scholarly journals A Comparative Study of Ramosetron and Lidocaine in the Attenuation of Propofol Induced Pain in Paediatric Patients – A Double Blinded Randomized Study in ESIC Medical College, Kalaburgi

2021 ◽  
Vol 8 (25) ◽  
pp. 2132-2137
Author(s):  
Sumalatha Gangur Basappa ◽  
Ravichandra Ramesh Dodawad
Keyword(s):  
Randomized Study ◽  
Study Drug ◽  
Venous Drainage ◽  
Controlled Study ◽  
Injection Pain ◽  
P Value ◽  
Chi Square ◽  
Exact Test ◽  
Elective Surgical Procedures ◽  
Double Blinded

BACKGROUND The incidence of pain on propofol injection varies between 28 – 90 % during induction and may be severe. Ramosetron has been proved efficacious in reducing propofol pain in adults but not in children, therefore we conducted this double blinded randomized controlled study to determine the effectiveness of ramosetron in attenuating propofol induced pain in children. The purpose of this study was to compare the effectiveness of injection ramosetron, a 5HT3 antagonist and lidocaine, the commonest drug for attenuation of pain caused by injection propofol. METHODS This is a randomised double-blinded study. Eighty children of American Society of Anaesthesiologist (ASA) grade I - II, aged 4 - 14 years, undergoing elective surgical procedures under general anaesthesia were randomly assigned to two groups of 40 each. Group PR received 6 µg/kg of ramosetron and Group PL received 0.2 mg/kg of 2 % lidocaine. After injection of study drug, occlusion of venous drainage was done manually by a trained assistant at mid-arm for 60 seconds. After releasing manual occlusion Injection propofol (1 %) 2 mg/kg was administered slowly over a period of 5 seconds. A four point scale was used to assess the severity of pain. The results were analysed by using unpaired student’s t - test and chi-square test/Fisher’s exact test. P value of < 0.05 was considered statistically significant. RESULTS The demographic characteristics were comparable in both groups. The incidence of no pain in Group PR and Group PL was 60 % (N = 24) and 65 % (N = 26) respectively which was comparable. The incidence of mild, moderate and severe pain was comparable in both groups. The overall incidence of propofol injection pain in group PL and group PR was 35 % and 40 % respectively (P = 0.862). CONCLUSIONS Intravenous ramosetron at a dose of 6 µg/kg can effectively attenuate the propofol induced pain comparable to 0.2 mg/kg of lidocaine in children. KEYWORDS Children, Lidocaine, Propofol Induced Pain, Ramosetron

scholarly journals The effects of magnesium sulphate on haemodynamic stress response to pneumoperitonium in laparoscopic cholecystectomy: a double blinded randomised controlled study

2021 ◽  
Vol 8 (7) ◽  
pp. 872
Author(s):  
Samiran Das ◽  
Sraboni Basu ◽  
Shibu Sasidharan ◽  
Harpreet Singh Dhillon
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Magnesium Sulphate ◽  
Ion Concentration ◽  
Controlled Study ◽  
Control Group ◽  
Chi Square ◽  
Exact Test ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Double Blinded

Background: To study the effect of intravenous magnesium sulphate on hemodynamic response to pneumoperitoneum during laparoscopic cholecystectomy and to study the side effects of the drug of any.Methods: Patients were randomly allocated into two groups of 40 each. Automated NIBP, Heart rate, Nausea, headache was noted. Magnesium ion concentration was measured. Chi square test was used to test the association between different study variables under study. Corrected test was used in case of any one of the cell frequency was found less than 5 in the bivariate frequency distribution. Fisher’s Exact Test was also used in the case where the test could not be applied. Test of proportion (Z-test) was used to test the significant difference between two proportions. t-test was used to test the significant difference between means. P≤0.05 was considered statistically significant.Results: Patients’ characteristics were comparable in both groups. Most data related to surgery and anaesthesia were comparable in both groups. The MAP of group N (control) was significantly higher than that of group M throughout surgery (P5,P10,P20,P30, and at extubation) except at baseline and at the time of PP (P0). The MAP is better maintained in M group. Usage of GTN in the control group was significantly higher. HR of the control group was significantly higher after 20 min (P20) of pneumoperitoneum and after extubation. There was significantly more incidence of nausea and vomiting in the control group.Conclusions: Use of magnesium sulphate just before pneumoperitoneum is very useful for attenuating haemodynamic alterations to pneumoperitoneum and the requirement of antihypertensive GTN is significantly much less compared to the control group during laparoscopic surgery without increasing any adverse outcome.  

