A randomized comparative study of preoperative fentanyl and dexmedetomidine nebulization on the hemodynamic response to endotracheal intubation

Background: Intense sympathetic activity is linked to laryngoscopy and endotracheal intubation, which could lead to intraoperative problems. We undertook this study to compare the effects of preoperative nebulized Fentanyl and Dexmedetomidine on hemodynamic response to laryngoscopy and endotracheal intubation, taking advantage of their high bioavailability and better absorption through nasal mucosa. Aim and Objectives: The objectives of the study were (i) to compare the effect of preoperative nebulization on the hemodynamic response to laryngoscopy and intubation; and (ii) to assess intraoperative requirement of anesthetic agents. Materials and Methods: This prospective, randomized, and comparative study was conducted among 100 American Society of Anesthesiologists (ASA) I, II patients (of either gender) undergoing elective surgeries and requiring tracheal intubation, were randomized in two groups. Group A was given Fentanyl Nebulization (2 ?g/kg in 4 ml of 0.9% saline) and Group B was given Dexmedetomidine nebulization (1 ?g/kg in 4 ml of 0.9% saline) 10 min before anesthesia induction. Hemodynamic parameters were noted before and immediately after induction, 1 min, 5 min and 10 min after intubation. The main goal was to assess how Fentanyl and dexmedetomidine nebulization affect the laryngoscopy and intubation-induced stress response. The secondary outcome was to assess the intraoperative requirement of anesthetic agents, observe adverse effects of study drug and sedation score. Results: Dexmedetomidine nebulization was found to be more effective in blunting rise in heart rate post laryngoscopy compared to Fentanyl Nebulization (P < 0.0001) as well as in MAP after 10 min of intubation (P < 0.0001). Requirement of propofol was seen to be significantly reduced in Group B compared to Group A (P < 0.05). Sedation scores were significantly higher in Group B (P < 0.05). No evidence of side effects was observed in any group. Conclusion: Nebulisation of dexmedetomidine was found to be more effective in attenuation of stress response of laryngoscopy and intubation compared to nebulisation of fentanyl, with stable intraoperative hemodynamic and no significant side effects.

Research progress of mesenchymal stem cells and their derivatives nebulization in the treatment of pulmonary diseases / 中华危重病急救医学

In acute or chronic lung diseases, inappropriate immune response and abnormal repair process can lead to irreversible damage to lung tissue, which in turn leads to decreased lung function and even respiratory failure or death. Mesenchymal stem cells (MSCs) and their derivatives have shown wide application prospects in cell therapy and acellular therapy of lung diseases and are entering the clinical transformation stage because of their unique physiological functions and characteristics, but the safety and efficacy of MSCs and their derivatives are still controversial. Nebulization therapy provides new opportunities and challenges for the innovative treatment of MSCs and their derivatives in lung diseases. In a number of preclinical studies and clinical trials, there have been evidence that atomization therapy of MSCs and their derivatives is safe and effective. This method could be an optimal solution for the treatment of various complex lung diseases. However, extensive research should be carried out on various strategies and their compatibility with different nebulizers before this method can be used in clinical setting. In this paper, we review the research progress of MSCs and their derivatives by nebulization in the treatment of pulmonary diseases.

Inhaloterapia: recomendaciones para Argentina 2021 / Inhalotherapy: recommendations for Argentina 2021

Resumen En las últimas décadas ha habido un importante desarrollo de dispositivos inhalados (DI) que permiten aumentar la eficacia de las drogas y disminuir los eventos adversos. Su correcto uso es de fundamental importancia para el control de las enfermedades respiratorias obstructivas. En la Argentina no existen recomendaciones locales sobre el uso de los DI. Se revisó la base biofísica, indicación, ventajas y limitaciones, técnica de correcto uso, errores frecuentes, mantenimiento y limpieza de cada DI. El uso de nebulizaciones ha quedado restringido a la administración de drogas que no están disponibles en otros DI (ejemplo: tratamiento de fibrosis quística), o ante la falla de los otros DI. No deben ser usados durante la pandemia de SARS-CoV2. Los inhaladores de dosis medida (aerosol) deben ser indicados siempre con aerocámaras (AC), las que reducen la incidencia de eventos adversos y aumentan el depósito de la droga en el pulmón. Son los dispositivos de elección junto a los inhaladores de polvo seco. Los aerosoles se deben usar en pacientes que no generan flujos inspiratorios altos. Los inhaladores de polvo seco deben recomendarse en aquellos que pueden realizar flujos inspiratorios enérgicos. Se revisaron los diferentes DI en fibrosis quística y en pacientes con asistencia respiratoria mecánica. La elección del DI dependerá de varios factores: situación clínica, edad, experiencia previa, preferencia del paciente, disponibilidad de la droga y entrenamiento alcanzado con el correcto uso.

