scholarly journals Yasser’s Maneuver for Regaining the Consciousness in the Psychogenic Coma; A Novel Maneuver in Emergency Medicine and Psychiatry

2021 ◽  
Vol 3 (5) ◽  
pp. 01-10
Author(s):  
Yasser Mohammed Hassanain Elsayed
Keyword(s):  
Clinical Medicine ◽  
Statistical Significance ◽  
P Value ◽  
Central Hospital ◽  
Hyperventilation Syndrome ◽  
Time Saving ◽  
Medical Practitioners ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Introduction: Psychogenic coma, generally is one of the most anxious and irritant problems in clinical medicine for all medical practitioners. Using recurrent painful or mischievous stimuli is contraindicated in a psychogenic coma. Method of study and patients: My study was technical, prospective, observational, and interventional for 321 cases. The study was conducted in a physician outpatient clinic, Fraskour Central Hospital, and Ras-Al-bar Central Hospital. The author reported the 321 cases of psychogenic coma over nearly 5 years and 7-months, started from August 07, 2015, and, ended on March 07, 2021. Three selective groups were included in the study. Three groups were selected and evaluated for safety or complications and efficacy or responses. Suggesting hypothesis: Yasser’s maneuver can regaining the consciousness in a psychogenic coma. The research objectives to evaluate this hypothesis might include: What is psychogenic coma? What is Yasser’s maneuver? How can Yasser’s maneuver do improvement of psychogenic coma? Is the study supported by past publicized literature studies? Results: The range of age in the study was 16-55 years with an insignificant P-value (0.231). There is a female sex predominance for all groups (67%). The response for the group I was: (97.35%)) vs. (85.85%)) in group II, and (81.37%) in group III. The most common associated risk factor was psychogenic hyperventilation syndrome (HVS); in the group, I was 79.6%, in group II was 78.4%, and in group III was 96.2±1.7 with no statistical significance (P-value 0.74). Conclusions: The author concluded thatYasser’s maneuver is easy, available, quick, non-costive, time-saving, and extremely safe in the psychogenic coma. Very few and mild few mild complications for this maneuver encourage the generalizing use in the psychogenic coma.

scholarly journals The prognostic role of inflammatory markers in COVID 19 patients – A retrospective analysis.

2021 ◽  
Author(s):  
Shivkumar Gopalakrishnan ◽  
sangeetha kandasamy ◽  
S.Malini ◽  
S.Peer Mohamed ◽  
k.velmurugan
Keyword(s):  
Inflammatory Markers ◽  
Severe Disease ◽  
Radiation Hazard ◽  
P Value ◽  
Binary Logistic Regression Analysis ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
D Dimer

Abstract Background. Approximately 5% of COVID-19 patients suffer near fatal disease. Clinical and radiologic features may predict severe disease albeit with limited specificity and radiation hazard. Laboratory biomarkers are eyed as simple, specific and point of care triage tools to optimize management decisions.This study aimed to study the role of inflammatory markers in prognosticating COVID-19 patients.Methodology. A hospital based retrospective study was conducted on COVID-19 adult inpatients classified into three groups as mild disease-recovered [Group I], severe disease-recovered [Group II] and dead [Group III]. Categorical outcomes were compared using Chi square test. Univariate binary logistic regression analysis was performed to test the association between the explanatory and outcome variables. Unadjusted OR along with 95% CI was calculated. The utility of lab parameters (Ferritin, LDH, D dimer, N/L ratio and PLT/L ratio) in predicting severity of COVID-19 was assessed by Receiver Operative Curve (ROC) analysis. P value < 0.05 was considered statistically significant.Results. The mean age was 49.32 +/- 17.1 years. Among study population, 378 were Group I, 66 Group II, and 56 Group III. Median levels of Ferritin among the 3 groups were 62ng/mL, 388.50 ng/mL and 1199.50 ng/mL. Median value of LDH were 95U/L, 720 and 982.50(p <0.001). D-dimer values of 3 groups were 23.20ng/mL, 104.30 ng/mL and 197.10 ng/mL (p <0.001). CRP done qualitatively was positive in 2 (0.53%), 30 (45.45%) and 53 (94.64%) of patients. The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH and D-dimer [unadjusted OR 1.007, 1.004 &1.020]Conclusion. One time measurement of serum ferritin, LDH, D-dimer and CRP is promising to predict outcomes for COVID 19 inpatients. Single qualitative CRP was equally good but more cost effective than quantitative CRP. The most specific combination was NLR, Lymphocyte percentage and D-dimer levels done between 7th – 10th day of symptoms.

