Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling

Objectives: To investigate and evaluate the therapeutic effects of Hoe hoa tan II in the treatment of internal haemorroids grade I, II and III. Ingredients of the remedy include: Hoe Hoa (Styphonolonium japonicum), Chi xac (Fructus citri Aurantii), Hau phac (Magnolia offinalis), Tran bi (Citrus deliciosa Tenore), Thuong thuat (Atractylodes lancea), O mai (Armeniaca vulgaris Lamk), Cam thao (Clycyrrhiza uralensis), Duong quy (Radix Angelicae Sinensis). Subjects and methods: Randomised controlled study (RCT) has been conducted on 60 patients which were divided into two groups, i.e. the first 30 patient group were treated with Hoe hoa tan II remedy 20 g, and the second 30 patient group were treated with Daflon 500 mg in the course of 14 days. Results: Study showed that Hoe hoa tan II has helped improve symptoms of internal haemorroids grade I, II and III such as bleeding, anal exudation, pain, reducing the size of the haemorroid tissues. The remedy has been shown to have the most significant effect on relieving constipation which is typical in haemorroids. The study also revealed no unwanted effects caused by this formula. Conclusion: Hoe hoa tan II can be therapeutically used to treat internal haemorroids grade I, II and III without causing any serious side effects. Key words: Hoe hoa tan II, internal haemorroids grade I, II, III.

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COMPARATIVE STUDY OF THE EFFICACY OF TOPICAL LOTEPREDNOL ETABONATE AND FLUOROMETHOLONE IN THE TREATMENT OF VERNAL KERATOCONJUNCTIVITIS : A RANDOMISED CONTROLLED STUDY

10.36106/ijsr/5403062 ◽

2021 ◽

pp. 8-10

Author(s):

Nandita Chaturvedi ◽

Nidhi Nidhi ◽

Malobika Bhattacharya

Keyword(s):

Side Effects ◽

Signs And Symptoms ◽

Subjective Symptom ◽

Controlled Study ◽

Vernal Keratoconjunctivitis ◽

Topical Steroids ◽

Loteprednol Etabonate ◽

Randomised Controlled Study ◽

Before And After ◽

Randomised Controlled

Introduction:Vernal keratoconjunctivitis(VKC) is a chronic, recurrent, inammatory disease of ocular surface showing seasonal exacerbation, affecting young children. Topical steroids are the mainstay in the treatment of ocular allergy, but their use should be judicious since they carry serious side effects . Loteprednol and uorometholone carry better safety prole. Present study was conducted with the aim of comparing the efcacy of these two widely used steroids.Objectives:To compare total subjective symptom score (TSSS), total objective sign score (TOSS) and side effects of medications before and after treatment at each visit.Materials & Methods:A prospective randomised controlled study was performed on 92 patients of VKC over four weeks. Patients were allotted to either of the two arms of treatment (i.e. LP 0.5% or FML 0.1%). Subjective and objective assessments of the signs and symptoms of VKC were done using standard scoring methodologies at 7, 14, 21 and 28 days post treatment. The main outcome measure was measured in terms of TSSS and TOSS before and after treatment at each visit. Secondary outcomes included side effects. Statistical analysis of the data collected was carried out.Results: Loteprednol showed greater reduction in symptoms initially but by the end of study there was no statistically signicant difference in effect between the two drugs.Conclusions: Final improvement in clinical features and safety prole, at the end of 4 weeks was similar in eyes treated with either of the two drugs. Hence, both the drugs can be safely used in the treatment of VKC.

