scholarly journals Comparison of a Combination of Caudal Levobupivacaine with Fentanyl and Levobupivacaine Alone for Alleviating Postoperative Pain During Infraumbilical Procedures in Children Under 3 Years

2019 ◽  
Vol 12 (1) ◽  
pp. 19-25
Author(s):  
Muralidar Vakkapatti ◽  
Thrivikram Shenoy ◽  
Sonal Bhat
Keyword(s):  
Analgesic Efficacy ◽  
P Value ◽  
Age Group ◽  
Parental Consent ◽  
Caudal Block ◽  
Physical Status ◽  
Medical College ◽  
Block Randomisation ◽  
To Receive ◽  
Caudal Blockade

Background: To compare the post-operative analgesic efficacy of caudal blockade using levobupivacaine alone and a combination of fentanyl with levobupivacaine in children under 3 years undergoing infraumbilical surgeries. Combination of levobupivacaine with fentanyl and levobupivacaine alone in children for caudal block was never studied before. Hence there was a need for the study. Methods: After approval from Institutional Ethical Committee, Kasturba Medical College, Mangaluru, 60 patients of age group 0-3 years, either sex of ASA physical status 1 and 2 undergoing infraumbilical surgeries were chosen after written parental consent and were randomised into 2 groups of 30 each L and LF using computer generated block randomisation to receive caudal blocks. Post operatively assessed for pain using CHIPPS scale at 2, 4, 6, 12 and 24 hours and compared in both groups. Results: Out of 60 patients, 30 in each group [L and LF], CHIPPS scores at 2, 4, 6, 12 and 24 hours post-operatively exhibited a p-value of 0.545, 0.492, 0.626, 0.166, and 0.329 respectively [not significant]. Mean duration of analgesia was 14.60 in Group L & 17.67 in Group LF with a t test p value of 0.119 [not significant]. Conclusion: Combination of fentanyl with levobupivacaine when compared to levobupivacaine alone for caudal block was equianalgesic in children less than 3 years undergoing infra umbilical procedures.

scholarly journals Serum albumin as predictor of post-operative morbidity and mortality

2017 ◽  
Vol 4 (3) ◽  
pp. 1078
Author(s):  
Latika Sharma ◽  
Poojan M. Purohit ◽  
Dharmendra Pipal ◽  
Saurabh Kothari ◽  
Harshit Srivastava ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Protein Energy Malnutrition ◽  
Organ System ◽  
Morbidity And Mortality ◽  
Surgical Patients ◽  
P Value ◽  
Age Group ◽  
Operative Morbidity ◽  
Medical College ◽  
Protein Energy

Background: Protein energy malnutrition affects every organ system. So correct assessment of nutritional status is important as malnourishment is a risk factor for morbidity and morality in surgical patients. In our study, serum albumin has been taken as parameter for nutritional assessment.Methods: Study is conducted on 50 patients admitted in Department of General Surgery, Dr. Sampurnanand Medical College and associated Hospital, Jodhpur, Rajasthan, India for surgeries during January 2014-December 2015. Data was analyzed using Z-test and Fischer exact t-test and p value was calculated. P value <0.05 is considered statistically significant.Results: Patients with serum albumin <3gm/dl had more complications with maximum number of complications in age group of 41-60 year group. This finding was statistically significant.Conclusions: Low serum albumin patients has more post-operative complication than those with normal level and so is a good indicator of post-operative morbidity and mortality.

Greater Incidence of Delirium during Recovery from Sevoflurane Anesthesia in Preschool Boys 

1997 ◽  
Vol 87 (6) ◽  
pp. 1298-1300 ◽  
Author(s):  
Jun Aono ◽  
Wasa Ueda ◽  
Kikyo Mamiya ◽  
Eri Takimoto ◽  
Masanobu Manabe
Keyword(s):  
Age Groups ◽  
Older Children ◽  
Caudal Block ◽  
Physical Status ◽  
Early Recovery ◽  
Sevoflurane Group ◽  
Preschool Boys ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
To Receive

