Single-blind Comparative Study Research Articles

A Comparative Randomized Cross-Over Trial to Examine Efficacy of Urine Capture and Comfort of Two Male External Urine Collection Devices in Healthy Male Volunteers.

This study assessed the efficiency of urine collection using external urine collection devices over two voids in a group of morbidly obese and non-obese men. Prospective single-blind comparative crossover study. We assessed the comparative urine capture efficiency of two commercially available male external urine management systems. Continent consenting men were randomized to use each device for a single void. The proportion of urine captured by each device expressed as a percentage of the total volume voided in grams was calculated and compared. Results were compared between morbidly obese (BMI≥40 kg/m2) and non-morbidity (BMI≤40 kg/m2) men. Fifty-nine men completed the study; their mean (standard deviation, SD) age was 40.8 (SD 12.4) years. For void 1, the mean proportion of urine capture for Device A was 97.8% (SD 10.0); for Device B it was 90.7% (SD 20.7). For void 2, the mean proportion of urine capture for Device A was 91.1% (SD 25.8); for Device B it was 85.2% (SD 21.7). The mean difference between devices was 6.6% (95% CI 0.18, 13.0), P =.044. Stratified by weight, in the morbidly obese men, Device A captured 99.7% (SD 0.88) of the first void versus 83.5% (SD 32.2) for Device B. Analysis of the second voids found that Device A captured 80.8% (SD 36.9) versus 79.3% (SD 23.3) for Device B. Device A (the investigational device) performed significantly better than Device B in capture rates when compared based on voided volume, order of void, or BMI category. Device A male external catheter system is an effective option for urine management in both obese and non-obese men.

Effectiveness of Family-Professional Collaboration on Functional Goals Achievement of Children with Cerebral Palsy and Caregivers' Quality of Life and Burden: A Randomized Comparative Study.

Background: Family-professional collaboration is important to enhance the outcomes for children with cerebral palsy and their caregivers. Aims: This study examined the effect of implementing a family-professional collaboration practice model on children with cerebral palsy and their caregivers. Materials and methods: A randomized, single-blind comparative study included 28 physical therapists, 44 children with cerebral palsy between the ages of 2 and 12 years old, and their caregivers. Physical therapists in the experimental group received training in how to implement collaboration in their therapy sessions over the course of two sessions (3 h each). The children's achievement goal-range rate was measured using the Goal Attainment Scaling, the caregivers' quality of life was assessed using the World Health Organization Quality of Life-Brief, and the caregiver burden was evaluated using the Zarit Burden Interview. Results: All children showed improvement on the Goal Attainment Scaling change rate (p = 0.002), with no significant differences between groups (p < 0.44). However, a group × time interaction was observed. The Children Goal Attainment Scaling rate decreased between the two assessment sessions for children in the control group, while the Goal Attainment Scaling change rate was steady for the experimental group. There were no main effects of time and group or interaction of time × group reported on World Health Organization Quality of Life-Brief domains and no main effect of time on the Zarit Burden Interview, but there was a main effect between groups (p = 0.03), with partial eta square = 0.11 in favor of the experimental group. Conclusions: The family-professional collaboration practice model could be a potential practice to positively improve the outcomes in children with cerebral palsy and their caregivers.

Orbital doppler ultrasound as an ancillary test for diagnosing brain death: A prospective, single blind comparative study

ObjectiveTranscranial Doppler ultrasound (TDUS), computed tomography angiography (CTA), and transcranial Doppler ultrasound to detect cerebral blood flow are among the adjunctive tests in diagnosing brain death. This study aimed to investigate the effectiveness of orbital doppler ultrasound (ODUS). MethodsThis prospective, single-blind study included 66 patients for whom brain death was to be diagnosed. Primary outcome measures were ODUS measurements, Ophthalmic artery peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive indices (RI) measurements recorded during the brain death determination process. Secondary outcome measures were computed tomography angio (CTA), transcranial Doppler ultrasound (TDUS), and demographic data. ResultsThis study investigating the effectiveness of ODUS in diagnosing brain death provided diagnostic success with 100% sensitivity and 93% specificity compared to CT angiography. It was noted that anatomical variations may limit its use. ConclusionODUS was found to have high sensitivity and specificity in the diagnosis of clinical brain death. It may assist in early prognostic assessment and shorten patient follow-up and diagnostic processes.

