Assesment of The Effect of Multimodal Preemptive Analgesia in Children

Background: Preemptive analgesia, an evolving clinical concept, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could amplify pain. Pain is inevitable after any surgery. Surgery offers the most promising setting for preemptive analgesia because the timing of noxious stimuli is known.Materials & Methods: This prospective double blind study included 60 children (30 in each group), undergoing major surgery under general anesthesia. Each patient in the study group (Group II) received pre-emptive analgesia (Local anesthesia, per-rectal diclofenac just prior to surgery, per-rectal paracetamol 2 hours prior to surgery) and regular pattern of postoperative pain intervention with per rectal diclofenac and per rectal or oral paracetamol in different phases of postoperative pain management up to 48 hours. On the other hand, each patient of control group (Group I) received pre-emptive analgesia (Local anesthesia & per-rectal diclofenac) regular pattern of postoperative pain intervention with per-rectal diclofenac in different phases of postoperative pain up to 48 hours. The degree of postoperative pain was assessed by universal pain assessment tools (VAS) at defined intervals.Results: Most children in the study group (Group II) has significantly better postoperative pain control with only mild pain at 4th postoperative hours. It is obvious that less pain in Group-II due to synergistic effect of paracetamol and diclofenac. In the control group (Group I) there was persistence of mild pain throughout the observation period i.e. up to 48 postoperative hours. The breakthrough pain occurred more in latter group, two patients needed rescue analgesia. Whereas no patient experienced breakthrough pain requiring rescue analgesia in study group (Group II).Conclusion: Therefore this study concludes that administrations of multimodal pre-emptive analgesia control pain more effectively in children in view of both the degree of pain control and sustainability of pain free state.DOI: http://dx.doi.org/10.3329/jpsb.v2i2.19545

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Features of the cervix uteri in women of reproductive age with endometrial polyps and micropolyps

HEALTH OF WOMAN ◽

10.15574/hw.2016.113.108 ◽

2016 ◽

pp. 108-111

Author(s):

T.F. Tatarchuk ◽

◽

D.G. German ◽

Keyword(s):

Reproductive Age ◽

Cervix Uteri ◽

Control Group ◽

Women Of Reproductive Age ◽

Endometrial Polyps ◽

Group Iii ◽

Aggressive Form ◽

Group I ◽

Group Ii ◽

Control Group Group

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.

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GAMBARAN HISTOLOGIK AORTA TIKUS WISTAR DENGAN DIET LEMAK BABI SETELAH PEMBERIAN EKSTRAK DAUN PEPAYA

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.5.1.2013.2610 ◽

2013 ◽

Vol 5 (1) ◽

Author(s):

Friska W. F. Panjaitan ◽

Marie M. Kaseke ◽

George N. Tanudjaja

Keyword(s):

