scholarly journals Comparison of Intravenous Ondansetron versus Intravenous Tramadol on Post-Spinal Shivering and Nausea/Vomiting in Cesarean Sections

2020 ◽  
Vol 1 (4) ◽  
pp. 6
Author(s):  
Sanum Kashif ◽  
Faisal Azam ◽  
Khalid Mehmood ◽  
Saira Tasneem ◽  
Asad Shamim ◽  
...  
Keyword(s):  
Placebo Group ◽  
Group Versus ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Repeated Measure ◽  
Elective Cesarean Section ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Elective Cesarean

Objective: To compare the effect of intravenous ondansetron versus intravenous tramadol on post-spinal shivering and nausea/vomiting in caesarean sections. Study Design: Prospective comparative study Place and Duration of Study: The study was carried out at Department of Anesthesia, Frontier Corps Hospital Quetta from 2nd July 2019 to 1st November 2019. Materials and Methods: Ninety patients, who were scheduled for elective cesarean section under spinal anesthesia were randomly allocated to one of three study groups to receive intravenous ondansetron (group O), tramadol (group T) or normal saline/placebo (group P). Intra- and post-operative shivering score, nausea/vomiting score and hemodynamic changes were recorded. Descriptive data was expressed as means and standard deviations (SD). Analysis of variance (ANOVA) and repeated measure analysis were used for continuous parametric variables. Within groups, comparisons were made using the Tukey's post-hoc analysis. Chi-square test was used for association of shivering and nausea/vomiting among the groups. Results: Both groups were comparable for the age and weight. Shivering was reported 0.35±0.59 in ondansetron group 0.73±0.55 in Tramadol group and 1.90±0.84 in Placebo group (p value< 0.001). Postoperative nausea and vomiting (PONV) was reported 0.25±0.53 in ondansetron group 1.04±0.63 in tramadol group and 0.99±0.71 in placebo group (p value<0.001).There was a significant difference in post- spinal shivering and nausea/vomiting in ondansetron (O) group versus tramadol (T) group and placebo group. Conclusion: The effect of intravenous ondansetron is better than intravenous tramadol in preventing shivering as well as nausea/vomiting.

scholarly journals Major clinical risk factors for seizures in febrile children aged 6 to 60 months.

2020 ◽  
Vol 27 (05) ◽  
pp. 891-894
Author(s):  
Shahid Ishaq ◽  
Ejaz Mazari ◽  
Fazal ur Rehman
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Febrile Seizures ◽  
Study Groups ◽  
Clinical Risk Factors ◽  
P Value ◽  
Chi Square ◽  
Clinical Risk ◽  
Significant Difference ◽  
History Of

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.

scholarly journals Nalmefene relieves epidural morphine-caused pruritus following caesarean section: a randomized and placebo-controlled clinical trial

2019 ◽  
Author(s):  
Chaochao Zhong ◽  
Xingguo Xu ◽  
Xiang Zhu ◽  
Yibin Qin ◽  
Haihang Miao ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Placebo Group ◽  
Cesarean Section ◽  
Epidural Morphine ◽  
Common Adverse Effect ◽  
Opioid Antagonist ◽  
Elective Cesarean Section ◽  
Controlled Clinical Trial ◽  
Significant Difference ◽  
Elective Cesarean

Abstract Background. Epidural morphine has an effective analgesic effect in cesarean section patients; however, a very common adverse effect caused by epidural morphine is pruritus, which is difficult to treat or prevent. Here, we aimed to investigate whether a μ-opioid antagonist with central and peripheral effects reduces morphine-induced pruritus. Methods. In this prospective randomized trial, eighty patients scheduled for an elective cesarean section under spinal aesthesia with 3 mg of epidural morphine were assigned into the nalmefene group (n=40) or placebo group (n=40). After delivery, either 50 μg of intravenous nalmefene hydrochloride (Nalmefene group) or an equivalent amount of normal saline (Placebo group) was administered to the patients. In the meantime, an assessment of a series of side effects such as pruritus, nausea, and pain was conducted at 2, 4, 8, 12, and 24h after epidural morphine administration. Results. All eighty participants completed this trial. The total incidence of pruritus in the first 24 hours following the section was reduced in IV nalmefene group compared with the placebo group (37.5% vs 65%, P=0.003). Moreover, IV nalmefene administration relieved the pruritus intensity, whereas the difference in the incidence of nausea and vomiting between the two groups was not significant. Besides, the nalmefene group displayed significantly higher pain scores at 8, 12 and 24h than the placebo group (all P<0.05). However, no significant difference in the percentage of patients with an analgesic treatment was found between the two groups (P=0.37). Conclusion. In this study, a single dose of 50 μg of IV nalmefene was found to decrease the overall severity and incidence of epidural morphine-induced pruritus, but cause no adverse effect on postoperative analgesia.

