IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay
Prospective Randomized Double-Blind Study of Effectiveness of Dexmedetomidine...asclepiuspdfs
Introduction: Laryngoscopy and endotracheal intubation is associated with transient increase in heart rate (HR) and arterial blood pressure due to the sympathoadrenal stimulation. It can produce deleterious effects in patients with cardiovascular and cerebrovascular disease, in the form of myocardial ischemia, pulmonary edema, and cerebral hemorrhage. Dexmedetomidine has been effective in blunting the hemodynamic response to laryngoscopy and tracheal intubation. In this study, we used dexmedetomidine in pre-operative intravenous infusion dose of 1 mcg/kg over 20 min before induction. Aims and Objectives: The aim of the study was to study the efficacy and safety of dexmedetomidine on attenuation of pressor response during laryngoscopy and tracheal intubation, w.r.t. (1) pressor response during laryngoscopy and tracheal intubation, (2) hemodynamic stability, and (3) any adverse effects.
“A Comparative Study of Bupivacaine with Dexamethasone and Bupivacaine with C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Endoscopic ultrasonography (EUS) is an outpatient procedure
During an EUS procedure, an upper gastrointestinal (GI) scope is inserted into the esophagus through the mouth to obtain ultrasonographic as well as endoluminal images of various upper gastrointestinal pathologies.
Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – O...info622939
Embark on a compelling exploration of anesthesia innovation with our presentation on 'Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – Our Experience.' Delve into the intricacies of this specialized technique, tailored for high-risk cardiac patients, as we share our unique insights and experiences.
Comparison of Ondansetron and Granisetron for Prevention of Nausea and Vomiti...Apollo Hospitals
The most common and distressing symptoms, which follow anaesthesia and surgery, are pain and emesis. The consequences of PONV are physical, surgical and anesthetic complications for patients as well as financial implications for the hospitals or institutions. Sometimes nausea and vomiting may be more distressing especially after minor and ambulatory surgery, delaying the hospital discharge. Laparoscopic surgery is one condition, where risk of PONV is particularly pronounced due to pneumo-peritoneum causing stimulation of mechanoreceptors in the gut. In spite of plenty of anti-emetic drugs available no single drug is 100% effective in prevention of PNV and combination therapy has got a lot of side effects.
Evaluation of Effect of Low Dose Fentanyl, Dexmedetomidine and Clonidine in S...iosrjce
In the present study effect of intrathecal hyperbaric Bupivacaine 0.5% with low doses of Clonidine
or Fentanyl or Dexmedetomidine were compared in elective lower abdominal surgeries. This was a prospective
randomized control trial. 90 patients belonging to ASA 1 &II, aged between 20-50 years were allocated into
three groups. Group-C: Clonidine 30µg, Group-D: Dexmedetomidine 5 µg, Group-F: Fentanyl 25 µg. The
onset of sensory blockade was comparable in all the three groups. The onset of motor blockade was earlier by
about 1.3 mins in Dexmedetomidine group when compared to Clonidine and Fentanyl group. Duration of
sensory blockade was prolonged in Dexmedetomidine group (346mins) when compared to Clonidine (300mins)
and Fentanyl (302mins) group. Time duration of motor blockade was prolonged in Dexmedetomidine group
(269mins) when compared to Clonidine (223mins) and Fentanyl (220mins) group. The haemodynamic
parameters were clinically and statistically insignificant The time of first request for analgesics by the patients
was more in Dexmedetomidine group (250mins) when compared to Clonidine (194mins) and Fentanyl
(189mins) group. The use of intrathecal Dexmedetomidine as an adjuvant to Bupivacaine is an attractive
alternative to Fentanyl or Clonidine for long duration surgical procedures due to its profound intrathecal
anesthetic and analgesic properties combined with minimal side effects.
