scholarly journals Effect of Topical Versus Sub-conjunctival Anaesthesia during Administration of Intravitreal Bevacizumab Injection

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Amna Rizwan ◽  
Rabeeah Zafar ◽  
Asfandyar Asghar ◽  
Naila Obaid ◽  
B A Naeem
Keyword(s):  
Pain Score ◽  
Intravitreal Injection ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Pain Scale ◽  
Ethical Review ◽  
P Value ◽  
Intravitreal Bevacizumab Injection ◽  
Department Of Ophthalmology ◽  
Group B

Purpose:  To compare the anesthetic effect of topical proparacaine hydrochloride 0.5% with sub-conjunctival lidocaine 2% for intravitreal injection of Bevacizumab. Study Design:  Quasi experimental study. Place and Duration of Study:  Department of Ophthalmology Fauji Foundation Hospital, Rawalpindi, from July 2017 to January 2018. Methods:  Sixty 60 patients who needed intravitreal Bevacizumab were included in the study after approval from the ethical review board. Exclusion criteria were patients with conditions that could affect pain sensation, acute ocular inflammation, history of intravitreal injection, using systemic analgesic/sedatives, uncooperative patients and unable to understand the pain scale. Written informed consent was taken. Name, age, gender, diagnosis, previous intravitreal injection, hospital registration number, address and contact numbers were noted. Patients were briefed about the visual analogue scale. Patients were divided into two groups. Group A received proparacaine drops and group B was given subconjunctival lidocaine injections before intravitreal bevacizumab. Results:  The mean age of patients in this study was 60.38 ± 10.55 years. There were 03 (5.0%) males and 57 (95.0%) females. Majority of the patients (30%) presented with choroidal neovascularization followed by diabetic maculopathy, vitreous hemorrhage, central retinal vein occlusion and proliferative diabetic retinopathy. Mean pain score among both the groups was 3.67 ± 1.97 (topical group) and 1.70 ± 1.51 (sub-conjunctival group) respectively which was statistically significant (p-value 0.000). Among age, diabetes, duration of diabetes and hypertension, only hypertension had moderate correlation with the pain score (correlation coefficient = 0.316, p values = 0.017). Conclusion:  Sub-conjunctival anaesthesia results in less pain during intravitreal drug administration as compared to the topical anaesthesia. Key Words:  Intravitreal injections, Bevacizumab, Intravitreal Anti-VEGF, Anesthesia.

scholarly journals Efficacy of Tamsulosin as Compared to Placebo, in Reducing Post Operative Flank Pain during Voiding, in Patients with Ureteric Stent

2021 ◽  
pp. 88-93
Author(s):  
Arif Ali ◽  
Suhail Dilawar ◽  
Bilal Suria ◽  
Safiullah Sohu ◽  
Ghulam Mujtaba ◽  
...  
Keyword(s):  
Pain Score ◽  
Renal Calculi ◽  
Pain Scale ◽  
Flank Pain ◽  
P Value ◽  
Trauma Patients ◽  
Ureteric Stent ◽  
Group A ◽  
Group B ◽  
Centre Hospital

