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Background: The current study aimed to investigate the efficacy of the Ischemia Reversal program (IRP) as an Ayurveda based therapy to standard anti-ischemic therapy in patients with ischemic heart disease (IHD). Methods: A retrospective, single centre, observational study was conducted from January 2022 to May 2023. A total of 39 patients diagnosed with ischemic heart disease and global longitudinal strain (GLS) <15, regardless of underlying co-morbidities such as diabetes mellitus, hypertension, obesity, hyperlipidemia, low ejection fraction, history of myocardial infarction were included in this study. The primary endpoint was improvement in GLS from baseline to the 90-day follow-up in various different categories. Secondary endpoints were improvement in EF, abdominal girth, weight and reduction in dependency on allopathic medication from baseline to the 90-day follow-up. Results: The mean age of the study population was 59.23±9.01 years. Weight (day 1: 67.29±13.16 kg and day 90: 61.39±11.11 kg; p=0.00), body mass index (day 1: 25.75±4.03 and day 90: 23.79±3.50; p=0.00), abdominal girth (day 1: 95.31±10.75 cm and day 90: 85.67±17.02 cm p=0.00), EF (day 1: 40.74±10.30% and day 90: 53.91±11.87%; p=0.00), and GLS (day 1: -10.99±2.72 and day 90: -13.17±3.75; p=0.00) improved at the 90 day follow-up. Conclusions: The study showed notable improvements in weight, body mass index, abdominal girth, EF, and GLS after 90 days. These results suggest that IRP is beneficial treatment for IHD, but more extensive research is needed to confirm its effectiveness.
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Background: Inguinal hernia repair is one of the commonly performed procedure and has undergone a paradigm shift from open to laparoscopic approach in the era of minimally invasive surgery but the superiority is still debatable. The aim was to compare open (Lichtenstein) versus laparoscopic transabdominal preperitoneal approach (TAPP) hernia repair techniques. Methods: A total of 60 patients were enrolled in the study and divided into two equal groups (open versus laparoscopic) were compared. Results: It was observed that laparoscopic repair (TAPP) has statistically significant superiority than open inguinal hernioplasty in terms of lesser post-operative pain (VAS score of 4.8±0.66, 3.67±0.66, 2.53±0.82 versus 6.7±0.92, 5.03±0.72, 3.83±0.65 at 24 hours, 48 hours and 72 hours post operatively, p value <0.001), shorter duration of hospital stay (3.1±0.71 days versus 5.83±0.75 days, p value <0.001) and early resumption to regular activities (10.57±2.28 days versus 12.2±1.52 days, p value 0.002). It also showed that incidence intra operative and post-operative complications was lesser in laparoscopic group but not statistically significant. Whereas duration of surgery was prolonged in laparoscopic group (104±27.49 min versus 61.5±17.08 min, p value <0.001). Conclusions: Laparoscopic inguinal hernioplasty (TAPP) is superior to open inguinal hernioplasty in terms of lesser intra operative and post-operative complications, lesser post-operative pain, shorter duration of hospital stay with early resumption to regular activities having better subjective and objective cosmetic results in short term follow-up. However, duration of surgery was prolonged on comparison with Lichtenstein open inguinal hernioplasty.
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Background: Many types of bacteria can produce septicemia. The most common infections that lead to septicemia are urinary tract infections, pneumonia, nephritis and abdominal infections. Methods: The study aims to assess the pattern of antimicrobial drugs used in septicemia and to assess the etiological organisms and their drug sensitivity and resistance pattern. Study participants admitted to tertiary health care centre and who are having septicemia were included in this prospective observational study. Blood culture, bronchial secretions were subjected to microbiological analysis. The etiological organisms, their drug sensitivity and resistance pattern and the outcome of drug therapy were recorded. The clinical course of the study participants was monitored till cure either the resolution of pneumonia. Qualitative data were analyzed using the chi-square test or Fischer's exact test and quantitative data using the independent t test. Results: Mean duration of hospital stay in all patients 13.22±0.45 days and in resistance cases it was found 19.22±0.45 days. Mean duration of ICU stay in all patients was 4.34±0.45 days and in resistant cases mean duration of ICU stay was 8.18±0.45 days. Clinical outcome in overall admitted patients recovered was 97 patients (80.83%) death was 16 patients (13.33%). Clinical outcome in resistant patients recovered 16 patients (13.33%) and death 26 patients (21.66%). Conclusions: The organisms had a varied sensitivity and resistance pattern. The clinical outcome was multifactorial.