Is intramedullary nailing of femoral diaphyseal fractures in the lateral decubitus position as safe and effective as on a traction table?

ObjectivesThe aim of this study was to compare the radiological and clinical results of femoral diaphyseal fractures operated in the lateral decubitus position with those operated in the supine position on a traction table and to detail the perioperative surgical technique. Patients and methodsBetween October 2018 and January 2022, in this prospective, randomized, and single-blind comparative study, 75 patients diagnosed with adult femoral diaphyseal fractures to whom intramedullary nails were applied were operated in the lateral decubitus position without a traction table (Group 1, 37 patients) and in the supine position with a traction table (Group 2, 38 patients). Preoperative age, gender, fracture mechanism, fracture type, and surgical waiting times were determined. Perioperative anesthesia type, surgery preparation time, surgical time, number of fluoroscopy doses, amount of bleeding, and type of reduction were evaluated, and detailed observational descriptions of the surgical techniques were made. In the postoperative period, radiological evaluations were made with x-ray radiography and orthoroentgenogram, while in the clinical evaluation, hip–knee joint range of motion and rotational evaluation were made with the Craigs test. Follow-up periods were determined and complications noted. ResultsThe average age was 32 in Group 1 and 28 in Group 2, the female/male ratio was 1:36 in Group 1 and 5:33 in Group 2, and the follow-up period was 18.2 months Group 1 and 21.7 months in Group 2. No significant difference was detected between the groups in terms of age, gender, fracture mechanism, fracture type, anesthesia type, surgical waiting time, and follow-up period (p > 0.05). Compared to Group 2, the shorter preparation time, surgical time, and number of fluoroscopy doses in Group 1 were found to be statistically significant (p < 0.05). The differences in the amount of bleeding and need for open reduction were not statistically significant between the groups (p > 0.05), and no statistical difference was found in joint range of motion and rotational evaluation in clinical evaluation in both groups (p > 0.05). There was no significant difference in terms of complications between groups. ConclusionsWe found the lateral decubitus method without a traction table to be a safe and effective alternative to the supine method with a traction table in terms of the radiological and clinical results and that it also has the advantages of shortening the surgical time, reducing radiation exposure. Level of evidenceLevel 1 prospective, randomized, single-blind controlled study

A Study on Paradiguna (Samskara) W.S.R to “Samaskarohi Gunantaradhanam Uchyate” and ITS Applied Aspect in the Management of Mukhadushika with an Indiginous Drug

Introduction: Acharya Charaka has clearly said that if one does not understand these Paradi Guna in proper way then he cannot perform Chikitsa in desire manner. Paradi Gunas are the one in which a physician needs to be expertise. Paradigunas are necessary in the field of pharmaceutical science, as well as by the physicians to treat the patients and researchers conducting research and creating new formulation. Samskara Guna is one of the important factors in the hands of Ayurvedic physician for improving other third padas of Bhesaja (i.e., Bahuta, Yogyatwa, and Sampat). Thus in this study, an attempt was made to know the comparative effect of Manjistha Lepa and Samskrita Manjistha with Madhu Lepa in the management of Mukhadushika. Aims and Objectives: The aim of the study was to study about the comparative clinical efficacy of Manjistha Lepa and triturated with Madhu Lepa in the management of Mukhadushika. Materials and Methods: This is a single-blind comparative clinical study with a pre-test and post-test design. The patients were randomly categorized into two groups. Forty patients of Group A (20) and Group B (20) patients were registered from outpatient department of Government Ayurvedic College and Hospital, Balangir, and Saradeswari Government Hospital, Balangir, presented with subjective parameters and objective parameters. After diagnosis, they were under trial with Ayurvedic formulations of Manjistha Lepa for local application and Manjistha triturated Madhu Lepa given 05 g in morning time daily, after drying face wash with normal water for 15 days, respectively. The subjective and objective parameters were assessed in 7-day interval to interpret the result by statistical evaluation. Observation and Results: It had been observed that the result of trial drug Group B patients was significant (&lt;0.05) to reduce both subjective and objective parameters after 15 days of treatment as compared to Group A patients. In Group A, NO patients had marked improvement, while 15% of patients had moderate improvement, 65% mildly improved and 20% had shown unsatisfactory result. In Group B, no patients had marked improvement, 50% moderate, 40% mildly improved, and 10% of patients showed unsatisfactory results. In both groups, the result was statistically significant, but more improvement was noticed in Group B. Conclusion: On comparison between two groups, Manjistha triturated with Madhu Lepa in Group B had shown more effect than Manjistha Lepa in Group A. No adverse effects were noticed during clinical trial in both groups.