A Comparative Study between Ketamine and Lidocaine ro Decrease Propofol Injection Pain During Induction of Anesthesia

2021 ◽  
Vol 6 (1) ◽  
pp. 1304-1309
Author(s):  
Bikash Khadka ◽  
Nil Raj Sharma
Keyword(s):  
Comparative Study ◽  
Venous Occlusion ◽  
Verbal Response ◽  
Injection Pain ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Lidocaine Group ◽  
Mild Pain ◽  
Significant Difference

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability. 

scholarly journals A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

2019 ◽  
Vol 8 (5) ◽  
pp. 1067
Author(s):  
Mallikarjuna Rao I. ◽  
Usha Kiran Prayaga ◽  
Dharma Rao Uppada ◽  
Ramachandra Rao E. ◽  
B. L. Kudagi
Keyword(s):  
Depressive Disorders ◽  
Low Dose ◽  
Rating Scale ◽  
Controlled Study ◽  
P Value ◽  
Chi Square ◽  
Double Blind ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Square Test

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression.

scholarly journals The Effect of the Covid-19 Free Operation Path Protocol on the Incidence of Lung Complications in Postoperative Elective Patients at dr. Moewardi Hospital Surakarta

2021 ◽  
Vol 5 (11) ◽  
pp. 1030-1036
Author(s):  
Galih Aktama ◽  
Henky Agung Nugroho ◽  
Muhammad David Perdana Putra
Keyword(s):  
Cancer Patients ◽  
Elective Surgery ◽  
Pulmonary Complications ◽  
P Value ◽  
Chi Square ◽  
Elective Surgical Procedures ◽  
Significant Difference ◽  
Before And After ◽  
Chi Square Test ◽  
Elective Patients

The pandemic that began in late 2019, COVID-19, affects all patients, including cancer patients. Patients with cancer that continues to spread and  there is no other effective alternative treatment must undergo surgery so that cancer does not get worse. Given this problem, many health care centers have developed a protocol system in the form of a COVID-19-free surgical route. This study is a retrospective cohort study comparing the incidence of pulmonary complications in patients undergoing elective cancer surgery at dr. Moewardi Surakarta before and during the COVID-19 pandemic. The study sample was adult patients  aged ≥ 18 years which underwent elective surgical procedures with the aim of curative cancer starting before COVID-19 (March 2019-February 2020) until the time the COVID-19 pandemic emerged (March 2020 - February 2021). The data obtained were 768 patients. Of these patients, 384 were classified as having a COVID19-free operation route during the pandemic, and 384 others underwent elective surgery in the pre-pandemic period. Based on the Chi-Square test, a p-value of 0.850 was obtained (P>0.05) which shows that there is significant difference between cases of pulmonary complications in surgical patients before and after the pandemic who were carried out through the COVID-19-free protocol route. In conclusion, there is no significant change in effect of the covid-19 free operation path protocol on the incidence of lung complications in postoperative elective patients at dr. Moewardi Hospital Surakarta, although this patented and mandatory protocol can reduce cancer patients’ morbidity and mortality who undergoing elective surgery during a pandemic.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY;

2013 ◽  
Vol 20 (05) ◽  
pp. 699-706
Author(s):  
HEMMATPOOR BEHZAD ◽  
MAHVAR TAYEBEH ◽  
MAKHSOSI BEHNAM REZA ◽  
Saeb Morteza
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Shoulder Pain ◽  
Rating Scale ◽  
Controlled Study ◽  
P Value ◽  
Medical Sciences ◽  
Preoperative Administration ◽  
Elective Laparoscopic Cholecystectomy ◽  
Double Blinded ◽  
To Receive

