Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial

Background and Objectives: Milligan Morgan Hemorrhoidectomy is one of the most commonly performed surgeries. Post-operative pain is the major cause of morbidity in post hemorrhoidectomy patients. Metronidazole has an established role in relieving post hemorrhoidectomy pain. The objective was to evaluate the pain score by using topical and oral metronidazole in post Milligan Morgan hemorrhoidectomy patients. Methods: A prospective randomized controlled trail was done in surgical departments of Akbar Niazi Teaching Hospital, Islamabad. A total of 166 consecutive patients with 3rd and 4th degree hemorrhoids were presenting in surgical OPD and who underwent Milligan Morgan hemorrhoidectomy between July 2018 and December 2018 were included in the study. Patients allocated in two groups, Group-A received topical metronidazole 10% post hemorrhoidectomy for seven days and Group-B were given oral metronidazole 400mg for 07 days. Analgesics were given on patient’s requirement. Patients post hemorrhoidectomy pain was recorded by using VSA scale at baseline (1st day) and on 7th post-operative day. Data analysis was done by using SPSS 21. Pain calculated by compared in terms of mean, standard deviation between groups and independent sample T test was used. Association between demographic details like gender and ages of the patients with pain scale on 7th day was measured and chi-square distribution was used. Results: Total 166 patients were included in this study. The mean ages of the patients were 44.07±10.62 years with minimum 20 and maximum 60 years. Out of 166 patients, female were 55 (33.1%) and male were 111 (66.9%). Results showed significantly lower pain in patients using topical metronidazole as compared to oral metronidazole (p=0.001). Association of pain with respect to ages was insignificant (p=0.202) whereas between genders inside the groups showed significant difference (p=0.028). Conclusion: These results showed that topical metronidazole significantly reduces pain in post hemorrhoidectomy patients as compared to oral metronidazole overall and even when data stratified among age, gender and type of hemorrhoids. doi: https://doi.org/10.12669/pjms.36.5.1796 How to cite this:Abbas ST, Raza A, Chaudhry I, Hameed T, Hasham N, Arshad N. Comparison of mean pain score using topical and oral metronidazole in post milligan morgan hemorrhoidectomy patient; A randomized controlled trial. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1796 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Randomized controlled trial of erdosteine for acute cough in children with colds

Paediatrica Indonesiana ◽

10.14238/pi51.2.2011.111-5 ◽

2011 ◽

Vol 51 (2) ◽

pp. 111

Author(s):

Yenny Yenny ◽

Roni Naning ◽

Amalia Setyati

Keyword(s):

Randomized Controlled Trial ◽

Clinical Improvement ◽

Common Cold ◽

Controlled Trial ◽

Research Subjects ◽

Acute Cough ◽

Chi Square ◽

Double Blind ◽

Randomized Controlled ◽

Significant Difference

Background T h e prevalence of the common cold in children is high, v.ith 30% of cases exhibiting an acute cough, the most common complaint by parents. Erdosteine, a recently developed cough medicine, is available for children. Erdosteine has been reported to increase mucodliary clearance, act as an antioxidant and prevent bacterial adhesion.Objective To assess the clinical improvement in acute cough in children \\lith a common cold taking erdosteine vs. a placebo.Methods We conducted a double􀀾blind, randomized, controlled trial at the Public Health Center of Gedongtengen, Yogyakarta with 140 children selected by a consecutive sampling method. Research subjects were randomized by computer program into two treatment groups, those receiving erdosteine therapy and those receiving a placebo. Both groups were monitored for 6 days. A scoring system was used to assess the improvement of acute cough symptoms and analyzed by Chi-square test.Results No significant differences in basic characteristics, cough severity, or environment were found among the 140 children with common cold in the two groups. After 6 days of treatment, no significant difference in clinical improvement of acute cough was found between the erdosteine (65 subjects improved out of 70) and placebo groups (62/70),92.5% and 88.6%, respectively (P=0.382).Conclusion Erdosteine was not more effective than the placebo for treatment of acute cough in children with common cold.

