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STABILITY BASED HPLC METHOD FOR CYCLOPHOSPHAMIDE RELATED SUBSTANCES IN FINISHED DRUG PRODUCTS: DEVELOPMENT AND VALIDATION 基于稳定性的 HPLC 方法检测药物成品中的环磷酰胺相关物质:开发与验证
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4061
HARIBABU JOTHULA, SRINIVASU NAVULURI, NAVEEN REDDY MULAKAYALA
Objective: The current study aimed to develop a simple, sensitive, and precise high-performance liquid chromatographic (HPLC) method for estimating cyclophosphamide and its related substances, as well as to implement the developed method in a capsule product. Methods: Method development was performed using various solvent and buffer-solvent ratios at different flow rates for better resolution and to decrease the run time. The developed method was validated in accordance with the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines. The developed method was implemented to estimate the amount of cyclophosphamide and its related substances. Results: Chromatographical conditions were optimised, and the best chromatographical conditions with adequate resolution for cyclophosphamide and its related substances were achieved using the enable X-Bridge C18 column, using a mobile phase combination of phosphate buffer pH 7.0, water, methanol, and acetonitrile at a flow rate of 0.5 ml/min. The detection was monitored at a wavelength of 200 nm. The developed method was validated for system suitability, specificity, limit of detection (LOD), limit of quantitation (LOQ), linearity, precision, accuracy and robustness. The results indicate that the method was sensitive and could detect and quantify lower levels of cyclophosphamide and its related substances. The linearity range was from LOQ to 150 %, and a correlation coefficient ranging from 0.9987 to 0.9999 indicates that at this concentration range, substances were highly linear. This was further supported by satisfactory forced degradation studies. Conclusion: The developed analytical method is simple, precise, and reproducible and thus can be used for the stability-indicating analysis of cyclophosphamide and its related substances in pharmaceutical formulations.
研究目的本研究旨在开发一种简单、灵敏、精确的高效液相色谱(HPLC)方法,用于估算环磷酰胺及其相关物质,并将所开发的方法应用于胶囊产品中。方法:采用不同的溶剂和缓冲溶剂比例、不同的流速进行方法开发,以提高分辨率并缩短运行时间。根据国际人用药品技术要求协调理事会(ICH)指南对所开发的方法进行了验证。采用所开发的方法估算了环磷酰胺及其相关物质的含量。结果:对色谱条件进行了优化,使用 enable X-Bridge C18 色谱柱,流动相组合为 pH 7.0 磷酸盐缓冲液、水、甲醇和乙腈,流速为 0.5 ml/min,获得了对环磷酰胺及其相关物质具有足够分辨率的最佳色谱条件。检测波长为 200 nm。对所开发的方法进行了系统适用性、特异性、检出限(LOD)、定量限(LOQ)、线性、精密度、准确度和稳健性验证。结果表明,该方法灵敏度高,能检测和定量较低浓度的环磷酰胺及其相关物质。线性范围为 LOQ 至 150%,相关系数为 0.9987 至 0.9999,表明在此浓度范围内,各物质的线性度很高。令人满意的强制降解研究进一步证明了这一点。结论所开发的分析方法简单、精确、重现性好,可用于药物制剂中环磷酰胺及其相关物质的稳定性指示分析。
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引用次数: 0
A CLINICAL COMPARATIVE STUDY OF SCALP BLOCK WITH 0.5% BUPIVACAINE VERSUS LEVOBUPIVACAINE 0.5% FOR MAYFIELD INSERTION ON HAEMODYNAMIC RESPONSE AND EFFICACIES OF POSTOPERATIVE ANALGESIA 使用 0.5% 布比卡因和 0.5% 左布比卡因进行头皮阻滞以插入 Mayfield 对血流动力学反应和术后镇痛效果的临床比较研究
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4089
Kalapala Ramesh, Bandrapalli Emeema, K. I. Priyadarshini, Chandrasekhar Vallepalli, Madhulika Yeluru
Objective: Present study was performed to compare the effectiveness of 0.5% bupivacaine hydrochloride and 0.5% levobupivacaine for scalp block on the haemodynamic response, efficacy and additional analgesic requirement of these drugs in the post operative period during Mayfield insertion for craniotomy. Methods: 60 patients of American society of anaesthesiologists physical status Ⅰ and Ⅱ who underwent elective craniotomies were randomly divided into two groups Group B (n=30) who received scalp block with 0.5% bupivacaine hydrochloride 25 ml, Group L (n=30) received 25 ml of 0.5% levobupivacaine 5 min prior to Mayfield insertion. Mean arterial pressure (MAP), pulse rate, pain score (VAS score), additional intraoperative and postoperative analgesic requirement were recorded at different time points. Results: Pulse rate, mean arterial pressure were stable during and after Mayfield insertion in both groups at all time points. Conclusion: Both bupivacaine and levobupivacaine for scalp block are equally effective in attenuating haemoynamic responses during Mayfield insertion. Levobupivacaine being less toxic can be a safe alternative for scalp block.
