scholarly journals Effect of single low dose intrathecal labor analgesia on maternal and fetal outcome

2019 ◽  
Vol 8 (11) ◽  
pp. 4543
Author(s):  
Poonam Samyal ◽  
Rama Thakur ◽  
Rohini Rao ◽  
Gian Chauhan ◽  
Sharad Kaushik ◽  
...  
Keyword(s):  
Apgar Score ◽  
Low Dose ◽  
Labor Analgesia ◽  
Cervical Dilatation ◽  
P Value ◽  
Single Shot ◽  
Rescue Analgesia ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari
Keyword(s):  
Upper Airway ◽  
P Value ◽  
Airway Patency ◽  
The Mean ◽  
Group 2 ◽  
Acoustic Pharyngometry ◽  
Nasoalveolar Molding ◽  
Area And Volume ◽  
Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

scholarly journals Comparison between use of combination of mifepristone and misoprostol versus misoprostol alone in the management of intrauterine fetal death

2018 ◽  
Vol 7 (7) ◽  
pp. 2778
Author(s):  
Sreeveena Talasani ◽  
Pran Hitha Venkamolla ◽  
Kalpana Betha
Keyword(s):  
Side Effects ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
P Value ◽  
Ultrasound Scan ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Intrauterine fetal death (IUFD) is estimated to occur in 1% of all pregnancies. The advent of prostaglandins has revolutionized the management of IUFD. There are limited studies using a combined regimen of mifepristone and misoprost for induction of labor in IUFD. Hence this study was undertaken to assess the efficacy and safety of combined regimen with misoprostol alone, in the management of IUFD.Methods: This hospital based prospective study included 60 pregnant women with IUFD admitted at Mediciti Institute of Medical Sciences, during the period January 2015 to July 2016. An ultrasound scan was performed to confirm IUFD and localize the placenta. Women were divided alternatively into 2 groups with 30 in each group (group 1- women received 200 mg mifepristone orally followed by misoprostol after 24 hours & in group 2, 100 µg misoprostol  every 6 hourly for a maximum of 4 doses between gestational age  24-26 weeks, 25-50 µg 4 hourly for a maximum of 6 doses beyond 26 weeks).Results: The mean induction to delivery interval was 10 hours in group 1 and 16.3 hours in group 2 (p value 0.007). Mean dose of misoprostol required in group 1 was 1.87 and 2.67 in group 2 (p value 0.008). With respect to side effects, the two groups did not differ significantly.Conclusions: The combined regimen was more effective than misoprostol for the induction of labour in IUFD, in terms of higher rate of successful delivery and shorter induction to delivery interval. 

scholarly journals A Study on Serum Electrolyte Imbalance in Type-2 Diabetes Mellitus - A Hospital-Based Study

2020 ◽  
Vol 7 (48) ◽  
pp. 2847-2851
Author(s):  
Sreenivasulu Uppara ◽  
Bhagyamma Sollapurappa Narayanaswamy ◽  
Rama Kishore Akula Venkata ◽  
Thanuja Ramanna ◽  
Shyam Prasad B.R
Keyword(s):  
Diabetes Mellitus ◽  
Serum Creatinine ◽  
Serum Sodium ◽  
P Value ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Serum Chloride ◽  
The Mean ◽  
Group 2 ◽  
Group 1

