Advanced cancer patients' priorities regarding wishes at the end of life: A randomized controlled study.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 44-44
Author(s):  
Marvin Omar Delgado-Guay ◽  
Alfredo Rodriguez-Nunez ◽  
Vera J De la Cruz ◽  
Susan Frisbee-Hume ◽  
Janet L. Williams ◽  
...  
Keyword(s):  
End Of Life ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
P Value ◽  
Advanced Cancer Patients ◽  
Randomized Controlled ◽  
Group A ◽  
Important People ◽  
Group B ◽  
Group D

44 Background: Conversations about wishes around the end-of-life(EOL) are challenging for clinicians. There is limited literature about the type and stability of patient’s reported EOL planning priorities. We compared a set of 36 cards (“Go-wish-Game”: GWG) v. a paper list of statements (LOS) to assist patients in establishing priorities. Methods: Randomized controlled study. Pts. were randomized to the GWG or to 36 LOS and were asked to categorize them as very, somewhat, or not important; Group A received LOS followed by LOS 4-24 hours later; group B: GWG-GWG; group C: GWG-LOS, and group D: LOS-GWG. The State-Trait Anxiety inventory for Adults(STAI) was done after the first set of questionnaires. Results: 100 pts. Median age (IQR): 56 (27-83) years. 60% female. 68% White, 17% Hispanic, and 9% African-American. 62% married. Age, marital status, religion, education and cancer diagnosis were not significant different among groups. All pts. were able to complete the GWG. 43/50 (88%) agreed that instructions of GWG were clear. 45/50 (92%) agreed that GWG was easy to understand. 31/50 (64%) patients exposed to both tools, preferred GWG. 39/50 (79%) expressed that GWG did not increased their anxiety. 31/50 (63%) expressed that having conversations about priorities near EOL is beneficial to them (p=NS). STAI median (IQR) score after GWG was 48 (39-59) v. 47 (27-63) for LOS, p=0.2952. The 10 most common “Very important” wishes expressed by pts. the first and second time they received the test (%; Spearman, p-value) were: to be at peace with God(74% v. 71%; r=0.73, p<0.0001), to pray(62% v. 61%, r=0.53, p<0.0001), to have my family with me(57% v. 61%; r=0.23, p=0.02), to be free from pain(54% v. 60%, r=0.31, p=0.001), not being a burden to my family(48% v. 49%, r=0.23, p=0.02), to trust my doctor(44% v. 45%; r=0.49, p<0.0001), to keep my sense of humor(41% v. 45%; r=0.53, p<0.0001), to say goodbye to important people in my life(41% v. 37%; r=0.46, p<0.0001); to have my family prepared for my death(40% v. 49%; r=0.48, p<0.0001). Conclusions: EOL wishes were similar and persistent using both GWG and LOS. Completing both GWG and LOS did not increase anxiety. All patients were able to complete and most preferred GWG.

Single or two instillations of pirarubicin as prophylaxis for recurrence after transurethral resection of Ta and T1 transitional cell bladder cancer: A prospective, randomized controlled study.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. LBA266-LBA266
Author(s):  
Takashi Saika ◽  
Tomoyasu Tsushima ◽  
Yasutomo Nasu ◽  
Hiromi Kumon ◽  
Keyword(s):  
Transurethral Resection ◽  
Intravesical Instillation ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Group A ◽  
Muscle Invasive ◽  
Group B

