scholarly journals THE EFFECT OF INTRAVENOUS MAGNESIUM SULFATE ON CHILDREN ADMITTED WITH ACUTE BRONCHIOLITIS IN A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 71 (6) ◽  
pp. 2148-51
Author(s):  
Andaleeb Ara ◽  
Farooq Ikram ◽  
Hidayat Ullah ◽  
Shakila Asmat ◽  
Nadia Tareen

Objective: To assess the efficacy of using intravenous Magnesium Sulfate along with the conventional treatment in the management of acute bronchiolitis Study Design: Quasi-experimental study. Place and Duration of Study: Pediatrics department in Sandeman Provincial Hospital, Quetta, from Jan to Jul 2019. Methodology: The study was approved by institutional ethical committee of Combined Military Hospital, Peshawar. Children, 2 months to 2 years of age, with acute bronchiolitis having clinical severity score of ≥5, presenting to the OPD and emergency department were enrolled in the study after getting informed consent from the guardian. They were randomly assigned group A receiving intravenous Magnesium Sulfate and group B receiving placebo along with the conventional treatment for both. Data was analysed with SPSS-21. Results: Total 108 patients were included in the study with 54 (50%) in group A and 54 (50%) in group B. Mean age in the study was 12.02 ± 6.421 months. Mean age in group A and B was 11.17 ± 6.40 and 12.87 ± 6.38 months respectively. Out of 108 patients 50 (46.3%) were males while 58 (53.7%) were females. There was statistically significant difference in the efficacy of treatment between two groups with values being 48 (88.9%) and 37 (68.5%) for Magnesium Sulfate and control groups respectively (p=0.01). Conclusion: From a clinical point of view, intravenous Magnesium Sulfate combined with conventional treatment is more effective than conventional treatment alone in the management of acute bronchiolitis.

Author(s):  
Shubhatara Swamy ◽  
Vijaya Rajendran ◽  
Durga Prasan ◽  
Pratibha Nadig

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.


2019 ◽  
Vol 6 (3) ◽  
pp. 1182
Author(s):  
Pragalatha Kumar A. ◽  
Indhuja Rajarathinam ◽  
Aruna Gowdra

Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49±1.03 and group B was 2.16±0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p <0.001).Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.


2020 ◽  
Vol 46 (2) ◽  
pp. 128-133
Author(s):  
MA Shakoor ◽  
Md Ali Emran ◽  
Abul Khair Ahmed Zaman ◽  
Md Moyeenuzzaman

Background: Cervical spondylosis is the results of disc degeneration with associated osteophytosis. Cervical traction is widely used to treat neck disorders. Rehabilitation treatment like cervical traction along with other measures at home may play an important role to reduce symptoms of the patients with cervical spondylosis. Objective: A randomised clinical trial was conducted among 125 patients having cervical spondylosis to find out the effects of manual continuous home cervical traction. Methods: The patients were selected on the basis specific selection criteria. They were subdivided into two groups. In Group-A (manual continuous home cervical traction group), 61 patients were treated with exercise, cervical collar, neck support, manual continuous home cervical traction, NSAID, warm moist compression and instruction in posture. In Group-B (conventional treatment receiving group), 64 patients were treated with exercise, cervical collar, neck support, warm moist compression, NSAID and instruction in posture. Results: Among the subjects there were 68 (54.4 %) male and 57 (45.6 %) female.  The mean age of the subjects was 45.94 ± 11.65 years.  There was marked improvement of symptoms of the patients of Group-A in response to treatment for 6 weeks (p < 0.007). It indicates that manual home cervical traction was found effective to reduce the sign and symptoms of cervical spondylosis. There was improvement after treatment in Group-B also (p < 0.01). It indicates that conventional treatment was also found effective. In comparison, there was no significant difference between two groups (p < 0.36, 95% CI= ‐0.56 to 1.51) found after first week. But there was significant improvement in Group-A than Group-B after six weeks of treatment (p < 0.003, 95% CI= -2.40 to -0.51). Conclusion: It may be concluded that manual continuous home cervical traction is beneficial for the patients with cervical spondylosis. Bangladesh Med Res Counc Bull 2020; 46(2): 128-133


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S445-47
Author(s):  
Muhammad Waqas Ayub ◽  
Syed Muhammad Asad Shabbir Bukhari ◽  
Mohsin Raza ◽  
Asma Waqas ◽  
Beenish Hassan Khan ◽  
...  

