scholarly journals Sedative and Analgesic Effects of Intravenous Midazolam and Ketamine Combination in Bone Marrow Aspiration and Biopsy of Childhood Cancer

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Seyed Mohammad Nasiraldin Tabatabaei ◽  
Ghasem Miri-Aliabad ◽  
Shahram Borjian Boroojeny ◽  
Ali Arab
Keyword(s):  
Bone Marrow ◽  
Side Effects ◽  
Bone Marrow Aspiration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Analgesic Effects ◽  
Sedation And Analgesia ◽  
The Mean ◽  
Waking Up

Background: Various drugs, including ketamine and midazolam, are used for sedation in children. Objectives: This study aimed to evaluate the effectiveness of intravenous midazolam and ketamine combination in bone marrow aspiration and biopsy in children with cancer. Methods: This descriptive cross-sectional study was conducted on 100 children aged six months to 17 years candidates for bone marrow aspiration or biopsy. Sampling was easy, accessible, and sequential. Children were injected with 0.05 mg/kg midazolam and 1 mg/kg ketamine for sedation and analgesia. Then, sedation rate, restlessness, nausea, vomiting, laryngospasm, and decreased oxygen saturation were assessed. Data were analyzed using SPSS version 18 software. Results: The mean age of children was 6.8 ± 4.3 years. The mean degree of sedation based on the modified Ramsey score was 5.2 ± 0.74. Nausea and vomiting were observed in nine (9%) children. Six (6%) children had arterial saturation of less than 90%. Twelve (12%) children showed restlessness when waking up. There were no cases of laryngeal spasms. Conclusions: The present study showed that the intravenous midazolam and ketamine combination provides suitable sedation and analgesia to children, with low and negligible side effects.

scholarly journals Attitude towards Antipsychotic Medications in Patients Diagnosed with Schizophrenia: A Cross-Sectional Study at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Tilahun Kassew ◽  
Demeke Demilew ◽  
Addis Birhanu ◽  
Mesele Wonde ◽  
Biks Liyew ◽  
...  
Keyword(s):  
Side Effects ◽  
Linear Regression ◽  
Associated Factors ◽  
First Generation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Antipsychotic Medications ◽  
Specialized Hospital ◽  
The Mean

Background. Poor attitude towards antipsychotic drugs is high, and it is a factor for non-adherence to treatment. This increases the risk of relapse, associated healthcare utilization, and costs. This study aimed to assess attitude towards antipsychotic medication among patients with schizophrenia. Objectives. The aim of this institution based cross-sectional study was to assess attitude towards antipsychotic medications and associated factors among patients with schizophrenia who attend the outpatient clinics at Amanuel Mental Specialized Hospital, 2018. Methods. In a cross-sectional study, 393 schizophrenic patients from Amanuel Mental Specialized Hospital were recruited by a systematic random sampling technique. Drug Attitude Inventory (DAI-10) was used to assess attitude, experience, and belief about antipsychotics. Glasgow antipsychotic side effect scale modified version, positive and negative syndrome scale, and Birch wood’s insight scale for psychosis were the instruments used to assess the associated factors. Simple and multiple linear regression analysis models were fitted, and the adjusted unstandardized beta (β) coefficient at 95% confidence interval was used. Results. The mean score of attitude towards antipsychotic medications was 6.51 with standard deviation (SD) of 2.22. In multiple linear regression, positive symptoms (β= -0.07, 95% CI: (-0.09, -0.05)), negative symptoms (β= -0.04, 95% CI: (-0.06,-0.02)), shorter (≤5 years) duration of illness (β= -0.39, 95% CI: (-0.63, -0.15)), first generation antipsychotics (β = -0.35, 95% CI: (-0.55,-0.14)), having sedation (β= -0.28, 95% CI: (-0.52, -0.02)), and extra-pyramidal side effects (β= -0.34, 95% CI: (-0.59,-0.09)) were factors negatively associated with attitude towards antipsychotic medication treatment. Insight to illness (β= 0.24, 95% CI: (0.20, 0.27) was a factor positively associated with attitude towards antipsychotic medications. Conclusion. The result suggests that the mean score of participants’ attitude towards antipsychotic medications was good. Prevention of side effects particularly due to first generation antipsychotics is necessary.

