Comparing the Role of Auditory Soothing Effect and Ketamine on Duration of Sedation and Recovery Time in Procedural Sedation and Analgesia (PSA) Among Pediatric Patients in Emergency Department. A Case-Control Comparative Study from a Tertiary Care Setting of LIC

Abstract Introduction: Pediatric pain, is a major concern of anxiety and fear during emergency procedures, to alleviate pediatric pain and distress different mode of sedation is required from local, nasal to parental. Appropriate pain relief with adequate sedation and analgesia different drugs are used, however, most have their side effects. Ketamine alone has been used for procedural sedation and analgesia (PSA), but a higher dose may be required to achieve adequate sedation and pain relief, leading to dose-dependent side effects. In this study, we hypothesize that cartoon music or parental/physicians soothing rhymes/sounds during PSA may reduce the dose and frequency of sedative medications, and reduce the duration of sedation and early recovery.Material and Methods: This is a prospective cross-sectional comparative hospital-based study, we used non-probability consecutive sampling from children below 16 years during 2018-2019, post ethical review board approval from Hospital Ethical Committee (3827-EM-ERC-15 (3827-EM-ERC-15{Emergency Medicine – Ethical Review Committee}), who need PSA in ED settings. The PSA was carried by ED physicians who were credentialed for PSA and advanced airway care, while the procedure will be dealt with by another physician from ED or another subspecialty. The study population was divided into two groups, one with Ketamine alone (control group) with 32 patients, while another (case group) with 60 children, who got a low dose of Ketamine along with either of the soothing auditory stimulus, like cartoon music via mobile, parental/physician rhymes during PSA. Data was entered and analyzed using SPSS version-21 Frequency and the percentage was calculated for qualitative variables. Shapiro-Wilk test was applied to check the hypothesis of normality for age (years), sedation, and recovery time, and descriptive statistics such as mean±SD, median (IQR), maximum and minimum were calculated appropriately. Effect modifiers like age, gender, sedation, and recovery time were addressed through stratification. The post-stratification chi-square test was applied by taking p ≤ 0.05 as significant.Results: Comparing the two major groups (case and control), there was no statistical difference among age, gender, types of procedures done, and recovery time, however LOS in ED (<60 minutes) and sedation time (<30 minutes) in the case group was statistically better than in control group (78% vs 87% and 85% and 78% respectively). Children with oxygen saturation ≤90% were slightly better in the case group 1.7% vs 3.1%, similarly 25% had tachycardia as compared to 28% in the ketamine-only group. Tachypnea was observed in 21.7% vs 28% among the case and control groups. Importantly ketamine repeat dose was observed in 34.4% among control (ketamine only) group and only 21.7 need repeated dose in the case group. Discussion: The goal of PSA was to relieve anxiety and fear of pain during the procedure in chaotic EDs. This will help in gaining child cooperation and parents' satisfaction along with reduced drug dose, minimizing LOS, speedy recovery time, and lessening the anticipated drug-related complications. The significant finding observed was the total sedation time and LOS in ED which was significantly better in the control group. Younger children were better soothed by parental voice (rhymes) as compared to other soothing methods examined, similarly lesser drop in oxygen saturation, minimal tachycardia or tachypnea were observed and fewer repeat doses of Ketamine was used as compared to the control group. Music during PSA demonstrates a reduction in patient anxiety, however, the dose and frequency of sedation required didn't show any such reduced medications.Conclusion: In conclusion, listening to cartoon music or parental sound/rhymes has no significant effect on the hemodynamic variables or the drug consumption among pediatric patients during PSA. By considering the reported beneficial results of previous studies, listening to music can be accepted as an adjunct non-pharmacological method for sedation.

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Investigation of TAGAP gene polymorphism (rs1738074) in Turkish pediatric celiac patients

Turkish Journal of Biochemistry ◽

10.1515/tjb-2020-0419 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Melek Pehlivan ◽

Tülay K. Ayna ◽

Maşallah Baran ◽

Mustafa Soyöz ◽

Aslı Ö. Koçyiğit ◽

...