Background In the authors' clinical experience, preschool children are more likely to show delirium after sevoflurane than are older children. Methods Sixty-three preschool boys aged 3-5 yr (classified as American Society of Anesthesiologists [ASA] physical status I), and 53 school-age boys aged 6-10 yr (ASA physical status I) who underwent minor urologic surgery were randomly assigned to receive either halothane or sevoflurane, thus creating four groups: preschool-halothane (n = 32), preschool-sevoflurane (n = 31), school-halothane (n = 27), and school-sevoflurane (n = 26). Anesthesia was induced by inhalation of halothane or sevoflurane in oxygen and was maintained at 1 minimum alveolar concentration of each agent throughout surgery. For intra- and postoperative analgesia, caudal block with 0.5-1.0 ml/kg 0.25% plain bupivacaine and topical infiltration with 3-5 ml 1% lidocaine were provided for all patients. Recovery characteristics and incidence of delirium on emergence were compared among the four groups. Results Two patients in the preschool-halothane group, one in the preschool-sevoflurane group, and one in the school-halothane group were excluded from the comparison because of insufficient analgesia or agitation before induction. In both age groups, the time to emergence from sevoflurane was significantly faster (about 3 min) than from halothane. The incidence of delirium during recovery in the preschool-sevoflurane group (40%) was significantly greater than that in the other groups (preschool-halothane, 10%; school-halothane, 15.4%; school-sevoflurane, 11.5%). Conclusion Sevoflurane provided quicker emergence and early recovery compared with halothane, but the incidence of delirium was greater in preschool boys after sevoflurane.

scholarly journals Role of adenosine deaminase and lymphocyte/neutrophil ratio in the diagnosis of tuberculous pleural effusion in patients with exudative pleural effusion

2017 ◽  
Vol 6 (1) ◽  
pp. 144
Author(s):  
Bijaya K. Behera ◽  
Sathish K. TN
Keyword(s):  
Pleural Effusion ◽  
P Value ◽  
Age Group ◽  
College Hospital ◽  
Tuberculous Pleural Effusion ◽  
Medical College ◽  
Combined Use ◽  
Medical Wards ◽  
Exudative Pleural Effusion

Background: Present study was conducted with an objective to evaluate the role of ADA and lymphocyte/neutrophil ratio in the diagnosis of tuberculous pleural effusion in patients with exudative pleural effusion and to analyze the cause of non-tuberculous exudative pleural effusion.Methods: This hospital based observational study was conducted from August 2011 to September 2013 with a total number of 120 patients of exudative pleural effusion who were admitted in medical wards of MKCG Medical College Hospital, Berhampur, Odisha, India. Patients with transudative pleural effusion, age less than 12years and those who were haemodynamically unstable were excluded from the study. Statistical analysis was done using standard statistical techniques.Results: A total number of 120 patients with exudative pleural effusion were analyzed. 83 patients were males and 37 patients were females. Maximum no of patients were seen in the age group of 21-40 years. Total ADA was found to be >40 U/L in all cases of TB effusion. All cases of TB effusion were lymphocyte predominant with L/N ratio > 0.75. In case of exudative pleural effusion due to non-tuberculous etiology L/N ratio was <0.75. P Value <0.0001 was considered extremely significant for L/N ratio for TB effusion.Conclusions: ADA value more than 100 U/L was observed only in patients of tuberculous effusion. L/N ratio was >0.75 in 97 patients of tuberculous effusion and none of the non-tuberculous effusion. Combined use of ADA and L/N ratio is more efficient means for diagnosing tuberculous pleural effusion than the use of ADA alone.

scholarly journals Prevalence of subclinical hypothyroidism in cases of cholelithiasis

2017 ◽  
Vol 5 (1) ◽  
pp. 34
Author(s):  
Brijendra Singh Raghuwanshi ◽  
Sandeep Jain ◽  
Mahendra Damor ◽  
Naveen Kumar Patbamniya
Keyword(s):  
Prospective Study ◽  
Subclinical Hypothyroidism ◽  
P Value ◽  
Age Group ◽  
Provisional Diagnosis ◽  
Abdominal Ultrasonography ◽  
Medical College ◽  
Gandhi Medical College ◽  
A Prospective Study ◽  
Multiple Stone

Background: This prospective study was carried out to analyse the prevalence of subclinical hypothyroidism in patients of gall stones.Methods: A prospective study was carried out in the Gandhi Medical College and associated Hamidia Hospital Bhopal from 2015 to 2016. Data was collected from patients who were admitted in surgical wards, with a provisional diagnosis of cholelithiasis. Patient was diagnosed cholelithiasis on abdominal ultrasonography and was tested for having subclinical hypothyroidism by testing fasting blood samples for serum TSH.Results: A total of 50 patients of cholelithiasis were included in present study. Females were 42 out of 50 (84%) and males were 8 out of 50 (16%). Most common age group was 41-50 (36%) correct (insignificant at p<0.05). 12 (24%) out 50 patients were hypothyroid. Out of total 42 females 11(26.19 %) were hypothyroid (insignificant at p<0.05). All stones in hypothyroidism patients were >1cm and overall 58% stones were >1cm (statically significant P<0.05). 03 out of 12 hypothyroidisms (25%) patient had single stones while 9 (75%) patient have multiple stone (statically significant P value <0.05). In hypothyroid cases most stones were of cholesterol type (58%) (Statically significant at P value≤0.05).Conclusions: Early diagnosis of hypothyroid state at subclinical level by monitoring TSH level so that they can be treated at early stages and burden of Cholelithiasis thus can be prevented.

