Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

Download Full-text

A comparative study of the effect of piroxicam versus diclofenac on wound healing in clean abdominal wounds

International Surgery Journal ◽

10.18203/2349-2902.isj20180827 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1041 ◽

Cited By ~ 2

Author(s):

Chandrashekar Reddy J. Madinur ◽

Prashant Tubachi ◽

A. S. Godhi ◽

A. S. Godhi

Keyword(s):

Wound Healing ◽

Controlled Trial ◽

Research Centre ◽

Female Ratio ◽

Factors Affecting ◽

Significant Difference ◽

Group A ◽

One Year ◽

Group B ◽

The Individual

Background: The primary function of the skin is to serve as a protective barrier against the environment. The process of wound healing constitutes an array of interrelated and concomitant events. Understanding these processes and various factors affecting these processes continue to expand. The present study was undertaken to compare and evaluate the effect of piroxicam versus diclofenac on wound healing in clean abdominal wounds.Methods: The present one year randomized controlled trial was conducted on all the patients undergoing appendicectomies for uncomplicated appendicitis and uncomplicated inguinal hernia repairs in the Department of Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during the period of one year. Based on the thumb rule a total of 60 patients divided into two groups of 30 each were studied. Based on the computer-generated randomization patients were allocated to two groups that is group A (Inj. Piroxicam) and Group B (Inj. Diclofenac).Results: In the present study, males outnumbered females with male to female ratio between of 1.72 to 2:1. The mean age in group A was30.9±7.86 years and in group B it was 30.3±7.97 years. Both the groups that is Group A and B were graded under grade I (Good wound healing) from the POD 3 onwards. Overall the individual score and total scores had no influence of the final grading (outcome) of the wound.Conclusions: Overall, better results were seen on wound healing in patients who received Inj piroxicam with significantly less post-operative redness and edema. However, this did not have significant difference in the final outcome of the grading of the wound.

Download Full-text

Anterior Trimming vs Outer Displacement of Inferior Turbinate: A Comparative Study at a Tertiary Care Hospital

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2021.11.3.654 ◽

1969 ◽

Vol 11 (3) ◽

pp. 169-174

Author(s):

Habib-Ur-Rehman ◽

Fazal-I-Wahid ◽

BakhtZada ◽

Muhammad Javaid ◽

Naseemul Haq

Keyword(s):

Comparative Study ◽

Nasal Obstruction ◽

Objective Assessment ◽

Tertiary Care ◽

Adhesion Formation ◽

Inferior Turbinate ◽

Care Hospital ◽

Female Ratio ◽

Significant Difference ◽

Group A

Background: Obstruction of nose due to enlargement of inferior turbinate is a very common problem faced by ENT surgeon.In thisstudy a usefultechnique for treatment of inferior turbinate hypertrophy is described.Objective:To determine the surgical outcome and complications ofthe two surgicalprocedures.Material and Methods: This non-randomized comparative study was performed in the Department of ENT, HNS, MTI/LRH,Peshawar, Pakistan, from June 01, 2017 to May 31, 2018. After ethical approval, sample size of 112 was calculated and patientsincluded of both genders fulfilling inclusion criteria. After taking consent patients were equally divided into two groups with nonrandom number table method. Both subjective and objective assessment was carried out and observations were recorded on apredesignedproforma.Data were analyzed using SPSS 20.Results: Total patients were 112,in age range from 16 to 50 years. There were 56(50%) patients in each group.Maleswere 71 andfemale 41withmale to female ratio of 1.7:1 and mean age was 32.92+S.D 10.29 years.Relief from nasal obstruction obtained was94.64% and 92.86% in Group A and B respectively. Headachewas relived 83.34 % and 88.38% in Group A and B respectively. Thecomplications experienced were post operative bleeding, adhesion formation and crusting 2.6%, 3.5% and 1.78% respectively.Statistics showed no significant difference between the two operations (p >0.05).Conclusion: Both trimming and outer displacement of hypertrophied inferior turbinate are effective procedures for relief of nasalobstruction but there was no significant difference betweenthe two techniques interm of outcome and complications.Keywords:Inferiorturbinate, Hypertrophy, Trimming, Outer displacement. Nasal obstruction

Download Full-text

Prevalence, knowledge, attitude and practice regarding self-medication among medical, dental and paramedical students in a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20183497 ◽

2018 ◽

Vol 7 (9) ◽

pp. 1822

Author(s):

Madhulika Johnson ◽

Dinesh Kumar Badyal

Keyword(s):

