scholarly journals Use of Caudal Analgesia Supplemented with Low Dose of Morphine in Children Who Undergo Renal Surgery

2015 ◽  
Vol 9 (3) ◽  
pp. 132-137 ◽  
Author(s):  
Boris Chertin ◽  
Alexander Zeldin ◽  
Stanislav Kocherov ◽  
Alexander Ioscovich ◽  
Israel A. Ostrovsky ◽  
...  
Keyword(s):  
Pain Score ◽  
Low Dose ◽  
Statistical Significance ◽  
Morphine Group ◽  
Renal Surgery ◽  
Hospitalization Period ◽  
Caudal Analgesia ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Introduction: To test the efficacy and safety of caudal anesthesia (CA) supplemented by low dose morphine in children who undergo renal surgery. Materials and Methods: Forty patients aged 2 months-14 years were enrolled and randomly divided into two groups of 20 patients each: Group A (bupivacaine 0.2% with fentanyl); Group B (bupivacaine with morphine). The duration of surgery and hospitalization time were recorded. Postoperative pain score was measured by Face Legs Activity Cry Consolability scale and Wong-Baker Faces scale for those who are older. Overall use of rescue analgesics was calculated. Results: There was no statistical difference in the length of surgery, incidence of pruritus, postoperative nausea, vomiting and urinary retention between the two groups. However the postoperative opioid requirements were significantly higher in Group A 1.03 ± 0.9 mg/kg compared to Group B, in which only one patient required opioid therapy (p < 0.0001). Moreover the need for non-opioid rescue analgesic was higher in Group A, (36 ± 5.7 mg/kg of paracetamol) compared to morphine CA group there only 26 ± 3.6 mg/kg required during first 24 h of the postoperative period (p = 0.0312). The Face Legs Activity Cry Consolability pain score (1, 4, and 24 h after surgery) and Wong-Baker Faces scale were significantly higher in Group A. The hospitalization period was shorter in the CA morphine group, but the difference did not reach statistical significance. None developed hemodynamic instability or respiratory depression. Conclusions: Our data show that CA supplemented with low dose morphine provides a longer duration of analgesia without significant side-effects in children undergoing renal surgery.

scholarly journals Comparison Between Paracetamol Vs Voltral Suppositories For Post Operative Pain In Gynaecological Procedure

Esculapio ◽  
2021 ◽  
Vol 17 (2) ◽  
pp. 191-194
Author(s):  
Zeeshan Khan ◽  
Saadia Khaleeq ◽  
Abaid ur Rehman ◽  
Aasam Maan ◽  
Umer Farooq ◽  
...  
Keyword(s):  
Pain Score ◽  
Controlled Trial ◽  
Gynaecological Surgery ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Intravenous Paracetamol ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare intravenous paracetamol vs Voltral (Diclofenac) suppositories for post operative pain in gynaecological procedures. Methods: This was a non randomized controlled trial that was carried out at Department of Anaesthesiology, Sheikh Zayed Hospital, Rahim Yar Khan during 01-07-2019 to 31-12-2019 in which all female cases with age range of 20 to 60 year undergoing any gynaecological surgery requiring general anaesthesia were included. The cases were divided into two equal groups and anesthesia was offered in standard doses. Just before reversal the cases in group Awere given intravenous paracetamol in a dose of 1 gm stat and then at 8-hour interval and those in group B were offered diclofenac suppositories in a dose of 50 mg twice a day, 12 hours apart. The pain was assessed at 4,8,12 and 24 hours and was labelled on visual analogue scale (VAS). Results: In this study there were 62 cases (31 in each group). The mean age in group A and B was 45.41±10.21 vs 48.12±11.13 years with p= 0.47. Mean duration of surgery in both groups was 57.51±15.23 vs53.11±14.79 minutes with p= 0.81. There was no significant difference in mean pain score at 4 and 8 hours with p= 0.91 and 0.81 respectively in group A and B. Mean pain score was 4.43±1.67 vs 3.21±1.09 with p= 0.01 at 12 and 4.57±1.71 vs 3.34±1.27 at 24 hours in group A and B with p values of 0.01 each. Mean time taken for rescue analgesia was 9.13±2.11 in group Aand 13.11±1.23 hours in group B with p= 0.001. Conclusion: Voltral (Diclofenac sodium) suppositories are better than paracetamol infusion in controlling pain after gynecological surgeries and this difference is significantly better at 12 and 24 hours. Key words: Gynaecological surgery, Pain, Paracetamol, Voltral suppository How to cite: Khan Z., Khaleeq S., Rehman Ur A., Maan A., Farooq U. Nadeem A. Comparison Between Paracetamol Vs Voltral Suppositories for Post-Operative Pain in Gynaecological Procedures. Esculapio 2021;17(02):191-194.

