Comparison of Efficacy of Intravenous Tramadol versus Normal Saline in Suppression of Postoperative Shivering in Patients undergoing Elective Surgery

2021 ◽  
Vol 15 (8) ◽  
pp. 2006-2009
Author(s):  
Riffat Saeed ◽  
Nasir Ali ◽  
Syed Mehmood Ali ◽  
Iram Qamar ◽  
Amer Latef ◽  
...  

Background: Shivering in the post anesthesia care unit is a common and distressing complication for patients after receiving general or regional anesthesia. Perioperative hypothermia has been associated with an increase in morbidity and mortality. Both central and peripheral thermoregulation is impaired by regional anesthesia. Thermoregulatory system synchronizes with defense system to maintain body’s heat and coolness within the narrow range, thus improving the normal functioning. Objective: To compare the efficacy of intravenous tramadol versus normal saline in suppression of postoperative shivering in patients undergoing elective surgery. Design: It was a randomized control trial. Study Settings: Trial was conducted at Department of Anesthesiology and ICU, Sheikh Zayed Hospital, Lahore, for a period of one year w.e.f 7-11-2019 to 7-11-20. Patients and Methods: A total of 50 patients with age 18 years and above from both the genders undergoing elective surgery under general anesthesia were included in the study and divided into two equal groups randomly. Patients in tramadol group were given tramadol 0.5mg/kg I/V and patients of control group were given 0.9% normal saline 5ml I/V. Results: In tramadol groups the mean age of patients was 27.88±2.79 years while the mean age of the patients from placebo group was 27.84±4.23 years. In this study the efficacy was achieved in 37(74.0%) patients. In control group the efficacy was achieved in 15(60%) patients and in tramadol group the efficacy was achieved in 22(88.0%) patients (p-value<0.05). Conclusion: According to this study the intravenous tramadol is safe and effective drug in suppression of postoperative shivering in patients undergoing elective surgery under spinal anesthesia. Keywords: Intravenous Tramadol, Spinal Anesthesia, Shivering, Elective Surgery.

Author(s):  
Albert; Akhyar Hamonangan Nasution ◽  
Qadri Fauzi Tanjung

Spinal anesthesia was typically used for elective surgery and was associated with the incidence of hypotension and bradycardia due to sympathetic block. Bezold-Jarisch reflex (BJR) is a reflex that contributes to cause hypotension and bradycardia mediated by serotonin receptors (5-HT3). Ondansetron, a 5-HT3 receptor antagonist, is assumed to inhibit the effect of serotonin and BJR. To assess the effectiveness of ondansetron in preventing hypotension and bradycardia after spinal anesthesia. This study was an experimental study with a "posttest with control group" design conducted at Haji Adam Malik General Hospital and USU Hospital in February 2020 to June 2020. Seventy study subjects who underwent lower abdominal, gynecology, lower extremities under spinal anesthesia were selected by consecutive sampling and were divided into 2 groups. Group 1 received 4 mg ondansetron, while group 2 received 2 cc normal saline, both interventions were given 30 minutes before spinal anesthesia Baseline and minimum mean arterial pressure were higher in the ondansetron group at 97.07 ± 5.09 mmHg and 85.20 ± 6.48 mmHg compared to the control group (p-value <0.05). Hypotension was more common in the control group (51.43%) than in ondansetron group (20%) (p-value <0.05). The mean baseline and minimum heart rate were higher in the ondansetron group at 81,09 ± 9,62 bpm and 79.7 ± 8.75 bpm compared to the control group (p<0.05). The incidence of bradycardia was more common in the control group (17.1%) compared to the ondansetron group (2.9%) (pvalue <0.05). Ondansetron 4 mg, given intravenously, is effective in lowering the incidence of hypotension and bradycardia under spinal anesthesia


2018 ◽  
Vol 9 (3) ◽  
pp. 182-184
Author(s):  
Najmeh Amani Babadi ◽  
Masoomeh Kheirkhah ◽  
Faraz Mojab ◽  
Hamid Haghani

Episiotomy is one of the most common midwifery interventions method for preventing injuries to the pelvic floor during the delivery process. Traditional medicine has a special place in improving the quality of postpartum care. Sesame is one of the herbs with anti-inflammatory, anti-bacterial and antioxidant activity.  This study was evaluate the effect of sesame ointment on episiotomy healing. Methods: This randomized control clinical trial was performed on 104 eligible women. The samples were block randomly assigned to one of the groups Intervention and control. Samples were used sesame and placebo ointment for epizootics from 4 hours after delivery for ten days every 8 hours. Clinical evaluation of episiotomy ulcer was performed 4 hours, 7 and 10 days after delivery with using REEDA tool. SPSS software version 16 was used for data analysis. P value less than 0.05 was considered significant. Results: The average of wound healing rate was 7 days after episiotomy in the intervention group 0.09 ± 0.29 and in the control group was 0.73 ± 0.44. Independent t-test showed that the two groups had a significant difference (p <0.001).Healing of the wound 10 days after episiotomy showed that the mean scores in the control group (0.4 ± 0.49) and in the intervention group (0.02 ± 0.13), healing in the intervention group significantly decreased from the control group (p <0.001). Conclusion: Sesame ointment can be used as a pain relief and accelerator for episiotomy healing.  