Background: shoulder pain after laparoscopic procedure is a frequent complication encountered in surgery ward. Severaltreatments have been proposed to reduce it. This study aimed to evaluate the efficacy of preoperative administration of gabapentin inpreventing and attenuating Post Laparoscpoic Shoulder Pain (PLSP) after laparoscopic cholecystectomy. Design: In a randomised,double blinded placebo controlled study. Setting: Woman's Hospital, Kermanshah University of Medical Sciences. Period: April 2011 toMarch 2012. Material and methods: 90 patients of ASA physical status I-II undergoing elective laparoscopic cholecystectomy wererandomly allocated to receive gabapentin 600 mg or placebo ,half an hour before surgery. The presence analgesia and side effects wererecorded for 12h postoperatively in same times. Results: Incidence Verbal Rating Scale (VRS) ≥ 4 at different times after arrival to PACUwere significantly lower in gabapentin group in arrival (P Value= 0.003) and then after 30 miniute (P Value= 0.02) and 2 (P Value=0.003), 4 (P Value= 0.03) and 6 (P Value= 0.04) hours after arrival to Post Anesthesia Care Unit (PACU). But this sigificancy lost at 12hours (P Value= 0.07) after arrival to PACU. Also there was a reduction in amounts of postoperative in ward analgesic consumption. Sideeffects were not different between two groups. Conclusions: 600 mg gabapentin as premedication is effective and safe for reducing postlaparoscopicshoulder pain intensity after general laparoscopy compared with placebo.

Kontribusi Karakteristik Ibu Terhadap kejadian Stunting Pada Anak Usia 24-36 Bulan Di Sleman Yogyakarta

2019 ◽  
Vol 12 (02) ◽  
Author(s):  
Prastiwi Putri Basuki ◽  
Triana Uminingsih
Keyword(s):  
P Value ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Purposive Sampling

Stunting pada masa balita perlu mendapat perhatian khusus termasuk pada anak usia 24-36 bulan. Usia 24-36 bulan merupakan usia anak yang mengalami perkembangan pesat dalam kemampuan kognitif dan motorik. Banyak faktor yang mempengaruhi terjadinya kejadian stunting pada anak, antara lain karakteristik ibu. Tujuan dari penelitian ini adalah mengetahui kontribusi karakteristik ibu terhadap kejadian stunting pada anak usia 24-36 bulan. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional yang dilakukan di Desa Sendang Mulyo Minggir Sleman Yogyakarta. Sampel yang diambil sebanyak 75 anak usia 24-36 bulan dengan teknik purposive sampling. Analisis data  bivariat menggunakan Chi Square dan Fisher Exact Test dan analisis multivariat menggunakan regresi linier. Hasil penelitian menunjukkan bahwa pendidikan ibu (p value=0,000), pengetahuan ibu (p value=0,022) dan pemberian ASI Ekslusif (p value=0,011) yang artinya terdapat hubungan dengan kejadian stunting. Sedangkan status pekerjaan ibu (p value=0,217) tidak signifikan berhubungan dengan kejadian stunting. Berdasarkan analisis multivariat regresi linier menunjukkan hasil bahwa pendidikan ibu, status  pekerjaan ibu, pengetahuan ibu tentang gizi, dan pemberian ASI Ekslusif bersama-sama mempunyai kontribusi terhadap kejadian stunting sebesar 88,2%. Perlu peningkatan program multisektoral dengan melibatkan semua lapisan masyarakat untuk mengurangi kejadian stunting.

