A Comparative Study of Different Doses of Lignocaine on Prevention of Etomidate Induced Myoclonus during Induction of Anesthesia

Abstract Background and Aims Etomidate, an intravenous (IV) induction agent known for its stable myocardial action, can produce myoclonus which can be detrimental for the cardiac patients. Though lignocaine has proven its efficacy in attenuating the etomidate-induced myoclonus, the ideal dose of lignocaine is not known. The aim of our trial was to analyze two different doses of lignocaine on the occurrence and intensity of etomidate induced myoclonus. Materials and Methods A total of 120 patients were randomly assigned into three groups of 40 each. Patients in group A were injected lignocaine 0.5 mg/kg intravenously, group-B patients were injected lignocaine 1 mg/kg intravenously, and group-C patients were injected saline placebo. After 2 minutes, anesthesia was induced with 0.3 mg/kg of etomidate over 30 seconds. The patients were assessed for myoclonus using clinical severity scoring system during first 2 minutes of induction. Our primary outcome was the incidence of myoclonus. The severity of myoclonus and adverse effects were the secondary outcomes. Results No remarkable variation was found regarding demographic profile among three groups. Incidence of myoclonus in groups A and B was 35% and in group C was 98%, the difference being statistically significant. Both doses of lignocaine reduced the severity of myoclonus up to same extent. Conclusion Pretreatment with IV lignocaine 0.5mg/kg and 1 mg/kg IV remarkably decreased the occurrence and severity of myoclonus induced by etomidate up to same extent.

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Adrenaline and Dexamethasone, vs Adrenaline and Fluticasone, vs Adrenaline alone in Bronchiolitis: A Randomized Controlled Trial

Asian Journal of Pediatric Research ◽

10.9734/ajpr/2020/v3i130120 ◽

2020 ◽

pp. 20-28

Author(s):

Jayendra R. Gohil ◽

Atul M. Sheladiya ◽

N. B. Adithya ◽

Ratna D. Bhojak

Keyword(s):

Hospital Stay ◽

Clinical Symptoms ◽

Controlled Trial ◽

Length Of Hospital Stay ◽

Primary Objective ◽

Assessment Instrument ◽

Clinical Severity ◽

Group A ◽

The Difference ◽

Group B

Background and Objectives: There is no consensus over which drug best reduces symptoms in Bronchiolitis syndrome. The primary objective of our study is to establish comparative effect of adrenaline nebulisation alone and combination of adrenaline nebulisation plus injectable dexamethasone and adrenaline nebulisation plus fluticasone nebulisation in the treatment of clinical cases of bronchiolitis. Methods: 100 patients diagnosed clinically as bronchiolitis were enrolled in study from 1 month to 24 months of age. Patients were enrolled by purposive sampling. Patients with respiratory distress assessment instrument score [RDAI] of 4 to 15 were chosen, randomized into three groups and treatment given till patient fullfilled discharge criteria. Group A (n=33) were given nebulised adrenaline alone, Group B (n=34) were given nebulised adrenaline plus injectable dexamethasone and Group C (n=33) were given nebulised adrenaline plus nebulised fluticasone. Results: The mean reduction in clinical severity-RDAI score was 1.75 ±0.86 in Group A, 2.30 ± 0.68 in Group B and 1.42 ± 0.9 in Group C when measured in terms of difference in clinical scores between day 1 and 2 (p=0.0003). Mean duration of hospital stay in the group A was (4.93±1.95 days), Group C (4.78±1.83) and Group B (3.91 ±1.37 days). The difference of stay between the Groups A and B was 1.02±0.58 days vs 0.87± 0.46 days in groups B and C (p-0.0048). Reduction in the length of hospital stay in group B was 22% compared to Group A & 19% compared to Group C (p-0.0048). Side effects were tachycardia in six patients. Conclusion: Combination of adrenaline nebulization and injectable dexamethasone was found significantly better as compared to nebulised adrenaline plus nebulised fluticasone and nebulised adrenaline alone in patients of clinical bronchiolitis in reducing severity of clinical symptoms and duration of hospitalization.

