Journal of the Indian Medical Association
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Parecoxib, a prodrug of valdecoxib, a selective COX-2 inhibitor, has been recently introduced for the treatment of moderate to severe postoperative pain. This prospective, open, multicentric study enrolled 260 patients undergoing orthopaedic, gynaecological, dental and general surgery. Postoperatively, patients were treated with parecoxib, 40 mg IM/IV. ⋯ The drug was well tolerated. There was no report of any hypersensitivity reaction. This study suggests that parecoxib, in a dose of 40 mg IM/IV, is an effective and safe option for the management of postoperative pain.
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Establishment of diarrhoea treatment and training units (DTTUs) in all major health facilities for promotion of appropriate oral rehydration therapy (ORT) is an important strategy for control of diarrhoeal diseases (CDD) in children in this country. Univariate analysis of mortality experiences of a random sample of 225 diarrhoea cases among children treated at DTTU in the department of paediatric medicine, RG Kar Medical College, Kolkata revealed that case fatality rate (CFR) of diarrhoea was much higher among children treated with parenteral fluid therapy with or without drugs (20.6% and 20.9% respectively), compared to those treated with oral rehydration solution (ORS) only (0.75%). ⋯ The CFR of diarrhoea cases did not depend on type of diarrhoea or nutritional status of the child. Thus, promotion of correct practice of ORT merits attention through all possible means.
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Sudden cardiac deaths in athletes are usually due to underlying cardiovascular disease. The final pathway is usually ventricular fibrillation following hypertrophic cardiomyopathy and coronary artery anomalies in young persons below the age of 30 years. ⋯ Out of 15 cases in autopsy finding, hypertrophic cardiomyopathy (n=7) was the commonest cause followed by coronary artery anomalies (n=4). Sudden unexpected death is a source of concern and careful screening of history and physical examination for potential athletes should identify majority of people at risk.
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Randomized Controlled Trial Clinical Trial
A pharmacodynamic basis for the peak effect of vecuronium: peak twitch versus peak tetanic fade.
Double burst stimulation (DBS), a tetanic test, shows two types of changes during nondepolarising neuromuscular block (NMB) viz, amplitude (D1) suppression and fading of second response (D2), quantified as DBS ratio (D2/D1). During subclinical dose effect of vecuronium bromide both parameters show peak suppression at two distinct intervals. To evaluate, which of the two is the true peak effect of vecuronium, twenty-two ASA 1 patients were given im buprenorphine (5 micro/kg) premedication and iv diazepam (0.1 mg/kg). ⋯ It was noteworthy that at the repeat dose of vecuronium while D1 showed recovery in group 2 patients, DBS ratio was concomitantly and significantly lower (0.37 +/- 0.10) (more intense NMB) than in group 1 (0.49 +/- 0.17) patients, with quicker onset of repeat dose. These findings suggest that as the NMB agents show two types of changes during clinical monitoring, DBS test seems to be a better clinical pharmacodynamics-monitoring test for NMB agents. In addition, the peak tetanic fade (peak DBS ratio suppression) correlated with peak effect of vecuronium than the usually measured peak twitch suppression.