scholarly journals A COMPARATIVE STUDY OF EFFICACY AND SAFETY AMONG METFORMIN WITH SITAGLIPTIN, METFORMIN WITH VOGLIBOSE, AND METFORMIN WITH GLIMEPIRIDE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2017 ◽  
Vol 10 (12) ◽  
pp. 313
Author(s):  
Kala P ◽  
Jamuna Rani R ◽  
Kumar Js
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Plasma Glucose ◽  
P Value ◽  
Efficacy And Safety ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Objective: Type 2 diabetes mellitus (DM) is a most common metabolic disorder. The present study aimed to compare the efficacy and safety among metformin with sitagliptin, metformin with voglibose, and metformin with glimepiride in patients with type 2 DM. Methods: This study was a prospective, randomized clinical trial study, conducted in patients attending the diabetology outpatient department of SRM Medical College Hospital and Research Center, Potheri, Kancheepuram, Tamil Nadu, from January 2013 to January 2014. The patients were randomized into three groups with 40 patients in each group. Fasting plasma glucose (FPG), 2 hrs postprandial plasma glucose (PPG), and hemoglobin A1c (HbA1c) level were assessed in all the patients before starting the treatment. In Group I, patients were prescribed metformin 500 mg with sitagliptin 50 mg, in Group II, patients were given metformin 500 mg with voglibose 0.2 mg, and in Group III, patients were put on metformin 500 mg with glimepiride 1 mg in the fixed combination. The outcome of the therapy was based on the level of improvement in the blood parameters. Results: There was a significant reduction of FPG level seen in all three groups (p value - Group I <0.0001, Group II < 0.005, and Group III <0.0001). Group I and III showed significant reduction of PPG with p value <0.0001. There was a significant reduction of HbA1c seen in all the three groups (p<0.0001). Conclusion: From the results of this study, it could be concluded that all the three groups were comparable in their efficacy.

scholarly journals IMPACT OF DIFFERENT ORAL HYGIENE AIDS FOR THE REDUCTION OF MORNING BAD BREATH AMONG DENTAL STUDENTS: A CROSSOVER CLINICAL TRIAL

2016 ◽  
Vol 89 (4) ◽  
pp. 525-533
Author(s):  
Shaijal Godha ◽  
Pralhad L Dasar ◽  
Sandesh N ◽  
Prashant Mishra ◽  
Sandeep Kumar ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Dental Students ◽  
Group Iv ◽  
Tooth Brushing ◽  
P Value ◽  
Plaque Score ◽  
Group Iii ◽  
Group I ◽  
Bad Breath ◽  
Group Ii

Background and aim. To assess and compare the effects of different oral hygiene procedures on the reduction of morning bad breath, plaque and gingival status in healthy subjectsMethods. A four step cross-over trial was performed on 32 study subjects. They were allocated into four groups: Group I: tooth brushing; Group II: tooth brushing and tongue scraping; Group III: tooth brushing and mouth washing; and Group IV: tooth brushing, tongue scraping and use of mouthwash. A washout interval of 7 days was employed. At the beginning and at the end of all intervention periods, breath score was measured by hand held sulfide monitor (Breath Alert) at four time intervals. The Plaque and Gingival status was evaluated using Plaque and Gingival Index.Results. The highest reduction in mean breath score (2.12±0.65), plaque score (0.75±0.47) and gingival score (0.67±0.41) were found in the Group IV followed by Group II and Group III. A significant positive correlation was observed between plaque scores and gingival scores before intervention (r=0.443; p value<0.001) and after intervention (r=0.846; p value<0.001).Conclusion. The study findings suggest that mechanical aids in conjunction with chemical regimens are considered as the most effective method for reducing the morning bad breath in healthy subjects and should be incorporated in daily oral hygiene practices.