Wistar Rats ◽

Leaf Extract ◽

Foam Cells ◽

Group Iv ◽

Control Group ◽

Histological Features ◽

Group I ◽

Group Ii ◽

Lard Diet ◽

Control Group Group

Abstract: Papaya leaves contain several antioxidants (flavonoid, tanin, and vitamin C) which have antiatherogenic effects that may inhibit the progression of an atherosclerotic lesion. One of the risk factors causing atherosclerosis is the consumption of food containing highly saturated fatty acids e.g. lard. Low density lipoproteins (LDL) accumulate within the intima and then are oxidized (LDL-ox). This LDL-ox is ingested by macrophages, resulting in foam-cell formation (early lesion of atherosclerosis). This study aimed to find out the histological features of the aorta of wistar rats having lard diets without the addition of the papaya leaf extract; having lard diets along with the papaya leaf extract; and having lard diets followed by papaya leaf extract. This was an experimental study on 16 wistar rats divided into 4 groups: group I without treatment (negative control group), group II lard diet for 14 days (positive control group), group III lard diet with papaya leaf extract for 14 days (treatment group I), and group IV lard diet for 14 days, and then followed by papaya leaf extract for 14 days (treatment group II). It was found that the aorta of group I showed adipose cells in the intima and media layers; group II and III showed foam cells in both layers; and group IV showed foam cells in fewer numbers than group II. Conclusion: The aorta histological features of wistar rats given lard diets for 14 days, with or without papaya leaf extract, showed foam cells in the intima and media layers. Papaya leaf extraxt added to lard diets had no effect on decreasing foam cells (no protective effect), meanwhile papaya leaf extract following lard diets showed a reduction of foam cells (therapeutic effect). Keywords: papaya leaf, lard dietary, foam cells, wistar rat. Abstrak: Daun pepaya mengandung antioksidan (flavonoid, vitamin C) yang berefek anti-aterogenik, sehingga diharapkan dapat menghambat perkembangan lesi aterosklerosis. Salah satu faktor risiko penyebab aterosklerosis yaitu makanan yang berkandungan tinggi asam lemak jenuh, antara lain lemak babi. Konsumsi lemak jenuh berlebihan dapat mengganggu fungsi sel endotel, sehingga lipoprotein berdensitas rendah (LDL) dapat masuk dan menjadi LDL teroksidasi (LDL-oks). Makrofag menangkap LDL-oks dan menjadi sel busa (lesi dini aterosklerosis). Penelitian ini bertujuan untuk mengetahui gambaran histologik aorta tikus wistar dengan diet lemak babi tanpa pemberian ekstrak daun pepaya, diet lemak babi bersamaan pemberian ekstrak daun pepaya, dan setelah diet lemak babi dilanjutkan pemberian ekstrak daun pepaya. Penelitian ini bersifat eksperimental. Subyek penelitian terdiri dari 16 ekor tikus wistar yang dibagi menjadi empat kelompok: kelompok I tanpa perlakuan (kelompok kontrol negatif); kelompok II dengan diet lemak babi selama 14 hari (kelompok kontrol positif); kelompok III dengan diet lemak babi serta pemberian ekstrak daun pepaya selama 14 hari (kelompok perlakuan I); dan kelompok IV dengan diet lemak babi selama 14 hari, dilanjutkan pemberian ekstrak daun pepaya selama 14 hari (kelompok perlakuan II). Hasil penelitian memperlihatkan gambaran histologi aorta kelompok I tampak perlemakan; pada kelompok II terdapat sel-sel busa; pada kelompok III masih terdapat sel-sel busa; dan pada kelompok IV terdapat sel-sel busa, namun dalam jumlah yang lebih sedikit dibandingkan pada gambaran kelompok II. Simpulan: Tikus wistar dengan diet lemak babi selama 14 hari, baik dengan maupun tanpa ekstrak daun pepaya, memperlihatkan gambaran histologik adanya sel-sel busa pada tunika intima dan tunika media aorta. Pemberian ekstrak daun pepaya bersamaan dengan diet lemak babi tidak berefek menurunkan jumlah sel busa (tidak ada efek protektif) sedangkan pemberian ekstrak daun pepaya setelah diet lemak babi berefek mengurangi jumlah sel-sel busa yang terbentuk (efek terapi). Kata kunci: daun pepaya, diet lemak babi, sel-sel busa, tikus wistar.

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Immunization of Guineapigs against Ascaris suum

Journal of Helminthology ◽

10.1017/s0022149x00021258 ◽

1960 ◽

Vol 34 (3-4) ◽

pp. 347-348 ◽

Cited By ~ 5

Author(s):

L. F. Taffs

Keyword(s):

Control Group ◽

Group Iii ◽

Successful Attempt ◽

Group I ◽

Third Stage ◽

Previous Infection ◽

Group Ii ◽

Intravenous Inoculation ◽

Subcutaneous Inoculation ◽

Control Group Group

It has been shown that guineapigs can be effectively protected against re-infection by the subcutaneous inoculation of embryonated Ascaris eggs (Soulsby, 1957). The purpose of this communication is to report a successful attempt to immunize guineapigs against a lethal oral challenge dose of eggs by the intravenous inoculation of third stage larvae of A. suum.Three groups, each containing nine guineapigs, were infected with Ascaris as follows: Group I was given 10,000 eggs by mouth. Group II Was inoculated intravenously with 2,000 third stage Ascaris larvae which had been obtained from the lungs of other guineapigs on the sixth day of infection. Both groups were challenged at the same time with 250,000 eggs by mouth, along with a control group (Group III) which had no previous infection. The guineapigs in Group I were re-infected after 18 days and those in Group II after 12 days.