A systematic review of the efficacy, safety and satisfaction of regenerative medicine treatments, including platelet-rich plasma, stromal vascular fraction and stem cell-conditioned medium for hypertrophic scars and keloids.

The primary objective of this study is to examine the efficiency of various regenerative medicine approaches, such as platelet-rich plasma, cell therapy, stromal vascular fraction, exosomes and stem cell-conditioned medium, in the process of healing hypertrophic and keloid scars. Major databases including PubMed, Scopus and Web of Science were systematically searched, and based on the content of the articles and the inclusion and exclusion criteria, eight articles were selected. Out of these eight articles, there were two non-randomized clinical trial studies (25%), one randomized, single-blinded comparative study (12.5%), one retrospective clinical observational study (12.5%) and four randomized clinical trial studies (50%). We employed EndNote X8 and Google Sheets to conduct article reviews and extract relevant data. Following the review phase, the studies underwent analysis and categorization. In all eight reviewed studies, the effectiveness of regenerative medicine in treating hypertrophic scars and keloids has been proven. Out of these studies, five (62.5%) focused on the effectiveness of platelet-rich plasma, two study (25%) examined the effectiveness of stromal vascular fraction and one study (12.5%) explored the efficacy of stem cell-conditioned medium. In two studies (25%), the treatment methods were added to standard treatment, while in six studies (75%), regenerative medicine was used as the sole treatment method and compared with standard treatment. The use of these treatment methods did not result in any serious side effects for the patients. Regenerative medicine is an effective method with minimal side effects for the treatment of hypertrophic scars and keloids. It can be used as a monotherapy or in combination with other treatment methods. However, further studies are needed to thoroughly evaluate the effectiveness of all sub-branches of this method.

Randomized trial of shunt infection rates comparing intraoperative Vancomycin versus Gentamicin in ventriculoperitoneal shunt system preparation

BackgroundVentriculoperitoneal (VP) shunt is the mainstay of surgical management of patients with hydrocephalus. The insertion of ventriculoperitoneal shunt may be accompanied by many potentially life-threatening complications including shunt infection. Concerted efforts have been made to reduce shunt infection rates, including use of saline- antibiotic solutions containing antibiotics such as Gentamicin, mixture of Gentamicin and Vancomycin in shunt system preparation. We therefore set out to determine the infection rates following the use of intraoperative Gentamicin and Vancomycin in ventriculoperitoneal shunt system preparation and compare the infection rates. Therefore, a randomized single blind comparative study was carried out for a period of seventeen months, among 56 patients that presented to 2 tertiary health centers in Nigeria diagnosed of hydrocephalus. Patients were randomized into Vancomycin- and Gentamicin-shunt preparation groups. The outcome measure was postoperative shunt infection rates. Statistical analysis was performed using SPSS software (version) 21. Group comparisons were made using the Student's t-test for numerical variables, and chi-square test or fisher’s exact test for categorical variables. Statistical significance was inferred at p-value < 0.05.ResultFifty-six patients were included in the study. One patient was lost to follow-up in Vancomycin group. Another patient died in Gentamicin group of sudden death without the patient exhibiting symptoms of shunt infection leaving a total of 54 for analysis. All the patients included in the study were followed up for six months. Their mean ages were between 1688.5 ± 665.3 (days) for Vancomycin group and 10,222 ± 6635.8 (days) for Gentamicin group. There was male preponderance of 55.6% as against female of 44.4%. Majority of the hydrocephalus were of congenital cause accounting for 64.8%. There was one shunt infection in the Gentamicin group giving rise to an infection rate of 1.9% which was not statistically significant (P –value—0.313). The organism isolated was Pseudomonas species.ConclusionVentriculoperitoneal shunt infection rates can be reduced to the barest minimum if standard concentration of antibiotics is used to prepare the shunt hardware employing a standard surgical technique.

Evaluating the Impact of a Cream Containing Horse Placental Extract on Eye Corner Wrinkles in Healthy Women: Single-Blind Comparative Study.

