RESUMO
Background: The benzodiazepine, Midazolam, has been used medication given for sedation in tympanoplasty and mastoidectomy because of a number of beneficial effects. However, Dexmedetomidine is a highly selective α2-adrenoceptor agonist is emerging as preferred choice now a day. The aim of the study is to compare hemodynamic stability and sedation under Dexmedetomidine vs Midazolam during tympanoplasty and modified radical mastoidectomy done under local anaesthesia. Methods: After obtaining ethics clearance from institution and written informed consent from patients, 50 patients of age group 15 to 50 years of ASA grade i & ii were selected and divided in to two groups: Group D: Inj. Dexmedetomidine 1µg/kg over 15min, followed by 0.5µg/kg/hr (n= 25). Group M: Inj. Midazolam 0.05 mg/kg i.v. slowly, followed by 0.01mg/kg/hr (n= 25). Arterial blood pressure, heart rate and sedation level were monitored. The surgeons and patients were asked to rate their satisfaction, using the Likert scale. Results: Sedation score difference between group Dand group M was not statistically significant. There was no statistically significant difference found in diastolic blood pressure of both the groups. There was a significant reduction in heart rate in group D as compared to group M. Surgeon’s satisfaction score and patient’s satisfaction score both were high in group D compare to group M. Conclusions: For monitored anaesthesia care in ENT surgeries performed under local anaesthesia, inj. Dexmedetomidine could be a better alternative over inj. Midazolam.
RESUMO
Background: Steroid, bronchodilator and the leukotriene receptor antagonist montelukast have demonstrated efficacy in children with mild persistent asthma, but comparative long-term studies in adult patient with moderate persistent asthma is needed. A randomized and prospective study was undertaken to find out the efficacy of montelukast as add on to β2-agonist and inhaled corticosteroids in patients of moderate persistent asthma. Methods: This was a continuous, longitudinal, prospective study carried out at a tertiary care teaching hospital. Newly diagnosed patients of moderate persistent asthma attending the chest out patient department (OPD) were enrolled. Group I was treated with salbutamol 200 mcg rotacap SOS and formoterol 6 mcg + budesonide 400 mcg rotacap BD. In addition to these medicines group II also received montelukast 10 mg OD. The patients were followed up every two months. Clinical examination and pulmonary function tests (PFT) were carried out at baseline and during each visit. Unpaired ‘t’ test was used for statistical analysis. Results: Comparison of clinical symptoms revealed a better improvement in group II as compare to group I [cough - 83% vs. 33%; breathlessness - 75% vs. 33%; and wheezing - 83% vs. 78%] at the end of one year. A significantly better (p < 0.05) improvement in forced expiratory volume (FEV1) was also observed in group II. Conclusions: Treatment with montelukast leads to better improvement in clinical symptoms and PFT in the patients of moderate persistent asthma.
RESUMO
Background: Emergency contraception is applied to prevent pregnancy after 72-120 hours of unprotected sexual intercourse. Emergency contraceptive (EC) pill is used to reduce unwanted pregnancy and unsafe abortion. EC pill is available as OTC in India since 2005. As EC pill highly used among adolescents we carried out to this study among college students. Methods: The study was conducted among female college students. A pre-validated questionnaire was used as tool for the study. It contains consent form and questions knowledge and attitude regarding EC pill. Results: We divided students into group A (medical, paramedical and pharmacy colleges) and group B (nonmedical colleges like science, arts and engineering). In group A 470 and group B 280 students were participated. Knowledge about appropriate time of taking EC pill (within 72 hours after sexual intercourse) was 44% in group A which is significant than 15% in group B. Knowledge about brand name, availability cost and side effects were more in group A than group B. Electronic media was the most common source of information mentioned by both the groups. Attitude regarding advice to use of EC pill to other was more in group A than group B. Conclusions: Knowledge about use of EC pill was higher in group A than group B. Attitude was not positive regarding availability of EC pill as OTC. So education about EC pill among young population is necessary.