scholarly journals Prophylaxis of post-operative nausea and vomiting in major obstetrics surgeries: a comparative study between palanosetron and neit guam point stimulation

2017 ◽  
Vol 6 (4) ◽  
pp. 1440
Author(s):  
Shaily Agarwal ◽  
Apurva Agarwal ◽  
Renu Gupta ◽  
Pranshi Gupta
Keyword(s):  
Random Sequence ◽  
Care Center ◽  
Tertiary Care ◽  
Current Treatment ◽  
Nausea And Vomiting ◽  
Chi Square ◽  
Post Surgery ◽  
Group I ◽  
Small Primary ◽  
Post Operative Nausea

Background: Post-operative nausea and vomiting (PONV) prophylaxis is an important component in providing safe anesthesia in antenatal women. Pharmaceutical interventions like metoclopramide and 5-HT3 antagonists are the current treatment of choice for PONV prophylaxis. However newer drugs are less easily available and more expensive and there is always a concern regarding the effects on fetus. The objective of the study was to evaluate and compare efficacy and safety of antiemetic effects of stimulation of neitguam point stimulation with palonosetron for PONV prevention in obstetric surgeries.Methods: A randomized control trial was done on 150 patients with ASA grade I-II, between ages of 18-45 undergoing obstetric surgery under spinal anesthesia at a tertiary care center. The patients were randomly allocated into two groups using a random sequence. In group I, 76 patients received 75μg palonosetron IV 5 minutes prior to induction. Group II contained 74 patients in which neitguam point stimulation was done by acupressure (wrist band) . All patients were followed till 24 hours post-surgery and incidence of PONV was recorded intra-operative and till 30 minutes, at 2 hours, 6 hours and 24 hours post-surgery. The results were analyzed using SPSS software and chi square test.Results: Both neit guam point stimulation and palanosetron were effective in prevention of PONV (p=0.32). neit guam point stimulation can be considered as effective as palonosetron in prevention of nausea. The cost analysis signifies the advantage of neit guam point stimulation.Conclusions: Neit guam point stimulation is a safe and highly effective method to prevent PONV. It can help in bringing down cost and can be easily made at the small primary healthcare centers and trained midwives.

Comparison of Dexamethasone with Ondansetron for Prevention of Post-Operative Nausea and Vomiting

2021 ◽  
Vol 15 (11) ◽  
pp. 3464-3466
Author(s):  
Nazeer Ahmed ◽  
Muhammad Arif Baloch ◽  
Muhammad Sharif ◽  
Zafar ullah ◽  
Yasir Reda Toble
Keyword(s):  
Laparoscopic Surgery ◽  
Tertiary Care ◽  
Cost Effective ◽  
Nausea And Vomiting ◽  
P Value ◽  
Care Hospital ◽  
Group I ◽  
Anesthesia Group ◽  
Cost Effective Alternative ◽  
Post Operative Nausea

Objective: To examine the effectiveness of dexamethasone and ondansetron in reducing the incidence of post-operative nausea and vomiting (PONV) in patients following laparoscopic surgery. Patients and Methods: A total number of 100 patients who were planned for laparoscopic surgery under general anesthesia having age 20-60 years were included in this study from a tertiary care hospital from Dec-2019 to June-2021. Patients were divided in to two group using Draw randomization technique. Group I; in these patients IV dexamethasone 8 mg was given at the time of induction of anesthesia. Group II; in these patients Ondansetron (4 mg IV) was given at induction of anesthesia. After completing the surgery and shifting the patient to the recovery room frequency of PONV within 6 hours after surgery was noted. Results: Mean age of the patients was 43.31±10.41 years. There were 54 (54.00%) male patients and 46 (46.00%) female patients. There were 75 (75.00%) patients with ASA I and 25 (25.00%) patients with ASA II. PONV occurred in 11 (22.00%) patients in dexamethasone group and in 21 (42.00%) patients in ondansetron group (p-value 0.03). Conclusion: After laparoscopic surgery, dexamethasone decreased the prevalence of nausea and vomiting. A single dosage of dexamethasone was proven to be a safe and cost-effective alternative to a single dose of ondansetron. Keywords: Dexamethasone, Ondansetron, post-operative Nausea and vomiting.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals CMET-18. IMPACT OF KRAS MUTATION STATUS ON THE EFFICACY OF IMMUNOTHERAPY IN LUNG CANCER BRAIN METASTASES