scholarly journals A COMPARATIVE STUDY OF CAUDAL BUTORPHANOL AND FENTANYL FOR ALLEVIATING POST-OPERATIVE PAIN IN INFRAUMBILICAL PROCEDURES IN CHILDREN BELOW 3 YEARS OF AGE

2019 ◽  
Vol 12 (1) ◽  
pp. 336
Author(s):  
Mohammed Irfanulla ◽  
Thrivikram Shenoy ◽  
Ranjan Rk
Keyword(s):  
Analgesic Efficacy ◽  
Anesthetic Technique ◽  
Caudal Block ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B ◽  
Fentanyl Group ◽  
Caudal Blockade

Objective: Caudal block is a common regional anesthetic technique used in children. However, it is limited by relatively shorter duration of analgesia. The objective of this study was to compare the analgesic efficacy of caudal blockade using butorphanol (1) and fentanyl in children below 3 years, undergoing infraumbilical surgeries.Methods: Patients were randomly allocated to two groups of 30 each. Without premedication, patients were induced with thiopentone, relaxed with atracurium for facilitation of LMA insertion, and maintained on O2, N2O, and halothane. Caudal block was then performed using an aseptic technique. One group received caudal butorphanol (25 μg/kg) with 0.25% bupivacaine (0.1 ml/kg) and the other received fentanyl (1 μg/kg). Incision was allowed after 15 min of block. After the completion of surgery, LMA was removed and patients were shifted to the PACU. Non-invasive blood pressure and heart rate were recorded; pain was assessed using modified objective pain score (MOPS) (2) at 2, 4, 6, 12, and 24 h, postoperatively. Oral paracetamol was given at a score >4.Results: The mean duration of analgesia in Group F was 12.47 (standard deviation [SD] 8.216) and 19.67 (SD 7.009) in Group B (p: 0.001, HS). Mean MOPS was 4.6 in the fentanyl group as compared to 2.6 in the butorphanol group at the end of 24 h (p=0.001, HS). Thus, butorphanol provided longer duration of analgesia compared to fentanyl.Conclusion: Caudal additives are safe in children and butorphanol provides significantly longer duration of analgesia as compared to fentanyl, thus avoiding caudal catheterization and intravenous analgesics.

scholarly journals Comparative evaluation of caudal tramadol and fentanyl when mixed with bupivacaine in paediatric age group

2020 ◽  
Vol 8 (4) ◽  
pp. 1445
Author(s):  
Abhinav Tewari ◽  
Ajit Kumar Singh
Keyword(s):  
Postoperative Analgesia ◽  
Comparative Evaluation ◽  
Pediatric Patients ◽  
Analgesic Efficacy ◽  
Age Group ◽  
Caudal Block ◽  
Pain Scores ◽  
Haemodynamic Changes ◽  
Paediatric Age ◽  
The Mean

Background: A caudal block is commonly performed block for postoperative analgesia pediatric surgeries. Duration can be enhanced by addition drugs like fentanyl, tramadol, clonidine midazolam etc to local anesthetics helps in decreasing the requirement of postoperative analgesics. This study was conducted to assess the analgesic efficacy of tramadol or fentanyl when mixed with bupivacaine in pediatric patients for surgeries below the umbilicus.Methods: Fifty children of ASA I and ASA status, between 2 to 12 years of age, of both sexes underwent elective surgeries below umbilicus were selected and randomly divided into groups of 25 each. One Group, T (n = 25) received 0.75 ml/kg of 0.25% bupivacaine with tramadol 1mg/ kg and other Group F (n = 25) received 0.75 ml/kg of 0.25% bupivacaine with Inj fentanyl 1μg/kg. Assessment of analgesia and any side effects after caudal injection to the first administration of analgesia were recorded for both the groups in next 24 hours following objective pain scores. Duration of analgesia and requirement of additional rescue analgesics was noted.Results: The Mean duration of analgesia recorded longer in Group T (18.26±6.1 hours) as compared to Group F (10.0+/- 2.68 hrs.) and no significant haemodynamic changes or adverse effect noted between 2 groups.Conclusions: Addition of tramadol, 1mg/kg to bupivacaine 0.25% for caudal anesthesia in children undergoing surgeries below umbilicus, enhances and prolongs postoperative analgesia compared to caudal fentanyl 1μg/kg and bupivacaine 0.25% alone.

