scholarly journals Superiority of Spacer/Mask Topical Anesthetic Compared with Conventional Spray and Gargle Method for Fibreoptic Bronchoscopy

1996 ◽  
Vol 3 (3) ◽  
pp. 176-180
Author(s):  
RC Balkissoon ◽  
L Clelland ◽  
L Whitehead ◽  
MT Newhouse
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Fibreoptic Bronchoscopy ◽  
Care Hospital ◽  
Topical Anaesthetic ◽  
Vocal Cords ◽  
Group A ◽  
Gag Reflex ◽  
The Mean ◽  
Group B

OBJECTIVE:To compare the safety and efficacy of a new spacer-oral nasal mask device with those of the standard needle nozzle spray method for the delivery of aerosolized lidocaine to the upper airway for pre-bronchoscopic anaesthesia in a tertiary care hospital.DESIGN:Single-blind randomized control trial.SETTING:University affiliated tertiary care hospital, ambulatory care bronchoscopy unit.SUBJECTS:Thirty consecutive consenting patients referred for fibreoptic bronchoscopy for various indications.INTERVENTION:Thirty randomized subjects received 150 mg of topical 1% aerosolized lidocaine via standard long needle nosed applicator (group A) or via a new oral/ nasal mask with spacer device (group B). Bronchoscopists, blinded as to the preprocedure topical anaesthetic method used, gave additional topical lidocaine at their discretion.MEASUREMENTS:The study nurse recorded the total dose of lidocaine (mg), timing of the procedure (s), cough frequency expressed as coughs per minute (c/min), vital signs, time for return of gag reflex and patients' subjective comments.RESULTS:Fifteen patients were randomized to each group. The lidocaine dose required for insertion through the vocal cords (mean ± SD) was 282.6±66.3 mg in group A and 203.3±70.6 mg in group B (PÃ0.005). Total lidocaine dose required for the procedure was 330.6±70.2 mg in group A and 256.6±75 mg in group B (PÃ0.01). The mean time for passage of the bronchoscope from mouth entry to through the vocal cords was 82.7±54.5 s in group A and 110.5±64.4 s in group B (P>0.1). The mean total time for the procedure was 699.7±377.5 s in group A and 697.2±409.1 s in group B (not significant). The mean cough frequency was 8.2±6.1 c/min in group A and 7.0±5.7 c/min in group B (not significant). There were no statistically significant differences in heart rate, in return of gag reflex time or in complication rate between the two groups.CONCLUSIONS:A statistically significant reduction in the dose of lidocaine is required to achieve equivalent topical anaesthetic for bronchoscopy with a new mask and spacer device compared with a more conventional method. Since no other variables related to the procedure showed a significant difference, the new method appears to be superior to the previous method.

scholarly journals EFFICACY OF CIPROFLOXACIN AND CEFOTAXIME IN PATIENTS WITH CIRRHOSIS LIVER PRESENTING WITH SPONTANEOUS BACTERIAL PERITONITIS TO A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 29 (02) ◽  
Author(s):  
Zahidullah Khan ◽  
Ahmar Rashid ◽  
Iqbal Haider ◽  
Shams Suleman ◽  
Aliena Badshah ◽  
...  
Keyword(s):  
Spontaneous Bacterial Peritonitis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Bacterial Peritonitis ◽  
Source Of Infection ◽  
Key Words Ciprofloxacin ◽  
Single Center Study ◽  
Group A ◽  
The Mean ◽  
Group B

