Objectives: To evaluate and compare the Ondansetron and Granisetron in preventing spinal anaesthesia induced hemodynamic instability in obstetric patients Methods: The comparative analytical study was conducted at Combined Military Hospital, Rawalpindi, from September to October, 2021. One hundred and twenty pregnant women undergoing cesarean section, were enrolled in the study via non probability convenience sampling, and divided into three groups containing 40 participants each based on the type of antiemetic premedication they received, if any: Group N were those not requiring antiemetic premedication, Group O consisted of those given ondansetron 4mg, and Group G had those receiving 3mg granisetron, 15 minutes prior to administration of spinal anaesthesia. Systolic blood pressures and heart rates were recorded before and at multiple intervals after spinal anaesthesia was administered. Episodes of hypotension and bradycardia were recorded. Requirement of phenylephrine and atropine as rescue drugs was recorded for each participant. Results: There was a statistically significant difference in incidence of hypotension among the three groups (p value <0.001), with both drugs being superior to the control group (p value <0.001 for both), and 3mg granisetron being superior to 4mg ondansetron (p value <0.001). As for incidence of bradycardia, ondansetron and granisetron were superior to control group (p value 0.03 and <0.001 respectively), but there was no significant difference between the two drug groups (p value 0.094). Conclusion: High dose granisetron (3mg) is superior to low dose ondansetron (4mg) in preventing hemodynamic fluctuations induced by spinal anaesthesia. doi: https://doi.org/10.12669/pjms.38.7.5585 How to cite this:Wahid M, Ali S, Yasin B, Farhat K, Noor M, Syed FT. Granisetron versus Ondansetron: Comparison of 5HT3 antagonists in preventing spinal anaesthesia induced hemodynamic instability in obstetric patients. Pak J Med Sci. 2022;38(7):---------. doi: https://doi.org/10.12669/pjms.38.7.5585 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction. The influence of epidural analgesia on the length of labourremains a source of controversy in literature. Objectives. To see the effect of epidural analgesia on the duration ofactive first stage and second stage of labour. Setting: Obstetric Department of CMH Kharian. Period: From 1 January st2005 to 31 March 2006. Material and methods. One hundred pregnant full term, women were included in the study. stFifty primiparous reporting at full term, half were given epidural analgesia the other half were control. Another fiftymultiparous reporting at full term, twenty five women were given epidural the other twenty five were control. Results.The mean duration of active first stage of labour in primiparous women after 3 – 4 centimeter cervical dilatation was5.10 hrs in the epidural group while it was 6.65 hrs in the control group (p less than 0.001). In the multiparous womenthe mean duration of active first stage of labour after 3 – 4 centimeter cervical dilatation was 2.40 hrs in the epiduralgroup while it was 3.43 hrs in the control group (p less than 0.001). In the primiparous women the mean second stagewas 23.76 minutes in the epidural group, and 37.33 minutes in the control group (p less than 0.001). In the multiparousgroup, the mean second stage was 17.58 minutes in the epidural group, and 22.00 minutes in the control group (p lessthan 0.001). Conclusion. Epidural analgesia decreases the duration of active first stage and second stage of labour.
Tuned mass dampers (TMDs) as vibration-mitigating devices are widely used in structures to reduce their displacement response under dynamic forces. Through a novel dolphin echolocation (DE) algorithm, this paper provides optimum tuning of TMD parameters. Developing some features of this algorithm results in a faster convergence to the optimum solution. Besides, grey wolf and whale optimization algorithms (GWO and WOA), as two other nature-based meta-heuristic algorithms, are employed in this problem. The modified DE illustrates a more optimum design of TMD's parameters rather than GWO and WOA. The code has been verified by a sample structure from the literature and then applied to a high-rise forty-story structure under strong ground motions. The numerical results reveal that the optimum TMD is viable in attenuating the structural responses, including relative displacements and absolute accelerations under different earthquake excitations. For instance, in the high-rise structure, the modified DE, GWO, and WOA reduce the maximum displacements up to 45%, 43%, and 38%, respectively. Moreover, the algorithms, specifically the modified DE, propose more cost-effective designs in comparison with previous studies in the literature by introducing smaller TMD parameters.
Providing a decent housing is a major challenge for governments and development authorities in Jordan and Arab countries. Nevertheless, the growing number of population falling under poverty put more demand on low cost housing options. The goal of the research was to find ways of rationalizing the cost and determine the appropriate standards and models that achieve an acceptable equation between cost and performance, and that during design and construction phases. The study follows the method of investigation and analysis to get factors that reduce the cost of the house construction for poor families by means of the concept of standardization in traditional (popular) buildings system. The research confirms that the traditional system has many advantages that could strengthen towards development a low-cost building system by applying the principles of standardization through architectural, structural and electro-mechanical considerations of design. Research recommends taking on studies for low cost building system through comprehensive analytical study of local building experiences.
Background: Over the last few decades, many researchers have investigated the properties and behavior of concrete mixtures incorporating rubber-based solid wastes as a partial substitution of natural aggregates. Within this context, they have conducted experimental studies and developed numerical models that simulate the nature of rubberized concrete. Some of these mathematical simulations were intended to provide a rapid mixture of proportioning approaches and property estimation methods. Currently, it is believed that regression analysis provides an effective tool to simply construct a mathematical expression that models a set of data. For that reason, multiple linear regression was extensively utilized in predicting rubberized concrete properties in the literature. However, the performances of regularized regression analysis approaches were not evaluated even though they provide better alternatives to traditional regression methods in terms of controlling the overfitting issue. Objective: This study aims to assess the performance of Ridge, Lasso, and elastic net regression models in estimating the compressive and tensile strengths, and modulus of elasticity of rubberized concrete. Additionally, it intends to benchmark their capabilities against the traditional multiple linear regression method. Methods: Multiple linear regression, Ridge regression, Lasso regression, ElasticNet regression, Bayesian ridge regression, Stochastic gradient descent, Huber regression, and Quantile regression methods were used in the study. Result: In general, the research findings illustrated the superior performance of regression assessment in modeling the mechanical properties of rubberized concrete. Conclusion: Indeed rubberized concrete mechanical properties can be better modeled using regularized regression techniques, such as ElasticNet-based SGD compared to traditional methods, such as MLR.
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