scholarly journals A study to assess efficacy of lower dose ketamine in labor analgesia and its effect on maternal and perinatal outcome

Author(s):  
Kavita N. Singh ◽  
Nivedita Tamta

Background: Present study is planned to study the effectiveness of lower dose ketamine in labor analgesia and its effect on progression of labor, maternal and perinatal outcome.Methods: After obtaining ethical approval from institutional ethical committee, a prospective randomized interventional case control study was conducted in Department of obstetrics and gynecology, N.S.C.B medical college, Jabalpur. Parturient in active labor without risk factors were given 0.2 mg/kg intravenous ketamine in bolus form and 0.1 mg/kg in maintenance dose at 30 minutes interval till full dilatation and the results were analyzed using VAS scale and WHO partogram.Results: In present study, 280 parturient were included in the study. In 140 cases, induction-delivery interval was shortened in 47.10% cases. Pain relief was satisfactory (VAS 2-8) in 77.90% cases. However, 80.70% cases had transient light headedness. Overall satisfaction was significantly high in the intervention group (P<0.001).Conclusions: A lower dose ketamine in bolus form with loading dose of 0.2 mg/kg followed by maintenance dose of 0.1 mg/kg could provide safe and acceptable analgesia during labor and delivery.

2013 ◽  
Vol 29 (1) ◽  
pp. 31-42
Author(s):  
Mohammad Selim Shahi ◽  
Aminur Rahman ◽  
Md Shaheen Wadud ◽  
Ak Takib Uddin Ahmed ◽  
Uttam Kumar Saha ◽  
...  

Background: Several epidemiological studies have identified the association of abnormal ABPI with ischemic stroke. So the goal of this study was to determine the actual relationship of ABPI with ischemic stroke in the context of our country. Materials and Methods: This case control study was carried out in the Department of Neurology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh. ABPI was measured by Doppler ultrasound machine of 100 patients who were admitted to the Mitford Hospital during the study period. Among them 50 patients with Ischemic stroke, confirmed by CT/MRI scan of brain were considered as ‘case’ and 50 age- sex matched individuals with one or more vascular risk factors (VRF) but without stroke were considered as ‘control’. Then the results of ABPI were compared between the two groups. Results: Among the 50 patients with ischemic stroke (case group) , 74% had normal ABPI and 26% had ABPI< 0.9; on the other hand among 50 age and sex matched individuals (control group) 90% had normal ABPI and 10% had ABPI <0.9. The difference was statistically significant between two groups (p=<0.05).This association remained significant even after adjustment for potential confounders (age, gender, high BMI, hypertension, diabetes mellitus, hyperlipidemia, smoking, ischemic heart disease and family history) in a multiple logistic regression model. Conclusion: The incidence of low ABPI is significantly higher in ischemic stroke patients than the age- sex matched control. Bangladesh Journal of Neuroscience 2013; Vol. 29 (1) : 31-42


2013 ◽  
Vol 12 (3) ◽  
pp. 37-43
Author(s):  
Md Shaheen Wadud ◽  
Aminur Rahman ◽  
Mohammad Selim Shahi ◽  
Uttam Kumar Saha ◽  
AK Takib Uddin Ahmed ◽  
...  

Background: Epidemiologic studies have reported that microalbuminuria is a risk factor for stroke in men and a limited case control study found that the highest quintile of microalbuminuria values was associated with 13 fold increased risk for stroke. The goal of this study is designed to determine its relationship to risk factors for ischemic stroke. Materials and Methods: It was a prospective observational study conducted in the Department of Neurology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh. Fifty consecutive patients with ischemic stroke with at least two risk factors who fulfilled the inclusion criteria of case were confirmed by CT or MRI. Equal number of controls same ages without stroke who had at least two risk factors were compared with the case group. The patients were assessed clinically with structured questionnaire including blood pressure, height and weight, and monitoring blood glucose and microalbuminuria. Results: Microalbuminuria was found 58.0% in patients with ischemic stroke. Patients who had diabetes mellitus will have 13.86 times the risk for developing microalbuminuria (p<0.05). Patients who had HTN will have 4.19 times the risk for developing microalbuminuria (p<0.05) and BMI (?23 kg/m2) will have 4.24 times the risk for developing microalbuminuria with (p<0.05). Whereas TIA, IHD, dyslipidemia, smoking and positive family history were not significantly (P>0.05) associated with microalbuminuria in patients with ischemic stroke. Conclusion: The findings of this study show that diabetes is the factor most closely associated with microalbuminuria followed by HTN and BMI?23 kg/m2 with statistically significance in patients with ischemic stroke. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 37-43


