Ovais Nazir - Academia.edu (original) (raw)

Papers by Ovais Nazir

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: Measurements of optic nerve sheath diameter (ONSD) in intracranial pathologies correl... more Background: Measurements of optic nerve sheath diameter (ONSD) in intracranial pathologies correlate well with raised ICP. Only recently the usefulness of ocular ultrasonography in preeclampsia has been sought. Objective of current study was the measurement of ONSD in preeclampsia and compare it to healthy pregnant females.Methods: A total of 90 subjects were included and divided into Group I- normal pregnancy (N=30), Group II - mild preeclampsia (N=30), Group III- severe preeclampsia group (N=30) and hemodynamic parameters. Optic nerve sheath diameter measurement is performed with a linear ultrasound probe placed over the eyelid with optic nerve sheath diameter measured 3 mm behind the globe. Patients with preeclampsia were compared to normal pregnant females as controls.Results: Optic nerve sheath diameter was significantly higher in patients with preeclampsia compared to controls (p<0.001). The mean of ONSD in group I was 4.5±0.2 mm, versus 5.7±0.2 mm in group II, versus, 5.9±...

The Gulf journal of oncology, 2015

Pheochromocytoma is a rare tumour which is usually suggested by sustained or paroxysmal hypertens... more Pheochromocytoma is a rare tumour which is usually suggested by sustained or paroxysmal hypertension however the spectrum of the presentation of pheochromocytoma continues to expand and hypertension may be absent despite excess catecholamine secretion. The normotensive pheochromocytoma is a distinct entity and as in the case we report the presentation was quite unique as well as the intraoperative behaviour was stormy.

Archives of Anesthesia and Critical Care, 2021

Background: Supracondylar fracture of the humerus is one of the commonly encountered injuries in ... more Background: Supracondylar fracture of the humerus is one of the commonly encountered injuries in paediatric age group accounting for 16% of all paediatric fractures and 60% of all paediatric elbow fractures, classically occurring as a result of fall on an outstretched hand. Regional anesthesia may represent one of the best solutions for intraoperative and postoperative paediatric pain management however, due to lack of proficiency and the increased risk of complications in children and difficulty in obtaining cooperation compared to adults, it is not the method of choice for most of the anesthesiologists in children. Methods: A total of 50 paediatric patients were included who were to undergo CRPP and divided into two groups Group I- General anaesthesia alone (n = 25), Group II- General anaesthesia with USG guided supraclavicular brachial plexus block studied for the intraoperative opioid consumption as well as postoperative analgesia quality, duration and Opioid consumption. Result...

Sri Lankan Journal of Anaesthesiology, 2019

Background: Addition of adjuvants to local anaesthetic in supraclavicular brachial plexus block h... more Background: Addition of adjuvants to local anaesthetic in supraclavicular brachial plexus block helps in improving duration of block and analgesia. We compare clonidine and dexmedetomidine as adjuvants to ropivacaine in supraclavicular brachial plexus block. Method: A total of 75 patients aged from 20 to 60 years belonging to ASA I-II scheduled for upper limb surgery were included and divided into three groups-Group I received 0.5% ropivacaine plus normal saline, Group II received 0.5% ropivacaine plus clonidine and Group III received 0.5% ropivacaine plus dexmedetomidine. The patients were compared for onset as well as duration of sensory and motor blockade, duration of analgesia and haemodynamic side effects. Results: The mean duration of sensory and motor block as well as analgesia was found to be more (statistically highly significant p<0.001) in group III (dexmedetomidine group) having a much longer duration of sensory and motor block as well as analgesia compared to group I (plain ropivacaine) and group II (clonidine group). Conclusion: Therefore, in present study it was found that addition of clonidine and dexmedetomidine to 0.5% ropivacaine are effective in supraclavicular brachial plexus block. However, dexmedetomidine is a better alternative to clonidine as adjuvant for 0.5% ropivacaine in to obtain early onset and prolong the duration of sensory and motor block and postoperative analgesia.