Biology ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 358
Author(s):  
Javier Aragoneses ◽  
Ana Suárez ◽  
Nansi López-Valverde ◽  
Francisco Martínez-Martínez ◽  
Juan Manuel Aragoneses

The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.


Author(s):  
Priyanka Jain ◽  
Rakesh Jain

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e.  adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nadia abdelaty Abdelkader ◽  
Moustafa Hamed Abdelaleem ◽  
Mohammed El-Gharib Abo El- maaty ◽  
Heba Ismail Aly ◽  
Sayed Ahmed Sayed

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and it is also a common cause of death in patients with chronic liver disease. The curative treatment options for HCC that are currently available are surgical resection, liver transplantation and radiofrequency ablation .Despite progressive improvements in the efficacy of RFA, the survival of patients with HCC who undergo RFA remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after RFA. Aim of the work To evaluate the role of transient elastography (as an indirect indicator to degree of liver fibrosis) in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation in hepatitis C related hepatocellular carcinoma .And to compare between transient elastography and other non invasive fibrosis indices in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation hepatitis C related hepatocellular carcinoma Patients and methods This prospective cohrt study was conducted on hepatocellular carcinoma patient, who underwent radiofrequency ablation in Tropical Medicine Department in Eldemerdash and Ain Shams Specialized Hospital, HCC clinic Ain Shams University Hospitals, Cairo, Egypt between march, 2017 and May, 2019. Data of the patient, who underwent radiofrequency ablation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and underwent radiofrequency ablation were followed up for 12 months. Results TE revealed 28 patients with F4 and only 2 patients with F3, the mean measurement of liver stiffness was (22.45 ± 10.36) KPa. There was a significant negative correlation between LS and denovo recurrence of HCC (mean of LS in patients with complete response was 17.19 ± 3.32 and the mean of LS in patient with denovo recurrence was 36,94 ± 5.93,with the The best cut off value ≥24.65 (p value &lt; 0.001)). There was no significant correlation between CDC, FIB4, API scores and denovo recurrence of HCC. Also it was found that the LS was significantly associated with prediction of manifestation of hepatic decompensation after RFA (means of LS in patient without manifestation decompensation after RFA (p value &lt;0.001) .Regarding prediction of mortality, LS at cut off value &gt; 42 .75 (p value = 0,031) was significantly associated with prediction of mortality after one year of RFA. As regard serum non invasive fibrosis indices our results showed correlation between FIB4 score and hepatic decompensation after one year of intervention (the mean of FIB4 score in patients ascites and jaundice was 6.05 ± 4.71 (p value = 0.05) ).Therewas no statistically significant correlation between CDS and API with hepatic decompensation after RFA .As regard role of serum non invasive fibrosis indices in prediction of mortality after RFA, FIB4 score, CDS and API were statistically non significant. Conclusion Our data suggest that LS measurement is a useful predictor of HCC de novorecurrence overall survival and possibility of hepatic decompensation after RFA


2018 ◽  
Vol 7 (2) ◽  
pp. 116
Author(s):  
Budi Darmawan ◽  
Diyah Fatmasari ◽  
Rr. Sri Endang Pujiast

Background: Wet cupping, furthermore mentioned cupping, decreases blood pressures through the level of negative air pressures added by hydrostatics filtration pressure to reinforce the power of fluids filtration in capillaries. However, an appropriate negative air pressure to decrease blood pressure remains an uncertainty.Purpose: This study aimed to analyze negative air pressure differences on cupping in decreasing blood pressures in hypertensive patients.Methods: This is a quasi-experimental design conducted in three Community Health Centers in Langsa City, Aceh, Indonesia. The samples were 36 hypertensive males with age from 45 to 55, who were randomly stratified into two groups with cupping pressures 400 mbar (n=18) as the control group; and 540 mbar (n=18) as the intervention group. The cupping session was performed to each group on T1 (alkahil) point and in the middle line of both shoulders blade points. The systolic blood pressure (SBP) and diastolic blood pressures (DBP) were measured by validated automatic sphygmomanometer. The follow-up periods were one week and two weeks. The data were then analyzed by repeated measures ANOVA.Results: Cupping pressure of 400 mbar decreased the mean of SBP and DPB with a p-value of 0.450 and 0.026, respectively after two weeks of intervention. Meanwhile, cupping pressure of 540 mbar decreased the mean of SBP and DBP with a p-value of 0.006 and 0.057, respectively. Tests of within-subjects resulted in the p-value of 0.250 (SBP) and 0.176 (DBP) after two weeks of intervention. There were no significant differences in SBP and DBP between the intervention group and the control group.Conclusion: The cupping pressure between 400 mbar and 540 mbar could reduce blood pressure; however, the cupping pressure of 540 mbar yielded greater effect in decreasing blood pressure than the 400 mbar. Negative air vacuum pressure loads on cupping to decrease blood pressure should be considered between 400 to 540 mbar, and further studies are needed.