Placental extract has been mostly used in skin care for cosmetic purposes. However, the use of various placental extracts has been limited due to the lack of established and effective application methods. In this study, we investigated the antiwrinkle effect of a cream formulation-LNC wrinkle eye cream (LNC-EC)-containing horse placental extract as the main ingredient. A total of 24 healthy women, aged 37-54 years, with wrinkle grades 1-3, were treated with LNC-EC for 2 weeks. The cream was applied on one-half of the participants' faces, and the results were compared with the untreated half of the face. Visual inspection, using the wrinkle grade standard, showed that the area treated with LNC-EC had a significantly lower wrinkle grade than the untreated area when comparing before and after the application of LNC-EC. In addition, replica analysis showed a significant reduction in both the maximum wrinkle width and the number of wrinkles in the LNC-EC-treated area in comparison to the untreated area before and after the application. These results suggest that LNC-EC has an antiwrinkle effect on the corners of the eyes based on parameters like the maximum wrinkle width and the number of wrinkles. LNC-EC, with horse placental extract as its main ingredient, was shown to be effective in improving wrinkles at the eye corners, presumably due to a reduction in the maximum wrinkle width and the number of wrinkles. Interpretation of the results is limited because this study was conducted only in the intervention group. A randomized controlled trial with a placebo control group is necessary to verify the antiwrinkle effects of horse placental extract.

A randomized controlled clinical study to evaluate the efficacy of Gomutra Triphala Vati in the management of Sthoulya

Background: Sthoulya is considered as one of the Kaphaja Nanatmaja Vyadhi. Overweight and Obesity are defined as an abnormal, excessive fat accumulation that may impair health. The aim of the study was to assess the efficacy of the two Ayurvedic formulations, Gomutra Triphala Vati which is one of the unexplored Aushadha yoga explained in Vangasena Samhita, Medorogaadhikaara and Navaka Guggulu explained in Chakradatta, Sthoulya Chikitsa in the management of Sthoulya. (Overweight and Class One Obesity). Materials and Methods: 60 patients fulfilling the Diagnostic and Inclusion criteria were selected for a Single Blind Comparative study. They were randomly allocated into 2 equal groups A &amp; B. Group A and Group B subjects received Gomutra Triphala Vati and Navaka Guggulu in a dosage of 500mg, two tablets, twice daily, after food with Ushna Jala (Warm water) for 45 days, respectively. Assessment was done at baseline i.e.; 0th day, 16th day, 31st day, after treatment on 46th day and after follow up on 61st day. Results: While comparing both the drugs clinically, Gomutra Triphala Vati and Navaka Guggulu showed effective results in Sthoulya. On statistical comparison within the groups, both the groups showed significant effect (P&lt;0.05) in Atinidra, Alpavyayama, Alasya, Body weight, BMI, Circumferences of Midarm, Waist, Chest, Hip and Thigh. Conclusion: On statistical comparison between the two groups there is no significant difference in the effect of both Gomutra Triphala Vati and Navaka Guggulu. Thus, H1 is rejected and H0 is accepted.

A randomized single-blinded comparative experimental study to test the influence of timing of intravenous fluid therapy on maternal hemodynamics during lower segmental caesarean section under spinal anaesthesia

: Spinal anaesthesia-induced hypotension can be prevented by several techniques and methodologies, which is very important as the life of the mother and fetus is at risk. This study compared the efficacy of crystalloid administration 6 hours and half an hour before spinal anaesthesia on reducing hypotension.: After obtaining informed consent, 110 ASA 2 patients aged between 20 and 40 were scheduled for elective lower segmental caesarean section under spinal anaesthesia. Patients were randomly allocated into two groups. Group 1: Participants were kept nil per oral overnight, and Ringer's lactate was administered over half an hour before surgery. Group 2: participants were given ringer lactate. The amount was based upon the Holiday Segar formula (first 10 kg received 4ml/kg, 10-20 kg- 2ml/kg and remaining received 1 ml/kg) and given steadily over half an hour and 6 hours respectively in both groups. The incidence of hypotension and the need for rescue vasopressor in the two groups was recorded.: The two groups were statistically comparable in terms of age, height and weight. The incidence of Hypotension in Group 1 was 12.7%, and in Group 2 was 25%, which was statistically insignificant. Seven out of 55 patients in Group 1 had SBP&amp;#60;20% from baseline, whereas in Group 2, 14 patients out of 55 patients had SBP &amp;#60;20% from baseline, which was statistically insignificant. The incidence of ephedrine usage was statistically insignificant in both groups.: This study's results showed no statistically significant difference in preventing hypotension whether the fluids were given as 6 hours or half an hour before surgery. Therefore, to deliver preload of fluid, it is unnecessary to delay surgery.