研究目的本研究旨在比较 0.5%盐酸布比卡因和 0.5%左布比卡因用于头皮阻滞时的血流动力学反应、疗效以及开颅手术 Mayfield 插入术后的额外镇痛需求。方法:将 60 名接受择期开颅手术的美国麻醉医师协会体能状态Ⅰ级和Ⅱ级患者随机分为两组,B 组(30 人)接受 0.5% 盐酸布比卡因 25 毫升头皮阻滞,L 组(30 人)在插入 Mayfield 前 5 分钟接受 0.5% 左布比卡因 25 毫升头皮阻滞。记录不同时间点的平均动脉压(MAP)、脉搏、疼痛评分(VAS 评分)、术中和术后额外镇痛剂需求。结果两组患者在所有时间点插入 Mayfield 期间和之后的脉搏率、平均动脉压均保持稳定。结论用于头皮阻滞的布比卡因和左旋布比卡因在减弱插入 Mayfield 期间的血流动力学反应方面效果相同。左旋布比卡因毒性较低,可作为头皮阻滞的安全替代方案。
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引用次数: 0
KNOWLEDGE, ATTITUDE AND PRACTICE OF MATERIOVIGILANCE AMONG MEDICAL POSTGRADUATE STUDENTS 医学研究生对药物警戒的认识、态度和实践
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.5007
Aditi Bhandari
Objective: Medical devices have become an indispensable part of the healthcare system in recent times. A major shift towards increasing demand and supply of devices has led to an increase in the number of adverse effects being reported from across the world. “Materiovigilance” (MV) is the coordinated system of identification, collection, reporting, and analysis of any untoward occurrences associated with the use of medical devices and protection of a patient's health by preventing its recurrences. Post-Graduate medical students play a key role in reporting and management of any adverse events associated with medical devices in patients. Therefore, this study was conducted to assess the knowledge, attitude and practice regarding Materiovigilance among the residents.Methods: A cross-sectional observational study was conducted among the Post graduate students of a tertiary care government institute of Southern Rajasthan. A pre-validated questionnaire comprising of 18 questions pertaining to knowledge, attitude, and practice of Materiovigilance was used.Results: Out of 110 participants ongoing programme 73.6% knew about an ongoing programme on Materiovigilance, 29.6% have been trained about MV while 70% consider reporting its ADR necessary, while 6.6% have reported ADRs caused by devices in their department.Conclusion: A large section of PG students was aware of the term “Materiovigilance,” but they need to be provided with more knowledge about the concept and its reporting. The attitude is positive but regular practice of reporting needs to be developed. Educational interventional programmes are required to promote Materiovigilance and ADR reporting due to medical devices in day-to-day practice.