BACKGROUND The multi-organ disorder, diabetes mellitus (DM) continues to be one of the commonest and challenging health-related problems in the 20th century, prevalent in about 9.3 % of the world's population in 2019 and likely to affect 10.2 % by 2030. Diabetes mellitus is a group of chronic metabolic disorders of multiple aetiology, characterized by chronic hyperglycaemia due to derangement in carbohydrate, fat and protein metabolism. Electrolytes are crucial in maintaining various metabolic functions and play a pivotal role in maintaining a healthy state's body. Diabetic patients are more prone to and frequently develop a constellation of electrolyte disorders due to hyperglycaemia, polydipsia and polyuria. METHODS Our study comprised a total of 70 subjects in the age group of 35 - 60 years with age and sex-matched controls. They were grouped into two groups; the first group, group-1 (healthy controls) and the second group was group-2 (patients of diabetes mellitus on oral hypoglycaemic agents with poor control). 5 ml of fasting venous blood was collected in a plain vacutainer tube in the morning after a zerocalorie overnight 08 hours fast. Post collection, the blood sample was used as serum or plasma or whole blood to estimate plasma glucose, blood urea, serum creatinine, serum sodium, serum potassium, serum chloride by kit methods using an auto analyser. RESULTS Among the various parameters tested, the mean value of fasting plasma glucose, blood urea, serum creatinine, serum potassium, serum chloride were higher in group-2 (diabetic patients) compared to group-1 (healthy controls) with a p-value of < 0.0001. The value of the mean of serum sodium was lower in group-2 (diabetes mellitus) compared to group-1 (healthy controls) with a p-value of < 0.0001. CONCLUSIONS We conclude that electrolyte abnormalities are present in diabetic patients and maybe a root cause for associated morbidity or mortality. These disturbances are generally seen in decompensated Diabetes Mellitus patients, elderly individuals and in the presence of renal impairment. KEYWORDS Diabetes Mellitus, Serum Electrolytes, Fasting Blood Glucose

Efficacy of Transversus Abdominis Plane Block After Post Caesarean Section Delivery

2018 ◽  
Vol 16 (1) ◽  
pp. 2-6
Author(s):  
Grisuna Singh ◽  
Farhat Banu ◽  
Husneyera Haque
Keyword(s):  
Caesarean Section ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
P Value ◽  
Transversus Abdominis Plane ◽  
Vas Score ◽  
Post Operative Pain ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Introduction: Post operative pain following caesarean section delivery can negatively affect early wound healing, proper breast feeding to the new born baby and therefore impair mother to child bonding. Combination of non steroidal anti inflammatory drugs (NSAIDS) and opioids has most commonly been used in pain management. The combination of regional anesthetic techniques like Transversus Abdominis Plane (TAP) block reduces pain and the dose of total analgesics consumed and therefore helps to prevent opioid related side effects. Objective: To evaluate the analgesic efficacy of Transversus Abdominis Plane block for management of postoperative pain in the first 24 hours after caesarean section. Methodology: It is a prospective randomized controlled single blinded study involving 60 patients of ASA II done in Nepalgunj Medical College Teaching Hospital over a period of 2 months. They are divided into two groups of 30 patients each. Group 1 received 20 ml of 0.25% isobaric bupivacaine in the triangle of Petit bilaterally. Group 2 received IV analgesics (NSAIDS and Tramadol 50 mg with Phenargan 25 mg). VAS score was taken every 6 hourly for 24 hours post operatively. Results: The mean VAS score of the patients in group 2 at 0-6 hours, 6-12 hours, 12-18 hours and 18-24 hours was 6.73(SD±0.69), 6.63(SD±0.610), 6.40(SD±0.56) and 6.43(SD±0.57) respectively. The mean VAS score of the patients who received block is significantly less as compared to those who did not receive the block with a p value of <0.001. The mean time to first analgesic request in group 1 was 10.83(SD±2.95) and in group 2 was 4.87(SD±0.68) with a p value of <0.001. In group 1, 70% patients received single dose of analgesics, 23.3% received two doses and 6.7% received three doses of analgesics. In group 2 all the patients received four doses of analgesics. Conclusion: Transversus Abdominis Plane Block can be used as a part of multimodal analgesic therapy for the management of post operative pain after caesarean section as it is technically less demanding, safe and economical. It reduces the side effects related with opioid analgesics and encourage early mobility, wound healing and proper mother to child bonding.

scholarly journals Compare frequency of wound infection with ceftriaxone versus amoxicillin in females undergoing C section

2021 ◽  
Vol 15 (7) ◽  
pp. 1607-1609
Author(s):  
Aneeqa Ilyas ◽  
Bilal Rafique Malik ◽  
Rehan Anwar
Keyword(s):  
Cesarean Section ◽  
Wound Infection ◽  
Gestational Age ◽  
Bacterial Infections ◽  
Controlled Trial ◽  
P Value ◽  
The Mean ◽  
Group 2 ◽  
Trial Setting ◽  
Group 1