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi55-vi55
Author(s):  
Adam Lauko ◽  
Assad Ali ◽  
Soumya Sagar ◽  
Addison Barnett ◽  
Hong Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Checkpoint Inhibitors ◽  
Care Center ◽  
Tertiary Care ◽  
Wild Type ◽  
Chi Square ◽  
Kras Mutations ◽  
Mutational Status

Abstract BACKGROUND Immunotherapy is increasingly used in patients with non-small cell lung cancer brain metastases (NSCLCBM). KRAS mutations are associated with worse prognosis and there is no FDA approved targeted therapy. KRAS mutations are associated with increased expression of PD-L1. We evaluated the outcomes of NSCLCBM with KRAS mutations treated with immune checkpoint inhibitors (ICI). METHODS We reviewed 800 patients with NSCLCBM treated at our tertiary care center. 226 had known KRAS mutational status, 121 of which received immunotherapy. Overall survival (OS) was calculated from either the start of immunotherapy (when both groups received immunotherapy) or from the date of diagnosis of brain metastasis. Kaplan-Meier method and Cox Proportional hazard model were utilized to determine differences in OS and the Chi-square test was utilized to determine differences in PD-L1 expression. RESULTS In 109 patients where both KRAS and PD-L1 status were known, KRAS mutations had greater PD-L1 expression (80.1% vs 61.9% positive, p=0.04). There was no difference in OS between KRAS mutant vs KRAS wild-type patients treated with immunotherapy. Median survival from the start of immunotherapy was 15.6 vs 15.5 months respectively (p=0.7), after adjusting for age, KPS, lesion number and extra-cranial metastasis (HR = .91, p=.7). Patients with KRAS mutations treated with immunotherapy versus those who received chemotherapy had a 1-year OS from the diagnosis of brain metastasis of 60.9% vs 38.7% respectively (trending towards significance, p=0.05). KRAS wild-type patients treated with immunotherapy versus those who did not receive immunotherapy had a 1-year OS from the diagnosis of brain metastasis of 61.9% vs 62.5% (p=0.85), respectively. DISCUSSION KRAS mutations are associated with increased PD-L1 expression. Use of immunotherapy negates the poor outcomes seen traditionally in patients with NSCLCBM and KRAS mutations and it improves survival compared to use of chemotherapy. Our experience supports the use of immunotherapy in these patients.

Knowledge and Practice among Nurses of Traction in Patients: In a Tertiary Care Center

2020 ◽  
Vol 2 (1) ◽  
pp. 47-51
Author(s):  
Sapana Gautam ◽  
Dinesh Kumar Thapa
Keyword(s):  
Nursing Care ◽  
Work Experience ◽  
Care Center ◽  
Tertiary Care ◽  
College Teaching ◽  
Sampling Technique ◽  
Chi Square ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Knowledge And Practice

Background and purpose: The role of nursing care among the traction patients is vital and they should be competent, experienced and educated well about the traction devices used and care to minimize the traction associated complications and infections. This study was designed to access the knowledge and practice regarding care and management of the patients with traction in orthopedic trauma by Nurses. Material and method: A cross sectional descriptive study was conducted on 100 eligible nursing staffs from Kathmandu Medical College Teaching Hospital. Non-probability purposive sampling technique and a self administered structured questionnaire were used to collect data. The statistical analysis was done by using the SPSS version 16. The association between the demographic factors was analyzed by using chi square test.  Result: The working area and traction training has significant relation to knowledge and other, such as age, education, work experience, worked in orthopedic ward has no significance. There is adequate knowledge as the percentage value is 88 and practice regarding care of the patient on traction is 98%. Conclusion: The knowledge regarding traction care seems sufficient in this study and every orthopedic nursing should be master in traction knowledge, application and nursing care to acquire early patient recovery without significant deformity and complications.

scholarly journals Correlation of Hormonal Profile and Lipid Levels with Female Adult Acne in a Tertiary Care Center of Nepal

2018 ◽  
Vol 16 (2) ◽  
pp. 222-227 ◽  
Author(s):  
Smriti Shrestha
Keyword(s):  
Lipid Profile ◽  
Clinical Symptoms ◽  
Care Center ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Bivariate Analysis ◽  
Female Adult ◽  
Chi Square ◽  
Chi Square Test ◽  
Relationship Of

