Comparative Study of the Prophylactic Effect of Intravenous or Gargling Dexamethasone in Reducing Postextubation Sore Throat and Cough

Background: Sore throat, cough and hoarseness after tracheal extubation are common complications after surgery. Due to the proven effect of dexamethasone on reducing these complications, in this study, we compared the prophylactic effect of intravenous dexamethasone and dexamethasone gargle on sore throat and cough after extubation. Methods: In this clinical trial study, 96 patients between the ages of 18-64 years who underwent elective surgery and intubation under general anesthesia were randomly divided into three groups, respectively, the first group received 6 mg dexamethasone gargle. The second group received 6 mg intravenous dexamethasone and the third group received normal saline. The frequency of cough and sore throat were assessed and compared in these three groups. Results: There was no significant difference between the three groups based on hemodynamic variables and demographic data (P> 0.05). The frequency of cough in the first (1.54± 2.82) and second (1.57±2.73) groups was less than the third group (1.79±3.14), but this difference was not statistically significant (P>0.66). The mean severity of sore throat in the second group and then in the first group was lower at the time of entry into recovery and 2 hours after surgery, than the third group. (P <0.005) Also, the mean severity of sore throat in the second group and then the first group in 24 hours after surgery was significantly lower than the third group. (P <0.005). Conclusion: Prophylactic single-dose intravenous dexamethasone is more effective than dexamethasone gargle in reducing sore throat due to endotracheal intubation. Also, gargling and intravenous injection of dexamethasone, both are effective in reducing postoperative cough without any side effects after extubation.

Download Full-text

Subjects living in an onchocerciasis focus and treated 3-monthly with ivermectin develop fewer new onchocercal nodules than subjects treated annually

10.21203/rs.2.22663/v1 ◽

2020 ◽

Author(s):

Jérémy Campillo ◽

Cédric B. CHESNAIS ◽

Sébastien D. Pion ◽

Jacques Gardon ◽

Joseph Kamgno ◽

...

Keyword(s):

Clinical Trial ◽

Poisson Regression ◽

Prophylactic Effect ◽

Poisson Regression Model ◽

Initial Number ◽

Treatment Groups ◽

The Third ◽

Significant Difference ◽

The Mean ◽

First Time

Abstract Background Little information is available on the effect of ivermectin on the third and fourth stage larvae of Onchocerca volvulus . To assess a possible prophylactic effect of ivermectin on this parasite, we compared the effects of different ivermectin regimens on the acquisition of onchocercal nodules. Methods We analyzed data from a controlled randomized clinical trial of ivermectin conducted in the Mbam valley (Cameroon) between 1994 and 1998 in a cohort of onchocerciasis infected individuals. The number of nodules that appeared between the start and the end of the clinical trial was analyzed, using ANOVA and multivariable Poisson regressions, between four treatment arms: 150 µg/kg annually, 800 µg/kg annually, 150 µg/kg 3-monthly, and 800 µg/kg annually. Results The mean number of nodules that appeared during the trial was reduced by 17.7% in subjects treated 3-monthly compared to those treated annually (regardless of the dose). Poisson regression model, adjusting on subject’s age and weight, initial number of nodules and intensity of O. volvulus infection in his village of residence, confirmed that the incidence of new nodules was reduced in 3-monthly treatment arms compared to annually treatment arms, and that the dosage of ivermectin does not seem to influence this effect. Besides, the number of newly acquired nodules was positively associated with the initial number of nodules. Analysis of disappearance of nodules did not show any significant difference between the treatment groups. Conclusions Our result suggest, for the first time in humans, that ivermectin has a prophylactic effect on O. volvulus . Three-monthly treatment seems more effective than annual treatment to prevent the appearance of nodules.

Download Full-text

Subjects living in an onchocerciasis focus and treated 3-monthly with ivermectin develop fewer new onchocercal nodules than subjects treated annually

10.21203/rs.2.22663/v2 ◽

2020 ◽

Author(s):

Jérémy T. Campillo ◽

Cédric B. Chesnais ◽

Sébastien D. Pion ◽

Jacques Gardon ◽

Joseph Kamgno ◽

...

