Effect of Chloroethane Spray in the Treatment of Spastic Torticollis in Children and Adolescents

Objective. A study to determine the efficacy of chloroethane spray compared to normal saline in the treatment of spastic torticollis in children and adolescents. Hypothesis. Chloroethane spray is more superior to normal saline for the treatment of spastic torticollis in children and adolescents in the pediatric emergency room. Design. Prospective randomized study. Setting. Urban inner-city hospital pediatric emergency department. Methods and Results. All children and adolescents (between the ages of 1 and 16 years) presenting to the author with the complaint of stiff neck were enrolled in the study. A total of 132 patients were enrolled. After complete evaluation to rule out cervical spine injury, a central neurological cause, patients were enrolled in the study. Sixty-six patients were treated with chloroethane spray to the neck and the other 66 were given normal saline as placebo. Sixty-three out of 66 patients treated with chloroethane spray achieved relief in 5 minutes as demonstrated by painless and free movement of the head and neck. No adverse effects were observed. The patients treated with placebo have no relief in 5 minutes. To test the null hypothesis that the percentages improved in the 2 groups equally, we calculated the Z statistic. The Z statistic of 24 corresponded to a P value of <.0001, whether the test is 1-sided or 2-sided. Chloroethane spray treatment was superior to placebo with a high statistical significance. Conclusion. For children and adolescents with spastic torticollis chloroethane spray was more superior to normal saline in the pediatric emergency room.

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Comparison of efficacy between levosalbutamol and levosalbutamol-ipratropum nebulization in mild to moderate childhood asthma

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193597 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1952

Author(s):

R. Ramanathan ◽

B. Mahalakshmi

Keyword(s):

Emergency Department ◽

Flow Rate ◽

Childhood Asthma ◽

Ipratropium Bromide ◽

Randomized Study ◽

Airflow Obstruction ◽

Pediatric Emergency ◽

P Value ◽

Pediatric Emergency Department ◽

The Mean

Background: The objective of the study was to compare the efficacy between levosalbutamol and ipratropium combination over levosalbutamol nebulisation in reversing airflow obstruction and improve oxygenation, evaluated using the pulmonary asthma score, SaO2, and PEFR in mild and moderate asthma.Methods: A prospective, randomized, study was performed in RMMCH pediatric emergency department. Children between 6 and 12 years of age who presented with mild to moderate asthma exacerberations were enrolled in the study. They were randomly allocated into two different groups: one nebulised with levosalbutamol alone and another with addition of ipratropium bromide to levosalbutamol. Baseline Peak expiratory flow rate and Final absolute values or change from baseline 60-120 minutes after the inhalation are measured. Patients were evaluated using the pulmonary score.Results: After treatment there is improvement in the mean pulmonary asthma scores and PEFR percentage in A+B group than A group, but it is not statistically significant (p value >0.05). There is statistically significant improvement in pulmonary asthma score and PEFR in each of the groups after nebulisation and pulmonary asthma score has a sensitivity of 66.7% and 65.6% in diagnosing severity of asthma in relation to PEFR.

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Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension

QJM ◽

10.1093/qjmed/hcab086.035 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Saeed Mohamed Ibrahim ◽

Rania Mahrous Aly Hussien ◽

Hazem Mohamed Sabry Abdel Aziz Ahmed

Keyword(s):

