scholarly journals A Prospective Study of Single Breath Vital Capacity Inhalation Induction with High Concentration of Sevoflurane (Sbvc-Hc) for LMA Insertion in Adults for Short Surgical Cases

2020 ◽  
Vol 5 (1) ◽  
pp. 30-33
Author(s):  
Kailash Prabhudev ◽  
Naveen Kumar K
Keyword(s):  
Prospective Study ◽  
Short Duration ◽  
Gas Flow ◽  
Vital Capacity ◽  
Randomized Study ◽  
High Concentration ◽  
Inhalation Induction ◽  
Inhalation Anesthesia ◽  
Volatile Anesthetic Agent ◽  
The Mean

Background: Sevoflurane is a new volatile anesthetic agent with rapid induction and recovery. A randomized study was carried to access conditions for LMA insertion using Sevoflurane in 25 ASA I & II patients undergoing short duration surgeries.Subjects and Methods:This prospective study was conducted at Department of Anesthesiology and Critical Care, SVS Medical College and Hospital, Mahabubnagar, Telangana, India. After obtaining the institutional ethics committee and written informed consent from the patients, 25 subjects of either sex were included in this study. Age of the subjects was 18 to 60 years. Patients received injection Fentanyl 1 – 2mcg/kg prior to induction. All patients were pre-oxygenated for 3 min with 100% oxygen using a fresh gas flow of 81/min. All patients received inhalational induction with 8% Sevoflurane and O2 flow at 8 L/min with single vital capacity breathe technique. Loss of verbal contact was considered as the desired endpoint for induction, which was assessed by the response to calling out the patient’s name. Then the time of loss of eyelash reflex and jaw relaxation was assessed by anesthesiologist. After adequate jaw relaxation, LMA insertion was attempted.Results:The mean loss of verbal contact was 65.40±9.67second, while the mean for time for loss of eyelash reflex and jaw relaxation were found to be 81.20±9.39 seconds and 103.20 ±12.07 seconds respectively. The mean time for LMA insertion was 122.00±15.61 and the mean attempts for successful LMA insertion was 1.12±0.33. LMA insertion was easy in 23 cases as against difficult in 2 cases. In 2 cases transient cough and biting were recorded. LMA insertion was excellent and satisfactory in 88.0 and 12 percent. However, the mean heart rate at 5 minute after induction showed a significant fall at 5 minutes after induction. The mean values of SBP, DBP and MAP did not differ significantly at pre and induction. However, a significant decrease in SBP was noticed at 1, 2 and at 5 minutes.Conclusion:Sevoflurane is an smooth inhalation anesthesia with rapid onset with adequate jaw relaxation for insertion of LMA in Adults for short duration surgeries. Sevoflurane has got good hemodynamic profile with lesser complications owing to choice of inhalation agent for insertion of LMA.

Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Close Contact ◽  
Randomized Study ◽  
Sarcoptes Scabiei ◽  
Efficacy And Safety ◽  
Common Skin ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

scholarly journals POS0853 DECREASE IN ANTI-TOPOISOMERASE-1 ANTIBODY TITER IN PATIENTS WITH SYSTEMIC SCLEROSIS DURING LONG-TERM RITUXIMAB THERAPY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 681.1-681
Author(s):  
L. Garzanova ◽  
L. P. Ananyeva ◽  
O. Koneva ◽  
O. Desinova ◽  
O. Ovsyannikova ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
B Lymphocytes ◽  
Vital Capacity ◽  
Clinical Parameters ◽  
Diffusion Capacity ◽  
Positive Group ◽  
Topoisomerase 1 ◽  
The Mean