Medical Students ◽

Information Source ◽

Tertiary Care ◽

Common Symptom ◽

Care Hospital ◽

Self Medication ◽

Cross Sectional ◽

Female Ratio ◽

Group A ◽

Group B

Background: Self-medication is practiced universally. Having medical knowledge plays a vital role in its prevalence. It is more prevalent in higher education course students especially medical students. However, it is increasing in dental and paramedical students. Hence, this study was conducted to evaluate self-medication among medical, dental and para-medical students in a tertiary care hospital.Methods: A cross sectional questionnaire based study was conducted among 449 undergraduate students. They were divided into three groups. A questionnaire was developed based on literature. The questionnaire was validated and finalised. The paper questionnaire was administered to students. The data collected from questionnaires was analysed. The results were expressed as percentages and frequencies.Results: The male female ratio of students who filled questionnaire was 65:35. All the students (100%) reported that they practice self-medication. The most common reason for self-medication was prior experience (36%) in group A as well as in group B (46%), but in group C, 39% mentioned no serious problem. Main information source was family members in all the groups (A 57%, B 53%, C 29%) followed by advice from senior/friends. Fever was most common symptom reported (29%) by group A followed headache (28%) in group C and cough and cold (23%) in group B. The commonest group of drugs used is cough syrups (25%) in group B, followed by analgesics (23%) in group C and antipyretics (21%) in group A.Conclusions: Self-medication is growing among dental and paramedical students too. It is necessary to educate them about self-medication to prevent future disastrous consequences as well as to make them aware of appropriate use of self-medication.

Download Full-text

Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24i4.1418 ◽

2020 ◽

Vol 24 (4) ◽

pp. 339-343

Author(s):

Tanveer Hussain ◽

Misbah Sattar ◽

Sara Mustafa ◽

Uzma Batool ◽

Shafqat Iqbal ◽

...

Keyword(s):

Hepatic Encephalopathy ◽

Local Population ◽

Tertiary Care ◽

Simple Random Sampling ◽

Complete Recovery ◽

Treatment Modalities ◽

Care Hospital ◽

Significant Difference ◽

Group A ◽

Group B

Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population. Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after start of the treatment. Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively. Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.

Download Full-text

Management of Neglected Achilles Tendon Division: Assessment of Two Novel and Innovative Techniques

Advances in Orthopedic Surgery ◽

10.1155/2014/729397 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Pradeep Jain ◽

Parthapratim Dutta ◽

Prabal Goswami ◽

Amol Patel ◽

Shammi Purwar ◽

...

Keyword(s):

Achilles Tendon ◽

Tertiary Care ◽

Tendon Graft ◽

Care Hospital ◽

Plantaris Tendon ◽

Significant Difference ◽

Group A ◽

And Gender ◽

Group B ◽

Innovative Techniques

Objective. Repair of injured Achilles tendon in neglected cases is one of the difficult and challenging procedures for surgeon. Here, we share our experience with the use of two innovative techniques for repair of chronic rupture of Achilles tendon. Design. Prospective Study. Setting. Tertiary care hospital. Patients. Twelve patients with chronic Tendo Achilles rupture were followed up over a period of three to five years. Intervention. Patients were divided in two groups, A and B. In Group A, the repair was done with Gastroc-soleus turndown flap and weaving with Plantaris tendon graft and in Group B, with modified Kessler’s technique strengthened with the free plantaris tendon graft. Outcome Assessment. Clinically and by Modified Rupp Scoring system. Results. At an average follow-up of 4 years (Group A, 3.7 and Group B, 4.4 years), the majority of the patients had excellent to good results as assessed with Modified Rupp Scoring with few minor complications in both the groups. There was no significant difference in the baseline variables such as age and gender and also in the Rupp’s score between the two groups. Conclusion. The two techniques are novel and simple and have been found to be useful for repair of chronically ruptured Achilles tendon.

Download Full-text

Comparison of Antibiotic treatment and Appendectomy for non-complicated Acute Appendicitis during Covid-19 pandemic

10.53350/pjmhs2115102699 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2699-2700

Author(s):

M. Waseem Anwar ◽

M. Faheem Anwer ◽

Wasif Majeed Chaudhry ◽

Farhana Anwar ◽

M. Usman Aslam ◽

...