Keyword(s):

Clinical Trial ◽

Poisson Regression ◽

Prophylactic Effect ◽

Poisson Regression Model ◽

Initial Number ◽

Treatment Groups ◽

The Third ◽

Significant Difference ◽

The Mean ◽

First Time

Abstract Background: Little information is available on the effect of ivermectin on the third and fourth stage larvae of Onchocerca volvulus. To assess a possible prophylactic effect of ivermectin on this parasite, we compared the effects of different ivermectin regimens on the acquisition of onchocercal nodules.Methods: We analyzed data from a controlled randomized clinical trial of ivermectin conducted in the Mbam valley (Cameroon) between 1994 and 1998 in a cohort of onchocerciasis infected individuals. The number of nodules that appeared between the start and the end of the clinical trial was analyzed, using ANOVA and multivariable Poisson regressions, between four treatment arms: 150 µg/kg annually, 800 µg/kg annually, 150 µg/kg 3-monthly, and 800 µg/kg 3-monthly. Results: The mean number of nodules that appeared during the trial was reduced by 17.7% in subjects treated 3-monthly compared to those treated annually (regardless of the dose). Poisson regression model, adjusting on subject’s age and weight, initial number of nodules and intensity of O. volvulus infection in his village of residence, confirmed that the incidence of new nodules was reduced in 3-monthly treatment arms compared to annually treatment arms, and that the dosage of ivermectin does not seem to influence this effect. Besides, the number of newly acquired nodules was positively associated with the initial number of nodules. Analysis of disappearance of nodules did not show any significant difference between the treatment groups. Conclusions: Our result suggest, for the first time in humans, that ivermectin has a partial prophylactic effect on O. volvulus. Three-monthly treatment seems more effective than annual treatment to prevent the appearance of nodules.

Download Full-text

Preemptive Effect of Two Different (Intracuff and Intravenous) Routes of Dexamethasone Administration on Postoperative Sore Throat and Cough

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v4i2.206 ◽

2019 ◽

Vol 4 (2) ◽

Author(s):

Nedasadat Mansouritehrani

Keyword(s):

Clinical Trial ◽

General Anesthesia ◽

Sore Throat ◽

Postoperative Sore Throat ◽

The Third ◽

Hemodynamic Variables ◽

Post Surgery ◽

Significant Difference ◽

Hoarse Voice ◽

Preemptive Effect

Introduction: The most common complications following anesthesia intubation include postoperative sore throat, post-extubation cough, and hoarse voice. Currently, the use of preoperative Dexamethasone has been effective in controlling these complications. Therefore, the present study aimed to compare the preemptive effect of intracuff and intravenous routes of Dexamethasone administration for postoperative sore throat and cough. Materials and Methods: In the present clinical trial, 96 patients who underwent general anesthesia intubation were randomly assigned to three groups. The first group received 4 mg intracuff Dexamethasone, the second group received 4 mg intravenous Dexamethasone, and the third group was administered a placebo. Cough frequency and severity of a sore throat after extubation were investigated in the three groups. Results: Any significant difference was not observed among the three groups regarding hemodynamic variables (P>0.01); however, the incidence of cough was significantly lower in all the three groups (P<0.01). Also, the average severity of a sore throat in PAR and 1 h after surgery in the three groups was significantly lower (P<0.05). Moreover, no difference was detected in the groups regarding the severity of a sore throat within 24 h post-surgery (P>0.01). Conclusion: The use of two methods of intravenous and intracuff Dexamethasone administration before surgery reduced the incidence of postoperative cough and the severity of sore throat in patients.

Download Full-text

Effect of Licorice and Green Tea Gargle on Post-Extubation Sore Throat, Cough, and Hoarseness: A Triple-blind Clinical Trial

10.21203/rs.3.rs-611260/v1 ◽

2021 ◽

Author(s):

Hamid Karimi ◽

Nahid Rajai ◽

Zahra Farsi ◽

Parisa Hashemi

Keyword(s):

Clinical Trial ◽

Sore Throat ◽

Green Tea ◽

Elective Surgery ◽

Controlled Clinical Trial ◽

Significant Difference ◽

High Prevalence ◽

Gag Reflex ◽

And Control ◽

Endotracheal Extubation

Abstract Background Endotracheal extubation is associated with a high prevalence of complications such as sore throat, cough, and hoarseness. This study aimed to compare the effect of green tea and licorice gargle on sore throat, cough, and hoarseness after endotracheal extubation. Method: The study was designed as a randomized, triple-blind, controlled clinical trial. 102 patients who were candidates for elective surgery in two specialized hospitals in Tehran, Iran in 2020–2021, were randomly divided into licorice, green tea, and control (placebo) groups. The scores of sore throat, cough, and hoarseness of patients were assessed one hour after endotracheal extubation. After the gag reflex returned, patients were given 100 cc of the prepared solutions to gargle for 30 seconds. The intervention was repeated two hours later. The scores of sore throat, cough, and hoarseness were assessed in the three groups, immediately after the first intervention and two hours after the second intervention. Result There was a significant difference between three groups, in posttest1 and posttest 2 in terms of three variables (P < 0.0001). In addition, both licorice and green tea interventions had a high effect size on the decrease of the studied variables and there was no significant difference between these solutions (P < 0.0167). Conclusion Both green tea and licorice solutions greatly reduced post-extubation complications. These results can be clinical evidence for the use of these two plants to prevent complications of endotracheal extubation. Trial registration: This study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code “IRCT20190729044373N1” on 2019-12-27.

