Background Antibiotic resistant bacterial nosocomial infections are a leading problem in intensive care units (ICU). Objective 12(20.33%) in 2010, 2(20%) in 2011 and 13(25%) in 2012. only collistin sensitive organism identified was 28(23.14%).

Background The concept of ‘Pre-emptive analgesia’ suggest that the best post operative pain management begins preoperatively. Preemptive low dose ketamine is effective in treating post operative pain after total abdominal hysterectomy. Objectives This study was designed to evaluate the analgesic efficacy of preemptive low dose ketamine in treating moderate to severe acute post operative pain in total abdominal hysterectomy surgery under general anesthesia. Methods Sixty patients aged between 35-50 years, weight between 45-65 kg with ASA physical status I & II underwent elective total abdominal hysterectomy under general anesthesia were randomly divided into two groups. In group A, patients received 10 ml of normal saline I/V over 60-90 second before surgical incision. In group B, patients received 0.15 mg/kg ketamine (mixed with 10 ml normal saline) I/ V over 60-90 second before surgical incision. Anesthetic technique was standardized & patients were interviewed regularly. Pain score, analgesic consumption, side effects & quality of recovery score were recorded for 24 hours. Results Patient received preemptive ketamine had a statistically significant lower pain score in first 24 hours after operation compared with placebo group. Mean value of first analgesic demand in group A was 25.67±1.60 & group B was 57.33±2.97 & p = 0.00. Mean value of total opioids consumption in group A was 290.00±9.09 & group B was 210.67±7.01 & p = 0.00. Significant differences were observed between two groups regarding first analgesic demand & total analgesic consumption. There were no significant differences between these two groups in respect to haemodynamic variable or side effects. Conclusion Preemptive low dose intra venous ketamine offer a safe, non opioid, well-tolerated analgesia with efficacy in moderate to severe post operative pain & spare opioid consumption in the post operative pain management. JBSA 2012; 25(1): 3-8

Medication error is a major cause of morbidity and mortality in medical profession . There is an increasing recognition that medication errors are causing a substantial global public health problem, as many result in harm to patients and increased costs to health providers.Anaesthesia is now safe and routine, yet anaesthetists are not immune from making medication errors and the consequences of their mistakes may be more serious than those of doctors in other specialties. Steps are being taken to determine the extent of the problem of medication error in anaesthesia. In this review, incidence, types, risk factors and preventive measures of the medication errors are discussed in detail.Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 31-35

Background Pregnancies and deliveries are potentially at risk. Well supervised antenatal, intranatal and postnatal care can reduce this risk to a minimal acceptable level. Objective To find out perinatal outcome of high-risk pregnant patients in comparison with the normal pregnant women and to evaluate the utility of numerical scoring system in identifying high-risk pregnancy. Methods 200 patients were selected from the admitted patients in the obstetric ward of Bangabandhu Sheikh Mujib Medical University, Dhaka. Study patients were divided into three groups: 100 patients (control group) were normal pregnancy (score 0-2), 85 patients were high-risk ( score 3 – 6), and 15 patients were severe-risk (score 7 or more). Both case and control subjects were followed intranatally and postnatally up to the discharge from the above institutions. All types of abnormalities or complications like prolonged ist stage, 2nd stage, APH, PPH and all types of operative and non operative interventions were recorded in order to correlate with perinatal mortality, morbidity and maternal morbidity. Each patient was followed up to discharge from the hospital and abnormalities important for the study were recorded. Neonatal morbidity was defined for surviving newborn by Apgar score <7 at 5 minutes or birth weight < 2.5 kg. Results In normal pregnancy group, 43% needed to be delivered by caesarean section in comparison to 63 (74.1%) and 14 (93.33%) patients respectively in high-risk and severe-risk group (P <0.001). Maternal complication following normal vaginal delivery was highest (100%) in severe-risk group, followed by highrisk group (36.36%) and normal pregnancy (19.30%). Complications following caesarean section were also highest in severe-risk group (28.47%), followed by normal pregnancy (25.59%) and high-risk pregnancy (20.63%). Neonatal complications in normal pregnancy group was 30.23% in comparison 38.46% in high risk group. 6 (6%) of neonates in the normal pregnancy group had Apgar score < 7 at 5 minutes and in high risk and severe-risk groups, 10 (11.76%) and 7 (43.75%) of the neonates respectively had Apgar score <7 at 5 minutes (P < 0.001). In the severe-risk group, 8 (50%) of the babies had birth weight <2.5kg, which is higher than high and normal pregnancy group, i.e. 25 (28.41%) and 3 (3%), respectively(P<0.001). Higher perinatal deaths also occurred in high-risk and severe risk groups. Conclusion It can be concluded that the perinatal morbidity, mortality and maternal morbidity are significantly higher in high-risk pregnancies. This group, though represent only 20-30 percent of all pregnant patients, is responsible for 70-80 percent of the perinatal morbidity and mortality. JBSA 2012; 25(2): 59-65

This study was undertaken to find out the efficacy of oral premedication with ondansetron to prevent post-operative nausea and vomiting in diagnostic gynaecological laparoscopy assisted surgery and to compare it with metoclopramide. We studied fifty patients of ASA physical status I & II, aged between 18-30 years and body weight between 50-60 kgs. The patients were randomized in equal numbers into two groups; Group A patients were received Tab Metoclopramide 10 mg orally an hour before operation and regarded as control and Group B patients were received Tab Ondansetron (0.15 mg/kg) or total 8 mg orally an hour before operation as case. They received a standard general anesthetic. Post-operative analgesia was provided with per rectal diclofenac sodium (50mg). In the recovery room occurrences of nausea and vomiting was assessed for 24 hours. The incidence of nausea was 80% in Group-A, 24% in Group-B (p<0.001) and vomiting was 64% in Group-A, 16% in Group-B (p<0.001). The difference among the groups was statistically significant. Key words: Laparoscopy assisted gynaecological surgery, PONV, oral ondansetron, metoclopramide. Journal of BSA, 2008; 21(2): 67-71