Comparison of Dexamethasone with Ondansetron for Prevention of Post-Operative Nausea and Vomiting

2021 ◽  
Vol 15 (11) ◽  
pp. 3464-3466
Author(s):  
Nazeer Ahmed ◽  
Muhammad Arif Baloch ◽  
Muhammad Sharif ◽  
Zafar ullah ◽  
Yasir Reda Toble
Keyword(s):  
Laparoscopic Surgery ◽  
Tertiary Care ◽  
Cost Effective ◽  
Nausea And Vomiting ◽  
P Value ◽  
Care Hospital ◽  
Group I ◽  
Anesthesia Group ◽  
Cost Effective Alternative ◽  
Post Operative Nausea

Objective: To examine the effectiveness of dexamethasone and ondansetron in reducing the incidence of post-operative nausea and vomiting (PONV) in patients following laparoscopic surgery. Patients and Methods: A total number of 100 patients who were planned for laparoscopic surgery under general anesthesia having age 20-60 years were included in this study from a tertiary care hospital from Dec-2019 to June-2021. Patients were divided in to two group using Draw randomization technique. Group I; in these patients IV dexamethasone 8 mg was given at the time of induction of anesthesia. Group II; in these patients Ondansetron (4 mg IV) was given at induction of anesthesia. After completing the surgery and shifting the patient to the recovery room frequency of PONV within 6 hours after surgery was noted. Results: Mean age of the patients was 43.31±10.41 years. There were 54 (54.00%) male patients and 46 (46.00%) female patients. There were 75 (75.00%) patients with ASA I and 25 (25.00%) patients with ASA II. PONV occurred in 11 (22.00%) patients in dexamethasone group and in 21 (42.00%) patients in ondansetron group (p-value 0.03). Conclusion: After laparoscopic surgery, dexamethasone decreased the prevalence of nausea and vomiting. A single dosage of dexamethasone was proven to be a safe and cost-effective alternative to a single dose of ondansetron. Keywords: Dexamethasone, Ondansetron, post-operative Nausea and vomiting.

scholarly journals Transport Factors Affecting the Outcome of Referred Neonates Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 41 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Madhabi Baidya ◽  
Mahfuza Shirin ◽  
Liton Chandra Saha
Keyword(s):  
Perinatal Asphyxia ◽  
Care Center ◽  
Tertiary Care ◽  
Preterm Neonates ◽  
P Value ◽  
Care Hospital ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Group I ◽  
Group Ii

Background: Adequate neonatal transport is a key component of care of the sick newborns who require referral to tertiary care center. Poor transportation is one of the iatrogenic factors associated with greater neonatal mortality. Neonatal transport is the greatest challenge faced today in our country. The purpose of this study was to find out characteristics of transport of referred neonates and to idention the factors that contribute to mortality.Methodology: This cross sectional study was conducted in Dhaka Shishu (Children) Hospital from June 2013 to November 2013. Both term and preterm neonates who were referred within first seven days of life were included and those with gross congenital abnormalities and left against medical advice were excluded from the study. After enrollment, data were collected using a structured questionnaire including birth details, interventions before transportation, reasons for referral, and details of transportation. Outcome & duration of hospital stay were also recorded. Neonates who were expired considered as group I and who were survived considered as group II. The study variables were analyzed for their association with immediate outcome by applying chi square test and t test. P value <0.05 was considered significant.Results: This study found that out of 332 neonates 181 were expired with 54.5% mortality rate. One eighty one neonates who were expired, considered as group I and one fifty one neonate were survived, considered as group II. The mortality was significantly high in male neonates [RR 0.80 (0.66-0.97)] and neonates those delivered at home [RR 1.34(1.10-1.64)] (p<0.05). Perinatal asphyxia, pre-term low birth weight, neonatal sepsis were the main causes of referral. It was found that transportation without any referral note [RR 1.40 (1.14- 1.71)], no advice regarding maintenance of airway[RR 1.50(1.17- 1.92)]and keeping warm [RR 1.51(1.17-1.950], resuscitation on admission [RR 1.63(1.23-2.17)] and transportation required > 3hours [RR 1.36(1.09-1.69)] were associated with significantly higher mortality among referred transported neonates(p<0.05).Conclusions: This study found that male neonates, home delivery, transportation without any referral note, no advice regarding maintenance of airway and keeping warm, resuscitation needed on admission and prolonged transportation time were significantly associated with mortality of referred transported neonates.Bangladesh J Child Health 2017; VOL 41 (3) :159-164

scholarly journals Prophylaxis of post-operative nausea and vomiting in major obstetrics surgeries: a comparative study between palanosetron and neit guam point stimulation

