The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study

2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal
Keyword(s):  
Transurethral Resection ◽  
Blind Study ◽  
Transurethral Resection Of Prostate ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.

scholarly journals Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Ahmed Salman ◽  
Norma Osama Zayed ◽  
Ahmed Mansour ◽  
Ramy Howaidi ◽  
Ahmed Gamaleldin Foly ◽  
...  
Keyword(s):  
Short Form ◽  
Cardiovascular Responses ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Randomized Controlled ◽  
Arterial Blood ◽  
Extubation Time ◽  
Significant Difference

Background: Both tracheal intubation and extubation are associated with dangerous consequences such as tachycardia, hypertension, myocardial ischemia and arrhythmias. The aim was to evaluate pre–extubation two different doses of fentanyl on hemodynamic stabilization and delayed recovery in mastectomy. Methodology: The randomized controlled double–blind study was conducted on 126 patients aged 16–60 years, with controlled hypertension, receiving chemotherapy before surgery and underwent mastectomy for breast cancer. Patients were randomly allocated into 3 equal groups. Before extubation, patients received 10 ml saline in group (C), 1 µg/kg fentanyl in Group–F1: and 2 µg/kg fentanyl in Group–F2. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at T1 (after maintenance of anesthesia), T2 (after giving the test drug), T3 (immediately after extubation), T4 (5 min. after extubation) and T5 (15 min after extubation). Results: MAP was significantly lower in fentanyl groups compared to Group–C at T2 and T3 without significant deference between fentanyl groups. HR was significantly lower in fentanyl groups compared to Group–C and in Group–F2 compared to Group–F1 at T3, T4 and T5. Time of extubation was significantly prolonged in Group–F2 compared to Group–F1 and Group–C without a significant difference between Group–F1 and Group–C. Conclusions: Pre–extubation fentanyl 1 µg/kg blunted cardiovascular responses to extubation without respiratory depression or prolonged recovery. Pre–extubation fentanyl 2 µg/kg provide more control in HR but with delay in the extubation time compared to 1 µg/kg of fentanyl. Key words: Pre–Extubation, Fentanyl, Mastectomy, Hemodynamics, Recovery Preregistration: The study was registered in the Ethical Committee of Faculty of Medicine, Cairo University, Cairo, Egypt (approval number: 281) Citation: Salman A, Zayed NO, Mansour A, Howaidi R, Foly AG, ElSharkawy MS, Abdelgalil AS. Role of pre–extubation fentanyl in mastectomy: a randomized, controlled, double–blind study. Anaesth. pain intensive care 2021;25(2):143-149. DOI: 10.35975/apic.v25i2.1462. Abbreviations: CST=Craniosacral therapy; SMT=Sensorimotor training; NCLBP=Nonspecific chronic low back pain; VAS=Visual analogue scale; ODI=Oswestry disability index, BDI-II=Beck depression inventory-II, and SF-36=Short Form-36; CSF=cerebral spinal fluid; CSS=craniosacral system; PRM=primary respiratory movements Received: 27 June 2020, Reviewed: 24 July 2020, Accepted: 27 July 2020

scholarly journals A Double-Blind Randomized Prospective Study Comparing Ondansetron with Droperidol in the Prevention of Emesis following Strabismus Surgery

1995 ◽  
Vol 23 (4) ◽  
pp. 438-443 ◽  
Author(s):  
A. Davis ◽  
S. Krige ◽  
D. Moyes
Keyword(s):  
Recovery Time ◽  
Strabismus Surgery ◽  
Double Blind Study ◽  
Double Blind ◽  
Oral Fluids ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
To Receive ◽  
Mean Time