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Epidural analgesia in labor in relation to the rate of instrumental deliveries

Annals of King Edward Medical University ◽

10.21649/akemu.v11i3.1031 ◽

2016 ◽

Vol 11 (3) ◽

Cited By ~ 1

Author(s):

Lubna Javed ◽

Anbrin Salick ◽

Naheed Jamal Faruqi

Keyword(s):

Epidural Analgesia ◽

Outcome Measures ◽

Control Group ◽

Stressful Event ◽

Study Group ◽

Psychological Outcome ◽

Second Stage ◽

Second Stage Of Labour ◽

Group I ◽

Group Ii

Aims & Objectives: To study the effect of epidural analgesia (EA) in labour on the rate of instrumental deliveries Study Design: Clinical Trial / Case Control study. Study Settings: Labour ward of Jinnah Hospital, Lahore during one year period from July 2002 to June 2003. Patients and Methods: One hundred women in labor at term were divided into two equal groups. Group-I comprised of those women who were provided with epidural analgesia while group-II consisted of those women who had labour without the block. The anesthetist provided epidural analgesia using 0.125% bupivacaine and the obstetrician or midwife gave intermittent top-ups. Main Outcome Measures: The main outcome measures were the effect of epidural analgesia on the duration of second stage of labor and the rate of instrumental deliveries. The data was collected on a pre-designed proforma and was analyzed on computer software (SPSS). Ratio and proportions were calculated and Chi-square test was used to check significant association between the groups. P<.05 was considered statistically significant. Results: Gestational age, gravidity, duration of first stage of labour, and fetal outcome were comparable between the two groups. There was prolongation of second stage of labour (P < 0.05). 30% of the parturient in the group with epidural analgesia had second stage of <1 hour while there were 84 % of women in the control group who had second stage of <1 hour. 66% of the women in group I (EA) had duration of second stage of 1-2hours while in group-II 16% of women delivered in the same period. 4% of the women in the study group had second stage of >2hours while there was none (0.0%) who took >2hours in the control group. There was an increased rate of instrumental deliveries in patients with epidural analgesia (P<0.05). 40% of women had instrumental deliveries in the study group as compared to 10 % in the control group. Patient satisfaction was excellent among parturient given EA, 94 % of the parturient being very satisfied. Conclusion: Epidural analgesia along with an experienced anesthetist, a dedicated obstetrician and a trained midwife can convert the painful labour into a less stressful event. Although it prolongs the second stage of labour and increases the rate of instrumental deliveries yet its advantages of pain free labour, better psychological outcome and no significant complications outweigh these drawbacks.

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Preemptive Caudal Ropivacaine: An Effective Analgesic during Degenerative Lumbar Spine Surgery

Asian Spine Journal ◽

10.4184/asj.2017.11.1.113 ◽

2017 ◽

Vol 11 (1) ◽

pp. 113-119 ◽

Cited By ~ 1

Author(s):

Shashwat Kumar ◽

Jagannath Manickam Palaniappan ◽

Anantha Kishan

Keyword(s):