Post-Intravitreal injection pain reduction using topical NSAIDS: A comparative study.

To compare the efficacy of two different topical non-steroidal anti-inflammatory drugs (NSAIDs) drops with versus without conservatives after intravitreal injections (IVIs). Prospective, randomized, placebo-controlled, single-blinded comparative study. A total of 308 eyes of 252 patients receiving an IVI of anti-vascular endothelial growth factor (anti-VEGF) were randomly assigned to receive either a single drop of nepafenac 0.1%, preservative-free diclofenac 0.1%, or artificial tears (control group) immediately after IVI. Primary outcome measure was pain scores immediately, six hours and twenty-four hours post- injection. 166 patients received one topical drop of NSAIDS, of which 90 in the diclofenac group and 76 in the nepafenac group. Additional 86 patients were included in the control group. Mean reported pain score was significantly lower at six hours after IVI in the preservative-free diclofenac group (17.1 ± 23.0) than in the nepafenac group (26.2 ± 31.9) and the control group (27.5 ± 29.2) (p = 0.03). At twenty-four hours post-injection there was no statistically significant difference between the groups. Patients reported less pain compared to previous IVIs and none referred to urgent health care, but these findings were not statistically significant. The use of topical preservative-free NSAIDs may be superior to preservative- containing NSAIDs in pain relief after IVIs and may be considered as part of the treatment protocol of this population.

Bilateral Superficial Cervical Plexus Block in Thyroid Surgery with Intravenous versus Local Infiltration of Dexamethasone – A Randomized Single Blinded Comparative Study

Background: Post-operative pain for thyroid surgeries under general anaesthesia is inadequately managed. Bilateral superficial cervical plexus block (BSCPB) for thyroid surgery causes adequate analgesia without any significant side effects. Dexamethasone is commonly used in anaesthesia to prevent postoperative nausea and vomiting (PONV). The study objective was comparison of efficacy between add-on Dexamethasone intravenously and Ropivacaine alone in bilateral superficial cervical plexus block versus Dexamethasone added with Ropivacaine in the same block in producing postoperative analgesia and in preventing post-operative nausea vomiting. Methods: Randomized single-blind clinical study was done on eighty patients of 18-60 years of either sex, ASA I and II, scheduled for elective thyroid surgery under general anaesthesia. Patients were divided into two groups (n=40). In bilateral superficial cervical plexus block, Group DB (n=40) had received 20 ml Inj. Ropivacaine (0.25%) and 2ml (8 mg) Inj. Dexamethasone and Group DI (n=40) had received 20ml Inj. Ropivacaine (0.25%) and 2 ml of distilled water, along with 2 ml IV distilled water in DB group and Inj. Dexamethasone 2ml (8 mg) IV in DI group. Time of rescue analgesia with VAS (Visual Analogue Scale) score of that moment and incidence of PONV were noted up to 24 hrs post-operatively. Results: No statistically significant difference was found among the two groups in respect of time of rescue analgesia, VAS score and incidence of PONV. Conclusion: From our study, we conclude that different routes of administration of Inj. Dexamethasone during BSCPB has no extra benefit in respect of postoperative analgesia and incidence of PONV in thyroid surgery.

COMPARISON BETWEEN TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH PROPOFOL – FENTANYL AND BALANCED ANESTHESIA WITH SEVOFLURANE – FENTANYL IN TERMS OF HEMODYNAMIC CHANGES AND RECOVERY PROFILES DURING LAPAROSCOPIC CHOLECYSTECTOMY

Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy. Methods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I &amp; II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile. Results: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p &lt; 0.05). Recovery profiles assessed in terms of time of eye opening (657.89 ± 172.30 s vs 453.58 ± 157.49 s), obeying command (696.79 ± 192.44s vs 481.06±164.96s), and time of extubation (706.41±166.27s vs 483.38±160.62s) were significantly faster in group B (p value &lt; 0.001). Conclusions: Hemodynamic changes were comparable between propofol group and sevoflurane group while sevoflurane group had faster recovery.

