scholarly journals Compliance with 14 day zinc therapy for acute diarrhoea: a prospective observational study

2020 ◽  
Vol 7 (4) ◽  
pp. 909
Author(s):  
Ajayprakash Veerapandiyan ◽  
Deepti Pandit ◽  
Sujatha Sridharan ◽  
L. Umadevi
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Acute Diarrhoea ◽  
Variable Number ◽  
Outcome Variable ◽  
P Value ◽  
Primary Outcome Variable ◽  
Effective Implementation ◽  
Diarrheal Episode ◽  
The Mean

Background: Acute diarrheal diseases remain a leading cause of global morbidity and mortality in young children. The effective implementation of provision of zinc in addition to low osmolarity ORS remains very poor.Methods: A prospective observational study was done to determine compliance with zinc therapy on 103 children aged between two months to five years with acute gastroenteritis. They were started on WHO ORS and zinc in the form of syrup (20 mg/day in those >6 months of age and 10mg/day in those <6 months of age) and advised to continue for 14 days. Further episodes of diarrhea was considered as the primary outcome variable. Number of days zinc taken was considered as the primary explanatory variable. p-value <0.05 was considered statistically significant.Results: The mean age was 19.49±14.41 months. The compliance to complete 14-day zinc therapy was 62.14%.  The mean number of days zinc was taken was 11.28±3.81 days. In 11.65% of participants, there was further episodes of diarrhea. The main reasons for discontinuation were diarrhea stopped (45%), Ignorance (37.5%), URI (12.5%).Conclusions: Findings indicate that the syrup formulation is acceptable, but further efforts are required to enhance adherence. These findings also highlight the importance of guiding in ensuring adherence to zinc duration while also addressing the tendency of caregivers to terminate treatment once a child appears to have recovered from an acute diarrheal episode.

scholarly journals The effectiveness of mini-CEX assessment tool for clinical competency achievement in clinical practice among anesthesia trainee.

2020 ◽  
Vol 27 (02) ◽  
pp. 279-283
Author(s):  
Aamir Furqan ◽  
Azeem Gulzar ◽  
Bilal Nazar ◽  
Masood Alam ◽  
Rahat Akhtar ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Clinical Expertise ◽  
The Mean ◽  
Preoperative Examination

Objectives: To determine the efficacy of Mini-CEX in assessing clinical expertise of anesthesia trainee during examination at Anesthesia department of Multan Hospitals. Study Design: Prospective Observational Study. Setting: Department of Anesthesia and Intensive Care Ch. Pervez Ellahi Institute of Cardiology and Nishtar Hospital Multan. Period: From January 2017 to March 2019. Material & Methods: The design of study was prospective observational study having the post-test with control group only. The size of the sample was based upon 70 trainee anesthesia being divided into two further groups: 35 trainee anesthesia were included in the control group whereas 35 trainee were part of the intervention group. The analysis of data was done by Mann Whitney test and it was descriptive type of test. Results: The mean result of Preoperative examination skills among the intervention group was greater than the control group. The mean score of Preoperative examination competence in control group was 72.11±4.56, while the mean score of Preoperative examination competence in intervention group was 81.28±2.86. The mean score of anesthesia trainees towards satisfaction of control and intervention group was 5.37±0.38 and 8.95±0.64, respectively. While the mean score of evaluators towards satisfaction of control and intervention group was 6.24±0.53 and 8.04±0.52, respectively. The difference of clinical abilities was significant among the two groups having the p value 0.000 (p<0.05). Conclusion: Clinical expertise among anesthesia trainee was significantly ameliorated after the use of Mini-CEX program. It is therefore suggested for anesthesia trainers to use the Mini-CEX program in order to determine the clinical skills among students.

scholarly journals Analgesic Efficacy of Perioperative Esmolol as an Adjunct to Morphine in Mastectomy- A Prospective Observational Study

2021 ◽  
Author(s):  
Jose Tania ◽  
Vadakkoot Raghavan Hema ◽  
Prabhakaran Vineetha
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
P Value ◽  
Numerical Rating ◽  
The Mean

