scholarly journals Postoperative Regional Scalp Block versus Intravenous Fentanyl for Postsupratentorial Craniotomy Analgesia in Adult Patients under General Anesthesia

2020 ◽  
Vol 11 (4) ◽  
pp. 6039-6046
Author(s):  
Ahmed Beniamen Mohamed Hussien ◽  
Zaki Taha Saleh ◽  
Hala Abdel Sadek Al attar ◽  
Yasser Mohamed Nasr

Majority of patients undergoing experienced moderate to severe pain in surgical site after the procedure, and there is a reluctance to manage this pain with systemic that is understandable as it may impair neurological assessment, that is crucial in the postoperative period. In addition to that, evidence concerning alternative analgesia techniques to manage post pain is deficient. This research aims at evaluating the effect of postoperative regional scalp block (RSB) versus intravenous for analgesia in adult patients under general . Patients were automatically divided into two groups with 15 patients in each, Group B: postoperative RSB was done after the end of skin closure and before emergence from general , Group C: control group: in which standard analgesia was given in the form of intravenous with no block. This study included patients with brain were admitted to Zagazig University Hospitals. We gathered the cases in the time between March 2018 and March 2020. Results: the results displayed highly significant differences between RSB group and control group. Postoperative RSB showed advantages over standard analgesia in the point of more significant reduction of response to pain in the form of heart rate and blood pressure , decrease consumption, lower Visual Analogue Score(VAS), Postoperative RSB can be performed easily in a short time with very high success rate allowing better postoperative control of , less postoperative pain. We recommend using postoperative RSB in as a gold standard in our hospital to get the advantages as mentioned above.

2021 ◽  
Vol 45 (5) ◽  
pp. 312-316
Author(s):  
Mishra Neha Sanjeev ◽  
Harsimran Kaur ◽  
Sandeep Singh Mayall ◽  
Rishika ◽  
Ramakrishna Yeluri

Objective: To evaluate the effectiveness of placing a resorbable collagen barrier in impeding the extrusion of obturation material in primary molars undergoing resorption. Study design: All the 94 canals in 47 mandibular molars were allocated to 2 groups- Group ‘A’- 47 canals with collagen barrier (Test group) and Group ‘B’- 47 canals without collagen barrier (Control group) based on randomization protocol. Pulpectomy was performed and obturation of both test and control canals were radiographically assessed. Pearson’s chi – square test was applied to analyze the results. The significance level was predetermined at p < 0.05. Results: Among the test group, 93.6% of the canals showed no extrusion while, 6.4% showed visible extrusion of the material outside the apex. In the control group, 83% showed no extrusion whereas 17% of the canals showed visible extrusion outside the apex. But no significant difference was noted (p>0.05). Conclusion: The placement of resorbable collagen barrier in the apical third of the canal prevented the extrusion of obturating material beyond the apex in resorbing primary molars.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Dmytro Ivanov ◽  
Mariia Ivanova ◽  
Illia Burlachenko

Abstract Background and Aims Edaravone is a low-molecular-weight antioxidant drug targeting peroxyl radicals of reactive oxygen species and has shown clinical efficacy in patients with acute ischemic stroke. We have conducted a multicenter open prospective randomized controlled study to evaluate the efficacy of edaravone in preventing AKI in patients with CKD 3b-4 stages. Method The study included 2 groups of patients aged 46 to 68 (55 ± 3): group A (n=16) with CKD stage 3b or 4 (eGFR EPI 32 ± 4 ml/min) that received intravenous edaravone 30 mg bid on 0,1,2 day of contrast media infusion and control group B (n=20) with CKD stage 3b or 4 (eGFR EPI 33 ± 3 ml/min) with no edaravone intervention during CT coronarography. Patients of both groups received intravenous hydration with 0.9% sodium before CT. Primary endpoint: CIN onset in 48 hours after contrast media infusion and need for RRT. Secondary endpoint: serum potassium level above 5.5 mmol/l. Results CIN onset was obtained in 4 patients of group A and 12 patients of group B (p>0,05, RR 0.417, RRR 0.583, RD 0.350, NNT 2.857). Other results are presented in table


2019 ◽  
Vol 99 (4) ◽  
pp. 262-267 ◽  
Author(s):  
Shan-shan Bai ◽  
Dong Li ◽  
Liang Xu ◽  
Hui-chuan Duan ◽  
Jie Yuan ◽  
...  