TO EVALUATE AND COMPARE THE POSSIBLE ANALGESIC PROPERTIES OF SEVOFLURANE WITH DESFLURANE IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMIES UNDER VOLATILE INDUCTION AND MAINTENANCE ANAESTHESIA (VIMA)

Introduction: Sevourane and desurane have been successfully used in labour analgesia. Need more evidence to prove their analgesic properties, intraoperatively and postoperatively, when used in volatile induction maintenance Anaesthesia (VIMA) for laparoscopic cholecystectomy. So, a randomized study single blinded comparative study was carried out. After obtaining appropriate approvals, 50 Method: consenting patients of either gender were randomly, equally allocated to two groups to be anaesthetized with VIMA, using either sevourane and desurane. Monitoring included, in addition to routine multiparametric monitoring, the depth of anaesthesia monitoring using Conox, qCON/qNOX kept between 40-60. Rest of the anaesthesia technique was similar, inclusive of Inj. Fentanyl, in both the groups. Pain was scored using, visual analogue scale (VAS), just before induction (T0), just after extubation (T1), as shifted to Post Anaesthesia Care Unit (PACU) (T2), and on demand of rescue analgesia/2 hours in PACU, whichever came rst (T3). With achievement of adequate modied Aldrete score, adequate rescue analgesia was administered before shifting to the ward. Demographically, pati Results: ents in both the groups were similar. Except for lowering of mean pulse rate intraoperatively as compared to before induction, the haemodynamic parameters remained steadfastly stable, suggesting, potentiation of fentanyl analgesia with appropriate depth of anaesthesia maintained. VAS scores were consistently lower (1-3), at all the timepoints. Recovery although far superior in the desurane group was also adequate even in sevourane group. In face of low VAS, the rescue analgesia, had to be given pre-emptively before shifting to the ward. It appears that, both the IAAs Conclusion: , seem to have signicant intraoperative and postoperative analgesic efcacy. Desurane has rapid onset of analgesia, starting from time of induction. Amongst themselves the efcacy is similar, but recovery in desurane group appears to be faster than sevourane.

Endoscopic Adenoidectomy with Microdebrider Versus Conventional Adenoidectomy

Background: Adenoidectomy is one of the most common surgical procedures performed in children in Bangladesh. Though conventional curettage is highly popular as it has the advantage of being cost effective and continues to be a commonly used method especially in developing countries but Microdebrider has opened the new horizon in this arena. To compare conventional curettage adenoidectomy and endoscopic-assisted powered adenoidectomy using a microdebrider.&#x0D; Materials and methods: This is randomized single blinded comparative study, which was performed in the Medical Center Hospital, Chattogram from August 2019 to July 2020. A total of 60 patients were randomly divided into two groups. Group I underwent conventional curettage adenoidectomy while Group II underwent endoscopic- assisted powered adenoidectomy. Duration of surgery, amount of intra-operative bleeding, adequateness of removal and damage to the adjacent structures were assessed and compared between two groups. All patients were followed for 12 months. Statistical analysis was done using statistical software package SPSS v 22.0. Data were represented as mean ± SD. Continuous variables were compared using the were using the t test while nonparametric data were compared using Mann-Whitney U test. The c2 test was used to compare the nominal data. A p value &lt;0.05 was considered statistically significant. Ethical directives from the Managing Body of Medical Centre Hospital, Chattogram for this study was obtained.&#x0D; Results: in our study, we observed approximately almost three times more mean blood loss and total operating time in the endoscopic-assisted powered procedure compared to the conventional technique (149 and 56 ml, respectively, 63 and 27 min, respectively). Nine (30%) cases in group I had more than 50% residual adenoid tissue while 20 – 50% of residual adenoid tissue was documented among 7 patients (23%). Postoperative pain was found to be significantly higher in group I compared to group II. In both groups, recovery time ranged from 24-48 hour with a mean of 33.6 hour in group I and 36 hour for group II. 23 patients (77%) in group I presented with residual disease in the 3 months follow up period, where number of patients with the exact instance in group II was 0.&#x0D; Conclusion: Endoscopic assisted adenoidectomy may appear more handy over conventional curettage. But precise peri-operative care and awareness are required to attain the successful outcomes.&#x0D; JCMCTA 2022 ; 33 (1) : 88-92

Randomized single-blind comparative study of the midazolam/pethidine combination and midazolam alone during bronchoscopy

