLUSION:
PAS system is easy, simple and useful tool in pre-operative diagnosis of acute appendicitis and can be used by pediatricians to reduce the number of admission to the hospital. Patients with scores of ≥ 7 show high probability of appendicitis and early operation is indicated, while patients with score of ≤3 rule out this disease. The CT scan and diagnostic laparoscopy is advocated for patients with score of (4-6).

The Yield of Genexpert in Pulmonary Tuberculosis & Rifampicin Resistance.

Mohammed Waheeb AL.Obaidy

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 2, Pages 184-190

ABSTRACT:
BACKGROUND :
Earlier and improved tuberculosis (TB) case detection, including smear-negative disease & expanded capacity to diagnose multidrug-resistant tuberculosis (MDR-TB) are global priorities for TB control. The development of the Genexpert of mycobacterium tuberculosis and rifampicin resistance (MTB/RIF) assay for the Genexpert platform was completed in 2009 and is considered an important breakthrough in the fight against tuberculosis (TB). For the first time, a molecular test is simple and robust enough to be introduced outside conventional laboratory settings.
Genexpert MTB/RIF detects M. tuberculosis as well as rifampicin resistance-conferring mutations using three specific primers and five unique molecular probes to ensure a high degree of specificity. The assay provides results directly from sputum in less than 2 hours. It is commercial real-time polymerase chain reaction (PCR) assay (Xpert™ MTB/RIF).
OBJECTIVE:
To assess the accuracy of the Cepheid Xpert™ MTB/RIF in the detection of M. tuberculosis from respiratory samples in the setting of data collected from TB center in Medical city complex.
MATERIALS& METHODS:
This is primarily laboratory -based study, used stored data from a previously reported retrospective evaluation of 56 patients suspected of having TB from clinical point of view.
9 patients subjected to the examination of sputum & broncoalevoaler lavage (BAL) at the same time rendering the total specimen number about 65 specimens. The results of Genexpert & RIF sensitivity for each patient were discussed &compared with that of direct AFB smear & culture of sputum and broncoalevoaler lavage (BAL).
RESULTS:
The result s of Gene xpert was compared with direct smear microscopically examination which considered as a primary diagnostic test although the highly sensitivity of Genexpert in diagnosing viable tubercle bacilli ,additionally it diagnose the the non-viable one with the same efficiency, such a feature considered an Achilles tendon of this test.The study revealed high sensitivity& extraordinary specificity in diagnosing TB making this technology the most rapid,simple&accurate diagnostic test of TB .
CONCLUSION:
The results demonstrate that rifampin-resistant M. tuberculosis can be detected in DNA isolated from sputum samples in a single-tube assay that takes less than 3 h to perform; the assay is extremely specific and extraordinarily sensitive.
More over the assay is simple to perform and readily automatable for high-throughput screening.

Echocardiographic Assessment of Left Ventricular Remodeling Process Among Acute Myocardial Infarction Patients

Abbas Khalifa Ressan; Asaad Abdullah Abbas; Mayyadah Dheyauldeen Mohsin

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 4, Pages 465-473

ABSTRACT:
BACKGROUND:
Echocardiography is use for assessment of left ventricular remodeling after myocardial infarction, which is the focus of this thesis. We investigated the influence of various traditional echocardiographic parameters to assess the process of left ventricular remodeling such as left ventricular volumes and ejection fraction, wall motion score index, mitral regurgitation and diastolic dysfunction
OBJECTIVE:
To invistigate the usefulness of two-dimensional echocardiography for accurate evaluation of left ventricular (LV) remodeling after acute ST elevation myocardial infarctions (STEMI).
METHODS AND RESULTS:
Two-dimensional echocardiography was performed within 5 days on a 100 patients admitted to the hospital with a first ST-elevation AMI. Several clinical and echocardiographic variables were analyzed. Baseline demographic data, blood pressure, and pulse were obtained. Various traditional echocardiographic parameters have been shown to provide diagnostic information, such as left ventricular volumes and ejection fraction, wall motion score index, mitral regurgitation and left atrial pressure. A left ventricular wall motion score index was derived from analysis of regional wall motion; an index of 1.5 or more within 5 days of admission identified patients at high risk for remodeling and LV dysfunction. Predictors of early LV remodeling were older age, male gender, history of diabetes mellitus or hypertension, high leukocyte count, high admission blood glucose level, high wall motion score and anterior location myocardial infarction.
CONCLUSION:
After acute ST-elevation myocardial infarction, early determination of the wall motion score index by two-dimensional echocardiography is useful for identifying patients at high risk for complications and to differentiate patients with and without development of LV remodeling accurately and early on the basis of wall motion score index as a measure of infarct size, a highly predictive variable.
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A Statistical Radiological Analysis in Patients with Sputum Smear Positive Pulmonary Tuberculosis

