Frequency Of Vomiting Research Articles

Dexamethasone versus 5-HT3 receptor antagonists in preventing nausea during awake craniotomy: a propensity score matching study

BackgroundNausea and vomiting during awake craniotomy (AC) can increase cerebral pressure and cause asphyxia and aspiration. 5-HT3 receptor antagonists, such as granisetron, are often administered before awakening to prevent nausea during AC. Recently, dexamethasone was reported to prevent nausea and vomiting during AC; however, the efficacy of both drugs in preventing nausea has not yet been investigated.MethodsWe examined the frequency of nausea and vomiting in AC patients (n = 170) treated at our hospital until the end of September 2019. We divided patients as those who received dexamethasone (n = 71) and or granisetron (n = 99) before awakening and examined the frequency of nausea and vomiting after propensity score (PS) matching.ResultEighty-two patients were selected after PS matching. The incidence of nausea was significantly lower in the dexamethasone group than in the granisetron group (9.8% vs 41.5%, p = 0.002). In the logistic regression analysis after matching, the incidence of nausea significantly reduced with dexamethasone treatment (odds ratio: 0.12, 95% confidence interval: 0.029–0.499, p = 0.03).ConclusionIn conclusion, dexamethasone was more effective than granisetron in preventing nausea during AC.

Prevalence and associated factors of norovirus infections among patients with diarrhea in the Amhara national regional state, Ethiopia

BackgroundNoroviruses (NoVs) are the leading cause of diarrheal disease among all age groups worldwide, with an increased burden in developing countries. As there is no surveillance, epidemiological data is limited in Ethiopia. Hence, this study aimed to investigate the prevalence and associated factors of NoV infection among patients with diarrhea in the Amhara National Regional State, Ethiopia.MethodsA prospective health facility-based cross-sectional study was conducted from May 2021 to November 2021. A total of 550 study participants of all age groups with symptoms of diarrhea were proportionately assigned to the four study areas, area with three health facilities. Study participants were systematically sampled in each health facility. A fecal sample from each case was collected. The RNA was extracted and tested for NoV by one-step RT-PCR. Sociodemographic and other variables were gathered using a pre-tested questionnaire. A descriptive analysis was performed. Both binary and multiple logistic regressions were utilized to identify factors associated with NoV infection. Variables with a p-value < 0.05 in the final model were considered statistically significant.ResultsFive hundred nineteen out of 550 samples were analyzed (94.4% response rate). The overall prevalence of NoV was 8.9% (46/519). The positivity rates were higher among the elderly (33.3%) and under-5 children (12.5%). Both genogroup I and genogroup II (GII) were identified, with GII being the predominant, at 82.6% (38/46). Of all participants, only 20% reported a history of vomiting. Norovirus infection was more prevalent among participants from Debre Tabor (AOR = 4, 95%CI: 1.2–14) and Bahir Dar areas (AOR = 3.6, 95%CI: 1.04–11) compared to Debre Markos. Additionally, older adults (AOR = 7, 95% CI: 2–24) and under-5 children (AOR = 3.5, 95% CI: 2.8–12) were disproportionately affected compared to adults. The previous history of diarrhea (AOR = 3.6, 95% CI: 1.7–7) was a significant factor contributing to NoV infections. Moreover, the odds of NoV infection were higher among individuals with a high frequency of diarrhea (AOR = 15.3, 95%CI: 7.6–43) and vomiting (AOR = 3.5, 95%CI: 1.5-8).ConclusionsThe prevalence of NoV was considerably high, with the predominance of NoV-GII. The positivity rate was higher among the extreme age groups and varied across the study areas. To obtain a comprehensive understanding of the virus`s epidemiology and its genetic diversity, further research is warranted.

Naldemedine for Opioid-Induced Constipation in Patients With Cancer: A Multicenter, Double-Blind, Randomized, Placebo-Controlled Trial.

