Jamshedpur

Researchers are conducting a phase 4 randomized controlled trial to assess whether a single intravenous dose of magnesium sulfate can reduce the need for opioid pain medication after laparoscopic cholecystectomy. This surgery, though minimally invasive, often causes significant postoperative pain usually managed with opioids that can have undesirable side effects. The study aims to explore if magnesium, which has pain-relieving properties, can lower morphine use and improve recovery. Participants aged 18 to 65 years, classified as ASA physical status I or II and scheduled for elective laparoscopic cholecystectomy, will be randomly assigned to receive either 30 mg/kg of intravenous magnesium sulfate diluted in 100 ml normal saline or a placebo of normal saline at the start of anesthesia. Both groups will also receive standard multimodal analgesia with intravenous diclofenac and paracetamol at the time of port closure. Rescue morphine will be given if pain scores reach a certain level. The trial includes thorough monitoring of pain, hemodynamics, neuromuscular function, and any side effects. During the study, 106 patients will be observed for 24 hours postoperatively to measure total morphine consumption as the primary outcome. Secondary assessments include pain intensity using a visual scale, timing of rescue analgesia, physiological monitoring, and tracking of adverse events. Data will be analyzed statistically to compare outcomes between the magnesium and placebo groups to determine if magnesium sulfate effectively reduces opioid use after surgery.

Researchers are evaluating the effects of two different default dialysate sodium concentrations, 137 mmol/l and 140 mmol/l, on major cardiovascular events and death in adults receiving maintenance haemodialysis. This pragmatic, cluster-randomised, open-label study takes place in real-world dialysis sites and aims to compare the outcomes associated with these sodium levels over an extended period. The study focuses on patients with end-stage kidney disease undergoing regular haemodialysis treatment. Dialysis sites are randomly assigned to use either a default dialysate sodium concentration of 137 mmol/l or 140 mmol/l for at least 90% of dialysis sessions at that site. All other care practices continue as usual based on local standards. The study plans to recruit sites over 5 to 7 years, with individual follow-up lasting roughly 2 to 5 years. Site participation requires consent, while individual patient consent may be waived or offered an opt-out option. Participants will be monitored for major cardiovascular events and death, with the primary outcome measuring the time until the first such event occurs. Data collection methods are implemented across participating dialysis units, focusing only on in-center or satellite dialysis patients where applicable. The study's duration depends on the occurrence of endpoints, with an average follow-up of about 5 years anticipated per participant.