Muhammed .W.AL.Obaidy; Jubouri; Adnan M. AL; Basil Fawzi Jameel; Waleed Latif Hussein

Iraqi Postgraduate Medical Journal, 2016, Volume 15, Issue 2, Pages 140-157

ABSTRACT:
BACK GROUND:
Tuberculosis (TB) a multi-systemic disease with various presentations and manifestations; is due to infection with the acid fast bacillus mycobacterium. Disease occurs in only (10%) of infected individuals, it is associated with overcrowding and immune-compromised states
OBJECTIVE:
To identity the main findings in plain chest X-ray and CT-scan of the chest of pulmonary tuberculosis patients with sputum smear positive in relation to certain factors and clinical conditions including : gender, age , smoking , alcohol- consumption , co-morbid diseases e.g. diabetes mellitus and steroid medication for more than 4 weeks .
PATIENT AND METHOD:
Across sectional study of randomly collected (100) patients all were new cases of pulmonary tuberculosis disease with sputum smear positive, A plain chest radiography was done to all of them , and a randomly chosen (30) patients (out of the same sample of the study) were examined also by ( high resolution CT-scan ) of the chest to compare the radiological findings.The sample of patients collected consisted of (68)males and (32) females , aged between (12 -82) years.The study was done in the specialized chest and respiratory diseases center in Baghdad during the period from first of March 2012 ,to the end of August 2012.
RESULTS:
100patients with sputum smear positive – pulmonary tuberculosis disease were collected, 68 patients (68%) were males and 32 patients (32%) females. From our study97 patients(97%)of total number presented with positive radiological findings whether by plain chest X-ray and /or CT-scan of chest, And 3 patients(3%) of the sample studied were with normal both plain chest X-ray and CT-scan of chest
.The radiological findings of all of the patients studied were as :Infiltrative lesion48 patients( 48% )Cavitary lesion(: 37%)Consolidation ( 32%)Pleural effusion (17%)Miliary shadowing( 1%)Clear radiological was found that 28 patients (28%) had radiological abnormalities in the right side of the chest and 25 patients were with left sided radiographic abnormality, while bilateral chest radiological finding had been shown in44 patients (44%).
CONCLUSION:
The CT- scan of chest is more sensitive than plain chest X-ray for evaluation of abnormal or obscured radiological findings. There is no specific pattern for radiological finding in the chestthe direct sputum examination is remained the 'gold standard' for the diagnosis of pulmonary tuberculosis.