scholarly journals Role of Apo B and Apo A1 Levels in Relation to Conventional Lipid Profile in Patients of Ischaemic Heart Disease with or without Type II Diabetes Mellitus

2021 ◽  
Author(s):  
Hardik N Javia ◽  
Milav H Bhavsar ◽  
Bhavesh R Sadariya ◽  
Amitkumar V Maheshwari ◽  
Hariom Sharma
Keyword(s):  
Diabetes Mellitus ◽  
Lipid Profile ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
P Value ◽  
Type Ii ◽  
Apo B ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Introduction: Ischaemic Heart Disease (IHD) or Coronary Artery Disease (CAD) is the most prevalent chronic disease and the main leading cause of death in the world, with more than half a million newly diagnosed IHD patients each year. Central to this are disorders of lipoprotein metabolism. Apolipoprotein B (Apo B) and Apolipoprotein A1 (Apo A1) are structural and functional components of lipoprotein particles that serve as transporters of cholesterol. Apo B and Apo A1 are among the emerging markers for Cardiovascular Diseases (CVD). Routine conventional lipid profile does not incorporate these markers. Aim: To determine the level of Apo A1 and Apo B in patients of IHD with or without Type II Diabetes Mellitus (T2DM) and analyse the significance of these parameters over the conventional lipid profile. Materials and Methods: The case-control study was conducted at Government Medical College, Bhavnagar, Gujarat, India from July 2013 to December 2013. The study consists of 100 participants including 50 having IHD only (Group I), 50 having IHD with T2DM (Group II) as study groups and 50 healthy individuals (Group III) as control. Various biochemical parameters including Apo B and Apo A1 were analysed and statistically evaluated to come to conclusion. Results: The demographic details of the participants which shows no significant different in age and gender among groups I, II and III. Apo B and A1 were elevated in group I and II and were found highly significant (p-value <0.0001) as compared to the group III. There was positive correlation of serum Apo B levels with total cholesterol (r=0.495, p-value <0.0001), Low-Density Lipoproteins (LDL-C) (r=0.526, p-value <0.0001) and Apo A1 (r=0.685, p-value <0.0001) in group I and LDL-C (r=0.468, p-value=0.001) and Apo A1 (r=0.754, p-value <0.0001) in group II. Similarly, Apo A1 levels were positively correlated with Apo B (r=0.685, p<0.0001) in group I and LDL-C (r=0.305, p-value=0.031) and Apo B (r=0.754, p-value <0.0001) in group II. Conclusion: As the Apo B and Apo A1 cover both atherogenic and antiatherogenic lipid parameters respectively, it can be used as a better predictor of development of IHD with and without T2DM in comparison to conventional parameters of lipid profile.

scholarly journals Tympanic membrane perforation: correlation of hearing loss with its site and size

2018 ◽  
Vol 4 (2) ◽  
pp. 397 ◽  
Author(s):  
Arvinder Singh Sood ◽  
Pooja Pal ◽  
Amit Kumar
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Linear Correlation ◽  
Tympanic Membrane Perforation ◽  
P Value ◽  
Cross Sectional ◽  
Group Iii ◽  
Group I ◽  
Membrane Perforation ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> The objectives of the study were <span lang="EN-IN">correlation of hearing loss with size and site of tympanic membrane perforation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A cross-sectional prospective study of 100 patients of both sex and age between 11-60 years with perforated tympanic membrane was conducted in the department of Otorhinolaryngology (ENT). Size and site of TM perforation was assessed using otoscope and otomicroscope. Size of perforation was measured with 1 mm thin wire loop and vernier caliper. Patients were divided into three groups according to size; Group I (0-9 mm), Group II (9-30 mm), Group III (&gt;30 mm). The tympanic membrane was divided into five segments anterosuperior, posterosuperior, anteroinferior, posteroinferior and central for the localization of the site of perforation. Data thus collected was statistically analysed.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Patients with Group I perforation had an average hearing loss of 31.42±7.15 decibel. Group II had an average hearing loss of 39.42±8.97 decibel. Group III had an average hearing loss of 48.91±7.38 decibel. Maximum hearing loss was noted in patients with central perforation with an average hearing loss of 39.34±9.47 decibel. Average hearing loss was found higher in posterior perforations than anterior quadrant perforations. This difference was however not statistically significant with ‘p’ value of ‘0.689’. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Linear correlation was found between size of tympanic membrane perforation and degree of hearing loss. No linear correlation between site of tympanic membrane perforation and hearing loss was found. We found no correlation between duration of disease and size of tympanic membrane perforation with degree of hearing loss.</span></p>