 Background: Acne beyond 25 years of age is frequently associated with hormonal derangement in women. Hormonal association provides the impetus for hormonal therapy as well as underpins the need for blood investigations in this population. Hence, we aim to estimate the presence of hormonal derangement and lipid alteration in female adult acne.Methods: A prospective, observational study was conducted in Dhulikhel Hospital from July 2015 to February 2016. Females older than 25 years with acne were taken in the study after informed consent. Total 100 patients were enrolled aftersample sizeestimation. Hormonal paneland lipid profile were measured. Hormones tested were androgens, C-peptide and thyroid stimulating hormone. Data analysis was done with SPSS-23. Bivariate analysis was done by chi-square test for categorical data.Results: In this study, majority of patients were younger than 30 years (70.5%) and perioral area most commonly involved. Hormonal alteration was seen in 37.2% patients, among which 17.9% had hyperandrogenism, 15.4% had abnormal thyroid level and 10.3% had high C-peptides respectively. Lipid profile was altered in 15.4% patients. Hormonal alteration had significant association with irregular menstruation (P<0.05) but not acne severity.Conclusions: We observed hormonal alteration frequently in females with adult acne, which comprised of various hormonal parameters including hyperandrogenism. Hormonal alteration reflects deranged metabolic milieu and we suggestthat wide hormonal panel should be done in female adult acne. Relationship of hormones with menstrual irregularity but not with acne severity, suggest that clinical symptoms should lead hormonal investigations in all grades of acne.

Validation of a Breastfeeding History Questionnaire for the Risk of In-Hospital Formula Supplementation Among Multiparous Women

2019 ◽  
Vol 35 (4) ◽  
pp. 665-671
Author(s):  
Whitney R. Bender ◽  
Nathanael C. Koelper ◽  
Mary D. Sammel ◽  
Celeste Durnwald
Keyword(s):  
Hospital Stay ◽  
Care Center ◽  
Tertiary Care ◽  
Categorical Variables ◽  
Chi Square ◽  
Multiparous Women ◽  
Chi Square Test ◽  
Student’S T ◽  
Relationship Of ◽  
The Relationship

Background: A woman’s prior breastfeeding history may influence future decisions regarding infant feeding. Few quantitative tools utilizing this information have been demonstrated to predict breastfeeding success. Research aim: To evaluate the efficacy of a prenatal breastfeeding history (BAP) questionnaire administered in prenatal care to predict in-hospital formula supplementation among multiparous women. Methods: This is a prospective observational study of multiparous women with singleton pregnancies who presented to a Baby-Friendly urban tertiary care center for 1st prenatal visit at < 20 weeks’ gestation. The BAP tool generates a numerical score, with higher score (≥ 2) indicating prior successful breastfeeding experiences. The primary outcome was occurrence of non-medically indicated formula supplementation during the postpartum hospital stay. Student’s t test and Pearson’s chi-square test were used to compare continuous and categorical variables. A multivariable logistic regression was performed to assess the relationship of BAP score to formula supplementation. Of 587 women screened, 433 (73.8%) mother–infant dyads were analyzed. Results: Rates of formula supplementation in women with BAP scores ≤ 1 were 67% (156/234) compared with 37% (73/199) in women with higher scores ( p < 0.0001). After controlling for race/ethnicity, insurance, and obesity, women with BAP scores of ≤ 1 were 2.6 times more likely to supplement formula than women with higher scores (a OR 2.62, 95% CI [1.70, 4.04], p < .0001). Conclusion: In this prospective validation study, women with negative prior breastfeeding experiences, as evidenced by a lower BAP score, were more likely to supplement formula during the postpartum hospital stay.

scholarly journals Types and Patterns of Colonic Polyps Encountered at a Tertiary Care Center in a Developing Country in South Asia

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Dakshitha Praneeth Wickramasinghe ◽  
Sanjeev F. Samaranayaka ◽  
Chamila Lakmal ◽  
Sashi Mathotaarachchi ◽  
Chula Kanishka Lal ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Colonic Polyps ◽  
Colorectal Polyps ◽  
Tubular Adenoma ◽  
Tubulovillous Adenoma ◽  
Chi Square ◽  
Chi Square Test ◽  
Pathology Reports ◽  
Spearman’S Correlation