2017 ◽  
Vol 6 (4) ◽  
pp. 1440
Author(s):  
Shaily Agarwal ◽  
Apurva Agarwal ◽  
Renu Gupta ◽  
Pranshi Gupta
Keyword(s):  
Random Sequence ◽  
Care Center ◽  
Tertiary Care ◽  
Current Treatment ◽  
Nausea And Vomiting ◽  
Chi Square ◽  
Post Surgery ◽  
Group I ◽  
Small Primary ◽  
Post Operative Nausea

Background: Post-operative nausea and vomiting (PONV) prophylaxis is an important component in providing safe anesthesia in antenatal women. Pharmaceutical interventions like metoclopramide and 5-HT3 antagonists are the current treatment of choice for PONV prophylaxis. However newer drugs are less easily available and more expensive and there is always a concern regarding the effects on fetus. The objective of the study was to evaluate and compare efficacy and safety of antiemetic effects of stimulation of neitguam point stimulation with palonosetron for PONV prevention in obstetric surgeries.Methods: A randomized control trial was done on 150 patients with ASA grade I-II, between ages of 18-45 undergoing obstetric surgery under spinal anesthesia at a tertiary care center. The patients were randomly allocated into two groups using a random sequence. In group I, 76 patients received 75μg palonosetron IV 5 minutes prior to induction. Group II contained 74 patients in which neitguam point stimulation was done by acupressure (wrist band) . All patients were followed till 24 hours post-surgery and incidence of PONV was recorded intra-operative and till 30 minutes, at 2 hours, 6 hours and 24 hours post-surgery. The results were analyzed using SPSS software and chi square test.Results: Both neit guam point stimulation and palanosetron were effective in prevention of PONV (p=0.32). neit guam point stimulation can be considered as effective as palonosetron in prevention of nausea. The cost analysis signifies the advantage of neit guam point stimulation.Conclusions: Neit guam point stimulation is a safe and highly effective method to prevent PONV. It can help in bringing down cost and can be easily made at the small primary healthcare centers and trained midwives.

scholarly journals Efficacy and safety of topical 2% dorzolamide and 0.5% timolol in cases of open angle glaucoma in a tertiary care hospital of East Singhbhum: an observational, prospective and comparative study

2018 ◽  
Vol 7 (7) ◽  
pp. 1303
Author(s):  
Akash Chandra ◽  
Manish Kumar ◽  
Amrendra Narayan Mishra
Keyword(s):  
Adverse Effects ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Open Angle ◽  
Group I ◽  
Drug Regimens ◽  
Ocular Pressure ◽  
Dorzolamide Hydrochloride

Background: Present study was undertaken to evaluate and compare the efficacy and side effects of 2% dorzolamide and 0.5% timolol in patients with open angle glaucoma.Methods: There were 60 randomly selected patients were equally divided into Group I (n=30) and Group II (n=30). Further both groups were divided into IA (n=10), IB (n=20), IIA (n=10) and IIB (n=20). 2% Dorzolamide hydrochloride in Group IA and IIA and 0.5% Timolol maleate in Group IB and IIB was administered for 24 weeks. Patients were evaluated for general and ocular examinations on day of enrolment and then at the end of 1st, 4th, 8th and 24th week. Adverse effects of the drug during study period were also noted. Mean±SD, t value, p value and comparison between groups were analysed by graph pad software.Results: At the end of 24 weeks difference in mean reduction of IOP was not significant with 6.2±1.85mm Hg (Right eye) and 5.55±1.68mm Hg (left eye) and 4.72±2.97mm Hg (Right eye) and 5.37±1.24mm Hg (left eye) in Group IA and Group IIA respectively. At the end of 24 weeks difference in mean reduction of IOP was not significant with 5.06±1.62mm Hg (Right eye) and 4.40±1.96mm Hg (left eye) and 4.30±1.41mm Hg (Right eye) and 4.12±2.08mm Hg (left eye) in Group IB and Group IIB respectively. Fall in both systolic and diastolic blood pressure in both the groups were significant. Both drug regimens were well-tolerated, and no serious drug-related adverse effects were reported.Conclusions: Dorzolamide was more efficacious for reduction of intra ocular pressure, well-tolerated, had low allergic response and had a favourable ocular, cardiovascular and respiratory safety profile than Timolol. 