Spontaneous Bacterial Peritonitis (SBP), a known complication of cirrhosis Liver is an acute bacterial infection of the peritoneum. Usually no source of infection is easily identifiable. Objective: To compare the efficacy of Ciprofloxacin and Cefotaxime in Cirrhosis Liver patients with SBP. Material and Methods: This prospective, comparative, single center study was conducted in the Department of Medicine, Khyber Teaching Hospital Peshawar from 1st October 2017 to 31st December 2018. A total of 300 admitted patients having Cirrhosis Liver with SBP were included in this study. The patients were randomized into Group A and Group B. Group A was treated with Intravenous Ciprofloxacin and Group B was treated with Intravenous Cefotaxime given twice daily for a period of 5 days. Diagnostic peritoneal paracentesis was done before the start of the treatment and repeated after 5 days therapy. Patients who were either non cirrhotic or had secondary bacterial peritonitis were excluded from the study. Results: A total of 300 Cirrhosis Liver patients with SBP were studied in two equal randomized groups. Out of these 168 were male and 132 were female. The mean age of patients in study was 51.14±11.9 years. The age ranged between 15-75 years. In Group A, 82 percent responded to ciprofloxacin and in group B, 86 percent responded to cefotaxime. Conclusion: Both intravenous ciprofloxacin and cefotaxime are effective in treating spontaneous bacterial peritonitis in patients with Cirrhosis Liver. Key Words: Ciprofloxacin, Cefotaxime, Spontaneous bacterial peritonitis, Efficacy.

scholarly journals EFFECT OF SINGLE-DOSE PREGABALIN ON POSTOPERATIVE PAIN IN DACRYOCYSTORHINOSTOMY SURGERY

2021 ◽  
Vol 71 (5) ◽  
pp. 1553-58
Author(s):  
Sana Abbas ◽  
Saquib Naeem ◽  
Amjad Akram ◽  
Beenish Abbas ◽  
Rashid Iqbal
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Opioid Administration ◽  
Quasi Experimental ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Study Participants

Objective: To evaluate the analgesic potential of pregabalin in ambulatory dacryocystorhinostomy surgeries under general anaesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Tertiary Care Hospital Rawalpindi, from Nov 2019 to Sep 2020. Methodology: A total of 110 patients undergoing ambulatory dacryocystorhinostomy surgery at our hospital were included in the study. Participants were divided into two groups, group A (n=55) were administered 150 mg oral pregabalin, while a placebo was given to participants of group B (n=55). Post-operative pain was assessed at recovery, four and eight hours after surgery with the help of the visual analogue scale. Results: Mean age of participants was 43.05 ± 7.5 years. Gender wise distribution showed 62 (56.4%) males and 48 (43.6%) females. At recovery, four and eight hours after surgery the mean pain scores in group A (pregabalin) vs group B (placebo) were (2.98 ± 0.8 vs 4.98 ± 0.8, p<0.001, 2.67 ± 0.6 vs 5.02 ± 0.8, p<0.001 and 1.49 ± 2.9 vs 2.95 ± 0.8, p<0.001 respectively). Opioid administration frequency in trial versus placebo group was [11 (20%) vs 32 (58.2%), p<0.001]. Conclusion: Pregabalin has analgesic potential moreover decreased postoperative consumption of opioids and associated adverse effects such as nausea and vomiting. Hence making it a suitable agent for pain relief in ambulatory surgeries.

scholarly journals Comparison of primary repair with healing by secondary intention for the treatment of pilonidal sinus, at a Tertiary Care Hospital in Karachi, Pakistan.

