Mymensingh medical journal : MMJ
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Randomized Controlled Trial Comparative Study
Comparative efficacy of combined nebulized salbutamol with ipratropium bromide and nebulized adrenaline to treat children with acute bronchiolitis.
As the efficacy of combined nebulized salbutamol & ipratropium bromide as well as L-adrenaline to treat acute bronchiolitis is not well studied among the Bangladeshi infants, this study was carried out to see their efficacy in acute bronchiolitis and to compare their effectiveness. This randomized clinical trial was done among 60 children aged less than 02 years, admitted in the department of Pediatrics, Dhaka Medical College Hospital, during January through December 2005 with acute bronchiolitis. After a quick initial assessment, nebulization were done twice at 6 hours interval with the mentioned drugs, group wise (one group with salbutamol plus ipratropium bromide and other group with L-adrenaline alone) and the outcomes were assessed after 30 minutes of each nebulization in respect to oxygen saturation and clinical modified respiratory distress assessment instrument (MRDAI) scores. ⋯ However, L-adrenaline showed more efficacy (MRDAI, p=0.021; SaO2, p=0.034) than combined Salbutamol & Ipratropium bromide. Both L-adrenaline and combined salbutamol & ipratropium bromide were found effective in acute bronchiolitis but L-adrenaline was found more effective. A large multi-centre clinical trial is recommended.
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Randomized Controlled Trial Comparative Study
Comparative study of stress response to central venous cannulation under local anesthesia and general anesthesia in patients undergoing open heart surgery.
The open heart surgery like coronary artery bypass graft (CABG), repair of ventricular septal defect (VSD) and atrial septal defect (ASD), valve replacement need a circulatory arrest, which is normally safe under conventional hypothermia. During this time not only the heart and lungs are bypassed but also a wide range of haemodynamic manipulation is necessary. For this reason continuous arterial and central venous pressure monitoring are mandatory. ⋯ All data were analyzed by using Student's 't' test in Statistical Program for Scientific Study (SPSS). From the study, we can conclude that central venous cannulation under local anesthesia in patients for open heart surgery has no significant changes of haemodynamic and humoral stress response in comparison to those of under general anesthesia. So, central venous access device can be placed under local anesthesia supported by premedication and it produces no significant changes in preoperative stress response in patients for open heart surgery.