Postoperative Pain ◽

Pain Relief ◽

Epidural Injection ◽

Epidural Block ◽

Postoperative Pain Relief ◽

Control Group ◽

Lumbosacral Spine ◽

Study Group ◽

Group I ◽

Caudal Epidural

<sec><title>Study Design</title>This was a prospective, randomized, controlled trial comprising 60 patients undergoing lumbosacral spine (noninstrumentation/nonfusion) surgery.</sec><sec><title>Purpose</title>The purpose of this study was to evaluate the efficacy of 0.2% ropivacaine (20 mL) administered alone as a single, preoperative, caudal epidural block injection versus that of intravenous analgesics in providing effective postoperative analgesia to patients undergoing lumbosacral spine surgery.</sec><sec><title>Overview of Literature</title>Various studies have shown the effectiveness of a caudal epidural injection (bupivacaine or ropivacaine) in providing postoperative analgesia in combination with steroids or other analgesics. This study uniquely analyzed the efficacy of a single injection of caudal epidural ropivacaine in providing postoperative pain relief.</sec><sec><title>Methods</title>Sixty patients who were scheduled to undergo surgery for degenerative lumbar spine disease (noninstrumentation/nonfusion) were consecutively divided into two groups, group R (Study) and group I (Control). 30 group R patients received a caudal epidural block with 20 mL of 0.2% ropivacaine after the administration of general anesthesia. 30 group I patients received no preoperative analgesia. Intravenous analgesics were administered during the postoperative period after a complaint of pain. Various parameters indicating analgesic effect were recorded.</sec><sec><title>Results</title>There was a significant delay in the average time to the first demand for rescue analgesia in the study group, suggesting significantly better postoperative pain relief than that in the control group. In comparison with the control group, the study group also showed earlier ambulation with minimal adverse effects. The requirement for intraoperative fentanyl was higher in the control group than that in the study group.</sec><sec><title>Conclusions</title>Preemptive analgesia with a single epidural injection of ropivacaine is a safe, simple, and effective approach, providing better postoperative pain relief, facilitating early mobilization, and decreasing the intraoperative requirement for opioid administration.</sec>

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Effect of Mobile Internet on Attitude and Self-Efficacy of Patients with Coronary Heart Disease Diagnosed by 12-Lead Holter ECG

Journal of Healthcare Engineering ◽

10.1155/2022/3414178 ◽

2022 ◽

Vol 2022 ◽

pp. 1-7

Author(s):

Haitao Sun ◽

Jing Li ◽

Yue Wang ◽

Xiaoke Ma

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Clinical Data ◽

Self Efficacy ◽

Mobile Internet ◽

Control Group ◽

Study Group ◽

Holter Ecg ◽

Group I ◽

Group Ii

Objective. To explore the effect of mobile Internet on attitude and self-efficacy of patients with coronary heart disease (CHD) diagnosed by 12-lead Holter ECG. Methods. The clinical data of 62 patients with CHD who underwent routine ECG examination (control group I) and 12-lead dynamic electrocardiogram (control group II) in our hospital (June 2017–December 2020) were retrospectively analyzed, and the clinical data of another 62 patients with CHD who received 12-lead Holter ECG examination combined with mobile Internet in our hospital at the same time (study group) were retrospectively analyzed. The clinical observation indexes of the three groups were compared. Results. No obvious difference in general data among groups ( P > 0.05 ). Compared with the control group I, the positive detection rate (PDR) of the study group and the control group II was obviously higher ( P < 0.05 ), and the PDR of the study group was obviously higher than that of the control group II, without remarkable difference between both groups ( P > 0.05 ). Compared with the control group, the scores of CAS-R of the study group were obviously higher ( P < 0.05 ), and self-efficacy of daily life, health behaviors, medication compliance, and compliance behavior of the study group was obviously better ( P < 0.05 ). The diagnostic efficacy was derived by ROC curve analysis, 12-lead Holter ECG combined with mobile Internet + routine ECG > 12-lead Holter ECG combined with mobile Internet > 12-lead Holter ECG > routine ECG. Conclusion. Compared with the routine ECG, the sensitivity of 12-lead Holter ECG in the diagnosis of CHD is conspicuously higher. Meanwhile, 12-lead Holter ECG combined with mobile Internet can enhance the diagnostic efficiency and improve patients’ perceived control attitude and self-efficacy.