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Comparative study of nitroglycerin dermal patch versus nifedipine in the management of preterm labour

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184160 ◽

2018 ◽

Vol 7 (10) ◽

pp. 4243

Author(s):

Manjeet Kaur ◽

Bharti Goel ◽

Jasveer Singh

Keyword(s):

Gestational Age ◽

Preterm Labor ◽

Primary Outcome ◽

Preterm Labour ◽

Signs And Symptoms ◽

Maternal Acceptance ◽

Group A ◽

Secondary Outcomes ◽

Group B ◽

Dermal Patch

Background: The aim of present study was to compare the effect of nitroglycerin dermal patch and nifedipine for taking control of preterm labor (tocolysis) and to find the safer drug for mother and foetus.Methods: Women with signs and symptoms of preterm labor between gestational ages 26-37 weeks were studied. These women were divided into 2 groups. Group A-50 women were prescribed nitroglycerin dermal patch and in Group B-50 women were given nifedipine. Primary outcome of the study was to delay the delivery for at least 48 hours. Secondary outcomes were gestational age at the time of delivery, prolongation of labor, effect on neonate and adverse effects.Results: Both groups were comparable regarding cervical effacement in cm and gestational age in weeks at the time of enrollment. Gestational age at the time of delivery in weeks (p < 0.01), prolongation of pregnancy in days (p > 0.05), neonatal Apgar score at 5 minutes (p < 0.05), neonatal weight in kg (p < 0.05) and foetal outcomes were better in nifedipine group in comparison to nitroglycerin. The overall side effects were less in nifedipine group as compared to nitroglycerin group. Overall success rate was 88% with nifedipine and 76% in nitroglycerin cases.Conclusions: Both the drugs were able to postpone the delivery for 48 hours. Nifedipine was found to be superior to nitroglycerin dermal patch in prolongation of gestational age at the time of delivery, in perinatal outcome and maternal acceptance.

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Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers

Scientific Reports ◽

10.1038/s41598-020-77093-z ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 3

Author(s):

Anshul Jain ◽

Rachna Chaurasia ◽

Narendra Singh Sengar ◽

Mayank Singh ◽

Sachin Mahor ◽

...

Keyword(s):

Vitamin D ◽

Serum Ferritin ◽

Inflammatory Markers ◽

Clinical Severity ◽

Medical College ◽

Marked Variability ◽

Group A ◽

The Difference ◽

Vitamin D Supplements ◽

Group B

AbstractCOVID-19 is characterized by marked variability in clinical severity. Vitamin D had recently been reviewed as one of the factors that may affect the severity in COVID-19. The objective of current study is to analyze the vitamin D level in COVID-19 patients and its impact on the disease severity. After approval from Ethics Committee, M.L.B Medical College the current study was undertaken as continuous prospective observational study of 6 weeks. Participants were COVID-19 patients of age group 30–60 years admitted during the study period of 6 weeks. Study included either asymptomatic COVID-19 patients (Group A) or severely ill patients requiring ICU admission (Group B). Serum concentration of 25 (OH)D, were measured along with serum IL-6; TNFα and serum ferritin. Standard statistical analysis was performed to analyze the differences. Current Study enrolled 154 patients, 91 in Group A and 63 patients in Group B. The mean level of vitamin D (in ng/mL) was 27.89 ± 6.21 in Group A and 14.35 ± 5.79 in Group B, the difference was highly significant. The prevalence of vitamin D deficiency was 32.96% and 96.82% respectively in Group A and Group B. Out of total 154 patients, 90 patients were found to be deficient in vitamin D (Group A: 29; Group B: 61). Serum level of inflammatory markers was found to be higher in vitamin D deficient COVID-19 patients viz. IL-6 level (in pg/mL) 19.34 ± 6.17 vs 12.18 ± 4.29; Serum ferritin 319.17 ± 38.21 ng/mL vs 186.83 ± 20.18 ng/mL; TNFα level (in pg/mL) 13.26 ± 5.64 vs 11.87 ± 3.15. The fatality rate was high in vitamin D deficient (21% vs 3.1%). Vitamin D level is markedly low in severe COVID-19 patients. Inflammatory response is high in vitamin D deficient COVID-19 patients. This all translates into increased mortality in vitamin D deficient COVID-19 patients. As per the flexible approach in the current COVID-19 pandemic authors recommend mass administration of vitamin D supplements to population at risk for COVID-19.

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Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

TAJ Journal of Teachers Association ◽

10.3329/taj.v33i1.49824 ◽

2020 ◽

Vol 33 (1) ◽

pp. 41-47

Author(s):

Mohsena Akhter ◽

Ishrat Bhuiyan ◽

Zulfiqer Hossain Khan ◽

Mahfuza Akhter ◽

Gulam Kazem Ali Ahmad ◽

...