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Background: Indoor air pollution (IAP) remains a major global public health hazard more so in developing countries where the use of biomass fuels is still very common. Since women tend to be in charge of cooking and young children commonly spend time with their mothers while they are cooking, women and young children are disproportionately affected. In this background, the present study was proposed to assess the bio-social correlates of IAP among women residing in rural areas. Methods: A cross-sectional study was conducted in rural field practice areas of JSS Medical College, Mysuru for six months. Totally 210 households were included by probability proportionate to the size sampling technique. Data was collected by structured questionnaire with details on socio-demographic characteristics, house and fuel characteristics and indoor air pollution meter values of particulate matter (PM) 1, 2.5, 10 respectively. Results: Among 210 study participants, 28 (13%) had indoor air pollution in their houses. 99% of the households were using LPG. The mean concentrations of pollutants like PM10, PM2.5 and PM1.0 were higher among the houses with indoor air pollution compared to their counterparts (p<0.001). A statistically significant association was found between age, socioeconomic status, and poverty line and the presence of indoor air pollution. Conclusions: The present study showed that IAP had a strong relation to socio-cultural factors such as age, poverty and economic level. As women are involved in cooking in the majority of Indian households, they are more prone to be affected by the negative effects of solid fuel usage.
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Background: Early postoperative mortality rates after pancreaticoduodenectomy are in the range of 2-5%. Nonetheless, morbidity rates are still at 30-50% calling for apt strategies. The goal of this study was to examine the outcomes in terms of postoperative morbidity and 30-day mortality while additionally reviewing the demographic, clinical and pathological features of patients undergoing Whipple procedure at our government institution and comparing the outcomes with literature. Methods: Data about demographic characteristics, intraoperative findings, postoperative histopathology, postoperative course, early post-operative outcomes, complications, and causes of postoperative death in patients who underwent pancreaticoduodenectomy for periampullary and pancreatic carcinoma between September 2006-August 2023 were collected and analysed. Results: 45 patients were analysed. Mortality rate was 15.6%. Seven patients died perioperatively; three from cardiac cause (myocardial infarction), two from bile leak and sepsis, one from pulmonary embolism, and one as a result of postoperative hemorrhage. The morbidity rate was 54%. The most common early postoperative complication was delayed gastric emptying (31%) followed by postoperative pancreatic fistula (22%). The median overall survival of 39 patients was 21�5 months. The 5-year survival was 17 months. Conclusions: Considering the fact that postoperative morbidity after Whipple procedure was similar to other centres, but the mortality rate being high, better knowledge about salvage techniques, improvements in perioperative care, use of interventional radiology, and running quality improvement projects to standardize postoperative recovery protocol could help in reducing the mortality and improve the outcome.
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Background: Stroke involving extracranial carotid (ECAS), vertebral (EVAS), and intracranial arteries (IAS) contributed to an annual stroke rate of 0.1-3.3%. Even though endarterectomy and/or angioplasty and stenting had revolutionized its� management, best medical treatment (BMT) is still the mainstay of therapy to prevent secondary stroke/transient ischemic attack. This study aimed to evaluate the effect of BMT to reduce the degree of stenosis by using six-months double antiplatelet therapy (DAPT). Methods: A retrospective cohort study was conducted in a secondary private hospital in Indonesia, in January-December 2022. Adults ?18 years old with ECAS, EVAS, or IAS detected using digital subtraction angiography (DSA), receiving DAPT for at least six months, and those who had second DSA evaluation were included. Any subjects with other brain pathologies or recorded incompliance to DAPT were excluded. Age, gender, stenosis degree, stenosis location, and conversion of stenosis degree were recorded and compared between pre-DAPT and post-DAPT group. Results: Of 30 subjects, there were insignificant changes (46.5�.3% to 50.8�.9%, p=0.09) of ECAS, EVAS, and IAS. There were 14 cases with constant stenosis (51.4�.5%), 8 cases with decreasing stenosis (46.9�.2% to 40.1�.8%, p=0.012), and 12 cases with increasing stenosis (40.4�.9% to 57.1�.0%, p=0.002). No significant association were found among those groups related to traditional vascular risk factors. Conclusions: There was no difference in respect to the degree of stenosis following six months of DAPT in either ECAS, EVAS, or IAS. Routine evaluation as well as recognizing features of high-risk stroke/TIA are important to help decide individual who may be candidates of endovascular procedures earlier.
