Mymensingh medical journal : MMJ
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Randomized Controlled Trial
Intrathecal neostigmine for postoperatrive analgesia in caesarean section.
This study was done for intrathecal adjuncts often are used to enhance small dose spinal bupivacaine anaesthesia. We designed this study to evaluate the postoperative analgesic efficacy and safety of intrathecal neostigmine. A randomized, double-blind prospective study was conducted in 90 healthy term pregnant patients scheduled to undergoing elective caesarean section using spinal anaesthesia. ⋯ Neostigmine significantly increased the duration sensory and motor block (p<0.05) and the time until for achieving discharge criteria. The addition of neostigmine produced dose-dependent nausea and vomiting and had no significant effect on haemodynamic or respiratory parameters. Addition of neostigmine to intrathecal bupivacaine extends the duration of postoperative analgesia with fewer side-effects without adverse effects on fetus following caesarean section.
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Randomized Controlled Trial
Prolonged analgesia by adding midazolam and hyperbaric bupivacaine in subarachnoid block for lower uterine caesarian section.
Antinociceptive effect and safety of sub-arachnoid (SAB) midazolam is well established in animals and human beings. In this randomized, prospective placebo control clinical study, we investigated the addition of 2.5mg midazolam to bupivacaine on the quality of surgical anaesthesia and duration of first analgesic in the post operative period after lower uterine caesarean section (LUCS). Sixty ASA I or II pregnant women scheduled for elective lower uterine caesarean section were selected for the study. ⋯ Sedation level, Apgar score was comparable in both groups. No neurological deficit or other significant adverse effects were recorded. The addition of midazolam with hyperbaric low dose bupivacaine in SAB significantly improves the quality of surgical anaesthesia and prolongs the duration of analgesia without any adverse effects.
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Randomized Controlled Trial Comparative Study
Comparison of post operative morbidity between laparoscopic and open appendectomy in children.
This prospective comparative study was conducted in the department of Pediatric Surgery, Dhaka Shishu (children) Hospital during the period of June 2007 to September 2008 with the children of <12 years, diagnosed as acute Appendicitis. Patient selection was done by simple random technique by means of lottery. For open Appendectomy (OA) conventional method & for Laparoscopic Appendectomy (LA) 3 trocher technique was applied. ⋯ About post operative wound infection in group A only 1(3.3%) case had developed post operative wound infection whereas in group B 7(23.3 %) cases had. The mean (+/-SD) of post operative length of hospital stay was 52.00+/-11.62 (range 48-96) hours for group A and 76.00+/-12.74 (range 48-96) hours for group B children (p<0.001). Laparoscopic Appendectomy is more effective, preferable & superior procedure than that of open Appendectomy to reduce the post operative morbidity in children undergone appendectomy for acute appendicitis.
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Randomized Controlled Trial
Use of povidone-iodine drop instead of sub-conjunctival injection of dexamethasone and gentamicin combination at the end of phacoemulsification cataract surgery.
To evaluate the use of 5% povidone-iodine drop with subconjunctival injection of dexamethasone and gentamicin combination at the completion of phacoemulsification cataract surgery. This prospective randomized study was conducted at the department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of July, 2005 to June 2006. Senile & pre-senile cataract patients undergoing phacoemulsification cataract surgery were included in the study. ⋯ Mean visual acuity was 0.16+/-0.12 in Group A and 0.15+/-0.13 in Group B. Anti-inflammatory, anti-infective effects and visual outcome are similar in both groups. But sub-conjunctival injection resulted more pain and hence less acceptable to patients.
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Randomized Controlled Trial
Effects of therapeutic modalities on patients with post stroke shoulder pain.
A randomized clinical trial was conducted to find out the effects of physical modalities transcutaneous electrical nerve stimulation (TENS) and ultrasonic therapy (UST) on the patients with post stroke shoulder pain in the Department of Physical Medicine & Rehabilitation & Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from 1st July 2006 to 31st December 2006. In that period a total of 750 stroke patients attended the stroke clinic of the Department of Neurology, BSMMU, of which 150(20%) patients presented with post stroke shoulder pain. Among the patients with post stroke shoulder pain, 45(6%) patients were included in the study. ⋯ Significant improvement was observed after treatment in each group except in active internal rotation in UST group. But in comparison between two groups, Group A (TENS) showed statistically significant better improvement in all planes of pain free range of motion than Group B except active abduction which was better improved in group B (UST) and in case of passive abduction, passive external rotation and passive extension, TENS had better effect than UST. It may be concluded that TENS and UST both are effective but TENS may be safer and superior to ultrasonic therapy (UST) in the treatment of the patients with post stroke shoulder pain.