الفهرس 
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Abstract
S
UMMARY
cute gastroenteritis is a leading cause of emergency department visits and hospitalization among children.
Oral rehydration therapy is recommended for children with mild to moderate dehydration, but children who present with vomiting cannot tolerate ORT. So intravenous rehydration in the emergency department is frequently offered.
Ondansetron is an antiemetic agent with consistent, proven efficacy in reducing vomiting from acute gastroenteritis and promote oral rehydration.
The modified vesikari scale score (MVS) was used to assess the clinical outcome of multiple doses of ondansetron in children with acute gastroenteritis, this score includes: diarrhea duration, maximum number of watery stool, maximum number of vomiting episodes, maximum rectal temperature recorded, health care revisit and treatment. Scores range from 0 to 20, with higher scores indicating more sever disease. Scores equal or more than 9 to define moderate disease and more than 11 to define severe disease.
The primary objective of this study was to evaluate the effect of multiple doses of ondansetron on the control of vomiting associated with acute gastroenteritis in the children below 5 years in comparison to a single dose of ondansetron.
A
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This was a randomized controlled study that was conducted on 70 children less than 5 years old presenting to the emergency department of pediatric hospital, Ain Shams University with acute gastroenteritis they were divided into 2 groups (35 patients in each group): Arm one : received single dose of ondansetron . Arm two : received (6 doses) of ondansetron in a period of 6 months.
In this study, there was no statistically significant difference found between the two groups at time of enrollment regarding symptoms of acute gastroenteritis, the range of duration of symptoms in group A (1-4) days. The range of duration in group B (1-5 days). In group A, there were 23 patients (65.7%) presented by mild dehydration and 12 patients (34.3%) presented by moderate dehydration, with the range of frequency of vomiting (1-6) attacks, the range of frequency of diarhea (3-10 times) and the range of temperature was 36.7-39°C. In group B, there were 17 patients (48.6%) presented by mild dehydration and 18 patients (51.4%) presented by moderate dehydration with the range of frequency of vomiting (2-6 times), the range of frequency of diarrhea (3-10 attacks) and the range of temperature 36.8-38.5°C.
The results of our present study can be summarized as follows: In the current study, there was no statistically significant difference found between group A and group B
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regarding all parameters of modified Vesikari scale score (MVS) at different times of measurement. Moreover, there was no statistically significant difference found between group A and group B regarding % of change of duration of diarrhea at 24 hours, 48 hours and 7 days with p-value = 0.070, 0.529 and 0.634. Also there was statistically significant increase in the percentage of change of number of episode of diarrhea in group B than group A at 24 hours and 48 hours with p-value = 0.003 and 0.001 while no statistically significant difference found between both groups regarding change of number of episode of diarrhea at 7 days with p-value = 0.234. Also there was no statistically significant difference found between group A and group B regarding % of change of duration of vomiting at 24 hours, 48 hours and 7 days with p-value = 0.826, 0.380 and 0.104. Also there was statistically significant decrease in the percentage of change of number of episodes of vomiting in group B than group A at 24 hours and 48 hours with p-value = 0.001 and 0.003 while no statistically significant difference found between both groups regarding change of number of episodes of vomiting at 7 days with p-value = 0.132. Regarding total Modified Vesikari Scale Score (MVS) there was no statistically significant difference found between
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group A and group B regarding % of change at 24 hours, 48 hours and 7 days with p-value = 0.953, 0.254 and 0.637. Finally, there are 2 patients in group B complained of drowniness but there was no statistically significant difference found between both groups regarding drowsiness while there was statistically significant increase in the percentage of patients with diarrhea in group B (17.1%) than group A (0.0%).