The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Desvenlafaxine Succinate: Is it a New Promise and Hope for Management of Vaso...Apollo Hospitals
Natural menopause, specifically, is confirmed after 12
consecutive months of amenorrhea in the absence of any
obvious, pathologic cause.1 These 12 months of amenorrhea and beyond, characterize a woman as postmenopausal. This can further be divided into early postmenopause (4 years after the FMP) and late postmenopause (>5 years since the FMP)
Desvenlafaxine Succinate: Is it a New Promise and Hope for Management of Vaso...Apollo Hospitals
Natural menopause, specifically, is confirmed after 12
consecutive months of amenorrhea in the absence of any
obvious, pathologic cause.1 These 12 months of amenorrhea and beyond, characterize a woman as postmenopausal. This can further be divided into early postmenopause (4 years after the FMP) and late postmenopause (>5 years since the FMP)
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
discuss about the need for pediatric pharmacists. explains about the pharmacological and physiological factors such as dose of drug, dosage forms, weight of child, age of child, BSA of child that have to be considered on prescribing a pediatric patient
Assessment of the Prevalence of Proactive Penicillin Allergy Testing in Patie...BRNSS Publication Hub
This study aims to promote penicillin allergy testing in an outpatient to penicillin allergy and educate both patients and clinicians about testing. Patients with a history of penicillin allergy were screened for penicillin allergy testing. The results of allergy testing and patient satisfaction after testing were the main outcomes. A total of 82 patients were recruited, although only 37 actually underwent testing. None of these 37 had a positive skin test and none of 36 had a positive oral challenge (one refused it). Following testing, 2 patients (5%) had subjective reactions within 24 h. Three (10%) were subsequently treated with a beta-lactam, and all reported that testing provided important information to their medical history. In conclusion, the penicillin allergy testing safely evaluates patients labeled as penicillin allergic. It is well tolerated and embraced by the patients who undergo testing. In our study, none of the patients tested had an allergic reaction, but we identified multiple barriers to developing a protocol for testing patients from the primary care setting.
A Systematic Review on the Efficacy of Iontophoresis
as a Treatment for Lateral Epicondylitis by James McKivigan*, Brent Yamashita and Derek Smith in Research & Investigations in Sports Medicine
Ojus Tablet in the Treatment of Irritable Bowel Syndrome Amit Kumawat
Irritable bowel syndrome (IBS) is on of the commonly occurring gastrointestinal disorder characterized by abdominal pain and altered bowel habits. https://www.biogetica.com/
Paediatric (pediatrics) medication-drugs therapy in pediatricsRavish Yadav
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
discuss about the need for pediatric pharmacists. explains about the pharmacological and physiological factors such as dose of drug, dosage forms, weight of child, age of child, BSA of child that have to be considered on prescribing a pediatric patient
Assessment of the Prevalence of Proactive Penicillin Allergy Testing in Patie...BRNSS Publication Hub
This study aims to promote penicillin allergy testing in an outpatient to penicillin allergy and educate both patients and clinicians about testing. Patients with a history of penicillin allergy were screened for penicillin allergy testing. The results of allergy testing and patient satisfaction after testing were the main outcomes. A total of 82 patients were recruited, although only 37 actually underwent testing. None of these 37 had a positive skin test and none of 36 had a positive oral challenge (one refused it). Following testing, 2 patients (5%) had subjective reactions within 24 h. Three (10%) were subsequently treated with a beta-lactam, and all reported that testing provided important information to their medical history. In conclusion, the penicillin allergy testing safely evaluates patients labeled as penicillin allergic. It is well tolerated and embraced by the patients who undergo testing. In our study, none of the patients tested had an allergic reaction, but we identified multiple barriers to developing a protocol for testing patients from the primary care setting.
A Systematic Review on the Efficacy of Iontophoresis
as a Treatment for Lateral Epicondylitis by James McKivigan*, Brent Yamashita and Derek Smith in Research & Investigations in Sports Medicine
Ojus Tablet in the Treatment of Irritable Bowel Syndrome Amit Kumawat
Irritable bowel syndrome (IBS) is on of the commonly occurring gastrointestinal disorder characterized by abdominal pain and altered bowel habits. https://www.biogetica.com/
Paediatric (pediatrics) medication-drugs therapy in pediatricsRavish Yadav
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
Neukirch & Colagiuri, 2013 (online) - PE sleep, warning, and side effectNadine Neukirch
Similar to Efficacy and safety of two doses of oral midazolam as premedication in paediatric patients: A prospective randomized and comparative study. (20)
Congenital Agenesis Of The Corpus Callosum With Intracerebral Lipoma And Fron...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
“Hemodynamic and recovery profile with Dexmedetomidine and Fentanyl in intrac...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Correlation of Estrogen and Progesterone Receptor expression in Breast Canceriosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Analytical Study of Urine Samples for Epidemiology of Urinary Tract Infection...iosrphr_editor
The current study was carried out in District Abbottabad aimed to determine the common urinary
tract infections in local community to determine the epidemiology of significant diseases in asymptomatic patients
of renal disorder. In this study a total of 1000 urine samples were examined during 3rd February to 1st April 2015
from patients attending Ayub Teaching Hospital Abbottabad by using dipstick and microscopic analysis of urine.