A case report of open reduction, internal fixation and platting of clavicle f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Prospective Randomized Double-Blind Study of Effectiveness of Dexmedetomidine...asclepiuspdfs
Introduction: Laryngoscopy and endotracheal intubation is associated with transient increase in heart rate (HR) and arterial blood pressure due to the sympathoadrenal stimulation. It can produce deleterious effects in patients with cardiovascular and cerebrovascular disease, in the form of myocardial ischemia, pulmonary edema, and cerebral hemorrhage. Dexmedetomidine has been effective in blunting the hemodynamic response to laryngoscopy and tracheal intubation. In this study, we used dexmedetomidine in pre-operative intravenous infusion dose of 1 mcg/kg over 20 min before induction. Aims and Objectives: The aim of the study was to study the efficacy and safety of dexmedetomidine on attenuation of pressor response during laryngoscopy and tracheal intubation, w.r.t. (1) pressor response during laryngoscopy and tracheal intubation, (2) hemodynamic stability, and (3) any adverse effects.
“A Comparative Study of Bupivacaine with Dexamethasone and Bupivacaine with C...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Endoscopic ultrasonography (EUS) is an outpatient procedure
During an EUS procedure, an upper gastrointestinal (GI) scope is inserted into the esophagus through the mouth to obtain ultrasonographic as well as endoluminal images of various upper gastrointestinal pathologies.
Similar to Hemodynamic Stress Response of Carbon-Di-Oxide Pneumoperitoneum during Laparoscopic Surgery: Effect of Oral and Intravenous Clonidine Premedication
Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – O...info622939
Embark on a compelling exploration of anesthesia innovation with our presentation on 'Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – Our Experience.' Delve into the intricacies of this specialized technique, tailored for high-risk cardiac patients, as we share our unique insights and experiences.
Comparison of Ondansetron and Granisetron for Prevention of Nausea and Vomiti...Apollo Hospitals
The most common and distressing symptoms, which follow anaesthesia and surgery, are pain and emesis. The consequences of PONV are physical, surgical and anesthetic complications for patients as well as financial implications for the hospitals or institutions. Sometimes nausea and vomiting may be more distressing especially after minor and ambulatory surgery, delaying the hospital discharge. Laparoscopic surgery is one condition, where risk of PONV is particularly pronounced due to pneumo-peritoneum causing stimulation of mechanoreceptors in the gut. In spite of plenty of anti-emetic drugs available no single drug is 100% effective in prevention of PNV and combination therapy has got a lot of side effects.
Evaluation of Effect of Low Dose Fentanyl, Dexmedetomidine and Clonidine in S...iosrjce
In the present study effect of intrathecal hyperbaric Bupivacaine 0.5% with low doses of Clonidine
or Fentanyl or Dexmedetomidine were compared in elective lower abdominal surgeries. This was a prospective
randomized control trial. 90 patients belonging to ASA 1 &II, aged between 20-50 years were allocated into
three groups. Group-C: Clonidine 30µg, Group-D: Dexmedetomidine 5 µg, Group-F: Fentanyl 25 µg. The
onset of sensory blockade was comparable in all the three groups. The onset of motor blockade was earlier by
about 1.3 mins in Dexmedetomidine group when compared to Clonidine and Fentanyl group. Duration of
sensory blockade was prolonged in Dexmedetomidine group (346mins) when compared to Clonidine (300mins)
and Fentanyl (302mins) group. Time duration of motor blockade was prolonged in Dexmedetomidine group
(269mins) when compared to Clonidine (223mins) and Fentanyl (220mins) group. The haemodynamic
parameters were clinically and statistically insignificant The time of first request for analgesics by the patients
was more in Dexmedetomidine group (250mins) when compared to Clonidine (194mins) and Fentanyl
(189mins) group. The use of intrathecal Dexmedetomidine as an adjuvant to Bupivacaine is an attractive
alternative to Fentanyl or Clonidine for long duration surgical procedures due to its profound intrathecal
anesthetic and analgesic properties combined with minimal side effects.