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Expanding uterine masses can be the cause of pregnancy loss and add technical difficulties to uterus evacuation due to the intense anatomical distortion of the endocervical canal and uterine cavity. The literature is scarce in the peculiarities of the management of missed abortions in uterus with important distorted anatomies. We report a case of a primigravida patient who presented a rapid and expressive increase of abdominal volume due to a giant uterine mass, evolving to miscarriage. Ultrasound can be a useful tool, allowing visualization of the endocervical path and uterine cavity, helping to perform uterine evacuation in the presence of anatomical distortion without compromising the reproductive future. To the best of our knowledge, no such case has been previously reported.
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The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.
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Background: Changes in the liver function test may serve as an early marker for timely diagnosis and identification of patients who may develop severe dengue. The purpose of this study was to examine the link between dengue fever severity and liver function test. Methods: This prospective observational study was conducted in the Department of General Medicine, Madhesh Institute of health sciences, provincial hospital, Janakpurdham in which we included dengue positive patients (aged 18 years or more) based on NS1 antigen or high titer on IgM/IgG testing from July 2023 till August 2023. We excluded patients with diseases like malaria, cirrhosis of liver, enteric fever, viral hepatitis or any other disease or taking any medication which can derange LFT. Results: We included 96 patients fulfilling the study criteria. Of these, 71% had DF, 22% had DHF and 7% had DSS. Among liver enzymes, mean AST of the patients was significantly higher in DSS group of patients (775.19�.65 U/l), as compared to those in the DF and DHF group of patients, p value <0.01. Similarly, mean ALT of the patients was significantly higher in DSS group of patients (387.8�.6 U/l), as compared to those in the DF and DHF group of patients, p value<0.01. On the contrary, mean alkaline phosphatase levels were similar between the three patient groups. Conclusions: Based on the results our study, we conclude that raised AST and ALT levels were significantly associated with severity of DSS and DHF. Patients with dengue infection should have a baseline liver function test and subsequent LFT monitoring to detect early hepatic impairment.
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The demand for products to replace high-cost raw materials, such oil and fish meal, in the manufacture of feed for use in aquaculture, while also guaranteeing the nutritional quality of the diets, is increasing. Silage produced with fish and vegetables residues is a low-cost and efficient protein source. The objective of the present study was to evaluate the physiological and biochemical responses of tambaqui fingerlings fed four different levels of silage included in commercial feed with 28% crude protein, over two periods: 45 and 90 days. Each treatment was carried out over three replications, with 10 tambaqui in each 100 L experimental tank. At the end of each established period, blood samples were collected from five animals from each repetition to determine the hematological and biochemical variables. Body weight and total length, hepatosomatic and liposomal indices and hematocrit of specimens fed with diets supplemented with silage did not exhibit significant changes in both assessment period. After 45 days of feeding, the hemoglobin concentration increased when tambaqui were fed a diet including 20% silage. The red blood cell count, mean corpuscular volume and mean corpuscular hemoglobin did not change between treatments in either period. The total protein concentrations increased significantly in the plasma of tambaqui fed with diets with the inclusion of 5 and 10% of silage, evaluated after feeding for 45 days. It was found that the groups which had silage included in their diet did not exhibit significant alterations in the evaluated parameters, and the diet was therefore not consider harmful to the health of tambaqui. Therefore, the use of silage as a feed supplement during tambaqui farming is a sustainable alternative for producers, as it leads to a reduction of impacts of fish and vegetables waste disposal.