目的:近年来,医疗器械已成为医疗保健系统中不可或缺的一部分。医疗器械的供求关系发生了重大变化,导致世界各地报告的不良反应数量增加。"材料警戒"(MV)是一个协调系统,用于识别、收集、报告和分析与使用医疗器械相关的任何不良事件,并通过防止其再次发生来保护病人的健康。医科研究生在报告和管理任何与医疗器械相关的患者不良事件方面发挥着关键作用。因此,本研究旨在评估住院医师对医疗器械安全的认识、态度和实践:方法: 在拉贾斯坦邦南部一家政府三级医疗机构的研究生中开展了一项横断面观察研究。研究使用了一份经过预先验证的调查问卷,其中包括 18 个与 "药物警戒 "的知识、态度和实践相关的问题:结果:在 110 名参加正在进行的计划的人员中,73.6% 的人知道有一个正在进行的药物警戒计划,29.6% 的人接受过关于 MV 的培训,70% 的人认为报告 ADR 是必要的,6.6% 的人报告过他们所在科室的器械引起的 ADR:结论:大部分研究生都知道 "药物警戒 "一词,但需要向他们提供更多有关这一概念及其报告的知识。他们的态度是积极的,但需要培养定期报告的习惯。需要开展教育干预计划,在日常实践中推广 "本品警戒 "和医疗器械所致不良反应报告。
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引用次数: 0
THORACIC SEGMENTAL SPINAL ANAESTHESIA IN UPPER ABDOMINAL SURGERIES AND SIMPLE MASTECTOMY-A CASE SERIES 上腹部手术和单纯乳房切除术中的胸椎节段脊髓麻醉--病例系列
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4088
Madhuchanda Borah, Kaveri Das, Bijoy Ahir, ANJALI VERMA, Pydimalla Venkata Gowtham, Karuna Kumar Das, Pritanu Deb Baruah
Objective: To observe safety and efficacy of Segmental thoracic spinal anesthesia (STSA) in upper abdominal and breast surgeries. Methods: 14 cases were selected, out of which 6 laparoscopic cholecystectomy (LC), 4 open cholecystectomy (OC), 3 emergency exploratory laparotomy and 1 simple mastectomy. Under full aseptic precaution, segmental thoracic spinal anesthesia was administered through midline approach in T8-9 space for upper abdominal surgeries and T5-6 space in a simple mastectomy. Using 25G Quincke spinal needle 1.5 ml [7.5 mg] of 0.5% Isobaric Levobupivacaine mixed with 0.4 ml (20µg) Fentanyl was given in abdominal surgeries and 1.2 ml [6 mg] of 0.5% Isobaric Levobupivacaine mixed with 0.4 ml (20µg) Fentanyl in simple mastectomy. Results: Age group of patients ranged from 25 to 65 y, Male: Female ratio of 4:10, Body Mass Index (BMI) range of 22 to 24.9 with physiological status of ASA I to ASA III. Hemodynamically, hypotension was observed in every patient after 5-10 min of STSA well managed with fluid and vasopressors with no bradycardia. Average width of sensory block was T3 to L1-2 in upper abdominal surgeries and T1 to T8 in a simple mastectomy. Motor block was Modified Bromage Scale (MBS) of 0 to 1 during and postoperatively. Regarding analgesia, Visual Analogue Scale (VAS) score was 0 intraoperatively and 0-1 postoperatively. Sedation score was 2 both intraoperatively and postoperatively with no significant complications and good patient and surgeon satisfaction. Conclusion: Segmental thoracic spinal anaesthesia is a safe and effective procedure with good patient and surgeon satisfaction.