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Omega-3 Fatty Acids plus Vitamin E Cosupplementation versus Vitamin E in Fibrocystic Breast Patient with Mastalgia: A Randomized Controlled Trial

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5682 ◽

2021 ◽

Vol 9 (B) ◽

pp. 116-121

Author(s):

Marwa Mostafa Ahmed ◽

Eman Ahmed Rushdy ◽

Dalia Ahmed Aboul Azm ◽

Rehab Mohamed Sabry ◽

Heba Galal El Nahas

Keyword(s):

Randomized Controlled Trial ◽

Vitamin E ◽

Pain Score ◽

Controlled Trial ◽

Control Group ◽

Common Symptom ◽

Omega 3 ◽

Negative Effects ◽

Randomized Controlled ◽

Significant Difference

BACKGROUND: Fibrocystic changes (FCCs) of the breast are a common breast condition. Mastalgia is the most common symptom of FCC; it usually causes fear of breast cancer and has negative effects on the quality of life. AIM: The objective of the research was to establish the effect of cosupplementation of omega-3 plus Vitamin E on mastalgia in FCC patients, to evaluate its effect with that of Vitamin E only, and to determine the effect of omega-3 plus Vitamin E versus Vitamin E only on the radiological findings in FCC patients. METHODS: This randomized controlled trial was conducted on 120 FCC patients with mastalgia. The participants were randomly assigned into three groups: Omega-3 plus Vitamin E group, Vitamin E only group, and control group. The new breast pain chart was used to assess the severity of mastalgia in the three groups before, through, and after intervention. Radiological assessment was done before and after the intervention. RESULTS: After 3 months of the intervention, there was a statistically significant difference between the three groups regarding radiological results with p > 0.05 and, after the 3rd month of interventions, there was a statistically significant difference between the groups regarding the new pain score with p > 0.001. The median of the new pain score premenstrual was 4.8, 2, and 2.5 in control, omega-3 plus Vitamin E, and Vitamin E only, respectively, but this difference was insignificant between the last two groups (p < 0.996). CONCLUSION: This study showed that Vitamin E and Vitamin E plus omega-3 were effective in relieving mastalgia in FCC patients. However, the addition of omega-3 was ineffective.

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Does Artificial Rupture of Membranes (ARM) Reduce Duration of Labor in Primigravidae: A Randomized Controlled Trial

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1057 ◽

2010 ◽

Vol 2 (1) ◽

pp. 37-39

Author(s):

MB Bellad ◽

Patil Kamal ◽

Patil Rajeshwari

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Mode Of Delivery ◽

Control Group ◽

P Value ◽

Chi Square ◽

Randomized Controlled ◽

Third Stage Of Labor ◽

Significant Difference ◽

One Year

ABSTRACT Objective To study the effectiveness of artificial rupture of membranes(ARM) in reducing the duration of labor in primigravida. Methods A one year prospective randomized controlled trial was carried out on 200 primigravida (100 each to ARM and no ARM group) meeting the selection criteria. The outcomes were noted in both the groups. Data analysis was done using Chi Square and Z test. Results The mean duration of labor from enrolment to full dilation of the cervix or bearing down sensation was 4.76 ± 1.64 in ARM group compared to 5.66 ± 1.85 in the control group which was statistically significant (p value = 0.000; 95%). There was no difference in the duration of second and third stage of labor in both groups. There was no significant difference in the mode of delivery between ARM and control group. There was no significant difference in mean birth weight and Apgar score between the two groups. Conclusion ARM definitely reduced the duration of labor without any detrimental effects on fetus, mother and mode of delivery. Hence, there is no reason to strive to maintain the integrity of the fetal membranes in spontaneous labor in women where ARM is not contraindicated.

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Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi

Jurnal Anestesi Perioperatif ◽

10.15851/jap.v7n1.1587 ◽

2019 ◽

Vol 7 (1) ◽

pp. 25-32

Author(s):

Arna Fransisca ◽

Iwan Fuadi ◽

Dewi Yulianti Bisri

Keyword(s):

Randomized Controlled Trial ◽

Postoperative Nausea ◽

Controlled Trial ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Chi Square ◽