A procura por insumos que substituam produtos de alto custo, como óleo e farinha de peixe, na fabricação de rações para uso na aquicultura é crescente, sendo necessário garantir a qualidade nutricional das dietas. A silagem produzida a partir de resíduos de pescado e de vegetais apresenta-se como uma alternativa de baixo custo e eficiente fonte proteica. O objetivo do presente estudo foi avaliar as respostas fisiológicas e bioquímicas de alevinos de tambaqui alimentados com quatro níveis de inclusão de silagem em ração comercial com 28% de proteína bruta, em dois períodos: 45 e 90 dias. Cada tratamento foi realizado em três repetições, com 10 tambaquis em cada caixa experimental de 100 L. Ao término de cada período estabelecido, amostras sanguíneas foram coletadas de cinco animais de cada repetição para determinação das variáveis hematológicas e bioquímicas. Peso, comprimento total e índices hepatossomático e lipossomático de espécimes alimentados com silagem não mostraram alterações significativas em ambos os períodos de avaliação, bem como os valores de hematócrito. A concentração de hemoglobina de tambaqui após 45 dias de alimentação aumentou quando foi fornecida dieta com inclusão de 20% de silagem. A contagem de eritrócitos, volume corpuscular médio e hemoglobina corpuscular média não apresentaram alterações entre os tratamentos, em ambos os períodos. As proteínas totais aumentaram significativamente no plasma de tambaquis que receberam dietas com inclusão de 5 e 10% de silagem, avaliados após 45 dias de alimentação. Evidenciou-se que os grupos com inclusão de silagem na dieta não apresentaram alterações significativas nos parâmetros avaliados, assim não sendo prejudiciais à higidez do tambaqui. Portanto, o uso da silagem como suplemento alimentar durante o cultivo do tambaqui é uma alternativa sustentável para produtores, por promover a redução do descarte de resíduos de pescado e da agricultura.
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Animais , Aquicultura , Suplementos Nutricionais , Custos e Análise de Custo , Dieta , Peixes/crescimento & desenvolvimentoRESUMO
Abstract The demand for products to replace high-cost raw materials, such oil and fish meal, in the manufacture of feed for use in aquaculture, while also guaranteeing the nutritional quality of the diets, is increasing. Silage produced with fish and vegetables residues is a low-cost and efficient protein source. The objective of the present study was to evaluate the physiological and biochemical responses of tambaqui fingerlings fed four different levels of silage included in commercial feed with 28% crude protein, over two periods: 45 and 90 days. Each treatment was carried out over three replications, with 10 tambaqui in each 100 L experimental tank. At the end of each established period, blood samples were collected from five animals from each repetition to determine the hematological and biochemical variables. Body weight and total length, hepatosomatic and liposomal indices and hematocrit of specimens fed with diets supplemented with silage did not exhibit significant changes in both assessment period. After 45 days of feeding, the hemoglobin concentration increased when tambaqui were fed a diet including 20% silage. The red blood cell count, mean corpuscular volume and mean corpuscular hemoglobin did not change between treatments in either period. The total protein concentrations increased significantly in the plasma of tambaqui fed with diets with the inclusion of 5 and 10% of silage, evaluated after feeding for 45 days. It was found that the groups which had silage included in their diet did not exhibit significant alterations in the evaluated parameters, and the diet was therefore not consider harmful to the health of tambaqui. Therefore, the use of silage as a feed supplement during tambaqui farming is a sustainable alternative for producers, as it leads to a reduction of impacts of fish and vegetables waste disposal.
Resumo A procura por insumos que substituam produtos de alto custo, como óleo e farinha de peixe, na fabricação de rações para uso na aquicultura é crescente, sendo necessário garantir a qualidade nutricional das dietas. A silagem produzida a partir de resíduos de pescado e de vegetais apresenta-se como uma alternativa de baixo custo e eficiente fonte proteica. O objetivo do presente estudo foi avaliar as respostas fisiológicas e bioquímicas de alevinos de tambaqui alimentados com quatro níveis de inclusão de silagem em ração comercial com 28% de proteína bruta, em dois períodos: 45 e 90 dias. Cada tratamento foi realizado em três repetições, com 10 tambaquis em cada caixa experimental de 100 L. Ao término de cada período estabelecido, amostras sanguíneas foram coletadas de cinco animais de cada repetição para determinação das variáveis hematológicas e bioquímicas. Peso, comprimento total e índices hepatossomático e lipossomático de espécimes alimentados com silagem não mostraram alterações significativas em ambos os períodos de avaliação, bem como os valores de hematócrito. A concentração de hemoglobina de tambaqui após 45 dias de alimentação aumentou quando foi fornecida dieta com inclusão de 20% de silagem. A contagem de eritrócitos, volume corpuscular médio e hemoglobina corpuscular média não apresentaram alterações entre os tratamentos, em ambos os períodos. As proteínas totais aumentaram significativamente no plasma de tambaquis que receberam dietas com inclusão de 5 e 10% de silagem, avaliados após 45 dias de alimentação. Evidenciou-se que os grupos com inclusão de silagem na dieta não apresentaram alterações significativas nos parâmetros avaliados, assim não sendo prejudiciais à higidez do tambaqui. Portanto, o uso da silagem como suplemento alimentar durante o cultivo do tambaqui é uma alternativa sustentável para produtores, por promover a redução do descarte de resíduos de pescado e da agricultura.