Opioid-induced constipation is the most frequent and non-self-limiting adverse effect of opioid analgesia, reducing adherence and interfering with pain relief. This clinical trial aimed to clarify the preventive effect of naldemedine versus placebo for constipation in patients with cancer starting regularly dosed strong opioids therapy. This multicenter, double-blinded, randomized, placebo-controlled, confirmatory trial was conducted between July 2021 and May 2023 at four academic hospitals in Japan (ClinicalTrials.gov identifier: jRCTs031200397). Patients with cancer starting a first-time regularly dosed strong opioid for cancer pain and age 20+ years were included. Eligible patients were randomly assigned to the naldemedine (Symproic 0.2 mg) or placebo group in a 1:1 ratio for 14 days with protocol treatment. The primary end point was the proportion of patients with a Bowel Function Index (BFI) of <28.8 on day 14. The secondary end points included frequency of spontaneous bowel movements (SBM), quality of life (QOL), and frequency of opioid-induced nausea and vomiting (OINV). Of the 103 patients assessed for eligibility, 99 received either naldemedine (n = 49) or placebo (n = 50). A BFI of <28.8 on day 14 was significantly more likely to occur in the naldemedine group (64.6%; 95% CI, 51.1 to 78.1) versus placebo (17.0%; 95% CI, 6.3 to 27.8), and the difference between groups was 47.6% (95% CI, 30.3 to 64.8; P < .0001). The frequency of SBM, QOL, and the severity of OINV were nominally significant in the naldemedine group than in the control group. Naldemedine prevented constipation and improved constipation-related QOL, with possible preventive effect on OINV in patients with cancer starting regularly dosed opioids therapy.

Propofol versus Dexmedetomidine for Sedation of Cancer Patients Undergoing Endoscopic Retrograde Cholangiopancreatography: Randomized Single-Blinded Controlled Study

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a primary diagnostic and therapeutic option for pancreaticobiliary pathologies. Objectives: This study aimed to investigate the efficacy and safety of dexmedetomidine versus propofol during ERCP in cancer patients. Methods: This randomized controlled single-blinded trial was conducted with 202 cancer patients aged 21 to 60 years, of both sexes, with a body mass index of 18.5 to 30 kg/m2, and classified as American Society of Anesthesiologists (ASA) class II - III, who were undergoing ERCP. The patients were randomly assigned to two equal groups. The Propofol Group (n = 101) received a loading dose of propofol (1 - 2 mg/kg over 30 seconds) followed by an infusion (0.05 - 0.1 mg/kg/hour). The Dexmedetomidine Group (n = 101) received a loading dose of dexmedetomidine (1 μg/kg over 10 minutes) followed by an infusion (0.2 - 0.7 μg/kg/hour). The maintenance dose was adjusted during the procedure based on vital signs, Bispectral Index (BIS), and oxygen saturation. Results: The Dexmedetomidine group showed a significantly lower incidence of intra-procedural hypoxemic events (14.9% vs. 26.7%, P = 0.037) and a comparable incidence of hypotension (17.8% vs. 13.9%, P = 0.441). Dexmedetomidine also demonstrated significantly lower intraoperative pain scores according to the Facial Pain Score (P &lt; 0.05), significantly lower postoperative Visual Analog Scale (VAS) scores (P &lt; 0.05), and a lower frequency of postoperative nausea and vomiting (PONV) compared to the Propofol group. Additionally, there was a significantly higher frequency of endoscopist satisfaction in the Dexmedetomidine group compared to the Propofol group (P &lt; 0.05). Conclusions: Dexmedetomidine can be used as a safe and effective alternative to propofol for deep sedation of cancer patients undergoing ERCP. It is associated with a lower incidence of hypoxemic events, effective intraoperative sedation, quicker recovery, and superior analgesic effects both intraoperatively and postoperatively compared to propofol.

Is There a Relationship Between Body Mass Index and Eating Disorder Symptoms in Professional Male Fashion Models?