Double Blind ◽

Consecutive Sampling ◽

Randomized Controlled ◽

Significant Difference

Mual muntah pascaoperasi merupakan salah satu komplikasi anestesi dan operasi yang menjadi perhatian khusus karena memengaruhi kualitas pelayanan kesehatan, memperpanjang lama perawatan, dan meningkatkan angka morbiditas perioperatif. Pascaoperasi payudara berkaitan dengan angka kejadian mual muntah pascaoperasi yang tinggi. Beberapa konsensus penatalaksanaan mual muntah pascaoperasi merekomendasikan pemberian terapi nonfarmakologi dengan aromaterapi sebagai terapi rescue untuk mengatasi mual muntah pascaoperasi. Tujuan penelitian ini adalah membandingkan aromaterapi pepermin dengan ondansetron sebagai terapi rescue dalam menurunkan kejadian mual muntah pascaoperasi mastektomi. Penelitian ini merupakan penelitian eksperimental yang dilakukan secara prospektif dengan desain penelitian double blind randomized controlled trial dan consecutive sampling terhadap 32 subjek penelitian yang menjalani operasi mastektomi elektif dan memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli–September 2018. Pada penelitian ini, data ordinal diuji dengan Uji Mann Whitney dan untuk data kategorik diuji dengan uji chi-square. Hasil penelitian ini didapatkan penurunan kejadian mual muntah pascaoperasi yang signifikan pada kelompok pepermin dibanding dengan kelompok ondansetron dengan perbedaan yang bermakna (p<0,05) pada penilaian menit kedua dan menit kelima setelah perlakuan. Simpulan, aromaterapi pepermin efektif menurunkan kejadian mual muntah pascaoperasi mastektomi dan dapat digunakan sebagai alternatif terapi atau terapi tambahan untuk penatalaksanaan mual muntah pascaoperasi.Comparison of Peppermint Aromatherapy with Ondansetron Intravenous as a Rescue for Postoperative Nausea Vomiting after Mastectomy SurgeryPostoperative nausea and vomiting are among anesthesia and surgery complications that receive special considerations as it affects the quality of healthcare services, prolongs care, and increases perioperative morbidities. The incidence of postoperative nausea and vomiting is high in patients that have undergone breast surgery. The consensus for postoperative nausea and vomiting management recommends non-pharmacological treatments, one of which is through the use of aromatherapy as a rescue to resolve postoperative nausea and vomiting. This study aimed to compare the effects of peppermint aromatherapy and ondansetron as a rescue in reducing the incidence of postoperative nausea and vomiting after elective mastectomies. This was a prospective experimental double blind randomized controlled trial study with consecutive sampling on 32 research subjects underwent elective mastectomies and met the inclusion criteria in Dr. Hasan Sadikin General Hospital in July–September 2018. The ordinal data were tested using the Mann Whitney statistics test and the categorical data using the chi square test. The results show a significant decrease in nausea and vomiting incidence in the peppermint group compared to the ondansetron group with significant difference (p<0.05) in two minutes and five minutes after treatment. In conclusion, peppermint aromatherapy is effective in reducing the incidence of postoperative nausea and vomiting after mastectomies and can be used as an alternative or additional treatment in managing postoperative nausea and vomiting.

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Randomized Controlled Trial of DDS for Covid-19 ARDS

10.21203/rs.3.rs-509122/v5 ◽

2021 ◽

Author(s):

Jong Hoon Lee ◽

Badar Kanwar ◽

Chul Joong Lee ◽

Jenny Balentine ◽

Asif Khattak ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

P Value ◽

Chi Square ◽

Randomized Controlled ◽

Pyrin Domain ◽

Significant Difference ◽

Chemically Reacting ◽

Second Period ◽

Receptor Family

Abstract Background Clinicians considered DDS administration to treat SARS-CoV-2 inflammasome. DDS is helpful in the molecular regulation of Nod-like receptor family pyrin domain-containing 3 (NLRP3).Objective To study the targeting of NLRP3 itself or up-/downstream factors of the NLRP3 inflammasome by DDS must be responsible for its observed preventive effects, functioning as a competitor.Methods This is a randomized controlled trial (RCT). We set out to use objective criteria of improvement. We treated the patients with standard Covid-19 acute respiratory distress syndrome (ARDS) treatment with DDS. The RCT results were analyzed.Results ARDS progression was blocked in 17 of 19 total patients at the first period. The 44 subjects were analyzed during the second period. It is significant at the ARDS onset stage. The mortality of ARDS-onset patients was 0% with DDS and 40% without DDS among the total of 65 cases. The t-value of RCT is -1.5, and the p-value is .075475. The result is significant at p < 0.10. ARDS onset with DDS prescribed group survived more 90% than ARDS onset without DDS group. The chi-square is 5.8108. The p-value is .015928. (Significant at p < .05) (RR 0.15, OR 0.09)Conclusion There was a significant difference in DDS treatment results in the ARDS-onset group. We confirmed that DDS clinically treated the onset of ARDS by targeting SARS-CoV-2-activated inflammasomes. Like chemically reacting substances, inflammasome and DDS compete, proving that it is effective in early ARDS.ClinicalTrials.gov Identifier: NCT04918914