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ABSTRACT Spodoptera cosmioides (Walker, 1858) is an economically relevant polyphagous moth, widely distributed in the Neotropics and part of the Spodoptera latifascia (Walker, 1856) species group. In this study, we used extensive sampling from different regions to describe the spatial distribution of S. cosmioides in Brazil and evaluate its variability both from morphological and molecular perspectives. Variable coloration and several morphological similarities were found among S. cosmioides and congeners of the S. latifascia complex, diverging from each 0.5 to 3.5% of mitochondrial DNA. The genetic divergence at the species level of S. cosmioides was 0.5% throughout Brazil, and a geographic structure was absent, including shared haplotypes with S. descoinsi Lalanne-Cassou & Silvain, 1994. Spodoptera cosmioides was found in all six biomes of Brazil, with the highest abundance recorded in the Cerrado, followed by the Amazon, Atlantic Rainforest, Caatinga, Pantanal, and Pampa.
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Abstract Introduction Biologics targeting type 2 inflammation have revolutionized the way we treat patients with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Particularly in severe and difficult-to-control cases, these drugs have provided a new reality for these patients, allowing for the effective and safe treatment of extensive diseases that were not completely managed with the typical strategy of surgery and topical medications. Objectives The experience achieved with the approval of these medications by ANVISA for use in CRSwNP and the knowledge obtained regarding outcomes, adverse effects, and the ideal patient profile prompted the update of the previously published guideline, with a detailed review of the most recent scientific literature, the personal experiences of experts, and the adaptation to the reality of the Brazilian healthcare system, both public and private. Results We proposed a new eligibility criterion for biologics in patients with CRSwNP based on four pillars of indication: the impact of the disease on the patient's life, whether in the presence of specific symptoms or in overall quality of life; the extent of sinonasal disease; the presence of type 2 comorbidities, considering other associated diseases that may also benefit from anti-T2 biologics, and the presence of biomarkers to define type 2 inflammation, especially those associated with worse disease prognoses. Conclusions This innovative and pioneering method has two major advantages. First, it ensures a comprehensive evaluation of patients; second, it is flexible, as advancements in our understanding of the disease and changes in cost-effectiveness can be addressed by simply adjusting the required score for indication, without the need to modify the entire evaluation scheme.
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Background: Numerous studies have documented an intergenerational cycle of adolescent motherhood, wherein daughters of adolescent mothers are more likely to follow suit. This pattern may result from biological predisposition, heritable attitudes, or the socioeconomic environment influenced by early childbirth. Surprisingly, the same cycle among young fathers remains unexplored in India. This research paper seeks to enrich the existing body of knowledge by shedding light on the intergenerational cycle of adolescent fatherhood in the rural Jharkhand and Odisha, possibly as a first of its kind study. Methods: A case control study was conducted between June 2023 to August 2023 amongst adolescent males residing in rural areas of Jharkhand and Odisha states with sample size of 228 using multi-stage sampling technique. Results: The study did not reveal statistically significant association between adolescent fathers of this generation and adolescent fathers or adolescent mothers of previous generation, unlike in the case of adolescent mothers. Conclusions: To address adolescent reproductive sexual Health challenges in rural Jharkhand and Odisha effectively, it is imperative to emphasize targeted educational campaigns with cultural sensitivity, actively involve adolescent males and maintain a steadfast long-term commitment to fostering cultural transformation.
