scholarly journals Role of Early Tracheostomy in the Management of Severe Head Injury

2019 ◽  
Vol 23 (3) ◽  
pp. 188-192
Author(s):  
ABDUL MAJID ◽  
MUHAMMAD FAROOQ ◽  
MUHAMMAD SHAKIR ◽  
ZUBAIR MUSTAFA KHAN ◽  
SAJID IQBAL

Objective: The objective of this study was to compare the role of early and late tracheostomy in patients presenting with severe head injuries.Material and Methods: This randomized controlled trial study was conducted in the department of neurosurgery, Lahore General Hospital Lahore from March 2018 to August 2018, after taking approval from the ethical committee. A total of one hundred and thirty patients was divided randomly into early (within three days) and late(after three days) tracheostomy groups. After tracheostomy, data regarding acute physiology, age and chronic health evaluation II (APACHE II), the total number of days since ventilation, tracheostomy, weaning, discharge from ICU and hospital, complications and mortality were noted. All the data was entered and analyzed with SPSS23.0. Quantitative variables were presented as mean and standard deviation, qualitative variables were presented as numbers and percentage. The Chi-square test was applied. A p-value of ≤0.05 was considered significant.Results: The mean age of the patients was 33.13 ± 2.53 years. There were 84 males (64.61%) and 46 females (35.38%) in the study. The duration of mechanical ventilation, ICU stay and stay in hospital for early and late tracheostomy groups were 25.68 ± 2.94 vs. 33.37 ± 3.32 days, 29.42 ± 2.97 vs. 38.54 ± 3.80 days and 37.20 ± 2.98 vs. 47.15 ± 3.84 days respectively. Four patients (3.08%) and seven patients (5.38%) suffered from mortality.Conclusion: Early tracheostomy among the patients presenting with severe head injuries was associated with a better outcome than late tracheostomy.

2021 ◽  
Vol 11 (03) ◽  
pp. 125-128
Author(s):  
Salman Habib Abbasi ◽  
Abdul Basit ◽  
Muhammad Farooq ◽  
Fazal Hussain Shah

Objectives: To compare frequency of SSIs with and without early showering after clean and clean contaminated surgical wounds. Study Design and Setting: Randomized controlled trial was conducted at Department of Surgery. HIT Hospital, Taxila from June 2020 to December 2020. Methodology: A total of 130 participants were recruited after taking informed consent. After clean and clean-contaminated surgery, first group was subjected to early showering (48 hours after surgery) while second group was not allowed showering until removal of stiches. Both groups were compared in terms of SSIs. Data was entered into SPSS version 25. The mean and standard deviation were used for the expression of continuous variables while frequency and proportion were used for qualitative variables. Both groups were compared by independent sample t test and chi square test. A p value of <0.05 was considered statistically significant. Results: The mean age of the patients was 39.92 ± 11.42 years and there was male gender dominancy i.e. 74 (56.9%) were males while 56 (43.1%) were females. Clean surgeries were 81 (62.3%) and clean-contaminated proportion was 49 (37.7%). Collectively, 12 (9.2%) patients developed SSIs during clinical followup. There was no difference between groups in terms of age, gender, and wound types (p values 0.680, 0.157 and 0.587 respectively). In shower group, 3 (4.6%) and in nonshower group, 9 (13.8%) patients developed SSIs (p value 0.069). Conclusion: Early postoperative showering can be implemented safely in clean and clean contaminated surgical wounds to minimize SSIs. The results should be evaluated in large RCTs


2021 ◽  
Vol 71 (5) ◽  
pp. 1736-40
Author(s):  
Ammara Rasheed ◽  
Imtiaz Aslam ◽  
Raafea Tafweez ◽  
Muhammad Rizwan Bashir Kiani ◽  
Muhammad Kamran Ameer ◽  
...  