2019 ◽  
Vol 26 (08) ◽  
pp. 1306-1310
Author(s):  
Muhammad Ghayasuddin ◽  
Fareya Usmani ◽  
Amtullah Sheikh ◽  
Hamid Raza
Keyword(s):  
Pilonidal Sinus ◽  
Primary Repair ◽  
Tertiary Care ◽  
Healing Time ◽  
Random Allocation ◽  
Care Hospital ◽  
Secondary Intention ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study is to assess the surgical outcome of healing by primary intention and compare it with primary repair for the treatment of pilonidal sinus. Study Design: Randomized controlled trial. Setting: Tertiary Care Center in Karachi Pakistan. Period: Two years from April 2015 to April 2017. Materials and Methods: 60 patients were divided into two groups by utilizing a Random Allocation Software. All the patients involved in the study signed a duly informed consent. The inclusion criteria were patients who presented to us with a pilonidal sinus and agreed to participate in the study. All the procedures were performed by the same team of surgeons. Patient follow up was bi-weekly at the outpatient. Data were collected in a predesigned proforma with various variables such as patient demographics, clinical findings, treatment option used, postoperative results, complications (if any), healing time, length of hospital stay and time for a return to function among others. The data were analyzed using IBM SPSS version 21.0. A p value of less than 0.05 was considered to be statistically significant. Results: N= 60 patients were included in the study. There were n= 51 men (85%) and n= 9 women (15%). The mean age of patients in group A was 26.45 +/- 5.81 years and the mean age of participants in group B was 27.10 +/- 5.75 years. Symptoms lasted for 6.52 +/- 2.03 days, the most common presenting complaint was pain in 51.66% of patients followed by discharge in 40% and swelling in 33.33% respectively. The mean length of stay at the hospital for both the groups was 4.40 +/- 2.11 days (4.09 +/- 1.96 days in group A and 4.85 +/- 2.33 days in group B), mean time to return to normal functioning was 17.88 +/- 8.46 days (14.50 +/- 7.30 days in group A and 23.80 +/- 6.50 days in group B). The mean healing time postoperatively for both the groups was 39.98 +/- 24.46 days (21.90 +/- 10.15 days in group A and 67.30 +/- 9.09 days in group B. Early postoperative infection was found in n=7 (11.66%) patients, wound necrosis was found in n= 2 (3.33%) patients, and recurrence of the pilonidal sinus was found in n= 3 (5%) of the patients respectively. Conclusion: According to the results of our study primary closure technique provides better outcomes in terms of early return to functioning, shorter duration of wound healing and lower rates of wound infection as compared to excision and healing by secondary intention.

scholarly journals Clinical and Biochemical Profile of COVID-19 Patients Admitted in a Tertiary Care Hospital of Kolkata

2021 ◽  
Author(s):  
Avick Nag ◽  
Soumyadeep Ghosh ◽  
Anushree Pal ◽  
Ankan Saha ◽  
Sanjay Kumar Mandal
Keyword(s):  
Prothrombin Time ◽  
Biochemical Parameters ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Severity ◽  
Care Hospital ◽  
Biochemical Profile ◽  
Group A ◽  
Group B ◽  
D Dimer

Introduction: The disease caused by Coronavirus (COVID-19), is now pandemic all over the world including India. There are different manifestations of the disease from asymptomatic and mild to severe form. Clinical severity varies from country to country. This study was conducted to document different clinical and biochemical profiles in this Tertiary Care Hospital of Kolkata. Aim: The study was done to observe and to compare the clinical and biochemical profile in asymptomatic to mild and moderate to severe symptomatic patients. Materials and Methods: This was an observational study conducted in Medical College, Kolkata, West Bengal, India. The study was conducted from June 2019 to mid-August 2019. Total 573 Real Time Polymerase Chain Reaction (RT PCR) positive COVID patients were included in this study. All patients were examined and investigated with blood parameters. Patients were divided into two groups (Group A-asymptomatic and mild symptoms and Group B moderate and severe symptoms) clinically. Statistical calculators like Statistical Package for Social Sciences (SPSS) and Soccalculator were used and different biochemical parameters were analysed using Chi-square, unpaired T-test to find out significance among these two groups. Results: Among 573 patients, 222 were in group A and 351 were in group B. Fever was the most common presenting feature (69.6%) followed by dry cough and shortness of breath. Other features were malaise/fatigability, diarrhoea and anosmia. Among the co-morbidities hypertension and diabetes were significantly different between the two groups. Among the biochemical parameters Neutrophil-Lymphocyte Ratio (NLR), C-Reactive Protein (CPR), D-dimer, Prothrombin time, Serum Glutamic Oxaloacetic Transaminase (SGOT), Serum Glutamic Pyruvic Transaminase (SGPT) were significantly different between the two groups. Conclusion: In a tertiary care hospital of Kolkata, fever is the most common presentation followed by dry cough and fatigability in COVID patients. Diabetes and hypertension are the common co morbidities. CRP, NLR, D-dimer, prothrombin time, SGOT and SGPT should be monitored to differentiate between mild and severe cases.