Background:Rituximab (RTX) is a new option in the treatment of systemic sclerosis (SSc) [1]. There is not enough data on changes in the level of autoantibodies and their clinical significance during RTM therapy. There are only a few reports on the higher efficiency of RTX in patients (pts) with SSc positive for anti-topoisomerase-1 antibodies (a-Topo-1), therefore the study of this issue might be interested.Objectives:To compare clinical parameters and B-lymphocytes (B-lymph) level in SSc pts depending on the presence or absence of a-Topo-1 during RTX therapy with prospective long-term follow-up.Methods:This study included 88 pts with SSc. The mean follow-up period was 26,3±10,7 months. The mean age was 47years (17-71), female-73 pts (83%), the diffuse cutaneous subset of the disease had 50 pts (57%). Symptoms of the interstitial lung disease (ILD) were observed in 70 pts (80%). The mean disease duration was 5,9±4,8 years. The cumulative mean dose of RTX was 2,9±1,1 grams. All patients received prednisone at a dose of 11,7±4,4 mg, immunosuppressants received 42% of them. There were 63 pts positive for a-Topo-1 and 25 pts - negative. The pts of the compared groups did not differ in the main demographic and clinical parameters, excepting lung involvement. In a-Topo-1 positive group 55 (87%) pts had ILD and only 15 (60%) – in a-Topo-1-negative group (p=0,02). The results at baseline and at the end of the follow up are presented in the form of mean values and changes in parameters (delta).Results:Considering the entire cohort, an improvement of almost all outcome parameters was found. When a-Topo-1 positive and a-Topo-1-negative pts were analyzed separately, we observed a significantly higher decrease in the activity score, depletion of B-lymph, an increase in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) in a-Topo-1 positive group of pts (table 1).Table 1.Changes of the main outcome parameters depending on the presence of a-Topo-1 on RTX therapy.Parametersa-Topo-1positive ptsa-Topo-1negative ptsPDelta Activity score (EScSG-AI)1,790,90,001Delta Rodnan skin score (mRSS)4,95,2NSDelta B-lymphocytes (absolute count)0,2120,1930,001Delta FVC*, %8,646,460,001Delta DLCO**, %2,860,0320,001*FVC - forced vital capacity % predicted, **DLCO - diffusion capacity for carbon monoxide % predictedThe a-Тopo-1 level decreased from 174,2±50,1 to 148,1±66,1 units/ml (p=0,0009). In this group, a-Тopo-1 became negative in 5 pts (7,9%). The disappearance of a-Topo-1 positivity was accompanied by a more pronounced decrease in mRSS (delta mRSS=7,4) and a higher depletion of B-lymph. There was a higher cumulative dose of RTX (4±1,4grams) in this 5 pts compared with the pts who sustained a-Topo-1 positivity. There was a moderate negative statistically significant correlation between the a-Topo-1 and the total dose of RTX (r=-0,298, p=0,017). A moderate negative statistically significant correlation was found between the a-Topo-1 and FVC (r=-0,322, p=0,009).Conclusion:In our study, the a-Topo-1 level significantly decreased during RTX therapy in Russian pts. The decrease in a-Topo-1 titers correlated with the total dose of RTX and was accompanied by a decrease in mRSS, disease activity index and an increase in FVC and DLCO. A higher efficacy of RTX in the a-Topo-1 positive group with prevalence of ILD was revealed, therefore a-Topo-1 positivity could be considered as a predictor of a better response to RTX therapy.References:[1]Jordan S, et al. Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group. Ann Rheum Dis.2015;74:1188–94.Doi:10.1136/annrheumdis-2013-204522.[2]Ebata S, Yoshizaki A, et.al. Rituximab therapy is more effective than cyclophosphamide therapy for Japanese patients with anti-topoisomerase I-positive systemic sclerosis-associated interstitial lung disease. J Dermatol.2019.Nov;46(11):1006-1013.doi:10.1111/1346-8138.15079.Disclosure of Interests:None declared

scholarly journals A prospective study on effectiveness of drotaverine in acceleration of labor

2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal
Keyword(s):  
Prospective Study ◽  
Drug Administration ◽  
Active Phase ◽  
Delivery Mode ◽  
Normal Delivery ◽  
Group I ◽  
Vacuum Delivery ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
Group Ii

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  

Pattern of plasma progesterone, oestradiol-17β, luteinizing hormone and androgen in non-pregnant buffalo (Bubalus bubalis)

1982 ◽  
Vol 100 (2) ◽  
pp. 279-284 ◽  
Author(s):  
R. C. Arora ◽  
R. S. Pandey
Keyword(s):  
Luteinizing Hormone ◽  
Peak Level ◽  
Systemic Circulation ◽  
Bubalus Bubalis ◽  
High Concentration ◽  
Plasma Progesterone ◽  
Blood Samples ◽  
Androgen Level ◽  
The Mean ◽  
Low Levels

Abstract. Domestic buffaloes were used to characterize the pattern of progesterone, oestradiol-17β, LH and androgen in the systemic circulation following infertile insemination. Concentrations of hormones were measured by RIA in blood samples collected daily or at alternate days following insemination. The concentration of progesterone was lowest on the day of insemination, and increased significantly to a peak level of 4.00 ± 0.60 ng/ml by day 13 post insemination. After day 17, it declined significantly (P < 0.01) to reach low levels by day 21. The concentration of oestradiol-17β was high at the time of insemination and declined significantly (P < 0.01) by day 2 after insemination. It was maintained around the basal level till day 18 with minor peaks in between this period. It again rose significantly (P < 0.01) at subsequent oestrus. The mean level of LH was highest at the time of insemination, and declined significantly (P < 0.01) by day 1 post insemination. It did not vary appreciably till the animal returned to oestrus. The oestrous value of LH and progesterone were negatively correlated (r = −0.77). The androgen level was observed to be high at insemination in 3 out of 5 animals, but the overall pattern of this steroid was inconsistent during the period studied. A high concentration of androgen was recorded in all the animals from day 2–5 before the onset of oestrus.