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Background: The care of cleft lip and palate patients at the general hospital of Mexico has nearly 70 years of experience. Methods: An observational study of a 7-year cohort of resolved cases of cleft lip and palate by the plastic and reconstructive surgery service of the general hospital of Mexico (2017-2023) was conducted. Results: The 121 patients were recorded, with 47 palatoplasties, 44 primary cheiloplasties, 24 secondary cheiloplasties, and 11 veloplasties performed. All patients are evaluated by a multidisciplinary team composed of plastic surgery, dentistry, clinical nutrition, speech therapy, audiology, genetics, and psychology to determine a comprehensive treatment plan. Conclusions: The data reported by the cohort in this work aligns with international reports. The frequency of cases decreased due to the COVID-19 pandemic, but has increased in recent years.
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Background: Transgender people are stigmatized, victimized and often driven towards attempting suicide due to institutionalized discrimination. We aimed, to determine the proportion and factors associated with suicidal ideation in last one year and suicide attempts in their lifetime and the proportion of transgender people who have faced sexual harassment in Puducherry. Methods: It was a cross sectional analytical study. All consenting adult transgender residing in Puducherry and registered with SCOHD (NGO) were included in the study. Pre-tested semi structured questionnaire was used as study tools (C-SSRS and TGISS). Suicidal ideation, suicide attempts and sexual harassment were expressed in proportion and multivariate analysis was done to find the independent association of variables with the outcomes using adjusted prevalence ratios. Results: Of the 119 transgender people who participated in this study, 50% were unemployed and 28.6% were involved in sex work. Overall prevalence of suicidal ideation, suicide attempts and sexual harassment was found to be 31.1% (95%CI 23.3%-39.8%), 46.2% (95%CI 37.4%-55.2%) and 84.87% (95%CI 77.5%-90.4%) respectively. In multivariate analyses, suicidal ideation was significantly associated with higher income; suicide attempts were associated with being employed. Conclusions: Lack of support from the family and friends and the stigmatizing behaviour of the society were the causes of their fear of living in the society. Extreme forms of stigma ultimately leads to their suicidal behaviour.
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Background: the study aimed to understand the prescription pattern of analgesics used in the post-operative period after a general surgical procedure in a tertiary care hospital in India and estimate the severity of post-operative pain up to 48 hours. Such a study was not done in this institute of recent hence it was carried out. Methods: 266 adults of either gender were recruited and prescription pattern analyzed over a period of 1 year beginning January 2021 to December 2021 from the post-operative general surgery wards of a tertiary care hospital in India. Patient interview and records were used to collect data. Follow ups at 4, 24 and 48 hours were undertaken to assess pain according to the visual analogue scale (VAS) that was analyzed using the Friedman’s test followed by the post hoc Dunn’s test. Results: an average of 1.52±0.58 analgesics were prescribed per patient. Paracetamol was most commonly used followed by tramadol and diclofenac. All analgesics prescribed were a part of the national list of essential medicines. Effective pain management is feasible as seen by the significant (p<0.0001) reduction in average pain score from 4.75±1.35 to 3.05±1.18 at 24 hours and further to 2.16±1.04 at 48 hours. Conclusions: Use of analgesics prescribed from a standardized list is effective in majority of patients.
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Background: Hospitalized children commonly experience pain and anxiety as the most prevalent adverse stimuli. One of the most alarming and distressing causes of pain and anxiety that is frequently reported is venipuncture. The objective of this study was to evaluate the impact of cold and thermomechanical stimulation on pain and anxiety levels experienced by pediatric patients during intravenous (i.v.) cannulation. Methods: This study aimed to assess the efficacy of cold and thermo mechanical stimulation in reducing anxiety and pain experienced by children during intravenous (i.v.) cannulation through a prospective case-control design. Children age 3-12 years and requiring i.v. cannulation were included. Children’s level of anxiety and pain was assessed using the children’s fear scale (CFS) and Wong-Baker faces pain scale (WBFS). Results: Mean scores of the self- reported procedural level of pain were less in the intervention group as compared to the control group (2.80±1.86, 7.47±2.40). Median of procedural pain level showed a significant difference between the intervention and control group at p<0.001, inferring that the cold and thermomechanical strongly resulted in a reduction of perception of pain during the cannulation procedure. Conclusions: The research provided evidence in favor of the cold and thermomechanical as a promising non-pharmacological intervention for pain reduction during the process of intravenous cannulation.