Introduction: Multimodal analgesia with opioids as the prime component is the mainstay of postoperative analgesia for mastectomy, which can lead to many opioid related unwanted side-effects. Esmolol infusion has been found as a useful adjunct in reducing opioid requirements. Aim: To find the effect of perioperative esmolol infusion on postoperative pain and opioid requirements. Materials and Methods: This prospective observational study was done in 140 American Society of Anaesthesiologists (ASA) physical status l and ll patients, between 20-65 years of age posted for mastectomy under general anaesthesia. Esmolol group (group E) received 0.25 mg/kg of esmolol bolus ten minutes before induction followed by continuous infusion 5 μg/kg/min till end of surgery while control group (group C) received equivalent volumes of saline. Primary outcome measures were Numerical Rating Scale (NRS) for pain, total postoperative opioid consumption and time to first rescue analgesic dosage till 24 hours. Intraoperative haemodynamics and other side-effects were secondary outcomes. Descriptive statistics of numerical rating scores and analgesic requirements were analysed in terms of mean and standard deviation. Independent t-test was used to compare numerical rating scores and analgesic requirement of the two groups. A p-value of <0.05 was considered statistically significant. Results: The mean numerical pain scores were significantly lower in the esmolol group for the first 24 hour. The mean time to first rescue analgesic was 17.59±5.012 hour in the esmolol group and 8.21±2.22 hour in the control group which was statistically significant (p<0.001). The total tramadol consumption was also significantly lesser in the esmolol group (42.14±29.03 mg), compared to control group (102.86±22.3 mg), (p=0.0001). Mean heart rate was statistically lower in the esmolol group, but there was no incidence of bradycardia requiring treatment. Mean Arterial Pressures (MAP) were comparable. Conclusion: Perioperative esmolol infusion when used as an adjunct to morphine decreased postoperative pain and analgesic requirements for the first 24 hours without any haemodynamic disturbances.

scholarly journals POS0441 DEVELOPMENT OF RHEUMATOID ARTHRITIS AMONG ANTI-CITRULLINATED PROTEIN ANTIBODIES POSITIVE ASYMPTOMATIC INDIVIDUALS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 449.1-449
Author(s):  
S. Mizuki ◽  
K. Horie ◽  
K. Imabayashi ◽  
K. Mishima ◽  
K. Oryoji
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Observational Study ◽  
Rheumatoid Factor ◽  
Prospective Observational Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
P Value ◽  
Healthy Population ◽  
Asymptomatic Individuals ◽  
Citrullinated Protein

Background:In the idividuals with genetic and enviromental risk factors, immune events at mucosal surfaces occur and may precede systemic autoimmunity. Anti-citrullinated protein antibodies (ACPA) are present in the serum for an average of 3-5 years prior to the onset of rheumatoid arthritis (RA) during an asymptomatic period. In ACPA-positivite individuals, the additional presence of RA-related risk factors appears to add significant power for the development of RA. To date, there have been few reports in which clinical courses of ACPA-positive asymptomatic individuals were investigated prospectively.Objectives:To observe the clinical time course of ACPA-positive healthy population for the development of RA.Methods:Healthy volunteers without joint pain or stiffness, who attended the comprehensive health screening of our hospital, were enrolled in this prospective observational study. The serum ACPA levels were quantified by Ig-G anti-cyclic citrullinated peptide enzyme-linked immunosorbent assay with levels > 4.4 U/mL considered positive. ACPA-positive subjects were followed by rheumatologists of our department clinically or a questionnaire sent by mail for screening to detect arthritis.Results:5,971 healthy individuals without joint symptons were included. Ninty-two (1.5%) were positive for ACPA. Of these, 19 (20.7%) developed RA and two were suspected as RA by mail questionnaire. Their average age were 58-years, and women were 68%. The average duration between the date of serum sampling and diagnosis was 10.7 months. ACPA-positive individuals who developed to RA had higher serum ACPA and Ig-M rheumatoid factor levels than ACPA-positive individuals who did not (P value by Mann-Whitney U test: 0.002, 0.005, respectively).Conclusion:Among ACPA-positive asymptomatic individuals, 20% developed RA. The higher titer of ACPA and Ig-M rheumatoid factor levels are risk factors for devoloping RA.Disclosure of Interests:None declared

scholarly journals Helicobacter pylori eradication in patients with type 2 diabetes mellitus: Multicenter prospective observational study

