scholarly journals Comparative Study of Oral Clonidine and Midazolam as Premedication in Pediatric Patients Undergoing Tonsillectomy

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Statistical Significance ◽  
Anxiety Score ◽  
P Value ◽  
Parental Separation ◽  
Oral Clonidine ◽  
Oral Midazolam ◽  
Group A ◽  
Group B ◽  
Double Blinded ◽  
Induction Of Anaesthesia

Background and Aim: Anxiety and fear of operation, injections, physicians, operation theatre environment and parental separation are all traumatizing experiences in children. The aim of the study was to compare the effects of oral midazolam and oral clonidine as premedication in children undergoing tonsillectomy .The preoperative sedation, anxiolytic, acceptance of mask for induction of anaesthesia, intravenous cannulation and post-operative recoverywere assessed in both groups. Methods: Aprospective randomized double blinded study of 100 patients of age group 4 -12 yrs undergoing tonsillectomy under general anaesthesia were selected. They were divided into 2 groups of 50 patients each. Group A (oral clonidine) received 4 mcg/kg 90 minutes before induction. Group B (oral midazolam) received 0.5 mg/kg 90 minutes before induction. The sedation and anxiety score was noted at the time of parental separation. The reaction to IV cannulation was assessed by sedation and anxiety scoring at the same time all of them were taken under GA with controlled ventilation. The Mask acceptance was graded by 5 point scoring system .Grade 3,4 and 5 are satisfactory.They were monitored throughout the surgery for any complications. Post operative status was assessed by Modified Objective Pain score. Results: The sedation score and anxiety score at venipuncture was better with clonidine group with statistical significance (p< 0.000 and<0.003). The mask acceptance was better with clonidine group with statistical significance (p <0.000).Postoperative score was also better with clonidine group with statistical significance of p value <0.000. Conclusion: We concluded that oral clonidine and midazolam can be used as better premedicants to produce optimal sedation and emotional state.Clonidine 4 μg / kg has been shown to be a more effective premedication for children undergoing elective tonsillectomy than midazolam 0.5mg/kg

scholarly journals Analgesic Efficacy of Paracetamol in Children Using Tonsillectomy as a Pain Model

1996 ◽  
Vol 24 (6) ◽  
pp. 669-673 ◽  
Author(s):  
B. Anderson ◽  
S. Kanagasundarum ◽  
G. Woollard
Keyword(s):  
Pain Score ◽  
Venous Blood ◽  
Analgesic Efficacy ◽  
Temperature Plasma ◽  
Paracetamol Concentration ◽  
Blinded Study ◽  
Group A ◽  
Group B ◽  
Double Blinded ◽  
Induction Of Anaesthesia

The analgesic efficacy of paracetamol was assessed in a prospective, randomized, double-blinded study of 100 children undergoing tonsillectomy with or without adenoidectomy. Fifty children were given paracetamol elixir 40 mg/kg 40 minutes preoperatively (Group A); the remaining 50 children were given an oral placebo 40 minutes pre-operatively and paracetamol suppositories 40 mg/kg after induction of anaesthesia (Group B). Paracetamol was the only analgesic given and was given either orally or rectally in order to produce high variations in plasma paracetamol concentrations postoperatively. At 30 minutes after the end of surgery a pain score (0–10) was obtained and a venous blood sample was taken for serum paracetamol concentration analysis. Children given paracetamol elixir had a higher mean paracetamol concentration (0.15 [SD 0.06] mmol/l vs 0.05 [SD 0.03] mmol/l, P < 0.001) and a lower median pain score (5 vs 7, P < 0.02) than those who were given suppositories. The use of rescue morphine was higher (10 vs 23, P < 0.001) in the latter group. The incidence of nausea and vomiting was the same in both groups (20%) during the 24 hour postoperative period. Plasma paracetamol concentrations of 0.066–0.132 mmol/l are known to reduce temperature; plasma paracetamol concentrations which provide analgesia are unknown. Children with plasma paracetamol concentrations above 0.07 mmol/l had superior analgesia to those with concentrations below this level (P < 0.05).

scholarly journals A comparative study of low dose magnesium sulphate (Dhaka regime) and Pritchard regime for the management of impending eclampsia and eclampsia