Keyword(s):

Pediatric Patients ◽

Disease Risk ◽

Polymerase Chain Reaction Method ◽

Control Group ◽

Healthy Children ◽

Single Nucleotide ◽

Significant Difference ◽

Allele Specific ◽

And Control

Abstract Objectives There are several hypotheses on the effects of the rs1738074 T/C single nucleotide polymorphism in the TAGAP gene; however, there has been no study on Turkish pediatric patients. We aimed to investigate the association of celiac disease (CD) and type 1 diabetes mellitus (T1DM) comorbidity with the polymorphism in the TAGAP gene of Turkish pediatric patients. Methods Totally, 127 pediatric CD patients and 100 healthy children were included. We determined the polymorphism by the allele-specific polymerase chain reaction method. We used IBM SPSS Statistics version 25.0 and Arlequin 3.5.2 for the statistical analyses. The authors have no conflict of interest. Results It was determined that 72% (n=154) of only CD patients had C allele, whereas 28% (n=60) had T allele. Of the patients with celiac and T1DM, 42.5% (n=17) and 57.5% (n=23) had T and C alleles, respectively. Of the individuals in control group, 67% (n=134) had C allele, whereas 33% (n=66) had T allele. Conclusions There was no significant difference in the genotype and allele frequencies between the patient and control groups (p>0.05). There was no significant association between the disease risk and the polymorphism in our study group.

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Hepatic steatosis: a risk factor for increased COVID-19 prevalence and severity—a computed tomography study

Egyptian Liver Journal ◽

10.1186/s43066-021-00131-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Asmaa Ali ◽

Mona Hasan ◽

Shaimaa Hamed ◽

Amir Elhamy

Keyword(s):

Hepatic Steatosis ◽

Severe Disease ◽

Severe Pneumonia ◽

Liver Disorder ◽

Control Group ◽

Case Group ◽

World Population ◽

Positive Class ◽

The Mean ◽

And Control

Abstract Background Around 25% of the world population was affected by the metabolic-related fatty liver disorder. Hepatic steatosis is frequently observed in conjunction with hypertension, obesity comorbidities, and diabetes. We evaluate the hepatic steatosis frequency found in chest CT exams of COVID-19-positive cases compared to non-infected controls and evaluate the related increased prevalence and severity of COVID. Results Our research includes 355 subjects, 158 with positive PCR for COVID-19 (case group) and 197 with negative PCR and negative CT chest (control group). The mean age in the positive group was 50.6 ± 16 years, and in the control, it was 41.3 ± 16 years (p < 0.001). Our study consists of 321 men (90.5%) and 34 women (9.5%). The number of males in both cases and control groups was greater. In the case group, 93% men vs. 6.9% women, while in controls, 88.3% men vs.11.6% women, p < 0.001. CT revealed normal results in 55.5% of individuals (i.e., CORADs 1) and abnormal findings in 45.5% of participants (i.e., CORADs 2–5). In abnormal scan, CO-RADs 2 was 13.92%, while CO-RADs 3–4 were 20.89% of cases. CO-RADs 5 comprised 65.19% of all cases. Approximately 42.6% of cases had severe disease (CT score ≥ 20), all of them were CO-RADs 5. The PCR-positive class had a greater prevalence of hepatic steatosis than controls (28.5% vs.12.2%, p < 0.001). CO-RADs 2 represented 11.1%, CO-RADs 3–4 represented 15.6%, and CO-RADs 5 represented 73.3% in the hepatic steatosis cases. The mean hepatic attenuation value in the case group was 46.79 ± 12.68 and in the control group 53.34 ± 10.28 (p < 0.001). When comparing patients with a higher severity score (CT score ≥ 20) to those with non-severe pneumonia, it was discovered that hepatic steatosis is more prevalent (73.2% vs. 26.8%). Conclusions Steatosis was shown to be substantially more prevalent in COVID-19-positive individuals. There is a relation among metabolic syndrome, steatosis of the liver, and obesity, as well as the COVID-19 severity.

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Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02311-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jingwei Cai ◽

Guixing Jiang ◽

Yuelong Liang ◽

Yangyang Xie ◽

Junhao Zheng ◽

...

Keyword(s):

Blood Loss ◽

Operative Time ◽

Harmonic Scalpel ◽

Peak Level ◽

Bile Leakage ◽

Liver Parenchyma ◽

Control Group ◽

Case Group ◽

Intraoperative Blood Loss ◽

And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

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In Vivo Therapeutic Effect of Triclabendazole + Levamisole on Hydatid Cyst in Rats

International Journal of Medical Parasitology and Epidemiology Sciences ◽

10.34172/ijmpes.2020.06 ◽

2020 ◽

Vol 1 (1) ◽

pp. 18-20

Author(s):

Peyman Sadeghi ◽

Yagoob Garedaghi ◽

Mirhadi Khayatnouri ◽

Hosein Hashemzade Farhang ◽

Ramin Kaffash Elahi

Keyword(s):