Topical 15% Resorcinol Is Associated with High Treatment Satisfaction in Patients with Mild to Moderate Hidradenitis Suppurativa

Dermatology ◽  
2021 ◽  
pp. 1-4
Author(s):  
Alexandre Docampo-Simón ◽  
Iván Beltrá-Picó ◽  
María José Sánchez-Pujol ◽  
Rosa Fuster-Ruiz-de-Apodaca ◽  
Juan Selva-Otaolaurruchi ◽  
...  
Keyword(s):  
Side Effects ◽  
Treatment Satisfaction ◽  
Hidradenitis Suppurativa ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Satisfaction Questionnaire ◽  
Global Satisfaction ◽  
The Mean ◽  
High Treatment

<b><i>Background:</i></b> Topical 15% resorcinol is commonly used in clinical practice for the treatment of nodules and abscesses in patients with hidradenitis suppurativa (HS). It has been shown to be clinically effective in some small studies, but data on satisfaction perceived by patients are lacking. The Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4 is a validated measure of patient satisfaction, evaluating four domains: effectiveness, side effects, convenience, and global satisfaction. Our objective was to obtain data from HS patients regarding resorcinol treatment satisfaction and its relationship with clinical and epidemiological variables. <b><i>Methods:</i></b> We performed a cross-sectional study providing TSQM version 1.4 questionnaires to HS patients who had been prescribed topical resorcinol during the previous 24 months. <b><i>Results:</i></b> Ninety-two patients answered the questionnaire. Eighty-five out of 92 (92.4%) were Hurley II and 7 Hurley I. The mean total score was 317.5 out of 400 (71.0 points in effectiveness, 93.6 in side effects, 79.3 in convenience, and 73.2 in global satisfaction). Total score was higher in men than in women (329.7 vs. 311.6, <i>p</i> = 0.026) and higher scores on convenience were seen in patients who were not overweight or obese (86.9 vs. 77.1, <i>p</i> = 0.016). Most patients (65, 70.6%) denied having any side effect. 78 (84.8%) of the patients would recommend the treatment. <b><i>Conclusion:</i></b> The results of this study suggest that HS patients treated with resorcinol 15% are very satisfied with this treatment.

scholarly journals Investigating the Characteristics of Tramadol-induced Seizures: A Cross-sectional Study

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Davood Soroosh ◽  
Mahdi Foroughian ◽  
Bahram Zarmehri
Keyword(s):  
Side Effects ◽  
Significant Relationship ◽  
Statistical Tests ◽  
Descriptive Study ◽  
Cross Sectional Study ◽  
Average Dose ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Drug ◽  
The Mean

Background: According to statistics, tramadol intoxication is one of the most common drug poisoning cases in Iran. Because seizure is one of the severe and dangerous side effects of tramadol, the present study aimed to investigate the characteristics of tramadol-induced seizures. Methods: In this cross-sectional descriptive study, all patients who referred to the emergency departments due to the tramadol-induced seizures were examined by the census method. The patients’ data were collected with a checklist. Then, the data were analyzed with descriptive and inferential statistical tests in SPSS v. 23 and at a significant level of P<0.05. Results: In this study, 350 patients (52.9% male, and 47.1% female) were examined. The Mean±SD dose consumed was 1171.4±802.77 mg. The minimum dose that caused the seizure was 200 mg, and the average dose consumed of tramadol was different in patients who had one, two, or three seizures outside the hospital (P=0.002). The consumed average dose of tramadol was 1144.5 mg, 2017.7 mg, and 511.1 mg for patients who had one, two, or three seizure(s), respectively. There was a significant relationship between dose consumed and the number of seizures (P=0.001). The study showed that patients who had a one-time seizure, have experienced this condition outside the hospital. There was a significant relationship between the number of seizures and the location of the seizure (outside or inside the hospital) (P=0.001). Conclusion: The results showed no significant relationship between consumed dose and location of the seizure. The number of seizures is not dependent on the consumed dose. It means that increasing the consumed dose, the number of seizures does not increase, and there is no significant relationship between the amount of dose consumed and the number of seizures.

scholarly journals IDIOPATHIC THROMBOCYTOPENIC PURPURA (ITP);

2013 ◽  
Vol 20 (02) ◽  
pp. 188-192
Author(s):  
ITAAT ULLAH KHAN AFRIDI ◽  
MUNAZZA SAQIB
Keyword(s):  
Bone Marrow ◽  
Clinical Features ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Bleeding Time ◽  
Bone Marrow Aspiration ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Sectional Study ◽  
Cross Sectional ◽  
Thrombocytopenic Purpura