Abstract Last decades, a broad spectrum of inhaled devices (ID) had been developed to enhance efficacy and reduce adverse events. The correct use of IDs is a critical issue for controlling obstructive respiratory diseases. There is no recommendation on inhalation therapy in Argentina. This document aims to issue local recommendations about the prescription of IDs. Each device was reviewed regarding biophysical laws, indication, strength, limitations, correct technique of use, frequent mistakes, and device cleaning and maintenance. Nebulization should be restricted to drugs that are not available in other IDs (for example, for treatment of cystic fibrosis) or where other devices fail. Nebulization is not recommended during the SARS-CoV2 pandemic. A metered-dose inhaler must always be used with an aerochamber. Aerochambers reduce the incidence of adverse events and improve lung deposition. Metered-dose inhalers must be prescribed to patients who cannot generate a high inspiratory flow and dry powders to those who can generate an energetic inspiratory flow. We reviewed the use of different IDs in patients with cystic fibrosis and under mechanical ventilation. The individual choice of an ID will be based on several variables like clinical status, age, previous experience, patient preference, drug availability, and correct use of the device.

Preventing Infection Measures of COVID-19 Patients during Mechanical Ventilation / 中国医疗器械杂志

OBJECTIVE@#To explore the preventing infection measures of new coronavirus disease 2019(COVID-19) patients during mechanical ventilation, and to provide reference for the safe application of mechanical ventilation.@*METHODS@#Retrieved from PubMed, Ovid and other databases, and combined with the application experience of mechanical ventilation were collected to explore the preventing infection measures of COVID-19 patients during mechanical ventilation.@*RESULTS@#This paper put forward the preventing infection measures of external circuit, internal circuit, outer surface, filter and special parts in ventilator. The preventing infection measures of sputum suction and nebulization were summarized.@*CONCLUSIONS@#The preventing infection measures of COVID-19 patients during mechanical ventilation are successfully completed, which can provide suggestions for the application and maintenance of mechanical ventilation.

Adherence to inhalation therapy and quality of life in children with cystic fibrosis: a cross-sectional study

Introduction: Inhalation therapy is a crucial part of the cystic fibrosis (CF) treatment regimen. Drugs that assist in mucociliary clearance and inhaled antibiotics are used by most patients. Methods: This is a cross-sectional study where patients with CF and their caregivers answered questionnaires regarding their adherence to inhalation therapy and QoL. Demographic, spirometric, and bacteriological data, as well as S-K scores and hospitalization frequencies were also collected. Results: We included 66 patients in this study; participants had a mean age of 12.3 years and Z-scores of -1.4 for forced expiratory volume in 1 second and 48.6 for body mass index. Patients were divided into 2 groups according to their self-reported adherence to inhalation therapy: high adherence (n = 46) and moderate/low adherence (n = 20). When comparing both groups, there was no statistically significant differences in age, sex, family income, and S-K score (p > 0.05). The high-adherence group had had shorter hospitalization periods in the previous year (p = 0.016) and presented better scores in the following domains of the QoL questionnaire: emotion (p = 0.006), eating (p = 0.041), treatment burden (p = 0.001), health perception (p = 0.001), and social (p = 0.046). Conclusions: A low self-reported adherence to inhalation therapy recommendations was associated with longer hospitalizations in the previous year and with a decrease in QoL in pediatric patients with CF. (AU)

Effects of Nebulized Dexamethasone Versus Nebulized Ketamine on the Attenuation of Post-operative Sore Throat Following Endotracheal Intubation