A case report of open reduction, internal fixation and platting of clavicle f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Manipulating gas deflation to reduce laparoscopic post-operative painPremier Publishers
Pneumoperitoneum is essential during laparoscopic surgeries. However, residual intra-abdominal gas was proved to be responsible for postoperative upper abdominal and shoulder-tip pain. The current study aimed to assess the safety and efficacy of active gas deflation at the end of gynaecologic laparoscopic surgeries, as a method to reduce post-operative gas-induced pain. The study included 40 cases, planned for operative laparoscopy for benign gynaecologic indications. Cases were randomly allocated to one of the 3 designed groups; Group-A (10 cases), where passive rapid gas deflation was done, group-B (15 cases), where passive slow gas deflation was done, and group-C (15 cases), where gas was rapidly and actively deflated. Postoperative pain was assessed by Visual Analogue Scale (VAS) at 1, 6, 24 hours and 7 days after operation. Postoperative analgesic requirements and frequency of nausea and vomiting were also recorded. The overall results showed that postoperative VAS was significantly less in group C. Total amount of analgesia needed in group C and B was significantly less compared to group A (p=0.0001). We concluded that active aspiration of residual gas at the end of gynaecologic laparoscopy significantly reduces postoperative pain. This simple clinical manoeuvre may also reduce postoperative nausea and vomiting.
Evaluvation of Perioperative Haemodynamic Changes in Hypertensive Patients Tr...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Use of Capnograph in Breathlessness Patientsnhliza
This is a research topic carried out in the Emergency Department and the abstract was presented at the International Conference In Emergency Medicine in SanFrancisco April 2008
Similar to Hemodynamic Stress Response of Carbon-Di-Oxide Pneumoperitoneum during Laparoscopic Surgery: Effect of Oral and Intravenous Clonidine Premedication (20)
An Examination of Effectuation Dimension as Financing Practice of Small and M...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Does Goods and Services Tax (GST) Leads to Indian Economic Development?iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Childhood Factors that influence success in later lifeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer’s Acceptance of Internet Banking in Dubaiiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumer Perspectives on Brand Preference: A Choice Based Model Approachiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Student`S Approach towards Social Network Sitesiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Broadcast Management in Nigeria: The systems approach as an imperativeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study on Retailer’s Perception on Soya Products with Special Reference to T...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladeshiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Media Innovations and its Impact on Brand awareness & Considerationiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer experience in supermarkets and hypermarkets – A comparative studyiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Social Media and Small Businesses: A Combinational Strategic Approach under t...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Implementation of Quality Management principles at Zimbabwe Open University (...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
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Hemodynamic Stress Response of Carbon-Di-Oxide Pneumoperitoneum during Laparoscopic Surgery: Effect of Oral and Intravenous Clonidine Premedication
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 11 Ver. VI (Nov. 2015), PP 19-23
www.iosrjournals.org
DOI: 10.9790/0853-141161923 www.iosrjournals.org 19 | Page
Hemodynamic Stress Response of Carbon-Di-Oxide
Pneumoperitoneum during Laparoscopic Surgery: Effect of Oral
and Intravenous Clonidine Premedication
Dr. Chethananand 1
, Dr. Vidyadhar Metri 2
,
Dr. Vasundhara Vadaguru Mallikarjuna3
, Dr. Amit Gandhi4
1,2,3,4
(Department of Anaesthesiology, Adhichunchanagiri Institute of Medical Sciences , B G Nagara, India)
Abstract : Hemodynamic response to carboperitoneum can be avoided by use of several pharmacological
agents. Clonidine is an α 2 adrenoreceptor agonist having sympatholytic effects. Clonidine has been shown to
reduce perioperative hemodynamic instability. The aim of this study was to investigate the clinical efficacy of
oral versus intravenous clonidine premedication in prevention of hemodynamic response associated with
carboperitoneum .
Sixty adult patients of ASA grade I and II, scheduled for elective laparoscopic cholecystectomy were
recruited for a prospective randomized double blinded comparative study. They were randomly allocated to one
of the two groups to receive either intravenous clonidine 0.8micrograms/kg (Group A) in 20ml dilution 30
minutes before or oral clonidine 150 µg (Group B) 90 minutes before induction of anaesthesia.
In our study following carboperitoneum the trend of heart rate showed that Group B has a better effect on heart
rate at the end of 30minutes with the heart rate for Group A being 75.73/min,. compared to Group B which was
74.2/min, this was statistically insignificant. The trend of mean arterial pressure(MAP) showed that Group A
has a better effect on MAP at the end of 30 minutes with the MAP for 77.73±5.9mmhg in Group A being
compared to Group B which was 91.8±8.75mmhg. Hence we found a significantly decrease in MAP in response
to carboperitoneum with intravenous clonidine.