Objective: To evaluate the efficacy of tamsulosin in reducing post operative flank pain during voiding, in patients with ureteric stent. Study Design: This is a Randomized control trial (RCT) study. Place and Duration: Study carried out at Department of Urology, Jinnah Post Graduate Medical Centre, Hospital, Karachi, Pakistan, from June 2016 to November 2016. Methodology: 60 patients aged between 15 – 45years, undergone placement of ureteric stent to treat ureteric and renal calculi and have pain score >4, were included in the study. Divided into two groups ‘group A’ and ‘group B’. In group ‘A’ and group ‘B’ Tamsulosin and Placebo was given respectively in patients with ureteric stent and reduction in post-operative flank pain was measured and compared. Tamsulosin was given post operatively when NPO is broken after 2 hours – 6 hours.  Patients having uretral trauma, patients having BPH,  patient underwent TURP or TURBT, patent having urinary tract infection and  patients with pregnancy or lactating females were excluded. All patients were received intravenous antibiotic (Ceftrixone 1gr). Also all patients were receive oral analgesic (diclofenic sodium 50mg BID) and antispasmodics (Drotaverine 80mg BID). Patients were discharged after 24 hours. Postoperatively stent related flank pain during voiding was assessed via Pain Scale. Results: 60 Patients who got operated for ureteric stent. In group ‘A’ there were 21 males (70%) and 9 females (30%), the mean age of group A was 35.67±5.99 as In group ‘B’ there were of 21 males (70%) and 9 females (30%) and mean age of group B was 35.04±6.42 (Table 1). Mean Pain score in ‘Group A’ (Tamsulosin) in week 1, 2, 3, 4, 5, 6 was 4.1, 3.5, 2.9, 2.3, 1.9, 1.3 respectively as shown in Table 2. Mean Pain score in ‘group B’ (Placebo) in week1, 2, 3, 4, 5, 6 was 6.9, 6.3, 5.9, 5.6, 5, 4.2 respectively as shown in Table 2.  Average pain score in ‘group A’ and ‘group B’ came out to be 2.67 and 5.64 respectively (P value 0.005).  Conclusion: Alpha blockers reduces the post-operative flank pain and voiding complaints in patients with ureteric stent. Our study shows that the efficacy of Tamsulosin in reducing post-operatice flank pain in patients with uretercic stent is better than placebo.

scholarly journals Efficacy of Oral Alprazolam and Mefenamic Acid in Relieving Pain During Pan Retinal Photocoagulation

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Iftikhar Ahmad
Keyword(s):  
Diabetic Retinopathy ◽  
Pain Score ◽  
Proliferative Diabetic Retinopathy ◽  
Mefenamic Acid ◽  
P Value ◽  
Eye Drops ◽  
Department Of Ophthalmology ◽  
Pan Retinal Photocoagulation ◽  
Group B ◽  
Retinal Photocoagulation

. Purpose:  To find out the efficacy of oral Alprazolam and Mefenamic acid in relieving pain during pan retinal photocoagulation in patients with proliferative diabetic retinopathy. Study Design:  Quasi experimental study. Place and Duration of Study:  Department of Ophthalmology, Al-Ehsan Eye Hospital, Lahore, from January 2018 to December 2018. Methods:   Patients were divided into two groups; groups A received one tablet of Xanax (Alprazolam 0.5 mg) and 2 tablets of Ponston Forte (Mefenamic acid 500 mg) an hour before PRP. In group B no pain relieving medicines were prescribed. Proparacaine hydrochloride 0.5% eye drops were instilled in the eye to achieve corneal anesthesia before the procedure in both the groups. Pain was scored, 15 minutes after PRP, using standard verbal rating scale and results were analyzed. Paired sample t-test was used to measure the mean difference in pain between the two groups. A p value of less than 0.01% was considered significant. Results:  Five hundred and sixty patients with proliferative diabetic retinopathy (PDR) requiring Pan Retinal Photocoagulation (PRP) were enrolled. There were 272 males and 288 females. Mean age of patients was 64.0 ± 6.8 years. Mean pain score for group A was 4.0 ± 0.6 and for group B was 2.1 ± 0.3. Difference in pain score felt by each group was -1.93 ± 0.7 with significant p value of ˂ 0.01%. Conclusion:  Oral administration of Alprazolam and Mefenamic acid one hour before PRP in patients with proliferative diabetic retinopathy was effective in reducing pain and in attaining patient cooperation during the procedure. Key Words:  Pan Retinal Photocoagulation, Pain, Proliferative Diabetic Retinopathy, Alprazolam, Mefenamic acid.

scholarly journals Comparison between intravenous injectable diclofenac and per rectal diclofenac suppository as analgesics in operated per anal and perianal benign pathologies