Keyword(s):

Acute Appendicitis ◽

Antibiotic Therapy ◽

Antibiotic Treatment ◽

Tertiary Care ◽

Care Hospital ◽

Oral Antibiotics ◽

Significant Difference ◽

Group A ◽

Group B ◽

Complicated Acute Appendicitis

Aim: To evaluate the efficacy of antibiotic treatment as the primary option for non-complicated acute appendicitis in pandemic situation. Study Design: Prospective interventional study. Setting & Duration of Study: CMH Lahore, a 700 bedded tertiary care hospital, for 4 months from 15th April 2020 to 15th august 2020. Methodology: A total of 110 cases meeting inclusion criteria, aged 13-65 years of both genders with suspicion of non-complicated appendicitis were included in the study, using probability sampling. They were divided in two groups on randomization basis. Group A for antibiotic therapy and Group B for appendectomy. Group A patients admitted in the ward 48 hours for IV antibiotics, were re-evaluated after 24 hours. If condition improves, the patient was discharged on oral antibiotics for next 10 days & if condition does not improve, antibiotics were prolonged for 48 hours. If deteriorating or patient. .chooses to change group, they underwent appendectomy. If condition improved, they were discharged on oral antibiotics for next 10 days. Group B patient were discharged after 2 post-operative doses of I/V antibiotics. Post-operative I/V antibiotics for 48 hours & 3 days oral antibiotics were given when appendix was gangrenous or perforated. Results: In a population of 110 patients, we studied the comparison of the groups having antibiotics and appendectomy as treatment for acute appendicitis. There is no significant difference in outcomes on basis of mean pain score and mean duration of hospital stay. Both ways of treatment can be adapted accordingly. Conclusion: Non-complicated acute appendicitis can be managed non-operatively in crisis situations like COVID-19 pandemic causing overburdening of hospitals. Keywords: Acute appendicitis, antibiotic therapy, appendectomy, pandemic.

Download Full-text

A Comparative Study of Endoscopic Versus Navigation Guided Microscopic Transsphenoidal Pituitary Surgery at Tertiary Care Centre in India

Romanian Neurosurgery ◽

10.2478/romneu-2018-0055 ◽

2018 ◽

Vol 32 (3) ◽

pp. 443-457

Author(s):

Anurag Sahu ◽

Sharad Pandey ◽

Kulwant Singh ◽

Vivek Sharma

Keyword(s):

Operative Time ◽

Tertiary Care ◽

Pituitary Surgery ◽

Controlled Study ◽

Complication Rates ◽

Care Hospital ◽

Significant Difference ◽

Transsphenoidal Pituitary Surgery ◽

Group A ◽

Group B

Abstract Introduction: The transsphenoidal route for pituitary surgery is considered the standard treatment for pituitary adenomas. The disadvantage of the smaller exposure of this route is partially compensated for by the introduction of the microscope with its coaxial illumination, stereoscopic view, adequate magnification, and microsurgical instruments. However, there are only few reports about the outcome of endonasal endoscopic transphenoidal technique. Aims & Objectives: Current study has been conducted to compare the efficacy, advantages and dis advantages of endoscopic versus navigation guided microscopic transsphenoidal Pituitary surgery. Material and methods: A controlled study was done in the department of neurosurgery, at tertiary care hospital in India, from the period of August 2012 to December 2017 prospectively. In Group A- 30 patients in whom endoscopic transnasal trans Sphenoidal pituitary surgery and in Group B - 30 patients, intraoperative neuronavigation was used. Observations and Results: Both the groups were similar in demographic variables. The most common age group of pituitary tumor patients was 30-40 years. Fourteen (46.6 %) patients in group A and fifteen (50 %) of the patients in group B had tumor volume less than 5 ml. In group A, thirteen (43%) patients had intrasellar tumors with no suprasellar extension, while in group B, fifteen (50%) patients had intrasellar tumors with no extension. Operative time was noted from incision to closure and average time taken in both the groups was compared. Twenty five (83%) cases of group A took between 2-3 hours and only four cases (13%) took more than 3 hours. While in group B, twenty (66%) cases took between 4-5 hours. This shows a significant difference by fisher extact test (p<0.001) in the operative time required in both the groups. Eighteen (60%) patients in group B had a residual volume between 1-1.5 ml while only two patients in group A had so. This difference is also significant Fischer Exact test (p<0.001). Four (13.3%) patients in group A had diabites insipidus while only half of this, i.e. two (6.6%) had so in group B. however this difference in postoperative complication rate is not statistically significant between two groups. Conclusion: The results of our study correlate with many previous studies to compare endoscopic and microscopic transsphenoidal surgery. These two approaches are equally efficacious in oncological outcomes and the complication rates are comparable.

Download Full-text

A comparative study of the efficacy and tolerability of parenteral ceftriaxone and cefotaxime in pediatric population for acute bacillary dysentery in a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20182090 ◽

2018 ◽

Vol 7 (6) ◽

pp. 1109

Author(s):

Sagar K. ◽

Shanmukananda P. ◽

Veena D. R. ◽

Shwetha H.