To conclude intravenous clonidine at a dose of 0.8 micrograms/kg is a useful premedication drug to alleviate
the hemodynamic response to carboperitoneum.
Keywords: Clonidine oral/IV, Hemodynamic response, Laproscopic cholecystectomy, Pneumoperitoneum.
I. Introduction
Laparoscopic surgeries have revolutionized surgical procedures mainly due to the important advantages
it offers. It takes lesser time in experienced hands, decreased post-operative pain, shorter duration of hospital
stay, minimal scar, minimal post operative morbidity and mortality. Hans Christian Jacobaeus in 1910 coined
this term. It refers to a minimal access procedure allowing endoscopic access to peritoneal cavity after
insufflations of gases to create space between anterior abdominal wall and viscera for safe manipulation of
instruments and organs.
Pneumoperitoneum is created by insufflations of gas into the peritoneal cavity. Various gases including
CO2, N2O, Helium has been used. Currently CO2 is most commonly used. Pneumoperitoneum is known to cause
various hemodynamic changes.
Several drugs including Nitroglycerin, Dexmeditomedine have been used for attenuating these effects.
Clonidine, an α-2 selective adrenergic receptor agonist has been associated with attenuation of these responses.
Our study deals with usage of clonidine in oral and intravenous route to attenuate the hemodynamic changes
during pneumoperitoneum in laparoscopic cholecystectomy surgeries.
II. Aims And Objectives
1.1 Primary: To record the Heart Rate, Non-Invasive Blood Pressure, SPO2, End Tidal CO2 values in both
groups at basal, at carboperitoneum and every 3 minutes for 30 minutes.
1.2 Secondary: To determine the significance of patient positioning with Mean Arterial Pressure.
III. Methods And Methodology
Ours was a prospective study conducted in a tertiary health centre. We included a total of 60
participants who were scheduled to undergo laparoscopic cholecystectomy.
Pre-anaesthetic evaluation was done for all the patients and they were optimized for laparoscopic
surgery. Institutional ethics committee approval and informed written consent from all participants was taken.
The inclusion criteria were ASA grade I and II Patients; aged between 18-50yrs; scheduled for elective
laparoscopic cholecystectomy. The exclusion criteria were patient refusal to participate in study; ASA grade
2. Hemodynamic Stress Response of Carbon-Di-Oxide Pneumoperitoneum during…
DOI: 10.9790/0853-141161923 www.iosrjournals.org 20 | Page
III/IV/V; hypertensive patients; patients with renal dysfunction; hepatic diseases including Child Pugh score B,
C; patients with preexisting history of IHD, valvular heart disease and congenital heart disease; conduction
abnormalities; heart rate less than 60/min; patient with history of allergic drug reactions; BMI<30; patients
receiving tricyclic antidepressants, beta blockers, diltiazem, verapamil.
60 consecutive patients were selected based on inclusion and exclusion criteria and were
randomly assigned to receive oral or IV clonidine.
Oral clonidine group: Received 150micrograms of clonidine 90 min prior to surgery.
IV clonidine group: Received 0.8 microgram/kg body weight of clonidine diluted in 20 ml of NS given over
10 minutes, 30 minutes prior to surgery.
Patients were shifted to Operating room and SPO2, NIBP, ECG, ETCO2 monitors connected.
Premedication with Inj.Glycopyrolate 0.2mg was given IV. Patients were preoxygenated with 100% oxygen for
3 min. The basal readings were recorded at time prior to intubation. Patients were induced with Inj propofol
2mg/kg body weight and intubated with appropriate size tube with Suxamethonium 1.5mg/kg body weight.
Pneumoperitoneum with CO2 was created with IAP not exceeding 15mmhg.
A blinded observer was then allowed to enter into the OR to take the values of Heart rate, SBP, DBP,
MAP, ETCO2, SPO2 readings. The readings were taken at carboperitoneum and subsequently every 3 minutes
till the end of 30 minutes. The patient position was also noted during the surgical procedure.
