Objective: To determine the effect of a single intravenous dose of tranexamic acid on intraoperative bleeding, duration of surgery and surgical field visualization during endoscopic sinus surgery. Methods: Study Design: Double-blind, randomized, placebo-controlled trial. Setting: Tertiary Government Hospital in Quezon City Participants: 10 patients aged 18-75 years old diagnosed with chronic rhinosinusitis with or without nasal polyposis and unresponsive to medical treatment, who underwent endoscopic sinus surgery from September 2016 to August 2017, were randomly allocated to treatment group and control group respectively. The “odd” numbers were assigned to the treatment group (intravenous Tranexamic acid) given 1 dose of 100mg/ml (500mg tranexamic acid per 5 ml) tranexamic acid slow intravenous drip 1 hour prior to the procedure, while the “even” numbers assigned to the control group received the same amount of normal saline solution. Results: The mean duration of surgery of the tranexamic group was 185 minutes (standard deviation, SD 55.23) and the control group was 122.6 minutes (SD 42.03) showing no significant difference (p=.08). The mean blood loss of the tranexamic group was less at 240ml (SD 108.39) compared with the control group at 290ml (SD 74.16), although there was no statistically significant difference (p=.42). Intraoperative surgical field assessed by the surgeon based on the Boezart grading scale showed that 2 (40%) of the tranexamic group had higher bleeding score compared with the placebo group. However, this was not found to be statistically significant (p=.460). Due to the small sample size, a type II error occurred with alpha level of 0.05 and estimated power of 0.0885, with not enough basis to refute that a single dose of intravenous tranexamic acid has no effect in improving surgical field visualization during endoscopic sinus surgery. No drug side effects were noted after administration until after surgery. Conclusion Single dose intravenous tranexamic acid in functional endoscopic sinus surgery decreased mean intraoperative blood loss (but this was statistically insignificant), but its effect on surgical field visualization cannot totally be assessed due to small sample size. There was also no change in the observed duration of surgery. No untoward side effects associated were noted from administration of the drug until after the surgery finished.
Administration, Intravenous ; Tranexamic Acid ; Sinusitis

No abstract available.
Administration, Intravenous* ; Cervix Uteri* ; Cisplatin* ; Female ; Fluorouracil*

Vancomycin is a bacteriocidal antibiotic experiencing a resurgence of utility because of increasing clinical problems with methicillinresistant staphylcoccal infections. Vancomycin can cause two types of hypersensitivity reactions, the red man syndrome and anaphylaxis. There is a consensus that slow intravenous administration of vancomycin should minimize the risk of infusion related adverse effects. We report a case of vancomycin hypersensitivity reaction with slow infusion of vancomycin.
Administration, Intravenous ; Anaphylaxis ; Consensus ; Hypersensitivity ; Vancomycin

No abstract available.
Administration, Intravenous* ; Nimodipine* ; Rabbits* ; Subarachnoid Hemorrhage*

No abstract available.
Aged ; Administration, Intravenous* ; Analgesia, Patient-Controlled* ; Humans

BACKGROUND: The worldwide incidence of osteomyelitis is approximately 21.8 cases per 100,000 person-years. The cornerstone of treatment is prolonged (4-6 weeks) intravenous antibiotic administration. This entails additional cost, inconvenience, and added manpower from the healthcare system. Thus, studies have explored the possible use of oral antibiotics as alternatives to improve patient compliance and reduce costs. Our meta-analysis aimed to compare the efficacy of oral versus intravenous antibiotics in treating adult patients with osteomyelitis. MATERIALS AND METHODS: Electronic databases (PubMed, Medline, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Research Gate) from 1966 to April 2020 were searched using the terms “oral antibiotics”, “osteomyelitis”, “randomized controlled trial”. Only studies that directly compared oral versus intravenous antibiotics and confirmed osteomyelitis through biopsy and/or imaging were included. Primary outcome is remission (resolution of symptoms with no relapse and bacteriologic eradication); secondary outcomes, (a) relapse (persistence of the pathogen after treatment) and (b) adverse events. The validity of included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. We performed a random-effects model in Review Manager Version 5.3 with 95% confidence interval. The I 2 test was used to assess heterogeneity. RESULTS: Seven of 89 trials comprised of 1,282 patients were included in the final analysis. All studies included patients with osteomyelitis of the lower extremities. Oral antibiotics used were Ciprofloxacin, Ofloxacin, and Co-trimoxazole; intravenous antibiotics used were deemed appropriate by the infectious disease specialist. Patients were only given either oral or intravenous antibiotics. Results showed an 8% increase in remission rates [RR 1.08 (0.81 to 1.44, 95% CI, Z = 0.52, p=0.60)] with no heterogeneity (I2 = 0%) in the intravenous antibiotics group. However, this was not statistically significant. Furthermore, there was a 62% decrease in relapse rates in the intravenous antibiotics group [RR 1.62 (0.85 to 3.07, 95% CI, Z = 1.47, p = 0.14)] with no heterogeneity (I2 = 0%) but was not statistically significant. CONCLUSION: Oral are comparable to intravenous antibiotics in treating osteomyelitis in terms of remission and relapse rates. However, larger and double-blinded trials should be done to generate more robust data to validate these claims.
Osteomyelitis ; Administration, Intravenous ' ; Parenteral Nutrition

