scholarly journals A Comparison of Metoclopramide and Ondansetron Efficacy for the Prevention of Nausea and Vomiting In Patients Suffered From Renal Colic

2018 ◽  
Vol 6 (10) ◽  
pp. 1833-1838
Author(s):  
Abolfazl Jokar ◽  
Peyman Khademhosseini ◽  
Koroosh Ahmadi ◽  
Alireza Sistani ◽  
Mohammad Amiri ◽  
...  
Keyword(s):  
Emergency Department ◽  
Standard Deviation ◽  
Renal Colic ◽  
Vital Signs ◽  
Renal Stones ◽  
Nausea And Vomiting ◽  
Common Disease ◽  
Double Blind ◽  
Significant Difference ◽  
Group 2

BACKGROUND: Renal stones are the third common disease of the urinary system after infections and diseases of the prostate. One of the most common manifestations of this disease after acute pain is nausea and vomiting. AIM: To compare the efficacy of metoclopramide and ondansetron in improving nausea and vomiting in patients referred to the emergency department with a chief complaint of nausea and vomiting. METHODS: This randomised double-blind clinical trial was conducted on patients referred to the emergency department of Vali-e Asr Hospital. Mg5 intravenous morphine and ketorolac ampoule were injected to control renal colic. Then, patients were randomly divided into two groups. Group 1 consisted of 90 subjects receiving 10 mg intravenous metoclopramide and group 2 including 90 subjects receiving 4 mg intravenous ondansetron. Vital signs were also measured and recorded. RESULTS: The mean and standard deviation of nausea in 0, 15, 30, 45, 60 and 120 minutes showed no significant difference between the two groups. Mean and standard deviation of vomiting at 0 minutes showed no significant difference between the two groups, but the remaining minutes, 15, 30, 45, 60 and 120, exhibited significant difference as a comparison of two groups, indicating that vomiting in the metoclopramide group was higher than ondansetron group. CONCLUSION: Our findings indicated that ondansetron was more effective than metoclopramide in preventing and improving vomiting in patients referred to emergency renal colic, where can be used with more efficacy and more acceptable side effects to improve nausea and vomiting.

scholarly journals Reported and unreported potentially important incidental findings in urgent nonenhanced abdominal CT for renal colic

2021 ◽  
Author(s):  
Elena Belloni ◽  
Stefania Tentoni ◽  
Ilaria Fiorina ◽  
Chandra Bortolotto ◽  
Olivia Bottinelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Status ◽  
Pleural Effusion ◽  
Incidental Findings ◽  
Renal Colic ◽  
Legal Issues ◽  
Abdominal Ct ◽  
Significant Difference ◽  
Original Report ◽  
The Difference

PURPOSE: To retrospectively evaluate the prevalence of reported and unreported potentially important incidental findings in consecutive nonenhanced abdominal CTs performed specifically for renal colic in the urgent setting. METHOD: One radiologist, blinded to the finalized report, retrospectively re-evaluated nonenhanced abdominal CTs performed from January through December 2017 on adult patients from the Emergency Department with the specific request of urgent evaluation for renal colic, searching for potentially important incidental findings. RESULTS: The CTs of 312 patients were included in the study. Thirty-eight findings were reported in 38 different CTs, whereas the re-evaluation added 47 unreported findings in 47 different CTs, adding to total of 85 findings (27%). The difference in the proportion of reported and unreported potentially important incidental findings between the original report and re-evaluation was significant (P<.001). No significant difference was found between the age of patients with and without reported findings. The proportion of potentially important findings did not vary significantly among the three shifts neither in the original report nor in the re-evaluation. The most frequent findings, both reported and unreported, were pleural effusion, lymphadenopaties and liver nodules. CONCLUSIONS: Potentially important additional findings are frequently present in urgent nonenhanced abdominal CTs performed for renal colic, and many are not described in the finalized reports. Radiologists should take care not to under report potentially important incidental findings even in the urgent setting because of the possible consequences on the patient’s health status and in order to avoid legal issues, while satisfying the need for timely and efficient reporting.

