scholarly journals Efficacy and safety of formoterol versus montelukast as add on therapy in moderate persistent asthma

2017 ◽  
Vol 6 (6) ◽  
pp. 1420
Author(s):  
Mamta Rani ◽  
Jarnail Singh ◽  
Prem Parkash Gupta
Keyword(s):  
Therapeutic Option ◽  
Symptom Control ◽  
Persistent Asthma ◽  
Point Of View ◽  
P Value ◽  
Night Time ◽  
Group A ◽  
Group B ◽  
Inhaled Budesonide ◽  
Moderate Persistent Asthma

Background: From a pathophysiologic point of view, asthma treatment is directed toward the airway to effectively suppress inflammation, attenuate airway hyper responsiveness. Ideally, this in turn should translate into benefits in terms of symptom control, prevention of exacerbations, optimizing dyspnoea, along with patient safety.Methods: This study was carried out at Department of Pharmacology and TB and Respiratory Medicine, Pt. BDS PGIMS, Rohtak, Haryana. The protocol was approved by institutional review board. Out of 60 OPD patients, group A (30) received inhaled budesonide 400μg and formoterol fumarate 6μg twice daily and group B (30) received oral montelukast 10 mg once daily along with inhaled budesonide 400μg twice daily. All values were expressed as mean±SEM and comparison between both groups was done using unpaired t-test.Results: Baseline PFT Values at 0 week and Improvement at 8 weeks were comparable between both groups with P-value >0.05. In Group A both day time cough/wheeze score (20.67±0.19 to 11.23±0.37) and night time cough/wheeze score (11.47±0.17 to 4.27±0.21) reduced after 8 weeks treatment. Also in Group B daytime cough/ wheeze reduced from (20.70±0.25) at 4 weeks to (12.93±0.43) at end of 8 weeks. Modified Borg’s dyspnoea score also decreased significantly (3.13±0.11 to 0.73±0.06) in Group A and (3.16±0.14 to 0.80±0.05) in Group B at end of 8 weeks and decrease was comparable in both groups (p value >0.05). Statistically there was no difference between two treatments as far as safety assessment was concerned. Most common ADRs reported were headache, asthenia and abdominal pain.Conclusions: Montelukast seems clinically effective and safe in controlling asthma symptoms, PFT and improving dyspnoea. So montelukast can be reasonable and alternative therapeutic option as add on to inhaled ICS in moderate persistent asthma patients.

scholarly journals MODERATE PERSISTENT ASTHMA IN CHILDREN;

2018 ◽  
Vol 21 (04) ◽  
pp. 704-716
Author(s):  
Aqdas Saqib ◽  
Saqib Ismail ◽  
Saadia Yasir
Keyword(s):  
Marked Improvement ◽  
Persistent Asthma ◽  
Pollen Allergy ◽  
P Value ◽  
Persistent Symptoms ◽  
Paediatric Department ◽  
Quasi Experimental ◽  
History Of ◽  
Group A ◽  
Group B

Objective: The objective of this study is to compare the effects of inhaledbeclomethasone with oral montelukast in long term management of moderate persistent asthmain children. Design: Quasi experimental study. Period: 6 months, from July 20,2007 to January20, 2008. Settings: Out patient paediatric department at Fauji Foundation hospital, Rawalpindi.Material and Methods: 8o children between 5-12yrs of age presenting with moderate persistentasthma, divided in two groups of 40 each. Group A treated with beclomethasone inhaler whileGroup B was started on oral montelukast. Drugs effect was recorded on a 2 wkly proforma for 8weeks. Results: There were 54(67.5%) male and 26(33%) female. Most common triggeringfactor seen in 54(67.5%) patients was recent history of respiratory tract infection, exposure tocarpet dust in 43(53.75%), cigarette smoke in 42(52.5%),recent psychological stress in 28(35%) ,pollen allergy in 26 (32.5%) , pets exposure in 8 (10%) and to mite was noticed in 5(6.25%)children. Marked improvement was observed in day time cough in group A with 10(25%) patientsbeing free of cough with inhaler, while 20(50%) showed mild intermittent symptoms. 1(2.5%)showed mild persistent symptoms. In Group B 3(7.5%) patients were symptom free,23(57.5%)with mild intermittent and 4(10%) with mild persistant symptoms while 6(15%)continued to have moderate persistent symptoms. P value was 0.01. Regarding day timebreathlessness, P value was significant of 0.258. Similarly marked improvement was observed innight symptoms of breathlessness, cough and sleeplessness in both groups. P value was lessthan 0.05 in majority of the variables showing statistically significant improvement with inhaledbeclomethasone than with oral montelukast. Conclusions: Inhaled beclom

