Study of the effect of added bronchoscopic suction to routine treatment of ventilator associated pneumonia patients in surgical ICU

2021 ◽  
pp. 1-16
Author(s):  
Seyyed Hasan Karbasy ◽  
Maryam Bayati ◽  
Amir Sabertanha ◽  
Aram Meshkini ◽  
Bibi Fatemeh Shakhs Emampour
Keyword(s):  
Body Temperature ◽  
Antibiotic Therapy ◽  
Normal Saline ◽  
Leukocyte Count ◽  
Apache Ii ◽  
P Value ◽  
Closed Suction ◽  
Significant Difference ◽  
Sterile Normal Saline ◽  
Blood Leukocyte

Abstract Objective: Comparing BAL and antibiotic therapy with antibiotic therapy itself for treating VAP patients in ICU. Methods: In this randomized clinical trial. The first group was treated using antibiotics and closed-suction was performed daily, using 50 cc of sterile normal saline. The second group was treated with antibiotics and daily closed-suction with 50 cc of sterile normal saline, plus bronchoscopic suction every other day. Patients of both groups were followed and investigated one, 3, 7, and 10 days after initial diagnosis. Results: Mean blood leukocyte count and body temperature was measured in groups one (no bronchoscopy) and two (with bronchoscopy) in first, 3rd, 7th, and 10th days which was higher in the second group. Mean treatment status was also measured using APACHE II index. There was also a statistically significant difference in 3rd day (p-value < 0.05). There was also no difference in final culture result or mortality rate between two groups. Conclusion: According to the results of this study like lower body temperature, higher leukocyte count reduction, and lower APACHE II scores in the second group, treated with bronchoscopic suction, adding bronchoscopy seems to be more useful than normal method. Keywords: Bronchoscopy, Pneumonia, VAP, Continuous...

TO COMPARE THE EFFECTIVENESS OF NEBULISATION WITH ADRENALINE, 3% HYPERTONIC SALINE AND NORMAL SALINE IN BRONCHIOLITIS IN CHILDREN OF 2 TO 24 MONTHS OF AGE BASED ON CLINICAL SEVERITY SCORE AND NEBULISATION FREQUENCY.

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Priyanka Jain ◽  
Rakesh Jain
Keyword(s):  
Hypertonic Saline ◽  
Normal Saline ◽  
Mean Difference ◽  
Clinical Severity ◽  
Research Centre ◽  
P Value ◽  
College Hospital ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean

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.

scholarly journals The effect of Curcuminvs. Curcumin combined Antibiotic Ointmentson the Healing of skin wound

2021 ◽  
Vol 14 (3) ◽  
pp. 1587-1593
Author(s):  
Emad K. Abbas ◽  
Hussein H. Echrish ◽  
Sabaa A. Mohammed
Keyword(s):  
Wound Healing ◽  
Normal Saline ◽  
Biological Effects ◽  
Skin Wound ◽  
Control Group ◽  
P Value ◽  
Average Weight ◽  
Wide Range ◽  
Significant Difference ◽  
Animal House

Background:Turmeric is typically used as a spicy food preservative and colorant. It has been proved that curcumin has a wide range of biological effects including anti-inflammatory, anti-viral, anti-fungal, and curcumin activity that can improve antibiotic activity on the wounds. Objectives: To evaluate the effects of Curcumin with and without antibiotics on skin wound treatment. Materials and Methods: The protocol was approved by the animal house in medical college / Basra university. This study used nine male rabbits aged about 6 months and an average weight of (1.083 g). Each group consists of 3 rabbits: control group (normal saline) A, topical curcumin in group B, topical curcumin, and tetracycline ointment in group C. Regular treatments were given to rabbits in therapeutic groups. Result: The lowest Mean ± SDof swelling of suturing area was noted in both groups that treated by curcumin alone (9.07 ± 0.97 vs 15±1 mm, p value = 0.002) and that treated with curcumine and antibiotic (9.1±0.9vs 15±1 mm, p value = 0.002) versus the control group ( that treated by normal saline) and the lowest Mean ± SD of elevation of suture line was noted in both group that treated by curcumin alone (2.63 ± 0.06 vs 4.07±0.21 mm, p value >0.001) and that treated with curcumin and antibiotic (2.7 ± 0.2 vs 4.07±0.21 mm, p value =0.001) versus control group. There is no significant statistical difference between the Mean ± SD neither of swelling of suture area nor of elevation of suture lines of groups that treated by curcumin alone and group that treated with curcumin and antibiotic [(9.07 ± 0.97 vs 9.1 ±0.9, p value=0.97),(2.63±0.06 vs 2.7 ± 0.2, p value=0.61) respectively]. The histopathological evaluation is consistent with morphological changes as at day 3 of wound healing in both groups that treated by curcumine with and without antibiotic, there is formation a thin layer of keratin and absence of features that indicate delay wound healing such as hemorrhage, inflammatory cell infiltrate of (Neutrophils, macrophages and lymphocytes) and debris, which are detected in control group. Furthermore, at day 7 of control group, there is decrease of inflammation, presence of gap between the two edgesof the wound but no keratin formation. No clear histopathological difference in wound healing between tested groups that treated by curcumin with and without antibiotic. Conclusion: There issignificant clinical and histological evidences that the curcumin not only prevent delay of wound healing but it is also enhanced wound healing. No significant difference in using curcumin alone or combine it with local antibiotic.

