West African journal of medicine
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Randomized Controlled Trial
Efficacy of nebulized furosemide in children with moderate attack of asthma.
Bronchodilators are the most commonly used drugs for asthma. However, alternative treatment is necessary for those patients who experience adverse effects from bronchodilators. ⋯ Combination of both furosemide and albuterol led to significant increase in peak flow rate but it did not significantly affect FEV1, FVC, FEF 25-75, respiratory rate, SaO2 or clinical scores as compared to other groups. There were no significant adverse effects from the three drugs used.
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The aim of the study was to determine the daily losses of water, sodium and potassium in the urine of Ghanaian children who presented to the paediatric surgery unit of the Korle-Bu teaching hospital. ⋯ This study showed that children between 5 and 12 years in a ward lose a mean of 1136.8ml of water per day, 4.6mmol per kilogram of sodium per day, and 1mmol per kg per day of potassium in their urine.
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Postintubation tracheal stenosis (PITS) occurs due to excessive pressure on the trachea by the cuff of the endotracheal tube which leads to local ischaemic necrosis of the tracheal cartilage and excessive growth of granulation tissue. The recognition of its aetiology and modifications in the design and management of endotracheal tubes have led to a diminished incidence of PITS. The management modalities that have been employed for the management of PITS include stenting, surgical resection and reconstruction, percutaneous dilatation, rigid bronchoscopic dilatation, fibreoptic assisted balloon dilatation and Nd:YAG (neodymium: yttritium-aluminum garnet) laser therapy with or without stenting. ⋯ Rigid bronchoscopic dilation in patients with PITS provides safe, effective tracheal dilatation and improved pulmonary function in the medium term.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparative study of the haemodynamic effects of atropine and glycopyrrolate at induction of anaesthesia in children.
Bradycardia following administration of halothane and suxamethonium in children leads to reduced cardiac output, which can be prevented with prophylactic anticholinergics. Anticholinergics may result in tachycardia and arrhythmias. This study was designed to compare haemodynamic changes and incidence of cardiac arrhythmias following intravenous atropine and glycopyrrolate. ⋯ The use of glycopyrrolate compared to atropine, offered better cardiovascular stability in Nigerian children. Arrhythmias occurred more in patients who had atropine and occurred most frequently after tracheal intubation.
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Agitation is a common and significant problem in the medically ill elderly. It is responsible for diminished quality of life for not only the patient, but the caregivers as well as the patient's relatives. This paper will illustrate the concept of agitation and different modes of classification. The major emphasis will be placed on discussing prompt, correct diagnosis of the underlying cause of agitation and effective treatment of both the cause of agitation and the symptoms of agitation itself.