Objective: To compare the effect of using the tablet Alprazolam 0.25mg in the treatment outcome of vertigo related anxiety by beck anxiety inventory. Study Design: Comparative study. Place and Duration of Study: Combined Military Hospital Okara Cantt, Sep 2018 to Jun 2020. Methodology: A total of 384 patients were included in the study. They were randomly assigned to group A and B by randomized clinical trial. Group A was given tablet alprazolam 0.25 mg along with the conventional treatment of vertigo and group B was given the treatment of vertigo only and no anxiolytic was added. Their pre & post treatment (after 2 weeks) anxiety level using Beck anxiety inventory was scored. Results: There was a significant improvement in group A patient’s vertigo effects after treatment with alprazolam. Also, it was observed that group A patients responded significant improvement in anxiety score as compared to Group B patients 02 weeks post treatment. Conclusion: Antianxiety treatment should be added in all cases with the conventional treatment of vertigo to reduce the vertigo associated anxiety of the patients.


2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Uzma Bashir ◽  
Moizza Tahir ◽  
Muhammad Irfan Anwar ◽  
Faisal Manzoor

Background & Objective: Cutaneous leishmaniasis (CL) is endemic in developing countries like Pakistan. Pentavalent antimonials are still drug of choice, despite being toxic and intolerable for patients. Second line treatments have been extensively studied but the results of their efficacy are conflicting. This, to our knowledge, will be the first study in this regard. Our objective was to  determine if combination of oral itraconazole with intralesional (IL) meglumine antimoniate (MA) reduces the duration of treatment for cutaneous leishmaniasis, as compared to intralesional MA alone. Methods: A randomized controlled trial (single blinded) was carried out from August 2017 till December 2017 on 69 patients who fulfilled inclusion criteria. They were assigned to Group-A or B by lottery method. Group-A patients received IL MA once a week while Group-B received oral itraconazole 200mg, once daily, for six weeks along with similar regimen of IL MA as Group-A. The patients were assessed every three weeks by the blinded assessor till clinical cure was achieved. A follow up visit, two months after clinical cure was done to look for relapse of the disease. Results: Thirty patients in Group-A and 35 patients in Group-B completed the study. At 3, 6, 9 and 12 weeks the patients were assessed for: no, partial or complete response and results of the two groups were compared for statistical significance. The p-values of 0.20, 0.57 and 0.11 at 3, 6 and 9 weeks, respectively, depict that there was no significant difference at any step of assessment between the two groups in terms of healing. The p values of each t test was >0.05 refuting the hypothesis. Conclusion: Combination of oral itraconazole with intralesional MA offered no benefit over intralesional MA alone in the management of cutaneous leishmaniasis in terms of duration of therapy.  Abbreviations Used: IL = Intralesional,  MA = Meglumine Antimoniate, LD = Leishmania Donovan, CL = Cutaneous leishmaniasis, CMH = Combined Military Hospital. doi: https://doi.org/10.12669/pjms.35.6.363 How to cite this:Bashir U, Tahir M, Anwar MI, Manzoor F. Comparison of Intralesional Meglumine Antimonite along with oral Itraconazole to Intralesional Meglumine Antimonite in the treatment of Cutaneous Leishmaniasis. Pak J Med Sci. 2019;35(6):1669-1673.   doi: https://doi.org/10.12669/pjms.35.6.363 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2017 ◽  
Vol 24 (07) ◽  
pp. 1062-1066
Author(s):  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish -

Objectives: The aim of our study which is to compare total intravenousanesthesia with target controlled infusion using the drugs Propofol and remifenatnil with thetechniques of volatile induction maintenance anesthesia using sevoflurane and sufentanil inpatients undergoing laparoscopic cholecystectomy procedure, at a tertiary care hospital inKarachi, Pakistan. Study Design: The type of study is a randomized control trial, conductedfor a period of 8 months Period: from June 2015 to January 2016 Setting: at a tertiary carehospital in Karachi Pakistan. Method: The patient population consisted of n=100 patientsbelonging to the ASA class I and II and undergoing laparoscopic cholecystectomy procedure atour institute. The patients were divided into two groups group A consisted of all those patientswho underwent total intravenous anesthesia and group B consisted of patients who underwentvolatile induction maintenance anesthesia. Appropriate blinding measures were taken for thosewho were involved in the post-operative care of the patients, and the patients themselves. Duringthe procedure routine monitoring was done, data was recorded in a pre-designed proforma.Patients were analyzed in the post-operative period for side effects and pain levels. Statisticalanalysis was done using SPSS version 23, a p value of less than 0.05 was considered to bestatistically significant. Results: The patient population consisted of n= 100 patients dividedinto two groups. No statistically significant difference was found between the demographicvariables of the patients of both groups (age, weight, baseline values of blood pressure, heartrate, time duration of surgery and anesthesia). The time for the loss of corneal reflex was longerin the group A (109 +/- 90) as compared to group B (45 +/- 10) having a p value of less than0.001. However the time for opening of the eyes and the duration of post anesthesia care unitwas shorter in group A (420 +/- 130 seconds for eye opening and 45 +/- 15 min for PACU) andin group B (484 +/- 116 seconds for eye opening and 53 +/- 25 mins for PACU) having p valuesof 0.006 (eye opening) and 0.017 (PACU) respectively. In group A n= 44 (88%) of the patientsrequired rescue analgesia, and in group B n= 36 (72%) of the patients required it, having a pvalue of 0.013 respectively. The need for the use of ephedrine and atropine in the pre and portoperative period was similar in both the groups. Conclusion: According to the results of ourstudy we found that each method of anesthesia has its own advantages and disadvantagesand the anesthetist present should weigh the risks and benefits for each patient individually,and use the most beneficial method of administration of anesthesia in the patient undergoinglaparoscopic cholecystectomy procedure, accordingly.