Determinants of pyelonephritis onset in patients with obstructive urolithiasis

2021 ◽  
pp. 039156032110352
Author(s):  
Georges Abi Tayeh ◽  
Ali Safa ◽  
Julien Sarkis ◽  
Marwan Alkassis ◽  
Nour Khalil ◽  
...  
Keyword(s):  
Emergency Department ◽  
Renal Colic ◽  
Demographic Data ◽  
Vital Signs ◽  
Kidney Injury ◽  
Stone Size ◽  
Positive Urine ◽  
Life Threatening ◽  
Fat Stranding ◽  
Obstructive Pyelonephritis

Background: Acute obstructive pyelonephritis due to urolithiasis represents a medico-surgical emergency that can lead to life-threatening complications. There are still no established factors that reliably predict progression toward acute pyelonephritis in patients presenting with a simple renal colic. Objective: To investigate clinical and paraclinical factors that are associated with the onset of acute obstructive pyelonephritis. Methods: Patients presenting to the emergency department for renal colic with obstructive urolithiasis on imaging were enrolled in the study. Demographic data, vital signs, medical comorbidities, blood test results, urinalysis, and radiological findings were recorded. Obstructive pyelonephritis was defined by the presence of two or more of the following criteria: fever, flank pain or costovertebral angle tenderness, and a positive urine culture. Results: Seventeen patients out of 120 presenting with renal colic, were diagnosed with acute obstructive pyelonephritis (14%). Parameters that were associated with the onset of obstructive pyelonephritis were: diabetes ( p = 0.03), elevated CRP ( p = 0.01), stone size (>5 mm) ( p = 0.03), dilatation of renal pelvis ( p = 0.01), peri-renal fat stranding ( p = 0.02), and positive nitrites on urinalysis ( p < 0.01). Hyperleukocytosis, acute kidney injury, multiple stones, pyuria (>10/mm3), hypertension, and were not associated with the onset of obstructive pyelonephritis. Conclusion: This study showed that known diabetic status, elevated CRP, positive urine nitrites, stone size (>5 mm), pyelic dilatation, and peri-renal fat stranding were associated with the onset of pyelonephritis in patients presenting to the emergency department with obstructive urolithiasis.

The effects of psychological counseling and acupressure based on couple therapy procedure for alleviation of vomiting and nausea in pregnant women in Iran country

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sahar Saadatnia ◽  
Azita Tiznobaik ◽  
Amir Saber
Keyword(s):  
Pregnant Women ◽  
Couple Therapy ◽  
Psychological Intervention ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Negative Effects ◽  
Psychological Counseling ◽  
Significant Difference ◽  
Group 2 ◽  
Short Time

Abstract Objectives Nausea and vomiting have psychological negative effects on some pregnant women during gestation. Different strategies have been used for the treatment of nausea and vomiting during pregnancy, such as acupressure and psychological interventions. This study was conducted to evaluate the effects of psychological counseling and acupressure based on couple therapy procedures on vomiting and nausea in pregnant women in Iran. Methods Two hundred and eight women were divided into four groups (n=52): 1) they did not any intervention (control group), 2) they received the psychological intervention, 3) they received acupressure intervention, and 4) they received a combination of psychological + acupressure interventions. To investigate the effects of interventions on nausea and vomiting, the Rhodes index of nausea, vomiting and retching were used. The counseling period has lasted for 4 weeks. The pressure intervention on the site was conducted in clockwise form for 1 min and anticlockwise form for another 1 min. Results Groups did not have a significant difference for abortion and income (p>0.05). The effects of counseling, and acupressure interventions on severity and period of vomiting and nausea were not significant (p>0.05), but the intervention based on counseling and acupressure decreased severity of vomiting and nausea (p<0.05). Conclusions The intervention based on counseling and acupressure could not reduce nausea and vomiting during the gestation, but the intervention based on a combination of both decreased nausea and vomiting. It can be suggested to apply an intervention based on a combination of counseling and acupressure in short-time period for decreasing nausea and vomiting in women during pregnancy.

scholarly journals Self-etching primer: the effect of contamination with a mixture of saliva and blood on bonding metallic brackets