Intravenous Ondansetron for Attenuation of Post Spinal Anesthesia Hypotension

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Saeed Mohamed Ibrahim ◽  
Rania Mahrous Aly Hussien ◽  
Hazem Mohamed Sabry Abdel Aziz Ahmed
Keyword(s):  
Spinal Anesthesia ◽  
Local Anesthetic ◽  
Normal Saline ◽  
Demographic Data ◽  
Randomized Study ◽  
P Value ◽  
Anthropometric Measures ◽  
Double Blind ◽  
Induced Hypotension ◽  
Significant Difference

Abstract Background Spinal Anesthesia is a common type of anesthesia used during many surgical procedures. This regional technique can be accomplished by administering an intrathecal dose of hyperbaric local anesthetic solution. The local anesthetic within the subarachnoid space can block sensory, motor and sympathetic pathways. Objectives The Purpose of this study was to find out the effectiveness of prophylactic administration of intravenous ondansetron for attenuation of spinal anesthesia induced hypotension in non-obstetric spinal anesthesia surgeries. Patients and Methods Therefore, A prospective double-blind, placebo-controlled, randomized study was found to be the most suitable design in order to achieve the study objectives. A total of 90 patients males & females included in the study, aged 20-40 years, and were divided equally into two groups: Group A received 8 mg ondansetron diluted in volume of 10 cm normal saline 5 minutes prior to spinal anesthesia. Group B received a placebo of 10 cm normal saline 5 minutes prior to spinal anesthesia. Results There was no statistically significant difference found between the two studied groups regarding demographic data, anthropometric measures, ASA score and total time of surgery. There was statistically significant increase in the incidence of hypotension immediately after spinal and at 5 min in placebo group than ondansetron group with p-value = 0.026 and 0.014 respectively. Conclusion The present study demonstrated that, among patients who received spinal anesthesia with bupivacaine for elective for surgeries below umbilicus, prophylactic intravenous ondansetron 8mg iv 5 mins prior to spinal anesthesia reduced spinal anesthesia induced hypotension decreases in SBP, MAP, and heart rate. Ondansetron did not have a significant effect on DBP. Ondansetron did not have a significant effect on DBP. The incidence of nausea and vomiting was lower following the administration of ondansetron, and vasopressor use and dosages were reduced.

scholarly journals The Evaluation of Neutrophil to Lymphocyte Ratio in Kawasaki Disease and Its Value in Predicting IVIG Therapy Resistance

2021 ◽  
Author(s):  
Hamidreza Houshmand ◽  
Ramin Farhadi ◽  
Amin Sedokani
Keyword(s):  
Kawasaki Disease ◽  
Diagnostic Criteria ◽  
Leukocyte Count ◽  
Systemic Vasculitis ◽  
Ivig Therapy ◽  
Response To Treatment ◽  
P Value ◽  
Time Interval ◽  
Blood Leukocyte ◽  
Clinical Records