Background:Post-caesarean wound infection is a frightful complication of cesarean delivery and increase burden on health care system. Prevention of post-cesarean wound infection must be the priority in any healthcare center in developing countries. Amoxicillin is an antibiotic often used for the treatment of a number of bacterial infections. Aim: To compare the frequency of wound infection with ceftriaxone versus amoxicillin in females undergoing cesarean section at term Study design: Randomized Controlled Trial Setting & duration: Department of Medicine and Gynecology, SIMS, Lahore from 01-07-2020 to 31-12- 2020. Methods: After fulfilling the selection criteria, 250 females were enrolled and were divided randomly into two equal groups. Group 1 was given intravenous amoxicillin and group 2 was given intravenous ceftriaxone. Then cesarean was done under spinal anesthesia. Post-op wound infection was noted in all the females. The data was analyzed in SPSS. Results: The mean age of the females of amoxicillin group was 28.09±6.01 years whereas the mean age of the ceftriaxone group females was 29.38 ± 6.41 years. The mean gestational age of the females in amoxicillin group was 38.98 ± 0.85 weeks whereas the mean gestational age in ceftriaxone group was 38.94±0.79 weeks. The mean BMI of the females in amoxicillin group was 26.58 ± 6.27 kg/m2 whereas the mean BMI in ceftriaxone group was 29.32±6.36kg/m2. The post-cesarean wound infection was found in 2(1.6%) females in amoxicillin group while in 8(6.4%) females in ceftriaxone group. This difference was statistically insignificant i.e. p-value=0.0.053. Conclusion: The amoxicillin is more effective from prevention of post-op wound infection than to ceftriaxone in females underwent cesarean section. Keywords: Amoxicillin, Ceftriaxone, cesarean section, post-cesarean wound infection

Low-dose Spironolactone: Treatment for Osteoarthritis-related Knee Effusion. A Prospective Clinical and Sonographic-based Study

2016 ◽  
Vol 43 (6) ◽  
pp. 1114-1120 ◽  
Author(s):  
Ahmed M. Elsaman ◽  
Ahmed R. Radwan ◽  
Walaa I. Mohammed ◽  
Sarah Ohrndorf
Keyword(s):  
Low Dose ◽  
University Hospital ◽  
Fluid Analysis ◽  
Group 4 ◽  
Knee Effusion ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Musculoskeletal Ultrasonography ◽  
Group 1

Objective.To evaluate the effectiveness of spironolactone as a treatment for osteoarthritis (OA)-related knee effusion in comparison to ibuprofen, cold compresses, and placebo.Methods.This study was carried out on 200 patients, aged 40 years or older, attending the outpatient clinic of the Rheumatology Department of Sohag University Hospital with unilateral knee effusion related to OA based on clinical examination, musculoskeletal ultrasonography (US), and synovial fluid analysis. In group 1, 50 patients received spironolactone 25 mg daily for 2 weeks; in group 2, 50 patients took ibuprofen 1200 mg daily for 2 weeks; in group 3, 50 patients used cold compresses 2 times daily for 2 weeks; and in group 4, 50 patients received placebo for the same duration. Fluid > 4 mm was considered as effusion. Decrease in fluid to reach below 4-mm thickness was considered complete improvement, and any decrease that did not reach below 4 mm thickness was considered partial improvement.Results.The mean age of the participants was 51.2 ± 8.1 years. The mean duration of effusion was 16.5 ± 3.6 days. In group 1, 66% had complete improvement, 20% partial improvement, and 14% no response. In group 2, 24% had complete improvement, 12% partial improvement, and 64% no response. In group 3, 28% had complete improvement, 14% partial improvement, and 58% no response. In group 4, only 6% had complete improvement, 10% partial improvement, and 84% no response.Conclusion.Low-dose spironolactone is a safe and effective medical treatment for OA-related knee effusion.

scholarly journals The Role of Tibial Osteotomy in the Outcome of Meniscus Allograft Transplantation