Objective: To find the frequency of common clinical features of Idiopathic Thrombocytopenic Purpura (ITP) in childrenand to see whether bone marrow aspiration needed in every child with typical presentation of ITP. Design: Cross-sectional study. Setting:Hematology/Oncology Department, the Children Hospital & the Institute of Child Health Lahore Pakistan. Duration: April 2008 to March2009 (One year). Material and Methods: A total of 30 children presenting with bleeding through any orifice with diagnostic evidence ofITP were evaluated by a cross sectional study. Common clinical features were recorded along with the related hematological parameters.After taking detailed history and thorough examination, relevant investigations like peripheral smear, bleeding time and coagulation screenwere carried out in all cases. Bone marrow examination was done only in selected cases. The cases were then managed according tostandardized management criteria. Results: Male: Female ratio was 3:2, age ranging from 18 months to 14 years (mean±SD of 5.2±years) with median age of 5.2 years. 26.6% (n=08) patients were having preceded history of upper respiratory tract infection. Thepositive clinical findings were bruises in 30% (n=09) cases; petechiae in 23.3% (n=07) cases; epistaxis in 23.3% (n=07) cases; gumbleeding in 13.3%(n=04) cases and hematuria only in 10% (n=03) cases. Anemia (<9gm%) was noted in 40% (n=12) patients. Onperipheral smear examination this was microctic hypochromic in nature. Bleeding time was prolonged in all patients in line withdocumented thrombocytopenia i.e platelet count < 150,000. PT/APTT was normal in all 30 patients. Conclusions: Bruises, Petechiaeand epistaxis are the commonest clinical findings of ITP. Bone marrow aspiration revealed inconclusive results in such cases.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

scholarly journals Assessment of Saudi Parents’ Beliefs and Behaviors towards Management of Child Fever in Saudi Arabia—A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5217
Author(s):  
Mohamed N. Al Arifi ◽  
Abdulrahman Alwhaibi
Keyword(s):  
Saudi Arabia ◽  
Side Effects ◽  
Febrile Seizures ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Electronic Thermometer ◽  
And Behavior

Objective: Fever alone can lead to rare serious complications in children, such as febrile seizures. The aim of this study is to assess the knowledge, beliefs, and behavior of parents toward fever and its management. Methods: A cross-sectional study using an online questionnaire was applied over a period of 3 months, from January to March 2018, to parents who were living in Saudi Arabia. The inclusion criteria were a parent who is a resident of Saudi Arabia, with at least one child aged 6 years or less, while incomplete questionnaires, having a child aged more than 6 years, or parents who were not living in Saudi Arabia were excluded. Results: A total of 656 parents completed the questionnaire. More than two-thirds of the subjects were female, the majority of whom were aged between 25–33 years old. The best-reported place to measure the temperature of children was the armpit (46%), followed by the ear (28%) and the mouth (10.7%). More than half of the parents considered their children feverish at a temperature of 38 °C. The majority of parents (79.7%) reported that the most serious side effects of fever were seizure, brain damage (39.3%), coma (29.9%), dehydration (29.7%), and death (25%). The most common method used to measure a child’s temperature was an electronic thermometer (62.3%). The most common antipyretic was paracetamol (84.5%). Conclusions: Our study demonstrates the good knowledge of parents in identifying a feverish temperature using the recommended route and tools for measuring body temperature.

Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod
Keyword(s):  
Trochlear Dysplasia ◽  
Cross Sectional Study ◽  
Magnetic Resonance Images ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

scholarly journals SAT0330 NEW IMMUNOMODULATORY COMBINATION THERAPIES IN PATIENTS WITH SYSTEMIC SCLEROSIS: A RETROSPECTIVE CROSS-SECTIONAL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1110.1-1111
Author(s):  
J. Qiao ◽  
S. X. Zhang ◽  
T. T. Zhang ◽  
J. Zhang ◽  
M. T. Qiu ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Side Effects ◽  
Lymphocyte Subsets ◽  
Cross Sectional Study ◽  
Peripheral Lymphocyte ◽  
High Morbidity ◽  
Combination Therapies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Treatment

