scholarly journals Use of single dose prophylactic antibiotic in routine abdominal hysterectomy - a randomized controlled trial

1970 ◽  
pp. 1-4
Author(s):  
Zaida Rahman
Keyword(s):  
Randomized Controlled Trial ◽  
Single Dose ◽  
Side Effects ◽  
Antimicrobial Therapy ◽  
Controlled Trial ◽  
Prophylactic Antibiotic ◽  
Abdominal Hysterectomy ◽  
Control Group ◽  
Case Group ◽  
Randomized Controlled

A randomized controlled trial was conducted in one unit of Gynecology and Obstetrics Dept. of a Govt. hospital by giving a single dose preoperative prophylactic antibiotic and the results were compared with a control group who received a conventional prophylactic regimen of antibiotic combination. A total of 60 samples were taken from the patients currently admitted and undergoing total abdominal hysterectomy in one unit of the Department of Obstetrics & Gynecology of a Govt. hospital for this trial and they were divided into two groups - 30 Cases and 30 Control. Case group were given a single dose cephradine 1 gm IV just before induction of anesthesia. Control group were given Inj. Ciprofloxacin 200 mg IV 12 hrsly plus inj. Metronidazol 500 mg 8 hrsly till oral feeding followed by oral tab. Ciprofloxacin 500 mg 12 hrsly plus tab. Metronidazol 400 mg 8 hrsly in the remaining days which was then practicing in that gynecology unit of the Govt. hospital. Variables measured for the trial were total cost and duration of antimicrobial therapy, rate of postoperative infection and side effects of antimicrobial therapy. While comparing the outcome between the case and control group, it was observed that both the duration and cost (P<0.001) and also the side effects (P<0.05) of antimicrobial therapy were significantly higher in control group than the case group (duration of antimicrobial therapy was 2.9± 0.88 days in case group and 8. 9±0.58 days in control group and cost of antimicrobial therapy was 113.06± 24.53 taka in case group and 957.376±32.05 taka in control group). But the rate of post operative infection which is the main objective of giving preoperative antibiotic prophylaxis, was significantly higher in case group than the control group (P<0.05). But this infection rate could be reduced if the sterilization procedure of the operation theatre and general conditions of the patients were improved. If these risk factors could be minimized, single dose preoperative prophylactic antibiotic could be effectively practiced in our country. DOI: 10.3329/bjpp.v22i1.3560 Bangladesh J Physiol Pharmacol 2006; 22(1/2) : 1-4

scholarly journals A Randomized Controlled Trial of Auricular Transcutaneous Electrical Nerve Stimulation for Managing Posthysterectomy Pain

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Hin Cheung Tsang ◽  
Chi Shan Lam ◽  
Ping Wing Chu ◽  
Jacqueline Yap ◽  
Tak Yuen Fung ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nerve Stimulation ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Controlled Trial ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Control Group ◽  
Electrical Nerve Stimulation ◽  
Randomized Controlled ◽  
Vas Scores

Background. A patient- and assessor-blinded randomized controlled trial was conducted to examine the effectiveness of auricular transcutaneous electrical nerve stimulation (TENS) in relieving posthysterectomy pain.Method. Forty-eight women who had undergone a total abdominal hysterectomy were randomly assigned into three groups (n=16each) to receive either (i) auricular TENS to therapeutic points (the true TENS group), (ii) auricular TENS to inappropriate points (the sham TENS group), or (iii) 20 minutes of bed rest with no stimulation (the control group). The intervention was delivered about 24 hours after the operation. A visual analogue scale was used to assess pain while resting (VAS-rest) and upon huffing (VAS-huff) and coughing (VAS-cough), and the peak expiratory flow rate (PEFR) was assessed before and at 0, 15, and 30 minutes after the intervention.Result. As compared to the baseline, only the true TENS group reported a significant reduction in VAS-rest (P=.001), VAS-huff (P=.004), and VAS-cough (P=.001), while no significant reduction in any of the VAS scores was seen in the sham TENS group (allP>.05). In contrast, a small rising trend was observed in the VAS-rest and VAS-huff scores of the control group, while the VAS-cough score remained largely unchanged during the period of the study. A between-group comparison revealed that all three VAS scores of the true TENS group were significantly lower than those of the control group at 15 and 30 minutes after the intervention (allP<.02). No significant between-group difference was observed in PEFR at any point in time.Conclusion. A single session of auricular TENS applied at specific therapeutic points significantly reduced resting (VAS-rest) and movement-evoked pain (VAS-huff, VAS-cough), and the effects lasted for at least 30 minutes after the stimulation. The analgesic effects of auricular TENS appeared to be point specific and could not be attributed to the placebo effect alone. However, auricular TENS did not produce any significant improvement in the performance of PEFR.