scholarly journals A comparative evaluation of the effects of ZLN and TLE anti-retroviral regimens in HIV positive patients: A retrospective record-based study

2021 ◽  
Vol 64 ◽  
pp. 298-302
Author(s):  
Ritika Singla ◽  
Neetu Sharma
Keyword(s):  
Opportunistic Infections ◽  
Tertiary Care ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Care Hospital ◽  
Immunodeficiency Virus ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Objectives: Until 2012, zidovudine+lamivudine+nevirapine (ZLN) was the first line treatment for human immunodeficiency virus (HIV)-positive patients, whereas in 2013, tenofovir+lamivudine+efavirenz (TLE) was recommended as a preferred regimen due to less adverse drug reactions and better virological response. The present study was done to compare the change in CD4 count and emergence of opportunistic infections (OIs) in HIV-positive patients on ZLN and TLE regimens. Materials and Methods: This retrospective record-based study was conducted at anti-retroviral therapy (ART) center of a tertiary care hospital on 150 charts of patients on ZLN (Group A) and TLE (Group B) regimens each for 1 year. Data were analyzed using GraphPad Prism version 6. Results: The mean age of patients in Group A was 38.72 (±10.5) years and Group B 37.75 (±11.57) years (P = 0.4460). After 1 year of ART, the mean CD4 count (cells/mm3) increased in both groups (Group A: 223.51 [±111.21] to 415.37 [±218.16] [P = 0.0001] vs. Group B: 255.05 [±164.50] to 433.12 [±247.66] [P = 0.0001]). With the baseline counts being comparable (P = 0.0527), the difference in mean CD4 counts between the groups post-ART was not statistically significant (P = 0.5105). The incidence of OI was 45% in Group A as compared to 25% in Group B. Overall, the most prevalent OI was tuberculosis (TB) (13.33%). Conclusion: Both ZLN and TLE regimens are equally effective in improving the immunological status of HIV-positive patients. Patients on ZLN have higher incidence of OI than those on TLE. However, therapy should be individualized as per patient’s suitability.

scholarly journals Vaginal progesterone after tocolytic therapy in threatened preterm labour

2020 ◽  
Vol 9 (8) ◽  
pp. 3233
Author(s):  
Aparajita Ashok Mishra ◽  
Shilpa N. Chaudhari
Keyword(s):  
Preterm Labour ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Positive Effects ◽  
Gestational Age At Delivery ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Micronized Progesterone

Background: Currently preterm labour is one of the most challenging problem faced by both obstetricians and perinatologists, this episode in the course of woman’s pregnancy takes a heavy tool for perinatal mortality which accounts for approximately 50-75%. The incidence of preterm labour is estimated to be 5-10% of all pregnancies.Methods: It was a prospective randomize control trail over a period of 3 year at department of obstetrics and gynecology, tertiary care hospital Pune, Maharashtra, India. Total 100 subjects were randomized into two groups with group one receiving vaginal micronized progesterone and group two control group receiving only tocolytics and steroids. Subsequently authors compared the safety and efficacy of vaginal micronized progesterone versus placebo as a maintenance therapy in preventing preterm labour.Results: This analysis showed that women who randomized to progesterone prophylaxis had a significantly increase in duration of pregnancy. The mean of birthweight in Group A and Group B was 2963±36 gm and 2567±49 gm and respectively which confirmed the positive effects of progesterone on increasing infants’ weights at birth.Conclusions: Authors concluded that progesterone therapy had acceptable efficacy in the prevention of preterm labor in terms of prolongation of delivery and by increasing gestational age at delivery.

scholarly journals Prospective, randomized, open label comparative study of efficacy of atorvastatin versus atorvastatin with vitamin D3 in patients with dyslipidemia attending tertiary care hospital