2022 ◽  
Vol 71 (6) ◽  
pp. 2228-2231
Author(s):  
Ghazala Yasmin ◽  
Naeem Raza ◽  
Arfan -Ul- Bari ◽  
Farah Yousaf ◽  
Summaya Saleem ◽  
...  

Objective: To compare the reduction in mean pain score with local Methylcobalamin injection versus local Bupivacaine injection in patients with acute herpetic neuralgia. Study Design: Quasi experimental study. Place and Duration of Study: Dermatology Outpatient Department, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2019. Methodology: Total 100 patients, having pain score more than 3, fulfilling the selection criteria were divided into two groups. Group A was treated with daily subcutaneous injection Bupivacaine, whereas Group B was treated with daily subcutaneous injection Methycobalamin at the site of neuralgia. Patients were followed up for 4 weeks. The pain score was noted. All the data was entered and analyzed on SPSS version 21. Results: In this study mean age of patients in group A was 43.82 ± 15.76 years and in group B was 44.76 ± 16.92 years. The mean visual analogue pain score at 4th week in the group A patients was 1.14 ± 0.32 and in group B was 1.90 ± 0.97. Statistically significant difference was found in group A (local Bupivacaine) with visual analogue score (VAS) at 4th week (pvalue=0.002). Conclusion: The local Bupivacaine injection showed significant reduction in mean pain score than local Methylcobalamin injection in patients with acute herpetic neuralgia.


2020 ◽  
Vol 24 (4) ◽  
pp. 339-343
Author(s):  
Tanveer Hussain ◽  
Misbah Sattar ◽  
Sara Mustafa ◽  
Uzma Batool ◽  
Shafqat Iqbal ◽  
...  

Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population. Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after  start of the treatment. Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively. Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.


2020 ◽  
Vol 70 (6) ◽  
pp. 1776-81
Author(s):  
Uzma Gul ◽  
Sunarays Akhtar

Objective: To compare intracaesarian placement of intrauterine contraceptive device (IUCD) with interval placement at 6 weeks in terms of device expulsion and continued use at 6 months postpartum. Study design: Randomized controlled trial. Setting: Obstetrics and Gynecology Department, Combined Military Hospital Jhelum, Oct 2017 to Oct 2018. Materials and methods: 104 pregnant women aged 20 to 40 years old, planned for an elective caesarian delivery and who opted for an IUCD were included. They were randomly divided into two equal groups using lottery method. Women were told about their assigned timing of IUCD placement well before their surgery. Group A had IUCD placed during caesarian section while group B (serving as controls) had insertion after 6 weeks. Cu-T 380 A was provided free of charge to all participants. Women were seen after 6 weeks, 3 months and 6 months. Both groups were analyzed and compared in terms of IUCD expulsion and continued use at 6 months postpartum. Results: The device was placed in 48 women in group A and 35 women in group B (p 0.001). There was no statistically significant difference in device expulsion rates between the two groups (p 0.37). After 6 months significantly higher proportion of women in the intracaesarian group were continuing to use the IUCD as compared to the interval group (p˂0.05) Conclusion: Intra-caesarian placement of IUCD leads to statistically significant higher continuation rates as compared to conventional interval placement with no statistically significant difference in expulsion rates.


2021 ◽  
Vol 71 (3) ◽  
pp. 767-70
Author(s):  
Ayesha Imran ◽  
Umairah Yaqub ◽  
Wafa Aslam ◽  
Tehreem Yazdani ◽  
Zarmeen Khawar ◽  
...  

Objective: To find the association of preterm delivery with metabolic syndrome in females presenting in a tertiary care hospital.Study Design: Cohort study.Place and Duration of Study: Department of Obstetrics & Gynecology, Combined Military Hospital Kharian, from May 2020 to Oct 2020.Methodology: A total of 150 females fulfilling inclusion criteria were enrolled in the study which were divided into two equal groups ‘A’ and ‘B’. Group ‘A’ was with metabolic syndrome and group ‘B’ without it. These females were followed in OPD till active labor, assessed and followed till delivery of fetus. If delivery occurred before 37 weeks, then preterm delivery was labeled. All this information was recorded on a pre-designed proforma.Results: The risk for preterm delivery was 2.18 times higher in group ‘A’ as compared to group ‘B’. (Relative Risk = 2.18, CI (95%) 1.1529 - 4.12).Conclusion: There is a strong association of preterm delivery with metabolic syndrome in females.


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