2019 ◽  
Vol 7 (1) ◽  
pp. 263
Author(s):  
Juthikaa Abhijit Deherkar
Keyword(s):  
Pain Relief ◽  
Hospital Stay ◽  
Pain Score ◽  
Pain Scale ◽  
Group A ◽  
Group B ◽  
At Home

Background: Per anal and perianal surgeries are one of the bread and butter surgeries in a surgeons life, and satisfaction of patient matters a lot. Early miraculous recovery has always been patient’s expectations hence we decided to study standard IV method of diclofenac as analgesic with diclofenac suppository and compared their effects on patients with the help of pain scale of 0 to 10.Methods: 200 common per anal surgeries were considered in the study, and were divided in two groups group A post operatively IV diclofenac was given 12 hourly and in group B cases diclofenac suppository 100 mg was started daily twice and the pain score was noted for a week.Results: Diclofenac suppositories resulted in early pain relief and thus early discharges of these patients. The pain score had decreased to a larger extent by day 3 and was almost negligible by day 5 and a few cases to day 7. The hospital stay reduced as patient could manage suppository at home by themselves. IV site complications like thrombophlebitis leading to pain and fever could be easily avoided.Conclusions: Thus diclofenac suppositories proved to be an effective way to give a pain free satisfaction compared to intravenous painful analgesics, thus decreased their hospital stay and also it was a patient friendly.

Intravitreal Bevacizumab for Proliferative Sickle Retinopathy: A Case Series

2017 ◽  
Vol 2 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Cindy X. Cai ◽  
Marguerite O. Linz ◽  
Adrienne W. Scott
Keyword(s):  
Sickle Cell ◽  
Large Scale ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Beta Thalassemia ◽  
Intravitreal Bevacizumab Injection ◽  
Initial Injection ◽  
Sea Fan ◽  
Recurrent Vitreous Hemorrhage

Purpose: To report outcomes of intravitreal bevacizumab therapy for proliferative sickle retinopathy (PSR). Methods: A retrospective, interventional case series. Five eyes of 5 patients with PSR were managed with intravitreal bevacizumab therapy over a 13-year period at a single institution. Results: Four patients had sickle cell-hemoglobin SC disease and 1 had sickle cell-beta thalassemia disease. Four of the patients treated with intravitreal bevacizumab injection were treated for recurrent vitreous hemorrhage and 1 was treated for new peripheral sea fan neovascularization. In those patients treated for vitreous hemorrhage, there was improvement in visual acuity as early as 2 weeks after treatment. Only 2 of the patients had documented recurrent vitreous hemorrhage during the period of follow-up after the initial injection. In 1 patient, the vitreous hemorrhage did not recur until 13 months after the injection. All patients showed an anatomic response to intravitreal bevacizumab therapy with partial regression of the peripheral sea fan neovascularization. All patients tolerated the injections without any complications. Conclusions: Intravitreal bevacizumab injections appear to be well tolerated and may be an effective treatment of PSR. Regression of peripheral sea fan neovascularization and decreased duration of vitreous hemorrhage may be observed. Large-scale randomized controlled trials are needed to further clarify the role of bevacizumab in PSR.

scholarly journals Acute Endophthalmitis Caused by Leuconostoc spp. following Intravitreal Bevacizumab Injection

2017 ◽  
Vol 8 (3) ◽  
pp. 510-514
Author(s):  
Supreet Singh ◽  
Chirag V. Patel ◽  
Kamal Kishore
Keyword(s):  
Intravitreal Injection ◽  
Intravitreal Bevacizumab ◽  
Outpatient Setting ◽  
Age Related Macular Degeneration ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Intravitreal Bevacizumab Injection ◽  
Persistent Inflammation ◽  
Age Related ◽  
Bevacizumab Injection