目的观察分段胸椎麻醉(STSA)在上腹部和乳房手术中的安全性和有效性。方法:选取 14 个病例,其中 6 例腹腔镜胆囊切除术(LC)、4 例开腹胆囊切除术(OC)、3 例急诊探查性开腹手术和 1 例单纯乳房切除术。在完全无菌预防措施下,上腹部手术通过中线T8-9间隙进行胸椎分段麻醉,简单乳房切除术通过T5-6间隙进行胸椎分段麻醉。在腹部手术中使用 25G Quincke 脊柱针头注射 1.5 毫升 [7.5 毫克] 0.5% 异丙基左旋布比卡因混合 0.4 毫升(20 微克)芬太尼,在单纯乳房切除术中注射 1.2 毫升 [6 毫克] 0.5% 异丙基左旋布比卡因混合 0.4 毫升(20 微克)芬太尼。结果:患者年龄介于 25 至 65 岁之间,男女比例为 4:10:男女比例为 4:10,体重指数(BMI)介于 22 至 24.9 之间,生理状态为 ASA I 至 ASA III。血流动力学方面,每位患者在 STSA 5-10 分钟后都会出现低血压,通过输液和使用血管加压剂得到了很好的控制,但没有出现心动过缓。在上腹部手术中,感觉阻滞的平均宽度为 T3 至 L1-2,在单纯乳房切除术中为 T1 至 T8。术中和术后的运动阻滞为改良布罗马格量表(MBS)的 0 至 1。关于镇痛,术中视觉模拟量表(VAS)评分为 0,术后评分为 0-1。术中和术后镇静评分均为 2 分,无明显并发症,患者和外科医生满意度良好。结论分段胸椎麻醉是一种安全有效的手术,患者和外科医生都非常满意。
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引用次数: 0
ANTIMICROBIAL USE AND RESISTANCE: SURVEY OF KNOWLEDGE AND AWARENESS OF GENERAL PUBLIC IN CHITTOOR DISTRICT 抗菌药的使用和耐药性:吉托尔地区公众知识和意识调查
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4070
PRASANNA LAKSHMI KAKARLA, PEDAPATIKASTURI, NELLORE SRIVANI, P. P. Babu
Objective: Antimicrobial resistance (AMR) leads to increased morbidity and mortality. WHO identified AMR as great threat to human health. India with highest bacterial disease burden in the world has rampant antibiotic usage. Natural phenomenon AMR is accelerated by the misuse and overuse of antibiotics. The responsibility of proper usage lies with both the prescribers and general public. Ecological, epidemiological, cultural and socioeconomic factors influence AMR. This study aims to enhance understanding of current public awareness and common behaviors related to antimicrobials, their use and AMR. Methods: Descriptive closed-questionnaire-based face-to-face survey was conducted between January to March 2022 among 400 attendants of patients visiting the tertiary care hospital at Tirupati, Chittoor District. Residents aged>18 y were included; health care providers excluded. Data was collected using WHO questionnaire consisting of two parts. Results: There is widespread antibiotic usage-70% of participants used at least once in past 6 mo. Many respondents were mistaken that head ache (42%) and cold (38%) require antibiotics. Only 66% of respondents knew to take full course of antibiotics. 26% of respondents never heard of antibiotic resistance terminology. 51% of participants had no idea that antibiotic-resistant bacteria can spread among persons. All the respondents agreed that regular hand washing is helpful. Conclusion: Huge knowledge gaps were found along with various misconceptions and misunderstandings in the public. It is imperative to address these gaps as soon as possible to save the potency of available antibiotics. Reasons for misconceptions and ways to dispel them need further studies.