2017 ◽  
Vol 6 (6) ◽  
pp. 2180
Author(s):  
. Ranjana ◽  
Abha Rani Sinha ◽  
Chandra Prakash
Keyword(s):  
Magnesium Sulphate ◽  
Low Dose ◽  
Statistical Significance ◽  
Perinatal Outcomes ◽  
P Value ◽  
Entire Treatment Period ◽  
Indian Women ◽  
Group A ◽  
Low Bmi ◽  
Group B

Background: Eclampsia is a common obstetrical emergency though preventable, yet remains a leading cause of maternal and perinatal morbidity and mortality in the developing world. Pritchard regime is most widely used magnesium sulphate regime for control of eclamptic fits but its dose related toxicity is a major concern among Indian women with low BMI and at peripheral institutions where the patients monitoring is limited. The objective was to study the efficacy of low dose MgSO4 regime (Dhaka regime) for control of convulsions in eclampsia and prevention of convulsions in impending eclampsia, to assess the magnesium related toxicity and to analyze the maternal and perinatal outcomes as compared to standard Pritchard regime.Methods: This prospective study was carried out in the Department of obstetrics and Gynaecology at Patna Medical College and Hospital, Patna. Study was done on 80 patients of eclampsia and impending eclampsia. Patients were divided into two groups A and B. Group A (n=40) received low dose MgSO4 regime (Dhaka regime) and Group B (n=40) received standard Pritchard regime. Results were analysed using statistical package of social sciences (SPSS) 21.0. Statistical significance was set at p ≤0.05.Results: In the present study, convulsions were controlled in 95% of eclampsia cases with low dose magnesium sulphate (Dhaka) regime. Recurrence of convulsion was seen in both groups. None of the patients with impending eclampsia in both the groups developed the seizure during entire treatment period. Signs of impending MgSO4 toxicity and the mean amount of magnesium sulphate received was found more in Pritchard regime group (22.5gms in Group A and 39gms in Group B) and was statistically significant with p value <0.001. There were 3 maternal deaths in present study.Conclusions: Low dose magnesium sulphate is as effective as standard Pritchard regime in controlling the eclamptic fits and preventing its recurrence with comparable maternal and perinatal outcome and less chances of magnesium toxicity. This regimen may be more suitable for use in Indian women with low BMI and in resource poor settings where clinical monitoring is limited.

scholarly journals Analgesic Effect of Caudal Bupivacaine with or without Clonidine in Pediatric Patient

2019 ◽  
Vol 16 (41) ◽  
pp. 428-433
Author(s):  
Sharad Khakurel ◽  
Shanta Sapkota ◽  
Anuj Jung Karki
Keyword(s):  
Inguinal Hernia ◽  
Adverse Effects ◽  
Lower Limb ◽  
P Value ◽  
Single Shot ◽  
Unilateral Inguinal Hernia ◽  
Caudal Analgesia ◽  
Group A ◽  
Group B ◽  
Double Blinded

Background: Caudal analgesia has long been the cornerstone to successful pain management in children undergoing abdominal and lower limb surgeries. Its analgesic duration with single shot injection is however limited. So adjuvants are used with local anesthetics in an attempt to increase the duration of caudal analgesia. This study aims to investigate the duration of analgesia provided by Clonidine when added to caudal Bupivacaine.Methods: A randomized, double blinded, comparative study was conducted on 64 patients, aged two to seven years, scheduled for unilateral inguinal hernia repair. Patients were randomly allocated into two groups of 32 each, with group A receiving bupivacaine two milligram/kilogram and group B receiving bupivacaine two milligram/kilogram with one microgram/kilogramclonidine, (total volume of injectate was one milliliter/kilogram). Duration of analgesia, hemodynamic response and adverse effects, if any were noted.Results: Mean duration of analgesia in group A was 264.12 ± 68.77 minutes and in group B was 520 ± 57.37 minutes, p-value <0.001.Incidence of vomiting was 9% in group A compared to 6% in group B.Conclusions: Clonidineas an adjuvant to caudal bupivacaine prolongs the duration of analgesia without increasing the adverse effects.Keywords: Bupivacaine; caudal analgesia; clonidine;pediatric.