Background: General anesthesia (GA) with endotracheal intubation is a frequent cause of airway mucosal trauma whichresults in the post-operative sore throat (POST), with an incidence of 21–65%. Although minor and self-limiting complication,it produces significant discomfort and annoyance to the patient. This study was aimed to compare the efficacy of nebulizeddexamethasone versus ketamine in preventing POST.Materials and Methods: After approval from the institutional ethics committee and written informed consent, 100 patients ofthe American Society of Anesthesiologists physical status 1–2, aged between 20 and 60 years of either sex, undergoing GAwith endotracheal intubation were included in this prospective, randomized, and double-blind study. Patients were randomizedinto two groups of 50 each (n = 50); Group D: Patients received dexamethasone 8 mg (2 ml) with 3 ml of normal saline (totalvolume of 5 ml) for nebulization and Group K: Patients received ketamine (preservative free) 50 mg (1 ml) with 4 ml of normalsaline (total volume of 5 ml) for nebulization. After 15 min of nebulization, induction was done, POST assessment was done at0, 2, 4, 6, 12, and 24 h post-extubation. The severity of POST was graded on a 4-point scale (0–3).Results: The total incidence of POST was 19% in this study. Five patients (10%) in dexamethasone group and 14 patients(28%) in ketamine group experienced POST (Fisher’s exact test, P = 0.039). Reduction in the incidence and severity of POSTin the dexamethasone group when compared to ketamine group at 2, 4, 6, and 12 h postoperatively is statistically significant(P < 0.05*).Conclusion: Pre-operative single dose of nebulized dexamethasone 8 mg effectively attenuates POST in patients followingGA with endotracheal intubation compared to nebulized ketamine 50 mg without any detrimental effects.

Hypertonic saline and adrenaline nebulization in the treatment of bronchiolitis: a retrospective study

Background: Bronchiolitis is the leading cause of acute illness and hospitalization in young children. There is limited role for diagnostic laboratory or radiographic tests in typical cases of bronchiolitis. Several large recent trials have revealed lack of efficacy of either bronchodilators or corticosteroids. Novel treatment like hypertonic saline and adrenaline nebulizations need to be evaluated for their efficacy.Methods: In this retrospective case control study, we included children aged between 6 months to 2 years admitted for bronchiolitis between August 2017 till July 2018. Each of the 45 children treated with adrenaline nebulisation was assigned a child who was given hypertonic saline nebulization only matched for age and duration of symptoms.Results: 45 children given adrenaline nebulization and 45 children given only hypertonic saline nebulization were compared. Mean duration of stay for children treated with adrenaline nebulization was 5.3 days and those given hypertonic saline was 4.8 days.' p value of 0.29.Conclusions:' Adrenaline nebulization did not shorten hospital stay in children admitted for bronchiolitis as compared to children given hypertonic saline.

Observational, Concurrent Study to Assess Safety and Efficacy of Glycopyrronium and Arformoterol Home Nebulization in High-risk, Symptomatic Acute Exacerbation of Chronic Obstructive Pulmonary Disease Cases: SYMPTOM Study

Background: Chronic obstructive pulmonary disease (COPD) is one of the most important reasons for hospitalizationworldwide with high 30-day readmission rates. Although the prognostic significance of early readmission is not fully understood,they are often associated with poor outcomes including high mortality rates of 4%–19% at 30 and 365 days, respectively.Similarly, in acute exacerbations of COPD (AECOPD) cases receiving emergency department care, current status on lungfunction and cardiovascular comorbidities are considered as best predictors for both 30- and 90-day COPD readmission rates.Dual bronchodilator strategy with long-acting muscarinic antagonist (LAMA)/long-acting beta-agonists (LABA) is thereforerecommended by GOLD (2019) in the postdischarge phase following an acute exacerbation.Aim: To further assess the clinical impact of dual bronchodilators including glycopyrronium and arformoterol as home nebulizationin the post-discharge phase of AECOPD, the current postapproval, observational study was conducted.Materials and Methods: An observational, concurrent, and non-inferiority study with glycopyrronium and arformoterol homenebulizing solutions on patients with moderate and severe COPD was conducted at two centers in India. An estimated samplesize of 40 patients involving moderate and severe COPD cases was factored for per-protocol analyses with P < 0.05 consideredas statistically significant. A concurrent study analysis for the follow-up visit was conducted as per the principles of InternationalConference of Harmonization for Good clinical practice and Declaration of Helsinki while ensuring confidentiality during accessof patient support registration sheets.Results: Per protocol analyses for consecutive 46 cases from two centers receiving Nebulized glycopyrronium (25 mcg) andarformoterol (15 mcg), as separate formulations are given as admixed solution with follow-up visit for at least 4 weeks wascarried out. Baseline demographics for the overall group showed exacerbation history (46, 100%), hospitalization for AECOPD(21, 45.6%); ED visit (25, 54.3%), forced expiratory volume in one second (FEV1) 1.2 ± 0.6 L/min; FEV1/FVC64.8% ± 10.6;reversibility 8.4% ± 11.8; CAT 34.6 ± 2.3; and vibrating mesh nebulizer (46, 100%). The mean predose FEV1 (∆) at the end of 4weeks for overall, moderate and severe COPD cases were observed as of 9.6±3.1%, 11.8% ± 3.1, and 8.4% ± 1.6, respectively(P < 0.0001). Similarly, the mean CAT(∆) score at the end of 4 weeks was observed as of 18.1 ± 0.69, 20.6 ± 0.69, and 18.26 ±0.6 for overall, moderate and severe COPD cases, respectively (P < 0.0001). The intergroup differences for rescue medicationuse for a lone case with severe COPD (1, 2.04%) complied with the suggested non-inferiority margin between the groups.There were no other treatment-emergent adverse events or serious adverse events that warranted treatment modification orwithdrawals in both groups.