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0018
Author(s):  
Peter Myers ◽  
Ahmed Mahmoud ◽  
Jamie Young
Keyword(s):  
Cartilage Damage ◽  
Oxford Knee Score ◽  
P Value ◽  
Consecutive Series ◽  
Tibial Osteotomy ◽  
Allograft Transplantation ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objectives: Meniscal allograft transplantation (MAT) is indicated to relieve pain and improve function and hopefully to delay the onset of osteoarthritis in patients with meniscus deficiency. The purpose of this study was to compare the effect of perioperative cartilage status on survivorship and whether this is influenced by a concurrent tibial osteotomy. Methods: We reviewed a consecutive series of 45 MATs in 42 patients with a minimum post-surgical time of four years. Patients were divided into two groups using the Outerbridge Cartilage Score (OSC) to group 1 (minimal cartilage damage of grade 0-2) and group 2 (severe cartilage damage of grade 3-4). Pre- and post-operative outcome scores were collected using the Lysholm, Tegner, Oxford Knee Score (OKS) and International Knee Documentation Committee (IKDC) subjective knee form. Survival end points were transplant removal and knee arthroplasty. Results: The mean post-surgical follow-up for patients in group 1 (n=14, age 32.0 +/- 9.8) and group 2 (n=31, age 36.2 +/- 10) was 10.6 years (SD +/-3.35) and 7.1 (SD+/-3.34) respectively. There was no significant difference in the mean age between the two groups (p-value 0.221, CI -2.62 to 11). Patients in group 1 demonstrated no failures of the MAT over the time frame evaluated. Group 2 (n=31) had a 74.2% survival of MATs. The clinical outcomes improved in all groups with no significant difference between group 1 and group 2. Those patients in the osteotomy group did not have a statistically significant different survival (Mantel-cox test p-value of 0.922) or clinical outcome. Conclusion: Patient with minimal cartilage status have improved MAT survivorship but both groups benefit clinically. Tibial osteotomy, when indicated, does not influence the outcome of MAT.

scholarly journals The Effectiveness of Ondansetron in Preventing Hypotension and Bradicardia in Spinal Anestesia

2020 ◽  
Vol 5 (8) ◽  
pp. 1611-1614
Author(s):  
Albert; Akhyar Hamonangan Nasution ◽  
Qadri Fauzi Tanjung
Keyword(s):  
Spinal Anesthesia ◽  
Serotonin Receptors ◽  
Elective Surgery ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Group Design ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Spinal anesthesia was typically used for elective surgery and was associated with the incidence of hypotension and bradycardia due to sympathetic block. Bezold-Jarisch reflex (BJR) is a reflex that contributes to cause hypotension and bradycardia mediated by serotonin receptors (5-HT3). Ondansetron, a 5-HT3 receptor antagonist, is assumed to inhibit the effect of serotonin and BJR. To assess the effectiveness of ondansetron in preventing hypotension and bradycardia after spinal anesthesia. This study was an experimental study with a "posttest with control group" design conducted at Haji Adam Malik General Hospital and USU Hospital in February 2020 to June 2020. Seventy study subjects who underwent lower abdominal, gynecology, lower extremities under spinal anesthesia were selected by consecutive sampling and were divided into 2 groups. Group 1 received 4 mg ondansetron, while group 2 received 2 cc normal saline, both interventions were given 30 minutes before spinal anesthesia Baseline and minimum mean arterial pressure were higher in the ondansetron group at 97.07 ± 5.09 mmHg and 85.20 ± 6.48 mmHg compared to the control group (p-value <0.05). Hypotension was more common in the control group (51.43%) than in ondansetron group (20%) (p-value <0.05). The mean baseline and minimum heart rate were higher in the ondansetron group at 81,09 ± 9,62 bpm and 79.7 ± 8.75 bpm compared to the control group (p<0.05). The incidence of bradycardia was more common in the control group (17.1%) compared to the ondansetron group (2.9%) (pvalue <0.05). Ondansetron 4 mg, given intravenously, is effective in lowering the incidence of hypotension and bradycardia under spinal anesthesia

scholarly journals Comparison of Tramadol with Combination of Tramadol and Ketorolac for Post Cesarean Section Analgesia

2020 ◽  
Vol 18 (1) ◽  
pp. 52-55
Author(s):  
Nabin Kumar Regmi ◽  
Kamar Jahan ◽  
Purnima Rai ◽  
Ankur Bhandari
Keyword(s):  
Patient Satisfaction ◽  
Cesarean Section ◽  
Analgesic Efficacy ◽  
Multimodal Analgesia ◽  
P Value ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Breast Feed ◽  
Group 2 ◽  
Group 1