A 15 º Tilt of reverse Trendelenberg was given in most patients. Patient was maintained with
mechanical ventilation O2:N2O with Isoflurane and Vecuronium for muscular relaxation. Any change in
hemodynamic variables on either side of the base value by 20% was taken to be significant. Intraoperative fluid
management was optimal. At the end of surgery neuromuscular blockade was reversed with Neostigmine 0.05
mg/kg body weight and glycopyrollate at 0.01 mg/ kg body weight. The patient after surgery was extubated and
shifted to PACU for further follow-up.
The results obtained were analysed using statistical analysis, average with standard deviations were
calculated between the two groups. Unpaired student t-test was used to assess statistical significance.
IV. Results
All the participants chosen for the study completed it (n=60). The demographic pattern for the
participants were similar in both groups (Table 1).
Group A (IV) Group B (Oral)
Age (yrs) 28.96 ± 7.01 33.5 ± 7.24
Weight (kg) 60.93 ± 7.38 60.8 ± 5.73
Height (cms) 165.26 ± 7.38 164.46 ± 5.76
Sex (M:F) 1:2 3:7
BMI(kg/m2
) 22.35 ± 2.62 22.54 ± 2.14
Table 1: Depicting the demographic profile of the two groups
The hemodynamic parameters were measured at various intervals to achieve a trend. They were
measured at : 1. Basal value prior to the start of surgery and intubation; 2. At the start of carboperitoneum; 3.
Every 3 minutes subsequently after carboperitoneum till 30 minutes.
The Heart Rate, Systolic Blood Pressure, Diastolic Blood Pressure, Mean Arterial Pressure were all
noted by a blinded observer. The overall duration of carboperitoneum was 90 – 120 minutes. The patients were
given 15 º tilt in reverse Trendelenburg position for the surgery.
4.1 Heart rate:
The basal heart rates records were 77.66 ± 7.46/minute for group A (IV) whereas they were 78.76 ±
5.63/minute for group B (Oral). The recording of the heart rates between the two groups depicted as a line graph
is shown in the figure below (Figure 1). The trend of the heart rate showed that oral clonidine has a better effect
on the heart rate at the end of 30 minutes with the heart rate for IV group being 75.73/minute compared to oral
group which was 74.2/minute; however compared to IV clonidine but it was statistically insignificant.
3. Hemodynamic Stress Response of Carbon-Di-Oxide Pneumoperitoneum during…
DOI: 10.9790/0853-141161923 www.iosrjournals.org 21 | Page
Figure 1: Depicting the difference between the heart rates between the two groups
4.2 Mean arterial Pressure:
The basal mean arterial pressures recorded were 90.53 ± 6.45 mmHg for group A (IV) whereas they
were 91.4 ± 6.16 mmHg for group B (Oral). The recording of the MAP between the two groups depicted as a
line graph is shown in the figure below (Figure 2). The trend of the MAP showed that IV clonidine has a better
effect on the MAP at the end of 30 minutes with the MAP for 77.73 ± 5.9 mmHg in IV group being compared to
oral group which was 91.8 ± 8.75mmHg.
Figure 2: Depicting the difference between the mean arterial pressures between the two groups.