This paper present a microcontroller system for target controlled infusion according to pharmacodynamic parameters of intravenous anesthetics. It can control the depth of anesthesia by adjusting the level of plasma concentrations. The system has the advantages of high precision, extended function and easy operation. It has been now used in the clinical anesthesia.
Algorithms ; Anesthesia, Intravenous ; instrumentation ; methods ; Anesthetics, Intravenous ; administration & dosage ; pharmacokinetics ; Computer Systems ; Humans ; Infusions, Intravenous ; Microcomputers ; Software Design

PURPOSE: Phenytoin is effectively and widely used drug for the treatment of status epilepticus and patient with ongoing seizure by intravenous infusion. It is generally recommended to maintain serum concentration above 10microgram/ml for the sustained effective anticonvulsant effect. This study was designed to know the optimal time to begin oral maintenance therapy after initial intravenous infusion. METHODS: Total 17 patients with status epilepticus and ongoing seizure who were admitted to the pediatric department of Han Yang University during the period from July 1993 to September 1995 were enrolled in this study and serum level was monitored at 2, 6 and 12 hours after the intravenous phenytoin infusion of loading dose, 20mg/kg of body weight by enzyme multiplict immunoassay technic. Student t-test was used for statistical analysis and P value below 0.05 interpreted as statistically significant. RESULTS: 1) The subjects were 5 boys and 12 girls, average age was 7.6 years old and age distribution was from 3 months to 15 years old. 2) The serum concentration ranged from 9.42microgram/ml to 43.98microgram/ml (24.04+/-8.97microgram/ml) after 2 hours, 8.82microgram/ml to 33.95microgram/ml (18.62+/-6.43microgram/ml) after 6 hours, and 7.20microgram/ml to 31.38microgram/ml (14.97+/-6.58microgram/ml) after 12 hours. 3) There was no significant differences of average serum concentration and the decline of serum concentration by time between patients over and below 2 years of age and both sexes. 4) The average decrease in serum phenytoin concentration per hour was 0.91microgram/ml. 5) The average maintenance duration of therapeutic serum level after initial infusion of loading dose was 22.4 hours. CONCLUSIONS: The average maintenance duration of therapeutic serum level after initial infusion of loading dose was 22.4 hours, hence it would be appropriate to administer maintenance dose of phenytoin if the serum level at 2 hours after loading dose is satisfactory.
Administration, Intravenous* ; Adolescent ; Age Distribution ; Body Weight ; Female ; Humans ; Immunoassay ; Infusions, Intravenous ; Phenytoin* ; Seizures ; Status Epilepticus

Orthopedic surgery was performed under Thalamonal-N2O-O2 anesthesia by an intravenous injection of a small dose of Thalamonal and N2O inhalation. Respiratory rate was compared before and after intravenous administration of nalorphine at the end of operation. From 22 cases, the following results were obtained: 1) Average dose of Thalamonal during induction of anesthesia was 1.67ml/10kg. During induction, rigidity of chest wall developed in 5 cases, 2) Intermittent injections of Thalamonal for maintenance of anesthesia were needed at. each 43. 8 min. interval, and average dose of Thalamonal was 0. 013 ml/kg/30min. 3) After injection of nalorphine, average rate of respiration per minute increased from 15. 1 to 21. 1(39. 9%) 4) 21 cases among 22 cases recovered promptly after discontinuation of N2O, and recovery was delayed in 1 case. Self extubation was seen in 3 cases.
Administration, Intravenous ; Anesthesia* ; Inhalation ; Injections, Intravenous ; Nalorphine ; Orthopedics* ; Respiration ; Respiratory Rate ; Thoracic Wall

PURPOSE: Knee IVIR images were repeatedly obtained after intravenous administration of gadopentetate dimeglumine to evaluate the arthrographic effect and to determine the optimal scan timing and technique. MATERIALS AND METHODS: Sagittal Tl-weighted (650/15) sequences were repeated before and after intravenous gadolinium enhancement in 26 patients who were divided into exercise (14/26) and nonexercise (12/26) groups. Fourteen patients in exercise group were allowed to move the affected knee joint actively for 10 minutes immediately after the first post-enhancement scan and before repeating scans. The signal intensities in central and peripheral portions of the joint were measured and compared between these two groups. RESULTS: In all cases, enhancement of joint fluid began at peripheral portion and progressed toward central portion. The diffusion rate in exercise group was far faster than that in nonexercise group and homogeneous arthrographic image was revealed within 10 minutes after completion of joint movement. The arthrographic effect continued and the rate of signal decrease was quite slow. CONCLUSION: MR arthrographic image of knee joint can be obtained within 10 minutes after completion of a few minute exercise following intravenous injection of gadopentetate dimeglumine. Intravenous MR arthrography is expected to become an useful method as a convenient alternative to direct MR arthrography.
Administration, Intravenous ; Arthrography* ; Diffusion ; Gadolinium ; Gadolinium DTPA ; Humans ; Injections, Intravenous ; Joints ; Knee Joint ; Knee*