Keyword(s):

Skin Diseases ◽

Close Contact ◽

Randomized Study ◽

Sarcoptes Scabiei ◽

Efficacy And Safety ◽

Common Skin ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

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Effect of Sample Storage Conditions on Body Burden Analysis of Organic Contaminants in Unionid Mussels

Water Quality Research Journal ◽

10.2166/wqrj.1992.050 ◽

1992 ◽

Vol 27 (4) ◽

pp. 833-844 ◽

Cited By ~ 1

Author(s):

Micheline Hanna

Keyword(s):

Organic Contaminants ◽

Body Burden ◽

Storage Conditions ◽

The Body ◽

Sample Storage ◽

Pcb Congeners ◽

Unionid Mussels ◽

Group A ◽

The Difference ◽

Group B

Abstract In order to quantitatively assess the effect of sample storage conditions on the body burden analysis of organic contaminants, a comparative analysis was carried out on the unionid mussel Elliptic complanata. The mussels were divided into two groups, each with distinct storage conditions, while Group A was kept in the freezer at −20°C, Group B was kept in the refrigerator for five days at 5°C. All the compounds present in the control were also present in Group B samples. Analysis of the organic contaminants in each of these two groups showed that for total PCB concentrations, the two treatments were not significantly different; however when compared individually 6 of the 13 PCB congeners showed significant differences. The observed differences were relatively small for individual PCB congeners (7.1 to 15.3%), higher for chlorobenzenes (10.5 to 36.4%), and yet higher for HCE (44.1%); the difference for HCE, although large is nevertheless not significant, even if only marginally so.

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The Pandemic and Changes in the Self-Perception of Teacher Digital Competences of Infant Grade Students: A Cross Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094756 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4756

Author(s):

Rosalía Romero-Tena ◽

Carmen Llorente-Cejudo ◽

María Puig-Gutiérrez ◽

Raquel Barragán-Sánchez

Keyword(s):

Intervention Group ◽

Cross Sectional Study ◽

Self Perception ◽

Digital Competence ◽

Cross Sectional ◽

Self Perceptions ◽

Group A ◽

Different Dimensions ◽

The Difference ◽

Group B

Without having a reaction time, the pandemic has caused an unprecedented transformation in universities around the world, leading to a revolution from structured models anchored in the conception of transmission of training towards a teaching approach-learning saved thanks to the incorporation of technology. This study aims to verify whether the pandemic situation has influenced the digital competence self-perception of students. Comparing two groups during the academic years 2019/2020 and 2020/2021, the instrument used is the questionnaire for digital competence “DigCompEdu Check-In” for future teachers. After the educational intervention, group A (before COVID-19) presented higher self-perceptions of competence than group B (during COVID-19); the pandemic situation caused by COVID-19 has negatively influenced students’ self-perception of their digital skills in the pretest in the different dimensions under study. Before receiving the training, the group that did not experience the pandemic enjoyed a higher self-perception of their competencies than the group that experienced the pandemic. The data obtained indicate that the difference exists, and that it is statistically significant, and may be a consequence of the clear relationship between self-perception and the way in which students face reality through their personal and subjective vision.

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Effects of different thermal insulation methods on the nasopharyngeal temperature in patients undergoing laparoscopic hysterectomy: a prospective randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-021-01324-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Guanyu Yang ◽

Zefei Zhu ◽

Hongyu Zheng ◽

Shifeng He ◽

Wanyue Zhang ◽

...

Keyword(s):