Augmentation rhinoplasty is one of the most common plastic surgery procedures performed in Asia. Most Asian patients desire not only a natural-looking nose but also a nose with natural feel. Achieving such rhinoplasty outcomes with grafts has been a challenge for surgeons due to rigidity of grafting material. We propose a novel technique to address this limitation. A total of 200 healthy adult patients aged from 18 to 25 years were randomly chosen and classified into 5 groups: A, B, C, D, and control. Each group included 40 patients. The patients assigned to conventional grafting underwent rhinoplasty with L-shaped silicone prosthesis (group A) or expanded polytetrafluoroethylene (e-PTFE; group B), using traditional carving methods. The patients assigned to dynamic rhinoplasty underwent silicone (group C) or e-PTFE grafts (group D) using the modified double “V” method, which involves removing bilateral wedges from the graft to decrease rigidity. Patients in control group do not undergo the surgery. A 3-dimensional raster surface scanner was used to capture the images of the patients accurately and nasal mobility was measured. Subjective evaluations were carried out by a series of questionnaires asked to the patients. The angle α of nasal mobility was significantly lower in conventional grafting (23.09 [5.34] mm for silicone and 17.88 [4.96] mm for e-PTFE) versus the “V” carving (30.53 [3.76] mm for silicone and 23.77 [4.53] mm for e-PTFE; P < .05). The double “V” carving method is a simple, effective, and practical method for improving dynamic nasal outcomes in patient undergoing augmentation rhinoplasty.


2020 ◽  
Vol 12 (3) ◽  
pp. 407-412
Author(s):  
Junheng Bai ◽  
Tingyu Guo ◽  
Wenwen Dong ◽  
Yingming Song ◽  
Tingfang Guo ◽  
...  

To observe the clinical effect of nano-carbon adsorption of 5-fluorouracil (5-FU) on Breast cancer lymph node metastasis in New Zealand rabbits. A breast cancer animal model was established by local injection of a VX2 tumor tissue suspension in thirty New Zealand rabbits. An observation group, control group A, and control group B were established using a random number table, with ten rabbits in each group. Once tumors with a diameter ≥5 mm were identified in the lymph nodes, the animals received the intervention. The observation group had nano-carbon-5-FU suspension subcutaneously injected, control group A had 5-FU subcutaneously injected through the ear margin, and control group B had 5-FU subcutaneously injected; all received a drug dose of 30 mg · kg–1. Half of the animals in the three groups were killed following treatment for thirty minutes, while the rest of the animals were killed following treatment for seven days. Tumors and lymphatic metastases were removed. Tumor and lymphatic metastasis volume were compared. H&E stained sections were used to determine the ND of tumor cells. A dTUP TUNEL assay using Terminal Deoxynucleotidyl Transferase (TdT) was used to assess tumor cell apoptosis. The expression level of casapase-3 mRNA in tumors and lymphoid tissues was determined using RT-PCR. After treatment for 30 mins, the observation group exhibited a significantly higher 5-FU concentration in lymph node metastases, and significantly lower 5-FU concentrations in plasma and tumors. Nano-carbon can increase the 5-FU concentration in tumor tissue, as well as enhance the clinical effect of drugs on lymph node metastases.


Author(s):  
Branimir Radmanovic ◽  
Jovan Jovanovic ◽  
Natasa Djordjevic ◽  
Dejan Baskic ◽  
Jelena Cukic ◽  
...  