2013 ◽  
Vol 1 (2) ◽  
pp. 175
Author(s):  
Bernardo Urbanetto Peres ◽  
Felipe Weidenbach Degrazzia ◽  
Renésio Armindo Ghers ◽  
Fabíola Rossato Arrais ◽  
Vilmar Antonio Ferrazzo
Keyword(s):  
Standard Deviation ◽  
Bond Strength ◽  
Shear Bond Strength ◽  
Color Change ◽  
Homogeneous Distribution ◽  
Distilled Water ◽  
Significant Difference ◽  
Student Test ◽  
Group 2 ◽  
Group 1

PURPOSE: To evaluate the shear bond strength (SBS) of metallic brackets bonded with Transbond Plus Self-Etching Primer (TPSEP) and Transbond Plus Color Change (TPCC) under contamination with a mixture of saliva and blood. MATERIALS AND METHODS: 42 human premolars were randomly divided into 2 groups (n=21). Group 1 (G1) were bonded under no contamination, and Group 2 (G2) was contaminated with saliva/blood before bonding. Both groups were bonded according to the manufacturer’s instructions and were cleaned with pumice before bonding. The shear bond strength (SBS) tests were performed after 24 hours in distilled water at 37°C and after thermocycling. RESULTS: Both groups showed a homogeneous distribution in the Levene’s test (p>0.05). The main shear bond strength value of G1 was 8.89 MPa with a standard deviation of 2.27; the value for G2 was 6.00 MPa with a standard deviation of 2.62 MPa. There was a significant difference between G1 and G2 (t-student test p<0.05). IRA scores indicated that the main value was IRA 0, and no significant difference (α=0.05) was found between the groups. CONCLUSION: Contamination of blood mixed with saliva significantly decreases the shear bond strength, but even so, the performance is clinically acceptable.

scholarly journals Intravenous paracetamol versus ketorolac for pain attenuation in patients with renal colic; a randomized, single blind and controlled clinical trial

2020 ◽  
Vol 9 (2) ◽  
pp. e10-e10
Author(s):  
Arash Ardestani Zadeh ◽  
Davood Arab ◽  
Mohammadreza Moonesan ◽  
Majid Mirmohammadkhani ◽  
Pouya Morid
Keyword(s):  
Clinical Trial ◽  
Adverse Effects ◽  
Renal Colic ◽  
Vital Signs ◽  
Analgesic Efficacy ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
Single Blind

Introduction: Pain control is an essential care for patients with renal colic in emergency wards. Objectives: This study aimed to compare the analgesic efficacy of intravenous (IV) paracetamol (PC) versus ketorolac (KET) for patients with renal colic. Patients and Methods: In a randomized controlled clinical trial, 110 patients with renal colic referred to the emergency department of Kosar hospital, Semnan between October 2015 and June 2016 were selected. Eighty-eight patients were divided into two groups (44 patients in each group) of PC (1 g/IV) and KET (30 mg/IV). One patient in each group was excluded during the study. Vital signs and pain severity (measured by visual analogue scale [VAS]) of all patients were recorded at admission time 0, 20, 40 and 60 minutes after treatment. Then, the results were compared in two groups. Results: The results showed that at the time of 0, 20, 40 and 60 minutes after the administration of the PC and KET drugs, no significant difference was seen in severity of pain based on VAS score between the two groups (P<0.05). Moreover, there were no significant differences in the vital signs of two groups (P<0.05). No adverse effects were reported in each group. Conclusion: In conclusion, the use of IV-PC and KET in patients with renal colic had similar pain relieving effects without any adverse effects.

scholarly journals Intravenous Paracetamol vs Intranasal Desmopressin for Renal Colic in the Emergency Department: A Randomized Clinical Trial

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3437-3442
Author(s):  
Hamed Basir Ghafouri ◽  
Niloofar Abazarian ◽  
Mohammadreza Yasinzadeh ◽  
Ehsan Modirian
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Pain Score ◽  
Randomized Clinical Trial ◽  
Renal Colic ◽  
Rating Scale ◽  
Pain Scores ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
Intranasal Desmopressin