scholarly journals A COMPARATIVE STUDY OF CAUDAL BUTORPHANOL AND FENTANYL FOR ALLEVIATING POST-OPERATIVE PAIN IN INFRAUMBILICAL PROCEDURES IN CHILDREN BELOW 3 YEARS OF AGE

2019 ◽  
Vol 12 (1) ◽  
pp. 336
Author(s):  
Mohammed Irfanulla ◽  
Thrivikram Shenoy ◽  
Ranjan Rk
Keyword(s):  
Analgesic Efficacy ◽  
Anesthetic Technique ◽  
Caudal Block ◽  
Invasive Blood Pressure ◽  
Non Invasive ◽  
Post Operative Pain ◽  
The Mean ◽  
Group B ◽  
Fentanyl Group ◽  
Caudal Blockade

Objective: Caudal block is a common regional anesthetic technique used in children. However, it is limited by relatively shorter duration of analgesia. The objective of this study was to compare the analgesic efficacy of caudal blockade using butorphanol (1) and fentanyl in children below 3 years, undergoing infraumbilical surgeries.Methods: Patients were randomly allocated to two groups of 30 each. Without premedication, patients were induced with thiopentone, relaxed with atracurium for facilitation of LMA insertion, and maintained on O2, N2O, and halothane. Caudal block was then performed using an aseptic technique. One group received caudal butorphanol (25 μg/kg) with 0.25% bupivacaine (0.1 ml/kg) and the other received fentanyl (1 μg/kg). Incision was allowed after 15 min of block. After the completion of surgery, LMA was removed and patients were shifted to the PACU. Non-invasive blood pressure and heart rate were recorded; pain was assessed using modified objective pain score (MOPS) (2) at 2, 4, 6, 12, and 24 h, postoperatively. Oral paracetamol was given at a score >4.Results: The mean duration of analgesia in Group F was 12.47 (standard deviation [SD] 8.216) and 19.67 (SD 7.009) in Group B (p: 0.001, HS). Mean MOPS was 4.6 in the fentanyl group as compared to 2.6 in the butorphanol group at the end of 24 h (p=0.001, HS). Thus, butorphanol provided longer duration of analgesia compared to fentanyl.Conclusion: Caudal additives are safe in children and butorphanol provides significantly longer duration of analgesia as compared to fentanyl, thus avoiding caudal catheterization and intravenous analgesics.

scholarly journals Prevalence of hypothyroidism in reproductive age group in rural population of Haryana and its effects on menstrual disturbances

2021 ◽  
Vol 10 (2) ◽  
pp. 567
Author(s):  
Priyanka Yadav ◽  
Geetika Arora
Keyword(s):  
Thyroid Dysfunction ◽  
Management Plan ◽  
Reproductive Age ◽  
P Value ◽  
Age Group ◽  
College Hospital ◽  
Medical College ◽  
Menstrual Irregularities ◽  
Reproductive Age Group ◽  
Menstrual Disturbances

Background: Menstrual disorders are a common problem in reproductive age females. These disorders may cause significant anxiety for patients and their families. Thyroid dysfunction is one of the common cause of menstrual irregularities. Aim of the study was to determine the prevalence of hypothyroidism in reproductive age group women (15-45years), describe its various modes of clinical presentation and to assess the menstrual pattern in women with hypothyroidism.Methods: Prospective observational hospital based study during a period of 6 months (January 2020 to June 2020) on patients presenting in OPD in department of obstetrics and gynaecology, SGT medical college, hospital and research institute, Budhera, Gurgaon.Results: Prevalence of hypothyroidism was found to be 52.6% (190 out of total 338 patients) and it increased with increasing age group. 213 patients out of total came with complains of menstrual irregularities. 49.2% with normal menstrual cycle had hypothyroidism while 60.4% presenting with irregular heavy menstrual bleeding had hypothyroidism, p value being 0.019 which was statistically significant.Conclusions: Menstrual irregularities increase with severity of hypothyroidism. So screening for thyroid dysfunction should be included in management plan of menstrual disturbances.

