AbstracBackground: Acute normovolaemic haemodilution (ANH) is one of the types of autotransfusion which can be used as an alternative method of replacing lost blood during surgery. Normovolaemia has to be maintained during ANH by administering sufficient volume of haemodiluents either crystalloids or colloids. Aim: To compare prospectively the effects of two haemodiluents, Crystalloid (Ringer lactate) and Colloid (Polygeline) in moderate Acute Normovolaemic haemodilution (ANH). Methodology: 50 patients(ASA physical status I or II) undergoing elective gynaecological surgeries with an estimated prediction of blood loss from 500-750ml in each patient were divided into two groups of 25 each. In Group R – Ringer lactate in the ratio of 3:1 and in Group H –Polygeline (Haemaccel) in the ratio of 1.5:1 were used during haemodilution. Heart rate, systolic BP, diastolic BP, SPO2 and Haematocrit were observed before and after haemodilution, before and after retransfusion of the blood. All the data were analyzed using Student’s ‘t’ test and P values < 0.05 were taken to be significant. Results: During all the stages there were no statistical differences in heart rate, systolic BP, Diastolic BP, SPO2, Haematocrit and surgical blood loss between the two groups. Conclusion: We conclude that during moderate acute normovolaemic haemodilution(ANH) either Ringer’s lactate or Polygeline(Haemaccel) can be used as replacement fluid as both are comparable in terms of haemodynamic stability, oximetric and haematological profiles.

ABSTRACT Background: Tuberculosis (TB) remains a major health problem across the world and commonly involves the lungs. Analysis of adenosine deaminase activity is a very useful diagnostic approach to achieve a more rapid and precise diagnosis in serosal fluids and serum of pulmonary tuberculosis.  Objectives: To estimate the serum adenosine deaminase (ADA) levels in pulmonary tuberculosis and other common respiratory diseases & to evaluate the role of serum ADA estimation in differentiation of tubercular and common non tubercular respiratory diseases. Methods:  The study was a hospital based, non randomized comparative study conducted at Kempegowda Institute of Medical Sciences, Bangalore and DOT centres of RNTCP, BBMP, Bangalore.                                        We measured serum adenosine deaminase levels in 3 groups, group Ι: 41 cases of pulmonary tuberculosis, group ΙΙ: 30 cases of tubercular pleural effusion, group ΙΙΙ: 49 cases of non tubercular respiratory diseases viz, bronchiectasis, chronic bronchitis in the age group of 20 – 64 years over a period of one year. Age and sex matched 30 healthy volunteers, were taken as controls. Estimation of serum ADA was done by sensitive colorimetric method described by Giusti and Galanti m Results: Mean serum ADA levels in cases of pulmonary tuberculosis (50.93 ± 9.22 U/L), tubercular pleural effusion (42.48 ± 8.2 U/L), non tubercular respiratory diseases (21.03±3.64 U/L) were significantly more than controls (17.07±2.71U/L). But the mean serum ADA value between  pulmonary  tuberculosis and non tubercular respiratory diseases shows higher significant mean difference and was  statistically significant with a p value < 0.01. The mean difference of serum ADA levels between the tubercular pleural effusion and non tubercular respiratory diseases was also statistical significant with a p value < 0.01. Conclusion: We conclude that elevated serum ADA level in pulmonary tuberculosis is statistically significant compared to non tubercular respiratory diseases and healthy controls.

Abstract A forty two year old male, a chronic smoker, was posted for lumbar discectomy at L3-4 level. General anaesthesia was administered and was maintained with isoflurane and nitrous oxide with oxygen. On turning the patient to prone position, the patient developed hypoxaemia. Air entry was reduced on the left lung field along with a rise in peak inspiratory pressure. CT scan of the thorax showed left sided pneumothorax, pneumomediastinum and subcutaneous emphysema. A chest tube thoracostomy was done and the patient made an uneventful recovery. We recommend that pneumothorax should be considered a possibility in any patient who has unexplained hypoxaemia during general anaesthesia and exercise caution while using nitrous oxide in chronic smokers.

ABSTRACT Background: Smoking now is identified as a major cause of respiratory diseases, heart related ailments, cancer and a wide variety of other health problems. The total number of tobacco users in the world has been estimated at 1.2 billion, which is expected to rise 1.6 billion during 2020’s.At present, tobacco use causes death of    3.5 ­to 4 million people globally and expected to increase about 10 million during 2020’s. It is well known that the acute effects of smoking produce an increase in systolic and diastolic blood pressure, tachycardia, cardiac output and vasoconstriction, increase in carotid artery occlusion, and sometimes instantaneous MI.  The present study is being undertaken to study the effects of smoking on electrocardiogram and blood pressure among smokers and non-smokers.Objectiv   To study the variation of ECG wave forms in healthy young smokers compared to nonsmokersMethodology: The study was conducted in the Department of Physiology, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka. The study included 100 apparently healthy males, 50 smokers and 50 non-smokers, between ages 20-35 years. Demographic data, history of smoking habit (quantity and duration) and detailed medical history were obtained from the subjects. Electrocardiogram was recorded during resting state in supine position. The ECG recordings were evaluated for different parameters like heart rate, PR interval, QRS complex, QRS axis, QT interval, QTc interval, ST segment, Q wave and T wave. Results were compared from the two groups using statistical tools.Results: There was statistically significant increase in heart rate, decrease in PR interval, decrease in QT interval, increase in QTc interval, decrease in QRS axis, decrease in T wave amplitude, occurrence of Q wave in smokers when compared to non-smokers.

ABSTRACT Heart Rate Variability (HRV) is a specific and sensitive noninvasive tool to evaluate cardiac autonomic activity. Our study focuses on using Heart Rate Variability to determine and compare cardiac autonomic status in asymptomatic and symptomatic menopausal women. Methods: Subjects were categorized as asymptomatic menopausal women (n=50) and symptomatic menopausal women (n=50) based on 21 postmenopausal symptoms given in The Greene Climacteric Scale. ECG was recorded in a quiet room with the subject in supine position after 10 minutes of rest. Analog ECG signal was converted to digital by using National Instruments NI-DAQ 7.5 USBD 6008. HRV parameters like SDNN, E: I, LF nu, HF nu, LF/HF was calculated with the help of HRV software (version 1.1). Results: There was a significant (p<0.001) decrease in SDNN, E/I ratio, HF nu and a significant (p<0.001) increase in LF nu, LF/HF in symptomatic women, compared with asymptomatic women. Conclusion: In symptomatic menopausal women our study showed a significant reduction in parasympathetic activity and a significant increase in sympathetic activity. There was a shift in the sympathovagal balance towards sympathetic predominance among symptomatic menopausal women in contrast to asymptomatic menopausal women.