In Vitro Comparative Assessment and Characterization of Vibrating Mesh Nebulizers with Glycopyrronium Nebulizing Solution: New Generation Impactor Study

Background: Inhalation therapy involving nebulization remains important modality of therapy for severe or high-risk obstructive airwaydiseases including bronchial asthma. The likely incremental factors for the translational impact of this delivery strategy includes fine particledose (FPD), fine particle fraction (FPF), mass median aerodynamic diameter (MMAD), and respirable fraction (RF) of the pharmaceuticalaerosols playing a key role in site-specific delivery to the lungs. The new generation active vibrating mesh nebulizers (VMNs) offer aconvenient, portable strategy in above clinical cases without compromising the delivery efficiency for improved therapeutic outcomes.Aim: This in vitro study was conducted to validate the improved efficiency and aerodynamic effect of glycopyrronium solutionnebulization with novel patented active and passive VMN devices.Materials and Methods: A in vitro lung deposition study was conducted using drug samples of glycopyrronium bromide(25 mcg/2 ml and 1 ml) using new generation cascade impactor at a flow rate of 15 L/min at Glenmark R&D Center, Sinnar, India.Results: Three samples of glycopyrronium nebulizing solution were analyzed using next generation impactor at a flow rate of15 L/min for aerodynamic aerosol parameters (FPF and RF) and total/active substance delivered (FPD and delivered dose) whenloaded with active (NEBZMART*, 2 ml) and passive (E-flow*, 1 ml) VMN. The results demonstrated comparable aerodynamicaerosol, particle size, and total delivered dose as FPF (64.9% vs. 72.8%), FPD (16.4 vs. 14.2 mcg), MMAD (3.9 vs. 3.2), andGSD (1.8 vs. 1.62) for active and passive VMN, respectively. The nebulization time was observed as 3–5 min for both thedevices demonstrating higher efficiency for active VMN.Conclusion: The results showed comparable aerodynamic aerosol, particle size, and total delivered dose or RF forglycopyrronium nebulizing solution delivered by the VMNs.

Ketamina nebulizada para la prevención del dolor faríngeo postoperatorio / Nebulised ketamine for preventing postoperative pharyngeal pain

Resumen: Introducción: El dolor faríngeo postoperatorio es una complicación frecuente posterior a la intubación endotraqueal, caracterizado por odinofagia. Objetivo: Comparar ketamina nebulizada preoperatoria contra placebo para la disminución del dolor faríngeo postoperatorio en cirugía electiva bajo anestesia general. Material y métodos: Estudio experimental prospectivo, aleatorizado, doble ciego, realizado de febrero a julio del 2016. Dos grupos de pacientes aleatorizados: grupo K: ketamina nebulizada (50 mg: 1 mL de ketamina + 2 mL de solución salina 0.9%); grupo P: placebo (nebulización de 3 mL solución salina 0.9%). Se evaluaron signos vitales así como síntomas e intensidad del dolor faríngeo postoperatorio de acuerdo con la escala numérica análoga a la hora 1 y a la hora 4. Resultados: El uso de ketamina nebulizada no representa una ventaja estadísticamente significativa con relación al placebo para el dolor faríngeo postoperatorio. La incidencia de éste en nuestro estudio fue de 59.29%. Conclusiones: Se necesitan más estudios con ketamina nebulizada en vía aérea difícil en la población mexicana, así como una mayor muestra para poder determinar el estándar de oro para el tratamiento del dolor faríngeo postoperatorio.

Abstract: Introduction: The postoperative sore throat is a frequent complication, characterized by odynophagia after endotracheal intubation. Objective: To compare nebulized ketamine in the preoperative period against nebulized placebo for the reduction of the postoperative sore throat on elective surgery under general anesthesia. Material and methods: We performed an experimental, prospective, randomized, double blind study; conducted from February to July 2016. Patients were randomly assigned into two groups: group K: preoperative nebulized ketamine (50 mg: 1 mL of ketamine + 2 mL of saline solution 0.9%) against group P: placebo (nebulization of 3 mL saline solution 0.9%). We collected vital signs as well as symptoms and intensity of postoperative sore throat according to the analog numeric scale at the first and forth postoperative hours. Results: The use of nebulized ketamine does not represent a statistically significant difference compared to placebo for postoperative sore throat. The incidence of postoperative sore throat in our study was of 59.29%. Conclusions: We need further studies of nebulized ketamine in the Mexican population, as well as a larger study to determine the gold standard for the treatment of POST.