Comparison of montelukast versus montelukast plus inhaled corticosteroid (Budesonide) in children with mild persistent asthma.

2021 ◽  
Vol 28 (05) ◽  
pp. 677-681
Author(s):  
Versha Rai ◽  
Muhammad Nadeem Chohan ◽  
Nazimuddin ◽  
Khuda Bux ◽  
Saadullah Chacher
Keyword(s):  
Controlled Trial ◽  
Persistent Asthma ◽  
Forced Expiratory Volume ◽  
P Value ◽  
Inhaled Corticosteroid ◽  
Inhaled Steroids ◽  
Group A ◽  
Duration Of Disease ◽  
Mild Persistent Asthma ◽  
Group B

Objective: To compare therapeutic response between Montelukast versus Montelukast plus inhaled corticosteroid (Budesonide) in children having mild persistent asthma. Study Design: Randomized Controlled Trial. Setting: Department of Pediatrics Medicine, National Institute of Child Health, Karachi. Period: 1st April 2016 to 30th September 2016. Material & Methods: Children aged 2 years to 14 years having mild persistent asthma for more than 6 months were included. After treatment Good response was considered when, forced expiratory volume in first second (FEV1) became >7.5% from baseline. Group A was given montelukast as monotherapy once daily and Group B was given Montelukast along with inhaled corticosteroid (Budesonide.  At 6 weeks followup change in FEV1 was recorded. Result: Mean age of the patients in montelukast alone (Group A) was 6.77+/-2.16 years while in montelukast with Inhaled Corticosteroid (Group B) was 6.97+/-2.17 years. Duration of disease in Group A was 18.32+/-6.12 months while in montelukast with ICS group was 18.50 +/-6.08 months. Baseline FEV1 in Group A was 81.83+/-0.85% while in Group B was 82.05 +/-0.63%. Males were higher with 131 (61.8%). Family history was positive in 82 (38.70%) patients. After 6 weeks mean FEV1 was 89.49 +/-0.87% in Group A while in Group B was 89.53+/-0.86%. Overall good responses were found in 21 (9.09%) patients. In Group A, good response was found in 5 (4.7%) patients while in Group B was in 16 (15.1%) with significant p-value. Conclusion: In our study montelukast along with inhaled steroids had better response than montelukast alone in mild persistent asthma.

scholarly journals Induced Sputum Nitrite Levels Correlate with Clinical Asthma Parameters in Children Aged 7–18 Years with Mild to Moderate Persistent Asthma

2016 ◽  
Vol 8 (02) ◽  
pp. 090-095
Author(s):  
Devki Nandan ◽  
Prachi Kansal ◽  
Neha Patharia ◽  
Parul Goyal
Keyword(s):  
Persistent Asthma ◽  
Asthma Severity ◽  
Induced Sputum ◽  
P Value ◽  
School Absence ◽  
Acute Exacerbations ◽  
R Value ◽  
Inhaled Budesonide ◽  
Clinical Asthma ◽  
Moderate Persistent Asthma