There were 638 females and 362 males patients examined during this period. The range of age groups is between
1.5 years to 80 years. Results of this study was reported as Pyuria 11%, Proteinuria 21.1%, Hematuria 10.4%,
Epithelial Cells 8.2%, pH 7.8 %, Granular casts 7.3%, Triple phosphate 6.6%, Calcium oxalate 6.4%, Glycosuria
6.3%, Bacteria 6.2% and mucous 4.1%. This study concludes that routing urinalysis should be performed for all
individuals to diagnose the asymptomatic diseases that will help in simple therapeutic measurements as urinalysis
is a simple step to determine the root of Urinary tract disorders.
Chest sonography images in neonatal r.d.s. And proposed gradingiosrphr_editor
BACKGROUND : Lung sonography has been used to monitor the patients of R.D.S. in
N.I.C.U. in recent times.
AIMS : To Describe and Grade the changes of R.D.S. by lung sonography.
SETTING & DESIGN : Tertiary care institutional set up in a rural medical college.
STUDY DURATION : September 2014 to May 2015. Follow-up variable, upto 2 weeks.
PROSPECTIVE, ANALYTICAL STUDY.
MATERIALS AND METHODS -This was a single institute study approved by the institutional ethics
committee. Prior informed consent was obtained from the parents. 100 consecutive patients admitted in
N.I.C.U. WITH gestational age < 36 weeks with respiratory complaints were enrolled. Chest x-ray was
obtained within few hours of admission and lung sonography was performed within 24 hours. Follow – up
sonography was performed as and when necessary. Sonography image was graded and correlated with chest
xray and clinical picture
The Comprehensive Review on Fat Soluble Vitaminsiosrphr_editor
This review article deals with brief description of fat soluble vitamins with figures and tables
showing statistical analytical data duly quoting the references wherever necessary. The word “soluble” actually
means “able to be dissolved.” Whether a vitamin is classified as 'fat-soluble' or 'water-soluble' has to do with
how the vitamin is absorbed, stored and removed from the body. Vitamins are tiny organic compounds with a
huge impact on the health and well-being of the body. The body needs a small amount of fat soluble vitamins in
order to stay in optimal health. Fat soluble vitamins play an important role in keeping the body healthy and
functioning from immune system and muscle and heart function, easy flow and clotting of blood as well as eye
health. They are critical to health and wellness–particularly reproductive health and wellness. Low-fat, no-fat
and vegan diets are woefully lacking in fat soluble vitamins. However a diet based on traditional foods can
naturally provide these vitamins. Science is still learning about many of the functions of vitamins. "Too much
vitamin A, D, or K can lead to increased levels that are unhealthy and can cause serious health consequences.
Diseased conditions leading to decreased fat absorption leads to decreased absorption of vitamins. The fatsoluble
vitamins work most safely and effectively when obtained them from natural foods within the context of a
diet rich in all their synergistic partners. If fat soluble vitamins are stored for lengthy time they generate threat
for toxicity than water soluble vitamins and such situation even aggravated, provided they are consumed in
excess. Vitamin products, above the legal limits are not considered food supplements and must be registered as
prescription or non-prescription (over-the-counter drugs) due to their potential side effects. Vitamin A and E
supplements do not provide health benefits for healthy individuals, instead they may enhance mortality, and it is
held proved that beta-carotene supplements can be harmful to smokers
Sulphasalazine Induced Toxic Epidermal Necrolysis A Case Reportiosrphr_editor
Toxic Epidermal Necrolysis (TEN) is a rare and life threatening mucocutaneous reaction
characterized by extensive necrosis and detachment of epidermis. The Worldwide incidence of TEN is 0.9 to 1.4
per million populations per year [1]. Here we have discussed a case of Toxic Epidermal Necrolysis secondary
to Sulfasalazine managed with fluid replacement, analgesics, anti-infective therapy aggressive nutritional
support and intravenous high dose steroid therapy.
Keywords- Toxic Epidermal Necrolysis, Sulfasalazine
Evaluation the efficacy of IVIgG in treatment of Hemolytic Disease of Newborniosrphr_editor
Hemolytic disease of newborn (HDN) is an important cause of hyperbilirubinemia in the
neonatal period,and delayed diagnosis and treatment may lead to permanent brain damage. Traditional
neonatal treatment of HDN is intensive phototherapy and exchange transfusion.Intravenous
immunoglobulin(IVIgG) has been introduced as an alternative therapy to exchange transfusion. This study was
conducted to assess the effect of IVIG in HDN .