Indian Journal of Clinical Anaesthesia, 2019

Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its ... more Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its advantages of rapid and predictable onset, no airway handling, safe to mother and minimal drug exposure to fetus. But spinal anaesthesia caesarean section is associated with high incidence of IONV. Role of ondansetrone as antiemetic is well established. Not many studies are there for low dose ketamine in prevention of IONV. Materials and Methods: A total of 225 pregnant patients scheduled for CS under spinal anaesthesia were included and divided into three groups Group I-Patients who received low dose ketamine, group II-Patients who received ondansetron, group III-Patients who received normal saline. The patients were compared for intraoperative hemodynamic parameters, IONV, side effects like sedation and shivering. Results: The results of this study showed low dose ketamine group (group I) 26.6% and ondansetron (group II) 32% had lower incidence of IONV in comparison to control group 49.3%. Conclusion: Low dose ketamine and ondansetron are both good agents for reduction of IONV during CS in pregnant patients under spinal anaesthesia without significant adverse effects.

Trauma Monthly, 2016

Background: The importance of decreasing bleeding in spine surgery is not only important to maint... more Background: The importance of decreasing bleeding in spine surgery is not only important to maintain the patient's hemodynamic balance but also allow a better view of the surgical field. Objectives: The current study aimed to compare dexmedetomidine and Esmolol™ as agents to induce hypotension in lumbar spine surgeries. Patients and Methods: A total of 50 patients aged 20 to 65 years belonging to the American society of anaesthesiologist (ASA) class I-II scheduled for decompression and fixation of the lumbar spine were included and divided into two groups namely, Group I, who received Esmolol and group II, who received dexmedetomidine, intravenously. The patients were compared for intraoperative hemodynamic parameters, estimated blood loss, operation time, intraoperative analgesic (fentanyl) consumption, and total fall in haemoglobin (Hb) during the perioperative period. Results: The study results showed that dexmedetomidine had lower (100.8 µg) fentanyl and sevoflurane consumption (1.2%), and less blood loss (278 mL) in comparison to the Esmolol group. Conclusions: Both dexmedetomidine and Esmolol can be used as agents to control hypotension in patients undergoing lumbar spine decompression and fixation surgery; the dexmedetomidine group, however, was associated with better intraoperative hemodynamic stability and reduced intraoperative analgesic and volatile anaesthetic requirement.

International Journal of Contemporary Surgery, 2013

The palladium-catalyzed oxidative carbonylation of phenylacetylene (PCPOC reaction) is known to e... more The palladium-catalyzed oxidative carbonylation of phenylacetylene (PCPOC reaction) is known to exhibit autonomous oscillations in a variety of parameters including pH, redox potential and heat of reaction. Previous studies report that external addition of both an oxidizing agent and water is required to allow production/ consumption of H ? in an oscillatory fashion. In this work we show that solutions of PdI 2 / KI dried over 3 Å molecular sieves can catalyze phenylacetylene carbonylation in the absence of an external oxidizing agent. Oscillations are readily achieved in this considerably simplified PCPOC system. Palladium-catalyzed carbonylation of methanol generates HI as a by-product, which can react with excess KI and methanol producing methyl iodide and water in situ. Methyl iodide can also undergo decomposition, generating iodine as an internally formed oxidizing agent, which accounts for recorded catalyst regeneration. Oscillations are observed in the pH range 1.5-3.5 commencing, at the earliest, 70 min after introduction of phenylacetylene. Oscillations vary in period between 1 and 3.5 h and last for several days. The onset of oscillations may be delayed via portion-wise addition of the phenylacetylene substrate.