Spinal Anesthesia ◽

Local Anesthetic ◽

Normal Saline ◽

Demographic Data ◽

Randomized Study ◽

P Value ◽

Anthropometric Measures ◽

Double Blind ◽

Induced Hypotension ◽

Significant Difference

Abstract Background Spinal Anesthesia is a common type of anesthesia used during many surgical procedures. This regional technique can be accomplished by administering an intrathecal dose of hyperbaric local anesthetic solution. The local anesthetic within the subarachnoid space can block sensory, motor and sympathetic pathways. Objectives The Purpose of this study was to find out the effectiveness of prophylactic administration of intravenous ondansetron for attenuation of spinal anesthesia induced hypotension in non-obstetric spinal anesthesia surgeries. Patients and Methods Therefore, A prospective double-blind, placebo-controlled, randomized study was found to be the most suitable design in order to achieve the study objectives. A total of 90 patients males & females included in the study, aged 20-40 years, and were divided equally into two groups: Group A received 8 mg ondansetron diluted in volume of 10 cm normal saline 5 minutes prior to spinal anesthesia. Group B received a placebo of 10 cm normal saline 5 minutes prior to spinal anesthesia. Results There was no statistically significant difference found between the two studied groups regarding demographic data, anthropometric measures, ASA score and total time of surgery. There was statistically significant increase in the incidence of hypotension immediately after spinal and at 5 min in placebo group than ondansetron group with p-value = 0.026 and 0.014 respectively. Conclusion The present study demonstrated that, among patients who received spinal anesthesia with bupivacaine for elective for surgeries below umbilicus, prophylactic intravenous ondansetron 8mg iv 5 mins prior to spinal anesthesia reduced spinal anesthesia induced hypotension decreases in SBP, MAP, and heart rate. Ondansetron did not have a significant effect on DBP. Ondansetron did not have a significant effect on DBP. The incidence of nausea and vomiting was lower following the administration of ondansetron, and vasopressor use and dosages were reduced.

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A randomized comparison study of conventional normal saline and silver nanocrystalline gel as topical wound dressings in non-healing wounds

International Surgery Journal ◽

10.18203/2349-2902.isj20213993 ◽

2021 ◽

Vol 8 (10) ◽

pp. 3050

Author(s):

V. Mahadev

Keyword(s):

Normal Saline ◽

Primary Outcome ◽

Statistical Significance ◽

Healing Process ◽

Randomized Study ◽

Wound Dressings ◽

Secondary Outcome ◽

Open Label ◽

Chronic Ulcers ◽

Healing Wounds

Background: Non-healing wounds and chronic ulcers are being consequence of the abnormality in healing process and disturbance in the recovery pathway. Picking an ideal choice of topical application and dressing helps in enhancing the wound heal in addition to the antibiotics administration. To identify the outcome of topical dressing in chronic ulcers by using, silver nanocrystalline gel dressing (AgNP) and conventional normal saline dressing (NS).Methods: This study was an open label randomized study in patient with chronic non-healing wound. The wound healing outcomes of two different dressing methods were compared, which was evaluated by independent assessor. The primary outcome is area reduction of wound and duration of healing. The secondary outcome is the formation of healthy granulation, slough and discharge and wound site infection control.Results: The outcome of AgNP and conventional NS dressing was compared. The 100 patients with non-healing wounds were randomized in the ratio of 1:1. The primary outcome was study group had better area of reduction of 41.97% (SD-7.41) with statistical significance (p<0.0001) and mean duration of healing, 15.64 weeks. The secondary outcome of healthy granulation tissue and reduced slough and discharge at the end of 3 weeks with topical silver nanocrystalline dressing was significant. Conclusions: Topical silver nanocrystalline dressing shall be an effective dressing option to achieve apposite recovery of healing process in non-healing wounds.

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Efficacy of local anaesthetic cocktail infiltration in a total knee replacement: a prospective, randomized study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203719 ◽

2020 ◽

Vol 6 (5) ◽

pp. 992

Author(s):

Ameya U. Kulkarni ◽

Umesh M. Kulkarni

Keyword(s):

Local Anaesthetic ◽

Breakthrough Pain ◽

Statistical Significance ◽

Randomized Study ◽

High Volume ◽

Control Group ◽

P Value ◽

Study Group ◽

Total Knee ◽

Double Blinded

Background: The aim of this study is to assess the efficacy of local anaesthetic cocktail infiltration in pain management during a total knee arthroplasty.Methods: In this study we had 25 patients each in study and control group. The study group was infiltrated with the local anesthetic cocktail just before final implantation. Pain was documented by a visual analogue scale in a double blinded manner. Statistical significance was calculated using an unpaired “t” test.Results: In study group, pain levels were significantly lower as compared to control group for the first 48 hours after surgery with a ‘p’ value of 0.0224 (<0.05). The need of intravenous tramadol for breakthrough pain on the second day was significantly lower in study group as compared to control group with a ‘p’ value of 0.033(<0.05).Conclusions: This study shows that the local high volume anaesthetic infiltration is effective in reducing immediate postoperative pain and the need of IV opioids for the first 48 hours after surgery.