FIBROLIPOMATOUS HAMARTOMA OF ULNAR NERVE: A RARE CASE REPORT.iosrphr_editor
Nervous fibrolipomatous hamartoma is said to be a rare tumor-like condition involving the peripheral
nerves,in which the epineurium and perineurium are enlarged and distorted by excess of fatty and fibrous tissue
s that infiltrate between and around nerve boundaries. The median nerve is more likely to develop a hamartoma
than other nerves with a predilection for the carpal tunnel.
A fibrolipomatous hamartoma – is a rare, benign, congenital lesion most commonly found in the median nerve,
usually at the level of the wrist or hand.
We report a case of this rare condition in ulnar nerve.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
Introduction: Self‑ medication is commonly practiced all over the world. Self-medication is defined as the use
of medication by a patient on his own initiative or on the advice of a pharmacist or a lay person instead of
consulting a medical practitioner. The present study was aimed to estimate the prevalence of self-medication for
oral health problems among dental patients in Bengaluru city; to identify triggering factors that could influence
self-medication practices; to identify sources of medications used; to identify sources of information about
medications used; and to identify reasons for self-medication.Study Design: A Cross sectional Study.Methods:A
survey was conducted among 175 subjects among dental patients in Bengaluru city. Data were collected
through a specially designed proforma using a closed‑ ended, self‑ administered questionnaire containing 15
questions, in five sections.
Results: The prevalence of
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
Indonesian Wild Ginger (Zingiber sp) Extract: Antibacterial Activity against ...iosrphr_editor
Lempuyang gajah (Zingiber zerumbet (L.) Smith), lempuyang pahit (Zingiber amaricans BL.), and
lempuyang wangi (Zingiber aromaticum Vahl.) are used as traditional medicine (jamu) in Indonesia. It is also
used for treatment of microbial infections, helps to increase appetite and stimulate digestion in chickens.
Information on their uses are available, but only limited in the scientific data on their bioactivity. The study was
conducted on the antibacterial effect of organic extracts of these plants with Mycoplasma gallisepticum as the
agent of chronic respiratory disease in chickens. Juice and extracts of fresh and dried rhizome are evaluated
through the disc diffusion assay and minimum inhibitory concentration. Oxytetracyclin (30 µg) are used as
standards. All extracts are individually exhibited as antibacterial activity against Mycoplasma gallisepticum (7
± 0.11 mm to 21 ± 0.86 mm). The minimum inhibitory concentration (MIC) determination of plants extracts are
ranged from 7.8 mg/ml to 31.2 mg/ml. The preliminary results suggested promising antibacterial properties of
wild ginger from Indonesia, and probably could be used in management of chronic respiratory disease in
chickens.
A case of allergy and food sensitivity: the nasunin, natural color of eggplantiosrphr_editor
Abstract: Allergies and food sensitivities can both be considered as "adverse reactions individualistic" to food.
Are pathological and individual forms because they affect a few individuals in way rather serious; immediate
or delayed reactions occur instead with simple effects histamine, or, in severe cases with respiratory and
anaphylactic shock
The eggplant (Solanum melongena L.) is known to cause food allergies in some Asian countries, but detailed
studies on allergies caused by eggplant are lacking, however, it was highlighted the presence of allergens in
edible parts of eggplant with preponderance in the peel .
The purpose of this study was to propose an extraction method rapid, efficient and cost of natural dye from
waste products from the food industry, such as the peels of eggplant, from which it was extracted, isolated and
purified the nasunin,a colored molecule in red-fuchsia.
Nasusin was tested on 58 patients to evaluate the potential sensitizing effect on the skin. The results demonstrate
that allergenic effects are negligible and therefore the nasunin can be used as a colorant in various industrial
sectors with a certain safety margin
Complete NMR Assignment of MogrosidesII A2, II E andIII A1Isolated from Luo H...iosrphr_editor
NMR analysis allowed complete assignments of three known mogrol glycosides, Mogroside IIA2 (1),
II E (2)and IIIA1 (3), isolated from the extracts of Luo Han Guo. Herein, complete 1H and 13C NMR
assignmentsof all threemogrosidesare described based on NMR experiments (1H NMR, 13C NMR, COSY,
HSQC-DEPT, HMBC, NOESY and 1DTOCSY) and mass spectral data.
Nanoemulsion and Nanoemulgel as a Topical Formulationiosrphr_editor
: Nanoemulsion is referred type of emulsion with uniform and extremely small droplet size in the range
of 20-200 nm. Nanoemulsion provides numerous advantages over other carrier such as polymeric nanoparticle
and liposomes, including low cost preparation procedure, high hydrophilic and lipophilic drug loading system
to enhance the longer shelf live upon preserving the therapeutic agents. Incorporating the preparation of
nanoemulsion with hydrogel matrix to produce nanoemulgel exhibited by the two separate systems that forming
it. Nanoemulgel possesses the properties of thixotropic, non-greasy, effortlessly spreadable, easily be removed,
emollient, not staining, soluble in water, longer shelf life, bio-friendly, translucent and agreeable appearance.
