scholarly journals Abbreviated (8 hours) versus Traditional (24 hours) Postpartum MgSO4 Prophylaxis in Severe Preeclampsia: A Randomised Control Trial

2021 ◽  
Author(s):  
Shyamal Dasgupta ◽  
Anindya Das ◽  
Anurag Mallick ◽  
Chiranjit Ghosh
Keyword(s):  
Magnesium Sulphate ◽  
Total Duration ◽  
Severe Preeclampsia ◽  
Randomised Control Trial ◽  
Controlled Study ◽  
P Value ◽  
Time Duration ◽  
Traditional Group ◽  
Suitable Alternative ◽  
Number Of Patients

Introduction: Preeclampsia is a multisystem disorder affecting pregnancy after 20 weeks of gestation featured by hypertension and proteinuria. Magnesium Sulphate (MgSO4) has been used for 24 hours following delivery to prevent eclampsia in patients with severe preeclampsia. Aim: To determine the need to continue magnesium sulphate therapy 8 hours following delivery. Materials and Methods: The double blinded randomised controlled study was performed in the Department of Gynaecology and Obstetrics at R.G. Kar Medical College, Kolkata, West Bengal, India, from 1st July 2015 to 30th June 2016. Total 90 patients with severe preeclampsia were randomised in two group. In group A MgSO4 was discontinued 8 hours following delivery (abbreviated group) and in the group B it was continued for 24 hours following delivery (traditional group). The primary objective of study was to determine the need to continue MgSO4 therapy 8 hours following delivery. Secondary objectives were monitoring time by doctors, nursing care time, postpartum ambulation time, duration of urinary catheterisation, minor complication like urinary tract infection, duration and total dose of MgSO4 therapy. In order to calculate statistical significance of the different variables in between two groups, Student’s independent sample’s t-test was used for normally distributed numerical values and Chi-square test or Fischer’s-exact test was used for unpaired proportion data. Results: In abbreviated group, the number of patients (n=1) who did not need to continue MgSO4 therapy beyond 8 hours following delivery as safety measures were statistically significant (p-value <0.0001) in comparison to traditional group. Total duration and dose of MgSO4 therapy were significantly less (p-value <0.0001) in the abbreviated group. There was statistically significant reduction in time from delivery to postpartum ambulation and duration of indwelling urinary catheter in the abbreviated group. Conclusion: The abbreviated (8 hours) regime of postpartum MgSO4 for seizure prophylaxis is a suitable alternative to the traditional (24 hours) regime.

scholarly journals APHACHE Score as a Predictive Indices for Weanability from Mechanical Ventilation

2013 ◽  
Vol 1 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Md Sayedul Islam
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Private Hospital ◽  
Total Duration ◽  
Apache Ii ◽  
Apache Ii Score ◽  
P Value ◽  
Apache Score ◽  
Number Of Patients ◽  
Weaning Outcome

Objective: To determine the significance of acute physiology and chronic health evaluation (APACHE) score as an important parameter of weaning outcome for mechanical ventilation. Design: prospective, observational. Setting: The medical ICU of a modernized private hospital, Dhaka. Method: The study was carried out during the period of 2008 to 2009 in a specialized private hospital Dhaka. Critical care physicians were asked to filled up the data sheets having detail problem of the patients including the APACHE II score. The APACHE II score is divided into three steps High score>25, Medium score 20-24 and Low score < 20. The clinicians were suggested to predict whether it would take < 3 days or 4to 7days or >8days to wean each patients from mechanical ventilation. The cause of respiratory failure and total duration of weaning were recorded. The significance was set at p<.05. Result: Total number of patients included in this study were 40. Male were 22 (55%) and female were 18 (45%), the mean age of the patients were 51.1±13.9. The most common cause of respiratory failure were COPD 11(24.5%) and next common were pneumonia and ARDS due to sepsis 8 (20%) each. Among the studied population 20 (50%) having low APACHE score (<20), 12 (30%) were medium score (20-24) and 8 (20%) patients were high score (>25). Total 25 (62.5%) of the patients were successfully weaned from mechanical ventilation, 10 (25%) of the patient died and 5 (12.5%) of the patent were shifted to other low cost hospital. The successfully weaned groups 17 (68%) had lower APACHE II score than the unsuccessfully (failure) group which were statistically significant ÷2 =.8546, df =2, p-value >.005. Conclusions: The overall severity of illness as assessed by APACHE II score correlates better with weaning outcome. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14360 Bangladesh Crit Care J March 2013; 1: 18-22

scholarly journals Effects of Ketamine Gargle for Post-operative Sore Throat, Hoarseness of Voice and Cough Under General Anaesthesia- A Randomised Control Study