Objective: To investigate the outcomes of energy drink on renal tubules of albino rats. Study Design: Laboratory-based experimental study. Place and Duration of Study: King Edward Medical University, Lahore from Aug 2018 to Dec 2019. Methodology: Group A and B were experimental groups received 1.5ml/kg and 2.2ml/kg body weight of energy drink, respectively. Group C received 1ml/kg body weight of distilled water. Comparison among groups was made by applying One-Way ANOVA for quantitative variables. Tukey’ test was used for post hoc analysis. For qualitative variables, chi-square test was applied to make comparison among groups Results: The mean initial and final weight of animals was around 152.7 ± 5.3g and 171.9 ± 5.1g, respectively. The mean paired kidney weight, relative tissue weight index, length and width of kidneys for all three groups were found insignificant. Microscopic examination showed tubular vacuolization in groups A and B showing p-value of 0.027. Conclusion: Consumption of energy drinks results in histopathological injury of epithelial cells of renal tubules.


2020 ◽  
Vol 8 (4) ◽  
pp. 193-199
Author(s):  
Pujan Balla ◽  
Anil Shrestha ◽  
Ninadini Shrestha ◽  
Navindra Bista ◽  
Moda Nath Marhatta

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.


Author(s):  
Etienne Belinga ◽  
Isidore Tompeen ◽  
Claude Cyrille Noa Ndoua ◽  
Junie Metogo Ntsama ◽  
Sandrine Mendibi ◽  
...  

Background: Uterine synechiae refers to a total or partial union of the inner walls of the uterus resulting from endometrial trauma. It is a cause of reproductive failure. Until now, synechia was not optimally treated and has remained understudied in Cameroon. Objective of present study was to Evaluate the diagnostic, therapeutic and prognostic aspects of uterine synechiae treated by hysteroscopy.Methods: We conducted a descriptive cross-sectional study with an analytical component from January 1st 2015 to July 31st 2017 at Yaounde. All patients diagnosed with uterine synechiae and treated with hysteroscopy were our sample. Sampling was consecutive. The chi-square test was used for the comparison of qualitative variables and Fisher's test for ANOVA variance analysis. The comparison of the averages was made by the Student's test. P-value less than 0.05 was considered as statistically significant.Results: Hysteroscopies were indicated for uterine synechiae in 14.50%. Nulliparous were 56.67%. A history of curettage/aspiration was present in 66.66%. All of the patients had a form of infertility and 83.33% had menstrual disorders. Hysterosalpingography showed a better sensitivity (88%). After hysteroscopic treatment, 63.30% had a complete anatomical restitution. There is a significant correlation between the stage of severity of synechia and anatomical restitution (p=0.008; Spearman correlation coefficient=-0.477).Conclusions: Uterine synechiae represent one-sixth of all indications for hysteroscopy and present clinically as menstrual disorder associated with infertility. A past history of uterine curettage is common. Hysterosalpingography has a better preoperative diagnostic sensitivity. Hysteroscopy allows optimal treatment.


2020 ◽  
Vol 14 (3) ◽  
pp. 445-451
Author(s):  
Asnuddin Asnuddin ◽  
Asrini Mattrah