Pharmacokinetics of High-Dose Methotrexate in Egyptian Children with Acute Ly...iosrphr_editor
Aim:Since several factors have been shown to influence the clearance of methotrexate, the purpose of this study
was to identify potential relationships between patient covariates and the methotrexate clearance estimates and
deduce a pharmacokinetic model for the estimation of methotrexate clearance in Egyptian pediatric ALL
patients that may help dosage adjustment and achieve target steady-state plasma concentrations in a similar
sittings.
Patients and methods: A total of 94 pediatric patients with B-cell ALL, of whom 70 were the studied population
and 24 were the test population, were treated with four courses of HDMTX doses 2.5 gm/m2
(low-risk arm) or 5
gm/m2
(standard-/high-risk arm) given every other week by intermittent intravenous infusions over 24 hours as
a part of their treatment protocol. Patients were monitored for the 24 hour MTX concentration and the systemic
methotrexate clearance was calculated for each methotrexate dose
Epidemiology of Tuberculosis (TB) in Albania 1998-2009iosrphr_editor
Abstract : In Albania, many people erroneously think that tuberculosis (TB) is a disease of the past-an illness
that no longer constitutes a public health threat. Surveillance is an integral part of tuberculosis (TB) control.
Albania has a highTB notification rate and there are doubts about underreporting. The evolution of the
incidence of tuberculosis is presented, together with more detailed figures over the period 1998-2009. These
figures were obtained by the monthly forms (called 14/Sh) compared with the individual notification data.
Objective: To examine the distribution and sources of increased tuberculosis (TB) morbidity and reporting
system deficiencies in the Albania from 1998 through 2009. Metodology: The study is descriptive one conductet
during the period 1998-2009. The statistical analysis is based on data reported from regional level (regional
epidemiological departments) to the central level (Public Health Institute). Results: The main findings were:
discordance between the collected data (individual form) and reported data (monthly form); tuberculosis
incidence rate shows little oscillations which ranges from 6.67 to 9.2 cases/100.000 population; 50% of the
regions show a lack of information on the confirmation of diagnosis and laboratory examination type used for
confirmation. Conclusion: TB disease in high-risk populations where it is difficult to detect, diagnose, and treat;
limitations of current control measures and the need for new tests and treatments, including an effective
vaccine; improving information system, regulation of individual form and personnel training.
Total Phenol and Antioxidant from Seed and Peel of Ripe and Unripe of Indones...iosrphr_editor
Study on total phenol and antioxidantactivity ofsugar apple fruits of various solvent, part of fruits, and level of ripening. Solvent extraction used were 80% (v/v) methanol, 50% (v/v) acetone, boiling water, and 50% (v/v) ethanol. Part of fruits thatbeen used for samples were seed and peel which are normally by products of sugar apple processing, level of ripening were unripe, and ripe sugar apple fruits. Total phenol was determined by Folin-ciocalteau method. Total antioxidant was quantified by 1,1-diphenyl-2-picrylhydrazyl(DPPH) method.Therewas a difference in type of solvent, part of fruits, and level of ripeningon total phenol and antioxidant concentration of sugar apple fruits. Seeds have higher total phenol concentration than peels of this fruits. Unripe sugar apple fruits have higher total phenol and antioxidant than ripe fruit. The best solvent for phenol extraction was ethanol 50%butthe best solvent for antioxidant extraction was acetone 50%.
A Review on Step-by-Step Analytical Method Validationiosrphr_editor
When analytical method is utilized to generate results about the characteristics of drug related samples it is essential that the results are trustworthy. They may be utilized as the basis for decisions relating to administering the drug to patients. Analytical method validation required during drug development and manufacturing and these analytical methods are fit for their intended purpose. To comply with the requirements of GMP pharmaceutical industries should have an overall validation policy which documents how validation will be performed. The purpose of this validation is to show that processes involved in the development and manufacture of drug, production and analytical testing can be performed in an effective and reproducible manner. This review article provides guidance on how to perform validation characteristics for the analytical method which are utilized in pharmaceutical analysis.
A Cross Sectional Study of Ethnic Differences in Occurrence and Severity of A...iosrphr_editor
Non-steroidal anti-inflammatory drugs are the most widely used "over the counter" medication all over the world despite their complications in different major organs. Present studies envisaged for knowing the occurrence and severity of adverse drug reactions from NSAIDs in different ethnic communities of Sikkim. A cross sectional study was undertaken in the medicine outpatients department of a secondary and tertiary care hospital. The patients belonging to Nepalese, Bhutias, Lepchas ethnic communities and others community (settlers from other parts of India) were included to analyzed the data based on the age and gender, ethnicity and ADRs, drugs and ADRs. Severity assessment was done using Hartwing and Siegel scale and causality assessment by Naranjo scale. Total 109 cases of ADRs, predominating in female were detected. Nepalese were the most affected and Gastrointestinal tract (GIT) being the most affected organ in them. Diclofenac showed maximum number of ADRs in all the communities. Maximum number of cases occurred on single day use (40.36%) of drugs. All the cases were belonging to the "possible category" and the maximum being the mild (72.48%) in nature. It is advisable to consider the ethnic/racial differences equally with other factors, to improve the safety and efficacy of a drug.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Efficacy and safety of two doses of oral midazolam as premedication in paediatric patients: A prospective randomized and comparative study.