A prospective double-blind study was conducted to compare the anti-emetic efficacy of ondansetron and droperidol in preventing postoperative emesis following strabismus surgery. A sample size of 213 patients was divided into three equal groups to receive ondansetron 150 μg/kg (Group A), ondansetron 75 μg/kg (Group B), or droperidol 75 fig/kg (Group C). All patients received a standardized anaesthetic technique. All episodes of emesis, recovery time, and time to tolerating oral fluids were recorded. The incidence of emesis during 24 hours was Groups A and B 19.7%, and Group C 28.2%. The lower incidence of emesis recorded by the ondansetron groups compared with the droperidol group was not statistically significant. Ondansetron at 75 μg/kg was as effective as 150 μg/kg in reducing emesis when compared with droperidol. Mean time to discharge from the recovery room was 75.3 minutes (Group A), 44.4 minutes (Group B), and 41.0 minutes (Group C). The mean time to tolerating oral fluids was 356.5 minutes (Group A), 402.8 minutes (Group B), and 378.1 minutes (Group C). There was no statistical difference in discharge times from recovery or time to tolerating oral fluids in any of the three groups.

scholarly journals Role of Immediate Release and Delayed Release Omeprazole in Patients with Gastro Esophageal Reflux Disease

2017 ◽  
Vol 11 (2) ◽  
pp. 67-73
Author(s):  
Mahabub Rahman ◽  
Dewan Saifuddin Ahmed ◽  
Syeda Nur E Jannat ◽  
MM Shahin Ul Islam ◽  
Abu Ahmed Abdullah
Keyword(s):  
Reflux Disease ◽  
Immediate Release ◽  
Esophageal Reflux ◽  
Double Blind ◽  
Delayed Release ◽  
End Of Treatment ◽  
Significant Difference ◽  
Group A ◽  
Group B

Proton pump inhibitors are widely used for Gastro Esophageal Reflux Disease (GERD) treatment. This prospective double blind randomized cross over study was carried out in the Department of Gastroenterology, BSMMU from June 2007 to May 2008 to assess the efficacy of Immediate-release omeprazole (IR-OMEP) & Delayed-release Omeprazole (DR-OMEP) in relieving symptoms & healing of oesophagitis in GERD. All patients who fulfilled the inclusion criteria underwent upper gastrointestinal (UGI) endoscopy to be lebelled as nonerosive and erosive GERD. Among total 69 patients, 43 (62.3 %) had nonerosive and 26 (37.7 %) had erosive GERD. Patients were divided into group A (35) and group B (34) who received group A drugs (20 mg IR-OMEP bd) and group B drugs (20 mg DROMEP bd) from day 1-14 respectively. Then drugs were crossed over (group A: 20mg DR-OMEP bd; group B: 20 mg IR-OMEP bd) from day 15-28. Improvement of heartburn, regurgitation in each group were assessed in every week, during drug cross over and at the end and then compared between two groups. There was no significant difference in relieving heartburn and regurgitation between IR-OMEP and DR-OMEP either in erosive or nonerosive GERD (P>0.50). Patients with erosive GERD underwent UGI endoscopy at the end of treatment to see healing of esophagitis. Study showed significant healing of oesophagitis in group A after 4 weeks than group B (14%) (P<0.05) but there is no superiority of IR-OMEP over DR-OMEP in relieving symptoms of GERD.Faridpur Med. Coll. J. Jul 2016;11(2): 67-73

scholarly journals Randomized Controlled Clinical Trial Comparing Transurethral Eneucleation and Resection of Prostate and Trans-urethral Resection of Prostate in the Management of Benign Prostatic Hyperplasia