This study is the first to examine the utility of body mass index (BMI) as an indicator of eating disorder (ED) pathology and fitness for employment for professional male fashion models. We assessed the relationship between experimenter-measured BMI, muscle mass, body fat percentage, and ED severity (EDE-Q score) in male models and nonmodels. Except for higher eating concern, the two groups displayed similar EDE-Q scores after controlling for age. Models relative to nonmodels endorsed significantly greater frequency of compulsive exercise and self-induced vomiting as a means of controlling shape or weight. BMI was a poor indicator of body fat percentage in models. Lower BMI in models, and higher BMI in nonmodels, was associated with higher EDE-Q scores. Interestingly, all the male models with clinically significant EDE-Q scores (≥4.0) had >18.5 experimenter-measured BMI. Higher muscle mass in models, and lower muscle mass in nonmodels, was associated with higher EDE-Q scores. Inversely, lower percentage body fat in models, and higher percentage body fat in nonmodels, was associated with higher EDE-Q scores. BMI, muscle mass, and percentage body fat were associated with ED tendencies in male models and nonmodels. Findings also suggest males with clinical ED symptoms would be overlooked if only low BMI (<18.5) was considered. These results may guide the development of more effective mandates to safeguard models' wellbeing, and men generally.

Effectiveness of Using Lemon Aromatherapy to Reduce the Frequency of Nausea and Vomiting in Pregnant Women in the First Trimester

Nausea and vomiting are a common symptom of early pregnancy for pregnant women. Aromatherapy may be used in the treatment to reduce this. The method for utilizing fragrant healing to decrease sickness and spewing can be by breathing in utilizing a diffuser, candles and tissue. Lemon aromatherapy is frequently used during pregnancy and childbirth and is regarded as safe. At TPMB Titin Prihartini, S.ST., Bd, Pandeglang Regency in 2024, the purpose of this study is to determine whether lemon aromatherapy reduces the frequency of nausea and vomiting in pregnant women who are in the first trimester. A one-group pre-test, one-group post-test design is used in this quasi-experimental design. Total Sampling was used for the sampling, with 30 respondents, and observation sheets were used to collect the data. According to the findings of this study, the majority of pregnant women experienced a frequency of nausea and vomiting prior to the intervention, with 27 respondents (90 percent), and after the intervention, with 26 respondents (86.7%) in the mild category. The Wilcoxon signed-rank test, which has a p-value of 0.000 (0.05), is used in statistical tests. These results demonstrate that lemon aromatherapy reduces the frequency of nausea and vomiting in pregnant women in their first trimester at TPMB Titin Prihartini, S.ST., Bd in 2024. Lemon aromatherapy can help alleviate nausea and vomiting in pregnant women who are in the first trimester of their pregnancy.

Pengaruh Pemberian Minuman Jahe Terhadap Penurunan Hiperemesis Gravidarum Pada Ibu Hamil Trimester 1 di Klinik Pratama Keluarga Sehat

Hyperemesis gravidarum is excessive nausea and vomiting in pregnant women that can interfere with maternal and fetal health. Ginger has long been used as a traditional medicine to treat nausea and vomiting. This study aims to determine the effect of giving ginger drink on reducing hyperemesis gravidarum in first trimester pregnant women.This research plan uses experimental method (pre-experiment), with one group pretest posttes design. The population in this study were 11 first trimester pregnant women who experienced hyperemesis gravidarum at the Keluarga Sehat Private Clinic. Data were collected using a questionnaire to measure the frequency of nausea and vomiting and observation to measure the severity of hyperemesis gravidarum. The results showed that from the data analysis using the t-test, it was found that t count t table, namely 4.183 2.228 and based on significance, it was found that the significance value was 0.05, namely 0.02, so ho was rejected and ha was accepted, meaning that there was an influence between the implementation of ginger drink in reducing hyperemesis gravidarum in 1st trimester pregnant women. There is a decrease in hyperemesis gravidaraum after being given ginger drinks, there is an effect of giving ginger drinks on reducing hyperemesis gravidarum in pregnant women in the first trimester at the Keluarga Sehat Private Clinic. (p value = 0.00).

