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Background: Gastric cancer (GC) is one of the leading causes of mortality and morbidity and adds significantly financial burden to patient and their family on healthcare. The incidence of gastric cancer continues to increase in Bangladesh; therefore there is unmet need of promising treatment modalities. Objective: To investigate the survival of patients undergoing gastric cancer surgery with epidural combined with general anesthesia (EGA) and general anesthesia alone (GA). Methods: A retrospectively observation study was carried out at the Dept. of Anesthesia, National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka, Bangladesh from June 2021 March 2022. 451 patients with gastric cancer who were scheduled for radical resection. Propensity score matching was performed at a 1:1 ratio between GA (n=75) and EGA (n=75) to reduce selection bias. Univariate and multivariate analyses were used to identify factors significantly correlated with recurrence and/or metastasis and prognosis. The 3-year overall survival rates of patients receiving EGA and GA alone were compared. Results: After the propensity scores were matched, there were 75 patients who underwent EGA and 75 patients who underwent GA. For the entire population, reconstruction type, pN stage, and complications were significantly correlated with prognosis based on multivariate analyses. For patients with a recurrence and/or metastasis, lymphadenectomy and pN stage were shown to be independent prognostic factors by multivariate analysis. Conclusions: In summary, patients might benefit from EGA as a result of better analgesic and anti-inflammatory effects, fewer postoperative complications, higher safety, and a lower rate of metastasis and recurrence is conducive to postoperative recovery in patients with gastric cancer.

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Introduction: The pre anesthetic consultation is the essential element of the continuity of peri and post interventional care. In fact, it gathers all the information concerning the pre, per operative anesthetic period. For any patient whose condition requires anesthesia, the health structures must provide a preanesthesia consultation. General objective: To highlight the importance of a preanesthetic consultation through the profile and prognosis of the patients as well as the operative indications recorded. Patients and method: This was a prospective and descriptive study conducted over a period of six months from January 1 to June 30, 2021 in the anesthesia and intensive care unit of the national hospital of Zinder. Patients consulted by a surgeon, scheduled for surgery and having a preoperative workup were included. Age, sex, history, ASA class, anesthetic technique, operative indication and outcome of the patent were the variables studied. The data analysis was done by Excel. Results: During the study 401 patients were registered with a sex ratio of 3.6%. The mean age was 42 years with extremes from 02 months to 84 years. Medical history represented 08.72% including hypertension (68.57%) and diabetes (11.42%). ASA II class represented 73.81% (n= 296) and ASA I class 26.18% (n= 105). General anesthesia was the chosen technique in 63.34% (n=254) versus 36.5% (n=147) for spinal anesthesia. Hernia and restoration of digestive continuity were the main surgical indications with respectively 17.45% (n=70) and 10.47% (n=42) followed by benign prostatic hypertrophy for 10.47% (n=42). Visceral surgery occupied the first place with 21.19% (n=85) followed by urology with 15.96% (n= 64). The per and post operative evolution was generally favorable, no case of death was recorded. Conclusion: The pre-anaesthetic consultation remains the essential element of the continuity of pre- and post-anaesthetic care. It should be popularized in health structures with high-risk patients.

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Introduction: Inhalational anaesthesia is commonly used in paediatric patients. The study was designed to compare sevoflurane and halothane anaesthesia in the neonate and paediatric patients and to assess the haemodynamic status of both agents during induction, maintenance and recovery of anesthesia. Material and Methods: We studied 60 patients aged between 1 day to 7 years. All routine and emergency surgery were included. Children were randomly selected between two groups receiving halothane and sevoflurane. Induction time, intubating condition and haemodynamic changes were recorded. Results: Induction of anaesthesia was smooth in both groups but induction was smooth in the sevoflurane group. Maintenance of anaesthesia was smooth in both groups but recovery was rapid in the sevoflurane group. There was no unwanted side effect.

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Introduction: Spinal anesthesia is the most commonly used technique for lower abdominal surgeries postoperative pain control is a major problem because spinal anesthesia using only local anesthetics is associated with relatively short duration of action, and thus early analgesic intervention is needed in the postoperative period. Short acting spinal anaesthesia may help to prevent complications associated with delayed immobilization. Objective: To examine whether adding intrathecal Fentanyl to bupivacaine intensify sensory and motor block without prolonging recovery time for urosurgeries. Materials and Methods: A prospective observational study was contact at dept. of Anaesthesia, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh from March to August 2021. Seventy five (75) patients included in our study. American Society of Anaesthesiologists physical status I and II scheduled for elective urological procedures were studied in a double-blinded, randomized prospective manner. Random allocation was done as, Group A (n=25) receiving intrathecal bupivacaine 12.5 mg; Group B (n=25) bupivacaine 10 mg with 25 μg of fentanyl; and Group C (n=25), bupivacaine 5 mg with 25 μg of fentanyl. Assessment of sensory, motor block and duration of sensory analgesia was done. Results: In our study the demographic data were comparable in all the three groups. The time for two segment regression was statistically significant between all three groups (p<0.001). The mean time for two segment regressions for group A was 104.8 minutes whereas for group B mean time was 161.8 min and for group C mean time was 80.37 minutes. It was longest for group B and shortest for group C. The total duration of motor block was compared among the three groups after initiation of the SAB. There was statistically significant difference regarding total duration of motor block, time for two segment regression and duration of sensory analgesia between each pair of groups. The duration of motor