Purpose. To identify the prevalence, types, and patterns of colonic polyps in a cohort of patients presenting to a tertiary care referral center in Sri Lanka.Methods. Endoscopy and pathology reports of a single unit from 2006 to 2013 were analyzed retrospectively. Spearman’s correlation coefficient and chi-square test were used to identify correlations.Results. There were a total of 158 patients (M : F, 10 : 57) who had polyps encountered on colonoscopy (n=1408) and flexible sigmoidoscopy (n=2402) with an incidence of 4.1%. Mean age was 56.5 years (SD 16.4) and the incidence of polyps increased with age. The majority (81.6%) had one polyp. A total of 188 polyps were assessed and most were seen in the rectum (33.5%) followed by sigmoid colon (22.9%). The commonest histological type was tubulovillous adenoma (33.5%) followed by tubular adenoma (24.5%). Most polyps were benign (91.5%). There was no statistically significant correlation with age or gender with malignancy, site, or histology.Discussion and Conclusion. The incidence of colorectal polyps was lower than the values reported in the west. More polyps were identified in males. There was no statistically significant association between age, gender, or multiplicity and malignant change in the polyps.

scholarly journals A six years prospective epidemiological study of acute encephalitis syndrome among children admitted in a rural tertiary care center

2019 ◽  
Vol 6 (5) ◽  
pp. 2125
Author(s):  
Debadyuti Datta ◽  
Balai Ch. Karmakar
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Public Health Issue ◽  
Gender Variance ◽  
Chi Square ◽  
College Hospital ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
And Gender

Background: Acute Encephalitis Syndrome (AES) is a major public health issue in India. The common etiologies of AES in India are various infectious agents. There are seasonal and regional variations in etiologies making diagnosis and effective intervention often difficult. Our study represents the epidemiological data that will help in planning management in larger perspective.Methods: This is a six years prospective observational study conducted in the Department of Pediatrics, North Bengal Medical College Hospital, Darjeeling from January 1st, 2013 to December 31st, 2018. In this study all clinically diagnosed AES cases were included fulfilling inclusion and exclusion criterion.Results: 585 out of 39420 patients (1.48%) were diagnosed clinically as AES over six years. Male patients (372) contributing to 63.6% and female patients (213) 36.4% of the study. Majority cases (271) were seen in the age group of 1-5 years amounting to 46.3% with mean age 5.1±3.6 years. In July 2014 number of cases were maximum 59 (10%) followed by May 2013 20 (3.4%). Among the 585 AES cases, 263 (45%) were suspected for viral etiology (JE= 84, 14.3%). Total 457 cases (78.1%) were alive with insignificant to age and gender variance. Vaccination status revealed 11 among 15 JE deaths were unimmunized which is statistically significant (p < 0.05) by Chi-square test.Conclusions: The magnitude and etiologies of AES need to be explored and understood in various geographic regions and in different seasons to have a better insight for development of future policies to reduce the burden.

scholarly journals The effect of low dose midazolam in addition to ondansetron on post-operative nausea and vomiting in laparoscopic cholecystectomy – a comparative study

2014 ◽  
Vol 24 (1) ◽  
pp. 8-12
Author(s):  
MM Masum-Ul Haque ◽  
Montosh K Mondal ◽  
S Afroz ◽  
SS Akhter ◽  
Abdul Hye ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Low Dose ◽  
Postoperative Nausea And Vomiting ◽  
Group Iv ◽  
Nausea And Vomiting ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Post Operative Nausea

Background Nausea, retching and vomiting are among the most common postoperative complaints. Premedication with low dose midazolam in addition to ondansetron is more effective in controlling postoperative nausea and vomiting. Objectives This study was designed to observe the effect of low dose midazolam 7.5mg in addition to ondansetron 4mg on postoperative nausea and vomiting in laparoscopic cholecystectomy. Methods 100 patients of ASA grade I and II, age range 30-50 years and weight 50-70 kg were randomly selected by a blind envelop method. They were equally divided into four groups of 25 patients in group each. Group I received vitamin, Group II ondansetron 8mg, Group III ondansetron 8mg and midazolam 7.5mg and Group IV ondansetron 4mg and midazolam 7.5 mg orally one hour before operation. In the recovery room occurrence of nausea and vomiting was assessed for 24 hours. Results The incidence of nausea was in vitamin Group I 64%, in ond8 group II 32%, in ond8+mid7.5 group III 24% and in ond4+mid7.5 group IV 24%. The incidence among the groups was highly significant (p=0.008). The incidence of vomiting was in vitamin Group I 16%, in ond8 group II 16%, in ond8+mid7.5 group III 8% and in ond4+mid7.5 group IV 8%. The difference among the groups were not significant (p=0.808). Conclusion Low dose midazolam 7.5mg in addition to ondansetron 4mg is more effective in controlling postoperative nausea and vomiting in laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i1.19793 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(1): 8-12

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