We present a case of acute endophthalmitis caused by Leuconostoc spp. following intravitreal bevacizumab injection. An 86-year-old immunocompetent female developed acute endophthalmitis after intravitreal injection of bevacizumab for neovascular age-related macular degeneration. The patient presented with pain, visual acuity of hand motions, hypopyon, and dense vitritis 96 h after treatment. She was treated with vitreous and anterior chamber tap followed by intravitreal injections of 1 mg vancomycin, 2.25 mg ceftazidime, and 400 μg dexamethasone. Cultures revealed growth of Leuconostoc spp., a genus of gram-positive bacteria that is inherently resistant to vancomycin. Due to persistent inflammation, pars plana vitrectomy (PPV) with intravitreal injection of 0.4 mg amikacin was performed 16 days later, followed by resolution of endophthalmitis and return of vision to 20/40. In conclusion, the management of acute endophthalmitis caused by Leuconostoc spp., a gram-positive coccobacillus, can be particularly challenging due to its inherent resistance to vancomycin. PPV with intravitreal amikacin led to resolution of endophthalmitis. Our case expands the number of cases of endophthalmitis caused by Leuconostoc spp. and highlights the possibility of Leuconostoc-related endophthalmitis in an outpatient setting in an immunocompetent host.

scholarly journals Outcome of intravitreal bevacizumab injection without pre and postoperative antibiotics

2020 ◽  
Author(s):  
Ruchi Shrestha ◽  
Pratap Karki ◽  
Sagun Narayan Joshi
Keyword(s):  
Retrospective Study ◽  
Intravitreal Injection ◽  
Treatment Modality ◽  
Intravitreal Bevacizumab ◽  
Prophylactic Antibiotics ◽  
The Other ◽  
Intravitreal Injections ◽  
Intravitreal Bevacizumab Injection ◽  
Retinal Pathologies ◽  
Bevacizumab Injection

Abstract Backgound Intravitreal injections are the most common treatment modality for several retinal pathologies. Despite endophthalmitis being the most feared complication, antibioprophylaxis remains controversial in intravitreal injections.Methods This was a retrospective study done for a period of 2 years from 1st January 2017 to 31st December 2018 in BPKLCOS among patients receiving intravitreal bevacizumab. The intravitreal injection was given by a single surgeon. It included 503 eyes which received intravitreal bevacizumab over a period of 2 years without pre and postoperative antibiotics.Results Out of 503 eyes studied over a period of 2 years without antibiotic prophylaxis the rate of endophthalmitis was 0.0019% which is very low compared to the other studies with rate of endophthalmitis between 0.019-0.09%.Conclusion The rate of endophthalmitis doesn’t increase after giving intravitreal injections without the use of preoperative/postoperative prophylactic antibiotics. Intravitreal injection can be given safely without pre-operative and post-operative antibiotics. Trial Registration not applicable as it is a retrospective study.

scholarly journals COMPARISON OF TRIGGER POINT PRESSURE RELEASE WITH ULTRASOUND THERAPY TO DECREASE RHOMBOIDS TRIGGER POINTS PAIN

2016 ◽  
Vol 5 (2) ◽  
pp. 32-36
Author(s):  
Azam Mahmood ◽  
Saad Saleem ◽  
Muhammad Usman Khan
Keyword(s):  
Pain Score ◽  
Outcome Measures ◽  
Trigger Point ◽  
Sampling Technique ◽  
P Value ◽  
Ultrasound Therapy ◽  
Pressure Release ◽  
Group A ◽  
The Mean ◽  
Group B

