Sreedhar Ganga - Academia.edu (original) (raw)
Papers by Sreedhar Ganga
International Journal of Advanced Research in Medicine
Background and objectives: In newborns and infants who have just undergone major surgery, the pla... more Background and objectives: In newborns and infants who have just undergone major surgery, the plasma concentrations of the painkiller acetaminophen (INN, paracetamol) have not yet been determined in the research literature. As a result, we conducted a study in the intensive care unit of our hospital. Study Methods: During elective craniofacial correction, 40 toddlers with a mean (standard deviation) age of 10.3 (2.3) months received 20 mg/kg of acetaminophen orally (n = 20) or rectally (n = 20) every 6 hours following a rectal loading dose of 40 mg/kg. Pain assessments were made every three hours, and blood samples were taken an hour before and two hours after the administration of acetaminophen maintenance dosages. Results and discussion: The mean area under the concentration-time curve (AUC) for patients receiving rectal acetaminophen was 171.2 mg/h/L, while the mean AUC for patients receiving oral acetaminophen was 111.9 mg/h/L. Patients receiving oral acetaminophen reported greater pain scores. However, acetaminophen plasma concentrations and pain scores did not differ across the groups once the patients who vomited were removed from the oral acetaminophen group. Acetaminophen plasma concentrations and pain ratings did not correlate. Despite the fact that 9 out of 40 patients (or 22.5%) did not achieve the desired analgesic acetaminophen plasma concentrations of 10 to 20 mg/L, 7.5% of the pain scores on the visual analogue scale were higher than the 4 cm cutoff criterion. Conclusion: These are the first results demonstrating that following major surgery in this age range, the analgesic acetaminophen plasma concentration does not always reach the 10 to 20 mg/L level. These results also demonstrate that the rectal route is the most effective approach to provide acetaminophen following craniofacial surgery once a rectal loading dosage of 40 mg/kg has been administered during surgery.
International Journal of Advanced Research in Medicine
Postoperative pain is frequent among hospitalized patients. Different therapeutic traditions and ... more Postoperative pain is frequent among hospitalized patients. Different therapeutic traditions and the attitudes of each hospital's medical staff impact its treatment. This study Aim to find out how analgesic drugs were prescribed and used to treat pain after abdominal surgery in Indian hospitals. It also Aim to find out how common and bad postoperative pain was, as well as how much the way pain was treated differed between the centers that took part. Methods: The study involved a descriptive cross-sectional examination of drug use in 12 Indian hospitals. The subjects were a non-selected sample of consecutive abdominal surgery patients who were hospitalized between October 2020 and January 2022. Information about the surgical technique and the use of analgesics was prospectively obtained for each patient. On the first day after surgery, a visual analogue scale (VAS) and a six-point scale (none, mild, moderate, severe, very severe, and intolerable) were used to rate the level of pain. Results: There were 993 patients (547 men) involved in the study. Inguinal hernia repair (315, 32%), cholecystectomy (268, 27%), appendectomy (140, 14%), bowel resection (137, 14%), and gastric surgery (58, 6%) were the most prevalent surgical procedures. 59% (587) of patients received only nonopioid analgesics, 9% (89) received only opioid analgesics, and 27% (263) received both opioid and nonopioid analgesics. Metamizole (667 patients) and pethidine were the medications provided most frequently (213 patients). Although the administration of analgesics was scheduled in the majority of physician orders, the majority of actual doses were administered "as needed." The average daily doses of all analgesics delivered were less than those indicated. 38 percent (371/967) of patients reported severe to terrible first-day maximum pain. The surgical procedures that had been conducted, the analgesics that had been administered, and the pain scores that had been reported by patients exhibited substantial interhospital variation. Between 22% and 67% of patients in each facility had pain that was severe or intolerable. Conclusions: It appears that poor usage of analgesics is to blame for the fact that many patients in India continue to experience significant pain after undergoing abdominal surgery. It was found that there were big differences between hospitals in how pain after surgery was treated and how often it happened.