Concomitant Traumatic Brain Injury and Hemorrhagic Shock: Outcomes Using the Spanish Trauma ICU Registry (RETRAUCI)

2020 ◽  
pp. 000313482094999
Author(s):  
Mario Chico-Fernández ◽  
Jesús A. Barea-Mendoza ◽  
Jon Pérez-Bárcena ◽  
Iker García-Sáez ◽  
Manuel Quintana-Díaz ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hemorrhagic Shock ◽  
Fresh Frozen Plasma ◽  
Categorical Variables ◽  
P Value ◽  
Trauma Patients ◽  
Chi Square ◽  
Exact Test ◽  
Fresh Frozen

Background To compare the main outcomes of trauma patients with and without traumatic brain injury (TBI), hemorrhagic shock, and the combination of both using data from the Spanish trauma intensive care unit (ICU) registry (RETRAUCI). Methods Patients admitted to the participating ICUs from March 2015 to May 2019 were included in the study. The main outcomes were analyzed according to the presence of TBI, hemorrhagic shock, and/or both. Comparison of groups with quantitative variables was performed using the Kruskal-Wallis test, and differences between groups with categorical variables were compared using the Chi-square test or Fisher’s exact test as appropriate. A P value <.05 was considered significant. Results Overall, 310 patients (3.98%) were presented with TBI and hemorrhagic shock. Patients with TBI and hemorrhagic shock received more red blood cell (RBC) concentrates, fresh frozen plasma (FFP), a higher ratio FFP/RBC, and had a higher incidence of trauma-induced coagulopathy (60%) ( P < .001). These patients had higher mortality ( P < .001). Intracranial hypertension was the leading cause of death (50.4%). Conclusions Concomitant TBI and hemorrhagic shock occur in nearly 4% of trauma ICU patients. These patients required a higher amount of RBC concentrates and FFP and had an increased mortality.

scholarly journals ATIM-06. TREATMENT OF RECURRENT/REFRACTORY (R/R) ANAPLASTIC ASTROCYTOMA (AA, WHO GRADE 3) PATIENTS WITH ANTI-TGFß2 RNA THERAPEUTIC OT-101 VERSUS TEMOZOLOMIDE IS ASSOCIATED WITH IMPROVED OVERALL SURVIVAL

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi2-vi2
Author(s):  
Fatih Uckun ◽  
Sanjive Qazi ◽  
David Nam ◽  
Larn Hwang ◽  
Vuong Trieu
Keyword(s):  
Overall Survival ◽  
Phase 1 ◽  
Single Agent ◽  
Objective Response ◽  
Clinical Results ◽  
P Value ◽  
Convection Enhanced Delivery ◽  
Chi Square ◽  
Who Grade ◽  
Exact Test

Abstract BACKGROUND OT-101 is a first-in-class RNA therapeutic designed to disrupt the immunosuppressive action of TGFß2. During Phase 1 clinical trials, OT-101 induced partial responses in R/R AA patients. We now report our clinical results from a randomized Phase IIB study (NCT00431561) that further evaluated its single agent activity in R/R AA patients in side-by-side comparison with the standard chemotherapy drug temozolomide (TMZ). METHODS OT-101 was administered via high-flow microperfusion with an intratumoral catheter using a convection enhanced delivery (CED) system. 26 AA patients (12: 2.5 mg/cycle; 14: 19.8 mg/cycle) received 7-day cycles of OT-101 every other week via continuous infusion for 4–11 cycles. Response determinations were based on central review of MRI scans by an independent review committee according to standard as well as modified McDonald criteria. 11 patients in the active control arm were treated with TMZ (150–200 mg/m2, 5 days/28-day cycles x up to 6 treatment cycles). Standard statistical methods were applied for the analysis of data. RESULTS 14 of 26 patients (53.8%) treated with 4–11 cycles of OT-101 had either a CR (N=2) or PR (N=12) as their best overall response. The average time until 99% reduction of their tumor volumes ranged from 9.9 to 115.4 (median: 23.7) months. In contrast, only 1 of 10 evaluable patients (10%) treated with TMZ achieved an objective response which was a PR (Fisher’s exact test, 2-tailed, P-value = 0.0002). The median overall survival (OS) was 1154 days (95% CI: 811 - >1743) for the OT-101 group and 590 days (95% CI: 287 - >1137) days for the TMZ group (Log Rank Chi Square = 7.55, P-value = 0.006). CONCLUSION Our results confirm and extend previous studies and provide early evidence that the anti-TGFß2 RNA therapeutic OT-101 is at least as active as TMZ in salvage therapy of R/R AA patients.