2019 ◽  
Vol 7 ◽  
pp. 205031211983209 ◽  
Author(s):  
Seung-Joo Nam ◽  
Sung Chul Park ◽  
Sang Hoon Lee ◽  
Dong Wook Choi ◽  
Sung Joon Lee ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Eradication Rate ◽  
Laboratory Data ◽  
P Value ◽  
Diabetic Patients ◽  
Multicenter Prospective Observational Study ◽  
H Pylori

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.

scholarly journals Anaesthesia and Perioperative Care in Remote Health Camps- Patients’ Concerns

2010 ◽  
Vol 49 (179) ◽  
Author(s):  
Balkrishna Bhattarai ◽  
A Ghimire ◽  
BK Baral ◽  
A Shrestha ◽  
Y Dhungana
Keyword(s):  
Observational Study ◽  
Perioperative Care ◽  
Local Anaesthesia ◽  
Prospective Observational Study ◽  
Main Concern ◽  
Surgical Experience ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Mean ◽  
Remote Health

INTRODUCTION:Identifying patients' concerns and expectations regarding anaesthesia and perioperative care in mobile surgical camps is relevant for the camp workers. This prospective observational study was conducted to assess knowledge, concerns, and expectations about anaesthesia and perioperative care in patients undergoing surgery in mobile surgical camps in remote mountainous districts of Eastern Nepal.METHODS:A questionnaire with seven items related to anaesthesia and perioperative care was used for interviewing 80 individuals of age > or = 12 years, 20 from each camp at Solukhumbu, Sankhuwasabha, Khotang and Bhojpur districts.RESULTS:Data of two patients were lost leaving only 78 individuals for analysis. The mean age of the subjects was 30.5 (+/- 14.6) years with the male: female ratio of 43: 35. Fifty-eight (74.4%) patients had some gross idea about the modality of administration of anaesthetics. Twenty-six (33.3%) individuals preferred GA over local anaesthesia, whereas 22 (28.2%) were happy either way if there was no pain. Pain was the main concern for 73.1% of the patients. Of the 25 patients expressing fear of GA, death or not being able to wake up anymore was the main concern for 60.0%. Increasing age was associated with lower fear of GA (p < 0.05). Surgical experience was distressing for 17 (21.8%) patients. The overall experience of the anaesthesia and surgery was worse than expected for 25.6% of the patients.CONCLUSIONS:Patients presenting to these health camps have limited knowledge regarding anaesthesia and perioperative care but have valid concerns and expectations in respect of their safety, comfort and outcome.

scholarly journals Role of JIGSAW method of teaching in improving clinical diagnosis among final year medical students – A prospective observational study

2021 ◽  
Vol 12 (12) ◽  
pp. 44-49
Author(s):  
Appandraj S ◽  
Sivagamasundari V ◽  
Varatharajan Sakthivadivel
Keyword(s):  
Observational Study ◽  
Test Score ◽  
Prospective Observational Study ◽  
Coronary Syndrome ◽  
Post Test ◽  
Jigsaw Method ◽  
The Mean ◽  
The Difference ◽  
Didactic Lecture ◽  
Teaching Learning

Background: The Jigsaw method is a form of cooperative learning, in which students are actively involved in the teaching-learning process that improves the long-term retention of acquired knowledge. Aims and Objectives: The objective of this study was to assess the knowledge acquired by students using the Jigsaw learning method in Internal Medicine. Materials and Methods: A prospective observational study was conducted with 100 students. The acute coronary syndrome was taken for 1 h as a didactic lecture, and a pre-test was conducted. The students were divided into five groups and were put for the intervention “Jigsaw.” The pre- and post-test were conducted, and feedback was collected from the students. Paired t-test was used to perform analysis of pre- and post-test. Feedback evaluation was done by a 5-point Liker scale. P<0.05 was considered statistically significant, and the data were analyzed using CoGuide software. Results: The mean pre-test score was 8.44 ± 2.33 ranged (3–14) and the mean post-test score was 11.03 ± 2.07 (ranged 6–15). The difference of 2.39 (95% CI: 2.19–2.59) increase in marks post-test after the Jigsaw method was statistically significant (P<0.001). The satisfaction level was 50–55% on the Likert scale based on the questionnaire given. There was a significant improvement in the post-test scores of the students after Jigsaw. Conclusion: The Jigsaw method improved knowledge in the short-term by engaging students in group work and motivation to learn. Overall response based on the questionnaire about the Jigsaw method was positive.