2013 ◽  
Vol 5 (1) ◽  
pp. 9-14
Author(s):  
Tanmay Jyoti Sau ◽  
Sandip Kumar Dey ◽  
Arun Kumar ◽  
Utpal Kumar Biswas

Background: Diabetes Mellitus (DM) is frequently associated with the development of premature atherosclerotic vascular disease and is the major cause of morbidity and mortality. Approximately 80% of all deaths and more than 75% of all hospitalizations are due to CAD. Individuals with DM are usually associated with accelerated atherosclerosis. Common Carotid artery intima-media thickness (CCAIMT) is now also considered as a surrogate marker of atherosclerosis. Materials and Methods: This case-control study was conducted from Jan, 2011 to June, 2012 among Type-II diabetes, aged between 30-80yrs. Patients with Type-I diabetes, aged <30yrs or >80yrs and other secondary causes of diabetes, hypertensive, smokers and patients under therapy with lipid lowering drugs were excluded from this study. The biochemical tests were done in the department of Biochemistry, Nilratan Sarkar Medical College and Hospital, using standardized reagent kits. CCAIMT was measured by high resolution imaging using 10MHz transducer in the department of Radiodiagnosis, Nilratan Sarkar Medical College and Hospital. Results: The results of our study indicate that dyslipidemic diabetic patients had significantly higher blood glucose at any phase along with glycated haemoglobin compared to controls. The lipid variables were also significantly higher in the diabetes patients with dyslipidemia compared to controls except HDL levels were significantly higher in control. CCAIMT was higher in the dyslipidemic group (1.71 ± 0.57mm) compared to the non-dyslipidemic group (0.77 ± 0.10) which was statistically significant (p value <0.001). Conclusion: CCAIMT reflects the cumulative burden of atherosclerosis and is highly correlated and predicted well by Total-C/HDL-C ratio in Type-II diabetic patients. So it is advised that a direct examination of the vessel wall is extremely essential for early detection of the affected individuals so that the cost burden in Intensive coronary care unit can be minimized and also the individual can be advised to control the extensive dyslipidemia through dietary restrictions and exercise. DOI: http://dx.doi.org/10.3126/ajms.v5i1.8450 Asian Journal of Medical Science Vol.5(1) 2014 pp.9-14


2014 ◽  
Vol 5 (2) ◽  
pp. 39-42
Author(s):  
A Nesa ◽  
MT Rahman ◽  
Y Kabir ◽  
FA Rupam

A N acetyltransferases 2 (NAT2) is one of the phase II metabolizing enzyme that participate in the bioconversion of heterocyclic arylamines into electrophilic nitrenium ions, which are important ultimate carcinogens that are directly implicated in tumor initiation process. Prostate epithelial cell express N acetyltransferases (NAT) enzymes and recent molecular epidemiological studies have analyzed the relationship between NAT2 in etiology of prostate cancer. A review by chen (2001) in prostate cancer (PCa) suggests that the frequencies of some polymorphisms in certain genes differ among different racial and ethnic groups. In a case control study in India by Srivastava and Mittal (2005), observed significant association between rapid acetylator genotype NAT2 and PCa in tobacco users (OR = 3.43, 95% CI: 1.68-7.02, p< 0.001) when compared with controls. Hamasaki et al (2003) in Japanese men, observed the frequency of the NAT slow acetylator genotype was statistically higher among prostate cancer patients (17.1%) compared with controls (8.6%). Another case control study in Turkey by Kosova et al. (2009), concluded that Nat2* 6A and NAT2 *7A/B gene polymorphism were significantly associated with prostate cancer. DOI: http://dx.doi.org/10.3329/akmmcj.v5i2.21131 Anwer Khan Modern Medical College Journal Vol. 5, No. 2: July 2014, Pages 39-42


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