Background: Trauma in the head is one of the most common childhood injuries. Children with minor head trauma are at higher risk of intracranial injury (ICI). Vomiting is one of the most common signs after minor head trauma in children, and different treatments are suggested for managing it. Objective: To determine the antiemetic effects of dexamethasone in children with minor head trauma. Methods: This single blind randomized clinical trial study was carried out during the period from September 2015 to August 2016 in Imam Khomeini and Golestan Hospitals in Ahvaz, Iran, on 64 children (2-8 years old) with minor head trauma (Minor head trauma was considered as GCS 14-15) who were admitted to the hospitals' emergency departments. In the intervention group, metoclopramide (0.15 mg/kg) and dexamethasone (0.15 mg/kg) were injected. In the placebo group, patients received metoclopramide (0.15 mg/kg) and placebo. Nausea severity was measured using Rhodes Index of Nausea and Vomiting. The data were analyzed using SPSS version 19. We used descriptive statistics, Chi-squared, t-test, and ANOVA for the analyses of the data. P-value of less than 0.05 was defined as the level of significance. Results: Finally, 62 patients (mean age of 56.4 and 62% male gender) attended the study and were equally divided into intervention and placebo groups. The Rhodes Index of Nausea and Vomiting on the intervention and placebo groups was 4.9±3.73 and 7.19±3.79, respectively (p=0.021). Conclusion: Collectively, our results indicated that dexamethasone can be used as an effective medication along with metoclopramide to control vomiting in children with minor head trauma. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016081128944N1.
BackgroundVertigo is an illusion of rotation that is caused by the asymmetry of neurological function of the right and left vestibular nuclei. The aim of this study was to compare the efficacy and side effects of oral betahistine with injectable promethazine in treatment of acute peripheral vertigo.MethodsIn this double-blind clinical trial study, the patients with acute peripheral vertigo were assigned in the two groups: receiving promethazine intramuscularly at a dose of 25 mg (group A) and receiving 8 mg betahistine tablets (group B) and the severity of their vertigo was evaluated on the visual analog scale (VAS) scoring system. In addition, adverse events in both groups of patients were compared and evaluated.ResultsA total of 162 patients (82 subjects in group A) participated in this study. The mean age, gender distribution, intensity and symptoms of vertigo were similar in both groups before the intervention. At 2 and 3 h after the intervention, the score of VAS in patients taking betahistine was significantly higher than promethazine. In addition, the clinical symptoms after taking betahistine were significantly less. Side effects seen in patients taking the promethazine include mainly drowsiness. After taking betahistine, the most common complication was abdominal problems (nausea and vomiting).ConclusionThe results of this study show that betahistine is a safe and effective drug in controlling patients with acute vertigo and its impact is more than promethazine.
Background clinical efficacyMethods: In Emergency Ho group A receiv recorded at 5 d The pain score Also, ANOVA applied to comp Results: The that received de was 20 minute tervention.Conclusion: ketamine prod dexmedetomid departments.
Objective This study aimed to compare the efficacy of using dexmedetomidine with salbutamol and salbutamol nebulization alone in patients with acute exacerbation of asthma presenting to the emergency department.Methods This clinical trial included 60 patients, in the age range of 18 to 55 years, with signs of bronchospasm presenting to the emergency department. In the intervention group, dexmedetomidine 0.5 µg/kg was injected intravenously and three doses of salbutamol nebulization were administered over 60 minutes. In the control group, salbutamol nebulization was administered for 60 minutes three times. The patient's clinical status, based on clinical symptoms, consciousness, speech, breathing rate, heart rate, and blood pressure were recorded before the intervention, and peak expiratory flow rate and forced expiratory volume in 1 second were measured at 20, 40, and 60 minutes after intervention. Patients who did not respond to the intervention were excluded from the study within 60 minutes.
ResultsThe increased mean forced expiratory volume in 1 second and mean peak expiratory flow rate were found to be similar in both groups during the treatment (P = 0.304). The mean systolic and diastolic blood pressure recorded at 40 and 60 minutes were significantly lower in the intervention group. During this study, no patient was excluded before 60 minutes.
ConclusionAdministration of dexmedetomidine in addition to standard salbutamol treatment has no beneficial effect in patients with acute asthma attacks and merely causes hypotension in patients.
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