1. IOSR Journal Of Pharmacy
(e)-ISSN: 2250-3013, (p)-ISSN: 2319-4219
www.iosrphr.org Volume 5, Issue 6 (June 2015), PP. 46-49
46
Efficacy and safety of two doses of oral midazolam as
premedication in paediatric patients: A prospective randomized
and comparative study.
Pooja Vaskle1
, Rashmi Pal2,
KK Arora3
1
(Department of Anesthesiology, MGM Medical College,Indore/ Jabalpur Medical University,(M.P.)India)
2
(Department of Anesthesiology, MGM Medical College,Indore/ Jabalpur Medical University, (M.P.)India)
3
(Department of Anesthesiology, SS Medical College,Rewa/ Jabalpur Medical University, (M.P.)India)
Abstract : The present study was conducted to assess and compare the efficacy and safety of two doses of oral
midazolam as premedication in pediatric patients undergoing surgeries under general anesthesia. Forty
children aged 1-5 years were enrolled and randomly assigned to one of the two groups and received oral
preparation of midazolam in two doses of 0.5 mg/kg and 0.75 mg/kg in two groups respectively, 30 minutes
before separation from parents. They were assessed for patient’s acceptance of the medication , reaction to
separation from parents, sedation scores and recovery conditions. With regard to children’s reaction to
separation from their parents, the number of comfortable children was more in group B (18,90%) as compared
to group A (15,75%). On arrival to the operation room eight children (40%) had satisfactory sedation scores in
group B as compared to 5(25%) in group A. Satisfactory sedation score was also higher in group B (10,50%) as
compared to group A (4,20%) after reversal of residual paralysis. Time to spontaneous ventilation and
extubation and time from pre-medication to full recovery were not different in two groups. Oral midazolam in a
dose of 0.75 mg/kg is an acceptable, effective and safe premedication in children aged 1-5 years.
Keywords: anesthesia, midazolam, pediatric, premedication, ,sedation.
I. INTRODUCTION
Effective premedication is an integral component of balanced anesthesia. As in adults, children also
suffer from anxiety and separation from parents which may rise autonomic hyperactivity, dysrrythmias,
hypersalivation, breath holding and laryngospasm perioperatively. Additionally it can also add to surgical stress
response. Establishment of adequate pre-anaesthetic sedation and amnesia for pre and intraoperative event has
thus assumed an important role in the anesthetic management of pediatric patients. An ideal premedication
should allay apprehension regarding anesthesia and surgery, lessen the trauma of separation from family and
facilitate induction of general anesthesia without prolonging the post-anaesthetic recovery period.[1]
As a general consensus pharmacological approach should be adopted only when behavioral (non-
pharmacologic) management techniques fail. Midazolam has been found to be good pre-anaesthetic agent and
also is the most commonly used benzodiazepine in pediatric patients. Its principal pharmacological effects are
sedation, anxiolysis, anticonvulsant actions, spinal cord mediated skeletal muscle relaxation and anterograde
amnesia. Midazolam in its syrup form has been shown to be an extremely safe premedication for children with
a dose range of 0.25 to 1.0 mg/kg. [2,3] So this prospective, randomized and comparative study was undertaken
to assess and compare the efficacy and the safety of oral midazolam in two different doses and to determine the
optimal dose as a premedication in children of 1-5 years of age undergoing surgical procedures under general
anesthesia.
II. MATERIALS & METHODS
In a randomized, prospective and comparative study, 40 children aged 1-5 years with American
Society of Anesthesiologists (ASA) I & II status presenting for various surgical procedures under general
anesthesia were included. After approval from institutional ethics committee, the study protocol was explained
to the parents and informed consent was obtained from them. The children having upper respiratory tract
infections, rhinopharyngitis, hypersensitivity to benzodiazepines, those treated with sedatives or anticonvulsants
or if parents did not give consent were excluded from the study. The study patients were randomly assigned to
one of the two groups according to the computer based randomization. Group A received oral midazolam in a
dose of 0.5 mg/kg and Group B received oral midazolam in a dose of 0.75 mg/kg, 30 minutes before the
procedure. The drug was prepared and administered by an anesthesiologist not involved in the study.