目的:抗菌药耐药性(AMR)导致发病率和死亡率上升。世界卫生组织认为,抗菌药物耐药性是对人类健康的巨大威胁。印度是世界上细菌性疾病负担最重的国家,抗生素的使用十分猖獗。滥用和过度使用抗生素加速了 AMR 这一自然现象。正确使用抗生素的责任在于处方者和公众。生态、流行病学、文化和社会经济因素都会影响 AMR。本研究旨在加深对当前公众对抗菌药物、抗菌药物使用和 AMR 的认识以及相关常见行为的了解。研究方法:在 2022 年 1 月至 3 月期间,对前往奇托尔区蒂鲁帕蒂三级医院就诊的 400 名病人的护理人员进行了基于封闭式问卷的描述性面对面调查。调查对象包括年龄大于 18 岁的居民;不包括医护人员。采用世界卫生组织问卷收集数据,问卷由两部分组成。结果:抗生素的使用非常普遍,70%的受访者在过去 6 个月中至少使用过一次抗生素。许多受访者误认为头痛(42%)和感冒(38%)需要使用抗生素。只有 66% 的受访者知道要服用完整疗程的抗生素。26% 的受访者从未听说过抗生素耐药性这一术语。51% 的参与者不知道耐抗生素细菌会在人群中传播。所有受访者都认为定期洗手很有帮助。结论调查发现,公众在这方面的知识存在巨大差距,同时还存在各种错误观念和误解。当务之急是尽快消除这些差距,以挽救现有抗生素的效力。造成误解的原因和消除误解的方法需要进一步研究。
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引用次数: 0
STEROIDS AND TRITERPENOIDS IN ACACIA CATECHU BARK EXTRACTS: A COMPARATIVE STUDY AND BIBLIOGRAPHIC ANALYSIS 刺槐树皮提取物中的类固醇和三萜类化合物:比较研究和文献分析
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4073
Archana Tiwari, Avinash Tiwari
Objective: Plant-derived steroids and triterpenes have been recognized for a number of health benefits. As indicated in previous research, some of the phytosterols are essential dietary substances. This study was aimed at investigating the presence or absence of these phytochemicals in various test bark extracts from Acacia catechu plant samples. Methods: For this study, thirty samples of test plants were gathered in various seasons from the research location. Six different solvents were then prepared for each sample. Then the qualitative tests of the studied parameters were done using various standardized methods. Additionally, bibliographic analysis was done to validate and co-relate the present study with earlier findings. Results: Results showed the presence of test parameters in all solvent systems except aqueous extracts, though the colour intensity (quantity) was different in all other extracts. Based on the dark-colored reaction mixture, it can be claimed that the steroid and triterpene content was relatively higher in methanolic and ethanolic extracts. The comparative bibliographic study was also validating the beneficial applications of the same. Conclusion: Possibly, this preliminary study helped to find out the medicinal significance of native flora of Guna district and also serve as the base for further investigations.
目的:从植物中提取的类固醇和三萜类化合物被认为具有多种健康益处。正如以前的研究表明的那样,一些植物甾醇是必需的膳食物质。本研究旨在调查这些植物化学物质在儿茶相思植物样本的各种测试树皮提取物中的存在与否。研究方法本研究在不同季节从研究地点采集了 30 份测试植物样本。然后为每个样本制备了六种不同的溶剂。然后使用各种标准化方法对研究参数进行定性测试。此外,还进行了文献分析,以验证本研究与之前的研究结果之间的联系。结果结果显示,除水提取物外,所有溶剂体系中都存在测试参数,但其他提取物的颜色强度(数量)不同。根据深色反应混合物,可以认为甲醇提取物和乙醇提取物中的类固醇和三萜含量相对较高。文献比较研究也验证了相同提取物的有益应用。结论:这项初步研究可能有助于发现古纳地区本地植物区系的药用价值,也可作为进一步研究的基础。
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引用次数: 0
PHYTOCHEMICALS SCREENING, ANTIOXIDANT AND ANTIMICROBIAL ACTIVITY OF CARICA PAPAYA LEAF EXTRACTS 木瓜叶提取物的植物化学成分筛选、抗氧化和抗菌活性
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4087
Prashant Purohit, M. Kataria
Objective: The objective of the present study aimed at investigating the phytochemical antioxidant and anti-microbial properties of Carica papaya leaf extracts. Methods: As phytochemicals are biologically active compounds and a powerful group of plant chemicals believed to stimulate the immune system along with antioxidants, the molecules which hinder oxidation of other molecules by the process of inhibiting or by generating the oxidizing chain reactions and preventing diseases. The anti-microbial activity on various gram-positive and gram-negative bacteria were determined using zone of inhibition and antioxidant by the 2,2,1-diphenyl-1-picrylhydrazyl method. Results: Phytochemical screening, antioxidant and antibacterial potential were determined using different aqueous and organic solvents in addition to the determination of trace element in leaves of C. papaya. Antioxidant activity using DPPH free radical scavenging assay indicated leaves extracts leaves showed inhibition of per oxidation. The result showed that the ethanolic extract of C. papaya possessed a significant antioxidant activity as compared to methanol and aqueous extract. The antibacterial study showed leaves extract is the best to cope infectious action of bacteria. Conclusion: This study was conducted to test the medicinal profile of C. papaya by extracting secondary metabolites with organic and aqueous solvents. Ethanol was found to be the best solvents of choice to extract natural products to get maximum medicinal benefits and could be used to medicinal formulation against different infectious diseases.