scholarly journals Comparison of Propofol Vs Thiopentone in Post Operative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 18 (1) ◽  
pp. 23-29
Author(s):  
Bhuwan Raj Kunwar ◽  
Thaneshowr Rijal ◽  
Puja Thapa ◽  
Mallika Rayamajhi ◽  
Biswo Ram Amatya
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Statistical Significance ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
P Value ◽  
Fisher Exact Test ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Introduction: Postoperative Nausea and Vomiting (PONV) is one of the commonest causes of significant morbidity in the patients after laparoscopic cholecystectomy. The purpose of this study was to compare the incidence of PONV when propofol and thiopentone were used as induction agents during laparoscopic cholecystectomy. Methods: A prospective, randomised comparative study was conducted in operation theatre at a tertiary level referral hospital of Nepal. A sample size of 100 ASA I - II patients aged between 18 and 70 years were included and scheduled for elective laparoscopic cholecystectomy. The study population were divided into two groups: Group A (Propofol), n = 50 and Group B (Thiopentone), n = 50. These patients were followed up for the first 24 hours postoperatively for any PONV at 0-6 hrs, 6-12 hrs, 12-24 hrs. Results: Out of the 100 patients, PONV was observed almost similar in both groups. i.e. group A (Propofol) n = 31, (62%) and group B (Thiopentone) n = 26 (52%) with no statistical significance (p value = 0.1998) within the first 24 hours postoperatively in both groups; and no significant difference was observed at the different time intervals viz. at 0-6 hrs (p value 0.262): Group A = 45%; Group B = 40%; 6-12 hrs (p value 0.781): Group A = 17.5%, Group B = 22.5%; 12-24 hrs (p value 1.000) Group A = 0%; Group B = 2.5% when using the Fisher exact test. The mean ages for development of PONV in these two groups were: Group A = 40 years and Group B = 38 years. The p-value was 0.5125 which showed no statistical significance. In our study 76% (n = 38) were females and 24% (n = 12) were males in Group A; while 70% (n = 35) were females and 30% (n = 15) males in Group B. However, there was no statistical difference between the two groups in terms of PONV. Conclusions: The study showed that there was a high incidence of PONV during laparoscopic cholecystectomy. However, there was no significant difference in the incidence of PONV when propofol or thiopentone was used.  

scholarly journals Efficacy of growth hormone in improving the pregnancy rate in poor responders in ART

2017 ◽  
Vol 6 (7) ◽  
pp. 2883
Author(s):  
Nisha E. ◽  
Sunitha H. B. ◽  
Vidya V. Bhat ◽  
K. M. Guddy
Keyword(s):  
Growth Hormone ◽  
Pregnancy Rate ◽  
Statistical Significance ◽  
Pregnancy Rates ◽  
P Value ◽  
Poor Responders ◽  
High Dose ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Poor responders impose a great challenge to ART clinicians. Research to improve their pregnancy rate is going on. This study was conducted to analyze the effect of growth hormone in poor responders in ART.Methods: This study was done from January 2015 to December 2015. It was a retrospective, single centre, cohort study in which 36 poor responders were selected and allotted into group A (18) with growth hormone and group B (18) without growth hormone. High dose of gonadotrophins was used for ovarian stimulation and antagonist protocol was followed in all patients. Group A received 4 IU of growth hormone along with usual treatment from day 2 till ovulation trigger with HCG injection, group B usual protocol.Results: Statistical analysis was done with independent T test, and p value <0.05 was considered significant. Higher number of mature oocytes and pregnancy rates were observed in growth hormone group. Number of MII oocytes was 5.8, on an average in group A and 3.7 in group B, the difference was statistically significant (p 0.0000001).  Clinical pregnancy rates were 27.7% in group A and 16.6% in group B, statistical significance (p 0.02).Conclusions: Addition of growth hormone shows increase in number of oocytes retrieved and pregnancy rates in poor responders in ART patients.

scholarly journals Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

2020 ◽  
Vol 6 (11) ◽  
pp. 2001
Author(s):  
Sreeshma Balan ◽  
Prakash M. D.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
P Value ◽  
Hearing Improvement ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared.  </p><p class="abstract"><strong>Results:</strong> In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p&lt;0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.</p>

scholarly journals Determining Relation between Gallstone and Lipid Profile

2018 ◽  
Vol 3 (2) ◽  
pp. 418-422 ◽  
Author(s):  
Rabin Raj Singh ◽  
Sunil Chandra Adhikari ◽  
Ravi Bastakoti ◽  
Sunil Regmi ◽  
Ravindra Baskota ◽  
...  
Keyword(s):  
Lipid Profile ◽  
Serum Cholesterol ◽  
Statistical Significance ◽  
Serum Triglyceride ◽  
P Value ◽  
Number Of Patients ◽  
Increased Risk ◽  
Group A ◽  
Group B ◽  
Low Serum

