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Background: Serotonin receptors 5-HT1B and 5-HT1D in the cerebral arteries are activated by the 5-hydroxytryptophan agonists (triptans) to relieve the discomfort associated with migraines. Even though triptans are often used to treat acute migraines, there is some debate over their effectiveness. Objective: Our systematic review aimed to evaluate the effectiveness of triptans for acute treatment of migraine in young individuals. Methods: Utilizing the databases of Google Scholar, Cochrane Library, and PubMed, a literature search was conducted, and all papers published till July 2022 were included. This systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. In addition to the Boolean operators AND, OR, and NOT, the following descriptive terms were also used: “Triptans,” “Pediatric Migraine,” “Migraine disorders,” “Headache,” “Children,” and “Adolescent.” Results: A total of 1047 studies were identified, and 25 articles were finally included in the study. 17 of them were RCTs while the remaining were non-randomized trials. Most studies recruited participants aged between 12-17 years. Among 25 studies, 7 reported sumatriptan use, 3 assessed a combination of sumatriptan and naproxen, 4 were on almotriptan, 1 on eletriptan, 6 on rizatriptan, and 4 on zolmitriptan use. Conclusion: We found that rizatriptan (good tolerability profile with a dose of 5 mg) and sumatriptan (nasal spray, 10 mg and 20 mg) had higher efficiency as compared to other triptans. Regardless of type or dose, all triptans are generally well tolerated by patients, but a few adverse effects such as light-headedness (sumatriptan), nasopharyngitis, and, muscular spasms (sumatriptan/ naproxen), somnolence, and dry mouth (rizatriptan), and dizziness (zolmitriptan group) were reported with the triptans.
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Background: The aim of the present study was to evaluate the indications, complications and outcome of colostomy in newborn patients.Methods: This is a descriptive, retrospective study carried out in the Department of Pediatric surgery, Gandhi Medical College Bhopal to evaluate acceptance and outcome of colostomy in newborn over a one year period from March 2018 to March 2019. All newborn with diagnosis of anorectal malformation, Hirshsprungs disease and other emergency conditions underwent transverse loop colostomy by expert and trained pediatric surgeon.Results: Out of 40 patients operated complications of colostomy was seen in 18 (45%) patients. Most common complication was skin excoriation in 08 patients (20%), bleeding from stoma site in 02 (05%) cases. Stoma prolapse occurred in 02 (05%) patients. Wound infection, dehiscence, stomal stenosis and parastomal hernia was seen in one patient each 2 (2.5%). 2 (0.5%) patient died due to multiple congenital anomalies.Conclusions: Colostomy in children is associated with significant morbidity in developing country. To minimize these problems, the pediatric surgeon should focus on the management and early closure of a colostomy.
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Introduction: With scientific advancements day care surgery (DCS) nowadays has become a modern and effective way to treat pediatric patients. DCS and anesthesia are practiced and has been reported to be safe and economical for infants and children requiring routine minor surgeries in all specialties. Objective: To assess the feasibility and acceptability of day-care anesthesia and surgery in a tertiary care center. Materials and Methods: A 4 years prospective study was conducted from January 2011 to January 2015 in Chirayu Medical College and Hospital Bhopal, India. Total of 201 consecutive patients with American Society of Anesthesiologists I-I1 status and aged 3 months to 14 years were studied. Patients were operated as day-cases using monitored general or local anesthesia. Results: The age distribution of patients’ shows that maximum no of patients were in the age group 4-6 years, 98 (48.7%) cases. Circumcision was the most common surgery performed in our setting. Most of the operative procedures were completed within 30 min (29.8%) cases. Nausea, vomiting and minor bleeding were the most common complaint and reason for post-operative night stay in the hospital. Conclusion: Pediatric day care anesthesia and surgery are safe and feasible, but good selection criteria, appropriate setup, and careful monitoring are must for good results.
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Background: In emergency neonatal surgery is challenging and difficult, causing high morbidity and mortality. In our country, only few reports are there about the results and consequences of acute surgical abdominal emergencies in newborns. Objective: The aim of present study was to determine the etiology and clinical results in neonates with acute abdomen requiring surgical intervention. Materials and Methods: This was a 3 years prospective hospital-based study of all neonates who underwent surgery for acute gastrointestinal emergencies at Chirayu Medical College and hospital Bhopal from January 2012 to January 2015. Patient’s profile, symptoms, causes of acute surgical abdomen, clinical outcomes were analyzed. Results: A total of 25 neonates were studied, males were the majority being 18 (72.0%) Neonatal intestinal obstruction was the main abdominal surgical emergency. Anorectal malformation was seen in 12 (48%) cases. Abdominal distension was seen in 15 cases and failure to pass meconium was seen in 15 (19.2%) cases. Palliative surgery was done in 16 cases and definitive surgery was done in 9 cases. The mortality was seen in 5 neonates (20%). Conclusion: In present study, Intestinal obstruction was the major cause of acute surgical abdominal emergency. There is a need to increase care at all levels of referral in our country for the early management of sick newborns. Facilities such as neonatal ventilators, specialized neonatal surgeon, and operative facilities will result in better outcome.