Randomised controlled trial of diazoxide for small for gestational age neonates with hyperinsulinaemic hypoglycaemia provided early hypoglycaemic control without adverse effects

2018 ◽  
Vol 107 (6) ◽  
pp. 990-995 ◽  
Author(s):  
Binesh Balachandran ◽  
Kanya Mukhopadhyay ◽  
Naresh Sachdeva ◽  
Rama Walia ◽  
Savita Verma Attri
Keyword(s):  
Randomised Controlled Trial ◽  
Adverse Effects ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Controlled Trial ◽  
Hyperinsulinaemic Hypoglycaemia ◽  
Randomised Controlled

scholarly journals Randomised Controlled Trial Assessing Head Down Deep Breathing Method Versus Modified Valsalva Manoeuvre for Treatment of Supraventricular Tachycardia in the Emergency Department

2021 ◽  
Vol 22 (4) ◽  
pp. 820-826
Author(s):  
Hoon Chin Lim ◽  
Yi-En Clara Seah ◽  
Arshad Iqbal ◽  
Vern Hsen Tan ◽  
Shieh Mei Lai
Keyword(s):  
Emergency Department ◽  
Randomised Controlled Trial ◽  
Adverse Effects ◽  
Sinus Rhythm ◽  
Supraventricular Tachycardia ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Valsalva Manoeuvre ◽  
Deep Breathing ◽  
Randomised Controlled

Introduction: Supraventricular tachycardia (SVT) is commonly encountered in the emergency department (ED). Vagal manoeuvres are internationally recommended therapy in stable patients. The head down deep breathing (HDDB) technique was previously described as an acceptable vagal manoeuvre, but there are no studies comparing its efficacy to other vagal manoeuvres. Our objective in this study was to compare the rates of successful cardioversion with HDDB and the commonly practiced, modified Valsalva manoeuvre (VM). Methods: We conducted a randomised controlled trial at an acute hospital ED. Patients presenting with SVT were randomly assigned to HDDB or modified VM in a 1:1 ratio. A block randomisation sequence was prepared by an independent biostatistician, and then serially numbered, opaque, sealed envelopes were opened just before the intervention. Patients and caregivers were not blinded. Primary outcome was cardioversion to sinus rhythm. Secondary outcome(s) included adverse effects/complications of each technique. Results: A total of 41 patients were randomised between 1 August, 2018–1 February, 2020 (20 HDDB and 21 modified VM). Amongst the 41 patients, three spontaneously cardioverted to sinus rhythm before receiving the allocated treatment and were excluded. Cardioversion was achieved in six patients (31.6%) and seven patients (36.8%) with HDDB and modified VM, respectively (odds ratio1.26, 95% confidence interval, 0.33, 4.84, P = 0.733) . Seventeen (89.5%) patients in the HDDB group and 14 (73.7%) from the modified VM group did not encounter any adverse effects. No major adverse cardiovascular events were recorded. Conclusion: Both the head down deep breathing technique and the modified Valsalva manoeuvre appear safe and effective in cardioverting patients with SVT in the ED.

scholarly journals Ureteric bupivicaine infusion for loin pain haematuria syndrome

2010 ◽  
Vol 92 (2) ◽  
pp. 139-141 ◽  
Author(s):  
P Ahmed ◽  
P Acher ◽  
AM Deane
Keyword(s):  
Randomised Controlled Trial ◽  
Adverse Effects ◽  
Controlled Trial ◽  
Opiate Dependence ◽  
Ureteric Catheter ◽  
Loin Pain ◽  
Loin Pain Haematuria Syndrome ◽  
Randomised Controlled ◽  
Trial Setting

INTRODUCTION Loin pain haematuria syndrome is a common problem with complications including opiate dependence. Morbidity treatments include intra-ureteric capsaicin infusion, nephrectomy, autotransplantation and nephrolysis. We explored the use of flexible cystoscopic infusion of intra-ureteric bupivicaine. PATIENTS AND METHODS Patients presenting with chronic loin pain underwent urological and nephrological evaluation. Bupivicaine (0.5%, 20 ml) was infused via an intra-ureteric catheter under flexible cystoscopic guidance. Repeat infusions were offered if indicated. RESULTS Sixteen of 17 patients with 1-year follow-up responded and were satisfied. Twelve of these required repeat infusions (mean, 2.9 infusions). The procedures were well tolerated by all patients without adverse effects. CONCLUSIONS Intra-ureteric bupivicaine infusion has a place in the management of patients with chronic renal pain. It offers a minimally invasive alternative to other treatments. This procedure warrants further investigation within a randomised, controlled trial setting.

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