2021 ◽  
Vol 10 (9) ◽  
pp. 1076
Author(s):  
Motakatla Usha Rani ◽  
Chitra Karuppiah ◽  
Novaladi Kiruthiga ◽  
Vivek Rayavarapu
Keyword(s):  
Vitamin D ◽  
Cardiovascular Diseases ◽  
Lipid Profile ◽  
Vitamin D3 ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Open Label ◽  
Group A ◽  
Group B

Background: Cardiovascular diseases are one of the most important group of diseases causing premature mortality and morbidity. Dyslipidemia is an independent risk factor for cardiovascular diseases and is a disorder of lipoprotein metabolism. Various research studies support role of vitamin D against dyslipidemia. Vitamin D concentration positively correlates with HDL cholesterol and negatively with serum LDL and triglyceride levels. Vitamin D supplementation to Atorvastatin appeared to have increased cholesterol lowering activity more than either substance did alone.Methods: The study was conducted in an outpatient department of general medicine for a duration of 12 weeks in a tertiary care hospital. Total of 100 patients with dyslipidemia were selected based on measurement of lipid profile. Out of 100 patients, 50 patients under group A were treated with atorvastatin 10mg and balance 50 patients under group B treated with atorvastatin and Vitamin D3 1000 IU/day orally. Patients were followed up monthly for 3 months and lipid profile was assessed at baseline and at the end of study. The baseline characteristics were similar in both study groups.Results: On comparing groups at the end of 12 weeks mean LDL, triglycerides and VLDL were significantly reduced in group B than group A with p<0.001. The mean HDL level too increased in group B than group A with p<0.001.Conclusions: Fasting plasma lipid profile improvement was higher in the atorvastatin with vitamin D3 group compared to atorvastatin group.

scholarly journals An assessment of knowledge, attitude and practices (KAP) towards warfarin medication among patients with prosthetic valve in a tertiary care hospital of south India

2018 ◽  
Vol 7 (10) ◽  
pp. 1877
Author(s):  
Gopisankar M. G. ◽  
Surendiran A. ◽  
Hemachandren M.
Keyword(s):  
Valve Replacement ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cardiac Valve ◽  
Care Hospital ◽  
Significant Difference ◽  
Group A ◽  
Cardiac Valve Replacement ◽  
Group B

Background: Warfarin is a drug with narrow therapeutic index. It requires varied adequate doses for achieving target INR so as to prevent episodes of thromboembolism. It is important to properly educate the patient while prescribing this drug to reduce the side effects and maintain perfect anticoagulation status. This study was done to assess the baseline Knowledge, Attitude and Practices (KAP) towards warfarin medication among patients with cardiac valve replacement in a tertiary care hospital of south India to get a baseline data which can recommend implementation of health education programs targeting these patients.Methods: An observational cross-sectional study was approved by Institute Ethics Committee JIPMER, Puducherry. It included patients on treatment with warfarin maintenance therapy for a period of not less than three months following cardiac valve replacement in the months of October 2016 to October 2017. The questionnaire included 39 questions of qualitative and quantitative basis, which was scored for a total of 50 and analysed using SPSS software.Results: About 240 patients were interviewed who attended cardiothoracic vascular surgery outpatient department and taking warfarin for at least 3 months following surgery of valve replacement. Patients were divided into two groups. Group A included patients who achieved target INR and group B are those out of target INR. 15.7 percent (35) had low score, 76.2 (160) had medium score and 15 (7.1) percent had high scores in group A. In group B 22(81.5%) had medium score and 5 (18.5%) had high score. The median score was more among patients with higher education (p=0.01). There was no significant difference between scores between different age groups or profession.Conclusions: Lack of adequate knowledge exists in patients who are followed in CTVS OPD when assessed about the basic nature of their disease and drug use. It has been shown that group B had more score which may be due to more education they may have received owing to non-attainment of target INR. This study acts as a baseline and thus advocates the need of proper patient education for patients taking warfarin which may improve the treatment outcome.

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