scholarly journals A comparative study of low dose magnesium sulphate (Dhaka regime) and Pritchard regime for the management of impending eclampsia and eclampsia

2017 ◽  
Vol 6 (6) ◽  
pp. 2180
Author(s):  
. Ranjana ◽  
Abha Rani Sinha ◽  
Chandra Prakash
Keyword(s):  
Magnesium Sulphate ◽  
Low Dose ◽  
Statistical Significance ◽  
Perinatal Outcomes ◽  
P Value ◽  
Entire Treatment Period ◽  
Indian Women ◽  
Group A ◽  
Low Bmi ◽  
Group B

Background: Eclampsia is a common obstetrical emergency though preventable, yet remains a leading cause of maternal and perinatal morbidity and mortality in the developing world. Pritchard regime is most widely used magnesium sulphate regime for control of eclamptic fits but its dose related toxicity is a major concern among Indian women with low BMI and at peripheral institutions where the patients monitoring is limited. The objective was to study the efficacy of low dose MgSO4 regime (Dhaka regime) for control of convulsions in eclampsia and prevention of convulsions in impending eclampsia, to assess the magnesium related toxicity and to analyze the maternal and perinatal outcomes as compared to standard Pritchard regime.Methods: This prospective study was carried out in the Department of obstetrics and Gynaecology at Patna Medical College and Hospital, Patna. Study was done on 80 patients of eclampsia and impending eclampsia. Patients were divided into two groups A and B. Group A (n=40) received low dose MgSO4 regime (Dhaka regime) and Group B (n=40) received standard Pritchard regime. Results were analysed using statistical package of social sciences (SPSS) 21.0. Statistical significance was set at p ≤0.05.Results: In the present study, convulsions were controlled in 95% of eclampsia cases with low dose magnesium sulphate (Dhaka) regime. Recurrence of convulsion was seen in both groups. None of the patients with impending eclampsia in both the groups developed the seizure during entire treatment period. Signs of impending MgSO4 toxicity and the mean amount of magnesium sulphate received was found more in Pritchard regime group (22.5gms in Group A and 39gms in Group B) and was statistically significant with p value <0.001. There were 3 maternal deaths in present study.Conclusions: Low dose magnesium sulphate is as effective as standard Pritchard regime in controlling the eclamptic fits and preventing its recurrence with comparable maternal and perinatal outcome and less chances of magnesium toxicity. This regimen may be more suitable for use in Indian women with low BMI and in resource poor settings where clinical monitoring is limited.

scholarly journals Comparative Study on the Efficiency of 2 Different Types of Meshes (Polypropylene and ProGripTM ) in the Surgical Treatment of Incisional Hernias

2018 ◽  
Vol 55 (2) ◽  
pp. 152-155
Author(s):  
Bogdan Andrei Suciu ◽  
Ioana Halmaciu ◽  
Decebal Fodor ◽  
Cristian Trambitas ◽  
Adrian Ivanescu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Polypropylene Mesh ◽  
Incisional Hernias ◽  
Hospitalization Period ◽  
Duration Of Surgery ◽  
Different Types ◽  
Group A ◽  
Group B ◽  
Clinical Records

Postoperative eventration is a quite common condition in patients with clinical records of abdominal surgery. The purpose of this study was to investigate the efficacy of use of 2 different types of meshes (Polypropylene mesh and ProGripTM mesh-self-gripping mesh) in the surgical treatment of incisional hernias. In this respect, we conducted a study in which we introduced 128 patients operated for incisional hernias. Patients were divided into 2 lots: group A (102 patients with polypropylene mesh) and group B (26 patients with ProGripTM mesh). From the analysis of the data studied, we noticed that the average duration of surgery and hospitalization for patients with ProGripTM mesh is lower compared to patients with polypropylene mesh. Also, the rate of local postoperative complications was lower when using the ProGripTM mesh (15.38%) than in the case of polypropylene mesh. In conclusion, we can state that the use of the ProGripTM heterologous mesh is beneficial in the surgical treatment of patients with incisional hernias. The major advantage of using this type of mesh is given by a shorter hospitalization period for these patients, as well as by a lower rate of local postoperative complications in these patients.