scholarly journals Nephro protection property of double blockade versus single blocked of RAAS in delaying the progression of CKD

2018 ◽  
Vol 5 (3) ◽  
pp. 748
Author(s):  
Arvind Gupta ◽  
Upma Narain ◽  
Romar Dabu
Keyword(s):  
Blood Pressure ◽  
Phase Iii ◽  
P Value ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Group Iii ◽  
Arterial Blood ◽  
Group I ◽  
Group Ii ◽  
Protection Property

Background: Dual renin angiotensin aldosterone system blockade using angiotensin receptor blockers in combination with angiotensin converting enzyme inhibitors is reported to improve proteinuria in non-diabetic patients.Methods: A prospective observational study was done on 810 non-diabetic chronic kidney disease patients during July 2012 to August 2014 to compare the nephro protection property of double blockade and single blocked of renin angiotensin aldosterone system in delaying the progression of chronic kidney disease.Results: At the end of 24 months urinary protein excretion rate of group I and group III were compared by using student t-test and p value (0.0001) was found significant. Similarly, on comparing group II and group III, p value (0.003) was again significant. Mean arterial blood pressure of group I and group III were statistically significant (<0.0496) while comparing group II and group III, p value (0.0419) was again significant.Conclusions: The study concludes that the use of double renin angiotensin aldosterone system blockade therapy is more effective than monotherapy at reducing albuminuria and proteinuiria, and in decreasing blood pressure at the same time not causing significant deterioration in glomerular filtration rate. Newer potassium lowering therapies can effectively and safely correct hyperkalemia and maintain normokalemia in patients receiving background treatment with renin angiotensin aldosterone system blockade. However, the use of new potassium binders for cardiovascular and renal risk reduction with combined renin angiotensin aldosterone system blockade therapy will require phase III trials.

scholarly journals Clinical outcome of right ventricle outflow tract management for repair of Tetralogy of Fallot with three contemporary surgical strategies

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Tariq Waqar ◽  
M. Zubair Ahmed Ansari ◽  
Kamran Khan
Keyword(s):  
Mechanical Ventilation ◽  
Operative Mortality ◽  
Pulmonary Valve ◽  
P Value ◽  
Chi Square ◽  
Surgical Strategies ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Post Hoc