Maternal Serum Corticotrophin Releasing Hormone Level In Preterm Labour

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 4, Pages 543-547

ABSTRACT:
BACK GROUND:
Preterm birth still remains a significant management problem and a large number of markers were investigated.
OBJECTIVE:
To assess the increasing of Corticotrophin Releasing Hormone(CRH) level in women diagnosed with preterm labour and are of medical value.
Design: - Case control study .Al-Kadhymia Teaching Hospital.
METHODS:
Plasma samples of 80 women diagnosed with preterm labour were used in this study. Samples were divided into three groups ,according to week of gestation (24th-28th, 29th- 32nd, 33rd-37th). CRH values determined by ELISA . Twenty low risk women of control group were recruited near the end of 2nd trimester, all of them delivered healthy infants at gestational age greater than 37 weeks.
RESULTS:
In a study population of one hundred pregnant women, eighty of them were diagnosed as preterm labour and twenty women as a control group, sixty-four out of eighty high risk women delivered preterm birth while the remaining sixteen of the same group delivered term babies. Our study shows that CRH level is elevated in the women with preterm birth, and ranged between (18.30-95.03)pg/ml., serum values of CRH were significantly lower in women with term birth ,and ranging between (13.5-14.9) pg/ml, , the (p<0.001).The sensitivity of CRH was 80% while specificity was 100%
CONCLUSION:
Maternal serum CRH level was elevated in women who gave preterm birth compared with those giving term delivery.

Study of Occurrence of Polycystic Ovarian Syndrome Among Infertile Women

Hanaa Rahman Eleawi; Enas Talib Abdul-Karim; Anam Rasheed AL- Salihi

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 3, Pages 329-336

ABSTRACT:
BACKGROUND:
Most women with polycystic ovary syndrome PCOS don’t even know that they have it ,and do not get a diagnosis until they begin trying to get pregnant.
OBJECTIVE:
To identify the prevalence of the polycystic ovary syndrome (PCOS) among infertile women attending the Institute of Embryo Research and Infertility Treatment in AL-KadhymiaBaghdad, and to identify some of the common characteristics of infertile women with PCOS and others without PCOS .
METHODOLOGY:
A cross sectional study was conducted for about four months,during which a review of records of all the women attending the Institute during the year 2010 (six hundred women) .
RESULTS:
Results showed that the most common factors of infertility in infertile women is the PCOS, PCOS had a higher frequency among women aged 20-29 years, Slightly higher frequency of diabetes mellitus and hypertension among them than other group. higher frequency of acne & hirsutism among the PCOS cases than other causes group, and a higher frequency of increased prolactin level& LH level in the PCOS cases.
CONCLUSION:
PCOS infertility comprises more than one fourth of causes of infertility and is associated mainly with primary infertility & among younger age group(20-29years) .

Do All Anterior Cruciate Ligament Tears Need Reconstruction?

Qasim M.AL Janabi; Adnan H. Hnoosh; Ahmed N.M. Altaei

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 2, Pages 166-171

ABSTRACT:
BACKGROUND:
Anterior cruciate ligament (ACL) injury is common among active individuals, and mostly associated with other complex injuries in the knee. ACL reconstruction is vital for normal knee function. The treatment of ACL injuries of knee depend on many factors including Age of the patients, degree of laxity, level of activities and associated injuries .
OBJECTIVE:
To assess outcome after conservative management of ACL tear. Moreover, determine the patients who need reconstruction, and the best time to perform surgery.
PATIENTS AND METHODS:
Prospective study of 72 patients who had unilateral ACL tear, 61 males and 11females (age 18-40Y). 56 patients started management with rehabilitation program without reconstructive surgery, 12of them have underwent surgery after that because of unsatisfied outcome. ACLR performed for 28 patients 7 of them were female, complete ACL tear was observed in 21patients. Hamstring graft by one-incision technique were used: same protocol of rehabilitation was followed postoperatively. This study has been achieved in Al Shaheed Ghazi Al Hariri Hospital.
RESULT:
Average follow up period of 18 months, 78.5% of patient with rehabilitation (no ACLR) had good functional result. While all patients with ACLR have been satisfied where 85% of them return to their activity at level of I and II sport and 97% of quadriceps girth gaining compared to the sound side also observed at the end of follow up period.
CONCLUSION:
Not all ACL tear need surgical reconstruction. It is indicated for high-risk life style and repeated attacks of giving way. There is no differences between early and late reconstruction.