Pengaruh Kombinasi Aromaterapi Lemon dan Air Jahe pada Emesis Gravidarum

Emesis gravidarum is common problem experienced by 50-90% of pregnant women, and 2% of these cases into hyperemesis gravidarum. One of the safe solutions to nausea and vomiting of pregnant women with non-pharmacological therapy of lemon aromatherapy and ginger drink. This study aims to test the effectiveness of a combination of lemon aromatherapy and ginger drink to reduce nausea and vomiting in pregnant women. This research method used quasy experiment, pre-post test control group design. Population was pregnant women at TPMB in Songgon District who experienced nausea and vomiting. This study used consecutive sampling inclusion criteria, 20 people for the treatment group and 20 people in the control group. Data analysis used the Wilcoxon Sign Rank Test. Before the intervention, the frequency of nausea and vomiting in the study subjects was high. However, after treatment, there was decrease in the frequency of nausea and vomiting. The results of data analysis show a value of P = 0.000, which states that P &lt; 0.05, meaning that there is an effect of giving a combination of lemon aromatherapy and ginger drink on reducing emesis gravidarum in TPMB in the Songgon Banyuwangi sub-district area in 2021. Health workers can use non-pharmacological alternative therapy in the form of combination of lemon aromatherapy and ginger drink as a step to reduce and overcome symptoms of nausea and vomiting. In addition, there is an opportunity to conduct research as one of the safe solutions to overcome nausea and vomiting of pregnant women with other complementary therapies.

Gastrogastric Intussusception 10 Years After Laparoscopic Gastric Greater Curvature Plication: a Case Report

The use of a nonadjustable silicone band around the gastric pouch of Rouxen-Y gastric bypass (RYGB) to reduce the recurrence of obesity is still being debated in the literature. The primary objective of this study was to evaluate banded and non-banded RYGB regarding % total weight loss (%TWL) and complications up to 10years postoperatively and regarding the removal rate of the silicone band. A retrospective study of the medical records of all patients submitted to banded and non-banded RYGB between 2000 and 2020 was conducted. Clinical data (age, gender, weight, body mass index-BMI, comorbidities, %TWL, and the prevalence of vomiting) and laboratory data (hemoglobin, serum iron, albumin, and vitamin B12) were obtained preoperatively and at six months, 1, 2, 3, 5, 7, and 10years for both groups and at 12, 15, and 20years after banded RYGB. In total, 858 patients underwent RYGB: 409 underwent banded RYGB and 449 underwent non-banded RYGB. In the preoperative period, banded RYGB patients were heavier and had higher rates of hypertension and dyslipidemia. The %TWL was higher in the banded RYGB group up to 7years. The prevalence of vomiting is much higher in this group, which also had lower laboratory test values. Of the banded RYGB patients, 9.53% had to have the silicone ring removed after presenting complications. Banded RYGB promotes significantly higher rates of TWL at the expense of a higher frequency of vomiting.

Effect of comfortable nursing on postoperative nausea and vomiting in patients with idiopathic scoliosis after posterior orthopedic surgery.

To evaluate the effect of comfort nursing on postoperative nausea and vomiting in patients with idiopathic scoliosis undergoing posterior correction surgery. 92 patients with idiopathic scoliosis were taken as the subjects and segmented into a control group and an experimental group (n = 46/each group). The former received routine care, while the latter one performed comfortable care. The observation period is 48 h after surgery. Record and compare the incidence, grade, frequency, and pain level of nausea and vomiting in both groups, as well as postoperative physical signs and symptoms, drug use, and postoperative recovery. Investigating the patient's satisfaction with nursing care. The research data is analyzed using SPSS26.0 software. P < 0.05 means statistical significance. Within 48 h after surgery, the number of nausea and vomiting in the control is 24 and the experimental group is 8, with an incidence rate of 52% and 16%. The latter is significantly lower than that in the control. The average number of nausea and vomiting episodes in the control is 2.5, significantly higher than the 0.45 episodes in the experimental set. There is a significant difference in the frequency of nausea and vomiting/temperature and urine volume/scores of nausea, vomiting, dizziness, headache, decreased appetite, and discomfort between the two groups (P < 0.05). Comfortable care has a relieving effect on postoperative nausea and vomiting in patients with idiopathic scoliosis after posterior correction surgery. It can low down the incidence and frequency of nausea and vomiting, and reduce the score of related symptoms. Comfortable care can also help patients recover after surgery, increase dietary intake, and improve nutritional status. Comfortable care has a significant effect on postoperative nausea and vomiting in cases with idiopathic scoliosis undergoing posterior correction surgery, which can improve their postoperative recovery and quality of life.