scholarly journals A prospective observational study conducted in tertiary teaching hospital of Uttar Pradesh to compare safety and efficacy of PPIUCD and interval IUCD (380A)

2018 ◽  
Vol 8 (1) ◽  
pp. 295
Author(s):  
Nidhi Gupta ◽  
Akanksha .
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Uttar Pradesh ◽  
P Value ◽  
Efficacy And Safety ◽  
Puerperal Sepsis ◽  
Medical College ◽  
Tertiary Teaching ◽  
Reversible Method ◽  
Tertiary Teaching Hospital

Background: The objective of this study was to compare the efficacy and safety of PPIUCD and interval IUCD.Methods: This was a prospective observational study conducted on women attending the OPD and indoor services of S.N. Medical college, Agra. 800 women willing for PPIUCD insertion were included in the study after informed consent excluding chorioamnionitis, PROM>18 hours, unresolved PPH and puerperal sepsis. Another 200 willing women were inserted interval IUCD according to MEC criteria of WHO. All were followed up for 1 year.Results: It was found that rate of expulsion was more in PPIUCD group compared to interval IUCD group (6%vs 1.5% p value <.05),rate of removal was almost similar in both groups (11.5%inPPIUCD and 14%in interval IUCD group), cause of removal was mainly social in PPIUCD group while bleeding was more in interval IUCD group compared to PPIUCD (85.7%vs26%).Conclusions: Postpartum insertion of IUCD is a safe effective, feasible and reversible method of contraception.

scholarly journals Incisional Hernia Repair in Contaminated Surgical fields (I.H.R.C.S.) study using biological prostheses in emergency surgery setting with contaminated hernias: a multicenter prospective observational study

2016 ◽  
Author(s):  
Belinda De Simone ◽  
Fausto Catena ◽  
Antonio Biondi ◽  
Gianluca Baiocchi ◽  
Fabio Campanile ◽  
...  
Keyword(s):  
Observational Study ◽  
Incisional Hernia ◽  
Prospective Observational Study ◽  
Wound Complication ◽  
Hernia Recurrence ◽  
Mesh Placement ◽  
Asa Score ◽  
Surgical Field ◽  
The Mean ◽  
Biological Prostheses

There are still difficulties to find appropriate indication for prosthetic implant in hernia surgery in contaminated surgical fields. Biologic prosthetic materials have been developed and proposed for the clinical use in contaminated surgical fields with interesting outcomes. The aim of this study is to analyze data from nine Italian Emergency Surgery Units concerning patients consecutively admitted with diagnosis of strangulated incisional hernia (IH), submitted to surgery in emergency and treated with biological prostheses. This is a prospective observational study. Subjects submitted to singlestaged IH repair in a contaminated surgical field, with the use of biologic mesh, were prospectively studied over a 1-year time period. All patients enrolled in this study were submitted to bowel/intestinal resection at the same operative time for perforation. Primary end points of our study were wound complication and hernia recurrence. Seventy-one patients were enrolled (F=21, M=50); the mean age was 69.2±11.1 standard deviation (SD) years and the mean American Society of Anesthesiologist (ASA) score was 3.1±0.8 SD. Twenty-one patients (29.57%) had a wound complication, associated with high ASA score, diabetes, smoking, chronic immunosuppression, number of previous hernia repairs, dirty surgical field, sublay extra peritoneal mesh placement and no anterior fascia closure. After a mean follow up time of 27.2 months, hernia recurrence occurred in 19 patients (26.76%). Predictors of hernia recurrence included wound complications, high ASA score, diabetes, chronic immunosuppression, dirty surgical field and sublay extra peritoneal mesh placement. Use of biological prostheses in contaminated fields is safe with favorable medium term recurrence rate (26.76% in our experience). Surgical technique performed is important to decrease hernia recurrence rate.