Troponin Positive Acute Coronary Syndrome with and without Significant Stenosis on Coronary Angiography

Mohammed Hilal AL-Ali; Hassan A. Farhan

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 2, Pages 237-243

ABSTRACT:
BACKGROUND:
Occasionally, coronary arteries without significant stenosis are observed during invasive treatment of acute coronary syndrome (ACS).
OBJECTIVE:
The aim was to study the frequency and to determine the most predictive factors of Troponin positive ACS without significant Stenosis on angiography.
METHODS:
The study involved one hundred twenty four patients admitted with Troponin positive ACS who underwent cardiac catheterization during hospitalization. The primary end-point was the estimation of coronary arteries without significant stenosis, and the secondary end-point was analysis of the most predisposing factors. In evaluating the primary end-point, the patients were divided into two groups according to the presence of ST elevation myocardial infarction (STEMI) or not. Also the patient who has no significant coronary artery Stenosis (< 50%) was subdivided to two groups:
a- Myocardial Infarction with No critical lesion in Coronary angiogram (MINC)
b- Normal coronary angiogram
RESULTS:
Overall, 20 patients (16%) had coronary arteries without significant lesions, from which 8 patients (6.4%) had MINC and 12 patients (9.6%) had normal coronary angiogram. The predictors were: female sex (P=0.008), age <45 years (P=0.001), and the absence of: diabetes (P=<0.001), hypertension (P=0.005) and absence of ST-segment elevation (P=0.001). Furthermore absence of regional wall motion abnormality (RWMA) is considered as another predictors for non-significant coronary artery lesion (P=0.008). Also the angiographic analysis of all lesions revealed that single vessels CAD are the commonest finding in Group I patients (P= 0.02). We further analyzed a suspicious angiographic lesions by using QCA {18 lesions (14.5%)} and FFR {6 lesions (4.8%)} technique.
CONCLUSION:
Overall, patients with Troponin positive ACS had non- significant coronary artery Stenosis on angiography, and female sex, age <45 years and the absence of diabetes, hypertension, ST- segment elevation or RWMA were all associated with coronary angiography showing no significant stenosis.

Early Experience in Percutaneous Nephrolithotomy in Al-Jumhori Teaching Hospital Mosul City

Asim Tahseen Suhail

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 1, Pages 102-107

ABSTRACT:
BACKGROUND:
Percutaneous nephrolithotomy (PCNL) mean extraction of renal calculi through nephrostomy tracts placed percutaneously ,it was reported in the early 1970s. Percutaneous nephrolithotomy is widely accepted, more safe and effective treatment modality and it is the procedure of choice for removing large, complex, and/or multiple renal PCNL has lower morbidity and postoperative patient discomfort.
OBJECTIVE:
To evaluate the initial experience of PCNL in al jumhoori teaching hospital, taking 21 patients with renal stones of different sizes ,with it is complications.
METHODS:
Between May 2012 and July 2013 a case series study was applied in AL- Jumhori Teaching Hospital, PCNL was used in 21 patients (Mean age was 55 years, ranging between 16-63 years, 15 men and 6 women) while only one child of 8 year old was enrolled. All cases have renal stone of different size varied from (21mm-60 mm). Preoperative evaluation included , history, clinical examination and routine labarotory investigation, all patients had intravenous urography( IVU), some of them have non contrast or enhanced CT scan of urinary tract to evaluate the cortical thick -ness of the kidney, anatomical abnormalities, stone location, burden and radiolucency of the stone. All patients submitted to PCNL in AL-Jumhoori teach ing hospital ,under general anesthesia in prone position, subcostal approach, using fluoroscopic guidance(c-arm.),and irrigation fluid (0.9% N.S.) at body tempreture was used . Steps of PCNL include(1) Ureteric and urethral catheterisation (supine)(2) Percutaneous renal access in the posterior axillary line ,guide wire must always be in place to maintain access and to get (3) Tract dilatation .A track has been dilated and a 34 F working sheath is being advanced over a 30F metal dilator. Tracts can be dilated with either metalic, telescopic, plastic or balloon dilators. Balloon dilatation is quicker and perhaps less traumatic(4) Endoscopic stone fragment extraction (rigid-flexible endoscopy)(5) Post-extraction drainage (nephrostomy, ureteric catheter or tubeless)(6) Wound dressing and care.
RESULT:
The mean age was (55 years), with a male to female ratio of 2.5:1. The stone burden varied from 21-60mm most of them were radio-opaque (85.7%). The range of operative time varied from 75-200 minutes with a mean of 120 minutes, including cystoscopic and stenting procedure. The duration of exposure to radiation was ranging from 1.1minutes - 4.5minutes, with a mean of 2.1 minutes. The mean ±SD value of irrigant fluid was19.00±3.98 liters ranging from 12 -25 liters. In the present study the clearance rate was 76%, where 16 patients out of 21 had complete clearance together with stone < 5 mm. In 5 patients (24%) ESWL sessions were needed since they were already have staghorn calculus > 3cm or renopelvic plus multiple stones. The clearance rate for staghorn (62%), non staghorn calculus varied between 75% - 100% .
Tow months later all patients except 2 became stone free;(one of them had multiple stone resist ESWL and other one had duplex of pelvicalyseal system and his residual stone was located in the upper mieoty) both of them probably need second PCNL. The range of hospital stay was 1-5 days, with a mean of 2.2 days. Nephrostomy tube were removed on 1st, 2nd or even 3rd post operative day. All patients had double J (DJ) placement except 3 patients who regarded as tubeless PCNL.
CONCLUSION:
With the development of new devices for renal access, lithotripsy and renal drainage systems the procedure PCNL has become the first choice treatment modality for renal stones larger than 1.5 cm by the urologists worldwide. To avoid complications during the procedure and to gain successful outcomes after the procedure, proper patient selection, maintenance of available instruments, training and experience of the surgeon are critical.