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Comparison of Intravenous Paracetamol Prophylaxis versus Placebo for Prevention of Pain with Injection Rocuronium

10.53350/pjmhs211581852 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1852-1854

Author(s):

Aneeque Alam Khan ◽

Kiran Mehwish ◽

Ravi Kumar ◽

Pavan Kumar ◽

Tahir Ali ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Placebo Group ◽

Pain Score ◽

Elective Surgery ◽

Controlled Trial ◽

P Value ◽

Randomized Controlled ◽

Intravenous Paracetamol ◽

Significant Difference ◽

The Mean

Aim: To compare the frequency of absence of pain with injection paracetamol versus placebo given before injection rocuronium in patients undergoing elective procedures Study design: Randomized Controlled Trial Place and duration of study: Dept of Anaesthesia, Civil Hospital, Karachi from 15th January to 14th July 2017. Methodology: One hundred and two patients aged 25-75 years of either gender undergoing elective surgery were enrolled. The lottery method was used to divide the patients into two equal groups. Paracetamol (5 mL, 10 mg/mL) or normal saline (5 mL) were used as pretreatment solutions. When the tourniquet was removed after 2 minutes, the rocuronium at 1% concentration was injected throughout the 10 second’s period. Patients were then advised and asked to rate their pain on the hand's dorsum using VAS. Results: Mean age of the patients was 44.11±7.75 years. Mean pain score was 1.49±1.38. Significant difference was observed in the mean pain score in between paracetamol and placebo group (p-value <0.001). Overall absence of pain was found in 49 (40.8%). Absence of pain was found to be higher 34 (69.4%) in paracetamol group as compared to placebo group (p-value <0.001). Conclusion: Frequency of absence of pain found lower in patients undergoing elective procedures with injection paracetamol versus placebo given before injection rocuronium. Keywords: Injection rocuronium, Elective procedures, Injection paracetamol, Absence of pain

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The The Effectiveness of Early Mobilization Time on Balance and Functional Ability after Ischemic Stroke

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.269 ◽

2019 ◽

Vol 7 (7) ◽

pp. 1088-1092

Author(s):

Umi Budi Rahayu ◽

Samekto Wibowo ◽

Ismail Setyopranoto

Keyword(s):

Randomized Controlled Trial ◽

Ischemic Stroke ◽

Functional Ability ◽

Controlled Trial ◽

Early Mobilization ◽

Berg Balance Scale ◽

Early Mobilisation ◽

Inclusion Criteria ◽

Randomized Controlled ◽

Significant Difference

BACKGROUND: Early mobilisation (EM) after-ischemic stroke is a motor learning intervention aimed to restore nerve cells and to improve balance and functional ability. Unfortunately, the study of when this intervention began has not been widely studied. AIM: On this study was compared the effect of EM started at 24 hours and 48 hours after an ischemic stroke on balance and functional ability. MATERIAL AND METHODS: Randomized controlled trial involving 40 patients on 2 groups meeting predefined inclusion criteria. The levels of balance were measured using the Berg Balance Scale, and the functional ability was measured using the Barthel Index, at 5th and 7th day. RESULTS: A significant difference was observed in both balance (p = 0.038) and functional ability (p = 0.021) obtained on the 7th day of assessment between both groups. A significant difference on the 5th day was observed only in the functional ability (p = 0.002) and not in the balance (p = 0.147), between the groups. CONCLUSION: EM started at 24 hours after the ischemic stroke has been found to have a better impact on balance and functional ability compared to that at 48 hours.

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Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n2p70 ◽

2019 ◽

Vol 10 (2) ◽

pp. 70

Author(s):

Samah Nasser Abd El-Aziz El-Shora ◽

Amina Mohamed Rashad El-Nemer

Keyword(s):

Randomized Controlled Trial ◽

Cesarean Section ◽

Controlled Trial ◽

Intervention Group ◽

Cost Effective ◽

Control Group ◽

Induced Hypotension ◽

Randomized Controlled ◽

Significant Difference ◽

Wrapping Technique

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.