scholarly journals A Study to Evaluate Pharmacoeconomics of Antihypertensive Drugs in a Tertiary Care Teaching Hospital

2020 ◽  
Vol 10 (4-s) ◽  
pp. 176-180
Author(s):  
Nimmy N John ◽  
Athira Krishnan ◽  
JV Midhun ◽  
Riya Juan
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Combination Therapy ◽  
Financial Burden ◽  
Tertiary Care ◽  
Cost Effective ◽  
Effective Therapy ◽  
P Value ◽  
Major Public Health Problem ◽  
Care Hospital

Background: Hypertension is a major public health problem associated with large health burden as well as high economic burden at individual and population levels. A prospective observational study carried out in in-patients admitted to general medicine department of tertiary care hospital to evaluate the most cost effective therapy among the monotherapy of Amlodipine and combination therapy of telmisartan + hydrochlorthiazide. Methods: A total of 120 Hypertensive patients case records prescribed with monotherapy of Amlodipine and combination therapy of Telma H were reviewed and evaluated using descriptive statistics and ‘p’ value and assessed for their financial burden based on the cost per tablet for an year, Cost effectiveness ratio for the patients with controlled Blood Pressure by using a particular drug. Results: Out of 120 patients females were more (59.2%) and most of them were under the age group of 41-60 years. Majority of the patients had a known history of hypertension (65%). Most of the patients were prescribed with Telma H 40/12.5mg (40%) followed with Amlong 5mg (35.8%). There was a significant positive correlation (i.e., p value= 0.05) between persistence patterns of patients with drug therapy. Probability of patients with controlled Blood Pressure taking Amlong 10 mg were 82.35% followed by patients with Amlong 5mg. Conclusion: This study clearly showed that monotherapy of amlodipine is the most cost effective therapy than combination therapy of Telma H in order to reduce financial burden to the patient as well as to decrease the complications. Keywords: Hypertension, Pharmacoeconomics, Cost effectiveness, Blood Pressure.

scholarly journals Dexamethasone is cost-effective alternative to ondansetron in preventing Post-Operative Nausea and Vomiting

2020 ◽  
Vol 24 (1) ◽  
pp. 14-21
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Mamunur Rashid ◽  
Mahiuddin Alamgir ◽  
Md Waliullah ◽  
...  
Keyword(s):  
Placebo Group ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Cost Effective ◽  
Nausea And Vomiting ◽  
Dexamethasone Group ◽  
Ent Surgery ◽  
Cost Effective Alternative ◽  
Post Operative Nausea ◽  
Late Postoperative Period

Background: Postoperative nausea and vomiting (PONV) is a common complication of anesthesia and surgery. Numerous anti-emetics have been studied to prevent and treat PONV. Methods: This study evaluated the antiemetic efficacy, cost-effectiveness and clinical utility of prophylactic dexamethasone and ondansetron compared with placebo in prevention of postoperative nausea and vomiting after ENT surgery in 90 patients. Results: The incidence of PONV was significantly greater in placebo group than dexamethasone group and ondansetron group (p<0.05). The incidence in the dexamethasone group 10% and ondansetron group 26.66% were comparable p>0.05. The incidence of early (0-6 h) PONV was significantly lower in dexamethasone group and ondansetron group than the placebo group (p <0.05). The early incidence was comparable in the dexamethasone (10%) and ondansetrone (13.33%) group( p>0.05). The incidence of PONV in the late postoperative period (6-24 h) was significantly lower in the dexamethasone group (3.33%) than the ondansetron group (23.33%) P<0.05. Conclusion: Both dexamethasone and ondansetron were more effective than placebo in preventing postoperative nausea and vomiting after ENT surgery but dexamethasone was more effective, less expensive and safer than ondansetron, therefore, it may be better substitute for ondansetron. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 14-21

scholarly journals Comparison of Dexamethasone and Ondansetrone Use in Prevention of Post-operative Nausea and Vomiting