AbstractAssociation of SOD2 V16A single-nucleotide polymorphism (rs4880) with drug hepatotoxicity were reported but relationships with amiodarone prescriptions remained unexplored. Research was an exploratory, controlled prospective clinical trial. Patients hospitalized and treated in Clinical Center in Kragujevac, Serbia (in year 2017) were divided into experimental (using amiodarone, having liver injury, n=29, 19 males, the mean age 66.8±10.4 years), control A (neither amiodarone use nor hepatotoxicity, n=29, 19, 66.1±10.3) and control B group (using amiodarone, not having hepatotoxicity, n=29, 19, 66.8±9.8). From blood samples, among other routine biochemistry, genotyping for SOD2 polymorphism Val16Ala was conducted using real-time PCR method with TaqMan® Genotyping Master Mix and TaqMan® DME Genotyping Assay for rs4880. Patients taking amiodarone and having liver injury were mostly carriers of Val/Val (TT) genotype (13 of 24 patients, 54.2%) while Val/Ala (TC) and Ala/Ala (CC) genotypes prevailed in control group A (19 of 40, 47.5%) and control group B (9 of 23, 39.1%), respectively (2=10.409, p=0.034). Frequency of Val (T) and Ala (C) alleles were 0.51 and 0.49, respectively in the whole study sample (Hardy Weinberg equilibrium, 2=0.56, p=0.454). Carriers of TT genotype had significantly higher ALT (437.0±1158.0 vs 81.9131.5 U/L), total bilirubin (28.320.5 vs 15.313.0 mol/L) and total bile acid concentrations (10.910.2 vs 6.45.3 mol/L) compared to carriers of TC genotype (U=2.331, p=0.020, U=3.204, p=0.001 and U=2.172, p=0.030, respectively). Higher incidence of 47T allele of SOD2 was inpatients with amiodarone-associated liver injury as compared to patients on amiodarone not experiencing hepatotoxic effects.


2020 ◽  
Vol 5 (1) ◽  
pp. e08-e08
Author(s):  
Gholam Reza Masoomi ◽  
Zeinab Rastegar Chupani ◽  
Hazhir Heidari Beigvand ◽  
Mahdi Rezai ◽  
Shahin Dokht Hasan Pour

Introduction: The prevalence of multiple symptoms, including mental illness, symptoms that mimic diseases such as pancreatitis, nonspecific abdominal pain and cholecystitis, are high in drug-dependent patients. Objectives: The aim of this study was to consider the clinical signs and serum lead levels of individuals referred to four university hospitals with various complaints. Patients and Methods: In this study, 128 sample cases in two groups, the case group and control group, have been examined. The case group included 64 persons using oral opium who were suffering from various complaints and referred to emergency department of mentioned hospitals. The control group included 64 patients without any history of addiction. Results: Mean of blood serum lead level in opium users and control group was 76.34±17.82 mg/dL and 7.68±3.72 mg/dL respectively, and the difference between these groups was significantly meaningful (P<0.001). The most prevalent complaints were abdominal pain and pulmonary complaints. Conclusion: Findings of the current study showed high levels for an average serum lead level for oral opium addicts among the studied statistical population. In addition, results show that ultimate diagnosis of lead poisoning is a factor justifying symptoms for addicts with nonspecific symptoms, the subject that confirms several previous reports. This finding asserts the necessity of screening of serum lead level for patients addicted to opium compounds in order to prevent more severe side effects.