OBJECTIVE To compare the effects of trigger point (TrP) pressure release with ultrasound therapy to reduce rhomboid pain due to TrP. STUDY DESIGN Experimental study STUDY SETTINGS Outpatient department of Ziauddin Hospital, Clifton campus, Karachi, Pakistan. SAMPLE SIZE 50 patients SAMPLING TECHNIQUE Simple random sampling. The patients were divided into two groups of 25. Group A were given TrP pressure release treatment with exercise and group B were given ultrasound (u/s) treatment with exercise. OUTCOME MEASURES The outcome measures were visual analog scale (VAS) for pain and functional rating index (FRI) for functional performance RESULTS In group A, mean pain score on VAS before the treatment were 5.88±1.130 and after treatment were 1.80±1.041 with a p-value of <0.006. Group B, mean pain score on VAS before treatment were 6.56±1.446, after treatment were 2.72±1.208, with a p-value of <0.006. The mean FRI in group A before treatment was 39.92 ± 2.691 and after treatment was 29.60 ± 5.454, with a p-value of 0.002. The mean FRI in Group B before treatment was 41.12 ± 2.505 and after treatment was 35.92 ± 4.183, with a p-value of 0.002.

scholarly journals Murottal Surah Ar-Rahman and Aromatheraphy Lavender (Lavendula Augustfolia) Inhalation to Decrease Labor Pain on First Stage Active Phase

2020 ◽  
Vol 12 (1) ◽  
pp. 10
Author(s):  
Nurul Azizah ◽  
Rafhani Rosyidah ◽  
Evi Destiana
Keyword(s):  
Pain Score ◽  
Design Method ◽  
Active Phase ◽  
Behavioral Observation ◽  
Pain Scale ◽  
Labor Pain ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Significance Level

Childbirth is a natural process and causes pain, but many mothers can not resist the pain because it is influenced by stress. The study using non-phamacological pain relief therapy with aromatherapy which is believed to reduce pain and the aims to compare between murotal Al-Qur'an Surat Ar-rahman therapy and inhalation of lavender aromatherapy to reduce the intensity of labor pain when first active phase.The research design used Quasi Experimental with Non-equivalent Control Group Design method and using pretest - posttest. The population of the first phase active labor mothers in RB Nuril Masrukha Candi Sidoarjo. The technique sampling used Consecutive sampling. Data collected by observing 2 groups of labor mothers: 30 respondents listened to surah Ar-Rahman murottal and 30 respondents inhaled Lavender Aromatherapy. In both of groups, the pretest was given before treatment, then posttest was done after treatment using observation sheet assessment of pain scale with behavioral observation (FLACC behavioral scale). Data analysis using Independent Sample T-Test with a significance level α = 0.05. The results showed that the difference in pain score reduction in lavender aromatherapy inhalation was 3.26 ± 0.25, whereas in the murottal group of the Ar-Rahman Surah mean decrease in pain score was 2.62 ± 0.057 with P value <0.001, that showed a significant relationship.The conclusion is inhalation of aromatherapy lavender (Lavendula Augustfolia) and murottal surah Ar-Rahman can reduce intensity of labor pain during the first active phase, but inhalation group of aromatherapy lavender has a greater pain reduction score than murottal surah Ar-Rahman group.  

scholarly journals Immediate Effect of Intravitreal Bevacizumab Injection on Intraocular Pressure

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Rabeeah Zafar ◽  
Amna Rizwan ◽  
Badar-ud-din Ather Naeem ◽  
Asfandyar Asghar ◽  
Naila Obaid
Keyword(s):  
Intraocular Pressure ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
P Value ◽  
Diabetic Patients ◽  
Vascular Endothelial ◽  
Post Injection ◽  
Intravitreal Bevacizumab Injection ◽  
Applanation Tonometer ◽  
Endothelial Growth Factor