LBA266 Background: Although single intravesical instillation chemotherapy immediately after transurethral resection (TUR) is the standard treatment for non-muscle-invasive bladder tumors, 40% to 80% of tumors show intravesical recurrence. In this prospective randomized controlled study, we try to evaluate the prophylactic efficacy and safety of twice intravesical instillation using pirarubicin (THP) administered immediately after TUR and on the next day following TUR by comparison with single instillation immediately after TUR. Methods: Between 2005 and 2009, 250 patients with Ta and T1 solitary bladder carcinoma were enrolled in this study. Patients were randomized into two groups. Group A patients were treated with two intravesical instillations of THP 30 mg/50 ml saline immediately after TUR and within 24 hours. Group B patients were treated with single instillation of the same dose immediately after TUR as a control group. The primary endpoint was duration to the first recurrence, and the secondary endpoint was safety. Results: The enrollment was closed on 2009, and the follow-up phase is in process. Of the 250 patients, 125 in Group A and 125 in Group B could be evaluated as full analysis set. One hundred eight male and 17 female were in Group A, on the other hands, one hundred five male and 20 female were in Group B. Eighty-six cases (69%) in group A, and 88 cases (70%) in group B were primary tumor. Fifty-seven cases (46%) in group A, and 56 cases (45%) in group B were small tumor (less than 10mm). There was no difference between backgrounds of both groups. The randomization worked well. In this ad interim report, median follow up was 48 months. Two-year recurrence-free rates were 76.8% in group A and 67.5% in group B. Adverse reactions related to instillation were observed in about 20% of the patients. These toxicities were mild and transient. Only the incidence of frequency in group A was higher than that in group B (20% vs. 8%, p=0.0106). Conclusions: Intravesical instillation of THP 30 mg twice within 24 hours after TUR was effective as prophylactic therapy for non-muscle-invasive cancer with tolerable toxicity problems.

scholarly journals Efficacy and safety of iontophoresis combined sodium salicylate in acquired plantar keratoderma-a randomized controlled study

2021 ◽  
Vol 8 (1) ◽  
pp. 101
Author(s):  
Shreya P. Somani ◽  
Bhavsh N. Astik ◽  
Hita H. Mehta ◽  
Milan D. Jhavar
Keyword(s):  
Sodium Salicylate ◽  
Randomized Controlled Study ◽  
Treatment Modalities ◽  
Controlled Study ◽  
Mean Values ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p><strong>Background</strong>: Palmoplantar keratoderma is a heterogenous group of disorders, hereditary or acquired, characterized by thickening of palms and soles. Though it is not a life-threatening condition, it affects individual’s quality of life. As treatment of keratoderma has always been troublesome, upgraded treatment modalities which improves keratoderma efficiently are always encouraged.</p><p><strong>Methods</strong>: In this randomized controlled study, patients of plantar keratoderma of age group of 18-65 years were randomly divided in group A and group B. In group A, iontophoresis combined sodium salicylate was offered to patients twice weekly for 8 weeks of duration, during which DC current was supplied at 5-15 mA for 10 min of duration. Whereas, in group B patients applied topical salicylic acid 12% ointment at home twice a day for 8 weeks.</p><p><strong>Results</strong>: Our study of 70 patients of keratoderma, revealed diffuse (94%) pattern of involvement with female preponderance (55.7%) and occupation wise, most common among laborers (54.2%) followed by housewives (27.1%). Statistically significant number of patients showed reduction in severity grading of parameters, in both groups at end of 8 weeks. Same way, mean values of parameter grading significantly reduced at 8 weeks in both the groups. But intergroup values showed no significant difference. Mean EASI (Eczema Area Severity Index) score showed statistically significant reduction in group B as compared to group A at 8<sup>th</sup> week. Percentage of reduction of EASI score was also significantly higher in group B at end of treatment.</p><p><strong>Conclusions:</strong> Here both treatment modalities are safe and effective, topical being slightly more efficacious than iontophoresis. So, we can conclude that no additional privilege of drug delivery through iontophoresis.</p>

scholarly journals Randomized Controlled Trial to Evaluate the Efficacy of Intrathecal Dexmedetomidine to Low dose hyperbaric 0.5% Bupivacaine in Elective Lower Segment Caesarean Section

2022 ◽  
Vol 9 (3) ◽  
pp. 48-53
Author(s):  
Yogesh Borse ◽  
Anil Patil ◽  
Sandip Thorat ◽  
Rajesh Subhedar
Keyword(s):  
Low Dose ◽  
Neonatal Outcome ◽  
Controlled Study ◽  
P Value ◽  
Lower Segment ◽  
Hyperbaric Bupivacaine ◽  
Randomized Controlled ◽  
Group B ◽  
Group D ◽  
Motor Onset