BackgroundBronchoscopy can be a distress for the patient. There have been few studies on the combination of sedatives and opioids. The aim of this study was to demonstrate the usefulness and safety of administration of the combination of midazolam and pethidine during bronchoscopy.MethodsIn this prospective randomized single (patient)-blind study, we randomly assigned 100 patients who were scheduled to undergo bronchoscopy biopsy to receive treatment with either the midazolam/pethidine combination (combination group) or midazolam alone (midazolam group) during examinations. After the end of bronchoscopy, patients completed a questionnaire and the visual analogue scale was measured. The primary outcome was the patients’ acceptance of re-examination assessed by visual analogue scale. We also assessed pain levels, vital signs, midazolam use, xylocaine use, and adverse events. Univariate analyses were performed using Fisher’s exact test for categorical data, and the t-test or Mann-Whitney test was carried out for analysis of numeric data. All P-values were two-sided, and values < 0.05 were considered statistically significant.ResultsWe analyzed 47 patients in the combination group and 49 patients in the midazolam group. The primary outcome was a good trend in the combination group, but not significantly different (3.82 ± 2.3 in combination group versus 4.17 ± 2.75 in midazolam alone, P = 0.400). In the combination group, the visual analog scale score for pain during bronchoscopy was significantly lower (1.10 ± 1.88 versus 2.13 ± 2.42, P = 0.022), and the sedation level score per the modified observer’s assessment of alertness/sedation scale was significantly deeper (3.49 ± 0.98 versus 3.94 ± 1.03, P = 0.031). Maximal systolic blood pressure during testing was significantly lower (162.39 ± 23.45 mmHg versus 178.24 ± 30.24 mmHg, P = 0.005), and the number of additional administrations of midazolam was significantly lower (2.06 ± 1.45 versus 2.63 ± 1.35, P = 0.049). There were also significantly fewer adverse events (30 versus 41, P = 0.036).ConclusionsThe combination uses of midazolam and pethidine for sedation resulted in significant improvements in the pain, blood pressure, additional use of midazolam, and safety during bronchoscopy among patients.Trial registrationThis study was registered in the University Medical Hospital Information Network in Japan (UMINCTR Registration number: UMIN000032230, Registered: 13/April/2018).

A Clinico-Pathological Study on Pleehodaraw.s.r. to Splenomegaly and its Comparative Management with Sarapunkha Ksharaand Sarapunkha Ghana Vati

Introduction-Udara rogasare classified into 8 types according to different Acharyas.Pleehodarais one among them.The main cause behind the development of Udara rogais ‘Mandagni’. In Ayurveda Pleehodaramay be correlated with Splenomegaly. Sarapunkhaa herbal drug mentioned in Ayurvedaclassics is effective in Pleehodara.So, a comparative single blind study of Sarapunkha Ksharaand Sarapunkha Ghana Vatiare taken into consideration for clinical trial for present study. Aims:To study about the comparative clinical efficacy of Sarapunkha Ksharaand Sarapunkha Ghana Vatiin the management of Pleehodara.Material and Methods-This is a single-blind comparative clinical study with a pre-test and post-test design. The patients were Randomly categorised into two groups.30 patients of Group-A(15) and Group-B(15) patients were registered from OPD and IPD of Govt. Ayurvedic College and Hospital, Balangir presented with Subjective parameters and Objective Parameters. After diagnosis they were under trial withAyurvedicformulations of Sarapunkha Ksharagiven 500mg twice daily after food in Group A and Sarapunkha Ghana Vatigiven 2tab(1 tab-500mg) twice daily after food with luke warm water for a period of 30 days respectively. The subjective and objective parameters were assessed in 10 days interval to interpret the result by statistical evaluation.Observation and Results: It had been observed that the result of trial drug Group-A patients was significant (&lt;0.05) to reduce both subjective and objective Parameters after 30 days of treatment as compare to Group-B patients.Conclusion:On comparison between two groups, Sarapunkha Kshara had shown more effect thanSarapunkha Ghan Vati.No adverse effects were noticed during clinical trial in both groups

Shall we start? Ready, set, go! Toward early intervention in infants with unilateral cerebral palsy. A randomized clinical trial protocol.