Keyword(s):

Comparative Study ◽

Bacillary Dysentery ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Paediatric Patients ◽

Significant Difference ◽

Group A ◽

Group B ◽

Acute Bacillary Dysentery

Background: Diarrheal disorders in childhood account for a large proportion (18%) of childhood mortality. Among diarrheal diseases, dysentery is a major cause of childhood morbidity and mortality, especially in developing countries.Methods: This is an open labelled, prospective, randomised, comparative study carried out at Dr. B. R. Ambedkar Medical College Hospital, Bangalore from November 2014 to November 2015 after Institutional Ethics Committee approval. A total of 80 Paediatric patients who met the inclusion criteria were included in the study after taking written informed consent from parents and assigned into two groups, Group A- Inj. Ceftriaxone (50-100mg/kg/day) and Group B- Inj. Cefotaxime (100 mg/kg/day) in divided doses for a period of 3-5 days based on requirement.Results: In this study, Cefotaxime was non inferior to Ceftriaxone as the Mean Duration of Hospitalisation was 3.30±0.72 days in Group A and 3.30± 0.72 days in Group B with p value of 1.000, showing no statistically significant difference. Both were well tolerated without any reports of ADR (Adverse Drug Reaction).Conclusions: In this study shows that Inj. Cefotaxime is equally efficacious and well tolerated as Inj. Ceftriaxone in the treatment of Acute Bacillary Dysentery in paediatric patients.

Download Full-text

Comparison of efficacy and safety of topical luliconazole with topical fluconazole against tinea corporis in a tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20212383 ◽

2021 ◽

Vol 10 (7) ◽

pp. 840

Author(s):

E. Seshathri ◽

R. Deepthi Krishna

Keyword(s):

Tertiary Care ◽

Tinea Corporis ◽

Tolerability Profile ◽

Care Hospital ◽

Efficacy And Safety ◽

Once Daily ◽

Significant Difference ◽

Group A ◽

Low Incidence ◽

Group B

Background: Dermatophytosis is a common cutaneous infection worldwide with prevalence varying from 20% to 25%. Luliconazole is a newer topical antifungal applied once daily with greater reservoir property in stratum corneum. Objective of the study was to compare the clinical efficacy and safety of luliconazole 1% cream with Fluconazole 1% cream in patients with mild to severe grades of tinea corporis.Methods: A total of 100 patients with mycologically confirmed tinea corporis were randomised into group A and B respectively. Group A, 50 patients received luliconazole 1% for 2 weeks and group B, 50 patients received fluconazole 1% cream for 4 weeks. Patients were clinically and mycologically evaluated on 0, 2nd and 4th week of treatment and followed up on 8th week for any relapse.Results: Significant improvement in efficacy was seen in Luliconazole while compared with fluconazole group against tinea corporis infection. Mycological cure and clinical improvement showed significant difference in group A. The safety and tolerability profile of both groups were good and statistically comparable.Conclusions: Luliconazole 1% cream is found to be safe, effective and tolerable with low incidence of relapse than fluconazole 1% cream.

Download Full-text

Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20184353 ◽

2018 ◽

Vol 4 (6) ◽

pp. 1417

Author(s):

Subodh Kumar ◽

Awadhesh Kumar Mishra ◽

Ajay Mallick ◽

Ashwani Sethi

Keyword(s):

Hearing Loss ◽

Otoacoustic Emissions ◽

Pure Tone ◽

Tertiary Care ◽

Care Hospital ◽

Distortion Product ◽

Significant Difference ◽

Group A ◽

Group B

Background: A large proportion of blast victims suffers ear injuries; however, these injuries are often overlooked.Methods: We assessed 411 blast victims to detect ear injury employing detailed history, otological examination, pure tone audiometry, auditory steady state response and distortion product otoacoustic emissions. TM perforations were managed by thorough cleaning of ear by suctioning, edges approximation and gelfoam splinting in group A and only suctioning in group B. Prednisolone in tapering doses was prescribed for managing hearing loss in all except those in whom it was contraindicated. Results: Out of 411 blast victims, 228 (55.47%) had aural trauma. All cases were males (being serving soldiers) between ages of 21 and 57 years. (Mean 37.77 years, SD 10.38). 285 ears had a perforated TM. Of these, 145 were assigned to group A while 140 were in group B. There was no significant difference in spontaneous healing of perforation between the two groups but at 5 years’ follow up group A had significantly higher number of unscarred, healthy TMs than group B (Z score=2.2111, p=0.0271). Mean pure tone average was 51.16 dB (SD 8.79 dB) at presentation and 38.91 dB (SD 7.86 dB) at 5 years. Recovery of SNHL component was significantly better in steroid treated patients.Conclusions: Edges approximation and gelfoam splinting helped in reducing scarring of TM on healing, on long follow up. Steroid treated group showed better recovery of hearing loss.

Download Full-text