2. Efficacy and safety of two doses of oral midazolam as premedication in paediatric patients….
47
A standard general anesthesia protocol was followed for all the patients. All children were given
atropine 0.01 mg/kg intravenously and induced with ketamine 1 mg/kg and propofol 2-3 mg/kg, intravenously.
Orotracheal intubation was facilitated with intravenous succinylcholine 2.0 mg/kg. Children were taken on
controlled ventilation and anaesthesia was maintained with a mixture of O2 and NO2 :: 50%:50% supplemented
with sevoflurane (0.25-1.0%) and atracurium as and when required. Intrvenous fluids were administered as per
standard protocol. After the completion of surgery, residual neuromuscular block was reversed with neostigmine
.05 mg/kg and glycopyrrolate .01 mg/kg intravenously. Patient electrocardiogram, noninvasive blood pressure,
pulse–oximetry and temperature were monitored intraoperatively. Paracetamol 10 mg/kg was given
intramuscularly 30 minute before the end of the procedure. Tracheal extubation was done when
normoventilation was achieved and the patients regained gag and cough reflex. Thereafter all patients were
shifted to postoperative care unit and heart rate, blood pressure, arterial oxygen saturation were monitored.
Children were also observed for the acceptance of the oral medication, reaction to the separation from parents,
pre-induction and post extubation sedation scores and recovery conditions. Acceptance of the medication was
defined as swallowing without immediate regurgitation. Reaction to the separation from parents was the
response of the children when taken away from the parents, 30 minutes after the administration of the study
syrups. It was graded as inconsolable cry, complaining, quiet but awake or sleepy. The degree of sedation when
the child was first seen in the operative room and at the end after reversal of the residual paralysis was based
upon 5 point sedation Score [4] as follows:
I. Anxious agitated
II. Oriented, calm and co-operative
III. Drowsy, responding to verbal commands
IV. Not responding to verbal commands but to the painful stimuli
V. Not responding to painful stimuli
With respect to recovery conditions, the children were also observed for spontaneous ventilation after
giving the reversal and time required for establishing adequate spontaneous ventilation and extubation was
noted. Time from pre-medication to full recovery was also noted.
Statistical analysis was performed using statistical package of social science (SPSS) version 20 . The
percentage between the two groups were compared using two- sample proportion- Z test. Mean value were
compared between the groups using student’s unpaired T test. P value of < 0.05 was considered as significant.
III. RESULTS
The children in both groups were comparable with regard to age, sex, weight and ASA status. The
duration of general anesthesia was also not statistically significant [Table-1].There were no incidence of
bradycardia (heart rate< 20%), hypotension (mean blood pressure< 20% of baseline) or desaturation episodes
( o2 saturation< 95%), after premedication or in operation room. The children in both groups accepted oral
medication well and did not vomit soon after the swallowing of premedication. Although, the number of
comfortable children were more in group B (18,90%) as compared to group A (15,75%), there was no
significant difference in level of reactions to separation from parents, 30 minutes after receiving premedication
(p>.05). [Table- 2]
There was no significant difference in the preoperative sedation scores in the both groups (P >0.05).
[Table-3] There were no incidences of children responding to painful stimuli in any of the group. After reversal
of residual paralysis, the number of children with satisfactory sedation score i.e. drowsy but arousable was
higher in the 0.75 mg/kg dose group (10,50%), than in .05 mg/kg group (4,20%) (p<.05)), whereas, the number
of children with desirable sedation score i.e. oriented and calm was significantly higher in 0.5 mg/kg dose
group (15, 75%) as compared to the group B (5,25%) (p<.05). There were 5 (25%) children in group B and
none in group A, who responded to painful stimuli but not to verbal command (P<.05). [Table-4]
There was no significant difference in the time to spontaneous ventilation and extubation in both groups. Most of
the children in both groups recovered spontaneous ventilation and could be extubated within 5 minutes. Average time
interval from pre-medication to full recovery was also not significantly different in two groups(p>.05). [Table-5]
IV. DISCUSSION
As preanesthetic medication has become an essential component of current anaesthesia practice in children, several
studies have reported that it can allay anxiety preoperatively and facilitate separation of children from their parents. [5,6,7] It
has also been suggested in many previous studies that midazolam is an effective preanesthetic medication for children. When
administered either intramuscularly,[8] rectally [9] Intranasally [10] or orally.[11,12] Oral midazolam is found to be safe and
effective without altering the haemodynamics and oxygen saturation values in the pre-operative or immediate post operative
periods. It produces good anxiolysis in a dose range of 0.4-0.6 mg/kg in older children (>5 years of age) allowing parenteral
separation by 15-30 minutes.