scholarly journals Evaluation of the Therapeutic Effect of Low Level Laser in Controlling Low Back Pain: A Randomized Controlled Trial

2020 ◽  
Vol 11 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Leyla Kholoosy ◽  
Dariush Elyaspour ◽  
Mohammad Reza Akhgari ◽  
Zahra Razzaghi ◽  
Zeinab Khodamardi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Controlled Trial ◽  
Control Group ◽  
Case Group ◽  
Low Back ◽  
Randomized Controlled ◽  
Level Laser ◽  
Laser Group

Introduction: Low back pain (LBP) is a very common musculoskeletal disorder. The big burden of disease necessitates investigating a more effective modality of treatments with more persistence and also fewer side effects. Low power laser has been proved as a pain reducing modality, but there is a lack of studies comparing it with other treatments and also among the Iranian race and society. The purpose of this study was to evaluate the effect of low-level laser on patients with LBP. Methods: Our study was a single-blind, randomized controlled trial. Forty subjects, aged between 20 to 70 with LBP participated in the study. Their pain severity scale was 3-10 according to the visual analogue scale of pain (VAS). They were randomly assigned to two groups, a case group (true laser) and a control group (sham laser). Naproxen was prescribed with a free dose (250-1000 mg/ daily) to both groups. We evaluated patients’ subjective pain, functional status (using the Roland Morris disability questionnaire), spinal range of motion (ROM) and spinal tenderness at the basic time, one month and 3 months after treatment. The true laser group received 12 sessions of laser (160 mW) and the control group took 12 sessions of sham laser (the same laser instrument in off status). An infrared laser GaAlAs, wavelength 808 nm, power 160 mw and spot size 1 cm2 and power density 0.16 J/cm2 in continuous mode was used in treatment. We applied the laser to articular spaces of vertebral column, adjacent paravertebral points, pain radiating areas, tender points and also pain-controlling acupuncture points. Results: Of the 40 participants in the study, 6 persons were excluded and thus the data obtained from 34 participants were statistically analyzed. There was significant improvement in pain (P<0.001 for both groups), functional status (Case group: P<0.001; control group: P=0.004) and spinal ROM (Case group: P<0.001; control group: P=0.007) in both groups at the end of the first month, but these gains persisted for 3 months only in the case group (P<0.001). Regarding spinal tenderness, it was disappeared in 89.47% of the patients in the true laser group at the end of one month but remained unchanged in 73.33% of the subjects of the sham laser group. Conclusion: We concluded that laser therapy (in combination with NSAIDs) is an effective and long-lasting therapeutic strategy in bringing relief from LBP without any significant side effect.

The Role of Preoperative Steroids for Hearing Preservation Cochlear Implantation: Results of a Randomized Controlled Trial

2017 ◽  
Vol 22 (4-5) ◽  
pp. 292-302 ◽  
Author(s):  
Jafri Kuthubutheen ◽  
Samidha Joglekar ◽  
Leah Smith ◽  
Lendra Friesen ◽  
Kari Smilsky ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Single Dose ◽  
Cochlear Implantation ◽  
Controlled Trial ◽  
Hearing Preservation ◽  
Oral Steroid ◽  
Control Group ◽  
Randomized Controlled ◽  
Steroid Group ◽  
Better Than

Objectives: To determine whether preoperative steroids can improve hearing outcomes in cochlear implantation (CI). Methods: This is a randomized controlled trial involving 30 postlingual deaf CI patients. Subjects had preoperative thresholds of better than or equal to 80 dB at 125 and 250 Hz, and better than or equal to 90 dB at 500 and 1,000 Hz. The subjects were randomized to a control group, an oral steroid group (receiving 1 mg/kg/day of prednisolone for 6 days prior to surgery), or a transtympanic steroid group (receiving a single dose of 0.5 mL of 10 mg/mL dexamethasone at 24 h prior to surgery). Results: The subjects receiving transtympanic steroids had a significant decrease in the pure tone average over 3 months compared to the control and oral steroid group, which persisted over 12 months (p < 0.05). Conclusion: A single dose of preoperative transtympanic steroids prior to CI appears to have a beneficial effect, at least in the short term, with minimal effects seen in the longer term.