Objective: To compare the early operative outcome of TOF repair with three contemporary repair strategies of RVOTO repair i.e. TAP, Mono-cusp construction (MC) in TAP and pulmonary valve repair. Methods: Study is performed at Punjab Institute of Cardiology, Lahore from May 2016 to April 2020. Retrospective analysis of data was performed for patient who underwent TOF repair by three different strategies of RVOT repairs during TOF surgery based on z scoring for pulmonary valve annulus. Group-I underwent trans-annular patch repair, while Group-II and III underwent Mono-cusp repair with autologous pericardium and pulmonary valve repair respectively. Analysis of Variance (ANOVA) and Pearson Chi-Square (PCS) statistics were used to compare the three groups for numeric and categorical variables respectively. Post-hoc t-test and Bonferroni correction were performed for numeric data to compare two groups with each other. Chi-square test was used to perform comparison between groups for categorial variables. Results: ANOVA for aortic cross clamp time, total CPB time, Post-operative mechanical ventilation time, ICU stay and hospital stay showed statistical difference among all three group with p-value less than 0.05 however post hoc T-test showed this variation is limited to post-operative mechanical ventilation only when groups compared with each other. PCS showed there was difference for incidence of difficult weaning from CPB when all three groups compared while there was no difference in operative mortality with p-value of 0.15. However, Group-II comparison with Group-I showed that weaning from CPB was superior in-Group-II with p-value of 0.016. Group-III showed the best statistics for all operative outcome variables among all three groups. Comparison of incidence of post-operative moderate pulmonary regurgitation before discharge between Group-II and Group-III showed significant difference with p-value of 0.0052. Conclusion: PV repair strategy should be employed for RVOT repair of TOF whenever feasible. MC repair showed fewer hours of postoperative mechanical ventilation and higher incidence of easy weaning from CPB when compared to TAP, however its impacts over ICU stay, Hospital stay and operative mortality is not profound in our TOF repair population. doi: https://doi.org/10.12669/pjms.37.5.3961 How to cite this:Waqar T, Ansari MZA, Khan K. Clinical outcome of right ventricle outflow tract management for repair of Tetralogy of Fallot with three contemporary surgical strategies. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3961 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals A Retrospective Study on Importance of CRP as a Predictor and To Analyse the Effectiveness of Antibiotics in the Treatment of Neonatal Sepsis at Secondary Care Hospital of Tiruppur

2018 ◽  
Vol 10 (01) ◽  
Author(s):  
Nandhakumar Jothivel ◽  
Sabitha V. P. ◽  
Sharon Jacob ◽  
S. Sonapreethi ◽  
Teres Siby ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Neonatal Sepsis ◽  
Empirical Therapy ◽  
P Value ◽  
Care Hospital ◽  
Chi Square ◽  
Group V ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Early diagnosis of sepsis in a neonate is often difficult because symptoms and signs are usually non-specific. A study was conducted to evaluate C-reactive protein (CRP) as a screening tool and the effectiveness of antibiotics in the treatment of neonatal sepsis. This retrospective study was conducted at NICU, Government District Headquarters Hospital, Tiruppur from December 2016 to June 2017, on total of 120 neonatal sepsis patients. Patients of Group I received Ampicillin + Gentamicin, Group II received Ampicillin + Gentamicin followed by Cefotaxime + Amikacin, Group III received Cefotaxime + Amikacin, Group IV received Ampicillin + Gentamicin followed by Piptaz followed by Amikacin + Ciprofloxacin and Group V received, Ampicillin + Gentamicin followed by Piptaz then by Amikacin + Meropenem and then by Ciprofloxacin. Chi-square test two side p-value and ONE WAY ANOVA followed by Tukey-Krammer Multiple Comparison Test is used for statistical analysis. Among study subjects, 18 (15%) and 102 (85%) had negative and positive CRP respectively. According to blood culture studies, 15 cases were culture positive, with the following organisms, Klebsiella pneumoniae (53.33%), Escherichia coli (20%), Staphylococcus aureus (20%) and Proteus marbilis (6.66%). Group II is an appropriate choice for empirical therapy of neonatal sepsis and was 46.96% of 66 patients. Group I, which is considered as First Line treatment was 33.33% of 66 patients.

scholarly journals Protective Effect of Morus Nigra Leaf Extract on Diazinon-Induced Hepatotoxicity in Rats

2020 ◽  
Vol 9 (3) ◽  
pp. 175-181
Author(s):  
Hina Majid ◽  
Salman Shahid ◽  
Sadia Shakeel ◽  
Mariam Ashraf ◽  
Muhammad Yasoob Ali ◽  
...  
Keyword(s):  
Leaf Extract ◽  
Hepatic Tissue ◽  
Medical Institute ◽  
Control Group ◽  
P Value ◽  
Central Vein ◽  
Group Iii ◽  
Morus Nigra ◽  
Group I ◽  
Group Ii