scholarly journals COMPARISON OF NEONATAL APGAR SCORES AND PATIENT SATISFACTION LEVELS IN SPINAL VERSUS GENERAL ANESTHESIA IN ELECTIVE CESAREAN SECTIONS

2021 ◽  
Vol 71 (4) ◽  
pp. 1183-87
Author(s):  
Syed Khurram Naseer ◽  
Aijaz Ali ◽  
Shizan Hamid Feroz ◽  
Dr Danish ◽  
Amir Sohail
Keyword(s):  
Patient Satisfaction ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Military Hospital ◽  
P Value ◽  
Apgar Scores ◽  
Significant Difference ◽  
Elective Cesarean

Objective: To compare patients undergoing cesarean section under spinal and general anesthesia in terms of neonatal APGAR scores and patient satisfaction. Study Design: Comparative cross-sectional study. Place and Duration of Study: Departments of Anesthesia and Gynecology and Obstetrics, Combined Military Hospital Peshawar, for six months from Mar to Aug 2019. Methodology: In this study, 120 females with a singleton pregnancy of 36-40 weeks, and requiring a non-emergency elective cesarean section were enrolled through consecutive sampling in the study. The patients were randomly allocated into two equal groups of 60 women each through random table numbers. Group A received spinal anesthesia and group B general anesthesia. APGAR score was assessed at 5 minutes after delivery, and score of ≥7 was taken as satisfactory. Patient's satisfaction level regarding anesthesia was recorded on a visual analogue scale of 0 (extremely unsatisfied) to 10 (completely satisfied), and score of ≥7 was taken as satisfactory. Results: Women receiving general anesthesia were more satisfied as compared to receiving spinal anesthesia (95% vs. 78.3%; p-value 0.007). There was no significant difference in terms of APGAR scores in general anesthesia and spinal anesthesia (83.33% versus 90%; p-value 0.283). Conclusion: After an elective caesarean section, more mothers were satisfied after receiving general anesthesia as compared to spinal anesthesia. However, both types of anaesthesia were found to be equally safe for babies born in terms of APGAR scores at 5 minutes.

scholarly journals A Randomised Blinded Comparison of Epidural Infusion of Ropivacaine, Ropivacaine with Fentanyl for PONV and Sedation in Elective Lower Abdominal Oncosurgeries

2021 ◽  
Author(s):  
SS Srihari ◽  
KS Henjarappa ◽  
BH Arathi ◽  
NR Rashmi ◽  
VB Gowda ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Postoperative Recovery ◽  
Epidural Infusion ◽  
P Value ◽  
Chi Square ◽  
Randomised Study ◽  
Sedation Scores

Introduction: Epidural analgesia is one of the preferred and convenient mode of perioperative management. Neuraxial opioids augment local anaesthetic effect, thus reducing their requirement for analgesia. The addition of fentanyl may cause side-effects like Postoperative Nausea and Vomiting (PONV), sedation which results in patient discomfort, thus effecting postoperative recovery. Aim: To estimate the incidence, compare the requirement of rescue antiemetics for PONV and Ramsay Sedation Scores within first 24 hours of postoperative period in patients undergoing elective lower abdominal oncological sugeries. Materials and Methods: The present study was a randomised study which was carried out from September 2016 to May 2018, in 70 patients of American Society of Anesthesiologists (ASA) 1 and 2, scheduled for elective lower abdominal oncological surgeries. The study population was divided into group R, comprising of patients receiving epidural infusion of 0.2% ropivacaine and group RF with patients receiving epidural infusion of 0.2% ropivacaine with 2 μg/mL fentanyl. The incidence of PONV, rescue antiemetics for PONV and the incidence of sedation using Ramsay sedation score were evaluated in each group and compared. All data was statistically analysed and compared using Student's t-test, Chi-square. The p-value <0.05 was considered to be statistically significant. Results: Groups were comparable with regard to demographic data. The incidence of PONV in group R was 37.1% and in group RF was 28.6%. The requirement of rescue antiemetic for PONV were comparable in the study groups. However, this was not statistically significant. Patients in group RF had higher mean Ramsay sedation scores at 0, 1, 2, 4, 6, 12, 18 and 24 hours but the observed difference in both the groups was statistically significant p<0.05 except at 0 and 2nd hours which were not statistically significant (p>0.05). Conclusion: This study concludes that the patients receiving epidural infusion of ropivacaine with fentanyl should be given prophylactic antiemetic to minimise patient’s discomfort. Also, these patients when compared to patients receiving epidural infusion of ropivacaine alone require monitoring for sedation during the postoperative period.