Abstract 65: Use of Implantable Cardioverter-Defibrillators Among Older Patients Hospitalized with Heart Failure

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Paul L Hess ◽  
Maria Grau-Sepulveda ◽  
Adrian F Hernandez ◽  
Eric D Peterson ◽  
Deepak L Bhatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
P Value ◽  
Implantable Cardioverter Defibrillators ◽  
Age Group ◽  
To Receive ◽  
Cardioverter Defibrillators ◽  
Present On Admission

Background: Practice guidelines recommend the use of implantable cardioverter defibrillators (ICDs) in patients with heart failure (HF) and a left ventricular ejection fraction (LVEF) of ≤ 35% across all age groups in the absence of contraindications. The influence of age on ICD use among eligible patients, including sex differences, has not been fully explored. Methods: We performed an analysis of patients admitted with HF and a LVEF of ≤ 35% and discharged alive from 251 hospitals participating in the American Heart Association’s Get With The Guidelines-HF program between January 2005 and September 2011. Results: Among 35,772 eligible patients, 17,639 (49.3%) had ICDs at discharge (10,886 with ICDs present on admission, 4,876 with ICDs placed during the hospitalization, and 1,877 with referral for ICDs post discharge). Among those eligible, ICDs were used in 3,383 of 7,153 (47.3%) aged <55 years; 4,003 of 7,360 (54.4%) aged ≥ 55 to 64 years; 4,828 of 3,843 (55.7%) aged ≥ 65 to 74 years; 4,394 of 8,890 (49.4%) aged ≥ 75 to 84 years; and 1,031 of 3,698 (27.9%) aged ≥ 85 years. After adjustment for patient characteristics and hospital factors, the odds ratio (OR) of ICD use was 0.89 (95% confidence interval (CI), 0.87-0.91) for every 5-year increase in age. Compared with males in the same age group, females were statistically significantly less likely to receive an ICD; this disparity is more marked with increasing age (p-value for interaction=0.006). There was an overall temporal increase in ICD use (adjusted OR of ICD use per year=1.23, 95% CI 1.15-1.31), mainly driven by a rise in the proportion of ICDs present on admission. The temporal increase in ICD use was similar in each age group (p-value for interaction =0.67) ( Table ). Conclusions: After accounting for patient and hospital characteristics, eligible older patients were significantly less likely to receive an ICD. With increasing age, females were less likely to receive ICDs. Despite an overall increase in ICD use over time, age- and sex-related differences in ICD use persist.

scholarly journals Comparison of Efficacy of Nebulisation with Salbutamol versus Adrenaline in Acute Bronchiolitis in Children aged Two Months to Two Years

2019 ◽  
Vol 8 (1) ◽  
pp. 27-32
Author(s):  
Vijay Kumar Sah ◽  
Arun Giri ◽  
Sanjay Sah ◽  
Niraj Niraula
Keyword(s):  
Age Groups ◽  
College Teaching ◽  
Assessment Instrument ◽  
P Value ◽  
Age Group ◽  
Acute Bronchiolitis ◽  
Medical College ◽  
Group A ◽  
One Year ◽  
Group B

Background: Bronchiolitis is an acute, highly communicable lower respiratory tract infection. A variety of agents ranging from nebulised racemic epinephrine, salbutamol and routinely available levoepinephrine have been tried. The Present study was aimed at comparing the effectiveness of adrenaline and salbutamol in acute bronchiolitis in children aged 2 months to 2 years. Materials and Methods: The Present study was conducted at Nobel medical College Teaching Hospital over the period of one year from Feb 2018 to Jan 2019. Two different cohorts were identified in which clinically diagnosed cases and were grouped into Group A and Group B to receive the different drugs as per the study protocol. Respiratory Distress Assessment Instrument (RDAI) Scores was used for clinical assessment. Results: The age of the patients ranged from 2 months to 24 months with a median of 8 months. The males constituting about 57.42% of the study population of 155 patients. On comparing the prenebulisation variables with 10 and 30 minutes post nebulisation values, it was found that Both adrenaline and salbutamol caused overall significant improvement in RR (p-value <0.00001 in both groups) except in the age group of 19-24 months. Adrenaline was seen to be superior to salbutamol in decreasing the RR (p<0.0001) except for children in the age group of 19-24months. Adrenaline also caused greater rise in heart rate in comparison to salbutamol in all age groups. Conclusion: This study concludes that Adrenaline was seen to be superior to salbutamol in decreasing the RR and RDAI, although it showed variance with age.

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