International Journal of Research in Medical Sciences, 2014

Background: The importance of decreasing bleeding in spine surgery is not only important to keep ... more Background: The importance of decreasing bleeding in spine surgery is not only important to keep the patient's hemodynamic balance but also allow a better view of surgical field which has the vicinity of major and highly fragile neurologic structures.Various agents have been used to provide controlled hypotension that include direct acting vasodilators (sodium nitroprusside-nitroglycerin), ganglion-blocking agents, beta adrenergic blockers (esmolol), calcium channel blockers (nicardipine), α 2 -agonists (clonidine-dexmedetomidine), and magnesium sulphate. Methods: The aim of this present study was to compare the dexmedetomidine and esmolol infusions as agents for hypotensive anaesthesia in lumbar spine decompression and fixation surgeries and compare the intraoperative hemodynamic parameters, estimated blood loss, operative time, intraoperative analgesic (fentanyl) consumption, and total fall in Haemoglobin (HB) during perioperative period. Results: The results of this study showed dexmedetomidine group (group III) had low (100.8 mcg) fentanyl consumption in comparison to esmolol (140.83 mcg) and control (180 mcg).Also sevoflurane consumption was least in dexmedetomidine group (dexmedetomidine group sevoflurane use 1.2%, esmolol group 2.19%, control group 2.5%).The total intraoperative blood loss was least in dexmedetomidine group (210.8 ml), when compared to esmolol group (328.33) and control group (580). Conclusion: The results of this study showed that both dexmedetomidine and esmolol can be used as agents for controlled hypotension in patients undergoing lumbar spine decompression and fixation surgery with dexmedetomidine group, however, was associated with better intraoperative haemodynamic stability, reduced intraoperative analgesic and volatile anestheic requirement.

International Journal of Research in Medical Sciences, 2014

Placement of CVC can lead to complications such as, malposition of the catheter and complications... more Placement of CVC can lead to complications such as, malposition of the catheter and complications relating to perforation and/or injury of nearby blood vessels and structures. We present a case report is about malposition of central venous catheter (CVC) from right internal jugular vein (IJV) into right subclavian and axillary vein. It is advisable to check free venous outflow in all the ports of CVC, central venous waveform should obtained with transducer in place and following placement of CVC catheter, chest radiograph should be completed to confirm the position.

Journal of the Scientific Society, 2014

Placement of central venous catheter (CVC) can lead to complications such as, malposition of cath... more Placement of central venous catheter (CVC) can lead to complications such as, malposition of catheter and perforation and/or injury of nearby blood vessels and structures. We present a case about malposition of central venous catheter (CVC) from right internal jugular vein (IJV) into right intra pleural space. It is advisable to check free venous outflow in all the ports of CVC following placement of CVC catheter. Chest radiograph should be taken to confirm the position.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019

Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique,... more Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique, without risk of major haemorrhage, early postoperative ambulation and alimentation, making it suitable for ambulatory surgery. The choice of aneasthesia for laparoscopic ligation hence should consider the anaesthetic agents with a rapid onset of action and fast recovery time, with minimal problems for intraoperative control of haemodynamic, airway and pain relief as well as take consideration of the safety, quality, efficacy, and utilization of resources available to the given situation.Methods: A total of 100 patients aged from 18 to 45 years who were scheduled to undergo laparoscopic tubal ligation were divided into Group I- Ketamine plus pentazocine group (n=50), Group II- Propofol plus fentanyl group (n=50) and studied for the intraoperative parameters (hemodynamic and respiratory profile), recovery time, postoperative side effects and discharge time.Results: Intraoperatively MAP...