The Sensitivity Pattern of Uropathogens towards Oral Antibiotics among Children with Urinary Tract Infection

Background: Urinary tract infection (UTI) is common in paediatric age group. Because of extensive and injudicious use of oral antibiotics, uropathogens show increasing resistance to these drugs. The objective of the study was to identify the susceptibility pattern of uropathogens towards oral antibiotics among children suffering from UTI who were admitted to the paediatric ward at Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet. Materials and methods: This cross-sectional study was carried out among 100 children aged 2 months to 12 years, who had a confirmed diagnosis of UTI based on urine culture reports and was admitted to the paediatric department of Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet. The study period was 1st January 2018 to 31st December 2019. Results: The mean age of the patients was 46.48±38.58 months. Males were 34% and females were 66% and the male-female ratio was 1:1.9. The common presenting complaints of UTI cases were fever (67%), dysuria or crying during micturition (53%), abdominal pain (42%), an increased frequency of micturition (30%), and nausea and vomiting (26%). The most common isolated organism was E. coli (61%), followed by Klebsiella species (31%). Nitrofurantoin was the drug that the isolated organisms were most sensitive to, followed by levofloxacin and ciprofloxacin. The isolated organisms were highly resistant to cephalexin, amoxicillin, cephradine, cefaclor, cefixime, azithromycin, and co-trimoxazole. Conclusion: Uropathogens are mostly sensitive to nitrofurantoin, levofloxacin, and ciprofloxacin. These drugs may be used to empirically treat UTI in children, if necessary. Judicial antibiotic use should be practised to prevent the development of antibiotic resistance.

EFEKTIVITAS PEMBERIAN KAPULAGA JAHE DALAM MENGURANGI FREKUENSI MUAL MUNTAH PADA IBU HAMIL TRIMESTER PERTAMA DI DESA SUKA RAYA

Nausea and vomiting are most common in the first trimester of pregnancy, but about 12% of pregnant women continue to experience them up to 9 months. Nausea and vomiting are part of the normal spectrum of pregnancy, hyperemesis is considered an extreme condition. This study aims to evaluate the effect of Kajah ( Cardamom-Ginger) Pudding on reducing the frequency of nausea and vomiting in first trimester pregnant women. This study used a quasi-experimental design with a pretest-posttest approach on 10 pregnant women who experienced nausea and vomiting. The respondents were divided into two groups: an intervention group that received Kajah pudding and a control group that did not receive the intervention. The results showed that consumption of Kajah pudding significantly reduced the frequency of nausea and vomiting in first trimester pregnant women compared to the control group (p &lt; 0.05). Kajah pudding may be an effective natural alternative in overcoming nausea and vomiting during the first trimester of pregnancy.