The Ontogeny of Ultrasonic Vocalization in Microtus Montanus

Behaviour ◽  
1977 ◽  
Vol 60 (1-2) ◽  
pp. 115-121 ◽  
Author(s):  
V.J. De Ghett
Keyword(s):  
Short Duration ◽  
Maternal Care ◽  
Ultrasonic Vocalization ◽  
Ultrasonic Vocalizations ◽  
Developmental Changes ◽  
Maternal Behaviour ◽  
Postnatal Ontogeny ◽  
Microtus Montanus ◽  
Early Peak ◽  
The Mean

AbstractDevelopmental changes in parameters of ultrasound production were investigated in M. montanus young. The rate of ultrasonic vocalization reached a peak on Day 2 of postnatal ontogeny and declined to zero on Day 15. A similar developmental pattern has been found in several other rodent species. However, the comparatively early peak rate is indicative of a degree of ontogenic precociousness. Other developmental changes, both behavioural and morphological, tend to confirm that M. montanus young are relatively precocious. The duration of ultrasonic vocalizations did not show a significant change across early development. The mean duration for each vocalization sampled was 22.92 msec. The distribution of these vocalizations showed that a considerable number of vocalizations were of very short duration (<30 msec). The developmental changes in the percentage of young emitting ultrasounds began to decline following Day 8 and reached zero percent on Day 15. This decline in the percentage of young vocalizing corresponded to changes in maternal behaviour. Both the rate of ultrasonic vocalization and the percentage of young vocalizing were significantly correlated with the age of the young. Being correlated with age, these parameters of ultrasound production have the possibility of having great communicative value for the purposes of maternal care.

Transanal Hemorrhoidal Dearterialization Versus Stapled Hemorrhoidopexy: Long-Term Follow-up of a Prospective Randomized Study

2018 ◽  
Vol 25 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Gabriella Giarratano ◽  
Edoardo Toscana ◽  
Claudio Toscana ◽  
Giuseppe Petrella ◽  
Mostafa Shalaby ◽  
...  
Keyword(s):  
Return To Work ◽  
Recurrence Rate ◽  
Randomized Study ◽  
Stapled Hemorrhoidopexy ◽  
Secondary Outcome ◽  
Sh Group ◽  
The Mean ◽  
Complications Rate ◽  
Grade Iii

Aim. This study aims to compare the early and late outcomes of transanal hemorrhoidal dearterialization (THD) versus stapled hemorrhoidopexy (SH) for the treatment of hemorrhoidal disease. Methods. From January 2013 to December 2014, 100 patients—50 patients on each arm—were randomly allocated to THD or SH groups. The inclusion criteria were grade III and IV hemorrhoids diagnosed by clinical examination and proctoscopy. The primary outcome was to compare the recurrence rate with a minimum follow-up of 2 years, and the secondary outcome was to compare complications rate, time to return to work postsurgery, procedure length, and patient’s satisfaction between the 2 techniques. Results. The mean follow-up period was 33.7 ± 7.6. The recurrence rate was 4% in the SH group and 16% in the THD group ( P = .04). There was no difference in the intraoperative and postoperative complications rate; the pain score was significantly higher in the THD group. The mean operative time was significantly shorter in the SH group compared with the THD group. Patients in the THD group returned to work or routine activities significantly later compared with patients in the SH group. The overall satisfaction rate was also higher in the SH group. Conclusion. Both procedures are simple and easy to perform for the treatment of grade III and IV hemorrhoids. SH showed better results in terms of lower rate of recurrence, lower postoperative pain, quicker return to work, and higher patient satisfaction.

scholarly journals A sensitive and reliable RP-HPLC method for the detection of cimetidine – a H2 receptor antagonist in human plasma

2019 ◽  
Vol 8 (3) ◽  
pp. 671-674
Keyword(s):  
Human Plasma ◽  
High Performance ◽  
Internal Standard ◽  
Bioequivalence Study ◽  
High Concentration ◽  
H2 Receptor Antagonist ◽  
Chromatography Method ◽  
Thaw Cycle ◽  
Limit Of Quantitation ◽  
The Mean