Introduction: Cholelithiasis is presence of stone in gallbladder. Female sex, obesity, pregnancy, fatty foods, all are associated with an increased risk of developing gallstones. There is paucity of information regarding relation of cholelithiasis and lipid profile. In this study the association of serum lipids to cholelithiasis has been tried to been elucidated.Objectives: The general objective was to determine the relation of Serum lipid in cholelithiasis. The specific objectives were to compare the relation between serum cholesterol, serum triglyceride, serum HDL and serum LDL in patients with and without gallstones.Methodology: A prospective, observational, hospital based study was conducted at Koshi Zonal Hospital from March 2017 to February 2018. Fifty four patients having gallstone (Group A) were compared with equal number of patients without gallstone (Group B). Data was entered into SPSS/MS Excel. Statistical Analysis was done by using Chi-square test. A 95% confidence interval was taken, and P value less than 0.05 was considered as statistically significant.Results: In Group A, 61%(33) patients were of age less than 45 years and 91%(49) were female. In group A, 3.7 %(2) and in group B, 7.4%(4) had raised serum cholesterol. Greater number of patient in group A had raised serum triglyclyceride and LDL as compared to group B. 18.5%(10) of group A had low serum HDL, and 9.3% (5) of group B had low serum HDL. Except for finding of gallstone more common in female, other findings had no statistical significance.Conclusion: There exists an inverse correlation between Serum Cholesterol and serum HDL with gallstone and positive association between serum Triglyceride and serum LDL with cholelithiasis. However the association could not reach the statistical significance.  BJHS 2018;3(2)6:418-422.

scholarly journals Latent Genital Tuberculosis – A Causative Factor for Ectopic Pregnancy- A Retrospective Analysis

2020 ◽  
Vol 3 (5) ◽  
pp. 01-06
Author(s):  
Siddhartha Chatterjee
Keyword(s):  
Ectopic Pregnancy ◽  
Retrospective Analysis ◽  
Statistical Significance ◽  
Previous History ◽  
Pelvic Surgery ◽  
P Value ◽  
Genital Tuberculosis ◽  
History Of ◽  
Group A ◽  
Group B

Background: Ectopic tubal pregnancy (ETP) is a dreadful situation for both the patient and the doctor. Prevalence of ETP is increasing because of availability of convenient and modern modalities for the diagnosis of ectopic pregnancy. Patients are aware of the condition and many lives can be saved when diagnosed and managed at an early stage; still almost 10% of maternal deaths are due to ETP. The etiology of ETP remains unknown in almost half of the cases and hence the risk of recurrence remains high. The present study has been conducted to screen patients with history of tubal ectopic pregnancyand to determine the role of tubercular infestation of the eutopicendometrium as an important etiological factor in ‘unexplained’ ectopic. Results: This retrospective analysis was conducted at Calcutta Fertility Mission in Kolkata, India, from January 2010 to December 2018. Of 282 patients with history of ETP,who were selected, 109 were in Group A, 72 of them in Group B and 101 in Group C. Tubercular infestation of the endometrium (DNA-PCR positive) was found in all (109) patients in Group A, and others in Group B and C had previous history of pelvic surgery or endometriosis, pelvic infection or unexplained infertility associated with tubercular infestation of the endometrium. In our study latent genital tuberculosis has been proved to be a statistically significant factor for ETP. (p value - <0.001) Moreover other factors like tubal surgeries (p value - <0.001) or correction of minor tubal defects (p value – 0.024); endometriosis (p value- <0.001) and pelvic inflammatory disease (p value -<0.001), have shown statistical significance in causing ectopic pregnancy. Clinical pregnancy rate (p value -0.002) and live birth rate (p value-<0.001) has been proved to be statistically significant after treatment of ETP. Conclusion: Along with the documented causes of ETP tubercular infestation of the endometrium should be considered as an important etiology for ectopic pregnancy and should be screened on a routine basis for early intervention and treatment.