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FACTORS ASSOCIATED WITH THE CARE OF CHILDREN AND ADOLESCENTS FOR EXTERNAL CAUSES IN EMERGENCY SERVICE

Texto & Contexto - Enfermagem ◽

10.1590/1980-265x-tce-2020-0337 ◽

2021 ◽

Vol 30 ◽

Author(s):

Vanessa Gross ◽

Luísa Pradié Algayer ◽

Neila Santini de Souza ◽

Leonardo Bigolin Jantsch

Keyword(s):

Children And Adolescents ◽

Emergency Care ◽

Emergency Service ◽

Suicide Attempts ◽

Descriptive Analysis ◽

Pediatric Emergency ◽

P Value ◽

Pediatric Emergency Care ◽

Frequency Comparison ◽

External Causes

ABSTRACT Objective to analyze the characteristics of children and adolescents treated for external causes in an emergency service. Method this is a retrospective, analytical study, developed in the emergency department of a sentinel hospital in southern Brazil. Seventy-nine children and adolescents, victims of external causes, participated in June to December 2018. Data were collected through access to medical records in May 2019. Descriptive analysis, frequency comparison and Odds Ratio were used to measure the association between the variables studied. Confidence Interval (CI) of 95% and P value of 5% were used. Results approximately 9.3% of pediatric emergency and emergency care were due to external causes; of these, 57% of the victims are under 12 years old and most of them are male (67%). Accidents are the most frequent events (71%), but violence is more frequent (61%) among women (p=0.002). The chance of violence is four times higher in women, especially self-inflicted violence/suicide attempts. Conclusion one out of ten pediatric emergency care is due to external causes, and emerging situations of violence and self-inflicted injuries stand out, a direct implication for public policies.

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EFFECT OF SEPARATION OF INITIAL ASSESSMENT DOCUMENTS ON THE LENGTH OF STAY IN EMERGENCY INSTALLATION IN KENDARI CITY GENERAL HOSPITAL

INDONESIAN JOURNAL OF HEALTH SCIENCES RESEARCH AND DEVELOPMENT (IJHSRD) ◽

10.36566/ijhsrd/vol3.iss2/83 ◽

2021 ◽

Vol 3 (2) ◽

pp. 14-19

Author(s):

Tono Sumanto ◽

Sunarsih Sunarsih ◽

Timbul Supodo

Keyword(s):

Length Of Stay ◽

Emergency Room ◽

General Hospital ◽

Sampling Technique ◽

Initial Assessment ◽

P Value ◽

City Hospital ◽

Number Of Patients ◽

Post Test ◽

Number Of Visits

Background: A preliminary survey of prospective researchers in the Kendari City General Hospital especially in the Emergency Installation (ER), the number of emergency room visits has decreased in the last 3 years, in 2017 the total number of patients treated in the ER was 10.869 patients, then in 2018 the number of visits decreased to 10.768 patients, and in 2019 the number of visits fell to 9.747 patients. Meanwhile, based on the data in the last few months in 2020 there was a very large spike in decline in the last month, in January 2020 the number of patient who visited, were 849 people, then in February 2020 the number of the patient were 1202 patients, March 2020 the number of visits was 1216 patients and finally in April 2020 it fell to 451 people. The purpose of this study is to analyse the effect of separation of the initial assessment documents on Length of Stay in Emergency Installation in Kendari City General Hospital. Methods: The research design was experimental with design pretest post-test one group design. The research location was in the Emergency Room of the Kendari City Regional General Hospital which was carried out during February 2021. The population of all patients who were hospitalized was> 17 years old while the sample was 18 people with the sampling technique of separated random sampling. Result: This study found separation of the initial assessment documents affected significantly to Length of Stay patients in Emergency room in Kendari City General Hospital (p- value = 0.045 < 0.05). Conclusion: Separation technique of the initial assessment documents on Length of Stay was effective to reduce the Length of Stay patients in Emergency room in Kendari City Hospital.