scholarly journals Breast Feeding Remains a Strong Protection against Infant Infections.

2019 ◽  
Vol 8 (4) ◽  
pp. 203-207
Author(s):  
Shagufta Sohail ◽  
Kaneez Fatima ◽  
Noshina Riaz
Keyword(s):  
Breast Feeding ◽  
Study Groups ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Exclusive Breast Feeding ◽  
Breast Feed ◽  
Significant Difference ◽  
Breast Fed

Background: Breast feeding prevents infections in infants. Those who are partially or never breast-fed and receiving bottle feeds are at higher risk of infections as compared to exclusive breast-fed infants. The objectives of this study were to record the effect of exclusive breast feeding versus partial and never breast feeding on infections in infants and also to find an association of infection with type of feed, gestation and vaccination status in infants till six months of age.Material and Methods: A total of 500 Infants were included in this cross-sectional study. Information regarding pattern of feeding and infections was obtained by verbal interview of mother and the questionnaire was filled by the study physician. The outcome evaluated was infections in infants till one year of age. Categorical comparisons were made using chi square test. A ‘p’ value < 0.05 was considered statistically significant.Results: Out of 500 infants, 59.4% were males. About 59.6% were exclusively breast-fed till 6 months of age, 31.2% were partially breast-fed and 9.2% were never breast-fed. In exclusively breast-fed group, 29.5% infants reported infections as compared to 40.4% in partial breast-fed group and 65.2% in never breast-fed infants (P < 0.000). Similarly, 40.6% of infants in exclusively breast-fed group, 55.1% in partial breast feed and 58.7% in the never breast-fed reported infections in 4-6 months of age, which was statistically significant (P = 0.003). There was no significant difference in infection rates among the three study groups in 7-9 (P=0.192) and 10 -12 months (P=0.42) of age.Conclusions: Exclusive breast feeding till six months of age significantly reduces the risk of infections in infancy.

Success Rate of Obturation of Root Canals by Different Techniques in Primary Molars: A Comparative Clinical Study

2020 ◽  
Vol 2 (1) ◽  
pp. 36-44
Author(s):  
Satyawan G. Damle ◽  
Ritika Bansal ◽  
Dhanashree D. Sakhare
Keyword(s):  
Success Rate ◽  
Study Groups ◽  
Primary Molars ◽  
Control Group ◽  
Second Primary ◽  
Chi Square ◽  
Exact Test ◽  
Root Canals ◽  
Significant Difference ◽  
Comparative Clinical Study

Objective: To compare the success rate of different obturation procedures in primary mandibular second molars clinically and also by digital radiovisiography. Methods: A total of 40 children aged between 4-8 years with deeply carious mandibular second primary molars indicated for single session pulpectomy were selected. Canals were obturated with Metapex. The 3 study groups (Endodontic plugger, Handheld lentulospiral, Navi Tip syringe) were compared with the control group (reamer) both clinically and radiovisiographically. The data collected were statistically analyzed using Pearson’s Chi-square and Fisher’s exact test. Results: The use of Navi tip syringe led to the least number of voids followed by Endodontic plugger and Reamer and the highest number of voids was reported with Lentulospiral. Navitip presented maximum number of optimally filled cases followed by Endodontic plugger and Lentulospiral and least number of optimally filled cases with reamer. However, there was no statistically significant difference (p>0.05) in any of the groups with clinical (pain and tenderness to percussion) and radiographic parameters (presence or absence of voids and length of obturation). Conclusion: Within the limitations of the present study, though the clinical outcome was statistically insignificant, Navitip syringe exhibited encouraging results and is a promising option for obturation in primary teeth.