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Interest of a standardized hypnotic message for the reduction of pain and anxiety in cancer patients treated by capsaicin patch for neuropathic pain: a randomized controlled trial

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03329-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rémi Etienne ◽

Myriam Laurent ◽

Aline Henry ◽

Antoine Bioy ◽

Julia Salleron ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Neuropathic Pain ◽

Rating Scales ◽

Controlled Trial ◽

Standard Group ◽

Randomized Controlled ◽

Significant Difference ◽

Numerical Rating ◽

Reduction Of Pain ◽

The Impact

Abstract Background Neuropathic pain is characterized by spontaneous painful symptoms. Medical therapies include the use of a capsaicin 8% patch (Qutenza®, Grünenthal Gmbh, Germany), and patients may experience a sharp burning sensation at application and removal of the patch. This study aimed to evaluate the impact of playing a standardized hypnosis recording during application, on the pain and anxiety induced by capsaicin treatment. Methods In a randomized, controlled trial, we assessed the benefits of the intervention firstly on pain and secondly on anxiety, as measured using numerical rating scales. All patients had application of the capsaicin patch, including the possibility for the patient to apply a cold patch. Participants were randomly assigned to one of 3 groups, namely the “Standard group” (no intervention), “Hypnosis group”, in which a standardized hypnotic message was played during application, or the “Music group” in which relaxing music was played during application of the patch. Results Sixty-nine patients were included. Overall, there was no significant difference in pain scores between groups (p = 0.355). Compared to standard application, anxiety was significantly lower in the hypnosis group after application (p = 0.007), with no significant difference between the standard and music arms (p = 0.271), or between the hypnosis and music arms (p = 0.423). Conclusions Listening to a standardized hypnotic message during application of a capsaicin patch was found to significantly lower anxiety. These findings indicate that the use of a hypnotic message can reduce discomfort and warrant its evaluation in other indications of pain or anxiety during treatment procedures. Trial registration NCT02822625.

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Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial

BMC Infectious Diseases ◽

10.1186/s12879-021-06045-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Keivan Ranjbar ◽

Mohsen Moghadami ◽

Alireza Mirahmadizadeh ◽

Mohammad Javad Fallahi ◽

Vahid Khaloo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Clinical Status ◽

Intervention Group ◽

Length Of Hospital Stay ◽

Ordinal Scale ◽

Control Group ◽

Randomized Controlled ◽

Group Data ◽

Significant Difference

Abstract Background Although almost a year has passed since the Coronavirus disease 2019 (COVID-19) outbreak and promising reports of vaccines have been presented, we still have a long way until these measures are available for all. Furthermore, the most appropriate corticosteroid and dose in the treatment of COVID-19 have remained uncertain. We conducted a study to assess the effectiveness of methylprednisolone treatment versus dexamethasone for hospitalized COVID-19 patients. Methods In this prospective triple-blinded randomized controlled trial, we enrolled 86 hospitalized COVID-19 patients from August to November 2020, in Shiraz, Iran. The patients were randomly allocated into two groups to receive either methylprednisolone (2 mg/kg/day; intervention group) or dexamethasone (6 mg/kg/day; control group). Data were assessed based on a 9-point WHO ordinal scale extending from uninfected (point 0) to death (point 8). Results There were no significant differences between the groups on admission. However, the intervention group demonstrated significantly better clinical status compared to the control group at day 5 (4.02 vs. 5.21, p = 0.002) and day 10 (2.90 vs. 4.71, p = 0.001) of admission. There was also a significant difference in the overall mean score between the intervention group and the control group, (3.909 vs. 4.873 respectively, p = 0.004). The mean length of hospital stay was 7.43 ± 3.64 and 10.52 ± 5.47 days in the intervention and control groups, respectively (p = 0.015). The need for a ventilator was significantly lower in the intervention group than in the control group (18.2% vs 38.1% p = 0.040). Conclusion In hospitalized hypoxic COVID-19 patients, methylprednisolone demonstrated better results compared to dexamethasone. Trial registration The trial was registered with IRCT.IR (08/04/2020-No. IRCT20200204046369N1).

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