Abstract Objective To evaluate the analgesic efficacy of intranasal desmopressin alone vs intravenous paracetamol in patients referred to the emergency department with renal colic. Design Randomized clinical trial. Setting This study was conducted in the emergency unit of a university hospital. Subjects Patients referred to the emergency room with renal colic. Primary Outcome Effect of intranasal desmopressin in pain relief in comparison with intravenous paracetamol. Methods In this trial, 240 patients diagnosed with renal colic were randomly divided into two groups to compare the analgesic effect of intravenous paracetamol (15 mg/kg) and intranasal desmopressin spray (40 μg). Pain scores were measured by a numeric rating scale at baseline and after 15, 30, and 60 minutes. Adverse effects and need for rescue analgesic (0.05 mg/kg max 3 mg morphine sulphate) were also recorded at the end of the study. Results Three hundred patients were eligible for the study; however, 240 were included in the final analysis. The patients in the two groups were similar in their baseline characteristics and baseline pain scores. The mean pain score after 15 minutes was more reduced and was clinically significant (&gt;3) in the desmopressin group (P &lt; 0.0001). There was no significant difference between mean pain scores in the two groups after 30 minutes (P = 0.350) or 60 minutes (P = 0.269), but the efficacy of the two drugs was significant in terms of pain reduction (&gt;6). Conclusions Our study showed that intranasal desmopressin is as effective as intravenous paracetamol for renal colic pain management; however, significant clinical reduction in pain score occurred faster with intranasal desmopressin.

scholarly journals Renal access in PNL under sonographic guidance: Do we really need to insert an open end ureteral catheter in dilated renal systems? A prospective randomized study

2017 ◽  
Vol 89 (3) ◽  
pp. 226
Author(s):  
Bilal Eryildirim ◽  
Murat Tuncer ◽  
Emre Camur ◽  
Fatih Ustun ◽  
Fatih Tarhan ◽  
...  
Keyword(s):  
Randomized Study ◽  
Total Duration ◽  
Renal Stones ◽  
Complication Rates ◽  
Nephrostomy Tube ◽  
Ureteral Catheter ◽  
Sonographic Guidance ◽  
Hospitalization Period ◽  
Significant Difference ◽  
Group 2

Purpose: To evaluate the true necessity of open end ureteral catheter insertion in patients with moderate to severe pelvicalyceal system dilation treated with percutaneous nephrolithotomy (PNL) under sonographic guidance. Patients and methods: 50 cases treated with PNL under sonographic guidance in prone position for solitary obstructing renal stones were evaluated. Patients were randomly divided into two groups; Group 1: Patients in whom a open end ureteral catheter was inserted prior to the procedure; Group 2: Patients receiving no catheter before PNL. In addition to the duration of the procedure as a whole and also all relevant stages as well, radiation exposure time, hospitalization period, mean nephrostomy tube duration, mean drop in Hb levels and all intra and postoperative complications have been evaluated. Results: Mean size of the stones was 308.5 ± 133.2 mm2. Mean total duration of the PNL procedure in cases with open end ureteral catheter was significantly longer than the other cases (p < 0.001). Evaluation of the outcomes of the PNL procedures revealed no statistically significant difference between two groups regarding the stone-free rates (86% vs 84%). Additionally, there was no significant difference with respect to the duration of nephrostomy tube, hospitalization period and secondary procedures needed, complication rates as well as the post-operative Hb drop levels in both groups (p = 0.6830). Conclusions: Our results indicate that the placement of an open end ureteral catheter prior to a PNL procedure performed under sonographic access may not be indicated in selected cases presenting with solitary obstructing renal pelvic and/or calyceal stones.

scholarly journals Comparing the Effects of Dexmedetomidine and Midazolam on Sedation in Children with Head Trauma to Perform CT in Emergency Department / Upoređivanje efekata deksmedetomidina i midazolama na sedaciju dece sa povredom glave radi snimanja CT-om na Odeljenju urgentne medicine