HR;
Basal
At
Carb
operi
toneu
m
3
min
6
min
9
min
12
min
15
min
18
min
21
min
24
min
27
min
30
min
GROUP A - IV 77.66 80.06 83.86 87.23 89.1 83.2 80.36 78.5 77.33 76 75.96 75.73
GROUP B - ORAL 78.76 76.36 83.86 84.76 83.33 80.4 79.1 76.6 76.1 76.46 75 74.2
0
10
20
30
40
50
60
70
80
90
100
HEARTRATE(PERMIN)
COMPARISON OF THE HEART RATES
BETWEEN THE TWO GROUPS
Basal
MAP
At
Carb
operit
oneu
m
3 min
MAP
6 min
MAP
9 min
MAP
12
min
MAP
15
min
MAP
18
min
MAP
21
min
MAP
24
min
MAP
27
min
MAP
30
min
MAP
Group A - IV 90.53 88.33 95.93 99.5 99.9 93.2 88.36 84.83 79.83 78.3 78.33 77.73
Group B - Oral 91.4 85.93 93.23 95.13 94.6 91.73 92.86 91.33 92.26 93.6 91.86 91.8
0
20
40
60
80
100
120
MAP(MMHG)
COMPARISON BETWEEN THE MEAN
ARTERIAL PRESSURES BETWEEN THE
TWO GROUPS
4. Hemodynamic Stress Response of Carbon-Di-Oxide Pneumoperitoneum during…
DOI: 10.9790/0853-141161923 www.iosrjournals.org 22 | Page
V. Discussion
Laparoscopy is a very well established procedure since more than two decades. Almost all procedures
are now being performed laparoscopically including oesophagectomy, intestinal resection and donor
nephrectomy. However experience with understanding of the effects of CO2 pneumoperitoneum are far from
nascent 1
. Insufflation of about 2.5 to 5 litres of CO2 are more appropriately called as carboperitoneum routinely
used to give the region in interest a good exposure.2
Carboperitoneum along with resultant increase in the intra-
abdominal pressure affects all the systems of the body, affecting hemostasis and leads to alterations in
cardiovascular, pulmonary physiology and stress response. Cardiovascular changes includes increase in the
MAP with no significant changes in heart rate3-5
, decrease in cardiac output and increase in Systemic vascular
resistance. These pressor responses are consequent to hypercarbia induced release of catecholamines6-8
vasopressin or both. 3,9,10
The physiological changes that occur in pneumoperitoneum are related to patient factors such as patient
position, the insufflations of gas and the effect of insufflations on intraabdominal pressure. Also the BMI of the
patient is significant as in obese to morbidly obese patients the intraabdominal pressures are 2 to 3 times that of
non-obese patients.11
Also systemic absorption of carbon-di-oxide in obese patients and increased need to
eliminate the carbon-di-oxide in these patients is also a challenge. CO2 is used for insufflations at the rate of 4-6
L/min12
and intra-abdominal pressure of 10-15 mmHg is maintained. Intra-abdominal pressure refers to the
pressure in the peritoneal cavity. It is maintained between 12- 15 mmHg in pneumoperitoneum to prevent
adverse effects.
On the cardiovascular system, a raised Intra-abdominal pressure can lead to a decreased venous return
due to the compression of Inferior vena cava and thereby a fall in the cardiac output and also there is increased
systemic vascular resistance13
. This increase in Systemic vascular resistance is a consequence of activation of
neurohumoral mechanisms including sympathetic activation, ADH and Renin- Angiotensin – Aldosterone
system stimulation. The heart rate and MAP are seen to increase with intra-abdominal pressure 14
. The central
venous pressure may also increase due to increased intrathoracic pressure. Hence due to an increased
myocardial overload even myocardial ischemia may occur. Also Giaquinto et al published a case of acute
congestive heart failure after laparoscopic cholecystectomy in a 59 year old lady with morbid obesity15
.
Adequate preoperative hydration is also said to be helpful in alleviating acid base changes to hypercarbia16
.
Patient positioning is also important as it has a lot of influence on hemodynamics of the patient.
ETCO2 changes also occur due to the use of CO2 as insufflating agent and also as CO2 can be
absorbed by the body and hence ventilation control becomes an important factor in preventing hypercarbia17
.
Figure 3: Structure of clonidine hydrochloride
Clonidine hydrochloride is a centrally acting α 2 adrenergic receptor agonist which has been used in
various routes including oral, intravenous, intrathecal, epidural, sublingual forms. The adult dosage is between 2
to 7 micrograms per kilogram body weight. Studies have shown that 2.4 mg is the maximum effective dosage18
.
The major use of clonidine is to alleviate the rise in blood pressure. There are various studies that have
demonstrated the use of clonidine in varying doses intravenously.
In our study similar to the other authors we found a significant decrease in MAP in response to the
carboperitoneum with intravenous clonidine. It has to be used with caution due to its interactions with tricyclic
antidepressants, beta-blockers, diltiazem, verapamil to name a few.
VI. Conclusion
Intravenous clonidine at a dosage of 0.8 micrograms/kg is a useful premedication to alleviate the
hemodynamic stress response to CO2 pneumoperitoneum.
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