scholarly journals Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Thomas Kiggundu ◽  
Robert Kalyesubula ◽  
Irene Andia-Biraro ◽  
Gyaviira Makanga ◽  
Pauline Byakika-Kibwika
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
P Value ◽  
Mulago Hospital ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Increased Risk

Abstract Background HIV infection affects multiple organs and the kidney is a common target making renal disease, one of the recognized complications. Microalbuminuria represents an early, important marker of kidney damage in several populations including HIV-infected antiretroviral therapy (ART) naïve patients. Early detection of microalbuminuria is critical to slowing down progression to chronic kidney disease (CKD) in HIV-infected patients, however, the burden of microalbuminuria in HIV-infected antiretroviral therapy (ART) naïve patients in Uganda is unclear. Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic among adult HIV − infected ART naïve outpatients. Data on patient demographics, medical history was collected. Physical examination was performed to assess body mass index (BMI) and hypertension. A single spot morning urine sample from each participant was analysed for microalbuminuria using spectrophotometry and colorimetry. Microalbuminuria was defined by a urine albumin creatinine ratio (UACR) 30-299 mg/g and macroalbuminuria by a UACR > 300 mg/g. To assess the factors associated with microalbuminuria, chi-square, Fisher’s exact test, quantile regression and logistic regression were used. Results A total of 185 adult participants were consecutively enrolled with median age and CD4+ counts of 33(IQR = 28–40) years and 428 (IQR = 145–689) cells/μL respectively. The prevalence of microalbuminuria was 18.9% (95% CI, 14–25%). None of the participants had macroalbuminuria. CD4+ count <350cells/μL was associated with increased risk of microalbuminuria (OR: 0.27, 95% CI: 0.12–0.59), P value = 0.001). Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria. Conclusion Microalbuminuria was highly prevalent in adult HIV − infected ART naive patients especially those with low CD4+ count. There is need to study the effect of ART on microalbuminuria in adult HIV − infected patients.

Circulating tumor DNA (ctDNA) landscape in metastatic castrate-resistant prostate cancer patients with germline alterations.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 200-200
Author(s):  
Marcus W. Moses ◽  
Peter Steinwald ◽  
Ellen Jaeger ◽  
Whitley Hatton ◽  
Patrick Cotogno ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
San Francisco ◽  
Splice Variants ◽  
Circulating Tumor Dna ◽  
P Value ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Exact Test ◽  
Viable Approach ◽  
Tumor Dna

200 Background: Circulating tumor-DNA (ctDNA) in mCRPC patients (pts) provides a viable approach for examining the genetic landscape of prostate cancer. In this follow-up, we report ctDNA variants in germline tested mCRPC pts. Methods: ctDNA alterations in 73 genes were detected using Guardant360 (G360) assays. Alteration types assessed were missense, frameshift, insertions, splice variants, truncations, amplifications (amp), deletions, and other. Pts included in the analysis received germline genetic testing (Invitae Corporation, San Francisco, CA) and ctDNA assays at various treatment timepoints. Statistical analyses were performed using chi-square and fisher exact test with p-value <0.05 for significance. Results: Germline and ctDNA testing was completed in 270 mCRPC pts. 13% (35/270) of pts had pathogenic germline alterations. Germline alterations detected were BRCA2 (43%, n=15), ATM (8.5%, n=3), CHEK2 (8.5%, n=3), and BRCA1 (6%, n=2). Of the 673 alterations detected in G360 assays, TP53 (25%, n=167) and AR (17%, n=117) were most commonly observed. ctDNA alteration breakdown for germline negative/positive pts is summarized in Tables A/B. Germline negative pts had more AR alterations compared to germline positive (p = 0.023). Also, germline negative pts presented with more amps (p < 0.001) and germline positive pts with more frameshift alterations (p = 0.005). The association of ctDNA alteration to clinical outcomes in germline positive/negative pts was also assessed and is ongoing. Conclusions: Pts with germline positive alterations had few somatic AR alterations and higher frequency of deleterious mutation in comparison to their germline negative counterparts.[Table: see text][Table: see text]

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