Abstract Introduction: Dexmedetomidine has been safely used as an adjuvant for subarachnoid block in obstetric as well as non-obstetric surgeries and was found to be effective without adverse effects. Hence, this study was conducted to determine the efficacy of intrathecal Dexmedetomidine for elective lower segment caesarean sections with reduction of local anesthetic dose. Objectives: This double blinded, randomized controlled study was designed to compare the effects of addition of Dexmedetomidine on 1) Sensory and motor block 2) Maternal hemodynamics 3) Post-operative analgesia and 4) Neonatal outcome. Methods: Eighty parturients were enrolled in study and randomized into two groups as of 40 each and named as Group D and Group B. Group D received 0.5% Hyperbaric Bupivacaine 9mg (1.8ml) + Dexmedetomidine 5µg (0.2ml of 25 µg per ml ) and for Group B received 0.5% Hyperbaric Bupivacaine 10mg (2ml) . Characteristics of block, maternal hemodynamics and neonatal outcome were recorded. P value <0.05 was considered as significant. Results: Sensory onset was rapid in D group as compared to B group (3.7 ± 1.1vs 4.5±1.2) and motor onset was also rapid in D group (3.8±2.0 vs 4.9 ±1.9) with 95% CI. Duration of analgesia was also significantly high in Group D (230.5±40.5 vs 145.1±28.5). No adverse maternal and fetal outcomes were reported. Conclusion: Intrathecal Dexmedetomidine with low dose bupivacaine for cesarean section hastens the sensory as well as motor onset without adversely affecting mother and neonate.

Advanced cancer patients’ reported priorities regarding wishes at the end of life: A randomized controlled study.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 9546-9546
Author(s):  
Marvin Omar Delgado-Guay ◽  
Vera J De la Cruz ◽  
Susan Frisbee-Hume ◽  
Janet L. Williams ◽  
Jimin Wu ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Advanced Cancer Patients ◽  
Randomized Controlled

The effect of Head Covering on Phototherapy-Induced Hypocalcemia in Jaundiced Full-Term Neonates

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amira Said Mohamed ◽  
Sherein M Abd El fattah ◽  
Safaa S Imam ◽  
Basma M Shehata
Keyword(s):  
Full Term ◽  
Controlled Study ◽  
Led Phototherapy ◽  
Group I ◽  
Group A ◽  
Rate Of Decline ◽  
Group B ◽  
Head Cover ◽  
Group D ◽  
Head Covering

Abstract Background Phototherapy is the main method used in treatment of significant indirect hyperbilirubinemia and it reduces the risk of exchange transfusion. Hypocalcemia is one of the side effects of phototherapy due to inhibition of pineal gland via transcranial illumination, resulting in decline of melatonin secretion that further inhibits the effect of cortisol on bone calcium and ultimately increase the bone uptake. Aim To assess the effect of head covering to ameliorate hypocalcemic effect of different types of phototherapy in full term jaundiced neonates. Patients and Methods A prospective randomized controlled study that included 120 jaundiced neonates requiring phototherapy which divided into two main groups; group I (treated with lamp phototherapy) which was equally subdivided into two groups, group A (without head cover) and group B (with head cover) and group Il (treated with LED phototherapy) which was equally subdivided into group C (without head cover) and group D (with head cover). Results Head cover reduced the incidence of phototherapy induced hypocalcemia without affecting rate of decline of bilirubin on both types of phototherapy used. In lamp hypocalcemia (&lt;8mg/dl) was detected in 33.3% in jaundiced neonates without head cover which was significant higher than those with head cover 6.7%. As for LED, yet not statistically significant hypocalcemia was detected in 13.3% in jaundiced neonates without head cover, which was higher than those with head cover 3.3%. Conclusion Incidence of phototherapy induced hypocalcemia is reduced by using head cover especially while using lamp phototherapy.

scholarly journals Effectiveness of ultrasound guided ethanol motor points block in reduction of spasticity and improvement of upper limb function in hemiplegic patients: a randomized controlled study