Social media use: The role of parents' perceptions about social media impact in early marriageBackground: Early marriage is a marriage that is conducted at adolescence, the factors causing early marriage are socio-cultural factors, economic pressure, level of education, difficulty in getting a job, social media, religion and views and beliefsPurpose: To find out the influence of social media and the role of parents on the incidence of early marriageMethod: A quantitative research using descriptive analytical research method with cross sectional study design with variable use of social media with the criteria for the results "active and inactive". For the variable of the role of parents with 2 outcome criteria, namely "influential and not influential". And for the variable incidence of early marriage, there are 2 criteria, namely age 14-16 years and age 17-19 years, the questionnaire used has been through the validity of previous researchers. Then the results of the data obtained were analyzed in the SPSS program using the Chi Square testResults: From the Chi Square test results for social media variables obtained p value = 0.001, then the value of p = 0.001 <0.05 (α) while the role of parents variable Chi Square test results obtained p value = 0.022, therefore the value of p = 0.022 <0.05 (α).Conclusion: Based on the results of the study it can be concluded that, there is a significant influence between the use of social media and the role of parents in the event of early marriage Keywords: Social media; Parents, Early marriagePendahuluan: Pernikahan usia dini adalah perkawinan yang dilakukan pada usia remaja, faktor penyebab pernikahan usia dini adalah faktor sosial budaya, desakan ekonomi, tingkat pendidikan, sulit mendapat pekerjaan, media sosial, agama serta pandangan dan kepercayaan.Tujuan: Untuk mengetahui pengaruh media sosial dan peran orang tua terhadap kejadian pernikahan dini di Kecamatan Marioriawa Kabupaten Soppeng Metode: Penelitian kuantitatif dengan menggunakan metode penelitian deskriptif analitik dengan rancangan cross sectional study dengan variabel penggunaan media sosial dengan kriteria hasil “aktif dan tidak aktif”. Untuk variabel peran orang tua dengan 2 kriteria hasil yaitu “berpengaruh dan tidak berpengaruh”. Dan untuk variabel kejadian pernikahan dini ada 2 kriteria  yaitu umur 14-16 tahun dan umur 17-19 tahun,  kuesioner yang di gunakan sudah melalui uji validitas peneliti sebelumnya. Kemudian hasil data yang di dapatkan dianalisis di program SPSS dengan menggunakan uji Chi SquareHasil: Dari hasil uji Chi Square untuk variabel media sosial didapatkan nilai p=0,001, maka nilai p=0.001<0.05 (α) sedangkan variabel peran orang tua hasil uji Chi Square didapatkan nilai p=0,022, oleh karena itu nilai p=0.022<0.05 (α).Simpulan: Berdasarkan hasil penelitian dapat di simpulkan bahwa, Ada pengaruh yang signifikan antara penggunaan media sosial dan peran orang tua terhadap kejadian pernikahan dini


2022 ◽  
Vol 7 (2) ◽  
pp. 150-160
Author(s):  
Putri Rahmadani ◽  
Besral Besral ◽  
Masrizal Masrizal

Background: The measles rubella (MR) immunization coverage rate in Padang City is only 30.82%, still far below Indonesia's national target of 95%. The coverage of measles rubella immunization at the Rawang Health Center is around 62.1%. This study aims to determine the role of health workers in the success of measles rubella immunization in the Rawang Public Health Center, Padang City. Methods: This study used a cross sectional design. The study was conducted in October 2018-July 2019. The research population is mothers who have children aged 12-59 months (toddlers) as many as 1807 respondents. The sampling method is proportional random sampling with a sample of 87 respondent. Data was collected by interview using a questionnaire. Results: The results showed that 37.9% of children under five had not been immunized against measles rubella and 44.8% of health workers had an unfavorable role. The results of the chi-square test showed a significant relationship  between  the role of officers in  the success of measles rubella immunization  (p-value=0.020). Recommendation: It is hoped that health workers can increase health promotion activities regarding the risks due to children not being immunized against measles rubella and intensify door-to-door programs in the implementation of measles rubella immunization


2021 ◽  
Vol 21 ◽  
pp. e226341
Author(s):  
Moses Okechukwu Azouru ◽  
Modupe Olufunmilayo Ashiwaju ◽  
Augustine Edomwonyi ◽  
Afolabi Oyapero ◽  
Bola Obisesan ◽  
...  

Treatment of dental caries in children still remains challenging due to lack of cooperation with conventional treatment modalities. Recently, the use of Silver Diamine Fluoride (SDF) has proved useful in addressing this challenge. Aim: This clinical trial aimed to evaluate the effectiveness of Silver Diamine Fluoride (SDF) in arresting caries in children in Lagos, Nigeria. Methods: This was a phase III balanced randomized controlled school based interventional study on 240 children. The study group was treated with SDF while GIC was used in the control group. Follow up visits in 2 weeks, 1 month, and 3 months were carried out to assess the treatment outcome. Inferential statistics with the use of Pearson Chi-square test and Independent Student t-test were used at 5% level of significance. Results: There was significant relationship between SDF and caries arrest in 2 weeks, 1 month and 3 months’ assessment period (p = 0.001). The control group showed continuous decline (71.7%, 54.3% and 50.9%) in restorative success from 2 weeks to 3 months respectively. The mean ± SD and Confidence Interval (CI) of arrested caries in the SDF group were 113± 1.24 and 113.1 – 113.5 respectively. In the control group the mean ± SD and CI of restorative success were 69.3±11.8 and 67.2 – 71.4. The effect size was 5.24. Conclusion: The result of the study showed that SDF was effective in arresting caries in children without any harm and there was statistically significant difference in the use of 38% SDF in arresting caries in children.