2021 ◽  
pp. 279-286
Author(s):  
Shakil Alam ◽  
Haris Rashid ◽  
Sagufta Khan ◽  
Mir Arsalan Ali ◽  
Obaidul Haseeb ◽  
...  
Keyword(s):  
Single Dose ◽  
Laparoscopic Surgery ◽  
Nausea And Vomiting ◽  
P Value ◽  
Chi Square ◽  
Common Procedure ◽  
Quasi Experimental ◽  
Chi Square Test ◽  
Risk Patients ◽  
Post Operative Nausea

Background: PONV remained the common cause of patient’s discomfort after anaesthesia 30% in all post-surgical patients and 80% in high-risk patients. With other common and serious complications of surgeries vomiting and nausea remained unpleasant trigger for patients who underwent the surgeries that prolongs the hospital stay and also leads to recurrent admissions. Therefore in this study we want to compare the effectiveness of pre-operative single-dose dexamethasone versus ondansetron in reducing post-operative nausea and vomiting after laparoscopic surgeries. Methods: Patients admitted for laparoscopic procedures at Ziauddin Hospital North site were recruited for this quasi-experimental study. All consecutive patients were assigned to one of the two groups (1 or 2) using computer generated simple randomised numbers and given either of the two treatments: single dose dexamethasone (5-8mg) or ondansetron (4mg). Researcher assessed post-operative nausea and vomiting at thirty minutes, two, four, eight, and twenty-four hours after the procedure. For statistical association the chi-square test and independent t-test were applied. Significant was defined as a P-value of less than 0.05. Results: The mean age of patients was 42.9±16.6years with mean weight of 62.9±8.8 kilograms. All the operation performed as laparoscopic and common procedure was cholecystectomy (72/98: 73.5%), followed by appendectomy (17/98: 17.3%). Patients with ondansetron had more episodes of vomiting after 30 minutes of laparoscopic surgery. In addition, we discovered a correlation between the two groups' nausea episodes 30 minutes after surgery. After 30 minutes of laparoscopic surgery, patients who took ondansetron reported more nausea episodes. Conclusion:  Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic surgery.

scholarly journals PRIMARY POSTPARTUM HEMORRHAGE

2016 ◽  
Vol 23 (10) ◽  
pp. 1178-1182
Author(s):  
Rozina Yasir ◽  
Mumtu Bai Lakhwani ◽  
Shaista Naz ◽  
Zain Ali
Keyword(s):  
Blood Loss ◽  
Tertiary Care ◽  
Active Management ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Group I ◽  
Third Stage ◽  
Uterine Massage ◽  
Group Ii

Objectives: The aim of our study is to determine the effectiveness of uterinemassage with active management and compare it with active management alone, in primarypostpartum hemorrhage prevention. Study Design: Randomized control trial. Period: 8months from September 2014 to April 2015. Setting: Tertiary Care Hospital in Karachi, Pakistan.Method: The study population consists of n=118 patients, both emergency and elected cases,who came to the gynecology and obstetrics ward at our hospital. The patient population wasdivided into two groups, group I received active management of labor ( third stage ) while groupII received active management of labor (third stage) in addition to the uterine massage (for a 2hrduration), the outcome was measured by measuring the amount of blood loss and the need foruterotonic agents. A p value of less than 0.05 was considered significant. Results: The studypopulation consisted of n=118 patients, undergoing spontaneous labor, and divided into twogroups, the mean blood loss in group I (control group) was 211.4mls and in group II (massagegroup) was 167.8mls (p value= 0.015). In group I n=15 patients required additional uterotonicsupport, while in group II only n=3 patients required it (p value= 0.00058). Conclusion:According to the results of our study, uterine massage in addition to the active managementof labor reduces post-partum hemorrhage, and it also reduces the requirement for additionaluterotonic agents for the control of hemorrhage.

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

2020 ◽  
Keyword(s):  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Traumatic Head Injury ◽  
Keywords Epilepsy ◽  
College Hospital ◽  
Cross Sectional

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.

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