Introduction: The combination of hypertension, dyslipedemia, centralobesity with insulin resistance or hyperinsulinemia or glucose intolerance has been termed the "Metabolic Syndrome."This syndrome is a powerful determinant for cardiovascular disease. Presence of one risk factor mandates search forother factors. Hypertension and obesity and smoking are assessed clinically while Hyperglycemia and dyslipedemiaare detected by lab screening. Objective: To detect the other component of metabolic syndrome in type 2 diabetics.Design of study: Observational study. Setting: At Al-Shifa Metabolic Center, Faisalabad. Study Period: FromJanuary 2005 to June 2006 Materials And Methods: All patients with type2 diabetes mellitus were assessed forhypertension, central obesity and fasting serum cholesterol to define the different components of the MetabolicSyndrome. on diabetics presenting for routine consultancy. Results. A total of 8300 labeled type2 diabetics wereenrolled. Random blood sugar, blood pressure and central obesity by waist hip ratio were assessed and appointmentwas given for complimentary screening of fasting serum cholesterol and triglyceroid level. Only 2656 presented forscreening of lipids and only this group was evaluated further. 92% of patients were between 30-70 years of age. 8%were above the age of 70. There were 39% males and 61% females, 39% of diabetics had hypertension, 60% werecentrally obese, 69% had fasting serum cholesterol level above 150 mg/dL and 49% had fasting serum triglyceride levelabove 150mg/dl. Conclusion. Diabetes Mellitus, obesity, especially the central type, hypertension and dyslipedemiaare metabolically linked together. All of these are clustered together quiet frequently. These are well-established riskfactors for coronary heart disease, the major cause of mortality. Treating hyperglycemia alone in diabetics does notprotect coronaries. All of the risk factors shall be defined and treated together in every patient at risk of CHD. Treatingobesity is beneficial in glycemic, lipemic and hypertension control.

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Aim: To compare the frequency of better glottic visualization and ease of tracheal intubation in Macintosh versus McCoy blades. Study design: An observational analytical study. Settings: Department of Anesthesia, Lahore Medical and Dental College/Ghurki trust teaching hospital, Lahore. Study duration: Six months (2nd September 2017 to 1st March 2018) Methods: After approval from research, education and clinical audit department, we selected 60 patients for elective procedures under general anesthesia of age ranges from 20-40 years including both males and females. Patients were randomized by lottery method into two groups I & II. Laryngoscopy was performed with McCoy in group I and with Macintosh in group II and the best possible view of the glottis was obtained. After achieving best possible glottis view of each patient, vocal cord visualization was determined according to Grade-I to IV. Ease of tracheal intubation was also noted. Results: The demographic data was comparable in both groups. In this study, we have found better glottic visualization in 60.0% of patients with Macintosh blade (group II) and with McCoy blade (group I), it was 83.33% (p-value = 0.045). Ease of intubation was 73.33% with Macintosh blade (group II) and with McCoy blade (group I), it was 93.33% (p-value = 0.038). Conclusion: We concluded that frequency of better glottic visualization and ease of tracheal intubation with McCoy blade is higher as compared to Macintosh blade. Keywords: Endotracheal intubation, Glottic visualization, McCoy blades, Macintosh blades.

Background: Pain is a common complaint of patients after surgery. Different techniques or medications including local anesthetics infiltration, non-steroidal anti-inflammatory drugs or opioids have been used for postoperative analgesia. Lidocaine is an amide local anesthetic agent that works by influencing the complex phenomenon of pain. Aim: To compare the mean pain score with intraoperative lidocaine versus control in patients undergoing laparoscopic cholecystectomy under general anesthesia. Methods: 350 patients aged 20-60 years of either sex scheduled for laparoscopic cholecystectomy were included in the study. Patients with allergy to lidocaine; patients with neuromuscular disease, endocrine or metabolic disorder and pregnant patients were excluded from study. Patients were randomly divided in two groups by using lottery method after taking informed consent. On arrival to the operating room, monitor was attached to display continuous ECG, mean arterial blood pressure, and arterial oxygen saturation. Results: In lidocaine group, the mean age of patients was 39.93±11.56years. In control group, the mean age of patients was 37.93±11.83years. In lidocaine group, there were 91 (52%) males and 84 (48%) females. In control group, there were 77 (44%) males and 98 (56%) females. In lidocaine group, the mean BMI of patients was 26.66±4.81kg/m2. In control group, the mean BMI of patients was 26.77±4.76kg/m2. In lidocaine group, the mean pain score of patients was 1.00±0.84. In control group, the mean pain score of patients was 2.39±1.10. The difference was significant (p<0.05). Conclusion: Thus lidocaine is found to be more effective in reducing postoperative pain than control. Keywords: General anesthesia, laparoscopic cholecystectomy, lidocaine, postoperative pain.

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