Inhalational Anaesthesia Versus Total Intravenous Anaesthesia During a Rigid Bronchoscopy in Paediatrics

Osama Haider Al-Hassani

Iraqi Postgraduate Medical Journal, 2014, Volume 13, Issue 4, Pages 504-508

ABSTRACT:
BACKGROUND :
General anaesthesia is routinely used for rigid bronchoscopy in paediatrics for different causes. Both methods of anaesthesia were used inhalational and total intravenous anaesthesia (TIVA).
OBJECTIVE:
Is to compare inhalational anaesthesia with total intravenous anaesthesia (TIVA) for rigid bronchoscopy in paediatric age group in regard to the heart rate, oxygen saturation, coughing, bucking, laryngeal spasm and bronchospasm.
PATIENT AND METHOD:
Thirty patients aged 2-6 years were chosen, divided randomly in two groups. In group I ( inhalational anaesthesia) consisted of 15 patients and the anaesthesia was maintained with halothane while in group II use (total intravenous anaesthesia) TIVA was consist of 15 patients and anaesthesia was inducd and maintained with remifentanyl and propofol. The heart rate, oxygen saturation, coughing, laryngeal spasm and bronchospasm were evaluated during and after the procedure.
RESULT:
Blood oxygenation and Heart rate were more stable in group II (P=0.045 and P=0.024 respectively). There were slightly less cough and bucking in group II as compare with group I.
CONCLUSION:
TIVA is a good choice of anaesthesia during rigid bronchoscopy because of a good and stable level of blood oxygenation and heart rate. Coughing, bucking, laryngeal spasm and bronchospasm were less in TIVA group compare with inhalational group.

Effect of Hypertension on Aortic Root Size and Prevalence of Aortic Regurgitation