Comparative study of the Effectiveness of the use of the universal tennis elbow splint compared to elbow brace in treatment of Lateral Epicondylitis

2020 ◽  
Vol 7 (4) ◽  
pp. 118-124
Author(s):  
Dr. Uday B. Pote ◽  
Aishwarya Solge ◽  
Vaishnavi Karpe ◽  
Mihir A Ghare ◽  
Antara A Thatte
Keyword(s):  
Functional Outcome ◽  
Grip Strength ◽  
Tennis Elbow ◽  
Statistical Significance ◽  
Lateral Epicondylitis ◽  
P Value ◽  
Vas Score ◽  
Group A ◽  
Group B ◽  
Wrist Splint

Background: Lateral epicondylitis is a serious condition affecting 1 to 3% of adult population between the age group of 30 to 50 year old. This group represents the working force and tennis elbow causes debilitating pain and patients are unable to perform the affected limb functions of lifting or holding anything. The main cause for tennis elbow is the tendinopathy of the extensor carpi radialis brevis muscle (ECRB). There are multiple treatment measures to relieve the pain and bring back the function of the limb to normalcy as early as possible. The elbow brace is used to reduce the expansion of the ECRB and thereby reducing the symptoms of tennis elbow. It was hypothesized that wrist splints would reduce the activation of the ECRB muscle and thereby will reduce the symptoms of the tennis elbow. Streek et al performed a study using the wrist splint with 20-30 degrees extension and mentioned in limitations the changing the degree of extension may improve outcomes as compared to elbow braces. On that hypothesis we used a brace with only 5-10 degrees of extension. Aims: 1) To study the symptomatic and functional outcome of the elbow brace. 2) To study the symptomatic and functional outcome of the wrist splint. 3) To compare the symptomatic and functional outcomes between the wrist splint and the elbow brace. Material & Methods: The patients included in the study were divided into Group A receiving the wrist splint and group B elbow brace. The patient rated tennis elbow evaluation score (PRTEE), grip strength and pain visual assisted (VAS) score on the day of enrolment and 6 weeks after using either the elbow brace or wrist splint was noted. We used Mann-Whitney U test to calculate P-value intergroup and for P-value intra-group we used Wilcoxon’s signed rank test. Result: Group A distribution of median 6 weeks PRTEE score improved significantly compared to median baseline PRTEE score (P-value<0.001). The VAS score, grip strength and improvement in PRTEE score at 6 weeks is relatively better in Group A compared to Group B, however the difference did not reach statistical significance (P-value>0.05).Conclusion: The use of wrist splint significantly improved the symptoms of the tennis elbow. The outcome is comparable to use of tennis elbow brace. The outcome is not statistically significant if compared between the two groups.

scholarly journals CURCUMA LONGA

2018 ◽  
Vol 25 (07) ◽  
Author(s):  
Sana Naz ◽  
Faisal Irshad ◽  
Hina Mawani
Keyword(s):  
Carbon Tetrachloride ◽  
Histopathological Examination ◽  
Curcuma Longa ◽  
Statistical Significance ◽  
Male Rats ◽  
P Value ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Animal House

Objectives: To analyze the hepatoprotective effects of Curcuma longa (CL)against carbon tetrachloride (CCl4) induced chemical injury in experimental rats. Study Design:Experimental study. Setting: Indus Medical College in collaboration with Animal house of SindhAgriculture University Tando Jam. Period: March 2016 to August 2016. Methodology: Sixtyadult male rats were selected according to inclusion and exclusion criteria. Rats were dividedrandomly into 3 groups – as group A. controls, group B – received CCl4 and group C- receivedCCl4 + CL orally. Blood samples were taken after 4 weeks of therapy by cardiac puncture.5μ thick liver tissue sections were stained for light microscopy examination. Analysis of datawas performed on Statistix 9.0 (USA) at statistical significance of p-value ≤ 0.5. Results: Livercell biochemical markers of injury and histopathological examination show the Curcuma longais effective against carbon tetrachloride induced liver injury (P <0.05). Liver histology wasimproved by the curcuma longa therapy. Conclusion: Liver aminotransferase and histologywere improved significantly by the curcuma longa therapy in carbon tetrachloride induced liverinjury.

Sign in / Sign up

Export Citation Format

Share Document