Premarin was administered prophylactically to every other patient in a series of 148 consecutive cases of open intracardiac surgery. Of these, 132 patients were matched to analyse the results of Premarin administration and postoperative blood loss. There were 67 patients who were given Premarin and 65 who did not receive this drug; both groups were identical in respect of age and sex. Matching was undertaken according to history of previous cardiac operations and anticoagulation, type of valve surgery or repair of congenital anomaly, duration of perfusion, platelet count and the use of fresh blood and epsilon-aminocaproic acid in the postoperative period. The prophylactic use of Premarin was not associated with a reduction in postoperative bleeding.
To observe the effects of preoperative pain education on Coronary artery bypass graft surgery (CABG) patients on postoperative pain management. Methods: A randomized control trial was performed from April-December 2019, after seeking ethical approval. Patients of Punjab institute of cardiology, Lahore, scheduled for CABG were selected after informed consent. Those with psychiatric illness, chronic pain/opioid addiction, or allergic to opioids, were excluded. The population was divided into control (received routine preoperative care) and interventional (received additional preoperative education via pain management booklet) groups, data was collected postoperatively via questionnaire and analyzed on SPSS. Chi-square was used as a statistical test and p-value <0.05 was significant. Results: Eighty patients with 47 males and 33 females aged 50-80 years (mean=61.05±8.32) were recruited. The interventional group agreed to the significance of instant in-hospital notifying/managing pain and 38(95%) controls agreed to it, 39(98%) interventional patients were willing for a stronger pain-relief medicine if not cured by the initial dose, while 12(30%) controls were willing for it. 38(95%) interventional patients denied the fear of addiction to painkillers, contrarily 5(12.5%) controls negated this fear. All interventional patients rejected the concern of incurable nausea with pain-relief medicine, while 37(92.5%) controls were threatened with this concern. Constipation associated with pain-relief medicine was refused by all interventional patients, 25(62.5%) controls accepted it. All the differences between both groups were significant (p<0.001). Conclusion: A significantly improved postoperative patient compliance/outcome (pain-related) was observed in the interventional group who preoperative received pain education compared to the control.
Objective: The objective of this study was to assess the predictive value of serum level of interleukin 31 (IL31) in diagnosis of osteoporosis (OP) in postmenopausal women.Methods: This case–control study was conducted on 80 individuals, 50 of them with postmenopausal OP diagnosed using dual X-ray absorptiometry study, and the other 30 were healthy postmenopausal female controls. Serum level of IL31 was measured using enzyme-linked immunosorbent assay technique in both groups.Results: The mean age of patients was 65.3±4.8 years and controls was 61.1±3.9 years. Mean serum IL31 level was significantly higher among postmenopausal patients with OP compared to healthy controls (83.5±34.2 vs. 34.9±7.3ng/ml, p<0.05). The optimum cutoff value of serum IL31 that can differentiate between patients with OP in postmenopausal women from controls was >44.51 ng/ml with perfect positive predictive value (PPV) (100%), very high accuracy of 92.5%, 88% sensitivity, 100% specificity, and negative predictive value (NPV) 83.3%.Conclusions: Serum IL31 level was significantly higher in postmenopausal osteoporotic women compared to healthy controls. It was a valid measure with high accuracy and perfect PPV and specificity, high sensitivity, and NPV. It can be used to confirm the diagnosis of OP in postmenopausal women.
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