It is crucial to start an early intervention in unilateral cerebral palsy. Intensive therapies are focused on training based on activities. The objective of the study was to study the changes in the bimanual functional performance (BFP) after early intensive therapies at home compared with standard care in children with unilateral cerebral palsy from 9 to 18 months of age. A single-blind comparative effectiveness study will be conducted. Children will be randomized into four groups: infant-mCIMT, infant-BIT, infant-hybrid, and infant standard therapy (control group, CG). Each early intensive protocol will last 50 h and will be applied throughout a 10-week period with the family involvement at home. The main outcomes are BFP measure with mini-Assisting Hand Assessment (mini-AHA) scale, functional goals measure with Goal Attainment Scale (GAS), and satisfaction and expectations on intensive therapy from parents measure through specific questionnaire. Baseline characteristics between groups will be compared using independent t test and Fisher's exact test. Pre- and post-treatment outcomes of standard assessments will be compared using analysis of variance (ANOVA) for parametric and Kruskal-Wallis test for non-parametric variables. The Bonferroni correction is applied for multiple comparisons. An alpha level of p ⩽ 0.05 is considered significant. In relation to other studies that have analyzed intensive therapies, although with fewer intervention groups, it seems that the application of any of the intensive interventions is effective with the applied dose to obtain changes in BFP and increase the spontaneous use of the affected upper limb. ClinicalTrials.gov Identifier: NCT04642872.

A Clinico-Pathological Study on Vatarakta w.s.r. to Gout andits Comparative Effect of Bodhivrikshya Kashayaand Bodhivrikshya Ghana Vati.

Vataraktais the major example of Vatavyadhi, caused due to avaranapathology. The scenario of Vataraktafeaturing sign &amp; symptoms which can very well be correlated with Gouty Arthritis. The literature enlists a number of formulation in the management of Vatarakta. An additional cavernous revise was indispensable to bring out the precise outcome of these products. Keeping these visions in mind, the particular comparative study was performed with Bodhivrikshya Kashayaand BodhivrikshyaGhana Vati, which are explained in the same context. This is a single-blind comparative clinical study with a pre-test and post-test design, wherein a minimum of 30 patients of either sex, suffering from Vatarakta, in an age limit of 20 to 50 years with symptoms like sandhishoola(joint pain),sotha(swelling),kandu(itching),daha(burningsensation),twakvaivarna(discolouration),sparshaasahatwa(tenderness),sphurana(twitching)and serum uric acid valuemore than 6.8mg/dl were selected and randomly categorized into two groups. The 15 patients of group A were treated with oral administration of Bodhivrikshya Kashaya25ml twice day and the group B patients with Bodhivrikshya Ghana Vati2tab(1tab-500mg) thrice daily with anupanaof Madhu. The therapeutic effect of the treatment was assessed in both the groups based on specific subjective and objective parameters. The results obtained were analyzed statistically in both the groups and the comparative effect was assessed using the unpaired “t”-test. In both the groups, a statistically significant improvement was observed in all the criteria of assessment. The outcome of the studyrevealed an identical therapeutic efficacy of Bodhivrikshya Kashayaand Bodhivrikshya Ghana Vatiin Vataraktabut Bodhivrikshya Kashayahave shown more than Bodhivrikshya Ghana Vati. No Adverse effect was noticed during clinical trial in both groups.

Effect of functional task training versus resistance training in improving activities of daily living performance in Indian community-dwelling older adults

IntroductionThere is little certainty about the effect of different exercise programs on the performance of activities of daily living (ADL). The purpose of this study was to compare the impact of functional task training (FTT) and resistance training (RT) on improving ADL performance in Indian community-dwelling older adults.MethodsThe single-blinded comparative experimental study involved 100 community-dwelling older adults aged 65 years and above. The subjects were randomly assigned to either the FTT group or the RT group. The FTT group (&lt;i&gt;n&lt;/i&gt; = 50) performed functional task exercises associated with functional performance and the RT group (&lt;i&gt;n&lt;/i&gt; = 50) performed resistance exercises focusing mainly on muscle performance. Exercises were practised in 1-hour sessions, 3 times a week, for 12 weeks. ADL performance of the participants was assessed at baseline and 12 weeks by using the Groningen Activity Restriction Scale.ResultsIn both groups, the Wilcoxon signed-rank test revealed a significant difference between median pre-intervention ranks and median post-intervention ranks, indicating a significant improvement in ADL performance in both groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). However, the Mann-Whitney U test demonstrated that the improvement in ADL performance in the FTT group was significantly greater than that in the RT group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05).ConclusionsAlthough both groups significantly enhanced their ADL performance, the improvement achieved by the FTT group was significantly greater than that in the RT group.