ABSTRACT Purpose: The objective of this study is to measure levels of nitrites in induced sputum in children with asthma and correlate it with clinical asthma parameters. Method: This prospective observational study was done in PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, on 91 children aged 7-18 years with mild and moderate persistent asthma. Patients were specifically evaluated for five clinical parameters of asthma (i.e. Days of acute exacerbations, use of salbutamol as rescue medication, emergency visits, nights with cough, days of school absence) and induced sputum nitrite levels was done at the time of enrollment and 3 months after treatment with inhaled budesonide. Results: The mean age of subjects was 10.79 ± 2.563yrs. Six (6.59%) patients were not able to perform induced sputum, eighty five (93.41%) patients were suitable for data analysis. There was significant reduction in sputum nitrite levels from 33.42 ± 22.04nmol/ml at enrollment to 11.72 ± 5.61 nmol/ml (P < 0.0005) after 3 months of inhaled budesonide therapy. Significant positive correlation was found between reduction in sputum nitrite level and control of asthma symptoms: Days of acute exacerbations(r value = 0.548, P value = 0.0001), Days of salbutamol use as rescue medication (r value = 0.431, P value =< 0.0001), Number of emergency visits(r value = 0.414, P value = 0.0001), Nights with cough (r value = 0.259, P value = 0.0169), Days of school absence(r value = 0.411, P value = 0.0001). Sputum nitrite levels were significantly higher in moderate persistent asthmatics as compared to mild at the time of enrollment (P < 0.0005), which shows that induced sputum nitrite levels correlate with asthma severity. Conclusions: This study confirms that nitrites in induced sputum correlate well with clinical asthma parameters and asthma severity in children and is a simple, non invasive, and cheap method which can be used as a parameter for monitoring of asthma.

scholarly journals COMPARATIVE OUTCOMES BETWEEN INHALED BUDESONIDE AND ORAL MONTELUKAST IN MILD PERSISTENT CHILDHOOD ASTHMA

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr Sushant Mane ◽  
Dr Pareekshit Prakash Rampur ◽  
Dr Sakina Shabbir Rajagara
Keyword(s):  
Childhood Asthma ◽  
Tertiary Care ◽  
Airflow Limitation ◽  
P Value ◽  
Care Hospital ◽  
Asthma Symptoms ◽  
Parallel Group ◽  
Group A ◽  
Group B ◽  
Inhaled Budesonide

Background: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of recurrent respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation. Aim: To compare the clinical efficacy of oral montelukast with inhaled budesonide as controller medication in mild persistent childhood asthma. Methods: 54 Children of both genders aged 3 to 12 years, diagnosed as mild persistent childhood asthma in OPD and in pediatric indoor admissions at the tertiary care Hospital in Mumbai were enrolled in this randomized prospective parallel-group comparative study. 28 (51.9%) patients of group A were started on Oral montelukast & 26 (48.1%) of group B were started on inhaled budesonide. Results: Amongst patients of Group A, 9 were asymptomatic & 19 were symptomatic at 4 weeks of treatment.10 were asymptomatic & 18 were symptomatic at 3 months of treatment. P-Value was 0.09 suggesting no significant change/improvement in control of asthma symptoms at 3months than at 4 weeks in children treated with oral montelukast. Out of 26 patients of Group B, 6 were asymptomatic & 20 were symptomatic at 4 weeks of treatment. 17 were asymptomatic & 9 were symptomatic at 3 months of treatment. P-Value was 0.046 suggesting a statistically significant improvement in control of asthma symptoms at 3 months than at 4 weeks in children treated with inhaled budesonide. Conclusion: More children on inhaled budesonide were controlled on their asthma symptoms, required significantly less reliever medications, had lesser episodes of night awakening due to asthma symptoms and had improvement in their day-time symptoms and activity than those on oral montelukast.

COMPARISON OF EFFECTIVENESS OF MOBILIZATION AND SELF-EXERCISES IN ADHESIVE CAPSULITIS OF SHOULDER

2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad
Keyword(s):  
Pain Intensity ◽  
Adhesive Capsulitis ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
T Test ◽  
P Value ◽  
Group A ◽  
Group B

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.