Purpose:  To determine the immediate effect of intravitreal Bevacizumab on intraocular pressure (IOP) in eyes with retinal vascular disorders. Study Design:  Interventional case series. Place and Duration of Study:  Ophthalmology Department, Fauji Foundation Hospital, Rawalpindi, from January 2019to July 2019. Methods:  One hundred and thirty one patients were included in this study using non probability consecutive sampling. IOP was measured before intravitreal injection (baseline) and at 5 and 30 minutes post-injection. Descriptive statistics were obtained using SPSS version 21.0. Results:  One hundred and thirty one eyes of 131 patients were observed for IOP change after intra vitreal injection of Bevacizumab. Among them 23 (18%) were males and 108 (82.4%) were females. Mean age was 57.57 ± 13.09 years. Mean IOP at baseline was 16.16 ± 2.52 mmHg. At 5 minutes after injection, 108 eyes (82.4%) had raised IOP, maximum IOP recorded was 44 mmHg. There was a statistically significant correlation between IOP at baseline and 5 minutes with p = 0.005 (≤0.05). At 30 minutes, 94 eyes (71.7%) had IOP fallen back to normal. Statistically, an insignificant correlation was present between IOP at baseline and 30 minutes (p = 0.081) post-injection. IOP rise was not significantly correlated to gender, age, hypertension and asthma at any interval (p value > 0.05). However, IOP rise was significantly correlated in diabetic patients at 30 minutes. Conclusion:  IOP elevation has been observed after intravitreal bevacizumab in immediate post-injection period which warrants the monitoring of IOP in this critical period to avoid serious blinding complications. Key Words:  Bevacizumab, Vascular endothelial growth factor, Intraocular pressure, Goldmann applanation tonometer.

scholarly journals Comparison of the outcome of amnion versus conventional (Vaseline-impregnated gauze) dressing in superficial partial thickness burn patients in terms of healing time and mean pain.

2021 ◽  
Vol 28 (09) ◽  
pp. 1262-1268
Author(s):  
Abdul Malik Mujahid ◽  
Husnain Khan ◽  
Usman Ishhaque ◽  
Sania Ahmad ◽  
Kashif Mehmood ◽  
...  
Keyword(s):  
Pain Score ◽  
Healing Time ◽  
P Value ◽  
Burn Patients ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Group A ◽  
Gauze Dressing ◽  
Group B ◽  
Dressing Change

Objectives: To compare the healing time and mean pain score of Amnion versus Conventional (Vaseline-impregnated gauze) dressing in superficial partial thickness burn patients. Study Design: Randomized controlled study. Settings: Plastic & Reconstructive Surgery Department, Jinnah Hospital & Burn Center, Lahore. Period: January 2018 to January 2019. Material & Methods: A total of 60 patients with superficial second degree burns full filling the inclusion criteria were recruited for the study. Subjects were divided into two groups randomly. All patients were followed up regularly and dressing was changed on alternate days in Group B (Vaseline-impregnated gauze) and only secondary dressing was changed in Group A (amnion) until the auto sloughage (self-removal) of amnion. Outcome variables i.e. pain during first dressing change and healing time were noted. Statistical analysis of data was done using SPSS version 22. Quantitative variables i.e. age, duration of burn, total body surface area, pain during dressing and healing time were presented as mean and standard deviation. Frequency and percentage was calculated for qualitative variables like gender. The pain during dressing change and healing time of both groups were compared for difference. Student’t’ test was applied to compare the outcome and p-value ≤0.05 was considered as significant. Results: Out of sixty cases, 18 (30.0%) were females and 42 (70.0%) were males, with female to male ratio of 1:2.3. Mean age of patients in group A was 33.0 ± 10.19 years and in group B was 33.73 ± 9.55 years. The mean pain score in group A (amnion group) was 1.93 ± 0.91 and in group B (Vaseline-impregnated gauze) was 3.33 ± 1.56 with p-value of 0.0001. The mean healing time in group A (amnion group) was 15.73 ± 2.79 days and in group B (Vaseline-impregnated gauze) was 22.80 ± 4.44 days with p-value of 0.0001. Conclusion: Amnion dressing in superficial partial thickness burn patients is more effective in terms of mean pain score and healing time as compared to conventional (Vaseline-impregnated gauze) dressing.

Sign in / Sign up

Export Citation Format

Share Document