A Randomized Controlled Study Of Reduction In Severity Of Postoperative Sorethroat Using Preoperative Ketamine Nebulization.

Endotracheal intubation is the prominent cause of airway mucosal injury which results in postoperative sore throat (POST). This study was conducted to evaluate the efficacy of nebulized ketamine in decreasing POST. 96 patients of the ASA grade1–2 , age 18 - 60 years, of either sex undergoing general anesthesia (GA) with tracheal intubation were randomized into two groups; Group 1 received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulization, while Group 2 received saline nebulization 5.0 ml for 15 min before administering GA. On reaching postanesthesia care unit, POSTmonitoring was done at 0, 2, 4, 6, 12, and 24 h after extubation and graded on a four-point scale (0–3). RESULTS: There was statistically significant reduction in severity of sore throat in ketamine group at 4 h (P = 0.030*) and 6 h (P = 0.016*) postextubation as compared to saline group. CONCLUSION: Preoperative ketamine nebulization effectively reduced the incidence and severity of POST, with no adverse effects.

Comparison of Corticosteroids by 3 Approaches to the Treatment of Chronic Rhinosinusitis With Nasal Polyps

PURPOSE: Corticosteroids are regarded as the mainstay of medical treatment of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP). To date, a head-to-head comparison of the efficacy and safety of glucocorticoid preparations administered via different routes for the treatment of chronic rhinosinusitis with nasal polyps has not been reported. To compare the efficacy and safety of steroids administered via the oral, intranasal spray and transnasal nebulization routes in the management of ECRSwNP over a short course. METHODS: Overall, 91 patients with ECRSwNP were recruited prospectively and randomized to receive either oral methylprednisolone, budesonide inhalation suspension (BIS) via transnasal nebulization, or budesonide nasal spray (BNS) for 2 weeks. Nasal symptoms and polyp sizes were assessed before and after the treatment. Similarly, nasal polyp samples were evaluated for immunological and tissue remodeling markers. Serum cortisol levels were assessed as a safety outcome. RESULTS: Oral methylprednisolone and BIS decreased symptoms and polyp sizes to a significantly greater extent from baseline (P < 0.05) than BNS. Similarly, BIS and oral methylprednisolone significantly reduced eosinophils, T helper 2 cells, eosinophil cationic protein, interleukin (IL)-5, and expression of matrix metalloproteinases 2 and 9, and significantly increased type 1 regulatory T cells, IL-10, transforming growth factor-β, and tissue inhibitor of metalloproteinases 1 and 2 in nasal polyps to a greater extent than BNS. Post-treatment serum cortisol levels were significantly decreased by oral methylprednisolone compared to BIS or BNS, which did not significantly alter the cortisol levels. CONCLUSIONS: A short course of BIS transnasal nebulization is more efficacious compared to BNS in the management of ECRSwNP and is safer than oral methylprednisolone with respect to hypothalamic-pituitary-adrenal axis function.

Inhalation properties of the nebulized recombinant human interferon α1b injection / 国际药学研究杂志

Objective: To investigate the aerodynamic characteristics of the nebulized recombinant human inter- feron α1b(rhIFN α1b)injection and its delivery in different respiratory modes both in vitro. Methods: The particle size distribution and aerodynamic properties of the nebulized rhIFN α1b injection for inhalation were evaluated with Spraytec STP5313 and the next generation pharmaceutical impactor(NGI). The total delivered dose and delivery rate were deter- mined using a breathing simulator. Results:After atomization, the D50 of rhIFN α1b droplets was 2.74 μm, the fine par- ticle fraction(FPF)was 77.49%, the mass median aerodynamic diameter(MMAD)was 3.26 μm, and the geometric standard deviation(GSD)was 1.93. In neonatal, infant, and child breathing modes, the delivered total amount of rhIFN α1b by spraying for 220 seconds was 2.10, 2.44, and 3.51 μg, respectively. Conclusion: After atomization, the particle size of rhIFN α1b injection was small enough to be transmitted to the lung, and the total delivered dose and delivery rate showed a tendency of increase in turn in the neonatal, infant, and child breathing modes, indicating that the effective dose of the drug and the age of patients should be considered when formulating the clinical treatment plan.