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The Correlation between Serum Creatinine and PTH Levels in Dialysis Patients in Egypt

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqab191.328 ◽

2021 ◽

Vol 156 (Supplement_1) ◽

pp. S154-S154

Author(s):

A S Boraik ◽

M Abdelmonem ◽

M Shedid ◽

H M Abd Elaal ◽

A Elhusseny ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Serum Creatinine ◽

Late Stage ◽

The Body ◽

Control Group ◽

Study Group ◽

Dialysis Patients ◽

Group I ◽

Group Ii

Abstract Introduction/Objective Chronic kidney disease (CKD) is affecting about 14% of the general population. CKD is associated with a decrease in calcium level in the body. In the early stages of (CKD), dialysis may not be needed. The late stages of CKD will require dialysis or a kidney transplant to save a life. Secondary hyperparathyroidism is a crucial disorder in CKD patients. It explains why the illness causes a significant change in bone and mineral metabolism. This study aims to study renal hyperparathyroidism (rHPT) in dialysis patients with late-stage of chronic kidney disease (CKD). Methods/Case Report A total of 55 subjects were enrolled in this study for late-stage dialysis patients from Egypt. Serum creatinine and PTH levels were measured. Among the 55 subjects; 41 subjects (74.5%) were males, 14 subjects (25.5%) were females with a mean age of 52.7 and 34.3 years for males and females, respectively. Subjects were divided into two groups; Study group I consists of 33 dialysis patients; three patients were females (9%) while 30 patients were males (91%), and control group II consists of 22 healthy individuals, 11 subjects were females (50%), and 11 subjects were males (50%). Results (if a Case Study enter NA) In our study, in comparison between two groups as regards blood investigations. The means of creatinine and PTH in the study group I were 8.93 mg/dl and 316.8, while in the control group II were 0.9, and 38.4 respectively. Comparing the two groups shows that mean of Creatinine and PTH in the study group was statistically significantly higher than the control group (p-value less than 0.001). Conclusion In patients with CKD, accurate measurement of (PTH) is critical for treatment decision-making to reduce the risk of bone and cardiovascular diseases. We recommend that patients with diabetes and high blood pressure be aware that they must take their medications consistently to avoid kidney problems.

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COMPARATIVE STUDY OF INTRATHECAL FENTANYL WITH HYPERBARIC BUPIVACAINE TO IMPROVE PERIOPERATIVE ANALGESIA IN PATIENT UNDERGOING ORTHOPEDIC SURGERY

10.36106/paripex/5801902 ◽

2021 ◽

pp. 55-58

Author(s):

Rahul Wagh ◽

Swapnil Sangale ◽

Nagesh Jambure

Keyword(s):

Side Effects ◽

Lower Limb ◽

Motor Block ◽

Control Group ◽

Study Group ◽

Hyperbaric Bupivacaine ◽

Analgesic Requirement ◽

Sensory Blockade ◽

Group I ◽

Group Ii

Background: Various methods exist for treating post-operative pain which includes systemic narcotics, NSAIDS, patient-controlled analgesia, regional anaesthesia techniques, epidural local anaesthetic – narcotic mixtures, cryoanalgesia, transcutaneous electric nerve stimulation, psychological methods. Various opioides intrathecally and epidurally have been tried for post-operative analgesia. These include - morphine, pethidine, pentazocine, methadone, tramadol, Fentanyl, sufentanyl. In present study, we tried to find out analgesic effectiveness of intrathecal Fentanyl for post-operative analgesia, combined with 0.5 % Bupivacaine and side effects if any, in patients undergoing lower limb surgeries. Materials and Methods: After approval from the local ethics committee and with written informed consent from patient, a randomized controlled prospective study is carried out in the medical college and hospital.100 patients belonging to American Society of Anesthesiologists (ASA)classification I & II, aged between 18-60 years, posted for elective lower limb surgeries, were randomly allocated for the study. Group-I: 50 patients received intrathecal 3 ml of 0.5 % hyperbaric Bupivacaine only. Group-II : 50 patients received intrathecal 3 ml of 0.5% hyperbaric Bupivacaine and Fentanyl 25 mcg.The patients studied across the group did not vary much with respect to age,height, weight and sex distribution. Results: The onset of sensory blockade was faster by 1.27 min in Group-BF. The perioperative and postoperative hemodynamic parameters were comparable in both the groups. The sensory analgesia in Group II was significantly prolonged by 159 mins, thus increasing the duration of analgesia. The time of first request of analgesics by the patients in group-II is prolonged compared to group-I thus prolonging the duration of analgesia. Analgesic requirement is also reduced in study group in early post-operative period. The onset of motor block was faster when Fentanyl was added to intrathecal Bupivacaine and it was 1.1 min earlier in study group. The duration of motor block to Bromage III was prolonged by almost 22 min in study group as compare to control group. Visual analogue scores were significantly lower in group-II compared to group-I after two hours of surgery thus reducing the frequency of supplemental postoperative analgesics. Conclusion: With the present study we can summarize that intrathecal Fentanyl potentiates the action of Bupivacaine thereby bringing about better quality and longer duration of analgesia, intense motor block, no hemodynamic disturbance and better postoperative outcome with/ minimum side effects.