2021 ◽  
Author(s):  
Dinesh Chauhan ◽  
Ankit Mankad ◽  
Jigisha Mehta ◽  
Tejash H Sharma
Keyword(s):  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Normal Saline ◽  
Healing Process ◽  
Voice Quality ◽  
Controlled Study ◽  
P Value ◽  
Time Duration ◽  
C 30 ◽  
Randomised Controlled

Introduction: Majority of the patient undergo endotracheal intubation for various time duration, when given general anaesthesia. Injury in airway mucosa or vocal cords due to endotracheal intubation can be a contributing factor. Ketamine without affecting local healing process has an anti-proinflammatory effect as it limits exacerbation of systemic inflammation. Aim: To study the role of ketamine gargles as a pharmacological measure in order to attenuate POST, HOV and cough followed by endotracheal intubation during surgeries under general anaesthesia. Materials and Methods: A randomised controlled study was carried out for a duration of 22 months from the institutional ethical committee (Study Approval No. SVIEC/ON/MEDI/BNPG18/D19046), on 50 patients of American Society of Anaesthesiologists (ASA) grade I and II. They were allocated into two groups of 25 patients. Group (K): ketamine 50 mg in 29 mL 0.9% normal saline and Group (C): 30 mL 0.9% normal saline. Patients were advised to gargle for 30 seconds just 5 minutes prior to induction of anaesthesia. Patients were intubated with appropriate size of the endotracheal tube and were extubated when fully awake and conscious. Pateints were shifted to postoperative ward and were kept in propped up position with oxygen. Pateints were assessed at 1,2,4,24 hours for incidence of POST, HOV and cough. Assessment was made as per the 4 point scale grading system. The statistical analysis was performed using unpaired t-test, p<0.05 considered statistically significant. Results: In terms of POST grading in both K and C groups p-value was statistically significant (p<0.05) at 1 and at 2 hours postoperatively. In terms of HOV, in group K voice quality issues were reduced till 24 hours, (p<0.05). In terms of cough, in group K there was a significant reduction in complaints of cough till 4 hours postoperatively, (p<0.05). Conclusion: Ketamine gargles is effective in attenuating POST and cough till 2 hours and HOV till 4 hours postoperatively in patients following endotracheal intubation.

scholarly journals A study of effect of low dose atorvastatin therapy on high sensitivity C-reactive protein in patients with modifiable and non-modifiable cardiovascular risk factors in central India

2019 ◽  
Vol 6 (6) ◽  
pp. 1863
Author(s):  
Archana Verma ◽  
Umesh Kumar Chandra ◽  
Sandhya Verma ◽  
Dharmendra Jhavar ◽  
Shivshankar Badole
Keyword(s):  
Risk Factors ◽  
Statin Therapy ◽  
Low Dose ◽  
Normal Population ◽  
Total Duration ◽  
Controlled Study ◽  
P Value ◽  
Baseline Serum ◽  
Group A ◽  
Hs Crp