Pengaruh Akupresure Pericardium 6 Terhadap Mual Muntah Pada Pasien Kanker Serviks Post Kemoterapi

Cervical cancer is a type of cancer that attacks the cervix in women and can be treated with chemotherapy. One of the side effects of chemotherapy is nausea and vomiting. Nausea and vomiting can be treated by administering Acupressure Pericardium 6. This study aimed to determine the effect of administering Acupressure Pericardium 6 on nausea and vomiting in post-chemotherapy cervical cancer patients. This type of research is quantitative, using a quasi-experimental pre-test and post-test one-group design. The study employed purposive sampling with 47 respondents, utilizing the INVR index measuring instrument. The results of the analysis showed that the majority were elderly, aged 46–65 years (70.2%), elementary school education level (42.6%), non-working employment status (61.7%), type of chemotherapy drug carboplatin (19.1%), and stage III cervical cancer (42.6%). Before receiving the acupressure pericardium intervention, post-chemotherapy patients experienced 6 frequencies of moderate nausea and vomiting (46.8%), and after the intervention, they experienced 6 frequencies of mild nausea and vomiting (44.7%). After that, a statistical test was carried out using the Wilcoxon test, obtaining a p-value of 0.000 or ≤ 0.05. In conclusion, pericardium 6 acupressure has an effect on nausea and vomiting in post-chemotherapy cervical cancer patients. Future researchers should develop variables and pay more attention to the timing of administering Pericardium 6 acupressure to ensure optimal results.

Long-term Comparative Evaluation of Weight Loss and Complications of Banded and Non-banded Roux-en-Y Gastric Bypass.

The use of a nonadjustable silicone band around the gastric pouch of Roux-en-Y gastric bypass (RYGB) to reduce the recurrence of obesity is still being debated in the literature. The primary objective of this study was to evaluate banded and non-banded RYGB regarding % total weight loss (%TWL) and complications up to 10years postoperatively and regarding the removal rate of the silicone band. A retrospective study of the medical records of all patients submitted to banded and non-banded RYGB between 2000 and 2020 was conducted. Clinical data (age, gender, weight, body mass index-BMI, comorbidities, %TWL, and the prevalence of vomiting) and laboratory data (hemoglobin, serum iron, albumin, and vitamin B12) were obtained preoperatively and at 6months, 1, 2, 3, 5, 7, and 10years for both groups and at 12, 15, and 20years after banded RYGB. In total, 858 patients underwent RYGB: 409 underwent banded RYGB and 449 underwent non-banded RYGB. In the preoperative period, banded RYGB patients were heavier and had higher rates of hypertension and dyslipidemia. The %TWL was higher in the banded RYGB group up to 7years. The prevalence of vomiting is much higher in this group, which also had lower laboratory test values. Of the banded RYGB patients, 9.53% had to have the silicone ring removed after presenting complications. Banded RYGB promotes significantly higher rates of TWL at the expense of a higher frequency of food intolerance and vomiting.

Assessment of the potential interactions between favipiravir and radiocontrast agents

BACKGROUND In cases of coronavirus disease 2019 (COVID-19), favipiravir is commonly included to the therapy regimen. Drug interactions between favipiravir and other COVID-19 therapy drugs are frequently researched. However, no research on possible drug interactions between Favipiravir and radiocontrast agents, which have become almost crucial in diagnostic processes while not being part of the treatment, has been found. AIM To determine potential medication interactions between Favipiravir and radiocontrast agents. METHODS The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) test while taking the medicine. The computerized patient files of the cases included in the study, as well as the pharmacovigilance forms in the designated hospital, were evaluated for this purpose. RESULTS The study included the evaluation of data from 1046 patients. The study sample's mean age was 47.23 ± 9.48 years. The mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions (P = 0.003). When evaluated with logistic regression analysis, a 1-year raises in age increases the risk of developing drug interactions by 1.63 times (P = 0.023). There was no statistically significant difference in the occurrence of medication interactions between the sexes (P = 0.090). Possible medication interactions were discovered in 42 cases (4%). CONCLUSION The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values, as well as an increase in the frequency of nausea and vomiting. The majority of drug interactions discovered were modest enough that they were not reflected in the clinic. Drug interactions become more common as people get older.

Effects of neuraxial anesthesia in sitting and lateral positions on maternal hemodynamics in cesarean section: A systematic review and meta-analysis.