2020 ◽  
Vol 7 (9) ◽  
pp. 1409
Author(s):  
Sreejith C. ◽  
Akoijam Joy Singh ◽  
Longjam Nilachandra Singh ◽  
Kanti Rajkumari ◽  
Margaret Chabungbam ◽  
...  
Keyword(s):  
Upper Limb ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Ultrasound Guided ◽  
Limb Function ◽  
Ethanol Injection ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Group A

Background: Stroke is the third leading cause of disability in general population commonly causing upper motor neuron syndrome complications like spasticity, which is more common in upper limb. Ethanol injection into spastic muscle is an emerging effective treatment in the spasticity management. Ethanol causes selective destruction of nerve fibers through denaturation of protein.Methods: A randomized controlled study was conducted for a period of 2 years from March 2018 on sixty-eight hemiplegic patients to assess the effectiveness of ethanol muscle block in reduction of spasticity and improvement in functional ability. The patients were allocated into two groups (Group A and B). Group A received ultrasound guided intramuscular ethanol injection along with range of motion (ROM) exercises and wrist hand orthosis (WHO) and Group B received ROM exercises and WHO. The outcomes were measured by modified ashworth scale (MAS) for spasticity and modified version of motor assessment scale for functional improvement.Results: Intervention group showed significant improvement in spasticity shown by reduction of MAS of elbow flexors from 3 at baseline to 1.15±0.3 at 12 weeks as compared to control group with 3 at baseline to 1.76±0.5 at 12 weeks (p<0.05). Upper limb function scale of study group improved from 1.5±0.8 to 3.0±0.6 at 12 weeks compared to control group 1.3±0.8 to 2.8±0.6 (p<0.05).Conclusions: It can thus be concluded that intramuscular injection of ethanol accompanied by wrist hand orthosis have beneficial effect on improvement of spasticity and upper limb function.

scholarly journals Quality of life, clinical outcomes and safety of early prophylactic levothyroxine administration in patients with Graves' hyperthyroidism undergoing radioiodine therapy: a randomized controlled study

2016 ◽  
Vol 174 (4) ◽  
pp. 491-502 ◽  
Author(s):  
David Taïeb ◽  
Claire Bournaud ◽  
Marie-Claude Eberle ◽  
Bogdan Catargi ◽  
Claire Schvartz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Endpoint ◽  
Radioiodine Therapy ◽  
Controlled Study ◽  
Thyroid Function Tests ◽  
Randomized Controlled ◽  
Sf 36 ◽  
Group A ◽  
Group B

ObjectiveWhile radioiodine therapy is commonly used for treating Graves' disease, a prolonged and clinical hypothyroidism may result in disabling symptoms leading to deterioration of quality of life (QoL) of patients. Introducing levothyroxine (LT4) treatment in the early post-therapeutic period may be an interesting approach to limit this phenomenon.MethodsA multicenter, prospective, open-label randomized controlled trial enrolled 94 patients with Graves' hyperthyroidism randomly assigned to the experimental group (n=46) (group A: early prophylactic LT4treatment) or the control group (n=48) (group B: standard follow-up). The primary endpoint was the 6-month QoL. The secondary endpoints were other QoL scores such as Graves' ophthalmopathy (GO) outcomes, thyroid function tests and safety.ResultsThe primary endpoint at 6 months was achieved: the mental composite score (MCS) of Short Form 36 (SF-36) was significantly higher in group A compared to group B (P=0.009). Four other dimension scores of the SF-36 and four dimension scores of the thyroid-specific patient-reported outcome (ThyPRO) significantly differed between the two groups, indicating better QoL in group A. After adjustment for variables, the early LT4administration strategy was found as an independent factor for only two scores of SF-36: the MCS and the general health (GH) score. There were no differences in GO, final thyroid status and changes in the anti-TSH receptor antibodies (TRAbs) levels between the two groups. No adverse cardiovascular event was reported.ConclusionEarly LT4administration post-radioactive iodine (RAI) could represent a safe potential benefit for patients with regard to QoL. The optimal strategy taking into account administered RAI activities and LT4treatment dosage and timing remains to be determined.