Hydatid Cyst ◽

Close Contact ◽

Control Group ◽

Case Group ◽

Hydatid Cysts ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

And Control

Introduction: Hydatidosis is a global disease and one of the most dangerous zoonotic diseases which is found in areas where humans, dogs, and herbivores are in close contact with each other. Methods: In this study, a total of 64 rats were divided into control and case groups, and then 3000 protoscolices were injected into the peritoneal cavity. After 2 months, rats in the case group were given triclabendazole + levamisole at a dose of 6 mg + 4.41 mg/mL orally for 60 days, respectively. Then, after 6 months of infection, the rats of the control and case groups were killed by anesthesia and then an autopsy was performed and the viscera were carefully examined for hydatid cyst infection. Results: The results showed that in the control group, 3 cysts were observed in the liver, 10 in the kidney, and 88 in the lung. The mean number of hydatid cysts in this group was determined to be 33.6. In the case group, 2 cysts were observed in the liver, 6 in the kidney, and 64 in the lungs. The mean number of hydatid cysts in the viscera was 24 in the case group. Conclusions: Statistical analysis of the results obtained from the case and control groups showed that the therapeutic efficacy of triclabendazole + levamisole was 31%, which is not enough to treat cases of hydatid cyst.

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The Relationship between Smoking and Sublingual Varices in the Elderly

Oman Medical Journal ◽

10.5001/omj.2021.94 ◽

2021 ◽

Vol 36 (4) ◽

pp. e288-e288

Author(s):

Niusha Barzideh ◽

Arezoo Alaee ◽

Arash Azizi

Keyword(s):

Older Adults ◽

Cigarette Smoking ◽

Elderly Patients ◽

Varicose Veins ◽

The Elderly ◽

Control Group ◽

Case Group ◽

Chi Square ◽

Number Of Patients ◽

And Control

Objectives: We investigated the existence of any connection between smoking and sublingual varices (SLV) in the older population. Methods: This case-control study was conducted in 2019 on adults > 65 years old at Kahrizak Charity Nursing Home, Alborz, Iran. We conducted clinical examination and inspection of 222 elderly patients. Both the case group and control group contained the same number of patients (n = 111). SLV were classified as grade 0 (few or none visible) and grade 1 (moderate or severe). The case group included patients with SLV and the control group consisted of those older adults without SLV and who were matched with the case group based on age, gender, blood pressure, denture wearing, and varicose veins in their legs. Cigarette smoking habits were investigated in both groups. Smokers were considered those who smoked at least one cigarette per day for more than six months. Chi-square and odds ratio (OR) were used to statistically analyze the exposure of participants to smoking in both groups. Results: Among 222 participants, 21.6% and 5.4% were smokers in the case and control groups, respectively. The results of our data analysis revealed that SLV were significantly associated with smoking (p < 0.001, OR = 4). Conclusions: Elderly patients with SLV are more likely to be cigarette smokers. Therefore, cigarette smoking cessation programs are recommended for older adults in society.

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Excess Morbidity Associated With Interhospital Transport

PEDIATRICS ◽

10.1542/peds.90.6.893 ◽

1992 ◽

Vol 90 (6) ◽

pp. 893-898 ◽

Cited By ~ 1

Author(s):

Robert K. Kanter ◽

Nancy M. Boeing ◽

William P. Hannan ◽

Deborah L. Kanter

Keyword(s):

Intensive Care ◽

Adverse Events ◽

Critically Ill ◽

Pediatric Patients ◽

Morbidity Rate ◽

Control Group ◽

Interhospital Transfer ◽

Excess Morbidity ◽

Interhospital Transport ◽

And Control

A prospective study was performed to determine whether excess morbidity occurred in critically ill and injured pediatric patients during interhospital transport compared with morbidity in a control group. Control observations were made during the first 2 hours of pediatric intensive care unit (PICU) care of patients emergently admitted from within the same institution and not requiring interhospital transport. The first 2 PICU hours of control patients corresponded to the interval of transport in those who required interhospital transfer. Transport care was provided by nonspecialized teams from referring hospitals. Morbidity occurred in 20.9% of 177 transported patients, exceeding the morbidity rate of 11.3% in 195 control patients (P < .05). The difference in morbidity was due to intensive care-related adverse events (eg, plugged or dislodged endotracheal tubes, loss of intravenous access) in 15.3% and 3.6% of transported and control patients, respectively (P < .05). Physiologic deterioration occurred at similar rates of 7.9% and 8.7% in transported and control patients, respectively (P > .05). Slightly greater pre-ICU severity of illness in transported than control patients (median Pediatric Risk of Mortality Score = 10 and 7, respectively, P < .05) and greater pre-ICU therapy relative to severity (P < .05) in control patients are potential confounding sources of the morbidity differences. If patients are stratified into subgroups of similar pre-ICU severity, an excess of intensive care-related adverse events in transported patients remains evident in the severe subgroup (P < .05). Further investigation is warranted to determine whether specialized transport teams can reduce the excess morbidity associated with interhospital transport of critically ill and injured pediatric patients.