IP innovative publication pvt. ltd, 2019

Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its ... more Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its advantages of rapid and predictable onset,
no airway handling, safe to mother and minimal drug exposure to fetus. But spinal anaesthesia caesarean section is associated with high
incidence of IONV. Role of ondansetrone as antiemetic is well established. Not many studies are there for low dose ketamine in prevention
of IONV.
Materials and Methods: A total of 225 pregnant patients scheduled for CS under spinal anaesthesia were included and divided into three
groups Group I – Patients who received low dose ketamine, group II- Patients who received ondansetron, group III- Patients who received
normal saline. The patients were compared for intraoperative hemodynamic parameters, IONV, side effects like sedation and shivering.
Results: The results of this study showed low dose ketamine group (group I) 26.6% and ondansetron (group II) 32% had lower incidence
of IONV in comparison to control group 49.3%.
Conclusion: Low dose ketamine and ondansetron are both good agents for reduction of IONV during CS in pregnant patients under spinal
anaesthesia without significant adverse effects.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: Measurements of optic nerve sheath diameter (ONSD) in intracranial pathologies correl... more Background: Measurements of optic nerve sheath diameter (ONSD) in intracranial pathologies correlate well with raised ICP. Only recently the usefulness of ocular ultrasonography in preeclampsia has been sought. Objective of current study was the measurement of ONSD in preeclampsia and compare it to healthy pregnant females.Methods: A total of 90 subjects were included and divided into Group I- normal pregnancy (N=30), Group II - mild preeclampsia (N=30), Group III- severe preeclampsia group (N=30) and hemodynamic parameters. Optic nerve sheath diameter measurement is performed with a linear ultrasound probe placed over the eyelid with optic nerve sheath diameter measured 3 mm behind the globe. Patients with preeclampsia were compared to normal pregnant females as controls.Results: Optic nerve sheath diameter was significantly higher in patients with preeclampsia compared to controls (p<0.001). The mean of ONSD in group I was 4.5±0.2 mm, versus 5.7±0.2 mm in group II, versus, 5.9±...

The Gulf journal of oncology, 2015

Pheochromocytoma is a rare tumour which is usually suggested by sustained or paroxysmal hypertens... more Pheochromocytoma is a rare tumour which is usually suggested by sustained or paroxysmal hypertension however the spectrum of the presentation of pheochromocytoma continues to expand and hypertension may be absent despite excess catecholamine secretion. The normotensive pheochromocytoma is a distinct entity and as in the case we report the presentation was quite unique as well as the intraoperative behaviour was stormy.

Archives of Anesthesia and Critical Care, 2021

Background: Supracondylar fracture of the humerus is one of the commonly encountered injuries in ... more Background: Supracondylar fracture of the humerus is one of the commonly encountered injuries in paediatric age group accounting for 16% of all paediatric fractures and 60% of all paediatric elbow fractures, classically occurring as a result of fall on an outstretched hand. Regional anesthesia may represent one of the best solutions for intraoperative and postoperative paediatric pain management however, due to lack of proficiency and the increased risk of complications in children and difficulty in obtaining cooperation compared to adults, it is not the method of choice for most of the anesthesiologists in children. Methods: A total of 50 paediatric patients were included who were to undergo CRPP and divided into two groups Group I- General anaesthesia alone (n = 25), Group II- General anaesthesia with USG guided supraclavicular brachial plexus block studied for the intraoperative opioid consumption as well as postoperative analgesia quality, duration and Opioid consumption. Result...

Sri Lankan Journal of Anaesthesiology, 2019

Background: Addition of adjuvants to local anaesthetic in supraclavicular brachial plexus block h... more Background: Addition of adjuvants to local anaesthetic in supraclavicular brachial plexus block helps in improving duration of block and analgesia. We compare clonidine and dexmedetomidine as adjuvants to ropivacaine in supraclavicular brachial plexus block. Method: A total of 75 patients aged from 20 to 60 years belonging to ASA I-II scheduled for upper limb surgery were included and divided into three groups-Group I received 0.5% ropivacaine plus normal saline, Group II received 0.5% ropivacaine plus clonidine and Group III received 0.5% ropivacaine plus dexmedetomidine. The patients were compared for onset as well as duration of sensory and motor blockade, duration of analgesia and haemodynamic side effects. Results: The mean duration of sensory and motor block as well as analgesia was found to be more (statistically highly significant p<0.001) in group III (dexmedetomidine group) having a much longer duration of sensory and motor block as well as analgesia compared to group I (plain ropivacaine) and group II (clonidine group). Conclusion: Therefore, in present study it was found that addition of clonidine and dexmedetomidine to 0.5% ropivacaine are effective in supraclavicular brachial plexus block. However, dexmedetomidine is a better alternative to clonidine as adjuvant for 0.5% ropivacaine in to obtain early onset and prolong the duration of sensory and motor block and postoperative analgesia.