Comparison of harmonic scalpel versus Milligan Morgan technique in haemorrhoidectomy patients

2021 ◽  
Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair
Keyword(s):  
Wound Healing ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Controlled Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group A ◽  
The Mean ◽  
Complete Wound Healing ◽  
Group B

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...

scholarly journals Effects of Aqueous Extract of Basella alba L. leaves on Blood Cell Count in Rats

2019 ◽  
Vol 22 (1) ◽  
pp. 73-78
Author(s):  
Farhana Sabrin ◽  
AF Mohammed Shafiqul Alam ◽  
Muhammad Rashedul Islam ◽  
Md Elias Al Mamun ◽  
Jakir Ahmed Chowdhury
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Aqueous Extract ◽  
Control Group ◽  
P Value ◽  
Blood Cell Count ◽  
Basella Alba ◽  
Group A ◽  
Group B ◽  
Group D

The effect of aqueous extract of Basella alba (puishak) leaves on blood cell count of rats was studied. Forty rats of both sexes weighing between 100-150 gm were used. The rats were divided into four groups (7 rats in each group), with group A as the control group and experimental groups were denoted as B, C and D. With all aseptic precautions, aqueous extract of Basella alba (Puishak) leaves was administered into the three different doses (For group B: 60 mg/kg bw, group C: 80 mg/kg bw and group D: 100 mg/kg bw). Control group A also received distilled water as a placebo at the dose of 10 mg/kg bw for 14 days. At day 15, blood samples were collected and sent for haematological analysis. Data analysis of blood count profile of 28 rats revealed that there is an increased number of RBC, WBC and platelet count in experimental groups than in control group. ANOVA test revealed that increased blood cell counts following administration of aqueous leaves extract of keeves of B. alba were statistically significant (p value for each case was .0001<.05) than control group. Paired samples t test was performed to compare between baseline hematological parameters and parameters after 14 days of intervention. Then comparison between Group A & Group B, between Group A & Group C and between Group A & Group D were done. In all cases, probability (p) value < 0.05 was considered as statistically significant.This it is clearly evident that aqueous extract of B.alba has positive stimulant effect on blood cells count of rats. Moreover, it was found that increment of doses also increases the cell count that is positively correlated with the hypothesis. Bangladesh Pharmaceutical Journal 22(1): 73-78, 2019

scholarly journals Tramadol as an adjunct to bupivacaine for brachial plexus block.

2019 ◽  
Vol 26 (09) ◽  
pp. 1482-1486
Author(s):  
Afifa Zahoor ◽  
Ranna Mussrat ◽  
Muhammad Ahmad Khan ◽  
Shakeel Ahmad
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Block ◽  
University Hospital ◽  
Orthopedic Procedures ◽  
Controlled Study ◽  
P Value ◽  
Rescue Analgesia ◽  
Group A ◽  
Group B ◽  
Plexus Block

Objectives: To compare the efficacy of tramadol and 0.25% bupivacaine versus 0.25% bupivacaine alone for brachial plexus block. Study Design: Randomized controlled study. Setting: Orthopedic department of Nishtar Medical University/Hospital Multan. Period: The study duration was Jan-2018 to Aug-2018. Material and Methods: 148 patients planned for with upper limb orthopedic procedures under BPB in the department of orthopedics department Nishtar Hospital Multan were included in this analysis. To Patients were randomly divided into two equal groups by lottery method. Group A patients were given solution with 38 ml 0.25% bupivacaine with 100 mg tramadol 2 ml and group B were given solution with 38 ml 0.25% bupivacaine and 2 ml 0.9 % normal saline. Time of onset of block and its duration and need for rescue analgesics were noted. Results: Time of onset of block was 14.56+1.01 minutes in group A versus 15.96+1.64 minutes in group B (p-value <0.001). Mean analgesia duration was 355.85+42.18 minutes in group A versus 310.47+38.79 minutes in group B (p-value <0.001). There were 51 (68.9%) patients in group A who required rescue analgesia and 68 (91.9%) patients in group B required rescue analgesia (p-value 0.004). Conclusion: We concluded that the addition of tramadol as adjunct to bupivacaine for BPB significantly shortens the duration of onset, prolongs the duration of analgesia and reduces the need for rescue analgesics.

Sign in / Sign up

Export Citation Format

Share Document