Background: Anti-inflammatory effects of statins have generated maximum interest, as has been demonstrated in a number of studies showing rapid decrease in CRP levels in patients of acute coronary syndromes. This CRP lowering property of statins has also translated into clinical benefits as suggested by reduction in rate of recurrent angina, recurrent myocardial infarction, and mortality.Methods: This prospective, open, and controlled study was conducted on 160 indoor and outdoor patients, for total duration of two years (2005-2006), in GMC Bhopal, MP, India.Results: In all the four groups, baseline serum hs-CRP was statistically significant (p value <0.01) higher than normal hs-CRP level. Mean reduction (%) in hs-CRP after 3 months of statin therapy was 83.6% in group A and 62.4% in group C which is highly significant (p value <0.001). In group B also, 26% hs-CRP reduction was noticed which is statistically significant (p value <0.01). Baseline hs-CRP was statistically significant high (p value <0.01) in hypertensive patients. Percentages reduction in group A (87%) and group C (66%) was statistically significant (p value <0.01). Baseline hs-CRP was statistically significant higher (p value <0.01) than normal population. After 3 months of statin therapy percentage reduction in group A and group C was statistically significant (p value <0.01). Conclusions: Low dose atorvastatin can significantly reduce CRP level in patients with risk factors for cardiovascular disease. Early initiation of low dose atorvastatin can reduce this inflammatory marker in both ACS and high risk for ACS patients and can prevent major adverse cardiac events.

scholarly journals Comparison of Bier's block with Lidocaine versus Lidocaine plus Verapamil

2014 ◽  
Vol 2 (1) ◽  
pp. 12-17
Author(s):  
S Tabdar ◽  
S Lama ◽  
ER Kadariya
Keyword(s):  
Motor Block ◽  
Total Duration ◽  
Pain Tolerance ◽  
P Value ◽  
Fisher Exact Test ◽  
Time Duration ◽  
Sensory Blockade ◽  
Medical College ◽  
Group A ◽  
Group B

Background: General anaesthesia and regional anaesthesia both are used for upper extremity surgeries. Bier’s Blockusing local anaesthetic alone or in combination with other adjuvants provides effective analgesia intraoperatively as wellas postoperatively with fewer complications as compared to general anaesthesia.Objective: This study was designed to compare effectiveness, haemodynamic alterations and total duration of analgesiawith Lidocaine versus Lidocaine plus Verapamil in Bier’s Block.Methods: This is a prospective randomised double blind trial conducted in Kathmandu Medical College TeachingHospital from February 2012 to December 2012 after approval from the ethical committee and informed consent fromthe participants. Total 40 adult patients of age 20 to 50 years, weight 50 to 70 kg, of both gender, belonging to AmericanSociety of Anaesthesiologists Physical Status I and II undergoing elective distal upper extrimity surgery lasting at one toone and half hours with Bier’s Block were included in this study. They were randomly divided into two groups of twentyeach to receive either 40 ml of 0.5% Lidocaine alone (Group A) or 40 ml of 0.5% Lidocaine plus 2.5 mg Verapamil (GroupB). The two groups were compared in terms of onset and recovery from sensory and motor blockade, tourniquet paintolerance time, duration of analgesia, alteration of haemodynamics and major side effects. Data analysis was done byMicrosoft Offi ce Excel 2007 [Polystat, Microsoft Offi ce Excel worksheet.XLS] using student’s two tailed t test. Categoricalparamatres were tested by Fisher Exact test and p-value of <0.05 was considered statistically signifi cant.Result: Onset of sensory blockade was faster in group B (Mean± SD: 3.07± 0.25 minutes) as compared to group A (Mean±SD: 5.59 ± 0.41 minutes). The onset of motor block in group B was 10.4 ± 0.77 minutes versus 13.17 ± 1.45 minutes ingroup A. Recovery of sensory block in group B occurred at 29.95 ± 6.96 minutes versus 11.45 ± 2.16 minutes in groupA. Similarly recovery of motor block in group B occurred in 13.6 ± 1.79 minutes versus 7.65 ± 1.04 minutes in group A.Tolerance of fi rst tourniquet pain in group B was long 41.15 ± 3.82 minutes versus 22.00 ± 2.9) minutes in group A. Secondtourniquet pain tolerance time was again longer (48.25 ± 3.96 minutes) in group B versus 28.05 ± 4.84 minutes in groupA. Total duration of analgesia was more in group B (207.25 ± 21.1 minutes) versus 32.2 ± 5.78 minutes in group A. Totalconsumption of analgesic (Tramadol) in 24 hours in group B was lesser than group A (47.5 ± 38.0 mg versus 112.5 ± 35.8mg). All these differences were signifi cant statistically (p value <0.05). Both of the groups showed stable haemodynamicparameters intraoperatively as well as postoperatively without any signifi cant adverse effects.Conclusion: Addition of Verapamil to Lidocaine was more effective than Lidocaine alone in Bier’s block.DOI: http://dx.doi.org/10.3126/jkmc.v2i1.10513Journal of Kathmandu Medical College, Vol. 2, No. 1, Issue 3, Jan.-Mar., 2013, Page: 12-17