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Hematological changes in pregnancy induced hypertension in their third trimester at Jhalawar Medical College, Jhalawar, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193632 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3497

Author(s):

Neelam Jhajharia ◽

Madhureema Verma

Keyword(s):

Control Group ◽

Case Group ◽

Haematocrit Level ◽

Haematological Parameter ◽

Pregnancy Induced Hypertension ◽

Medical College ◽

Induced Hypertension ◽

Life Threatening ◽

The Mean ◽

And Control

Background: Pregnancy induced hypertension (PIH) is one of the most common and potential life-threatening complications of pregnancy. This study is aimed to investigate and correlate the hemoglobin, haematocrit, white blood cell count, lymphocytes and platelets in PIH patients in their third trimester.Method: Total 126 subjects were studied out of them 63 patients (case) and 63 healthy pregnant women (control) visiting the Obstetrics and Gynaecology department Jhalawar Medical College, Jhalawar were registered in the study and followed during their pregnancy. Two millilitre of blood sample was drawn aseptically using the 5ml syringe from the median ante cubital vein of all the cases and control participants into EDTA-anticoagulated tubes. Haematological parameter calculated by using Sysmex XN-9100™ Automated Haematology System.Results: The mean hemoglobin level of the case group (8.8206±2.53779) was significantly lower than that of the control group (9.7289±2.47033) (p<0.05). The mean platelet count of the case group (131.4937±62.05999) was significantly lower than that of the control group (324.9683±230.78764) (p<0.05). The mean lymphocytes level of case group (1.2510±0.56369) was significantly lower than that of the control group (1.9295±1.4150) (p<0.05). The mean WBC level of case group (36.3467±119.90635) was significantly high than control group (11.5260±4.83059) (p<0.05). The mean haematocrit level of case group (32.6851±7.29789) was significantly high than control group (30.0424±23.38116) (p<0.05).Conclusion: The mean hemoglobin, mean platelets and mean lymphocytes are lower in PIH patients. The mean WBC and haematocrit are higher in PIH patient.

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The values of AHCY and CBS promoter methylation on the diagnosis of cerebral infarction in Chinese Han population

BMC Medical Genomics ◽

10.1186/s12920-020-00798-7 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Xiaodong Li ◽

Shufang Bu ◽

Ran Ran Pan ◽

Cong Zhou ◽

Kun Qu ◽

...

Keyword(s):

Cerebral Infarction ◽

Promoter Methylation ◽

Methylation Level ◽

Young Group ◽

Control Group ◽

Case Group ◽

Middle Aged ◽

Aged Group ◽

Significant Difference ◽

And Control

Abstract Background The goal of our study is to investigate whether the methylation levels of AHCY and CBS promoters are related to the risk of cerebral infarction by detecting the methylation level of AHCY and CBS genes. Methods We extracted peripheral venous blood from 152 patients with cerebral infarction and 152 gender- and age-matched healthy controls, and determined methylation levels of AHCY and CBS promoters using quantitative methylation-specific polymerase chain reaction. We used the percentage of methylation reference (PMR) to indicate gene methylation level. Results We compared the promoter methylation levels of two genes (AHCY and CBS) in peripheral blood DNA between the cerebral infarction case group and the control group. Our study showed no significant difference in AHCY promoter methylation between case and control. Subgroup analysis by gender showed that the methylation level of AHCY in males in the case group was lower than that in the control group, but the difference was not statistically significant in females. In a subgroup analysis by age, there was no significant difference in the AHCY methylation level between the case and control in the young group (≤44 years old). However, the level of AHCY gene methylation in the middle-aged group (45–59 years old) was significantly higher and the aged group (≥60 years old) was significantly lower than that in the control groups. However, CBS promoter methylation levels were significantly lower in the case group than in the control group (median PMR: 70.20% vs 104.10%, P = 3.71E-10). In addition, the CBS methylation levels of males and females in the case group were significantly lower than those in the control group (male: 64.33% vs 105%, P = 2.667E-08; female: 78.05% vs 102.8%, P = 0.003). We also found that the CBS levels in the young (23–44), middle-aged (45–59), and older (60–90) groups were significantly lower than those in the control group (young group: 69.97% vs 114.71%; P = 0.015; middle-aged group: 56.04% vs 91.71%; P = 6.744E-06; older group: 81.6% vs 119.35%; P = 2.644E-04). Our ROC curve analysis of CBS hypomethylation showed an area under the curve of 0.713, a sensitivity of 67.4%, and a specificity of 74.0%. Conclusion Our study suggests that hypomethylation of the CBS promoter may be closely related to the risk of cerebral infarction and may be used as a non-invasive diagnostic biomarker for cerebral infarction.