Extraction of Eight Ginsenosides from Leaves of Panax quinquefolium L. By Ultrasoinc Fountain-based Ultrasonic-assisted Nebulization Extraction Coupled with Solid Phase Extraction / 分析化学

A new ultrasonic-assisted extraction (UANE) method coupled with solid phase extraction (SPE) using ultrasonic fountain was established for the extraction of eight common ginsenosides from leaves of Panax quinquefolium L. The extraction system has been designed and several experimental parameters,including the type and volume of extraction solvent,pH value and salt concentration of extraction solvent,type and volume of elution solvent,and amount of C18, extraction time were examined and optimized. Under the optimal conditions,the recoveries of ginsenosides were in the range of 96. 3% -110. 6%, the relative standard deviations (RSDs) were in the range of 2.8%-4.3%,indicating that the method has a good performance for the extraction of these ginsenosides. Compared with traditional UANE-SPE method, the modified method simplified the extraction device,shortened the extraction time and improved the extraction efficiency.

Nebulized therapy in children / 中华实用儿科临床杂志

Nebulization is widely used in treating respiratory disorders in younger patients and critically ill children.Jet nebulizers,ultrasonic nebulizers and vibrating mesh nebulizers are the main types of small volume nebu-lizers used in emergency room and pediatric intensive care unit.Glucocorticoids,bronchodilators,mucolytic agents can be administered via nebulization.Different compatibilities exist among these therapeutic agents.

Efficacy of systemic glucocorticoids combined with inhaled steroid on children with acute laryngitis / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the efficacy of systemic glucocorticoid (steroid) combined with high dose inhaled steroid in the treatment of children with acute laryngitis.@*Methods@#A total of 78 children with acute laryngitis were randomly divided into study group(n=40) and control group(n=38) between November 2016 and April 2017. In addition to routine treatment of anti infection and symptomatic treatment, Dexamethasone injection(0.3-0.5 mg/kg, 1-3 d, according to the patient′s condition) was provided to each group. In addition to the treatment mentioned above, the study group were assigned to receive 1.0 mg Budesonide suspension for inhalation, oxygen-driven atomizing inhalation, every/30 minutes, 2 times in a row, after that every 12 hours. The improvement of inspiratory dyspnea, hoarseness, barking cough and wheezing of both groups was evaluated at 30 min, 1 h, 2 h, 6 h, 12 h, 24 h and 72 h after treatment.Sigmaplot 11.5 software was used to analyze the data.@*Results@#No significant difference was detected in terms of inspiratory dyspnea, hoarseness, barking cough or stridor score before treatment between the two groups(P>0.05). Compared with those before treatment, symptoms of inspiratory dyspnea, hoarseness, barking cough and stridor score of both groups improved markedly at 12 h and 24 h after treatment(P<0.05). While there was no significant difference regarding inspiratory dyspnea, hoarseness, barking cough or stridor score at each time point after treatment between the two groups(P>0.05). The effective rate was 92.50% and 92.11% in study group and control group, respectively, and no significant difference was noted (P>0.05).@*Conclusion@#Compared with single systemic glucocorticoid, systemic glucocorticoids combined with inhaled steroid possessed similar efficacy in treating acute laryngitis and relieving laryngeal obstruction of children.

Intraperitoneal nebulization of ropivacaine 075% vs intraperitoneal nebulization of bupivacaine 05% for post-operative analgesia in laparoscopic surgeries: Prospective double blinded randomised controlled trial