Indian Journal of Clinical Anaesthesia, 2019

Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its ... more Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its advantages of rapid and predictable onset, no airway handling, safe to mother and minimal drug exposure to fetus. But spinal anaesthesia caesarean section is associated with high incidence of IONV. Role of ondansetrone as antiemetic is well established. Not many studies are there for low dose ketamine in prevention of IONV. Materials and Methods: A total of 225 pregnant patients scheduled for CS under spinal anaesthesia were included and divided into three groups Group I-Patients who received low dose ketamine, group II-Patients who received ondansetron, group III-Patients who received normal saline. The patients were compared for intraoperative hemodynamic parameters, IONV, side effects like sedation and shivering. Results: The results of this study showed low dose ketamine group (group I) 26.6% and ondansetron (group II) 32% had lower incidence of IONV in comparison to control group 49.3%. Conclusion: Low dose ketamine and ondansetron are both good agents for reduction of IONV during CS in pregnant patients under spinal anaesthesia without significant adverse effects.

Trauma Monthly, 2016

Background: The importance of decreasing bleeding in spine surgery is not only important to maint... more Background: The importance of decreasing bleeding in spine surgery is not only important to maintain the patient's hemodynamic balance but also allow a better view of the surgical field. Objectives: The current study aimed to compare dexmedetomidine and Esmolol™ as agents to induce hypotension in lumbar spine surgeries. Patients and Methods: A total of 50 patients aged 20 to 65 years belonging to the American society of anaesthesiologist (ASA) class I-II scheduled for decompression and fixation of the lumbar spine were included and divided into two groups namely, Group I, who received Esmolol and group II, who received dexmedetomidine, intravenously. The patients were compared for intraoperative hemodynamic parameters, estimated blood loss, operation time, intraoperative analgesic (fentanyl) consumption, and total fall in haemoglobin (Hb) during the perioperative period. Results: The study results showed that dexmedetomidine had lower (100.8 µg) fentanyl and sevoflurane consumption (1.2%), and less blood loss (278 mL) in comparison to the Esmolol group. Conclusions: Both dexmedetomidine and Esmolol can be used as agents to control hypotension in patients undergoing lumbar spine decompression and fixation surgery; the dexmedetomidine group, however, was associated with better intraoperative hemodynamic stability and reduced intraoperative analgesic and volatile anaesthetic requirement.

International Journal of Contemporary Surgery, 2013

The palladium-catalyzed oxidative carbonylation of phenylacetylene (PCPOC reaction) is known to e... more The palladium-catalyzed oxidative carbonylation of phenylacetylene (PCPOC reaction) is known to exhibit autonomous oscillations in a variety of parameters including pH, redox potential and heat of reaction. Previous studies report that external addition of both an oxidizing agent and water is required to allow production/ consumption of H ? in an oscillatory fashion. In this work we show that solutions of PdI 2 / KI dried over 3 Å molecular sieves can catalyze phenylacetylene carbonylation in the absence of an external oxidizing agent. Oscillations are readily achieved in this considerably simplified PCPOC system. Palladium-catalyzed carbonylation of methanol generates HI as a by-product, which can react with excess KI and methanol producing methyl iodide and water in situ. Methyl iodide can also undergo decomposition, generating iodine as an internally formed oxidizing agent, which accounts for recorded catalyst regeneration. Oscillations are observed in the pH range 1.5-3.5 commencing, at the earliest, 70 min after introduction of phenylacetylene. Oscillations vary in period between 1 and 3.5 h and last for several days. The onset of oscillations may be delayed via portion-wise addition of the phenylacetylene substrate.