研究目的本研究旨在调查木瓜叶提取物的植物化学抗氧化和抗微生物特性。研究方法植物化学物质是具有生物活性的化合物,是一类强大的植物化学物质,被认为能刺激免疫系统和抗氧化剂,抗氧化剂是通过抑制或产生氧化链反应来阻碍其他分子氧化并预防疾病的分子。采用抑制区法和 2,2,1-二苯基-1-苦基肼法测定其对各种革兰氏阳性和革兰氏阴性细菌的抗微生物活性。结果:除了测定木瓜叶中的微量元素外,还使用不同的水溶液和有机溶剂进行了植物化学筛选、抗氧化和抗菌潜力测定。用 DPPH 自由基清除法测定的抗氧化活性表明,木瓜叶提取物具有抑制过氧化的作用。结果表明,与甲醇提取物和水提取物相比,木瓜叶乙醇提取物具有显著的抗氧化活性。抗菌研究表明,木瓜叶提取物是应对细菌感染作用的最佳提取物。结论本研究通过用有机溶剂和水溶剂萃取木瓜的次生代谢物来测试木瓜的药用价值。结果发现,乙醇是提取天然产物的最佳溶剂,可获得最大的药用价值,并可用于针对不同传染病的药物配方。
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引用次数: 0
COMPARISON BETWEEN EFFECT OF TWO DIFFERENT DOSES OF INTRAVENOUS DEXMEDETOMIDINE IN ATTENUATING HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION IN ELECTIVE GENERAL SURGERIES UNDER GENERAL ANAESTHESIA 比较两种不同剂量的右美托咪定在全身麻醉下的择期普通外科手术中减轻喉镜检查和气管插管时血流动力学反应的效果
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4066
JYOTI KABARA, Shriphal Meena, Priyanka Jain, VAIBHAV GAGRANI
Objective: The process of intubation is a noxious stimuli leading to a period of hemodynamic stress and is accompanied with intense sympathetic activity marked by tachycardia, hypertension and arrythmias. Methods: It was a randomised, prospective, double-blind study. After approval from the ethics committee 60 patients (ASA class 1 and II) were selected randomly, thirty in each group. Group A (n=30) received 0.5 µg/kg of inj. Dexmedetomidine and Group B received 0.75µg/kg of inj. Dexmedetomidine in 20 ml of normal saline as an infusion over 10 min. The patient was induced with inj Fentanyl 1µg/kg, inj. Propofol and inj. Succinylcholine administered and intubated. The primary outcome variables were heart rate and blood pressure at 1, 3, 5, 10, 15 min after intubation. The secondary outcome variables were the effect on the induction dose of propofol and any adverse effect associated with dexmedetomidine. The statistical package used was spss version 22. Results: The hemodynamic responses were attenuated in both groups after laryngoscopy and endotracheal intubation, with statistical significant difference between both groups and better obtundation of hemodynamic response in terms of heart rate, systolic, diastolic and mean arterial pressure at all points of time with dexmedetomidine 0.75µg/kg. Sedation scores were more with dexmedetomidine 0.75µg/kg. No significant side effects were there in both groups. Conclusion: Inj. dexmedetomidine 0.75µg/kg is more effective in attenuating the response to laryngoscopy and endotracheal intubation.