Bioanalytical methods for bioequivalence studies require high sensibility and rapidity due to the large number of samples and the low plasma concentration of drugs. The present study aimed to develop and validate a high-performance liquid chromatography method to quantify cimetidine (CMT) in human plasma and to apply it in a bioequivalence study. Spiked plasma of 500 µl (l, m and h concentration) was used for the assay. The HPLC injection volume was 20μl of the reconstitute sample where, 2 ml of ethyl acetate used for extraction purposes. Cimetidine was prepared separately for low (80 ng/ml), medium (2000 ng/ml) and high (3600 ng/ml) concentrations and internal standard (ranitidine) concentration was 3000 ng/ml. Freeze thawing and long terms stability were conducted at -25º c. The individual calibration curve for spiked standards was linear with R2= 0.99. The inaccuracy values for QC samples were within 15% of the actual value and not more than 20% for the LOQ. The limit of quantitation (LOQ) was 40 ng/ml, which was also the lowest concentration of cimetidine that was quantitated with the variability of 5.9%. The within day precision and between day precision for LOQ were 10.8 and 5.9 respectively. The retention time for the analyte was 4.1-4.5 minutes during the within a day and between day results. The mean % inaccuracy values for low, medium and high concentration were 6.8, 5.6 and 7.8 respectively for within day and 2.4, 6.1 and 7.9 respectively for between days. The within day and between day % inaccuracy for LOQ concentration was 12.4 and 5.5 respectively. The mean recoveries for low, medium and high concentration of cimetidine were 80.2, 70.9 and 74.2. The overall mean recovery for cimetidine was 75.1%. The maximum inaccuracy for freeze thaw cycle and long term stability samples for low, medium and high was found with CV less than 15% for all concentrations, indicating that cimetidine is stable. The developed method was precise and accurate and was suitable to be applied for the bioequivalence study of cimetidine.

scholarly journals Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

2019 ◽  
Vol 16 (3) ◽  
pp. 168-178
Author(s):  
Anu Malik ◽  
Smruti Ranjan Dethi ◽  
Yogesh Kumar Gupta ◽  
Alka Gupta
Keyword(s):  
Cataract Surgery ◽  
Randomized Study ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
The Mean ◽  
Group 2 ◽  
Surgically Induced ◽  
Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

scholarly journals ANALGESIC EFFICACY OF EPIDURAL MORPHINE AND CLONIDINEIN PATIENTS UNDERGOING DECOMPRESSION OF THE LUMBAR CANAL: A PROSPECTIVE RANDOMIZED TRIAL

2017 ◽  
Vol 16 (3) ◽  
pp. 188-192
Author(s):  
BRUNO RONCAGLIO ◽  
RAPHAEL FERNANDES CALHAU ◽  
CHARBEL JACOB JÚNIOR ◽  
IGOR MACHADO CARDOSO ◽  
JOSÉ LUCAS BATISTA JÚNIOR ◽  
...  
Keyword(s):  
Epidural Morphine ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Control Group ◽  
Lumbar Arthrodesis ◽  
The Mean ◽  
Group 2 ◽  
Student’S T ◽  
Microsoft Office ◽  
Student’S T Test

ABSTRACT Objective: To evaluate the postoperative analgesic efficacy in patients undergoing lumbar canal decompression using epidural morphine and clonidine at the Hospital Santa Casa de Vitória - ES, Brazil. Methods: Prospective, randomized study of 60 patients with stenosis of the lumbar canal up to two levels with surgical indication, in which decompression of the canal was performed in association with lumbar arthrodesis. In group 1 we performed conventional postoperative analgesia and in group 2, in addition to conventional analgesia, we associated epidural morphine and clonidine. We used VAS as a means of analyzing pain intensity at 1, 12, and 36 hours after surgery. The statistical analysis was performed using Microsoft Office/Excel and the software GraphPad Prism (San Diego, CA, USA). Results: The mean age of patients was 47 years, and 52% were female. The mean VAS in the first hour, 12th, and 36th hours after surgery in the control group was 5.44, 2.13, and 0.55 respectively. In the morphine-clonidine group it was 6.96; 2.21 and 0.60. Comparing one group with another in its absolute values through the Mann-Whitney test, as well as comparing the pain variations between the 1st and 12th hour (1h X 12h) and between the 12th hour and 36th hour (12h x 36h ) through Student’s t test it became clear that there was no statistical difference between groups (p > 0.05). Conclusions: The addition of epidural morphine and clonidine to conventional analgesia is not beneficial to reduce postoperative pain in patients undergoing lumbar canal decompression.

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