scholarly journals Patients’ Waiting Time in a University Health Clinic

2021 ◽  
Vol 6 (1) ◽  
pp. 21-26
Author(s):  
Mohd Shaiful Ehsan Shalihin ◽  
Sakinah Md Rifin
Keyword(s):  
Waiting Time ◽  
Time Management ◽  
Best Practice ◽  
Descriptive Analysis ◽  
Health Clinic ◽  
P Value ◽  
Time Duration ◽  
Mean Waiting Time ◽  
Number Of Patients ◽  
Consultation Time

Best practice management of a clinic can be measured through the achievement of appropriate waiting time and consultation time. These are important, especially in dealing with stable common cases seen in primary care. Among important associated factors include the number of patients per day, which can be various according to different operating days. Methods: This study aims to measure the waiting time and consultation time of common cases seen in the university health clinic for two weeks duration. The ‘time in’ and ‘time out’ information was captured on the information sheet attached to the patient’s registration slip. A descriptive analysis was done for common complaints, waiting time and consultation time duration. Kruskal-Wallis test was used to identify the association between different working days with waiting time and consultation time. Results: The results revealed a good mean waiting time 11.93 min (SD, 9.99) and consultation time 10.54 minutes (SD, 8.78) for the clinic. Waiting time is significantly associated with different operating days (P value < 0.05). Conclusion: The clinic’s waiting and consultation time is acceptable according to the target set by the Ministry of Health. However, further modification can be done to improve the time management of the clinic, specifically for the busy day.

scholarly journals Efficacy and Safety of Lycoprozen®, a Novel Tomato-Based Food Supplement in Patients with Benign Prostatic Hyperplasia

2018 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Alberto Cellini ◽  
Pier Giorgio Natali ◽  
Manuela Iezzi ◽  
Mauro Piantelli ◽  
Vincenzo Fogliano ◽  
...  
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Side Effects ◽  
Food Supplement ◽  
Prostatic Hyperplasia ◽  
Controlled Study ◽  
P Value ◽  
Efficacy And Safety ◽  
Suitable Alternative ◽  
International Prostatic Symptom Score ◽  
Before And After

Objective: To evaluate the efficacy and safety of a novel tomato-based food supplement on the lower urinary tract symptoms (LUTS) of patients with benign prostatic hyperplasia (BPH). Methods: Twenty patients with BPH were enrolled in this observational study. They were assigned to consume daily a sachet of Lycoprozen® (5 grams) dissolved in water for two months. Results: All patients successfully completed the Lycoprozen scheduled regimen and the IPSS (International Prostatic Symptom Score) questionnaire before and after treatment. No side effects due to treatment were noticed. In this preliminary study, we have found that Lycoprozen® significantly reduced the LUTS severity (paired t-test, two-tailed p value < 0.0001). The IPSS mean values before and after the treatment were 16.95+6.0 SD (range 31-6) and 12.2+4.9 SD (range 20-2), respectively. Conclusions: Based on these data, Lycoprozen® may represent a suitable alternative option for the treatment of symptomatic BPH patients which worth of further testing in a phase 2 prospective randomized double blind placebo controlled study. The treatment was without side effects and acceptance among patients was high.

scholarly journals Candidate urine biomarker discovery from only five pairs of samples before and after tumor resection in glioma patients

2018 ◽  
Author(s):  
Jianqiang Wu ◽  
Jun Zhang ◽  
Yuanli Zhao ◽  
Youhe Gao
Keyword(s):  
Biomarker Discovery ◽  
Killer Cell ◽  
Tumor Resection ◽  
Self Control ◽  
Controlled Study ◽  
Clinical Samples ◽  
P Value ◽  
Surgical Removal ◽  
Number Of Patients ◽  
Before And After