Background:Systemic sclerosis (scleroderma, SSc) is a rare complex connective tissue disease associated with high mortality and high morbidity1. Active SSc are typically treated with immunosuppressants, which may create a variety of severe side-effects, especially for long-term treatment2. As the pathogenesis of SSc is still a matter of debate, growing evidences have focused on the immune disorders3. However, the quantitative status of lymphocyte subsets in SSc patients are unclear and effects of immunomodulatory combination therapies (avoiding side-effects of conventional therapy) on the lymphocyte subsets are unknown.Objectives:To investigate the quantitative status of peripheral lymphocyte subpopulations and CD4+T subsets in SSc patients for the exploration of SSc pathogenesis and evaluate the effects of new immunomodulatory combination therapies on those cells.Methods:From July 2014 to December 2019, total 166 patients with SSc and 206 healthy controls (HCs) were enrolled in this study, in which, 79 follow-up patients received immunomodulatory drugs (IMiDs) such as low-dose interleukin-2, rapamycin, metformin, retinoic acid and coenzyme Q10. The absolute numbers of T, B, NK, CD4+T, CD8+T, Th1, Th2, Th17 and Tregs in peripheral blood of these subjects were detected by flow cytometry combined with standard absolute counting beads.Results:Patients with SSc had lower absolute counts of total T, NK, Th2, Th17 and Tregs as compared with those of HCs (P<0.05) (Figure 1). After immunomodulatory combination treatments, there were increases in a various of peripheral lymphocyte subsets such as T, B and CD8+T (P< 0.05). Moreover, the increased level of Tregs was much more dramatical than those of other lymphocyte subsets, resulting in the decrease ratios of Teffs/Tregs such as Th1/Tregs and Th2/Tregs and rebuilding immunologic equilibrium (Figure 2).Conclusion:This cross-sectional study clarified the abnormal status of lymphocyte subsets in SSc patients, suggesting lymphocyte subsets, especially Tregs, might be relevant and play a crucial role in the pathogenesis of SSc, thus providing a potential therapeutic target for SSc patients. Immunomodulatory combination therapies effectively increase the level of Tregs as well as other lymphocytes to some degree and maintain the immunologic equilibrium, which may help for SSc patients’ symptom remission.References:[1]Denton CP, Khanna D. Systemic sclerosis. Lancet 2017;390(10103):1685-99. doi: 10.1016/S0140-6736(17)30933-9 [published Online First: 2017/04/18][2]Winthrop KL, Weinblatt ME, Bathon J, et al. Unmet need in rheumatology: reports from the Targeted Therapies meeting 2019. Ann Rheum Dis 2020;79(1):88-93. doi: 10.1136/annrheumdis-2019-216151 [published Online First: 2019/10/31][3]Skaug B, Khanna D, Swindell WR, et al. Global skin gene expression analysis of early diffuse cutaneous systemic sclerosis shows a prominent innate and adaptive inflammatory profile. Ann Rheum Dis 2019 doi: 10.1136/annrheumdis-2019-215894 [published Online First: 2019/11/27]Acknowledgments :None.Disclosure of Interests:None declared

scholarly journals A cross-sectional study to identify the determinants of non-communicable diseases among fishermen in Southern India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Akhila Doddamani ◽  
A. B. Kirthinath Ballala ◽  
Sharath P. Madhyastha ◽  
Asha Kamath ◽  
Muralidhar M. Kulkarni
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Waist Circumference ◽  
Cross Sectional Study ◽  
Modifiable Risk Factors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Dietary Practice ◽  
The Mean

Abstract Background India is currently facing a rising epidemic of Non-Communicable Diseases (NCDs). Identification of modifiable risk factors is of paramount importance to curb this menace. Fishermen are one of the most vulnerable occupational groups with unique characteristics that make them prone to acquire NCDs, as a significant share of their life is spent at sea. Hence, this study was planned to ascertain the burden of NCDs, determine various risk factors of NCDs, and measure the association between risk factors and NCDs among fishermen of Coastal Karnataka in South India. Methods A cross-sectional study was conducted among 681 fishermen aged 18 years and above as per the semi-structured interview schedule for two years (2017–2019). A convenience sampling strategy was adopted. The data was entered and analyzed using SPSS v.15.0. The results were described in terms of proportions and their 95% confidence intervals. Continuous data were summarized using the mean and standard deviation or median and interquartile range depending on the skewness of data. Chi-square test was used to study the association between NCDs and modifiable risk factors. Multiple logistic regression was used to identify risk factors of NCDs. Results The mean (SD) age of the population was 42.5 (SD 12.5) years. The mean years involved in fishing was 19.8 years (SD 10.9). More than half (59.5%) of the study participants had severe stress and most (80.3%) were ever substance users. Advancing age, not being able to contact family while at sea, poor dietary practice, ever substance use, increasing waist circumference were significant correlates of NCDs. Conclusions The commonly prevalent risk factors of NCDs among fishermen included poor dietary practice, higher stress levels, substance use, increasing waist circumference, and inability to contact with family while at sea. Hypertension and Diabetes were the two common NCDs in the study population. There is a need for immediate attention in managing NCDs’ risk factors by promoting a healthy lifestyle by primary health care providers through a sustainable community awareness program targeting fishermen at a convenient time and location, either at the sea-port or meeting places. Harmful effects of substance use, healthy dietary practices, and the importance of physical activity outside their job need emphasis. In addition, screening programs should be organized with the help of boat owners and fishing associations at-least once a year to pick up NCDs at an early stage.

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