scholarly journals A STUDY TO COMPARE CAUDAL DEXMEDETOMIDINE VERSUS FENTANYL AS ADJUVANT TO 0.25% LEVOBUPIVACAINE FOR POSTOPERATIVE SEDATION IN PAEDIATRIC PATIENTS UNDERGOING INFRAUMBLICAL SURGERIES UNDER GENERAL ANAESTHESIA

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Kanchan Chauhan ◽  
Roma Sharma
Keyword(s):  
Study Groups ◽  
Demographic Variables ◽  
Sedation Score ◽  
Caudal Analgesia ◽  
Duration Of Surgery ◽  
Group A ◽  
Insignificant Difference ◽  
Group B ◽  
To Receive ◽  
Ramsay Sedation Score

Background: Caudal analgesia reduces the amount of inhaled and intravenous (i.v.) anaesthetic requirement, attenuates the stress response to surgery, facilitates a rapid, smooth recovery and provides good post operative analgesia and sedation. Methods: 135 patients of either sex, aged between 2 to 8 years, having body weight 10 to 30kg belonging to ASA Grade I and II scheduled for infraumblical surgeries under GA were randomized into three groups of 45 each to receive the caudal block i.e Group A received .25% levobupivacaine (.75ml/kg) with 0.9%NS. Group B received .25%levobupivacaine (.75ml/kg) with fentanyl 1mcg/kg diluted with 0.9%NS upto 1ml and Group C received 0.25%levobupivacaine (0.75ml/kg) with dexmedetomidine 1mcg/kg diluted with 0.9%NS upto 1ml. Results: There was statistically insignificant difference in the socio- demographic variables in terms of age, weight, sex ratio, ASA Grade and duration of surgery among the study groups. There was statistically significant (p<0.05) prolongation in the duration of arousable sedation, recorded using the Ramsay sedation score in Group C(up to 4hrs), in contrast to Group A( up to 1hrs) and Group B(up to 2hrs). Conclusion: The mean ramsay sedation score was significantly greater in the group levobupivacaine with dexmedetomidine as compared to levobupivacaine alone and levobupivacaine with fentanyl group. Keywords: Ramsay sedation score, Levobupivacaine, Dexmedetomidine, Caudal analgesia.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

scholarly journals The Influence of the Physiotherapeutic Program on Selected Static and Dynamic Foot Indicators and the Balance of Elderly Women Depending on the Ground Stability

2021 ◽  
Vol 18 (9) ◽  
pp. 4660
Author(s):  
Joanna Matla ◽  
Katarzyna Filar-Mierzwa ◽  
Anna Ścisłowska-Czarnecka ◽  
Agnieszka Jankowicz-Szymańska ◽  
Aneta Bac
Keyword(s):  
Elderly Women ◽  
Statistical Significance ◽  
Exercise Program ◽  
Control Group ◽  
Balance Assessment ◽  
Motor Functions ◽  
Static Test ◽  
Group A ◽  
Group B ◽  
The Impact

Seniors are a constantly growing group of people in many societies. It is necessary to develop physiotherapeutic programs to improve their mobility. The aim of this study was to assess the impact of the physiotherapeutic program conducted unstable ground on selected indicators of motor functions of elderly women. Sixty women (60–80 years) participated in the research. Group A (N = 20) underwent a 12-week physiotherapeutic program on stable ground, group B (N = 20) followed an exercise program on unstable ground, and group C (N = 20) (control group) had no therapeutic intervention. The effects of the therapy were assessed by using a FreeMed platform (foot load analysis) and a Biosway balance system. The results were compared using ANOVA (the one-way analysis), the Kruskal–Wallis test and also the post hoc tests (Tukey’s test and the multiple comparison test). In group A, a statistically significant change was observed in the static test and balance assessment, in group B this was observed in the static and dynamic foot tests and balance assessment, in group C, no statistical significance was achieved. The authors’ physiotherapeutic program had a statistically significant effect on changes in the balance and selected indicators of the motor functions of the examined people. Comparing the results before and after the therapy more improvement changes were noted in women training on an unstable ground compared to women training on a stable ground.

scholarly journals Marginal Integrity of CAD/CAM Ceramic Crowns Using Two Different Finish Line Designs

2021 ◽  
Author(s):  
Jaber Hussain Akbar ◽  
Ridwaan Omar ◽  
Yacoub Al Tarakmah
Keyword(s):  
Dental Treatment ◽  
Statistical Significance ◽  
United States Public Health ◽  
Finish Line ◽  
Marginal Integrity ◽  
Computer Aided ◽  
Cad Cam ◽  
Group A ◽  
Group B ◽  
Line Design