Ghassan Abbod Ahmed; Amal Noori Al; Marayati; Basil Najeeb; Asaad Abdullah Abbas; Talib Hashim Salim; Basil Najeeb Saeed; Riyadh S. Abultiman; Abdulhameed A. Majeed Al-kassir; Namir M. Taher Abdullah; Zainab Abdul Razak AL-SharifiA; Halla Ghazi Mahmood; Amjad Daoud Niazi; Hassan Sarhan Haider; Rafal Rajab Hasan; Alaa Hussein Altaee; Raghad Hannon Shinenalsudani; Iyad Abbas Salman; Saba J. AL-Wardi; Khudir Z. Mayouf; Faiq. I. Gorial; Warda S. Lasso; Mohanned A. Al-Falahi; Mohammad Saeed; Sinan Adnan; Islam Ghanem Mahmood; Ali A. Muttalib Mohammed; Ammar Hadi Khammas; Mohammed Radef Dawood; Yaseen Adeeb Sakran; Azad Mohammed Abdullah; Bassam Musa Sadik Al-Musawi; Waleed Mustafa Hussen; Osama Elhassani; Muhanad Fadhil

Iraqi Postgraduate Medical Journal, 2014, Volume 13, Issue 1, Pages 61-69

ABSTRACT:
BACKGROUND:
Although early reports suggested that hypertension predisposed to aortic root enlargement and consequent aortic regurgitation, more recent pathological and M-mode echocardiographic studies have not found an association between hypertension and aortic root enlargement when age is considered.
OBJECTIVE:
The aim of this study is to asses the effect of hypertension on aortic root size and to estimate the prevalence of aortic regurgitation.
METHODS:
measurement of two-dimensional echocardiographic diameters of the aortic root at four locations and compared findings with resting blood pressures and measures of body BMI in 110 normotensive and 110 hypertensive men and women matched for age and sex.Colour and continuous wave Doppler study are used to diagnose and assess severity of aortic regurgitation.
RESULTS:
Aortic diameters at the anulus (2.40±0.29 versus 2.33±0.24 cm, P=.06) and sinuses (3.45±0.43 versus 3.35±0.35cm, P=.08) were marginally higher, whereas diameters at the supra-aortic ridge (2.93±0.39versus 2.73±0.33cm, P

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such a difference in this population of
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asymptomatic hypertensive individuals.

Hemodynamic Effects of Muscle Relaxants a Comparative Study between Pancuronium and Vecuronium

Hassan Sarhan Haider; Rafal Rajab Hasan

Iraqi Postgraduate Medical Journal, 2014, Volume 13, Issue 1, Pages 91-98

ABSTRACT:
BACKGROUND:
The cardiac effects of equipotent doses of pancuronium and vecuronium were compared in 50 patients, anaesthetized with thiopentone and maintenance with halothane. Heart rate and arterial pressure were recorded from simultaneous tracings of ECG and pulse oximeter and automatic noninvasive monitor respectively. Pancuronium (0.08 mg/kg) caused a significant increase in heart rate and significant changes in arterial pressure.The equipotent dose of vecuronium (0.05 mg/kg) caused no significant changes in heart rate and arterial pressure.
OBJECTIVE:
The study was designed to determine the comparison between Pancuronium Bromide &Vecuronium Bromide according to cardiovascular effects in young adult patients undergo different variety of surgical operation under general anaesthesia.
METHODS :
Fifty adult patients (ASA class I and II ) were allocated to 2 subgroups: Group A (n=25) received pancuronium bromide 0.08mg/Kg Group B (n=25)received vecuronium bromide 0.05mg/Kg Anaesthesia was induced with Fentanyl (1μg/Kg), Sodium thiopentone (4-6mg/Kg) and maintained with Halothane 1% in Oxygen.The neuromuscular blocking agents were given and after 2-3 minutes tracheal intubation was performed with ease in all patients. Heart rate and mean arterial pressure were recorded every10minutes in all patients for40 minutes.
RESULT:
There was significant differences in mean heart rate and mean arterial blood pressure in group A (p<0.05). There was no significant differences in mean heart rate and mean blood pressure in group B (p<0.05).
CONCLUSION:
From this study, it can be concluded that:
1- The use of pancuronium as a muscle relaxant cause significant increase in heart rate and mean blood pressure in anaesthetized patients.
2- The use of vecuronium as a muscle relaxant cause insignificant changes in heart rate and mean blood pressure in anaesthetized patients that lead us to prefer vecuronium on pancuronium for hemodynamic stability.