scholarly journals Optimal Time of Thermotherapy for Reducing Pain, Anxiety, and Side Effects in Arteriovenous Fistula Puncture Patients: A Randomized Controlled Trial

2020 ◽  
Vol 17 (19) ◽  
pp. 7147
Author(s):  
Yangok Back ◽  
Yoonyoung Lee
Keyword(s):  
Renal Failure ◽  
Randomized Controlled Trial ◽  
Chronic Renal Failure ◽  
Side Effects ◽  
Arteriovenous Fistula ◽  
Controlled Trial ◽  
Nursing Intervention ◽  
Control Group ◽  
Pain Anxiety ◽  
Randomized Controlled

Chronic renal failure patients undergoing hemodialysis complain of moderate pain from repeated punctures of the arteriovenous fistula. This study examined the optimal application time of thermotherapy for reducing pain, anxiety, and side effects during arteriovenous fistula puncture. This study was conducted as a single-blinded randomized controlled trial. The participants were arteriovenous fistula puncture patients with chronic renal failure who were divided into two thermotherapy groups and one control group. This study was approved by the institutional review board and registered with the Clinical Research Information Service (KCT0003768). Differences between groups regarding pain, anxiety, and side effects were analyzed using one-way ANOVA, the χ2 test, and the Scheffé test. A significant difference was observed between the 10-min and 20-min thermotherapy groups and the control group in terms of the pain they experienced. Additionally, more side effects were encountered in the 20-min thermotherapy group than in the 10-min group. The 10-min application of thermotherapy for an arteriovenous fistula puncture showed the same pain-reducing effect as the conventional 20-min application. The study confirmed a 10-min application of thermotherapy to be an effective nursing intervention for pain relief without side effects.

Baclofen versus clonidine in the treatment of opiates withdrawal, side-effects aspect: a double-blind randomized controlled trial

2001 ◽  
Vol 26 (1) ◽  
pp. 67-71 ◽  
Author(s):  
S. A. Ahmadi-Abhari ◽  
S. Akhondzadeh ◽  
S. M. Assadi ◽  
O. L. Shabestari ◽  
Z. M. Farzanehgan ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Side Effects ◽  
Controlled Trial ◽  
Double Blind ◽  
Randomized Controlled

Role of preoperative pregabalin in reducing inhalational anesthetic requirements in abdominal hysterectomy: randomized controlled trial

2020 ◽  
Vol 86 (1) ◽  
Author(s):  
Nesrine A. El-Refai ◽  
Jehan H. Shehata ◽  
Ahmed Lotfy ◽  
Ahmed M. Elbadawy ◽  
Reham A. Abdel Rahman ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Abdominal Hysterectomy ◽  
Randomized Controlled ◽  
Inhalational Anesthetic

Evaluation of a collaborative protocolized approach by community pharmacies and general medical practitioners for an Australian minor ailments scheme: study protocol for a cluster-randomized controlled trial (Preprint)

2019 ◽  
Author(s):  
Sarah Dineen-Griffin ◽  
Victoria Garcia Cardenas ◽  
Kylie Williams ◽  
Shalom Isaac Benrimoj
Keyword(s):  
Randomized Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Self Care ◽  
Cluster Randomized Controlled Trial ◽  
Control Group ◽  
Community Pharmacies ◽  
Randomized Controlled ◽  
Minor Ailments ◽  
Cluster Randomized