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SERUM PROLACTINE LEVEL IN PATIENTS OF PSORIASIS VULGARIS AND ITS CORRELATION WITH DISEASE SEVERITY: A CASE-CONTROL STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.303 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Pawan Kumar Saini ◽

Devendra Yadav ◽

Rozy Badyal ◽

Suresh Jain ◽

Arti Singh ◽

...

Keyword(s):

Disease Severity ◽

Prolactin Level ◽

Case Control Study ◽

Statistical Significance ◽

Case Control ◽

Serum Prolactin ◽

P Value ◽

Serum Prolactin Level ◽

R Value ◽

Control Study

Background: Psoriasis is an autoimmune chronic inflammatory disorder affecting the skin mediated by T-lymphocytes resulting in production of cytokines which cause hyperproliferation of keratinocytes. Several factors and hormones like Prolactin have an action similar to these cytokines in promoting the multiplication of keratinocytes and other cells like lymphocytes and epithelial cells may have a role on the etiopathogenesis of psoriasis. Aim:-The aim of study is to compare the serum Prolactin levels in patients of psoriasis with a control group. Setting and study design: This is a case-control study conducted in the department of Dermatology, Venereology and Leprosy GMC, Kota over a period of 1year from July 2017 to June 2018 Material and method: The study included 100 cases of psoriasis (60 males and 40 females) and 100 controls similar for age and sex. Serum Prolactin levels were measured by ECLIA and results were obtained. Statistical analysis: Mean and standard deviation were calculated for each variable. Statistical significance of the results was analyzed using correlation analysis (Pearson correlation coefficient) and independent samples t-test. Statistical significance was assumed at p value<0.05. Result: Serum Prolactin level was significantly higher in cases of psoriasis compared to controls (p-value <0.001). PASI score and serum Prolactin levels were found to have a positive correlation (r value = 0.337; p-value: 0.001). No significant correlation was found between serum levels of Prolactin and duration of disease r value= -0.034, P value =0.733). Serum Prolactin level was higher in male patients compared to females patients. Conclusion:- High serum Prolactin may be a biological marker of disease severity in psoriasis and may have a role in the pathogenesis of psoriasis. Further studies with large sample size are required to confirm this hypothesis.

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Analisis Faktor Determinan Pelaksanaan Inisiasi Menyusu Dini Oleh Bidan Di Rumah Sakit Umum Anutapura Palu

Jurnal Bidan Cerdas (JBC) ◽

10.33860/jbc.v1i1.87 ◽

2018 ◽

Vol 1 (1) ◽

pp. 34

Author(s):

Ni Nyoman Novita ◽

Gusman Arsyad

Keyword(s):

Emergency Room ◽

Peer Support ◽

Statistical Tests ◽

Bivariate Analysis ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Implementation Processes ◽

Chi Square Test ◽

The Government

Implementation of IMD in hospitals has decreased from the previous year and has not reached the target set by the government. Some IMD implementation processes have not been carried out according to applicable standards. So that babies do not get an IMD in accordance with existing SOPs. The purpose of this study was to determine the determinant factors associated with the implementation of the IMD by midwives in the Midwifery and Maternity Room Emergency Room (IGD) at the Anutapura General Hospital in Palu. This research method is analytical with cross sectional approach. The population of this study was that all midwives in the obstetrics emergency room and maternity room at Anutapura Palu Hospital were 37 respondents. The sample in this study is total sampling. The analysis used was univariate, and bivariate analysis using the chi square test with a confidence level of 95% (α = 0.05). The results of statistical tests on variable knowledge of midwives with the implementation of IMD p value: 0.018 (p value <0.05). APN training with the implementation of IMD p value: 0.697 (p value> 0.05). length of work with the implementation of IMD p value: 0.029 (p value <0.05). and peer support with the implementation of IMD p value: 0.007 (p value <0.05). Conclusions there is a relationship between knowledge, length of work, peer support with the implementation of the IMD, and training factors that have nothing to do with IMD implementation. The strongest factor in the relationship is peer support. It is recommended that the Anutarapura Palu Hospital be able to motivate midwives so that they can further enhance their role in the implementation and provide support to their colleagues so that the implementation of the IMD can be carried out in accordance with applicable standards.Keywords: Knowledge, APN Training, Duration of work, Implementation of IMD

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