At a Base Hospital. 2151 patients of militancy trauma were managed from Jan 1990 to 31 May 1993. It involved military. paramilitary, ex-servicemen, civilians, foreigners and antinational elements. The nature of trauma was either gun shot wounds ( 1333) or blast injuries (818). Polytrauma (multiple injury to soft tissue, bone. parenchyma with shock or injury to more than one body region) was seen in 862 patients. Standard protocol was evolved for initial management in lCU/acute surgical ward. Time taken for initial evaluation of injury. resuscitation. respiratory care and oxygen therapy. analgesics. blood group cross matching, antibiotics and preparation of the part before surgery was usually 45 min. Anaesthesia was induced with ketamine 2 mgJkg or thiopentone 3 mgJkg based on haemodynaemic response and maintained with N20 : 02 (50 : 50 ratio). relaxant controlled ventilation. Mortality was 3.8% including 4 deaths on operation table.

Regional anesthesia is preferred world-wide for its distinct advantages. The benefits of regional anesthesia in patients with comorbid conditions are well-established. The administration of regional anesthesia can sometimes pose a challenge to the anesthesiologist due to the structural abnormalities of the spine. The most common difficulty encountered for spinal anesthesia in our hospital (Nalgonda District) is skeletal fluorosis. Apart from the midline approach, paramedian, and Taylor's approaches are advocated for difficult scenarios. This article reports two orthopedic cases, conducted under a novel spinal anesthesia technique, i.e., transforaminal sacral approach under C-arm guidance with a successful outcome. The sacral foraminal subarachnoid block is a method to access the subarachnoid space through the upper posterior sacral foramina.

No abstract

Although these data were affected by limitations in power and study design, they suggest that peripheral B-lymphocyte function is altered as a result of TMP-SMX exposure in HIV-infected patients concurrently receiving zidovudine. Further study of this effect is warranted.

No abstract