Objective: To compare the hemodynamic response to orotracheal intubation via direct laryngoscope versus fiberoptic bronchoscope in patients undergoing general anesthesia.Study Design: Comparative Study.Place and Duration of Study: Anesthesia Department of Military Hospital, Rawalpindi from 1st March to 30th May 2014.Materials and Methods: A total of 110 patients for elective surgeries with general anesthesia, were included and randomized into two groups. The patient in group F (n=55) were intubated by direct laryngoscopy (DLS) and group L (n=55) cases intubated by fiberoptic bronchoscopy (FOB). The hemodynamic response heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were recorded at baseline, at induction, at laryngoscopy, at the time of intubation and 3 minutes after intubation.Results: The age of the patients ranged between 19-45 years. Average age of participants was 33.76 and 31.56 and average weight of patients was 71.22±1.493 and 73.18±1.390 Kg in group F and L respectively. At induction, hemodynamic values dropped to 20% of the baseline values. At the time of intubation (laryngoscopy or fiberoptic bronchoscopy) and 3 min after intubation, hemodynamic values increased significantly (p<0.05) in both groups.Conclusion: Our study demonstrated that both groups (Fiberoptic bronchoscopy verses direct laryngoscopy) showed same hemodynamic responses during orotracheal intubations.

Objectives: To determine the safety and efficacy of Sevoflurane anaesthesia with a supraglottic airway device for MRI. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Anaesthesiology, of Pak Emirates Military Hospital, Rawalpindi Pakistan from Jul to Dec 2019. Methodology: A sample size of 152 patients were calculated, including both genders from birth to 12 years. After applying inclusion and exclusion criteria, patients were chosen to undergo inhalational anaesthesia with Sevoflurane, including supraglottic airway device (SAD) insertion. After MRI, SAD was removed upon awakening and patients were shifted to the post-anaesthesia care unit (PACU) for further monitoring. Results: The mean age of patients was 4.07±2.312 years. Out of 152 patients, ninety (60%) were males, and sixty patients (40%) were females. Hypoxemia was seen in 1.3% cases, laryngospasm in 1.3%, and apnoea in 8% and coughing in 5% patients. There were no any other complications. Conclusion: The study concluded that Sevoflurane anaesthesia with SAD is a safe and reliable technique for artefact-free MRI of paediatric patients.

Objective: To evaluate the prevailing practices regarding personal protective equipment in operation theaters. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, Karachi, from May to Jun 2020. Methodology: After the approval of the approval of the hospital ethical committee, 300 online forms were send. A total of 227 respondents returned the 22 questions survey forms. Data was collected and analyzed using online site www.surveyplanet.com. Results: A total of 203 forms were included in our final analysis. Most 128 (63.1%) were males with 90 (44.3%)common aged between 31-40 years and 168 (82.8%) working in tertiary care hospitals. One hundred and fiftyeight (77.8%) were routinely managing known Covid cases per-operatively. One hundred and seventy four(85.7%) reported that personal protective equipment was being provided by the hospital administration; 55(27.1%) have bought part of full protective equipment at their own expense; 72 (35.5%) re-using protective equipment; 167 (82.3%) being provided with N-95 masks and 120 (59.1%) re-using N-95 masks. One hundred and twenty one (59.6%) wearing level III protective gear during all surgeries. 192 (94.6%) respondents reportedmaintaining hand hygiene after each patient. Only 65 (32%) taking shower at the hospital at the end of their shift. Conclusion: Most of the operation theaters were providing protective equipment to their staff with nearly half reusing protective gear and N-95 masks.