CONVENTIONAL VERSUS THREE-DIMENSIONAL CONFORMAL EXTERNAL RADIOTHERAPY IN CANCER CERVIX: A COMPARATIVE STUDY FOR COMPLIANCE, RESPONSE AND TOXICITY

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Richa Gupta ◽  
Piyush Kumar ◽  
D. P. Singh ◽  
Arvind Kumar Chauhan ◽  
Kamal Sahni
Keyword(s):  
Clinical Response ◽  
Three Dimensional ◽  
Common Side Effect ◽  
P Value ◽  
High Dose ◽  
Cancer Cervix ◽  
Conventional Radiotherapy ◽  
Radiation Fields ◽  
Group A ◽  
Group B

INTRODUCTION: Cervical cancer is the second most frequent cancer among Indian women. Radiotherapy is the cornerstone of treatment in all its stages. Three-dimensional conformal radiotherapy (3DCRT) combines multiple radiation fields to deliver precise dose of radiation to the affected area. Tailoring each of the radiation fields to focus on the tumor delivers a high dose of radiation to the tumor and avoids nearby healthy tissue. The present study is done to compare conventional radiotherapy versus 3DCRT in cancer cervix for compliance, clinical response and toxicity. MATERIAL AND METHODS: Fifty patients were enrolled and randomised into two radiotherapy plans with radical intent - Group A treated by conventional radiotherapy and group B treated by 3DCRT. Concurrent cisplatin was delivered on weekly (35mg/m2) or tri-weekly (75mg/m2) basis during external beam Radiotherapy and was followed by High Dose Radiotherapy Brachytherapy. Clinical response and complication assessment were evaluated.Collected data was analyzed using standard statistical methods and softwares to calculate level of significance using “p” value by chi square test. RESULTS: In this study mean age of the patients was 48 years (26-67 years). The anemia was the most common side effect seen in both groups (96% vs 88%, p=0.29). Neutropenia was more in group B (36% vs 44%, p= 0.56). Lower GI toxicity was seen only in patients in group A (20% vs 0%, p=0.018). In follow up there were no significant early rectal and bladder reactions in both groups and 2 patients in each group had late rectal reactions of grade I and II (p= 0.312). No significant skin, bladder and small intestinal toxicity were seen in both groups. CONCLUSION: Conventional radiotherapy gives equally efficacious response though accompanied by toxicities which were acceptable.

scholarly journals Integration of a Virtual Dispensing Simulator “MyDispense” in an Experiential Education Program to Prepare Students for Community Introductory Pharmacy Practice Experience

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 48
Author(s):  
Ashley E. Johnson ◽  
Jillian Barrack ◽  
Jill M. Fitzgerald ◽  
Diana M. Sobieraj ◽  
Lisa M. Holle
Keyword(s):  
Community Pharmacy ◽  
Experiential Education ◽  
Self Care ◽  
Pharmacy Practice ◽  
Pharmacy Education ◽  
P Value ◽  
Community Practice ◽  
Practice Experience ◽  
Group A ◽  
Group B

Background: Technology is increasingly used to enhance pharmacy education. We sought to evaluate student learning and preparedness for community introductory pharmacy practice experiences (IPPEs) after implementation of “MyDispense” into experiential education. Methods: Both first-year pharmacy students and assigned community IPPE preceptors were eligible. Students were stratified based on previous community pharmacy experience (< or ≥ 50 h), then randomized to complete MyDispense exercises before IPPE (group A) or after 24–32 h of IPPE (group B). We evaluated preceptors’ assessment of student readiness using a 6-item Likert scale survey and students’ readiness and opinion of MyDispense using an anonymous 9-item survey. Descriptive statistics were used to characterize data. The Mann–Whitney U test was used to compare groups and a p-value < 0.05 was considered statistically significant. Results: Of 177 eligible students, 155 were randomized and 56 completed study. Group A included 32 students; 56.3% had prior community practice experience. Group B included 24 students; 50% had prior community practice experience. Forty-eight preceptors were enrolled. Students who completed exercises before rotation received higher preceptor scores for patient counseling of self-care and of medications (p < 0.05 for both). Students self-assessed their counseling skills lower than all other skills; 30.4% and 42.9% of students felt mostly or always prepared to counsel for self-care and medications, respectively. Students found MyDispense straightforward, realistic, and appreciated the ability to practice in a safe, electronic, community pharmacy, patient-care environment. Conclusion: Simulation-based software, such as MyDispense, can enhance learner understanding of the prescription fill and counseling process in a community pharmacy practice setting.