2018 ◽  
Vol 5 (2) ◽  
pp. 121-129
Author(s):  
Siti Khoiroh

Background : Hypertension is a condition of high blood pressure in the arteries that lasted continuously for the long term. Hypertension can be overcome in two ways: pharmacology and non-pharmacology. Pharmacology treatment usually use medicine while one of the ways for non-pharmacology treatment is to consumes apple juice.Research Objective : The aim of this research is to know the effect of apple juice on blood pressure decrease in elderly people with hypertension at Muara Kaman Community Health Center.Methods : The design of this research used quasi experimental design (quasi experiment) with pretest posttest control group design. The sample of the research was hypertensive respondents at Muara Kaman Community Health Center as many as 30 respondents were divided into 2 groups, 15 intervention groups and 15 control groups. The sampling technique used purposive sampling. The research instruments were stethoscope and sphygmomanometer, data analysis using t test dependent and t test independent.Results : There were a significant influence between pretest and posttest of apple juice in the intervention group (P value = 0,000; P <0.005). The mean difference in systolic blood pressure in the intervention group and the control group also had significant differences (P value = 0.002; P <0.05), where as the mean difference in diastolic blood pressure in the intervention group and the control group also had significant differences (P value = 0,039; P <0,05).The Conclusions : The results of this research showed that consumes apple juice gives an effect on the blood pressure of hypertensive patients by consumes regularly.The Suggestions : Nurses and the public can use apple juice as one of the ways to handling to hypertension sufferers besides antihypertensive drugs.


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):  
Salah A. Yousief ◽  
Khames T. Alzahrani ◽  
Suha M. Alhuwairini ◽  
Fai Y. Alharbi ◽  
Dalal A. Eissa ◽  
...  

Introduction: Saliva and blood contaminated impressions are often a source of cross contamination between the clinic and dental laboratory. Explicit communication and observance of an infection control protocol for handling of dental impressions must exist among the office staff as well as between office and dental laboratories. Though disinfection of impression is routinely followed, autoclaving elastomeric impression is an effective method of sterilization them. Objectives: The purpose of this study was to evaluate dimensional stability and detail reproduction of a new addition silicon impression material after disinfection. Methods: In this study, a total of twenty impressions for the master model using heat resistant plastic stock trays. The twenty impressions were divided into two groups according to disinfection technique: (Table 2) Group 1: (n=10) Control group, untreated impressions. (C.G) Group 2: (n=10) Impressions were chemically disinfected. (D.G). after all impressions treatment, they were poured with extra hard stone (type IV) to get stone casts. Dimensional accuracy and detail reproduction of the impression material were evaluated indirectly through the recovered improved stone casts from impressions of the master model using the travelling microscope. Results: Cross arch distance (A): Epoxy resin master model cross arch distance measurement (A) was (41.36 mm). 1.1 Measurements of the cross-arch distance of stone casts Control group (C.G): The mean and standard deviation values of distance (A) in stone models obtained from C.G. were 41.553 ± 0.170 mm. Disinfection group (D.G): The mean and standard deviation values of distance (A) in stone models obtained from D.G were 41.368 ± 0.083 mm. ANOVA test showed that there was a statistically difference shrinkage between the groups (P-value = 0.006). 1.2 Measurement of the dimensional changes in the cross-arch distance of the different groups. The mean and standard deviation values of cross arch distance changes in stone models of C.G. were 0.191 ± 0.170 mm. while dimensional changes in stone models obtained from D.G. were 0.006 ± 0.082 mm. Conclusion: The purpose of this study was to evaluate dimensional stability and detail reproduction of a new addition silicon impression material after disinfection. In this study an epoxy resin master model was duplicated from a modified dentate mandibular model. Within the limitations of this study, it could be concluded that Chemical disinfectant of polyvinyl siloxane impression material can be successfully used in making fixed partial dentures.


2017 ◽  
Vol 3 (5) ◽  
pp. 470-477
Author(s):  
Anjar Astuti ◽  
Suryono Suryono ◽  
Melyana Nurul Widyawati ◽  
Ari Suwondo ◽  
Mardiyono Mardiyono

Background: Autism is a neurodevelopmental disorder. Audio therapy is considered as one of the complementary therapies to improve the behavior of children with autism.Objective: This study was to analysis the effectiveness of the Al-Qur'an murrotal audio therapy on behavioral development in children with autism.Methods: This study was a true-experimental research using pretest and posttest approach with control group. This research was conducted on November 2016 in the Autism Foundation of Semarang City. There were 30 samples were selected using simple random sampling, with 15 samples assigned in the experiment and control group. Mann Whitney and Wilcoxon tests were used for data analysis in this study.Results: Results showed that there was a significant difference in the mean of behavioral development after given intervention between the experiment group and control group with p-value 0.034 (<0.05). The mean of behavioral development in the experiment group (4.53) was higher than the mean in the control group (3.47).Conclusion: The Al-Qur'an murrotal audio therapy is effective to develop behavior of children with autism. Therefore, it is expected that this audio therapy can be applied an alternative therapy for children with autism.


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