2017 ◽  
Vol 7 (3) ◽  
pp. 216-220
Author(s):  
Md Mehedi Hasan ◽  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Muhammad Abdus Salam
Keyword(s):  
Controlled Trial ◽  
Ethical Review ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Transurethral Resection Of Prostate ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Transurethral resection of prostate (TURP) is the predominant surgical procedure for benign prostatic hypertension (BPH) but is not devoid of complications like capsular perforation, drop in Hb%, drop in Na+, residual adenoma; hence endeavors are evolving to combat such complications. A newer technique transurethral enucleation and resection of prostate (TUERP) has been devised to solve these problems. This study was designed to compare the safety and the efficacy of newer technique, TUERP with widely practiced TURP Methods: This randomized controlled trial was done at BSMMU, after getting ethical approval from the ethical review committee of the institute, from January to October, 2009. A total of 60 BPH patients were purposively enrolled in this study, after obtaining informed written consent and they were randomized as control, Group A (30 patients, underwent TURP) and experimental group, Group B (30 patients, underwent TEURP).Results: The mean preoperative Hb% level of Group A was 15.1 gm% (SD ± 0.5) and perioperative Hb% level was 13.04 gm% (SD ± 6.06). There was significant difference (P <0.05). The mean preoperative Hb% of Group B was 15.2 gm% (SD ± 0.5) and perioperative Hb% was 15.2 gm% (SD ± 0.48). There was no difference (P >0.05). The mean preoperative Na + of Group A was 140 mmol/l (SD ± 4.1) and perioperative Na+ was 126 mmol/l (SD ± 6.8). There was significant difference (P<0.01). The mean preoperative Na+ of Group B was 136 mmol/l (SD ± 4) and perioperative Na+ was 136 mmol/l (SD ± 2.70). There was no difference (P >0.05).Conclusion: TUERP eliminates drop in Hb% and Na+which are usual consequences following TURP. Thus TUERP can be advocated in the treatment of BPH as it also allows completeresection down to surgical capsule.Birdem Med J 2017; 7(3): 216-220

scholarly journals Comparison of hemodynamic effect between the spinal anesthesia and saddle block during transurethral resection of the prostate

2021 ◽  
Vol 23 (09) ◽  
pp. 817-828
Author(s):  
Dr. Farooq Taher Abdulqader ◽  
◽  
Dr. Ali Abd-Alhameed Mohammed ◽  
Keyword(s):  
Spinal Anesthesia ◽  
Transurethral Resection ◽  
Major Complication ◽  
Hemodynamic Effect ◽  
Spinal Block ◽  
Transurethral Resection Of Prostate ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The best technique for transurethral resection of prostate (TURP) is regional anesthesia. The hypotension is the major complication following spinal anesthesia. The hemodynamic changes is less with saddle block than spinal block. Aim and Objective: To compare hemodynamic effect between the spinal block and saddle block in TURP. Patients and methods: 50 patients between 50-70 years old ASA I – II prepared for TURP, divided randomly in two groups 25 pt. in each group. Group A received spinal 10 mg of hyperbaric bupivacaine (2 ml of 0.5%), were group B received saddle block 10 mg of hyperbaric bupivacaine (2 ml of 0.5%). The blood pressure, oxygen saturation, heart rate measured and recorded subsequently. The hypotension treated by 100 mcg bolus of phenylephrine. Results: In our study there was statically significant difference (p < 0.05) between group A which received spinal anesthesia and group B which received saddle block in hemodynamic effect. In which the incidence of hypotension and vasopressor requirement more in group A. Conclusion: Under saddle block the TURP can safely performed with low risk of hypotension and less requirement of vasopressor.

PREVENTION OF DEEP VEIN THROMBOSIS (DVT) BY ENOXAPARINE (LOVENOXR) AFTER SURGERY FOR FRACTURE OF FEMORAL NECK. ONE DAILY INJECTION OF 40 MG VERSUS TWO DAILY INJECTIONS OF 20 MG

1987 ◽  
Author(s):  
J BARSOTTI ◽  
B DABO ◽  
J ANDREU ◽  
D ALISON ◽  
J LEROY ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Lower Limbs ◽  
Daily Injection ◽  
Bleeding Complications ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Orthopedic Operation ◽  
Group A ◽  
Group B