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Complete blood count, cholinesterase, and renal function of organophosphate sprayers in Kulonprogo

INTERNATIONAL JOURNAL OF ETHICS TRAUMA & VICTIMOLOGY ◽

10.18099/ijetv.v3i1.8791 ◽

2017 ◽

Vol 3 (1) ◽

Author(s):

Idha Arfianti Wiraagni

Keyword(s):

Renal Function ◽

Blood Count ◽

Complete Blood Count ◽

Exposed Group ◽

Control Group ◽

Case Group ◽

Pesticide Use ◽

Normal Limits ◽

The Mean ◽

And Control

Background: There are several risks to health associated with pesticide use. The use of Personal Protective Equipment (PPE) can minimize pesticide exposure to farmers. The aim of this study was to determine the basic characteristics of farmers, blood parameters (complete blood count, cholinesterase, and creatinine), patterns of pesticide use, and the use of PPE. Methods: This research was a cross-sectional study, with total sampling method. The data were taken from all farmers in Kulonprogo, Yogyakarta, Indonesia. Case group was organophosphate sprayers that have sprayed organophosphate for more than 1 year. Results: In case of group, there were 36 farmers (31 male and 5 female), while in control group, there were 11 persons (4 male and 7 female). The mean blood cholinesterase level in the exposed group was 7.8 ± 2.01Ku/L and in the control group 8.7± 1.56 Ku/L. The mean of exposed group blood urea nitrogen: 12.08±3.88 mmol/L and control Group: 11.4±3.11 mmol/L. The mean of blood creatinine was within normal limits (case group: 0.9 ± 0.17mg/dl and control group: 0.7 ± 0.19 mg/dl), but there were significant differences between them (p : 0.015). Conclusions: The results of a complete blood count, cholinesterase, and renal function in the organophosphate sprayers In Kulonprogro were within normal limits. There was an increase of creatinine levels on exposed group significantly, although still within normal limit. They have sufficient rest period for farmers (1 month) in every planting season. It is necessary to educate farmers about the importance of using PPE and management of acute pesticide poisoning.

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The effect of lavandula angustifolia in the treatment of depression

European Psychiatry ◽

10.1016/s0924-9338(11)72330-6 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 624-624 ◽

Cited By ~ 1

Author(s):

N. Parvin ◽

S. Farzaneh ◽

M. Nikfarjam ◽

N. Shahinfard ◽

N. Asarzadegan

Keyword(s):

Depression Score ◽

Control Group ◽

Case Group ◽

Double Blind Study ◽

Control Groups ◽

Chi Square ◽

Double Blind ◽

Treatment Of Depression ◽

Severity Of Depression ◽

And Control

Background and aimMedical plants have been used for centuries as a medicinal agent in treatment of depression and anxiety. The purpose of this study was to explore the effects of the lavendula officinalis on depression in patients using citalopram.MethodsThis clinical trial study was performed in Hajar hospital, Shahrekord, Iran. In this study eighty patients randomly allocated into two groups (40 patients in each group). Patients who complained from depression were studied during a two-month double-blind study. In control group, patients were given 20 mg citalopram twice daily plus placebo and case group were treated with 5 g arial part of dried Lavendula officinalis and citaloperam (20 mg, twice per day). After 4 and 8 weeks, patients were followed for evaluations of their depression and complications. Depression severity was scored using standard Hamilton’s depression questionnaire. Data were analyzed using Chi square and Paired-t test.ResultsAfter 1 month treatment, mean depression score in case and control groups were 15.2 ± 3.6 and 17.5 ± 3.5, respectively (P < 0.05). After 2 months the mean score of depression in case and control groups was 14.8 ± 4 and 16.8 ± 4.6, respectively (P < 0.01). The most common side effects in two groups were confusion and dry mouth, which were not significantly different between two groups.ConclusionLavendula officinalis has a positive effect on depressed patients and may be useful to decrease the severity of depression in patients using other antidepressants.

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