During cesarean section, hypotension is a frequent side effect of spinal anesthesia. As a sitting or lateral position is required for spinal anesthesia performance, which of these two positions is more likely to cause intraoperative nausea, vomiting, and hypotension is still unknown. This meta-analysis compared the effects of these two positions on maternal hemodynamics and intraoperative nausea and vomiting. Systematic review and meta-analysis. Operating room. This study included 803 patients from 12 randomized controlled trials (RCTs). Neuraxial anesthesia in sitting position vs. lateral position. We chose RCTs comparing the effects of spinal anesthesia in the sitting and lateral positions on maternal hemodynamics by thoroughly searching PubMed, Embase, the Cochrane Library, and the Web of Science for articles published from database inception until October 31, 2022. The Cochrane Handbook was used to assess the methodological quality of each RCT; the results were analyzed using RevMan 5.4 software; and the Egger test was used to assess publication bias. 12 randomised controlled trials with 803 participants were ultimately included in the final analysis. No significant differences were observed between the two positions in terms of the incidence of hypotension(RR, 0.82; 95% CI, 0.58-1.16; P = 0.26; I2 = 66%), lowest systolic blood pressure(MD, -0.81; 95% CI, -7.38-5.75; P = 0.81; I2 = 86%), the dose of ephedrine(MD, -1.19; 95% CI, -4.91-2.52; P = 0.53; I2 = 83%), and number of parturients requiring ephedrine(RR, 0.97; 95% CI, 0.64-1.46; P = 0.88; I2 = 74%). For the incidence of intraoperative nausea and vomiting, there was no statistical difference between the two positions. Parturients undergoing elective cesarean section under spinal anesthesia in the sitting or lateral position experienced similar incidence of hypotension, and there were no significant differences between these two positions in terms of the amount of ephedrine administered or the number of patients needing ephedrine. In both positions, the frequency of nausea and vomiting was comparable. The ideal position for anesthesia can be chosen based on the preferences and individual circumstances of the parturient and anesthesiologist.

Molecular and Entomological Characterization of 2023 Dengue Outbreak in Dhading District, Central Nepal.

In 2023, Nepal faced its second largest dengue outbreak ever, following a record-breaking number of dengue cases in 2022, characterized by the expansion of infections into areas of higher altitudes. However, the characteristics of the 2023 circulating dengue virus (DENV) and the vector density remain poorly understood. Therefore, we performed DENV serotyping, clinical and laboratory assessment, and entomological analysis of the 2023 outbreak in central Nepal. A total of 396 fever cases in Dhading hospital suspected of being DENV positive were enrolled, and blood samples were collected and tested by different techniques including PCR. Of these, 278 (70.2%) had confirmed DENV infection. Multiple serotypes (DENV-1, -2, and -3) were detected. DENV-2 (97.5%) re-emerged after six years in Dhading while DENV-3 was identified for the first time. Dengue inpatients had significantly higher frequency of anorexia, myalgia, rash, diarrhea, nausea, vomiting, abdominal pain, and thrombocytopenia (p < 0.05). In this area, Aedes mosquitoes largely predominated (90.7%) with the majority being A. aegypti (60.7%). We also found high levels of Aedes index (20.0%) and container index (16.7%). We confirmed multiple DENV serotype circulation with serotype re-emergence and new serotype introduction, and high vector density in 2023. These findings call for the urgent initiation and scaling up of DENV molecular surveillance in human and mosquito populations for dengue control and prevention in Nepal.