In a previous open study, a low-molecular-weight-heparinEnoxa-parine in a dose of 40 mg/24 hrs by subcutaneous (SC) injection, had been shown to be efficient and safe in preventing DVT after total hip replacement (THR), for a non traumatic hip disease. 103 patients (mean age : 82 years ± 10, mean weight : 52 kg ± 10) undergoing an orthopedic operation for fracture of femoral neck were included ina randomized, double blind study. These patients receivedSC Enoxaparine according to two different regimens : 54 patients received the treatment A (2 daily injections of 20 mg), 49 patients received the treatment B (1 daily injection of 40 mg).In both groups, administration of 40 mg of Enoxaparine was begun 12 hours before operation.Patients weretreated for 10-15 days, until bilateral ascending phlebography (BAP) had been completed.Lower limbs BAP were performed in 97 patients. The incidence of DVT is low and not significantly different betweenthe two regimens :a proximal DVT was detected in 6 patients of the group A and in 2 patients of the group B. This differenceis not significant(p = 0.28).3 patients of each group hada distal DVT. No clinical pulmonary embolism occurred.There was no serious bleeding complication, and the two groups are not significantly different on this point; 2 patients in each group had an important hematoma of the thigh.One hematoma, in a patient who received the treatment B, required a surgical treatment.Red cell transfusion requirementswere 2.6U+1.8 in the group A and 2.5 U ±1.4 in the group B (p = 0.84)There was no significant difference in the daily hemoglobinlevels between the two groups.This study shows that one daily SC injection of 40 mg of Enoxaparine is as efficient as two daily SC injections of20 mg of Enoxaparine in preventing DVT, in very elderly patients undergoing orthopedic operation for fracture of the femoral neck. The frequencies of bleeding complications in each group were not significantly different.Enoxaparine (LOVENOXR) - PHARMUKA S.F.

scholarly journals Comparative Efficacy of Topical Calcipotriol (0.005%) Versus Topical Corticosteroid (Betamethasone 0.1%) in Treating Plaque Type Psoriasis

2015 ◽  
Vol 26 (2) ◽  
pp. 88-94
Author(s):  
Gulam Kazem Ali Ahmed ◽  
Lubna Khandker ◽  
Moriom Nessa ◽  
Mohd Nurul Alam ◽  
Anjana Chakraborty ◽  
...  
Keyword(s):  
Topical Corticosteroid ◽  
Base Line ◽  
Double Blind Study ◽  
Double Blind ◽  
Plaque Type ◽  
Pasi Score ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Medical University

A clinical trial was carried out to compare the efficacy of topical calcipotriol (0.005%) and topical corticosteroid (betamethasone 0.1%) in the treatment of plaque type psoriasis. The study was conducted from January 2012 to August 2012 and patients of plaque type psoriasis attending outpatient department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka were the study population. Patients were divided into two groups, group A was treated with topical calcipotriol (0.005%) ointment and group B with topical corticosteroid (betamethasone 0.1%) ointment. The mean baseline PASI score was 6.7 ±4.5 and after 8 weeks, the mean PASI score was 2.0 ±1.4 for group A and mean baseline PASI score was 5.5 ±4.2 and after 8 weeks, the mean PASI score was 2.5 ±1.4 for group B. There was statistically significant reduction in PASI score from base line after 8 weeks of treatment in both treatment groups (p < 0.001). After 8th week of treatment moderate response was 11(73.3%) in group A and 9(60%) in group B. Very good response was 4 (26.7%) in group B and 2 (13.3%) in group A and minimal response of treatment occurs equally 2 (13.3%) in group A and group B. In the light of the findings of the study we conclude that each of the treatment of calcipotriol(0.005%) and betamethasone (0.1%) is individually effective. Further multicenter, randomized, double-blind study should be conducted with large sample size.Medicine Today 2014 Vol.26(2): 88-94

scholarly journals HUBUNGAN OKSIDA NITRAT DAN NILAI HISTOPATOLOGIS PADA ENDOTOKSEMIA

2016 ◽  
Vol 20 (3) ◽  
pp. 201
Author(s):  
Sotianingsih Sotianingsih ◽  
Suharyo Suharyo ◽  
Lisyani S ◽  
Guntur HA
Keyword(s):  
Nitric Oxide ◽  
Treatment Group ◽  
Control Group ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Termination Time ◽  
Control Group Group