A Study to Evaluate the Effectiveness of Webinar on Knowledge Regarding the Strategies to Prevent Covid 19 among Nursing Students of SIIHS, Honavar, Uttara Kannada

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Sagaya Arockiya Mary. A ◽  
Susai Mari.A ◽  
Wincy. C ◽  
Thirumurugan. M ◽  
Verginia Dsouza ◽  
...  
Keyword(s):  
Nursing Students ◽  
Student Nurses ◽  
Sampling Technique ◽  
Knowledge Score ◽  
P Value ◽  
Sufficient Information ◽  
Knowledge Level ◽  
Chi Square ◽  
Significant Difference ◽  
Post Test

Background: The one virus stumbled the whole universe is the novel corona virus and impacted physical, emotional and social health status of almost every individual in the world irrespectively. Since the existence of Covid-19 till now it is been noticed that student nurses also affected by this fatal viral infection during their clinical practice. Objectives: The study focused on evaluating the effectiveness of webinar on knowledge regarding the strategies to prevent Covid -19 among student nurses of SIIHS, Honavar, Uttara Kannada. The study aimed at enhancing the knowledge level and influences others through effective health teaching at clinical areas and even in community settings. Methodology: An evaluative approach with pre- experimental, non-randomized, one group pre and post-test research design was adapted. The sample size was 294, purposive sampling technique was adapted. Data collected through testmoz web page and webinar was conducted by google meet app for one week. Data analysed by descriptive and statistical methods (chi-square and z-test) and interpreted by graphs. Results: The findings show that in pre-test 10(3.41%) had poor, 127(43.19%) had average, 157(53.40%) Good and 00% excellent knowledge level whereas in post-test 00% had Poor, 59(20.06%) Average, 176(59.86%) Good and 59 (20.06%) had excellent knowledge level. The pre-test mean score was 23.1 (46.2 %.) and of post-test was 35.6 (71.2%). The computed z’-test value showing significant difference in the pre (x?1=23.1) and post-test (x?2=35.6) knowledge score (p=1.18357, < z= -5.1679, critical z score=-1.6449 ? =0.05 level of significance). Hence the p value is greater than the z value (p(x?Z) = 1.18357e-7), it indicates the webinar was effective and the null hypothesis (H0) is rejected. Conclusion: The study was concluded as the webinar was highly effective and influenced the participant to gain sufficient information on prevention and the spread of Covid 19. Hopefully this enables them to apply

A Comparative Study between Ketamine and Lidocaine ro Decrease Propofol Injection Pain During Induction of Anesthesia

2021 ◽  
Vol 6 (1) ◽  
pp. 1304-1309
Author(s):  
Bikash Khadka ◽  
Nil Raj Sharma
Keyword(s):  
Comparative Study ◽  
Venous Occlusion ◽  
Verbal Response ◽  
Injection Pain ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Lidocaine Group ◽  
Mild Pain ◽  
Significant Difference

Introduction: Pain during the injection of anesthetic agents may be distressing and can reduce the acceptability of an otherwise useful agent such as propofol during daycare surgeries. Lidocaine and ketamine both are used as pre-treatment to decrease propofol induced pain. This study aims to compare the effectiveness of ketamine injection to decrease propofol-induced pain in comparison to lidocaine injection. Methodology: This is a prospective cross-sectional comparative study. Eighty-nine cases were divided into two groups where group K received ketamine 2 ml (0.2 mg/kg) whereas group L received lidocaine 2% 2ml (0.5 mg/kg) after venous occlusion with rubber tourniquet. One-fourth dose of propofol was injected 1 min after release of tourniquet and pain accessed at 0, 1, and 2 minutes of propofol injection with a verbal response and behavioral signs. Chi-square test and paired T-test were used and a p-value less than 0.05 was considered significant. Result: Regarding hemodynamic, oxygenation, and adverse effects there was no significant difference. Immediately after propofol injection, only 1 patient of the ketamine group had mild pain (2.22%) while 12 patients from the lignocaine group had mild pain (27.27%) with a p-value of 0.009. Also after 2 minutes of propofol injection, only 12 cases had mild pain i.e. 13.48% (1 from ketamine group i.e. 2.22% and 11 from lidocaine group i.e. 25%) with p-value of 0.002. Conclusion: Our study helps prove low-dose ketamine is more effective in reducing the incidence and severity of pain on injection of propofol in comparison to Lidocaine with better hemodynamic stability. 