Background: Laparoscopic surgeries being minimally invasive surgeries are associated with a relatively minor surgical trauma. Excessive pain, nausea and vomiting and fatigue will delay the discharge. Bupivacaine and Ropivacaine, the long acting Local Anaesthetics when given intraperitoneally provide effective pain relief when the pain peaks within 4-6 hours of surgery. Aim: To compare the efficacy of intraperitoneally nebulised Ropivacaine 0.75% and Bupivacaine 0.5% for postoperative analgesia in Laparoscopic surgeries. Materials and methods: This study was a double blinded randomised controlled trial in ASA grade I and II patients” was conducted in 60 patients of both sexes, of age group 20-45 years. They were randomly divided into two groups of 30 patients each: Group R (Ropivacaine) – received intraperitoneal nebulization of Ropivacaine 0.75% 4 ml (30 mg) after the placement of umbilical port and Sreedevi Porika, T. Venkata Naga Lakshmi. Intraperitoneal nebulization of ropivacaine 0.75% vs intraperitoneal nebulization of bupivacaine 0.5% for post-operative analgesia in laparoscopic surgeries: Prospective double blinded randomised controlled trial. IAIM, 2018; 5(9): 105-117. Page 106 Group B (Bupivacaine) – received intra peritoneal nebulization of Bupivacaine 0.5% 4 ml (20 mg) after the placement of umbilical port. Results: There was no significant difference in age and weight between the two groups. Intraoperatively statistically significant differences were observed SBP - At 15 and 30 min post nebulization and at extubation. No significant differences were observed with respect to DBP and HR. Postoperatively DBP and HR differences were found to be statistically significant at 4th post-operative hour. There were no statistically significant differences in SBP and MAP between both the groups. Dynamic VAS scores were statistically significant at extubation and in first 6 hours and not significant at 24 hours between both the groups. Static VAS scores were not statistically significant at all times compared between both the groups. Mean Time for first rescue analgesic requirement was 8.23+0.511 hours in group R vs.7.59+0.52 in group B and was statistically significant (p=0.0001). Mean total rescue analgesic required was 95+33.3 mg Diclofenac in group R vs. 112.6+38.4 in group B with 26% of group R requiring 2 nd dose of rescue analgesic and 50% of patients in group B required 2 nd dose and was not statistically significant. Mean time for unassisted ambulation was 12.8+0.61 hours in group R vs.13.16+0.6 hours in group B which was not statistically significant (p=0.52). Conclusion: From the present study, it is concluded that both Bupivacaine and Ropivacaine are safe and similarly efficacious in reducing postoperative pain following intra-peritoneal nebulization in laparoscopic surgeries.

Atividade inseticida do óleo de Copaifera langsdorffii Desf. (copaiba) sobre Tribolium castaneum (Coleoptera: Tenebrionidae / Actividad insecticida de aceite de Copaifera langsdorffii Desf. (copaiba) sobre Tribolium castaneum (Coleoptera: Tenebrionidae / Insecticidal activity of Copaifera langsdorffii Desf. (copaiba) oil aga inst Tribolium castaneum (Coleoptera: Tenebrionidae

Introdução: utilizou-se o óleo de copaíba (Copaifera langsdorffii Desf) em duas formas de aplicação como alternativa de controle de Tribolium castaneum. Objetivo: avaliar o potencial tóxico do óleo de copaíba (C. langsdorffii) sobre adultos de Tribolium castaneum. Métodos: os bioensaios foram conduzidos no Laboratório de Análise de Sementes, da Universidade Federal de Campina Grande, Campina Grande, Paraíba, Brasil. Realizaram-se dois bioensaios: No primeiro, adultos de T. castaneum foram confinados em recipientes de acrílico (50 mL) com tampa, possuindo o óleo nas diluições de 0,0 (testemunha); 10; 30; 50; 70 e 90 por cento, aplicando-se 0,5 mL da diluição sobre um disco de papel filtro; No segundo experimento, os insetos foram confinados em recipientes de plástico (100 mL) com tampa, por onde o óleo foi levado para o interior desses, na forma de névoa, nas doses de 0,0 (testemunha); 0,5; 1,0; 1,5; 2,0 e 2,5 mL. Para os dois experimentos avaliou-se o número de insetos mortos após 24, 48 e 72 h, e determinou-se a DL 50 e DL90. Os bioensaios foram organizados em esquema fatorial 6 x 3. Resultados: em ambos os experimentos, o óleo de copaíba se mostrou eficiente para o controle de T. castaneum, com mortalidades de até 100 por cento por contato e 97,5 por cento por nebulização. Conclusão: o óleo de C. langsdorffii, por contato ou nebulização, é tóxico a T. castaneum(AU)

Introducción: en este trabajo se utilizó el aceite de copaiba (Copaifera langsdorffii Desf.) aplicado de dos formas distintas como alternativa de control do Tribolium castaneum. Objetivo: evaluar el potencial tóxico del aceite de C. langsdorffii aplicado en adultos de T. castaneum. Métodos: los bioensayos se realizaron en el Laboratorio de Análisis de Semillas, Universidad Federal de Campina Grande, Campina Grande, Paraíba, Brasil. Para alcanzar los objetivos se llevaran a cabo dos bioensayos: primero, los adultos de T. castaneum fueron confinados en contenedores de acrílico (50 mL) con tapa, contiendo el aceite en diluciones de 0.0 (control); 10; 30; 50; 70 y 90 por ciento, se aplicando 0,5 mL de la dilución en un disco de papel de filtro. En el segundo bioensayo, los insectos se colocaron en recipientes de plástico (100 mL) con tapa, por donde el aceite fue llevado a estos en la forma de niebla, en las dosis de 0.0 (control); 0,5; 1,0; 1.5; 2,0 y 2,5 mL. En ambos bioensayos se evaluó el número de insectos muertos después de 24, 48 y 72 h, y se determinó la DL50 y DL90. Los bioensayos fueron dispuestos en un factorial 6 x 3. Resultados: en ambos experimentos, el aceite de copaiba fue eficiente para el control de T. castaneum, con tasas de mortalidad de hasta el 100 por ciento, por contacto, y 97,5 por ciento por nebulización. Conclusión. el aceite de C. langsdorffii, por contacto o nebulización es tóxico para T. castaneum(AU)