Thermal Insulation ◽

Primary Outcome ◽

Controlled Trial ◽

Laparoscopic Hysterectomy ◽

Control Group ◽

Prospective Randomized Controlled Trial ◽

Warming Blanket ◽

Group A ◽

Insulation Effect ◽

Group B

Abstract Background This study explored the comparison of the thermal insulation effect of incubator to infusion thermometer in laparoscopic hysterectomy. Methods We assigned 75 patients enrolled in the study randomly to three groups: Group A: Used warming blanket; group B: Used warming blanket and infusion thermometer; group C: Used warming blanket and incubator. The nasopharyngeal temperature at different time points during the operation served as the primary outcome. Results The nasopharyngeal temperature of the infusion heating group was significantly higher than that of the incubator group 60 min from the beginning of surgery (T3): 36.10 ± 0.20 vs 35.81 ± 0.20 (P<0.001)90 min from the beginning of surgery (T4): 36.35 ± 0.20 vs 35.85 ± 0.17 (P<0.001). Besides, the nasopharyngeal temperature of the incubator group was significantly higher compared to that of the control group 60 min from the beginning of surgery (T3): 35.81 ± 0.20 vs 35.62 ± 0.18 (P<0.001); 90 min from the beginning of surgery (T4): 35.85 ± 0.17 vs 35.60 ± 0.17 (P<0.001). Regarding the wake-up time, that of the control group was significantly higher compared to the infusion heating group: 24 ± 4 vs 21 ± 4 (P = 0.004) and the incubator group: 24 ± 4 vs 22 ± 4 (P = 0.035). Conclusion Warming blanket (38 °C) combined infusion thermometer (37 °C) provides better perioperative thermal insulation. Hospitals without an infusion thermometer can opt for an incubator as a substitute. Trial registration This trial was registered with ChiCTR2000039162, 20 October 2020.

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Does body position, age, and heart rate induce IOP’s changes?

European Journal of Ophthalmology ◽

10.1177/11206721211023313 ◽

2021 ◽

pp. 112067212110233

Author(s):

Marcelina Sobczak ◽

Magdalena Asejczyk ◽

Malwina Geniusz

Keyword(s):

Heart Rate ◽

Body Position ◽

Age Groups ◽

Cardiovascular Parameters ◽

Entire Cohort ◽

Significant Difference ◽

Group A ◽

The Difference ◽

Group B ◽

Effect Of Age

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.

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Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽

10.3329/kyamcj.v10i1.41478 ◽

2019 ◽

Vol 10 (1) ◽

pp. 21-24

Author(s):

Md Abdus Salam ◽

Md Mahbub Alam ◽

Rezwan Ahmed ◽

Md Sultan Mahmud

Keyword(s):

Postoperative Pain ◽

Postoperative Bleeding ◽

Throat Pain ◽

Medical College ◽

Advantages And Disadvantages ◽

Case Surgery ◽

Group A ◽

The Difference ◽

Group B ◽

Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

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Anal sphincter dysfunction in multiple sclerosis: an observation manometric study

Open Medicine ◽

10.1515/med-2016-0088 ◽

2016 ◽

Vol 11 (1) ◽

pp. 509-517 ◽

Cited By ~ 3

Author(s):

Silvia Marola ◽

Alessia Ferrarese ◽

Enrico Gibin ◽

Marco Capobianco ◽

Antonio Bertolotto ◽

...

Keyword(s):

Multiple Sclerosis ◽

Fecal Incontinence ◽

Anal Pressure ◽

Before And After ◽

Group A ◽

The Difference ◽

Resting Anal Pressure ◽

Group B ◽

Multiple Sclerosis Patients ◽

Group D

AbstractConstipation, obstructed defecation, and fecal incontinence are frequent complaints in multiple sclerosis. The literature on the pathophysiological mechanisms underlying these disorders is scant. Using anorectal manometry, we compared the anorectal function in patients with and without multiple sclerosis.136 patients referred from our Center for Multiple Sclerosis to the Coloproctology Outpatient Clinic, between January 2005 and December 2011, were enrolled. The patients were divided into four groups: multiple sclerosis patients with constipation (group A); multiple sclerosis patients with fecal incontinence (group B); non-multiple sclerosis patients with constipation (group C); non-multiple sclerosis patients with fecal incontinence (group D). Anorectal manometry was performed to measure: resting anal pressure; maximum squeeze pressure; rectoanal inhibitory reflex; filling pressure and urge pressure. The difference between resting anal pressure before and after maximum squeeze maneuvers was defined as the change in resting anal pressure calculated for each patient.ResultsGroup A patients were noted to have greater sphincter hypotonia at rest and during contraction compared with those in group C (p=0.02); the rectal sensitivity threshold was lower in group B than in group D patients (p=0.02). No voluntary postcontraction sphincter relaxation was observed in either group A or group B patients (p=0.891 and p=0.939, respectively).ConclusionsThe decrease in the difference in resting anal pressure before and after maximum squeeze maneuvers suggests post-contraction sphincter spasticity, indicating impaired pelvic floor coordination in multiple sclerosis patients. A knowledge of manometric alterations in such patients may be clinically relevant in the selection of patients for appropriate treatments and for planning targeted rehabilitation therapy.

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