Effectiveness of Intrathecal Administration of Bupivacaine with Fentanyl versus Nalbuphine for Elective Cesarean Section

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nada Mohamed Bahaa Eldin Mostafa Abdel Rahman ◽  
Khaled Mohammed Maghawry ◽  
Raham Hasan Mostafa ◽  
Ahmed Wagih Ezzat
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Intrathecal Injection ◽  
Group Versus ◽  
Rapid Onset ◽  
Elective Cesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Elective Cesarean ◽  
Fentanyl Group

Abstract Background Spinal anesthesia is the most popular procedure in the field of anesthesiology. Subarachnoid block is the preferred anesthetic technique for cesarean section, being simple to perform and economical with rapid onset. Lower incidence of failed block, less drug doses, minimal neonatal depression and decreased incidence of aspiration pneumonitis are added advantages of spinal anesthesia. Objectives The study aims to compare the postoperative analgesic efficacy of Fentanyl versus Nalbuphine when used with intrathecal injection of 0.5% hyperbaric bupivacaine in spinal anesthesia in patients undergoing cesarean section as the primary objective and compare intraoperative hemodynamic changes and postoperative pruritus and shivering as the secondary objectives. Methods and material After Approval was obtained from the research ethics committee of faculty of medicine, Ain Shams University and after obtaining a written informed consent. Fifty adult females underwent elective cesarean section with spinal anesthesia, their ages ranged between 18-45 years old and classified as ASA I and II were enrolled in the study at obstetrics and gynecology Ain Shams university hospital over 4 months. The patients were randomly divided using computer generated randomization into two groups 25patients in each (n = 25), Group A received intrathecal injection of 2 ml of 0.5% hyperbaric bupivacaine plus 0.5 ml fentanyl (25 μg); Group B received intrathecal injection of 2 ml of 0.5% hyperbaric bupivacaine plus 0.5 ml nalbuphine (0.8 mg) Results The main significant findings in this study was that fentanyl has a more rapid onset of motor block (5.63±0.25 minute in fentanyl group versus 5.88±0.19 minute in nalbuphine group), while nalbuphine produces less perioperative side effects as: shivering (7 patients in fentanyl group versus 1 patient in nalbuphine group), pruritis (6 patients in fentanyl group versus 1 patient in nalbuphine group), nausea and vomiting (5 patients in fentanyl group versus 1 patient in nalbuphine group). Regarding perioperative hemodynamic parameters and postoperative analgesia, they were comparable between the 2 groups. Conclusions We concluded that either intrathecal nalbuphine (0.8 mg) combined with (10 mg) Bupivacaine or intrathecal fentanyl (25 µg) combined with (10 mg) Bupivacaine improves intraoperative analgesia and prolongs early postoperative analgesia in cesarean section with significantly lower incidence of side effects as shivering, pruritis, nausea and vomiting in Nalbuphine.

scholarly journals Orthodontics-Awareness Amongst Medical Students

2020 ◽  
Vol 10 (3) ◽  
pp. 49-56
Author(s):  
Türkan SEZEN ERHAMZA ◽  
Kübra A ARSLAN ÇARPAR
Keyword(s):  
Medical Students ◽  
Statistical Evaluation ◽  
P Value ◽  
Chi Square ◽  
Level Of Education ◽  
Significant Difference ◽  
Chi Square Test ◽  
Treatment Procedures

Introduction: The study aimed to evaluate the knowledge and awareness of orthodontics, a specialty of dentistry,amongst Medical Students. Materials and Method: A sample of 550 students (279 female, 226 male aged between 18 and 36 years) were attented.Of the subjects, 58.6% (n = 296) were preclinical students, while 41.4% (n = 209) were clinical students. The students were informed about the questionnaire and asked to fill in the questionnaire forms. For the comparison of data between groups (gender, level of education), the chi-square test was used. A chi-square test was used for statistical evaluation and the p-value < 0.05 was considered statistically significant. Result: 385 students (76.2%) had heard the term orthodontics although 41.2% of the subjects knew that orthodonticswas concerned with malocclusions and their treatment. The question about treatment procedures was answeredas scaling by 35.8%, tooth polishing by 40%, tooth aligning by 89.9% of the students. The percentage of knowingorthodontics to be related to tooth aligning showed a significant difference between female and male (p = 0.006), andpreclinical and clinical students (p = 0.033). Of the participants, 42.8% thought that dentures, 83% brackets, 78.8% ofremovable appliances were used by orthodontists. Conclusion: Our results have shown that medical students should have more information about orthodontics, aspecialty of dentistry.

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