Author(s):  
Reem M. Soliman ◽  
Mohamed B. Hamza ◽  
Rasha M. El-Shafiey ◽  
Hesham A. Elserogy ◽  
Nabil M El-Esawy

Background: There are few biomarkers that can be easily accessed in clinical settings and may reflect refractory Th2-eosinophlic inflammation and remodeling of the asthmatic airways. Serum periostin may be one such biomarker to aid our understanding of the patho-bio-physiology of asthma and exercise induced asthma. The aim of the study is to explore the relationship between serum periostin level and exercise induced bronchoconstriction in asthmatic children. Materials and Methods: This cross-sectional study was carried out on (90) children both sexes aged from 6 to 15 years including, (60) children with bronchial asthma and (30) children were enrolled as control group in the period from January 2018 to January 2019. Patients were randomly classified into two groups: I) Patient group: divided into 2 groups according to standardized treadmill exercise challenge test: Group A: (30) asthmatic children with positive test. Group B: (30) asthmatic children with negative test. II-Control group: (30) children apparently healthy with no personal or family history of asthma. All children were subjected to the following Investigations: Chest x-ray, pulmonary functions tests (FEV1 & PEFR) except controls, Laboratory investigations as CBC and Serum periostin level. Results: The mean values of both the percentage of PEFR and FEV1 after exercise in group A were significantly lower than those in group B and the percentage of PEFR and FEV1 after exercise in each group were significantly lower than the percentage before exercise in the same group. The mean value of eosinophilic count in group A was significantly higher than (group B and control group) and the mean value of eosinophilic count in group B was significantly higher than control group. The mean value of serum level of periostin in group A was significantly higher than (group B and control group), however, there was no significant difference between group B and control group as regard to serum level of periostin. Chest tightness, cough and wheezes after exercise and eosinophilic count in patients with high serum periostin level were significantly higher than patients with low serum periostin level, and both PEFR and FEV1 after exercise in patients with high serum periostin level were significantly lower than patients with low serum periostin level. Also the normal serum periostin levels vary among different age groups. Conclusion: Serum periostin level can be considered as a useful biomarker for diagnosis of Exercise induced bronchospasm (EIB) in asthmatic children especially when lung function test cannot be done However, cautious is required in evaluating serum periostin levels in children because it varies with age.


2017 ◽  
Vol 14 (1) ◽  
pp. 157-166
Author(s):  
Baghdad Science Journal

The aim of the present study is to highlight the role of total cholesterol (TC), triacylglycerol (TG), Glycated hemoglobin A1c and iron in Iraqi women with multiple sclerosis and also to examine the biochemical action of copaxone (which is the most widely used in the 21st century to treat multiple sclerosis) on these biochemical parameters. This is the first study in Iraq which deals copaxone action on TC , TG , HbA1c and iron. Ninety women in their fourth decade suffering from multiple sclerosis were enrolled in this study. They were divided into: the first (group B) composed of (30) women without any treatment related to multiple sclerosis or any treatment linked with chronic or inflammatory diseases. The second (group A1) included (30) women under treatment with copaxone for 1 year, whereas the third group (group A2) involved (30) women under treatment with copaxone for 2 years. Patients groups were compared with a healthy control group (group C) composed of (30) healthy women, TC, TG, HbA1c and iron levels were determined in the sera of patients and control groups. Results of the present study has revealed that TC was high significantly increasing in the sera of group B (250.68±9.76) mg/dl compared with group C (175.36±8.81) mg/dl, while it was high significantly decreasing in the sera of groups A1 (211.88±5.90) mg/dl and A2 (212.12±5.60) mg/dL compared with group B (250.68±9.76) mg/dl. Beside, a non-significant difference was suggested between groups A1 (211.88±5.90) mg/dl and A2 (212.12±5.60) mg/dl. The present study also reported that TG was high significantly increasing in group B (224.84±10.76) mg / dl compared with group C (131.36±7.53) mg/dL whereas a significant decrease was shown in group A1(142.48±4.63) mg/dl and group A2 (195±4.20) mg/dl compared with group B (224.84±10.76) mg / dl. Surprisingly, a highly significant increase was reported in group A2 (195±4.20) mg/dl compared with group A1(142.48±4.63) mg/dl. The present study also suggested that HbA1c level was high significantly increasing in the sera of group B (6.53±0.57) mg/dl compared with group C (4.99±0.07) mg/dl. Oppositely, it was high significantly decreasing in the sera of groups A1 (4.72±0.42) mg/dl and A2 (4.53±0.35) mg/dl compared with group B (6.53±0.57) mg/dl. Futhermore, a non-significant difference was noted between groups A1 (4.72±0.42) mg/dl and A2 (4.53±0.35) mg/dl. This study also reported that iron level was high significantly decreasing in the sera of group B (37.31±4.24) µg / dl compared with group C (98.23±9.21) µg/ dl, whereas it was significantly increasing in the sera of groups A1 (44.05±6.32) µg/dl and A2 (45.31±6.82) µg/dl compared with group B (37.31±4.24) µg/dl . A non significant difference was shown between groups A1 (44.05±6.32) µg / dl and A2 (45.31±6.82) µg / dl.