BACKGROUND Internationally, governments have been investing in supporting pharmacists to take on an expanded role to support self-care for health system efficiency. There is consistent evidence that minor ailment schemes (MAS) promote efficiencies within the healthcare system. The cost savings and health outcomes demonstrated in the UK and Canada opens up new opportunities for pharmacists to effect sustainable changes through MAS delivery in Australia. OBJECTIVE This trial is evaluating the clinical, economic and humanistic impact of an Australian minor ailments service (AMAS), compared with usual pharmacy care in a cluster-randomized controlled trial in Western Sydney, Australia. METHODS The cluster-randomized controlled trial design has an intervention and a control group, comparing individuals receiving a structured intervention with those receiving usual care for specific common ailments. Participants will be community pharmacies, general practices and patients located in Western Sydney Primary Health Network region. 30 community pharmacies will be randomly assigned to either intervention or control group. Each will recruit 24 patients seeking, aged 18 years or older, presenting to the pharmacy in person with a symptom-based or product-based request for one of the following ailments (reflux, cough, common cold, headache (tension or migraine), primary dysmenorrhoea and low back pain). Intervention pharmacists will deliver protocolized care to patients using clinical treatment pathways with agreed referral points and collaborative systems boosting clinician-pharmacist communication. Patients recruited in control pharmacies will receive usual care. The co-primary outcomes are rates of appropriate use of nonprescription medicines and rates of appropriate medical referral. Secondary outcomes include self-reported symptom resolution, time to resolution of symptoms, health services resource utilization and EQ VAS. Differences in the primary outcomes between groups will be analyzed at the individual patient level accounting for correlation within clusters with generalized estimating equations. The economic impact of the model will be evaluated by cost analysis compared with usual care. RESULTS The study began in July 2018. At the time of submission, 30 community pharmacies have been recruited. Pharmacists from the 15 intervention pharmacies have been trained. 27 general practices have consented. Pharmacy patient recruitment began in August 2018 and is ongoing and monthly targets are being met. Recruitment will be completed March 31st, 2019. CONCLUSIONS This study may demonstrate the utilization and efficacy of a protocolized intervention to manage minor ailments in the community, and will assess the clinical, economic and humanistic impact of this intervention in Australian pharmacy practice. Pharmacists supporting patient self-care and self-medication may contribute greater efficiency of healthcare resources and integration of self-care in the health system. The proposed model and developed educational content may form the basis of a MAS national service, with protocolized care for common ailments using a robust framework for management and referral. CLINICALTRIAL Registered with Australian New Zealand Clinical Trials Registry (ANZCTR) and allocated the ACTRN: ACTRN12618000286246. Registered on 23 February 2018.

Effectiveness of a web-based medication adherence tool with patient centered communication: Results of a clustered randomized controlled trial (Preprint)

2019 ◽  
Author(s):  
Jan van Lieshout ◽  
Joyca Lacroix ◽  
Aart van Halteren ◽  
Martina Teichert
Keyword(s):  
Randomized Controlled Trial ◽  
Medication Adherence ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Community Pharmacies ◽  
Web Based ◽  
Randomized Controlled ◽  
Tailored Interventions ◽  
Increased Risk

BACKGROUND Growing numbers of people use medication for chronic conditions; non-adherence is common, leading to poor disease control. A newly developed web-based tool to identify an increased risk for non-adherence with related potential individual barriers might facilitate tailored interventions and improve adherence. OBJECTIVE To assess the effectiveness of the newly developed tool to improve medication adherence. METHODS A cluster randomized controlled trial assessed the effectiveness of this adherence tool in patients initiating cardiovascular or oral blood glucose lowering medication. Participants were included in community pharmacies. They completed an online questionnaire comprising an assessments of their risk for medication non-adherence and subsequently of barriers to adherence. In pharmacies belonging to the intervention group, individual barriers displayed in a graphical profile on a tablet were discussed by pharmacists and patients at high non-adherence risk in face to face meetings and shared with their general practitioners and practice nurses. Tailored interventions were initiated by the healthcare providers. Barriers of control patients were not presented or discussed and these patients received usual care. The primary outcome was the difference in medication adherence at 8 months follow-up between patients with an increased non-adherence risk from intervention and control group, calculated from dispensing data. RESULTS Data from 492 participants in 15 community pharmacies were available for analyses (intervention 253, 7 pharmacies; control 239, 8 pharmacies). The intervention had no effect on medication adherence (-0.01; 95%CI -0.59 – 0.57; P= .96), neither in the post hoc per protocol analysis (0.19; 95%CI -0.50 – 0.89; P=.58). CONCLUSIONS This study showed no effectiveness of a risk stratification and tailored intervention addressing personal barriers for medication adherence. Various potential explanations for lack of effect were identified. These explanations relate for instance to high medication adherence in the control group, study power and fidelity. Process evaluation should elicit possible improvements and inform the redesign of intervention and implementation. CLINICALTRIAL The Netherlands National Trial Register: NTR5186. Date: May 18, 2015 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5186)

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