ABSTRACT
Background: The aim of the study was assessment of post-operative outcomes of rectus sheath block and comparison ofoutcomes between rectus sheath block and sub cutaneous bupivacaine.Materials and Methods: This study enrolled 58 patients who were scheduled to undergo laparotomy. Group I – 30 patientsreceived rectus sheath block using bupivacaine by placing catheters in between the muscle and posterior rectus sheath.Group II – 28 patients received bupivacaine infiltration by placing catheters in the subcutaneous plane. Visual analog scale(VAS) score, peak expiratory flow rate (PEFR), rescue analgesia, and complications were noted and follow-up of thesepatients was done.Results: Both the groups were comparable, hemoglobin concentration and anesthesiologists grades (statisticallyinsignificant). The majority of the patients from rectus sheath block group had VAS scores <5 comparing to subcutaneousinfiltration group which was statistically very significant (P ≤ 0.001). There was a statistically significant improvement ofpost-operative PEFR values in Group I as compared to Group II (P < 0.001). In Group I, 20 patients showed VAS scoreof 1 (no pain) at rest as compared only four patients in Group II. Rate of infection was more common in group receivingsubcutaneous infiltration.Conclusion: The patients from rectus sheath block group showed a statistically significant decrease in post-operative painin terms of VAS scores compared to that of subcutaneous bupivacaine infiltration group. There was statistically significantdecreased use of opioids as rescue analgesic in the rectus sheath group compared to that of the subcutaneous bupivacaineinfiltration group.
ABSTRACT
OBJECTIVES: To describe the clinical details and follow up of children with idiopathic pulmonary hemosiderosis. DESIGN: Retrospective case series. SETTING: Pediatric chest clinic of a tertiary care hospital. SUBJECTS: Children diagnosed as suffering from idiopathic pulmonary hemosiderosis (IPH). METHODS: Charts of patients diagnosed as IPH were reviewed for clinical features and treatment regimen. Diagnosis was based on presence of iron deficiency anemia, chest radiography and demonstration of hemosiderin laden macrophages in bronchoalveolar lavage (BAL), gastric aspirate, or sputum. Treatment consisted of oral prednisolone, hydroxychloroquine (HCQ) and inhaled corticosteroids (ICS). RESULTS: The common clinical features in 26 children with IPH (mean age 75 months) included: cough, breathlessness, fever, hemoptysis and wheezing in 26 (100%), 22 (85%), 19 (73%),15 (58%) and 14 (54%) children, respectively. Clubbing, hepatomegaly and splenomegaly was seen in 16 (62%), 15 (58%) and 10 (38%) children, respectively. Hemosiderin laden macrophages were documented in BAL and gastric aspirate in 92% and 30% patients, respectively. Symptoms did not recur in 17 patients who received prednisolone and HCQ initially. 5 patients had recurrence of symptoms and required short courses of oral prednisolone, 4 patients required frequent courses of prednisolone and were started on azathioprine. Older age, longer duration of illness, history of hemoptysis and jaundice were associated with poor response. CONCLUSION: Treatment with prednisolone and hydroxychloroquine followed by inhaled corticosteroids may improve survival in children with IPH.
Subject(s)
Acute Disease , Adolescent , Adrenal Cortex Hormones/therapeutic use , Child , Child, Preschool , Female , Glucocorticoids/therapeutic use , Hemosiderosis/diagnosis , Humans , Hydroxychloroquine/therapeutic use , Infant , Lung Diseases/diagnosis , Macrophages , Male , Prednisolone/therapeutic use , Retrospective StudiesABSTRACT
Cefprozil is a novel third generation, broad-spectrum oral cephalosporin with activity against a spectrum of aerobic gram-negative and positive bacteria, as well as certain anaerobes. The beta-lactamase stability of cefprozil may exceed that of other oral cephalosporins for some important pathogens. Cefprozil may be a suitable alternative to several other commonly used beta-lactams and cephalosporins in the treatment of mild to moderate upper and lower respiratory tract infections including sinusitis, otitis media, pharyngitis/tonsillitis, secondary bacterial infection of acute bronchitis, and acute bacterial exacerbations of chronic bronchitis, and skin and skin structure infections in children. Available data indicate the safety of cefprozil in both pediatric and adult population.