International journal of clinical practice
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Int. J. Clin. Pract. · May 2021
Meta AnalysisDexmedetomidine versus fentanyl as adjuvants to ropivacaine for epidural anesthesia：a systematic review and meta-analysis.
Several randomized controlled trials (RCTs) have evaluated the use of dexmedetomidine versus fentanyl as adjuvants to ropivacaine for epidural anaesthesia, yet the results are conflicting. We aimed to conduct this meta-analysis to assess the effects and safety of dexmedetomidine and fentanyl as adjuvants to ropivacaine for epidural anaesthesia. ⋯ Dexmedetomidine is better than fentanyl as adjuvant to ropivacaine for epidural anaesthesia with better effects and less adverse events.
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Int. J. Clin. Pract. · May 2021
Review Case ReportsAtrial fibrillation and cardiac arrhythmia associated with acute dental infection: a systematic literature review and case report.
This paper outlines how oral diseases such as periodontitis and periapical periodontitis may be linked to cardiovascular disease, atrial fibrillation and cardiac arrhythmia. We undertake a systematic review of the literature focused on acute dental infection and types of cardiac arrhythmia and also describe an illustrative case where an acute dental infection diagnosed as periapical periodontitis was associated with the occurrence of atrial fibrillation. ⋯ Based on the biological plausibility of a link between acute dental infection and types of cardiac arrhythmia such as atrial fibrillation, together with the case report presented, it is evident that further study in this area is needed. If there are possible cardiovascular consequences for patients suffering from acute dental infection, then this will have implications for healthcare staff since they can integrate professional advice relating to oral health with cardiovascular disease and atrial fibrillation. Screening programmes situated in dental settings can facilitate early intervention and prevention producing benefits for patients and savings to the health system.
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Int. J. Clin. Pract. · May 2021
Personal protective equipment (PPE) guidance during a global pandemic: A statistical analysis of National perceived confidence, knowledge and educational deficits amongst UK-based doctors.
On the 11th of March 2020, the World Health Organisation (WHO) declared a global pandemic following the upsurge of the novel coronavirus disease 2019 (COVID-19). Unprecedented global demand for personal protective equipment (PPE) resulted in restricted availability, as well as evolving guidance on use, the latter of which was complicated by conflicting guidance provided by numerous healthcare bodies. ⋯ Ensuring uniformity in published guidance, coupled with education may aid knowledge and subsequent confidence regarding the appropriate use of PPE. The absence of a unified consensus and sustained training not only poses significant ramifications for patient and healthcare professional (HCP) safety, but also risks further depletion of already sparse resources. Because of the novelty of COVID-19, appropriate PPE is continually evolving leaving an absence in formal training and education. This paper reveals insight into confidence and knowledge of PPE amongst doctors of various specialities/grades during a global pandemic, highlighting key deficits in education and training.
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Int. J. Clin. Pract. · May 2021
Randomized Controlled TrialAdjunctive Dexmedetomidine Infusion in Open Living Donor Hepatectomy: A Way to Enhance Postoperative Analgesia and Recovery.
Open living donor hepatectomy (OLDH) is a highly painful procedure. Advanced strategies for enhancing perioperative analgesia and accelerating recovery are needed for patients undergoing OLDH. This study evaluated the effects of intravenous infusion of dexmedetomidine (DEX) during OLDH on postoperative analgesia and recovery. ⋯ The present study revealed that the addition of intravenous infusion of DEX during OLDH provided several benefits in relieving postoperative pain and promoting recovery. Therefore, we concluded that intraoperative DEX infusion may play an important role in enhancing the recovery of patients undergoing OLDH.
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Int. J. Clin. Pract. · May 2021
Treatment Management of COVID-19 Positive Patients with Renal Colic Secondary to Distal Ureteral Stone.
In this study, we aimed to contribute to the literature by sharing and evaluating the clinical characteristics and our treatment and follow-up approaches in patients in the COVID-19 positive treatment process who had presented to our hospital's emergency department with a distal ureteral stone and to examine the effects of the pandemic and disease in this group of patients. ⋯ In most COVID-19 infected patients with renal colic and a distal ureteral stone, results can be obtained using MET. Patients with a distal ureteral stone and persistent renal colic can be safely and effectively treated by endoscopic ureteral stone treatment after taking necessary precautions. Prospective, randomised, and controlled studies are required on this subject.