Download Full-text

Publication activity of chief and consultant general/visceral surgeons in German university hospitals—a ten-year analysis

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02241-6 ◽

2021 ◽

Author(s):

Eva C. Böckmann ◽

E. S. Debus ◽

R. T. Grundmann

Keyword(s):

Impact Factor ◽

Publication Activity ◽

University Hospitals ◽

Cumulative Impact ◽

University Departments ◽

The Third ◽

Publication Number ◽

Significant Difference ◽

The Mean ◽

Number Of Publications

Abstract Purpose The publication activity of 38 German general/visceral surgery university departments, documented by first or last authorship from staff surgeons (chief and consultants), was evaluated. Methods The observation period extended from 2007 to 2017 and all PubMed-listed publications were considered. Impact factor (IF) was evaluated through the publishing journal’s 5-year IF in 2016, as was the IF for each individual publication. Ranking was expressed in quartiles. Results The staff surgeons of the 38 departments comprised 442 surgeons, of which only 351 (79.4%) were active as first or last authors. Four thousand six hundred and ninety-nine publications published in 702 journals were recorded. The four leading departments in publication number published as much as the last 20 departments (1330 vs. 1336 publications, respectively). The mean of the first (most active) department quartile was 19.6 publications, the second 15.4, the third 11.0, and the last quartile 7.6 per publishing surgeon. The total cumulative impact factor was 14,130. When examining the mean number of publications per publishing surgeons per the 10 year period, the mean of the first quartile was 57.9 cumulative IF, the second 45.0, the third 29.5, and the fourth quartile 17.1. With 352 (7.5%) publications, the most frequently used journal was Chirurg, followed by Langenbeck’s Archives of Surgery with 274 (5.8%) publications. Pancreas-related topics led in terms of publication number and IF generated per individual publication. Conclusion A significant difference in publication performance of individual departments was apparent that cannot be explained by staff number. This indicates that there are as yet unknown factors responsible for minor publication activity in many university departments.

Download Full-text

The Percutaneous Surgical Approach for Repairing Acute Achilles Tendon Rupture

Journal of the American Podiatric Medical Association ◽

10.7547/1000270 ◽

2010 ◽

Vol 100 (4) ◽

pp. 270-275 ◽

Cited By ~ 7

Author(s):

Shay Tenenbaum ◽

Niv Dreiangel ◽

Ayal Segal ◽

Amir Herman ◽

Amnon Israeli ◽

...

Keyword(s):

Achilles Tendon ◽

Tendon Rupture ◽

Demographic Data ◽

Achilles Tendon Rupture ◽

Treatment Modalities ◽

Main Concern ◽

Complication Rates ◽

Percutaneous Surgery ◽

Significant Difference ◽

The Mean

Background: Treatment modalities for acute Achilles tendon rupture can be divided into operative and nonoperative. The main concern with nonoperative treatment is the high incidence of repeated ruptures; operative treatment is associated with risk of infection, sural nerve injury, and wound-healing sequelae. We assessed our experience with a percutaneous operative approach for treating acute Achilles tendon rupture. Methods: The outcomes of percutaneous surgery in 29 patients (25 men; age range, 24–58 years) who underwent percutaneous surgery for Achilles tendon rupture between 1997 and 2004 were retrospectively evaluated. Their demographic data, subjective and objective evaluation findings, and isokinetic evaluation results were retrieved, and they were assessed with the modified Boyden score and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale. Results: All 29 patients demonstrated good functional outcome, with no- to mild-limitations in recreational activities and high patient satisfaction. Mean follow-up was 31.8 months. Changes in ankle range of motion in the operated leg were minimal. Strength and power testing revealed a significant difference at 90°/sec for plantarflexion power between the injured and healthy legs but no difference at 30° and 240°/sec or in dorsiflexion. The mean modified Boyden score was 74.3, and the mean Ankle-Hindfoot Scale score was 94.5. Conclusions: Percutaneous surgery for Achilles tendon rupture is easily executed and has excellent functional results and low complication rates. It is an appealing alternative to either nonoperative or open surgery treatments. (J Am Podiatr Med Assoc 100(4): 270–275, 2010)