Statement of problem- Research on evaluation of crowns made by the latest CAD/CAM systems for their marginal adaptation is scarce. Purpose- The purpose of this in vitro study was to evaluate the marginal integrity of crowns fabricated by the latest Chairside Economical Restorations of Esthetic Ceramic (CEREC) system using two different finish line preparation designs: Chamfer and Shoulder. Material and methods- Typhodont teeth were equally divided into two groups, group A and B. The teeth were prepared for full coverage crowns with a shoulder (group A) and chamfer finish line design (group B). An experienced prosthodontist prepared all crown preparations. Evaluation of six sites per sample was completed by two calibrated, experienced prosthodontists using the modified United States Public Health Services (USPHS) criteria. The descriptive statistics and Z-test were used to evaluate the results. Results- A total of 180 teeth were included in the study (90 teeth in each group). Only two crowns in group A and one crown in group B were clinically unacceptable. There was no statistical significance (p=0.282) between the two groups regarding finish-line design. Conclusions- CEREC system provides clinically acceptable crowns and can safely be utilized in dental treatment. Therefore, Contemporary Dental Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) restorations should be considered as a safe treatment modality by dental professionals.

Frequency of port site infection following gall bladder removal through Epigastric vs Umbilical port.

2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wound Infection ◽  
Port Site ◽  
Site Infection ◽  
College Hospital ◽  
Medical College ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.

scholarly journals Comparison of two different techniques of uterine closure in caesarean section: Continuous single layer technique versus Babu and Magon technique

2018 ◽  
Vol 7 (6) ◽  
pp. 2197
Author(s):  
S. Vinayachandran ◽  
Vedhapriya Sudhakar
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Single Layer ◽  
Adverse Outcomes ◽  
Caesarean Scar ◽  
Duration Of Surgery ◽  
Layer Technique ◽  
Observational Prospective Cohort Study ◽  
Group A ◽  
Group B

Background: To compare size of the caesarean scar and residual myometrial thickness (RMT) between continuous single non-interlocking and Babu and Magon technique for uterine closure following primary elective caesarean section (CS).Methods: An observational prospective cohort study was conducted at 6 weeks and 4 months postpartum following primary elective CS. Group A included 25 patients who underwent continuous single layer technique and Group B included 25 patients who underwent Babu and Magon technique for uterine closure. Baseline demographic profile, obstetric score, details of the CS and associated complications were studied. Two-dimensional Transvaginal ultrasonography (TVS) measurements of the length, width and depth of the caesarean scar and RMT were compared.Results: Mean age of study population was 29.6 years. Malpresentation (44%) was the most common indication for CS. Mean Bishops score at the time of CS was <4. The duration of surgery (-2.8 min, 37.96 ±5.660min) and estimated amount of blood loss (-51.6 ml, mean 671.20 ±136.208ml) was less in Group A compared to Group B (40.76 ±4.68min, 722.80±132.083ml respectively). The caesarean scar measurements were similar in both groups at both visits. The mean RMT in Group B at 6 weeks and 4 months postpartum (8.05mm±2.06 and 7.10mm±2.04 respectively) was statistically higher than Group A (6.23mm ± 1.76 and 5.36mm ± 1.70 respectively), p=0.002.Conclusions: We conclude that Babu and Magon technique for uterine closure in caesarean section could result in better healing of the scar and probably reduce the adverse outcomes in subsequent pregnancies.

scholarly journals Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

2008 ◽  
Vol 65 (5) ◽  
pp. 349-352 ◽  
Author(s):  
Biljana Djordjevic ◽  
Jelena Milosevic ◽  
Zorica Stanojevic
Keyword(s):  
Endometrial Carcinoma ◽  
Statistical Significance ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Atypical Hyperplasia ◽  
Endometrial Polyps ◽  
Female Population ◽  
Group A ◽  
Malignant Changes ◽  
Group B

Background/Aim. The prevalence of endometrial polyps (EPs) in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma), patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204) and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7). Results. In 211 (21.94%) patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94%) EPs, 29 (13.74%) EPs with hyperplasia without atypia, 5 (2.37%) EPs with atypical hyperplasia, and 2 (0.95%) EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A), patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B) were older (p < 0.05), and more commonly postmenopausal (p < 0.05) and with hypertension (p < 0.05), all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

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