2021 ◽  
Vol 71 (3) ◽  
pp. 976-79
Author(s):  
Qamar Zia ◽  
Nighat Arif ◽  
Tahira Sadiq

Objective: To determine the effect of paired formative assessment on students’ learning. Study Design: Quasi experimental study. Place and Duration of Study: Islamic International Medical College Rawalpindi, from Jan 2018 to Jun 2018. Methodology: A total of 160 students who attended otolaryngology module were included in the study. Randomized allocation was done by computerized software programme and students were divided into 2 groups i.e. experimental (group A) and control group (group B). Later on in group A, pairing of students was done by lottery method. Group A and B were dealt with paired and individual formative assessment respectively. Effectiveness of both methods of learning was calculated on the basis of academic scores obtained in tests consisting of 20 MCQs from predefined and taught syllabus. A p-value were obtained by applying independent sample t-test and considered statistically significant at 0.05. Results: Out of 160 participants, 94 (58.7%) were females and 66 (41.3%) were males. In individual testing phase mean scores of group A was 13.36 ± 2.22 and mean scores of group B was 13.24 ± 2.5 (p 0.861). In paired formative assessment phase, mean scores of group A was 16.70 ± 1.94 (CI 95% 2.16-4.55) and mean of scores of group B was 13.40 ± 2.23 (CI 95% 2.16-4.55) p=0.001. Conclusion: The effectiveness of paired formative assessment. This method provides students a conducive environment to achieve learning objectives.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Haruto Uchino ◽  
Naoki Nakayama ◽  
Ken Kazumata ◽  
Kiyohiro Houkin

Background and Purpose: Postoperative hyperperfusion-related transient neurological deficits (TNDs) are frequently observed in adult patients with moyamoya disease (MMD) who undergo direct bypass procedures. The present study evaluated the effect of the free radical scavenger edaravone on postoperative hyperperfusion in adult MMD. Methods: This study included 92 hemispheres in 72 adult patients who underwent direct bypass for MMD. Serial measurements of cerebral blood flow were conducted immediately after surgery and on postoperative days 2 and 7. In 40 hemispheres in 36 patients, edaravone (60 mg/day) was administered from the day of surgery until postsurgical day 7. The incidence of postoperative hyperperfusion and associated TNDs were compared with a control group that included 52 hemispheres in 36 patients. Results: Radiological hyperperfusion was observed in 28/40 (70.0%) and 39/52 (75.0%) hemispheres in the edaravone and control groups, respectively (P = 0.30). Hyperperfusion-related TNDs incidences were significantly lower in the edaravone group compared with the control group (12.5% vs. 32.7%, P = 0.024). Multivariate analysis demonstrated that edaravone administration (P = 0.009) and left-sided surgery (P = 0.037) were significantly correlated with hyperperfusion-related TNDs (odds ratios, 0.3 and 4.2, respectively). Conclusions: Perioperative administration of edaravone reduced the incidence of hyperperfusion-related TNDs after direct bypass procedures in adult patients with MMD.


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