Abstract Introduction: Kawasaki disease is a common systemic vasculitis of unknown cause in children and involves various organs but the main damage of this multisystemic vasculitis is mainly in the coronary arteries. Currently, the main treatments for this disease include aspirin therapy and IVIG. In the present study, we investigated the ratio of neutrophils to lymphocytes in patients with Kawasaki disease and its relationship with IVIG resistance in Kawasaki patients.Method: First, we reviewed the clinical records of patients diagnosed with Kawasaki, who received treatment at Motahari Hospital in Urmia from 2008 to 2018 (IVIG therapy). We re-examined Kawasaki diagnostic criteria for each individual before enrolling patients. Results: In our study, initially 460 cases of patients who were admitted to Motahari Hospital in Urmia between 2009 and 2019 with an initial diagnosis of Kawasaki disease were reviewed. Among them, patients who met Kawasaki diagnostic criteria were included in the final review and the rest of the cases were excluded from the study according to the exclusion criteria. Finally, out of 460 cases, 241 patients were included in the final analysis. The results indicated high blood leukocyte count (p-value = 0.013) and low urinary leukocyte count (p-value = 0.01) were directly related to response to treatment in Kawasaki patients, but age, sex, neutrophil ratio to Lymphocytes, neutrophil count, blood lymphocytes, CRP, hypoalbuminemia, ALT levels, anemia, thrombocytosis, and the time interval between onset of symptoms and treatment response to IVIG therapy in Kawasaki patients are not significantly related.Conclusion: High blood leukocyte count and low urinary leukocyte count in patients can be good criteria for predicting the prognosis of Kawasaki patients in response to IVIG, while the ratio of neutrophils to lymphocytes is not effective in this prediction.

scholarly journals Impact of Thyroid Dysfunction in Correlation to Mortality Rate of the Critically ILL ICU Patients (Prospective Observational Study)

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A E Mohammed ◽  
A M Saied ◽  
W Z Selima ◽  
W S Ibrahim
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Thyroid Dysfunction ◽  
Study Groups ◽  
The Body ◽  
Apache Ii ◽  
Apache Ii Score ◽  
P Value ◽  
Normal Thyroid Function ◽  
Significant Difference

Abstract Background during critical illness, changes in circulating hormonal levels are a common phenomenon. These alterations are correlated with the severity and outcome of patients in intensive care unit (ICU). Thyroid hormone stays a key role in the maintenance of the body growth. Modulating metabolism and the immune system. Aim of the Work is to access the relation between thyroid dysfunction and mortality in critically ill patients and to access the strength of thyroid dysfunction as a predictor of mortality against APACHE II score and CRP, also to assess the additive effect of low FT3 and high APACHE II score as a predictor of mortality. Patients and Methods the study population (n = 40) included 21 males (52.2%) and 19 females (47.5). their age range from (21 years) to (91 years) were selected from critically ill patients admitted to El Demerdash hospital general ICU in the period from March 2017 to March 2018. Patients were divided into 2 groups according to 7th day thyroid profile: Group 1 Normal thyroid function group (24 patients). Group 2 thyroid dysfunction group (16 patients). Results the most significant abnormality between the 2 groups was TT3 and FT3. The patients in thyroid dysfunction group showed significantly higher APACHE II score and CRP but lower GCS. They also needed more mechanical ventilation with longer duration. There was no significant difference between the 2 study groups as regard cardiovascular complication. Conclusion our study also showed highly significant correlation between thyroid dysfunction and mortality. FT3 appeared to be better predictor of mortality among critically ill patients with AUC 83% and p value &lt; 0.001 with sensitivity 99% and specificity 61%. The predictive value of FT3 for mortality increased by the addition of APACHE II score &gt; 25.

scholarly journals PENGARUH SKIN TO SKIN CONTACT (PMK) TERHADAP PENURUNAN SUHU TUBUH PADA BAYI DEMAM

2019 ◽  
Vol 3 (1) ◽  
pp. 79
Author(s):  
Heni Purwaningsih ◽  
Widuri Widuri
Keyword(s):  
Body Temperature ◽  
P Value ◽  
Temperature Decrease ◽  
Control Center ◽  
Purposive Sampling ◽  
Skin Contact ◽  
Significant Difference ◽  
Post Test ◽  
Quasi Experimental ◽  
Skin To Skin