目的:插管过程是一个有害刺激,会导致一段时间的血流动力学应激,并伴随着强烈的交感神经活动,表现为心动过速、高血压和心律失常。研究方法这是一项随机、前瞻性、双盲研究。经伦理委员会批准后,随机抽取 60 名患者(ASA 1 级和 II 级),每组 30 人。A 组(30 人)接受 0.5 µg/kg 的右美托咪定注射;B 组(30 人)接受 0.5 µg/kg 的右美托咪定注射。右美托咪定注射液 0.5 微克/千克,B 组注射液 0.75 微克/千克。B 组在 10 分钟内输注 0.75µg/kg 的右美托咪定注射液和 20 毫升生理盐水。给患者注射芬太尼 1µg/kg、丙泊酚注射液和丙泊酚注射液。丙泊酚和琥珀酰胆碱琥珀胆碱并插管。主要结果变量是插管后 1、3、5、10 和 15 分钟的心率和血压。次要结果变量是对异丙酚诱导剂量的影响以及右美托咪定的任何不良反应。使用的统计软件包为 spss 22 版。结果两组患者在喉镜检查和气管插管后的血流动力学反应均有所减弱,两组之间的差异有统计学意义,右美托咪定 0.75µg/kg 在所有时间点的心率、收缩压、舒张压和平均动脉压方面的血流动力学反应抑制效果更好。右美托咪定 0.75µg/kg 的镇静评分更高。两组患者均无明显副作用。结论右美托咪定注射液 0.75µg/kg 能更有效地减轻喉镜检查和气管插管时的反应。
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引用次数: 0
CLINICAL PRESENTATION AND MANAGEMENT OF DENGUE IN PEDIATRIC PATIENTS 登革热在儿童患者中的临床表现和处理方法
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4055
Abdul Haseeb, Sharanabasappa, Hareesh
Objective: Dengue fever poses a significant challenge to global health, particularly affecting children in endemic regions. The diverse clinical presentations, ranging from mild to severe forms such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), complicate its diagnosis and management in pediatric populations. Understanding the clinical nuances is crucial, given the substantial global burden of dengue. Methods: This prospective cross-sectional study conducted at the Department of Pediatrics, Yashoda Super Specialty Hospital, aimed to investigate the clinical, laboratory, and radiological features of dengue fever in pediatric patients aged 6 mo to 16 y. Data collection involved demographic details, clinical presentations, laboratory findings, and treatment administered. Statistical analysis was performed using SPSS version 19.0. Results: Among the 100 enrolled pediatric patients, high fever (100%), headache (75%), myalgia (70%), rash (65%), and hemorrhagic manifestations (40%) were prevalent clinical features. Laboratory findings revealed thrombocytopenia in 60% of cases and elevated liver enzymes in 30%. Correlation analyses identified associations between specific symptoms and diagnostic findings, aiding in the recognition of severe cases such as DSS. Conclusion: The study highlights the diverse clinical spectrum of pediatric dengue, emphasizing the importance of vigilant clinical assessment and laboratory testing for timely diagnosis and management. These insights are essential for optimizing patient care and outcomes, particularly in endemic regions.
