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Shahla Siddiqui

Publications and source records attributed to Shahla Siddiqui.

10 recordsLinked to original sources
PubMed2006

BIS monitoring in a patient with history of awareness and a difficult airway.

We describe a case where bispectral index (BIS) monitoring was used successfully to guide an inhaled induction technique for a difficult airway. The patient was a 34 years old male who had a previous history of awareness during anaesthesia. He was also morbidly obese with a Mallampatti score of III on preoperative examination.

Adult↗
PubMed2006

One year experience of MRI under general anaesthesia.

A case series over one year of our experience of using Propofol and Laryngeal mask airway (LMA) in children under 10 years of age undergoing MRI under general anaesthesia is presented. All paediatric patients under the age of ten attending out-patient department were included in the case series starting from January 1st, 2004 till December 31st, 2004. All patients underwent general anaesthesia using Propofol / LMA technique as described in detail in communication below. A total of 78 children were included; the only patient requiring intubation was the youngest: a neonate of 1 day who had a large orbital mass. Propofol in the dose of 2 mg/kg and an appropriate size LMA according to weight of the patient was used. Majority of the patients (67) had a brain or head MRI for 'developmental delay', 5 patients had a brain MRI for a 'mass lesion' and 5 patients had a lumbo-sacral MRI for 'abnormal growth'. There was only one complication when a child with history of seizures, seized on recovery and had to be subsequently admitted to the Emergency Room for observation. No other morbidity or mortality was noted. All patients were outpatients. We can conclude based on our results that providing GA for paediatric patients undergoing MRI with Propofol and LMA can be safe and effective in outpatient radiology.

Anesthesia, General↗
PubMed2006

Efficiency of PA catheters in the ICU of a tertiary care hospital.

Existing randomized controlled trials on Pulmonary Artery Catheter (PAC)-guided strategies reveal a modest risk reduction that does reach statistical significance. An observational, prospective, controlled study was carried out in the ICU of a tertiary care hospital. Incidence, indications, complication rate and outcome of Pulmonary Artery (PA) catheter over a period of 3 months was looked at, comparing cases to matched controls. Despite being a limited study, it is obvious that the cost effectiveness and outcome of patients with the PA catheter seems ambiguous. In a developing country where resources are limited, thought must be given to the risk and benefit ratio of placing this invasive monitor and use of the information provided properly justified.

Adult↗
PubMed2005

Outcome of home mechanical ventilation.

OBJECTIVE: To determine the outcome of patients discharged home on portable ventilator. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi from January 2000 to December 2004. PATIENTS AND METHODS: All ventilator-dependent patients discharged home were contacted. Survivors were administered the EQ-5D Quality-of-Life instrument. SPSS version 13 was used to analyze data. RESULTS: Eleven patients were discharged home on invasive ventilation. Mean age was 49 years (range 10-98 years). Cause of ventilatory failure were cervical spine trauma in 36%, primary neurological disease in 27%, critical illness neuropathy and respiratory failure in 18% each. Survival rate was 73%, with three deaths. Mean duration of ventilation was 9.45 months (95% CI 3.24, 15.67). Rate of successful weaning after discharge was 36%, with 4 patients off all forms of ventilatory support and 2 on only nocturnal support. A 2.8 (95% CI 0.5, 16.6) relative risk towards successful weaning was associated with the presence of a family member as the primary care giver. Mean scores on the EQ-5D descriptive tool were; mobility 2 (-/+0.82), self-care 2 (-/+0.82), usual activities 1.86 (-/+0.69), pain/discomfort 1.43(-/+0.79), anxiety/depression 1.29 (-/+0.76). Mean score on the EQ-VAS was 48.2(-/+ 27.3). CONCLUSION: In carefully selected patients, home ventilation is a viable option with the expectation of successful weaning and survival. Patients discharged home on ventilation reported a reasonably good quality of life with proportionately more problems related to independence compared to overall well-being.

Adolescent↗
PubMed2005

Apache II score as a predictor of length of stay and outcome in our ICUs.

The APACHE II (acute physiology and chronic health evaluation) is used widely for predicting probability of hospital mortality and length of stay in the ICU. APACHE II forms were available to all ICU residents within 24 hours of admission, and a score was assigned to them. Based on our results the APACHE II score has reliably predicted an outcome of the least amount of length of stay (LOS) in the ICU as well as a 100% probability of being shifted out of the ICU for a score of < 10 (according to international benchmarks). This reliable scoring system can be used for predicting mortality and length of stay and therefore, resource allocation, antibiotic use and ethical decisions regarding counseling families about end of life decisions--all within 24 hours of admissions.

APACHE↗
PubMed2005

Retrospective review of the use of Swan Ganz catheters in our intensive care unit (ICU): a short report.

The widespread and often 'misuse' of the Swan Ganz (SG) or Pulmonary artery catheter has often been seen in intensive care patients. The objective of this preliminary review was to observe the trends and possibly formulate an association with outcome of the use of SG catheters as well as to determine the frequency of use and possible complications. The chart review of ten patients was carried out for the months of January and February 2004 in a retrospective manner. The incidence of SG catheter insertion was 12% per month on average. Nine out of 10 patients received the SG catheters for 'fluid management'; and 1 for 'haemodynamic instability'. Eight out of 10 patients expired and average length of stay was 9 days. There were no complications recorded. The cause of death in all patients was 'severe sepsis'. The overwhelming majority of patients who received these catheters expired at the end of their stay.

Catheterization, Swan-Ganz↗