scholarly journals Premedication practices for tracheal intubation in neonates transported by French medical transport teams: a prospective observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e034052 ◽  
Author(s):  
Ricardo Carbajal ◽  
Noella Lode ◽  
Azzedine Ayachi ◽  
Ourida Chouakri ◽  
Véronique Henry-Larzul ◽  
...  
Keyword(s):  
Adverse Events ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Drug Regimen ◽  
Muscle Rigidity ◽  
Neonatal Transport ◽  
Registration Number ◽  
Medical Transport ◽  
The Mean ◽  
Paris Region

ObjectivesPremedication practices for neonatal tracheal intubations have not yet been described for neonatal transport teams. Our objective is to describe the use of sedation/analgesia (SA) for tracheal intubations and to assess its tolerance in neonates transported by medical transport teams in France.SettingThis prospective observational study was part of the EPIPPAIN 2 project and collected around-the-clock data on SA practices in neonates intubated by all five paediatric medical transport teams of the Paris region during a 2-month period. Intubations were classified as emergent, semiemergent and non-emergent. Sedation level and conditions of intubation were assessed with the Tonus, Reactivity, Awareness and Conditions of intubation to Help in Endotracheal intubation Assessment (TRACHEA score). The scores range from 0 to 10 representing an increasing ladder from adequate to inadequate sedation, and from excellent to very poor conditions of intubation.Participants40 neonates intubated in 28 different centres.ResultsThe mean (SD) age was 34.9 (3.9) weeks, and 62.5% were intubated in the delivery room. 30/40 (75%) of intubations were performed with the use of SA. In 18/30 (60.0%) intubations performed with SA, the drug regimen was the association of sufentanil and midazolam. Atropine was given in 19/40 intubations. From the 16, 21 and 3 intubations classified as emergent, semiemergent and non-emergent, respectively, 8 (50%), 19 (90.5%) and 3 (100%) were performed with SA premedication. 79.3% of intubations performed with SA had TRACHEA scores of 3 or less. 22/40 (55%) infants had at least one of the following adverse events: muscle rigidity, bradycardia below 100/min, desaturation below 80% and nose or pharynx–larynx bleeding. 7/24 (29.2%) of those who had only one attempt presented at least one of these adverse events compared with 15/16 (93.8%) of those who needed two or more attempts (p<0.001).ConclusionSA premedication is largely feasible for tracheal intubations performed in neonates transported by medical transport teams including intubations judged as emergent or semiemergent.Trial registration numberNCT01346813; Results.

scholarly journals Prospective observational study to evaluate the efficacy of labetalol versus nifedipine in the management of preeclampsia

2020 ◽  
Vol 9 (4) ◽  
pp. 1448
Author(s):  
Sarulatha D. ◽  
Menaga M.
Keyword(s):  
Blood Pressure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Age Distribution ◽  
Unknown Etiology ◽  
P Value ◽  
Maternal Risk ◽  
Medical Disorders ◽  
Number Of Patients

Background: Hypertensive disorders of pregnancy are the common medical disorders in pregnancy. It has effects both on expectant mother and fetus. Pre-eclampsia is a pregnancy specific multisystem disorder of unknown etiology, and accounts for 12-18% of maternal mortality. There is general consensus that maternal risk is decreased by antihypertensive treatment that lowers very high blood pressure. Objective of this study was to study the efficacy of oral labetalol versus oral Nifedipine in the management of preeclampsia in the antepartum and intrapartum period.Methods: The present study was conducted in a tertiary care centre, Chennai from October 2013 to September 2014. It was a prospective observational study done in antenatal ward and labor ward. All antenatal women diagnosed to have pre-eclampsia, irrespective of gestation are included in this study.Results: Age distribution of PIH patients and the maximum number of patients were 20-25 years of age. maximum patients of severe preeclampsia were primigravida. Both systolic and diastolic BP in the two groups (oral labetalol and oral Nifedipine groups) were not statistically significant as the p value is >0.005.Conclusions: From this study, authors found that both oral labetalol and oral nifedipine are effective and well tolerated when used for rapid control of blood pressure in severe hypertension of pregnancy.

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