目的:登革热对全球健康构成重大挑战,尤其影响流行地区的儿童。登革热的临床表现多种多样,从轻微到严重,如登革出血热(DHF)和登革热休克综合征(DSS),这使儿童登革热的诊断和管理变得更加复杂。鉴于登革热给全球带来的巨大负担,了解其临床细微差别至关重要。研究方法这项前瞻性横断面研究在雅舒达超级专科医院儿科进行,旨在调查 6 个月至 16 岁儿童登革热患者的临床、实验室和影像学特征。统计分析采用 SPSS 19.0 版进行。结果在 100 名登记的儿童患者中,高烧(100%)、头痛(75%)、肌痛(70%)、皮疹(65%)和出血性表现(40%)是主要的临床特征。实验室检查结果显示,60%的病例血小板减少,30%的病例肝酶升高。相关性分析确定了特定症状与诊断结果之间的关联,有助于识别 DSS 等严重病例。结论该研究强调了小儿登革热的多种临床表现,强调了警惕性临床评估和实验室检测对及时诊断和管理的重要性。这些见解对于优化患者护理和治疗效果至关重要,尤其是在登革热流行地区。
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引用次数: 0
EXPANDED DENGUE SYNDROME AND ATYPICAL MANIFESTATIONS 扩大的登革热综合征和非典型表现
Pub Date : 2024-05-15 DOI: 10.22159/ijcpr.2024v16i3.4056
Abdul Haseeb, Hareesh, Sharanabasappa
Objective: Dengue fever, once seen as a classical febrile illness, has transformed into a global concern with the emergence of Expanded Dengue Syndrome (EDS). EDS is characterized by atypical and severe manifestations affecting multiple organ systems, including the central nervous system, liver, heart, and kidneys. This syndrome challenges the traditional understanding of dengue and necessitates heightened clinical awareness, timely intervention, and comprehensive research. Co-infections further complicate the clinical landscape, emphasizing the need for accurate diagnosis and targeted therapeutic strategies. Methods: This prospective observational study was conducted at Yashoda Super Specialty Hospital, Malakpet, Hyderabad, from January 2018 to January 2021. The study aimed to identify and analyze atypical presentations of dengue fever in patients of all age groups. Inclusion criteria involved laboratory-confirmed dengue cases with atypical manifestations indicative of EDS. Data collection included comprehensive clinical, laboratory, and radiological information. Ethical considerations and statistical analysis were conducted using SPSS software. Results: The study analyzed 150 cases of EDS, encompassing atypical manifestations such as encephalopathy, myocarditis, acute liver failure, and renal impairment. CNS involvement was the most common atypical manifestation (20%), followed by myocarditis (15%) and acute liver failure (10%). Renal impairment was observed in 5% of cases. Co-infections were identified in 25% of EDS cases, further complicating clinical management. The mortality rate among EDS patients was 5%, emphasizing the importance of early recognition and aggressive organ-specific interventions. Conclusion: Expanded Dengue Syndrome challenges the conventional perception of dengue fever, highlighting atypical manifestations and co-infections. Heightened clinical awareness, a broad differential diagnosis, and aggressive management strategies are essential for addressing the multifaceted nature of EDS. Further research is needed to develop targeted interventions for this complex and evolving disease.
目的:登革热曾被视为一种典型的发热性疾病,但随着登革热扩展综合征(EDS)的出现,它已成为全球关注的焦点。EDS 的特点是影响中枢神经系统、肝脏、心脏和肾脏等多个器官系统的非典型严重表现。这种综合征挑战了人们对登革热的传统认识,需要提高临床认识、及时干预和全面研究。合并感染使临床情况更加复杂,强调了准确诊断和针对性治疗策略的必要性。研究方法这项前瞻性观察研究于 2018 年 1 月至 2021 年 1 月在海得拉巴 Malakpet 的 Yashoda 超级专科医院进行。研究旨在识别和分析各年龄段登革热患者的非典型表现。纳入标准包括实验室确诊的登革热病例,其非典型表现显示为 EDS。数据收集包括全面的临床、实验室和放射学信息。采用 SPSS 软件进行伦理考虑和统计分析。结果研究分析了150例EDS病例,包括脑病、心肌炎、急性肝功能衰竭和肾功能损害等非典型表现。中枢神经系统受累是最常见的非典型表现(20%),其次是心肌炎(15%)和急性肝功能衰竭(10%)。5%的病例出现肾功能损害。25%的EDS病例合并感染,使临床治疗更加复杂。EDS患者的死亡率为5%,这强调了早期识别和积极干预特定器官的重要性。结论登革热扩展综合征挑战了人们对登革热的传统认识,突出了非典型表现和合并感染。提高临床意识、广泛鉴别诊断和积极的管理策略对于解决 EDS 的多面性至关重要。需要进一步开展研究,为这种复杂且不断演变的疾病制定有针对性的干预措施。
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引用次数: 0
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International Journal of Current Pharmaceutical Research
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