AbstractBiomarkers are measurable changes associated with the disease. Without the control of homeostatic mechanisms, urine accumulates systemic body changes and thus serves as an excellent early biomarker source. However, urine is affected by many factors other than disease. Although many candidate biomarkers have been identified in animal models, a large number of clinical samples might still be required for the disease related changes. A self-controlled study should be able to avoid the interferences of individual differences among patients. Gliomas are the most common primary malignant brain tumors and have a very poor prognosis. Early diagnosis of gliomas and the monitoring of tumor recurrence are crucial to improve glioma patient outcomes. Here we set to try if biomarker candidates can be identified by comparing urine samples from five glioma patients collected at the time of tumor diagnosis and after surgical removal of the tumor. Using label-free liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) quantification, twenty-seven urinary proteins were significantly changed after tumor resection (fold change ≥ 1.5, P-value < 0.05, and similar changes in all 5 patients), many of which have been previously associated with gliomas, such as CEACAM1, ANXA7, CALR, CRYAB, CD276, pIgR and cathepsin D. Functions of these proteins were significantly enriched in the regulation of tissue remodeling, autophagy, the inhibition of gene expression, the positive regulation of natural killer cell-mediated cytotoxicity and angiogenesis, which are associated with glioma development. Our results suggested that using the self-control of before and after tumor resection is an effective method to identify differential proteins associated with the disease, even with a small number of patients.

scholarly journals Clinical Outcome of Intravascular Ultrasound Guided Left Main Coronary Intervention

2020 ◽  
pp. 46-58
Author(s):  
Mohamed Ezzelregal ◽  
Luca Testa ◽  
Medhat Alashmawy ◽  
Ayman Elsaid ◽  
Hanan Kassem
Keyword(s):  
Myocardial Infarction ◽  
Intravascular Ultrasound ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Target Lesion Revascularization ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Left Main ◽  
Number Of Patients

Introduction: Intravascular ultrasound is a new imaging modality that facilitate the process of coronary intervention. The angiographic evaluation of left main lesions significance is always questionable, IVUS detect the significance, guide the procedure and some studies proves a benefit in mortality. Objectives: To investigate whether intravascular ultrasound IVUS guided Left Main coronary intervention could improve clinical outcomes compared with angiographic-guided Left main coronary PCI. Patients and Methods: This controlled study was carried out between June 2017 and June 2019, in Tanta university Hospital and San Donato Hospital, Milan, 83 patients eligible to Left Main coronary intervention divided into two groups, IVUS-guided group (n=19) and angiographic-guided group(n=64). The occurrence of major adverse cardiac events (MACE): death, non-fatal myocardial infarction, or target lesion revascularizations) were recorded 6 and18 Months of follow-up. Results: The IVUS-guided group had a lower rate of 18-months MACE than the control group. The incidence of target lesion revascularization was lower in the IVUS-guided group than in the control group. The incidence of TLR after 6 months was not different between both groups (1 cases in IVUS group (5.3%), 6 cases in angiography group (9.4%) (P value 0.686) while the incidence of TLR after 18 months was significantly different between both groups (1 cases in IVUS group (5.3%), 17 cases in angiography group (26.6%) (P value 0.048), However, there were no differences in death, myocardial infarction, stent thrombosis and number of patients treated with CABG in the 2 groups. Conclusion: The present study demonstrates that IVUS-guided LM angioplasty can improve 18 -months MACE events especially the incidence of target lesion revascularization.

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

4G Intravenous Magnesium Sulphate in Severe Preeclampsia For Prevention of Eclampsia

2011 ◽  
Vol 4 (3) ◽  
pp. 422-424
Author(s):  
DR RUCHI SHAH ◽  
◽  
Dr. S.S. Mehendale Dr. S.S. Mehendale
Keyword(s):  
Magnesium Sulphate ◽  
Severe Preeclampsia ◽  
Intravenous Magnesium
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