National Journal of Physiology, Pharmacy and Pharmacology, 2021
Background: Diabetes mellitus type 2 is associated with deteriorating blood sugar levels along wi... more Background: Diabetes mellitus type 2 is associated with deteriorating blood sugar levels along with countless metabolic disorders. Treatment strategy plays a crucial role in achieving target blood sugar levels to reduce morbidity and early mortality. Diabetes mellitus type 2 is a chronic, long-term medical condition, in which the body does not produce insulin or is unable to utilize it properly resulting in uncontrolled blood sugar levels. Oral antidiabetic drugs are given as mono and combination therapy to achieve controlled blood sugar levels, based on the clinical conditions of each patient. Aims and Objective: The purpose of our study is to compare the efficacy and adverse effects in monotherapy with that of combination therapy for oral anti-diabetics in diabetes mellitus type 2 patients. Materials and Methods: A prospective cross-sectional study of 11 months period was conducted on 200 patients, in the Department of General Medicine of a Tertiary Care Hospital. Ethics committee permission was obtained from the institutional ethical committee before initiation of the study. Based on the oral anti-diabetic therapy pattern, patients were divided into three groups, Group 1 (Monotherapy), Group 2 (Dual therapy), and Group 3 (Triple therapy). Following inclusion and exclusion criteria, demographic parameters, and oral anti-diabetic therapy patterns were collected and assessed for efficacy and adverse effects. Results: Among 200 patients studied, 50% received monotherapy (Group 1), 30% received dual therapy (Group 2), and 20% received triple therapy (Group 3) treatment. Fasting blood sugar, postprandial blood sugar, and glycosylated hemoglobin levels were monitored. Controlled blood glucose levels were achieved successfully in combination therapy groups and it was found to be more efficacious than monotherapy group. Patients on monotherapy had less adverse effects than combination therapy. Conclusion: Combination therapy was substantial in controlling blood sugar levels compared to monotherapy. Combination therapy is a better treatment choice for diabetes mellitus type 2 patients. Adverse effects were reported fewer in the monotherapy group in comparison with combination therapy groups.
International Journal of Advanced Research in Medicine
Background and objectives: In newborns and infants who have just undergone major surgery, the pla... more Background and objectives: In newborns and infants who have just undergone major surgery, the plasma concentrations of the painkiller acetaminophen (INN, paracetamol) have not yet been determined in the research literature. As a result, we conducted a study in the intensive care unit of our hospital. Study Methods: During elective craniofacial correction, 40 toddlers with a mean (standard deviation) age of 10.3 (2.3) months received 20 mg/kg of acetaminophen orally (n = 20) or rectally (n = 20) every 6 hours following a rectal loading dose of 40 mg/kg. Pain assessments were made every three hours, and blood samples were taken an hour before and two hours after the administration of acetaminophen maintenance dosages. Results and discussion: The mean area under the concentration-time curve (AUC) for patients receiving rectal acetaminophen was 171.2 mg/h/L, while the mean AUC for patients receiving oral acetaminophen was 111.9 mg/h/L. Patients receiving oral acetaminophen reported greater pain scores. However, acetaminophen plasma concentrations and pain scores did not differ across the groups once the patients who vomited were removed from the oral acetaminophen group. Acetaminophen plasma concentrations and pain ratings did not correlate. Despite the fact that 9 out of 40 patients (or 22.5%) did not achieve the desired analgesic acetaminophen plasma concentrations of 10 to 20 mg/L, 7.5% of the pain scores on the visual analogue scale were higher than the 4 cm cutoff criterion. Conclusion: These are the first results demonstrating that following major surgery in this age range, the analgesic acetaminophen plasma concentration does not always reach the 10 to 20 mg/L level. These results also demonstrate that the rectal route is the most effective approach to provide acetaminophen following craniofacial surgery once a rectal loading dosage of 40 mg/kg has been administered during surgery.