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Specific humoral immunity in mink infected with the Aleutian disease virus (AMDV) and vaccinated against distemper

Medycyna Weterynaryjna ◽

10.21521/mw.6544 ◽

2021 ◽

Vol 77 (07) ◽

pp. 6544-2021

Author(s):

ANDRZEJ ŻMUDA ◽

KRZYSZTOF KOSTRO ◽

URSZULA LISIECKA

Keyword(s):

Humoral Response ◽

Serum Levels ◽

Suppressive Effect ◽

Control Group ◽

Reproductive Effects ◽

Group I ◽

Group Ii ◽

And Control ◽

Aleutian Disease Virus ◽

Control Group Group

The Aleutian mink disease (AD) is one of the most serious threats to modern mink breeding. In farms where AD is endemic, a significant effect on breeding and reproductive effects is caused by permanent AMDV infection. The aim of this study was investigating the influence of subclinical infection of AMDV on the functional immune status and on the state of postvaccinal immunity against mink distemper. The analyses involved 30 brown mink females aged 12 weeks and allocated into an experimental group (group I) and control group (group II), with 15 animals in each. The minks from group I originated from the farm with an endemic form of Aleutian disease. The control minks from group II originated from the AMDV-uninfected farm. The dynamics of the growth of specific antibodies was examined after vaccination of the minks from both groups against distemper. Serum levels were determined in both groups with a seroneutralisation assay (SN). Obtaining positive values in the SN test in both groups of animals confirmed the induction of a specific immune response. There were significant differences in the magnitude of the positive SN assay values between the minks from group I and group II at all days of determination. The significantly lower SN values noted in the group minks with subclinical course of AMDV reveal that Aleutian disease can cause a suppressive effect on humoral response after vaccination.

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Polydrug- and Methadone-Addicted Newborns: A Continuum of Impairment?

PEDIATRICS ◽

10.1542/peds.70.2.210 ◽

1982 ◽

Vol 70 (2) ◽

pp. 210-213 ◽

Cited By ~ 5

Author(s):

Ira J. Chasnoff ◽

Roger Hatcher ◽

William J. Burns

Keyword(s):

Methadone Maintenance ◽

Behavioral Assessment ◽

Controlled Study ◽

Control Group ◽

Group Iii ◽

Group I ◽

Outcome Group ◽

Group Ii ◽

Prospective Controlled Study ◽

Control Group Group

Two groups of infants born to drug-addicted mothers were evaluated in a prospective controlled study and compared with a third control group. Group I infants (N = 39) were born to mothers on well-controlled low-dose methadone maintenance. Group II infants (N = 19) were born to polydrug-abusing mothers, and group III infants (N = 27) were born to control mothers who had no history or evidence of drug abuse. All three groups were matched for maternal factors that might affect neonatal outcome. Group I infants were significantly smaller than control infants for all growth measurements and had a significantly smaller head circumference than group II infants. Utilizing the Brazelton Neonatal Behavioral Assessment Scale, group I infants showed more depression of interactive behaviors and state controls than group II infants, who in turn were more depressed than group III infants. The effects of nonnarcotic drugs on intrauterine growth and neonatal behavior appear to place the polydrug-addicted newborn in an intermediate zone of deficit between normal and opiate-addicted newborns.

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