3. Efficacy and safety of two doses of oral midazolam as premedication in paediatric patients….
48
In a comparative study done by Saarnivarra et al [13] on children (1-9 years of age) receiving oral
midazolam or chloral hydrate (in combination with atropine), they concluded that midazolam 0.4-0.6 mg/kg per
oral provided only "fair analysis in children younger than 5 years of age, but good anxiolysis in children more
than 5 years of age. In the same context, our study has tried to compare two doses of oral midazolam (0.5 mg/kg
and 0.75 mg/kg) in children of 1-5 years of age and we found that oral midazolam in the dose of 0.75 mg/kg was
similar to dose of 0.5 mg/kg with respect to children,s separation from their parents, preoperative sedation
scores and recovery conditions, whereas it was better in producing favourable sedation scores after reversal of
residual paralysis.(p<.05)
Administration of small amount of fluid (5 to 10 ml) to children prior to induction of general anesthesia
does not pose a significant risk for aspiration of abdominal contents [14]. The limited bioavailability of oral
midazolam due to its high first pass metabolism may explain the high dose requirement for sedation and
anxiolysis after the oral route of administration. This combination of sedative and anxiolytic characteristics of
midazolam is believed to create a calming effect which eases the separation of children from their parents [15].
Finley et al.[15] showed that midazolam induced decrease in anxiety was more pronounced for children with
higher baseline levels of anxiety. Oral midazolam was reported to give a more predictable and effective sedation
than oral diazepam [16]. It was also associated with a faster and smoother recovery, when compared with oral
ketamine [17]. Patel and Meakin [18] also reported greater anxiolysis after oral midazolam (0.5 mg/kg) than
after a combination of diazepam (0.25 mg/kg) with droperidol (0.25 mg/kg) or trimeparazine (2 mg/kg).
Age of the child is also an important variable. Separation anxiety usually peaks at approximately 1 year
of age, but children at the age of 1-5 years are at the highest risk for extreme preoperative anxiety [19]. Clinical
sedative effects are seen within 5 to 10 minutes of oral midazolam administration. The peak effect is achieved
in 20 to 30 minutes [20]. In present study, separation time was set at 30 minutes and we found a satisfactory
anxiolysis in 90% of children after 0.75 mg/kg dose and 75% of children in 0.50 mg/kg dose.
Preoperative oral midazolam has proved effective in treating preoperative anxiety. Orally administered midazolam
can be given in a dose of 0.25 to 1 mg/kg up to a total dose of 20 mg depending on the duration of surgery and the anxiety
level of the child. In this study, after reversal of residual paralysis, the satisfactory level of sedation score was achieved in 10
(50%) children in group B and 4 (20%) children in group A and the difference was statistically significant (p<.05), whereas
the number of oriented and calm children was higher in group A (15, 75%) than in group B (5,25%)(p<..05). There were
5(25%) children in group B and no children in group A, who were not responding to verbal command but to painful stimuli
(p<.05). Feld et al [3] also reported a superior anxiolysis 30 minutes after a 0.75 mg/kg dose of midazolam as compared to
0.25 mg/kg and 0.5 mg/kg dose or placebo. Similarly, it was reported that the use of a 0.75 mg/kg dose of oral midazolam
did not result in clinical respiratory depression or upper airway obstruction, but in some children caused an increased level of
sedation beyond simple conscious sedation. [21] Our study correlates to this study.
According to Cox et al [22] oral midazolam effectively reduced both separation and induction anxiety in children
with minimal effect on recovery times. There was no significant delay in recovery time of both groups in our study. Small
sample size has been the limitation of our study and statistically significant difference could have been drawn with a
relatively larger sample with respect to chlldren’s reaction to parent’s separation and preoperative sedation score as well.
V. CONCLUSION
It can be concluded that oral midazolam in a dose of 0.75 mg/kg is an optimal and effective premedication drug in
children of 1 to 5 years of age with minimal effects on recovery time. There were no hemodynamic alterations and
respiratory depression reported in this dose of midazolam. Other side effect like nausea, vomiting and hiccough were also
not reported.
Table 1 : Demographic Profile
Variable Group A Group B
Age (years) 2.74±1.54 2.86±1.65
Sex (M/F) 13/7 12/8
Weight(kg) 15.25±6.98 14.78±6.28
ASA I/II 16/4 15/5
Duration of general anesthesia 62.0±21.4 54.8±23.5
Values are expressed as mean±standard deviation.
Table 2 : Reaction to parents separation
Reaction Group A
(0.5 mg/kg)
Group B
(0.75mg/kg)
P value
Inconsolable cry 1(5%) 0(0%) 0.305
Complaining 4(20%) 2(10%) 0.371
Total number of uncomfortable children 5(25%) 2(10%) 0.203
Quiet-but-awake 13(65%) 13(65%) 1.000
Sleepy 2(10%) 5(25%) 0.203
Total number of comfortable children 15(75%) 18(90%) 0.203
4. Efficacy and safety of two doses of oral midazolam as premedication in paediatric patients….
49
Table 3: Preoperative Sedation score in operation room
Score Group A
(0.5 mg/kg)
Group B
(0.75mg/kg)
P value
Anxious 3(15%) 0(0%) 0.060
Oriented, calm 11(55%) 8(20%) 0.337
Drowsy-RVC 5(11%) 8(20%) 0.305
Not RVC but to painful stimuli 1(5%) 4(20%) 0.141
Not responding to painful stimuli 0(0%) 0(0%)
Table 4: Sedation score on reversal of residual paralysis.