2015 ◽  
Vol 32 (1) ◽  
pp. 59-65
Author(s):  
Hojjat Derakhshanfar ◽  
Farzad Bozorgi ◽  
Adel Hosseini ◽  
Shamila Noori ◽  
Abolfazl Mostafavi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Head Trauma ◽  
Recovery Time ◽  
Vital Signs ◽  
Loading Dose ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Pediatric Sedation ◽  
Group B

Summary Many of the children referred to the emergency complain of head trauma. Children usually require sedition to reduce their failure and fear because of high activity and fear of performing computed tomography (CT). Dexmedetomidine and Midazolam belong to short-acting drugs for this purpose. This study aimed to compare the effect of the above mentioned drugs on sedition in children. Children referred to the emergency department were randomly divided into two groups. Group A was sedated with 0.05 mg/kg IV Midazolam and group B with 2μg/kg IV Dexmedetomidine over 10 minutes (loading dose), and then repeat boluses 2μg/kg IV over 10 minutes. Measurements included induction time, recovery time, efficacy, side effects, complications, and failure with each drug and vital signs and RAMSY scale. SPSS V.20 was used for data analysis. p<0.05 was considered statistically significant. Totally, 100 patients participated in the current study (44 girls and 56 boys). The mean and standard deviation of age was 5.3 ± 2.5 years. During the study, just 5 patients (10%) from group A did not have appropriate sedition following the injection of first dose of Midazolam and received the second dose. However, in B group patients no such case was reported. No significant difference was observed among blood pressure, heart rate, respiration and RAMSY Scale among the groups. No significant difference was seen between efficacy of Midazolam and Dexmedetomidine in pediatric sedation. More research should be done for generalization of our findings .

scholarly journals Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Renu Sinha ◽  
Dilip Shende ◽  
Souvik Maitra ◽  
Neeraj Kumar ◽  
Bikash Ranjan Ray ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Fisher Exact Test ◽  
Double Blind ◽  
Exact Test ◽  
Oculocardiac Reflex ◽  
Significant Difference

Aim.Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery.Methods.A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen.Results.The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex.Conclusion.Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial wasCTRI/2009/091/001000.

scholarly journals Comparison of Ondansetron with Gabapentin for prevention of intrathecal morphine induced pruritus

2019 ◽  
Vol 2 (3) ◽  
pp. 142-148
Author(s):  
Rohini Sigdel ◽  
Anil Shrestha ◽  
Roshana Amatya
Keyword(s):  
Single Dose ◽  
Intrathecal Morphine ◽  
Double Blind Study ◽  
Physical Status ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Subarachnoid Block ◽  
Significant Difference ◽  
Group 2 ◽  
To Receive

Background: Ondansetron has been used successfully for prophylaxis and treatment of intrathecal morphine induced pruritus. Gabapentin has anxiolytic, antiemetic, antipruritic effects and has also been shown to potentiate the analgesic effect of intrathecally or epidurally administered opioids. Materials and method: We compared the effectiveness of oral gabapentin with intravenous ondansetron to prevent incidence of intrathecal morphine induced pruritus. In a prospective, double-blind study, sixty patients aged 18-65 years with ASA physical status I and II undergoing surgery under subarachnoid block were randomized to receive placebo tablets (ondansetron group) or gabapentin 1200 mg (gabapentin group) 2 hours before surgery. Patients receiving placebo tablets received 8 mg of intravenous ondansetron and those receiving gabapentin received 4 ml of intravenous normal saline just prior to subarachnoid block with 3 ml of 0.5% hyperbaric bupivacaine plus 0.2 mg morphine. The incidence, onset, severity, location of pruritus and incidence of side effects were studied for next 24 hours. Results: The overall incidence of pruritus was 48.3%. The incidence, severity, location of pruritus was comparable between the two groups. There was significant difference between the onset of pruritus between groups (p=0.009). The incidence and grade of nausea vomiting, requirement of intraoperative sedation was comparable between groups. The incidence of urinary retention was significantly high in gabapentin group (p=0.020). Respiratory depression was observed in one patient. Conclusion: A single dose of 1200 mg oral gabapentin 2 hours before, is as effective as prophylactic intravenous ondansetron 8 mg for prevention of intrathecal morphine induced pruritus.

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