Author(s):  
Obaid Ul Haseeb ◽  
Haris Rashid ◽  
Afrin Ahmed ◽  
Mir Arsalan Ali ◽  
Shakil Alam ◽  
...  

Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique. Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant. Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002. Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.


2018 ◽  
Vol 5 (2) ◽  
pp. 139-144
Author(s):  
Vera Sesrianty

Emergency nurses connect knowledge with skills to deal with life-threatening patients. The high number of emergency case visits such as respiratory arrest and cardiac arrest in each country is one of the impacts in the failure of emergency cases handling which is generally caused by failure to recognize risks, delays in handling, and lack of facilities and knowledge and skills of medical and paramedical personnel. Based on data obtained at the IGD and ICU RSUD Lubuk Sikaping, during 2016 there were 146 people experiencing emergency with the division of 62 people with respiratory failure, 52 heavy head injuries and 32 cardiac arrest, most died. The purpose of this research is to identify factors related to nurse skill in performing BHD action in IGD Room and ICU of Lubuk Sikaping Hospital. This research uses descriptive analytic method with corelation study approach design. Data processing using Chi Square test, with a sample of 30 respondents. The result of statistical test, it can be concluded that there is correlation of education level factor with BHD action, p value = 0,007 (p = P <α) the existence of time factor relationship with BHD action, p value = 0,000 (p <α) IGD Room and ICU of Lubuk Sikaping Hospital 2017. Suggestion in this research is the result of this research Can add insight and knowledge about the management of BHD properly so that emergency patients can be helped well.


2020 ◽  
Vol 27 (08) ◽  
pp. 1595-1601
Author(s):  
Shahid Rasool ◽  
Salman Azhar ◽  
Talha Munir ◽  
Mian Sajjad Ahmad ◽  
Rizwan Abbas ◽  
...  

Hepatic encephalopathy (HE), a syndrome observed in some patients with cirrhosis, with depressed level of consciousness. Lactulose as well as lactitol has been used in the treatment of HE. Lactitol is comparable to lactulose in the treatment of HE with fewer side effects and better tolerated. However, literature showed equal efficacy of both drugs. So we conducted this trial to find better drug to implement its use in future. Objective: To compare the effectiveness of lactulose and lactitol in patients with acute hepatic encephalopathy. Study Design: Randomized Controlled Trial. Setting: Department of Medicine OPD and Emergency (East, West, North, South), Mayo Hospital, Lahore. Period: 6 Months June 2017 to Dec 2017. Material & Methods: 570 patients were included through non-probability, consecutive sampling after informed consent. Initial grade of HE was assessed and patients were randomly divided in two groups by using lottery method i.e. lactulose or lactitol. Patients were admitted to ward for management and kept under observation for 5 days. After 5 days, HE grades was measured again, then improvement in grade of HE (effectiveness) was measured. All data was entered and analyzed by using SPSS version 21.0. Chi-square was applied to compare both groups for effectiveness taking p-value≤0.05 as significant. Results: In this study the mean age of the patients was 44.22 ±11.81 years, the male to female ratio of the patients was 2.4:1. The mean duration of the cirrhosis of the patients was 3.73±1.61 months. In our study the effectiveness was achieved in 538 (94.39%) patients, out of which 263 cases were from lactulose group and 275 were from lactitol group and the difference was significant (p<0.0.5). Conclusion: Our study results concluded that Lactitol is better choice for the treatment of patients with acute hepatic encephalopathy as compared to lactulose. More efficacy was achieved in lactitol group patients than in lactulose group patients.


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