Conference Presentations by priyanka dev
This book contains the write up of few of the topics presented in Indian College of Anaesthesiolo... more This book contains the write up of few of the topics presented in Indian College of Anaesthesiologists national conference (ICACON) 2016 held in Shillong, India.
Papers by priyanka dev
Pain Physician, 2018
Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it b... more Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Intraarticular depo-steroid injection is a traditional approach to treating sacroiliac joint pain. For long-term pain relief, however, lesioning the sacral lateral branches may be a better approach. This study compared the efficacy of intraarticular depo-methylprednisolone injection to that of pulsed radiofrequency ablation for sacroiliac joint pain. This study used a randomized, prospective design. Thirty patients with diagnostic block-confirmed sacroiliac joint dysfunctional pain were randomly assigned to 2 groups. One group received intraarticular methylprednisolone and another group underwent pulsed radiofrequency of the L4 medial branch, the L5 dorsal ra...
SN Comprehensive Clinical Medicine
Hematological parameters like total leukocyte count (TLC), neutrophil, lymphocyte, and absolute e... more Hematological parameters like total leukocyte count (TLC), neutrophil, lymphocyte, and absolute eosinophil counts (AEC), and neutrophil-to-lymphocyte ratio (NLR) are known to predict the severity of novel coronavirus disease 2019 (COVID-19) patients. In the present study, we aimed to study the role of complete blood count parameters in triaging these patients requiring intensive care unit (ICU) admission. A retrospective study was done over a period of 2 months. Patients, who were ≥ 18 years of age with COVID-19 confirmed on SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) and whose routine hematology counts were sent within 24 h of admission, were included in the study. Cutoff values of 47.5 years for age, 11.3 × 10 9 /L for TLC, and 9.1 for NLR were predictive of disease severity among COVID-19 patients. Relative neutrophilia ≥ 70% (p < 0.007), relative lymphopenia ≤ 20% (p < 0.002), AEC ≤ 40/cumm (p < 0.001), and NLR ≥ 9.1 (p < 0.001) were significantly associated with ICU admission. Routine hematological parameters are cost-effective and fast predictive markers for severe COVID-19 patients, especially in resource-constrained health care settings to utilize limited ICU resources more effectively.
Cureus
Introduction: Various types of arrhythmia have been reported during cesarean section under spinal... more Introduction: Various types of arrhythmia have been reported during cesarean section under spinal anesthesia. But the possible causative factors and the effects of arrhythmia on immediate post-delivery neonatal outcome are not well established. Methods: This prospective observational study was conducted over a period of one year in a tertiary care hospital on women undergoing cesarean section under spinal anesthesia. The objectives of the study were to determine the incidence of arrhythmia, its types, the possible factors influencing arrhythmia, and the immediate post-delivery neonatal outcome. Data collected were analyzed using Statistical Package for the Social Sciences (SPSS) software version 21 (IBM Corp. Armonk, NY). Results: In our study, the incidence of arrhythmia was 31.9% during cesarean section under spinal anesthesia; and sinus bradycardia was the most common type. Arrhythmia occurred more in women with hypotension, when maximum block height was above T4 level and dose of intrathecal hyperbaric bupivacaine was more than 2.2 mL (P value <0.05). Also, uterine manipulation led to sudden bradycardia and transient cardiac asystole in two patients which was preceded by subjective symptoms of pain and discomfort. None of the neonates required cardiopulmonary resuscitation or neonatal intensive care unit admission within an hour of birth. APGAR (Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration) scores at 1 and 5 minutes were similar in all the newborns born to mothers with or without arrhythmia. Conclusion: The occurrence of arrhythmia during cesarean section under spinal anesthesia, though very common, is rarely life-threatening. Keeping maximum level of block height between T4 and T6, using lower possible drug dose to provide adequate level of sensory block, prompt management of hypotension, and strict monitoring during uterine manipulation may reduce the overall incidence of arrhythmia. Intraoperative arrhythmia, however, does not adversely affect the immediate post-delivery neonatal outcome.
Indian Journal of Pain, 2020
Background: The ongoing COVID-19 pandemic has affected the current health care to the core. As a ... more Background: The ongoing COVID-19 pandemic has affected the current health care to the core. As a result, there is a shift of focus on health care to control the pandemic. The chronic pain patients, though at risk, are also the sufferers. The aim of this online survey was to evaluate the perspective of the pain physicians on chronic pain management during COVID-19 pandemic in India. Methods: The survey was conducted under the aegis of Indian society for study of pain. The questionnaire in the form of Google Forms was filled by pain physicians online after webinar. Results: In this survey, majority of the pain physicians (71.12%) reported that they are practicing pain even during COVID pandemic but with precautions. Around 65.77% of the pain physicians were using telemedicine for consultation. A prior COVID test for interventional procedures was opted by 85.56% of pain physicians. Total 89.30% feel that personal protective equipment is necessary for doing pain interventions. Meanwhile...