Demam merupakan suatu keadaan suhu tubuh diatas normal sebagai akibat peningkatan pusat pengatur suhu di hipothalamus. Cara yang dapat menurunkan suhu tubuh adalah dengan menggunakan metode kontak kulit ibu dan kulit bayi (Skin to Skin Contact). Tujuan penelitian ini adalah untuk mengetahui pengaruh skin to skin contact (PMK) terhadap penurunan suhu tubuh pada bayi demam di Rumah Sakit Ken Saras Kabupaten Semarang. Jenis penelitian ini adalah Quasi Experimental dengan pre-post test dalam satu kelompok (One-Group Pre-test-posttest Design). Populasi adalah rata-rata jumlah bayi yang mengalami demam perbulan di Rumah Sakit Ken Saras selama tahun 2016 sebanyak 87 anak. Sampel 14 orang yang diambil secara purposive sampling. Alat pengumpulan data menggunakan termometer digital axila. Hasil penelitian menunjukkan terdapat perbedaan secara bermakna suhu tubuh pada bayi demam sesudah dilakukan skin to skin contact (PMK)  dengan p value 0,000 < α (0,05). Perawat dapat memberikan intervensi skin to skin contact (PMK) sebagai salah satu intervensi keperawatan nonfarmakologis dalam penatalaksanaan bayi demam. Kata kunci: Bayi demam, skin to skin contact, perawatan metode kanguru Abstract The Effects of Skin to Skin Contact (PMK) on Body Temperature Decrease in Infants with Fever. Fever is a body temperature above normal circumstances as a result of increased temperature control center in the hypothalamus. One of the ways that can reduce body temperature is using skin to skin method of mother and baby’s skin (Skin to Skin Contact). The purpose of this research is to analyze the effects of skin to skin contact (pmk) on body temperature decrease in infants with fever at Ken Saras Hospital of Semarang Regency. The type of this research was Quasi Experimental with pre-post test in one group (One-Group Pre-test-posttest Design). The population was all the average number of infants with fever per month at Ken Saras Hospital during 2017 as many as 38 patients. 14 samples were taken by purposive sampling. The collecting data tool used a axilla digital thermometer. The research results showed that  there is a significant difference of body temperature in infants with fever after skin to skin contact (PMK) with p value 0,000 <α (0,05). Nurses can provide skin to skin contact (PMK) interventions as one of the nonpharmacological nursing interventions in the management of infants with fever. Keywords : Infants with fever, skin to skin contact, kangaroo care method

scholarly journals Role of Antibiotics in Neonates Born through Meconium Stained Amniotic Fluid

2021 ◽  
Vol 8 (9) ◽  
pp. 142-148
Author(s):  
Ravi Tiwari ◽  
Om Shankar Chaurasiya ◽  
Sapna Gupta
Keyword(s):  
Antibiotic Therapy ◽  
Amniotic Fluid ◽  
Final Outcome ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Antibiotic Group ◽  
The Difference ◽  
Sepsis Screen ◽  
Meconium Stained Amniotic Fluid

The objective of our study was to compare the clinical course and infection related outcome in cases of meconium stained amniotic fluid neonates treated with or without antibiotic therapy. One hundred fifty eligible neonates were randomized to antibiotic group and non antibiotic group. Both groups were compared for development of sepsis screen and final outcome in both groups were compared. The incidence of sepsis screen positive was observed in both groups. In antibiotic group sepsis screen was positive in 5 cases and in non antibiotic group sepsis screen was positive in 4 cases. overall incidence of sepsis screen positive was similar in both antibiotic and non antibiotic group. The difference was not found to be statistically significant (p value = 1.00 and chi square value 0.118). Final outcome in both antibiotic group and non antibiotic group showed that in antibiotic group, out of 75 neonates 71 were discharged successfully and 4 were died. In non antibiotic group, 73 were discharged successfully and 2 died, out of 75 neonates. There was statistically no significant difference on final outcome between these two groups (p value 0.68 and chi square value 0.694). Conclusion: There was no difference in the incidence of infection and in final outcome in neonates born through meconium stained amniotic fluid treated with or without antibiotics. Keywords: Meconium Stained Amniotic Fluid, Neonates, Antibiotic Therapy.

scholarly journals Effectiveness of Thermos to Maintain the Temperature of Ringer Lactate and Normal Saline 0.9% at AC Temperature 18˚C

2013 ◽  
Vol 9 (2) ◽  
pp. 204-211
Author(s):  
Rifda Nur A Arif ◽  
◽  
Abdurrahman Wahid ◽  
Ifa Hafifah ◽  
Gia Eka Negara
Keyword(s):  
Fluid Resuscitation ◽  
Normal Saline ◽  
P Value ◽  
Ringer Lactate ◽  
Temperature Changes ◽  
Significant Difference ◽  
The Media ◽  
Study Type ◽  
Statistical Results

Hemorrhagic shock patients require fluid resuscitation, but extra efforts should be made to provide 39 C fluids to avoid hypothermia. One of the media to maintain temperature is a thermos. The purpose of this research is to identify whether the flasks can keep 39-degree crystalloid fluids at 18 degrees Celsius. This study used a pre-experimental method, with One-Shot Case Study type, 12 bottles of crystalloid liquid was warmed to 39°C, then put into 2 rice flasks, and temperature changes were measured for 6 hours at AC temperature 18˚C. The study was conducted on 30 November 2019. The findings show that temperatures in 6 bottles of RL liquid decreased by 6.8 -7.4 C and in 6 bottles of NS 0.9% liquid decreased by 5.3 - 6.4 C. Statistical results using the Mann-Whitney p-value is 0,000. It was concluded that there was a significant difference between changes in temperature of lactate Ringer's fluid and normal saline 0,9%. A thermos can maintain a temperature of 39˚C for about 1 hour and can prevent hypothermia from reaching 36˚C for about 3 hours.