Lipopolysaccharide (LPS) is an endotoxin from the outer membrane of Gram-negative bacteria, which has an important role in the occurrence of sepsis. Exposure to LPS will stimulate increase of nitric oxide (NO). Nitric oxide is a bioregulator of apoptosis and has some sepsis prognostic role of apoptosis regulators within the gastrointestinal cells. The objective of the study is to know if endotoxemia induces an increase in NO levels and histopathology scores as well as the existing relationship between them. This study is an observational intervention. The subjects were 48 male mice Balb/C, divided into 2 groups. The samples consisted of 24 tail as control group (group A) and 24 as treatment group (group B). The A group as well as the B group is divided into 4 subgroups according to the time of termination. The levels of NO were examined by Griess method. Histopathology score was examined by HE and read as a score of 0–5. There was a statistically significant difference between the mean NO in the treatment group with the control group at the termination of the group of 12h (p=0.009), 24h (p=0.015), 36h (p=0.014), 48h (p=0.002) and the whole group (p=0.0001), as well as between the mean histopathology score at the termination time of 12 h (p=0.0001), 24h (p=0.0001), 36h (p=0.0001), 48h (p=0465) and the whole group (p=0.0001). Increase in NO and histopathology scores in all groups of mice (r=0.527) showed a statistically significant correlation. NO levels and histopathology scores are increased during endotoxemia and thus have a significant correlation.

scholarly journals Role of Zinc in Patients Presenting with Recurrent Hepatic Encephalopathy in Medical Unit of Tertiarycare Hospital Lahore

Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Asma Kamal ◽  
Asifa Kamal ◽  
Naeem Afzal ◽  
Shazia Siddique ◽  
Khadija Tahir
Keyword(s):  
Hepatic Encephalopathy ◽  
Zinc Supplementation ◽  
Mean Value ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Improved Outcome

Abstract Objective: To observe the effects of zinc replacement on hepatic encephaopahty. To reducce hospital admission and heath burden by reducing episodes of recurrent hepatic encephalopathy. Methods: This study was carried out on 160 patients presenting with hepatic encephalopathy in medical ward of services hospital Lahore. The aim of the study was to assess the role of zinc in the improvement of encephalopathy. Results: The mean age of patients in group A was 55.78 and that in group B was 56.88years.There was significant difference in mean value of hepatic encephalopathy grade in both groups A and B after 3 months of follow up (p.value 0.027) indicating zinc is beneficial in treatment of hepatic encephalopathy. Conclusion: Our study showed that zinc replacement improved outcome in patients with Hepatic encephalopathy. Key words: Hepatic encephalopathy, zinc supplementation, chronic liver disease.

scholarly journals Intrathecal Pethidine: An Alternative Anaesthetic for Transurethral Resection of Prostate?

1997 ◽  
Vol 25 (6) ◽  
pp. 650-654 ◽  
Author(s):  
A. T. H. Sia ◽  
M. Y. H. Chow ◽  
C. K. Koay ◽  
J. L. Chong
Keyword(s):  
Heart Rate ◽  
Transurethral Resection ◽  
Motor Block ◽  
Prospective Trial ◽  
Sensory Block ◽  
Transurethral Resection Of Prostate ◽  
Significant Difference ◽  
Group A ◽  
Randomized Prospective Trial ◽  
Group B

We aimed to determine the usefulness of intrathecal pethidine as the sole anaesthetic for transurethral resection of prostate (TURP) while comparing the incidence of hypotension with intrathecal bupivacaine. A double-binded randomized prospective trial was conducted involving 40 patients for TURP. The patients were divided equally into two groups; group A received 2 ml 0.5% bupivacaine intrathecally and group B received 40 mg pethidine intrathecally. Changes in blood pressure and heart rate were measured over the first 30 minutes. The highest sensory block and the time to reach it were documented. The degree of motor blockade was also recorded. There was no significant difference in the incidence of hypotension. The pethidine group had significantly greater reduction in heart rate, a lower degree of motor block, shorter period before requests for postoperative analgesia but a higher incidence of sedation, nausea and vomiting. Intrathecal pethidine did not offer any advantage over intrathecal bupivacaine for TURP.

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