scholarly journals AB0393 EFFICACY OF HYDROXYCHLOROQUINE FOR LUPUS NEPHRITIS IN MAINTENANCE PHASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1496.2-1496
Author(s):  
M. Watanabe ◽  
Y. Haji ◽  
M. Kato ◽  
T. Ito ◽  
Y. Banno ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Therapeutic Option ◽  
Maintenance Phase ◽  
Base Line ◽  
Prednisolone Dose ◽  
Daily Urine ◽  
Group A ◽  
The Mean ◽  
Group B

Background:Hydroxychloroquine (HCQ) is an essential drug for systemic lupus erythematosus. But in Japan, chloroquine and HCQ remain unavailable until mid 2015 because of a series of lawsuits about its retinal toxicity in the 1970s. There is insufficient knowledge regarding renal protective effect of HCQ.Objectives:We aimed to investigate its efficacy of adding HCQ for Lupus nephritis (LN) as a maintenance-phase therapy.Methods:We conducted an observational retrospective cohort study included patients with LN (n=42) in maintenance-phase in Japan. We reviewed medical records of LN patients aged > 18 years who were initiated HCQ from May 2015 to May 2018. Maintenance phase was defined as stabilization in serum creatinine and urinary segment after induction therapy and who achieved complete or partial remission. The annual change of proteinuria was compared between patients on HCQ who have proteinuria (>0.5g/gCr) or not. Other outcome measures were disease flare, dose of steroids, renal and immunologic features.Results:A total of 42 patients were analyzed and allocated to two groups based on their amount of daily urine protein level: HCQ with proteinuria as group A (>0.5g/gCr, n=14) and HCQ without proteinuria as group B(≦0.5g/gCr, n=28). Both groups were comparable, with mean (SD) age of 36.1 (12.9) years and 37.5 (13.8), female 78.6% and 92.9% in each group, mean (SD) disease duration until HCQ of 3.5 (3.25) and 3.3 (2.9) years in group A and group B, with prednisolone dose at base line of 10.3 (7.1) mg and 7.9 (4.4) mg, respectively. The mean (SD) proteinuria at base line was 1.38 (1.11) g/gCr in group A and 0.20 (0.09) g/gCr in group B and after 12 months, proteinuria decreased in group A (-1.34 g/gCr in group A vs +0.03 g/gCr in group B; p<.001;95% CI,0.305-0.736). No relapse was experienced in group A during the study period.Conclusion:In patients with clinically stable LN but with proteinuria, hydroxychloroquine is a good therapeutic option for achievement of complete remission.Disclosure of Interests:None declared

scholarly journals 465 No Role for Postoperative Antibiotics in Uncomplicated Appendicitis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
N Ayoub ◽  
Y Tryliskyy ◽  
M K Baig
Keyword(s):  
Wound Infection ◽  
P Value ◽  
Nice Guidelines ◽  
Uncomplicated Appendicitis ◽  
Perforated Appendix ◽  
Group A ◽  
Preoperative Antibiotics ◽  
Group B ◽  
Variable Practice

Abstract Introduction Several studies have shown benefit from use of preoperative antibiotics in reducing postoperative infection after appendectomy as well as efficacy of postoperative antibiotics in complicated appendicitis (defined as perforated appendix or presence of pus in peritoneum). While for uncomplicated appendicitis, several studies showed no benefit from antibiotics postoperatively but there are no clear NICE guidelines till now and so surgeons have different practice based on their preferences. Method This study included patients who had appendectomy for uncomplicated appendicitis in Worthing hospital from 1st July 2019 till 30th June 2020. The end point was 30-day follow up postoperatively for wound infection or collection. Results 90 patients were admitted with uncomplicated appendicitis with age 6-80 years (mean of 31.3). 46 patients (51%) did not receive postoperative antibiotics (group A) and 44 (49%) received postoperative antibiotics (group B) with a variable practice from one dose to 8-day course. postoperatively, only 1 patient (2.1%) in group A developed wound infection requiring drainage while none in group B developed complications (p-value=1). Conclusions Administration of postoperative antibiotics in uncomplicated appendicitis showed no superiority over non-administration. in addition, they add extra cost on NHS. So, their routine use postoperatively is not recommended, however, larger studies are required to confirm this.

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

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