Introduction. we used the copaiba oil (Copaifera langsdorffii Desf.) in two application forms as an alternative control Tribolium castaneum. Objective: the objective of this study was to evaluate the toxicity of copaiba oil (C. langsdorffii) on adults of T. castaneum. Methods: bioassays were conducted in the Laboratory of Seed Analysis, Federal University of Campina Grande, Campina Grande, Paraíba, Brazil. There were two bioassays: (1) Mortality by Contact and (2) Nebulization. At first, the adults of T. castaneum were kept in acrylic containers (50 mL) with a lid having oil dilutions of 0.0 (control), 10, 30, 50, 70 and 90 percent, applying 0.5 mL of the dilution on a filter paper disc. In the second experiment, the insects were placed in plastic containers (100 mL) with lid, from which the oil was smuggled into these in the form of mist, at doses of 0.0 (control), 0.5, 1.0, 1.5, 2.0 and 2.5 mL. For the two experiments evaluated, the number of dead insects after 24, 48 and 72 hours as well as LD50 and LD 90. Bioassays were organized into 6 x 3 factorial arrangement. Results: in both experiments, the copaiba oil proved being effective for the control of T. castaneum, with mortality rates of up to 100 percent due to 97.5 percent by nebulization. Conclusion: the oil of C. langsdorffii, by contact or misting, is toxic to T. castaneum(AU)

A controlled clinical research of nebulization treatment for childhood respiratory virus infection with Human recombinant interferonα-1b / 中国基层医药

Objective To investigate the clinical efficacy and safety of nebulization treatment for childhood respiratory virus infection with human recombinant interferon α-1b.Methods A randomized,controlled clinical re-search was designed.375 subjects with children respiratory tract virus infection were randomly divided into the treat-ment group(250 cases) and control group(125 cases).In addition to conventional therapy,the treatment group with recombinant human interferon α-1b and the control group with ribavirin were executed by using nebulization treat-ment.Results A total of 357 subjects were statistically included in the trail.Sore throat,cough,wheezes,rale of lung disappearing time and the days of hospitalization of treatment group were significantly different(u=5.83,6.51,6.33, 7.39,5.57,6.62,all P<0.01) compared with the control group;The treatment group in the cure rate and total effec-tive rate was significantly higher(χ2 =7.85,25.71,all P<0.01),and no obvious adverse reactions were reported. Conclusion Nebulization treatment of childhood respiratory virus infection with human recombinant interferon α-1b is safe and effective.The method of operation is simple and thus its application is worth promoting in clinic.

A design of a prototype of traditional Chinese medicine nasal atomizer device / 国际生物医学工程杂志

Objective Nasal administration,as a common means of treatment of respiratory diseases,may normally cause bronchospasm,cough and other adverse reactions,the efficiency of nasal nebulizers has been criticized as well.This paper aims to develop a medicine atomizing device,pharmaceutically atomized in solving the existing problems,providing a modern instrument for treatment of respiratory diseases by traditional Chinese medicine.Methods The device could prepare medicine by decoction and filtration,which means this unit is divided into two functional modules,medicine preparation and herbal atomization.1 200 W heating plate is placed in decoction unit and is programmed to fit traditional decoction protocol.Steam and ultrasonic nebulised medicine are combined in atomizing unit.Another non-contact infrared heating unit also located in to control the temperature precisely.Different forms of traditional Chinese medicine and different filtration methods were selected to optimize the atomizing effect.Results An implementation of two sequence of filtration enabled optimization of atomizing.After 15 volunteers'trial,this device functioned well on Bama nasal medical protocol,and could effectively avoid the adverse reactions of the traditional way of cold fog atomizing.Conclusions The nasal nebulizer equipment on which Chinese herbal medicine treatments could directly performed,produced atomized mist particle size suitable for nasal treatment,and by generating warm steam to avoid the common clinical administration caused choking to hypoxia and other adverse reactions.Meanwhile,instrument has a friendly interactive feature to meet the clinical requirements for medicine nebulizer treatment.