International Journal of Research in Medical Sciences, 2014

Background: The importance of decreasing bleeding in spine surgery is not only important to keep ... more Background: The importance of decreasing bleeding in spine surgery is not only important to keep the patient's hemodynamic balance but also allow a better view of surgical field which has the vicinity of major and highly fragile neurologic structures.Various agents have been used to provide controlled hypotension that include direct acting vasodilators (sodium nitroprusside-nitroglycerin), ganglion-blocking agents, beta adrenergic blockers (esmolol), calcium channel blockers (nicardipine), α 2 -agonists (clonidine-dexmedetomidine), and magnesium sulphate. Methods: The aim of this present study was to compare the dexmedetomidine and esmolol infusions as agents for hypotensive anaesthesia in lumbar spine decompression and fixation surgeries and compare the intraoperative hemodynamic parameters, estimated blood loss, operative time, intraoperative analgesic (fentanyl) consumption, and total fall in Haemoglobin (HB) during perioperative period. Results: The results of this study showed dexmedetomidine group (group III) had low (100.8 mcg) fentanyl consumption in comparison to esmolol (140.83 mcg) and control (180 mcg).Also sevoflurane consumption was least in dexmedetomidine group (dexmedetomidine group sevoflurane use 1.2%, esmolol group 2.19%, control group 2.5%).The total intraoperative blood loss was least in dexmedetomidine group (210.8 ml), when compared to esmolol group (328.33) and control group (580). Conclusion: The results of this study showed that both dexmedetomidine and esmolol can be used as agents for controlled hypotension in patients undergoing lumbar spine decompression and fixation surgery with dexmedetomidine group, however, was associated with better intraoperative haemodynamic stability, reduced intraoperative analgesic and volatile anestheic requirement.

International Journal of Research in Medical Sciences, 2014

Placement of CVC can lead to complications such as, malposition of the catheter and complications... more Placement of CVC can lead to complications such as, malposition of the catheter and complications relating to perforation and/or injury of nearby blood vessels and structures. We present a case report is about malposition of central venous catheter (CVC) from right internal jugular vein (IJV) into right subclavian and axillary vein. It is advisable to check free venous outflow in all the ports of CVC, central venous waveform should obtained with transducer in place and following placement of CVC catheter, chest radiograph should be completed to confirm the position.

Journal of the Scientific Society, 2014

Placement of central venous catheter (CVC) can lead to complications such as, malposition of cath... more Placement of central venous catheter (CVC) can lead to complications such as, malposition of catheter and perforation and/or injury of nearby blood vessels and structures. We present a case about malposition of central venous catheter (CVC) from right internal jugular vein (IJV) into right intra pleural space. It is advisable to check free venous outflow in all the ports of CVC following placement of CVC catheter. Chest radiograph should be taken to confirm the position.

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019

Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique,... more Background: Laparoscopic tubal ligation have advantages of minimally invasive surgical technique, without risk of major haemorrhage, early postoperative ambulation and alimentation, making it suitable for ambulatory surgery. The choice of aneasthesia for laparoscopic ligation hence should consider the anaesthetic agents with a rapid onset of action and fast recovery time, with minimal problems for intraoperative control of haemodynamic, airway and pain relief as well as take consideration of the safety, quality, efficacy, and utilization of resources available to the given situation.Methods: A total of 100 patients aged from 18 to 45 years who were scheduled to undergo laparoscopic tubal ligation were divided into Group I- Ketamine plus pentazocine group (n=50), Group II- Propofol plus fentanyl group (n=50) and studied for the intraoperative parameters (hemodynamic and respiratory profile), recovery time, postoperative side effects and discharge time.Results: Intraoperatively MAP...

IP innovative publication pvt. ltd, 2019

Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its ... more Introduction: Spinal anaesthesia is considered as gold standard for caesarean section due to its advantages of rapid and predictable onset,
no airway handling, safe to mother and minimal drug exposure to fetus. But spinal anaesthesia caesarean section is associated with high
incidence of IONV. Role of ondansetrone as antiemetic is well established. Not many studies are there for low dose ketamine in prevention
of IONV.
Materials and Methods: A total of 225 pregnant patients scheduled for CS under spinal anaesthesia were included and divided into three
groups Group I – Patients who received low dose ketamine, group II- Patients who received ondansetron, group III- Patients who received
normal saline. The patients were compared for intraoperative hemodynamic parameters, IONV, side effects like sedation and shivering.
Results: The results of this study showed low dose ketamine group (group I) 26.6% and ondansetron (group II) 32% had lower incidence
of IONV in comparison to control group 49.3%.
Conclusion: Low dose ketamine and ondansetron are both good agents for reduction of IONV during CS in pregnant patients under spinal
anaesthesia without significant adverse effects.