Download Full-text

Treatment of Dentin Hypersensitivity Using Nano-Hydroxyapatite Pastes: A Randomized Three-Month Clinical Trial

Operative Dentistry ◽

10.2341/15-145-c ◽

2016 ◽

Vol 41 (4) ◽

pp. E93-E101 ◽

Cited By ~ 20

Author(s):

L Wang ◽

AC Magalhães ◽

LF Francisconi-dos-Rios ◽

MP Calabria ◽

DFG Araújo ◽

...

Keyword(s):

Clinical Trial ◽

Home Care ◽

General Linear Model ◽

Potassium Nitrate ◽

Dentin Hypersensitivity ◽

Analog Scale ◽

The Third ◽

Significant Difference ◽

Final Score ◽

Nested Analysis

SUMMARY Objectives: This randomized clinical trial tested the three-month desensitizing effect of two protocols using nano-hydroxyapatite formulations compared with Pro-Argin and fluoride varnish. Methods: Twenty-eight subjects with 137 teeth presenting dentin exposure with a minimal hypersensitivity of four on the visual analog scale (VAS) took part of this study. The subjects were randomly assigned to four groups: Desensibilize Nano-P paste (20% hydroxyapatite [HAP], potassium nitrate, and sodium fluoride [NaF]; 9000 ppm fluoride [F]); Desensibilize Nano-P associated with experimental home-care pastes (10% HA, potassium nitrate, and NaF; 900 ppm F); Pro-Relief professional paste (8% arginine with Pro-Argin technology) associated with home-care toothpaste (8% arginine, sodium monofluorophosphate, 1450 ppm F); and Duraphat professional varnish (NaF varnish, 22,600 ppm F). The professional treatments were performed in weekly appointments over three weeks. The home-care products were used continuously for three months. A VAS was used to assess the tooth sensitivity response after standardized evaporative stimulus at baseline and after one month and three months. The baseline score was deducted from the final score, and the means were analyzed using nested analysis of variance, while the comparison between times was performed by a general linear model (p<0.05). Results: At the first month all treatments were effective, but there were no significant differences among them (p=0.94). At the third month, despite the fact that NaF varnish had the lowest effect in reducing hypersensitivity, no significant difference was found among the treatments (p=0.09). Only Pro-Relief increased its effect over time (p=0.049). Conclusions: Nano-hydroxyapatite formulations (with or without home->care product association) were as effective as the other treatments in reducing dentin hypersensitivity over three months.

Download Full-text

The influence of nutrition on egg-production and longevity in unmated female body-lice (Pediculus humanus corporis: Anoplura)

Parasitology ◽

10.1017/s0031182000024264 ◽

1941 ◽

Vol 33 (1) ◽

pp. 40-46 ◽

Cited By ~ 1

Author(s):

A. J. Haddow

Keyword(s):

Female Body ◽

Egg Production ◽

Egg Laying ◽

The Body ◽

Unmated Female ◽

Pediculus Humanus ◽

The Third ◽

Significant Difference ◽

The Mean ◽

Body Lice

1. Isolated unmated female body-lice were worn in pillboxes between the skin and the clothes. They were kept constantly on the body but, by a simple device, groups of ten were permitted feeding periods of different length. These groups were fed for 4, 8, 12, 16, 20 and 24 hr. per day respectively. Another group of ten were never allowed to feed after the last moult.2. Some of the figures for egg yield were high. Lice in the 24 hr. group were able to maintain a rate of ten eggs per day for 4−5 days at a time.3. No significant difference in longevity or rate of egg-laying was found to exist between the 12, 16, 20 and 24 hr. groups nor between the 4 and 8 hr. groups but a pronounced and significant difference exists between the 8 and 12 hr. groups. Below 12 hr. there is a sharp fall in longevity and rate of egg production. The unfed group all died, without laying, on the third day.4. The rate of laying as shown by the mode increases progressively with increase in time allowed daily for feeding.5. With regard to the mean eggs per louse the position is less clear. It is felt that the 24 hr. group may differ significantly from the 12, 16 and 20 hr. groups but this is uncertain.