Score Group A
(0.5 mg/kg)
Group B
(0.75mg/kg)
P value
Anxious 1(5%) 0(0%) 0.305
Oriented, calm 15(75%) 5(25%) 0.000*
Drowsy-RVC 4(20%) 10(50%) 0.036*
Not RVC but to painful stimuli 0(0%) 5(25%) 0.010*
Not responding to painful stimuli 0(0%) 0(0%)
*= significant (p<.05)
Table 5 : Recovery profile.
REFERENCES
[1]. White PF : Pharmacologic and clinical aspects of preoperative medication. Anesth Analg 65:963-74,1986
[2]. McMillan CO, Spahr-Schopfer IA, Sikich N, Hartley E, Lerman J. Premedication of children with oral midazolam. Can J Anaesth.
1992;39:545-50.
[3]. Feld LH, Negus JB, White PF. Oral midazolam preanesthetic medication in pediatric outpatients. Anesthesiology.1990;73:831-4
[4]. Malviya S, Voepel-Lewis T, Tait AR, Merkel S, Tremper K and Naughton N. Depth of sedation in children undergoing computed
tomography : validity and reliability of the University of Michigan Sedation Scale (UMSS). Br J Anesth.vol.88,no.2, pp.241-
245,2002
[5]. Rita L, Seleny FL, Goodarzi M. Intramuscular midazolam for pediatric preanesthetic sedation. A double-blind controlled study with
morphine. Anesthesiology 63:528-31, 1985
[6]. Nicolson SC, Betts EK, Jokes DR, Christianson LA, Walters JW, Mayes FR, Korevaar WC. Comparison of oral and intramuscular
preanesthetic medication for pediatric inpatient surgery. Anesthesiology 71:8-10,1989
[7]. Brzustowicz RM, Nelson DA, Betts EK, Rosenberry KR, Swedlow DB. Efficacy of oral premedication for pediatric outpatient
surgery. Anesthesiology 60:475-77, 1984
[8]. Taylor MB, Vine PR, Hatch DJ. Intramuscular midazolam premedication in small children. Anesthesia 41:21-6,1986
[9]. Maurice C, Meistelman C, Rey E. Esteve C, De Lauture D, Olive G: Saint The pharmacokinetics of rectal midazolam for pre-
medication in children. Anesthesiology 65:536-538, 1986
[10]. Wilton W, Leigh J, Rosen D, Pandit V: Preanesthetic sedation of preschool children using intranasal midazolam. Anesthesiology
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patient oral surgery. Br J Anaesth 59:746-754, 1987
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Anesthesiology 69:A745, 1988.
[13]. Saarnivarra L, Lindgren L, Klemola U-M: Comparison of chloral hydrate and midazolam by mouth as premedicants in children
undergoing otolaryngological surgery. Br J Anaesth 61:390-396, 1988.
[14]. Splinter WM, Stewart JA, Muir JG: The effect of preoperative apple juice in gastric contents, thirst, and hunger in children. Can J
Anaesth 36:55-58, 1989.
[15]. Finley GA, Stewart SH, Buffett-Jerrott S, Wright KD, and Millington D, “High levels of impulsivity may contraindicate
midazolam premedication in children,” Canadian Journal of Anesthesia, vol. 53, no. 1, pp. 73–78, 2006.
[16]. Pywell CA, Hung YJ, and Nagelhout J, “Oral midazolam versus meperidine, atropine, and diazepam: a comparison of premedicants
in pediatric outpatients,” Journal of the American Association of Nurse Anesthetists, vol. 63, no. 2, pp. 124–130, 1995.
[17]. Alderson PJ and Lerman J, “Oral premedication for paediatric ambulatory anaesthesia: a comparison of midazolam and
ketamine,” Canadian Journal of Anaesthesia, vol. 41, no. 3, pp. 221–226, 1994.
[18]. Patel D and Meakin G, “Oral midazolam compared with diazepam-droperidol and trimeprazine as premedicants in
children,” Paediatric Anaesthesia, vol. 7, no. 4, pp. 287–293, 1997.
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no. 1, pp. 98–105, 2001.
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Time Group A
(0.5 mg/kg)
Group B
(0.75mg/kg)
P value
Time to spontaneous ventilation and extubation <5 min 18(90%) 16(80%) 0.371
Time to spontaneous ventilation and extubation 5–10 min 2(0%) 2(10%) 1.000
Time to spontaneous ventilation and extubation 10–40 min 0(0%) 2(10%) 0.136
Time from premedication to full recovery (hours) 97.5±21.0 92.3±25.7 0.483