Posterior reversible encephalopathy syndrome (PRES) usually presents with headache, confusion, vi... more Posterior reversible encephalopathy syndrome (PRES) usually presents with headache, confusion, visual disturbances or blindness and seizures. MRI is gold standard with parieto-occipital white matter changes due to vasogenic oedema in most of the cases. We report a 20-year-old unbooked primigravida with eclampsia prior to delivery which got complicated by PRES after delivery on day 1 postpartum. General anesthesia was given for caesarean section and post operatively patient was managed in ICU with strict blood pressure and seizure control. Clinical improvement with complete resolution without any complications was observed on the day 10 postpartum.
Pain Physician, Sep 15, 2018
Background: Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, ... more Background: Sacroiliac joint dysfunctional pain has always been an enigma to the pain physician, whether it be the diagnosis or the treatment. Diagnostic blocks are the gold standard way to diagnose this condition. Radiofrequency neurotomy of the nerves supplying the sacroiliac joint has shown equivocal results due to anatomical variation. Intraarticular depo-steroid injection is a traditional approach to treating sacroiliac joint pain. For long-term pain relief, however, lesioning the sacral lateral branches may be a better approach. Objective: This study compared the efficacy of intraarticular depo-methylprednisolone injection to that of pulsed radiofrequency ablation for sacroiliac joint pain. Study Design: This study used a randomized, prospective design. Setting: Thirty patients with diagnostic block-confirmed sacroiliac joint dysfunctional pain were randomly assigned to 2 groups. One group received intraarticular methylprednisolone and another group underwent pulsed radiofrequency of the L4 medial branch, the L5 dorsal rami, and the lateral sacral branches. Results: Reduction in Numeric Rating Scale (NRS) for pain at 1 month post-procedure remained similar in Group A, while in Group B few patients reported a further decrease in the NRS score (3.333 ± 0.4880 and 2.933 ± 0.5936, respectively). At 3 months post-procedure, the NRS score began to rise in most patients in group A, while in Group B, the NRS score remained the same since the last visit (4.400 ± 0.9856 and 3.067 ± 0.8837, respectively). At 6 months post-procedure, the NRS score began to rise further in most patients in group A. In Group B, the NRS score remained the same in most of the patients since the last visit (5.400 ± 1.549 and 3.200 ± 1.207). There was a marked difference between the 2 groups in Oswestry Disability Index (ODI) scores at 3 months post-procedure (Group A, 12.133 ± 4.486 vs Group B, 9.133 ± 3.523) and at 6 months post-procedure there was a significant (P = 0.0017) difference in ODI scores between Group A and Group B (13.067 ± 4.284 and 8.000 ± 3.703, respectively). Global Perceived Effect (GPE) was assessed in both groups at 3 months post-procedure Only 33.3% (Confidence Interval (CI) of 11.8-61.6) of patients in Group A had positive GPE responses whereas in Group B, 86.67% (CI of 59.5-98.3) of patients had positive GPE responses. At 6 months post-procedure, the proportion of patients with positive GPE declined further in Group A, while in Group B, positive GPE responses remained the same (20% with a CI of 4.30-48.10 and 86.67% with a CI of 59.5-98.3, respectively). Limitations: Small sample size. Conclusion: This comparative study shows that pulsed radiofrequency denervation of the L4 and L5 primary dorsal rami and S1-3 lateral branches provide significant pain relief and functional improvement in patients with sacroiliac joint pain.
Journal of Pharmacology and Pharmacotherapeutics
Journal of Pharmacology and Pharmacotherapeutics
Indian Journal of Anaesthesia
Journal on Recent Advances in Pain, 2016
Background: Both suprascapular nerve block (SSNB) and intra-articular injection are effective met... more Background: Both suprascapular nerve block (SSNB) and intra-articular injection are effective methods for the treatment of chronic shoulder pain. Recently, intra-articular steroid injection (IAI) and SSNB have become popular. Aims and objectives: To assess and compare the relative effectiveness of a novel technique of SSNB and combined SSNB and IAI steroid on relief of chronic shoulder pain. Materials and methods: A total of 40 patients were randomized to the two groups. Group A received SSNB by our novel technique, and group B received combined SSNB and IAI. Visual analog scale (VAS) for pain and shoulder pain disability index (SPADI) were assessed before giving the blocks and IAI and at both the follow-up visits, i.e. at 1 and 4 weeks. Result: Significant improvements were seen in all pain scores and disability in the shoulders in both the groups. Improvements in pain and disability scores were clinically and statistically significant. Conclusion: Combined IAI and SSNB were found to be better than SSNB alone.
Journal on Recent Advances in Pain, 2015
Platelet-rich plasma prolotherapy (PRPP) helps to heal the injured tissue. Connective tissue repa... more Platelet-rich plasma prolotherapy (PRPP) helps to heal the injured tissue. Connective tissue repair is the platelet function that PRPP operates on. Platelet concentrations, when increased in a specific area, stimulate rapid healing. The main focus of PRPP is on the alpha granules, as these structures house all of the growth factors essential to PRPP in inactivated forms. Here, we report a case of lumbar facet arthropathy, which was successfully treated with intra-articular PRP injection. Patient was pain free after 12 months follow-up. We want to highlight that intra-articular PRP injection may be a future potential alternative therapy for facet arthropathy.
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Conference Presentations by priyanka dev
Papers by priyanka dev