Browsing by Author "Gupta, Mahima"
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Item Comparison of two different doses of hyperbaric bupivacaine for intracavitary radiotherapy in patients with carcinoma cervix ? A randomized control trial(Wolters Kluwer - Medknow, 2023-06) Gupta, Mahima; Gupta, Nishkarsh; Abrol, Nupur; Kumar, Vinod; Bharti, Sachidanand Jee; Garg, Rakesh; Mishra, Seema; Kumar, Rajeev; Bhatnagar, SushmaBackground: Subarachnoid block has been used for intracavitary radiotherapy (ICRT) for carcinoma cervix, but the literature on the appropriate dose of local anesthetic required to achieve the desired effect is lacking. We compared two different intrathecal doses of 0.5% hyperbaric bupivacaine (1.2 and 1.5 mL) for providing optimal surgical conditions and readiness to discharge in patients undergoing ICRT for carcinoma cervix. Materials and Methods: This prospective double?blind study was done in 80 patients undergoing ICRT. The patients were randomized into two groups (Groups I and II) to receive 1.2 and 1.5 mL of intrathecal hyperbaric bupivacaine, respectively, for ICRT. The level of sensory achieved, the patient satisfaction score, radiation oncologist score, time to L5 regression, and time to motor recovery (walking unaided) were assessed. Statistical Analysis Used: The data were analyzed using SPSS 20 for Windows (IBM, Chicago, IL, USA). Results: The time taken for the block to regress to L5 (Group I: 134.6 � 32.4 minutes vs. Group II: 143.2 � 43.0 minutes, P = 0.31) were comparable. However, the mean time for walking unaided (Group I: 220.87 � 47.12 minutes versus Group II: 247.00 � 49.83 minutes, P = 0.032) after the subarachnoid block was significantly less in Group I. The patient satisfaction with the procedure and overall satisfaction of the radiation oncologists regarding the operating condition were comparable in both the groups. Conclusions: Hence, a 1.2 mL dose of intrathecal hyperbaric bupivacaine for ICRT provides optimal surgical conditions with hemodynamic stability and ensures the early discharge of the patient.Item Cotard’s syndrome in the postoperative period following head and neck cancer surgery – A case report(Wolters Kluwer - Medknow, 2022-06) Thakur, Nitish; Gupta, Mahima; Gupta, Raghav; Mishra, SeemaMajor head and neck surgery is a known factor for postoperative delirium; however, Cotard’s syndrome (CS) has been rarely reported following head and neck surgery. We report a case of a 51?year?old man who underwent surgery for carcinoma right buccal mucosa and developed agitation and nihilistic delusion after extubation. The patient had a preexisting psychiatric history which is often reported as a risk factor for CS. Of interest, though is that this condition subsided as quickly as it emerged with only supportive counselling and brief pharmacotherapy.