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Resuscitation is a discipline that allows the management of patients with or likely to have one or more acute visceral failures. It is the set of measures allowing the restoration of vital functions momentarily compromised during acute medical, surgical or traumatic situations. Resuscitation patients suffer from potentially serious physiological instability. What is the epidemiological profile of patients admitted to the multipurpose intensive care unit of the national hospital in Zinder? The aim was to highlight the epidemiological profile of the patients admitted and their fate in order to improve management. This was a prospective, descriptive and analytical study conducted in the polyvalent resuscitation service of the national hospital of Zinder from January 1st, 2019 to June 30, 2019. Patients admitted directly or transferred from the hospital's internal services or from other health structures were included. Age, sex, reason for admission, history and prognosis were the variables studied. The data collection was done from the admission register, the patient file and the survey form addressed to the patient and/or the family. The data analysis was done with the computer tool, Excel. During the study period, four hundred and forty-two (442) patients were registered, 72.62% of whom were men and 27.37% women, i.e. a sex ratio of 2.6. The average age was 30, 31 years with extremes of 01 day and 86 years. The 19 to 86 years age group was the most affected with 50.90% of cases followed by the 06 to 18 years age group (33.48%). Surgical pathologies were the main reason for admission with 76.47% of cases versus 07.69% for medical ones. Surgical history represented 76.69% versus 09.04% for medical history. Arterial hypertension, diabetes and envenomation were the main medical pathologies recorded. The surgical pathologies observed were peritonitis, appendicitis, hernia, occlusion, trauma, goiter and malformation. The prognosis was favorable for 84.16% against .........

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Introduction: Patients need intravenous fluids during Surgery to maintain adequate intravascular volume, cardiac output, and ultimately tissue Oxygen delivery. Aim of the study: Aim of the study was to evaluate serum sodium after infusion of isotonic fluid containing 131 mEq/L sodium with no glucose versus that after infusion of hypotonic fluids containing 75 mEq/L sodium with 5% dextrose. Methods: This study was conducted on pediatric patients of Bangladesh Shishu Hospital and Institute who underwent hernia operations between January 2021 and September 2021. Data are given as mean+standard deviation. P-value <0.05 was considered to be significant. continuous demographic variables were compared using the unpaired t-test, and the chi-square test was used for categorical variables. Result: There were no adverse events and all 40 patients enrolled in this study completed the procedures. The pre-anesthesia and post-anesthesia induction blood sodium concentration. Pre-anesthesia sodium (mEq/L), Isotonic was 138.7 + 1.4 and Hypotonic was 138.9 + 1.5, the charges from pre-anesthesia to postanesthesia induction was - 0.20 + 1.6. Post-anesthesia sodium (mEq/L), Isotonic was 138.5 + 1.5 and Hypotonic was 137.3 + 1.2, the charges from pre-anesthesia to postanesthesia induction was - 1.60 + 1.8. Conclusion: The administration of hypotonic fluids tends to reduce serum sodium absorption in pediatric cases, indeed when administered for a short period. But the use of isotonic fluids helps to avoid a reduction in serum sodium in pediatric and so may enhance patient safety.

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Objective: Ultrasound guidance nerve block in foot pain management is a new method in management of foot pain. It is simple, safe and cheap. We did this trial to compare the pain scores during both rest and activity and the functional ability after doing nerves block in comparison to patients who received non steroid anti-inflammatory drugs (conservative treatment). Materials and methods: We choose 90 patients in this double blind study, all are suffering of foot pain. Their ages ranging between35 and 80years, their weight ranging between 50 and 105 and their VAS pain scores between 6 and 9. We divided them into 2 groups, first group which has 45 patients who received NSAID only while the second group which also contain 45 patients who underwent nerve block. Results: The intensity of pain using VAS pain scores was small in the nerve block group after 6months, 1 year and 2 years in comparison with first group. The function scores of foot using American orthopedics of foot and ankle society scores (AOAFS) also was better in the second group (nerve block group). Conclusion: Ultrasound guidance ankle nerves block is better than using conservative anti-inflammatory drugs in reducing pain scores and improve the function capacity of the patients in patients with foot pain.