Eating Disorder Symptomatology Among Young Adult Cigarette and E-Cigarette Users

Objective: Tobacco use is elevated among individuals with eating disorders (EDs). Yet, further research is needed to understand associations between cigarette and e-cigarette use patterns and ED symptomatology. To gain a more comprehensive understanding of tobacco use and EDs, this study characterized ED symptomatology and tobacco use patterns, including exclusive cigarette use, e-cigarette use, dual use, and nonuse. Method: Young adults aged 18-24 years who self-reported exclusive cigarette, e-cigarette, dual, or nonuse (N = 2500) were recruited via Lucid, an online survey management company. Participants completed questionnaires assessing body dissatisfaction, global ED psychopathology, binge eating and self-induced vomiting frequency, and demographics. ED diagnostic groups included: anorexia nervosa (AN), bulimia spectrum eating disorders (BSED), atypical AN, and night eating syndrome (NES). Results: Multinomial logistic models revealed those with AN were more likely to be dual users, those with atypical AN were more likely to be exclusive e-cigarette users, and participants with a BSED or NES were more likely to be exclusive e-cigarette or dual users, compared to those without an ED. General linear models suggested body dissatisfaction and global ED psychopathology were higher among exclusive e-cigarette and dual users, while binge eating and self-induced vomiting frequencies were greater among all tobacco use groups compared to nonusers. Discussion: Our findings suggest young adults with ED symptomatology were more likely to be users of e-cigarettes exclusively or dual users. It will be necessary to examine how these associations manifest using longitudinal and clinical populations in future research.

Are There Any Advantages of the Low Opioid Anaesthesia and Non-Opioid Postoperative Analgesia Protocol: A Clinical Observational Study.

The methods of perioperative analgesia and pain control have changed. The principle of opioid-based analgesia has been modified to multimodal analgesia, followed by LOA (low opioid anaesthesia) and OFA (opioid-free anaesthesia). The aim was to describe the effects of LOA on nausea, vomiting, and pain control during general anaesthesia and postoperative period after laparoscopic cholecystectomy. The protocol included the study group-40 patients received low-opioid anaesthesia (LOA), and the control group-40 patients received general anaesthesia with opioid analgesia (OA). The scheme of LOA was based on ketamine, lidocaine, magnesium sulfate, paracetamol, and metamizole. The OA was based on standard opioid (fentanyl) administration in induction and maintenance phase due to clinical observation. Postoperative analgesia included 1g of paracetamol and 1g of metamizol intravenously, with a 6-hour interval between doses. Significant differences in the pain score in the periods of 2-6, 6-12, and 12-24 hours after anaesthesia between the groups were noticed (p < 0.001). Moreover, a significant difference in the frequency of nausea (p = 0.005) and vomiting (p = 0.04) between groups were presented. Nausea occurred in 54.05% of OA group, while in the LOA group, it occurred in a 23.08%. Vomiting occurred in 32.43% of control group, while in the study group, it occurred in 12.82% of patients. The LOA protocol was more beneficial in reducing nausea and vomiting than the opioid-based method of anaesthesia. The LOA protocol of general anaesthesia during laparoscopic cholecystectomy and non-opioid postoperative analgesia have better outcomes in pain control, as well as nausea and vomiting, and improve postoperative patient comfort. The LOA protocol during anaesthesia and non-opioid postoperative analgesia should be considered in routine practice.

The Influence of the Combination of Acupressure on the Meridian Point P6 and Peppermint Aromatherapy Inhalation on the Reduction of Nausea and Vomiting Frequency in First-Trimester Pregnant Women

Nausea and vomiting disorders during pregnancy, particularly in the first trimester, often impact the quality of life for pregnant women, with 50-90% of cases occurring during this period. Besides affecting maternal health, these disorders also influence fetal growth and development. Management can be achieved through pharmacological and non-pharmacological methods, including the combination of acupressure at Meridian Point P6 and inhalation of peppermint aromatherapy.This research aims to evaluate the impact of this combination on reducing the frequency of nausea and vomiting in first-trimester pregnant women at RSHM Yusuf Kalibalangan in North Lampung. Utilizing a quasi-experimental method, involving 12 first-trimester pregnant women experiencing nausea and vomiting at the mentioned hospital, the study results demonstrate that the combination of acupressure and peppermint aromatherapy significantly reduces the frequency of these symptoms. Statistical analysis using the paired t-test yields a p-value of 0.012. In conclusion, this combination proves effective in addressing nausea and vomiting issues in first-trimester pregnant women at RSHM Yusuf Kalibalangan in North Lampung, offering new insights into non-pharmacological options for improving the well-being of pregnant women.