Download Full-text

Efficacy of intrathecal midazolam on enhancing analgesic effect of fentanyl in patients undergoing lower limb surgery

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i10.487 ◽

2018 ◽

Vol 5 (10) ◽

pp. 2726-2732

Author(s):

Masoum Khoshfetrat ◽

Sima Davarpanah ◽

Aliakbar Keykha

Keyword(s):

Nerve Block ◽

Lower Limb ◽

Analgesic Effect ◽

Synergistic Effects ◽

Sensory Nerve ◽

Study Groups ◽

The Third ◽

Significant Difference ◽

Lower Limb Surgery ◽

The Mean

Background: Co-administration of drugs with synergistic effects is considered as one of the methods to increase the effectiveness of intrathecal anesthesia and to reduce the need for injectable analgesics. The purpose of this study was to investigate the efficacy of intrathecal midazolam on enhancing the analgesic effect of fentanyl in patients undergoing lower limb surgery. Materials: The present double-blinded clinical trial was conducted on 90 candidate patients undergoing lower limb orthopedic surgery in 2017 at Khatam-Al-Anbiya Hospital in the city of Zahedan, Iran. To this end, the patients were selected via convenience sampling method and then randomly divided into three groups. Afterwards, 3 cc of 0.5% hyperbaric Marcaine was injected intrathecally in the first group, 3 cc of Marcaine + 25 ug of fentanyl was administered to the second group, and 3 cc of Marcaine + 25 ug of fentanyl + 1 mg of midazolam was administered to the third group (the final volume of all three syringes was brought up to 3.7 cc with normal saline). The duration of sensory nerve block and those of motor block and analgesia, as well as changes in vital signs, were then measured in these groups. Moreover, the data were analyzed using SPSS Statistics (Version 22.0) through Chi-square test and one-way analysis of variance (ANOVA). Results: The mean age and gender distribution of the patients in the three study groups did not differ significantly. The mean duration of sensory nerve block was equal to 98.6+/-11.1 min in the first group, 142.2+/-12.4 min in the second group, and 174.3+/-10.9 min in the third group; all showed a statistically significant difference (P=0.0001, P=0.001, P=0.000).The mean duration of analgesia was also reported to be 204.43+/-0.3 min in the first group, 323.62+/-7.4 min in the second group, and 526.22+/-0.9 min in the third group, indicating a statistically significant difference between the three study groups (P=0.0001, P=0.000, P=000). Conclusion: The results of this study demonstrated that adding midazolam to intrathecal fentanyl could significantly increase the duration of sensory nerve block and that of post-operative analgesia.

Download Full-text

The Effect of Urtica Dioica Extract on Blood Lipids Profile in Patients with Type 2 Diabetes: A Randomized Double-blinded Clinical Trial

Journal of Nutrition and Food Security ◽

10.18502/jnfs.v6i4.7615 ◽

2021 ◽

Author(s):

Roya Khajeh Mehrizi ◽

Hassan Mozaffari-Khosravi ◽

Parisa Aboee

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Clinical Trial ◽

Total Cholesterol ◽

Density Lipoprotein ◽

Urtica Dioica ◽

Significant Difference ◽

The Mean ◽

Double Blinded

Background: Diabetes is an endocrine disorder that is strongly associated with cardiovascular disease. The use of alternative therapy has recently increased and medicinal plants are one of the alternative therapies for diabetic patients. This study aimed to evaluate the protective effect of Urtica dioica (Nettle) on lipid profile in patients with type 2 diabetes (T2D). Method: This parallel randomized double-blinded clinical trial was conducted on 60 men and women with T2D for an 8-week period. The participants were randomly assigned to received 100mg/kg/day extract of Urtica Dioica (UG) and the placebo group (PG). Blood triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDLc) and high density lipoprotein cholesterol (HDLc) were measured at baseline and end of the study. The data were analyzed using SPSS 16.0 and P < 0.05 was considered significant. Results: The mean difference of total cholesterol showed no significant difference in the UG compared to the PG which were -10.56±40.5 and -19.5± 35.9 (P = 0.14), respectively. The study also showed no significant difference between TG and LDLc in the UG compared to the PG (-39.8±171.5 vs. -23.37±72.3 (P = 0.68) and -3.16±33.4 vs. -11.2±35.6 (P = 0.15), respectively). The mean difference of HDLc in the UG and PG were -2.68±8.11 and 2.62±10.6 (P = 0.05), respectively, indicating a significant increase in the UG compared to the PG. Conclusion: The results demonstrated that consumption of 100mg/kg/day extract of UD for 8 weeks by increasing HDL concentration can decrease the risk of cardiovascular disease in patients with T2D.

Download Full-text