Background: Diazinon is a globally used pesticide. Morus nigra (Black Mulberry) possesses flavonoids and phenols, which act as antioxidants. The objective of this study was to determine the possible protective effects of Morus nigra leaf extract on Diazinon-induced hepatotoxicity in rats. Material and Method: It was an experimental study conducted in the Department of Anatomy, Postgraduate Medical Institute, Lahore. A total of 36 healthy male Wistar albino rats were divided into three groups with 12 rats in each group. Group I was the control group. Group II was treated with 60 mg/kg body weight (bw) Diazinon daily for 4 weeks through orogastric intubation. Group III was treated with Diazinon 60 mg/kg bw daily along with 350 mg/kg bw of Morus nigra extract daily for 4 weeks through orogastric intubation. Blood samples were collected through cardiac puncture, for estimation of alanine transaminase (ALT) and aspartate transaminase (AST) levels. Liver dissection was done, slides of the hepatic tissue were prepared and studied under light microscope. The histology of hepatocytes, portal lobule, portal vein and sinuosoids was observed. SPSS 20 was used for data analysis. One-way ANOVA followed by Tukey’s test was applied to establish difference among groups with P-value ≤0.05 considered as statistically significant. Results: Histology of Liver tissue in group I showed normal morphology while group II revealed hypertrophy and vacuolization of hepatocytes, congested central vein and sinusoids and presence of necrotic foci. These toxic effects were reversed by the co-administration of Diazinon with Morus nigra in group III which showed normal histology of the hepatic tissue. Similarly, Diazinon administration resulted in significant elevation of ALT and AST levels (P-value<0.05), while, Morus nigra resulted in a considerable decline in the levels of these enzymes (P-value <0.05). Conclusion: Morus nigra extract has hepatoprotective effects against liver toxicity induced by Diazinon.

scholarly journals Study on Efficacy of Nalbuphine Hydrochloride as Pre-Emptive Analgesic – Comparison With Diclofenac Sodium after Open Cholecystectomy

2009 ◽  
Vol 20 (2) ◽  
pp. 39-44
Author(s):  
Md Quamrul Islam ◽  
Hasina Begum ◽  
AKM Akhtaruzzaman ◽  
UH Shahera Khatun
Keyword(s):  
Muscle Relaxation ◽  
Open Cholecystectomy ◽  
Diclofenac Sodium ◽  
Randomized Study ◽  
Afferent Input ◽  
P Value ◽  
Group Iii ◽  
Central Processing ◽  
Group I ◽  
Group Ii

Preemptive analgesia is an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The aim of this study was to evaluate the effects of preemptively used nalbuphine and diclofenac on postoperative pain and opioid consumption. Seventy five patients scheduled for open cholecystectomy were investigated by randomized study. Patients were divided into three groups. In group I, patients received Inj. Nalbuphine Hydrochloride (0.3 mg/kg bw IV) before induction. In group II, patients received Inj. Diclofenac Sodium (1 mg/kg bw IV) before induction and in group III patients received placebo before induction. General Anesthesia was given in all groups with Inj. Thiopental sodium 5mg/kg and Inj. Succninylcholine 1.5mg/kg to facilitate endotracheal intubation. Anesthesia was maintained with halothane 0.5% and nitrous oxide 66% in oxygen. Muscle relaxation was maintained by Inj.Vecuronium 0.1 mg/kg. Intraoperative proper hydration was maintained by lactate ringer's solution.In post operative period patients in all three groups received Inj. Pethidine 10mg IV till the patients got relieved from pain. The minimum interval of giving pethidine was 10 minutes. Through our study we have found that, pethidine consumption in 24 hours in group-I (Nalbuphine group) was 54.00±1.0, in group-II (Diclofenac group) was 74.00±1.0 and in group-III (Placebo group) was 112.0±2.0 and p-value <0.001, which is highly significant (measured in mg). Time of first pethidine demand in group-I was 45.83±10.93, in group-II was 34.20±5.44and in group-III was 16.21±3.62 and p-value<0.001 which is also highly significant (measured in minute). Overall patients satisfaction was high in nalbuphine group. Under the condition of present study, we can conclude that preemptively used nalbuphine hydrochloride decreases post operative pain and opioid demand. Journal of BSA, Vol. 20, No. 2, July 2007 p.39-44

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