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The effects of Saccharomyces Boulardii supplementation on Helicobacter Pylori eradication rate and side effects during sequential therapy : A prospective randomised controlled study

10.26226/morressier.59a6b34dd462b80290b55da5 ◽

2017 ◽

Author(s):

Hanae Boutallaka

Keyword(s):

Helicobacter Pylori ◽

Side Effects ◽

Eradication Rate ◽

Sequential Therapy ◽

Saccharomyces Boulardii ◽

Controlled Study ◽

Helicobacter Pylori Eradication ◽

Randomised Controlled Study ◽

Randomised Controlled

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Technical Aspects of Electroconvulsive Therapy: An Update

European Psychiatry ◽

10.1016/s0924-9338(09)70305-0 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

P. Sienaert

Keyword(s):

Side Effects ◽

Electroconvulsive Therapy ◽

Pulse Width ◽

Additional Treatment ◽

Electrode Placement ◽

Treatment Conditions ◽

Antidepressant Efficacy ◽

Remission Criteria ◽

Standard Pulse ◽

Cognitive Side Effects

In an ongoing attempt to improve efficacy of electroconvulsive therapy (ECT) while minimizing side-effects, both different electrode placements and stimulus parameters have been studied. It has been shown that the traditional bitemporal electrode placement and modern techniques such as bifrontal and unilateral ECT are efficacious, depending on the stimulus used. Modern ECT-devices deliver a square wave brief pulse stimulus. An unresolved issue in the use of brief pulse stimulation concerns the optimal pulse width. It has been suggested that the use of a stimulus with an ultra brief (UB) pulse width, i.e. 0.3 ms, is substantially more efficient in seizure induction, thus needing less energy, and producing less cognitive side-effects than standard pulse width (i.e. 0.5-2 ms) stimulation. There has been a concern, however, of lower antidepressant efficacy of UB ECT, with patients needing additional treatment sessions. Moreover, it has been suggested that the diminished antidepressive efficacy is encountered solely with the combination of an ultra-brief pulse width and bilateral electrode placement, as compared to unilateral UB ECT or standard pulse ECT. In a randomized trial, the antidepressive efficacy and cognitive side-effects of bifrontal and right unilateral UB ECT were compared. It was shown that, using an ultra-brief pulse width, BF ECT is as efficacious as UL ECT, although patients receiving UL ECT achieved response/remission-criteria after a smaller number of treatments. In both treatment conditions there was an improvement of cognitive function, both during and after the treatment course.

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Computational models of Bitemporal, Bifrontal and Right Unilateral ECT predict differential stimulation of brain regions associated with efficacy and cognitive side effects

European Psychiatry ◽

10.1016/j.eurpsy.2016.09.005 ◽

2017 ◽

Vol 41 (1) ◽

pp. 21-29 ◽

Cited By ~ 16

Author(s):

S. Bai ◽

V. Gálvez ◽

S. Dokos ◽

D. Martin ◽

M. Bikson ◽

...

Keyword(s):

Side Effects ◽

Computational Models ◽

Computational Modelling ◽

Human Head ◽

Distribution Patterns ◽

Brain Regions ◽

Electrode Placement ◽

Direct Stimulation ◽

Cognitive Side Effects ◽

Stimulation Of

AbstractBackgroundExtensive clinical research has shown that the efficacy and cognitive outcomes of electroconvulsive therapy (ECT) are determined, in part, by the type of electrode placement used. Bitemporal ECT (BT, stimulating electrodes placed bilaterally in the frontotemporal region) is the form of ECT with relatively potent clinical and cognitive side effects. However, the reasons for this are poorly understood.ObjectiveThis study used computational modelling to examine regional differences in brain excitation between BT, Bifrontal (BF) and Right Unilateral (RUL) ECT, currently the most clinically-used ECT placements. Specifically, by comparing similarities and differences in current distribution patterns between BT ECT and the other two placements, the study aimed to create an explanatory model of critical brain sites that mediate antidepressant efficacy and sites associated with cognitive, particularly memory, adverse effects.MethodsHigh resolution finite element human head models were generated from MRI scans of three subjects. The models were used to compare differences in activation between the three ECT placements, using subtraction maps.Results and conclusionIn this exploratory study on three realistic head models, Bitemporal ECT resulted in greater direct stimulation of deep midline structures and also left temporal and inferior frontal regions. Interpreted in light of existing knowledge on depressive pathophysiology and cognitive neuroanatomy, it is suggested that the former sites are related to efficacy and the latter to cognitive deficits. We hereby propose an approach using binarised subtraction models that can be used to optimise, and even individualise, ECT therapies.

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