Background: Despite the tremendous progressive evolution in the field of medicine, wherein, most of the diseases can be diagnosed based on history, clinical examination and investigations, there are quite a number of diseases which remain undiagnosed. It is here, where the role of diagnostic laparoscopy becomes important to reach to a conclusion for further management of patients.Methods: This study comprising of 70 patients undergoing diagnostic laparoscopy at SKIMS over a period of 4 years. This study was done to evaluate the role of diagnostic laparoscopy in patients with acute and chronic abdominal conditions wherein final diagnosis could not be achieved after all necessary imaging, serological, cytological, and microbiological investigations.Results: Out of 70 patients subjected to diagnostic laparoscopy in our study, the commonest indication was as cites of undetermined etiology (42.9%) followed by chronic abdominal pain (25.7%) diffuse liver disease (11.4%) acute abdominal pain (SAIO, cholecystitis, acute appendicitis, PID, endometriosis) (5.7%) abdominal tuberculosis (4.3%) focal liver disease (2.9%) bleeding per rectum (2.9%) abdominal malignancy (2.9%) and primary infertility (1.4)%. The post diagnostic laparoscopy outcome (final diagnosis) were abdominal malignancy 22 (31.4%) followed by abdominal tuberculosis 16 (22.9%) diffuse liver disease 6 (8.6%) focal liver disease 6 (8.6%) PID 4 (5.7%) SAIO 4 (5.7%) post-operative pelvic adhesions 3 (4.3%) Meckel’s diverticulum 2 (2.9%) abdominal plus pulmonary tuberculosis 1 (1.4%), endometriosis 1 (1.4%), ovarian cyst 1 (1.4%), pseudomyxoma peritonei 1 (1.4%), chronic appendicitis 1 (1.4%) and inconclusive 2 (2.9%). Diagnostic laparoscopy confirmed pre-operative diagnosis in 10 (14.3%) patients. In 29 (41.4%) patients pre-operative diagnosis was corrected by diagnostic laparoscopy. In 29 (41.4%) patients diagnosis was made only after diagnostic laparoscopy.Conclusions: Diagnostic laparoscopy is a safe, quick, and effective adjunct to non surgical diagnostic modalities, for establishing a conclusive diagnosis with high percentage of accuracy in diagnosis and impact in further management in selected patients.

No abstract

BACKGROUND Pre-oxygenation with 100% oxygen is performed routinely before induction of anaesthesia. The purpose of pre-oxygenation is to increase the body oxygen stores and to replace nitrogen in the lungs by an equivalent volume of oxygen, thus delaying the onset of oxygen desaturation and hypoxemia during the apnoeic period following induction of anaesthesia. The objectives of this study were to compare the effects of varying periods of preoxygenation on intraoperative oxygen saturation and its hemodynamic effect. MATERIALS AND METHODS Sixty adults ASA I and II patients scheduled for surgery under general anaesthesia were divided into three groups according to method of pre-oxygenation. In Group 1 (n=20) patients were preoxygenated for 60 seconds, Group 2 (n=20) patients were pre-oxygenated for 120 seconds and Group 3 (n=20) patients were preoxygenated for three minutes of tidal volume breathing using oxygen flow of 6 Lmin-1. Following preoxygenation, face mask oxygenation was continued until the patient got relaxed and then trachea was intubated. Intraoperative saturation was measured using pulse oximetry after every 5 minutes along with other hemodynamic parameters. RESULTS The mean values of intraoperative oxygen saturation at 5 min, 10 min, 15 min and 20 min among three groups did not fall significantly and were statistically non-significant between the three groups (p value of > 0.05). Likewise, at different intervals of intraoperative stage like after 30 min, 45 min, 60 min, 75 min, 90 min, 105 minutes, the values remain same and statistically non-significant (p value> 0.05). Regarding vital parameters (heart rate, blood pressure, respiratory rate, oxygen saturation), there was non-significant difference between the three study groups (p value >0.05). CONCLUSION Rapid preoxygenation by one-minute and two-minutes, normal tidal volume breathing technique is equally efficient to three minutes of preoxygenation in healthy patients.