International Journal of Advanced Research in Medicine
Postoperative pain is frequent among hospitalized patients. Different therapeutic traditions and ... more Postoperative pain is frequent among hospitalized patients. Different therapeutic traditions and the attitudes of each hospital's medical staff impact its treatment. This study Aim to find out how analgesic drugs were prescribed and used to treat pain after abdominal surgery in Indian hospitals. It also Aim to find out how common and bad postoperative pain was, as well as how much the way pain was treated differed between the centers that took part. Methods: The study involved a descriptive cross-sectional examination of drug use in 12 Indian hospitals. The subjects were a non-selected sample of consecutive abdominal surgery patients who were hospitalized between October 2020 and January 2022. Information about the surgical technique and the use of analgesics was prospectively obtained for each patient. On the first day after surgery, a visual analogue scale (VAS) and a six-point scale (none, mild, moderate, severe, very severe, and intolerable) were used to rate the level of pain. Results: There were 993 patients (547 men) involved in the study. Inguinal hernia repair (315, 32%), cholecystectomy (268, 27%), appendectomy (140, 14%), bowel resection (137, 14%), and gastric surgery (58, 6%) were the most prevalent surgical procedures. 59% (587) of patients received only nonopioid analgesics, 9% (89) received only opioid analgesics, and 27% (263) received both opioid and nonopioid analgesics. Metamizole (667 patients) and pethidine were the medications provided most frequently (213 patients). Although the administration of analgesics was scheduled in the majority of physician orders, the majority of actual doses were administered "as needed." The average daily doses of all analgesics delivered were less than those indicated. 38 percent (371/967) of patients reported severe to terrible first-day maximum pain. The surgical procedures that had been conducted, the analgesics that had been administered, and the pain scores that had been reported by patients exhibited substantial interhospital variation. Between 22% and 67% of patients in each facility had pain that was severe or intolerable. Conclusions: It appears that poor usage of analgesics is to blame for the fact that many patients in India continue to experience significant pain after undergoing abdominal surgery. It was found that there were big differences between hospitals in how pain after surgery was treated and how often it happened.
National Journal of Physiology, Pharmacy and Pharmacology, 2021
Background: Diabetes mellitus type 2 is associated with deteriorating blood sugar levels along wi... more Background: Diabetes mellitus type 2 is associated with deteriorating blood sugar levels along with countless metabolic disorders. Treatment strategy plays a crucial role in achieving target blood sugar levels to reduce morbidity and early mortality. Diabetes mellitus type 2 is a chronic, long-term medical condition, in which the body does not produce insulin or is unable to utilize it properly resulting in uncontrolled blood sugar levels. Oral antidiabetic drugs are given as mono and combination therapy to achieve controlled blood sugar levels, based on the clinical conditions of each patient. Aims and Objective: The purpose of our study is to compare the efficacy and adverse effects in monotherapy with that of combination therapy for oral anti-diabetics in diabetes mellitus type 2 patients. Materials and Methods: A prospective cross-sectional study of 11 months period was conducted on 200 patients, in the Department of General Medicine of a Tertiary Care Hospital. Ethics committee permission was obtained from the institutional ethical committee before initiation of the study. Based on the oral anti-diabetic therapy pattern, patients were divided into three groups, Group 1 (Monotherapy), Group 2 (Dual therapy), and Group 3 (Triple therapy). Following inclusion and exclusion criteria, demographic parameters, and oral anti-diabetic therapy patterns were collected and assessed for efficacy and adverse effects. Results: Among 200 patients studied, 50% received monotherapy (Group 1), 30% received dual therapy (Group 2), and 20% received triple therapy (Group 3) treatment. Fasting blood sugar, postprandial blood sugar, and glycosylated hemoglobin levels were monitored. Controlled blood glucose levels were achieved successfully in combination therapy groups and it was found to be more efficacious than monotherapy group. Patients on monotherapy had less adverse effects than combination therapy. Conclusion: Combination therapy was substantial in controlling blood sugar levels compared to monotherapy. Combination therapy is a better treatment choice for diabetes mellitus type 2 patients. Adverse effects were reported fewer in the monotherapy group in comparison with combination therapy groups.