scholarly journals The study of effects of inhibition of the renin angiotensin system on memory in rats

2018 ◽  
Vol 7 (9) ◽  
pp. 1847
Author(s):  
Medhinee Kulkarni ◽  
Prasad Pandit ◽  
Kiran Bhave
Keyword(s):  
Avoidance Response ◽  
Normal Saline ◽  
Renin Angiotensin System ◽  
Conditioned Avoidance ◽  
Study Groups ◽  
Conditioned Avoidance Response ◽  
P Value ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Significant Difference

Background: The existence of an independent renin angiotensin aldosterone system (RAAS) has been well-established and is known to modulate various pathological processes such as neuroinflammation, neurodegeneration, and neural injury, in addition to the RAAS in the cardiovascular system.Methods: Eighteen Wistar rats were divided into 3 study groups (n=6; Losartan, Ramipril, Normal Saline), trained on the Cook’s Pole climbing apparatus till the conditioned avoidance response (CAR) rate was 100%. The retention of CAR was tested each week for 4 consecutive weeks. The number of times that the animal successfully avoided the shock, and the time taken for this avoidance were measured and compared with placebo (Normal Saline). The values have been expressed as Mean±Standard Deviation (SD). A p-value of less than 0.05 has been considered as significant.Results: The retention of the conditioned avoidance response in the group receiving study drugs was significantly more than the placebo group. However, there was no show significant difference between Losartan and Ramipril in the rate of retention, or the time taken for avoidance.Conclusions: In this study, Ramipril and Losartan have a beneficial effect on learning and memory as compared to plcebo.

scholarly journals INTRATHECAL BETAMETHASONE;

2017 ◽  
Vol 24 (05) ◽  
pp. 733-738
Author(s):  
Hamid Raza ◽  
Bashir Ahmed ◽  
Kamlaish -
Keyword(s):  
Cesarean Section ◽  
Normal Saline ◽  
Random Number ◽  
Random Number Generator ◽  
Control Group ◽  
P Value ◽  
Number Generator ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Study Population

Objectives: The aim of our study to determine the use of intrathecal betamethasoneadministration as effective post-operative analgesic in gynecologic procedures. Study Design:Randomized control trial. Period: 6 months duration from April 2015 to end of September 2015.Setting: Tertiary Care Centre in Karachi, Pakistan. Method: The study population consisted ofn= 120 (divided into three groups using a random number generator) patients, who presentedto our setup either via emergency or through the outpatient. The patients belonged to ASAclass I and II, and underwent cesarean section. The group A was the control group, patientswho received 0.5ml normal saline IV with bupivacaine 0.5% in 3ml, with 0.5ml of normal salineintrathecally. Group B consisted of patients who received 0.5ml IV normal saline, with 0.5%in 3ml bupivacaine along with 0.5ml betamethasone as 4mg per ml. The last group, groupC consists of patients who received 0.5ml betamethasone IV (4ml/ml) along with 0.5% 3mlbupivacaine with 0.5ml of normal saline intrathecally. For the subjective measurement of painlevel a visual analog scale was used. Various time intervals as time of initial first analgesic effect,time between intrathecal injection and first administration of diclofenac as rescue analgesicand the total number of analgesics used in the first twenty four hour period were also recordedin the proforma. Various side effects such as nausea, vomiting and headache were noted.Data was analyzed using SPSS version 23. Results: The study population consisted of n=120 patients, divided into three groups using a random number generator, the demographicdata like age, whether the procedure performed was elective or emergency etc did not showany difference p value of >0.05. The Visual analog scales scores at the 4 hour and 6 hourmark showed statistically significant difference, the values being lower in the medication groupsversus the control group. But no difference was found between the control and medicationgroups in the VAS score measured at 12 hour and 24 hours respectively. The requirement foruse of Diclofenac as rescue analgesia was also lower in the intrathecal and intravenous (groupB and C) as compared to the control group at the 24 hour mark post operatively, and thedose required was even lower in the intrathecal group as compared to the intravenous grouphaving a p value of 0.014. N= 27 patients suffered nausea and vomiting during the procedure,N= 40 patients reported headache following the 24 hour period post operatively. Conclusion:According to the results of our study intrathecal betamethasone administration is an effectivemethod of post-operative pain reduction in cesarean section surgeries and it also decreases theneed for rescue analgesia required.

Sign in / Sign up

Export Citation Format

Share Document