Introduction: Effective post-operative analgesia is mandatory following cesarean section (CS), as parturients need to recover quickly to breast feed and provide care for their newborns. Till date no single drug has been able to achieve this goal. Multimodal analgesia with opioids and non-steroidal anti-inflammatory drugs (NSAID) combination has shown promising results.  Aims: To compare the analgesic efficacy, patient satisfaction and maternal adverse effects, between intravenous (IV) tramadol and multimodal analgesia with IV tramadol and IV ketorolac combination for post cesarean section analgesia. Methods: This is a prospective, randomized and single-blinded comparative study, conducted in 60 parturients who underwent Lower Segment Cesarian Section. They were divided into two groups: Group 1 (IV Tramadol 50 mg given 8 hourly) and Group 2 (IV Tramadol 50 mg + IV Ketorolac 30 mg given 8 hourly). IV Promethazine was given with each dose of tramadol in both groups. Results: The (Visual analogue scale) VAS scores were significantly low in IV tramadol + IV ketrolac group than with IV tramadol alone group at 2 hours and 12 hours with p value of 0.003 and 0.08 respectively. Rescue analgesia was significantly reduced in group 2 (p value 0.005). Patient satisfaction was good in group 2 and fair in group 1(p value 0.002). No maternal side effects were found. Conclusion: IV tramadol and IV ketorolac combination used for post cesarean section analgesia significantly decreases post-operative pain, need of rescue analgesia and significantly increases patient satisfaction in comparison to IV tramadol alone.

scholarly journals Higher Intraocular Pressure Levels Associated With Lower Hysteresis In Type 2 Diabetes

2018 ◽  
Vol 12 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Sinan Bekmez ◽  
Tolga Kocaturk
Keyword(s):  
Intraocular Pressure ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Diabetics ◽  
Kolmogorov Smirnov ◽  
The Mean ◽  
Group 2 ◽  
Group 1 ◽  
Smirnov Test

Aim: To investigate the differences of corneal biomechanic characteristics using Ocular Response Analyzer (ORA, Reichert; USA) on type 2 diabetics and healthy subjects. Methods: One hundred eyes of 100 subjects (between the ages of 17-91) who applied to Adnan Menderes University’s Ophthalmology Clinic between January-March 2015 were included in this study, 50 diabetics (Group 1) and 50 healthy controls (Group 2). The eyes included in the study were randomly chosen. Corneal Hysteresis (CH), Corneal Resistance Factor (CRF), Goldmann correlated Intraocular Pressure (IOPg) and corneal compensated Intraocular Pressure (IOPcc) of patients were measured by ORA. Detailed ophthalmological examinations were done for every subject. Kolmogorov-Smirnov test was used to analyze the distribution of quantitative variables and t test was used for the data that were normally distributed. Any p value <0.05 was considered as statistically significant. Results: The mean ages were 63.3±9.0 and 61.7±11.6 in Group 1 and 2, respectively (p=0.459). 25 (50.0%) were female, 25 (50.0%) were male in Group 1 and 26 (52.0%) were female, 24 (48.0%) were male in Group 2 (p=1.000). Mean IOPcc values were 17.8±3.6 (12.1-29.0) and 16.0±3.1 (10.9-23.8) mmHg (p=0.006); mean IOPg values were 16.9±3.5 (10.9-25.9) and 15.4±2.9 (9.0-24.7) mmHg (p=0.032); mean CH values were 9.9±1.5 (6.1-13.3) and 10.5±1.7 (6.5-15.7) (p=0.080) and mean CRF values were 10.4±1.6 (7.5-14.0) and 10.5±1.7 (6.6-15.4) (p=0.730) in Groups 1 and 2, respectively. Conclusions: There was no any statistical difference between the groups in terms of CH and CRF. However, mean CH and CRF values were found less in diabetic group. Corneal biomechanical differences seen in diabetic patients may be associated with a statistically significantly higher IOP measurements.

Sign in / Sign up

Export Citation Format

Share Document