scholarly journals The effects of antithrombotic therapy on head trauma and its management

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takao Koiso ◽  
Masayuki Goto ◽  
Toshitsugu Terakado ◽  
Yoji Komatsu ◽  
Yuji Matsumaru ◽  
...  
Keyword(s):  
Therapy Group ◽  
Female Gender ◽  
Neurological Status ◽  
Outcome Data ◽  
Radiological Findings ◽  
Hematoma Enlargement ◽  
Number Of Patients ◽  
Traumatic Intracranial Hemorrhage ◽  
Group A ◽  
Group B

AbstractThe number of patients with traumatic intracranial hemorrhage (tICH) that are taking antithrombotics (ATs), antiplatelets (APs) and/or anticoagulants (ACs), has increased, but the influence of it for outcome remains unclear. This study aimed to evaluate an influence of AT for tICH. We retrospectively reviewed all patients with tICH treated between 2012 and 2019, and analyzed demographics, neurological status, clinical course, radiological findings, and outcome data. A total of 393 patients with tICH were included; 117 were on AT therapy (group A) and 276 were not (group B). Fifty-one (43.6%) and 159 (57.6%) patients in groups A and B, respectively, exhibited mRS of 0–2 at discharge (p = 0.0113). Mortality at 30 days was significantly higher in group A than in group B (25.6% vs 16.3%, p = 0.0356). Multivariate analysis revealed that higher age (OR 32.7, p < 0.0001), female gender (OR 0.56, p = 0.0285), pre-injury vitamin K antagonist (VKA; OR 0.42, p = 0.0297), and hematoma enlargement (OR 0.27, p < 0.0001) were associated with unfavorable outcome. AP and direct oral anticoagulant were not. Hematoma enlargement was significantly higher in AC-users than in non-users. Pre-injury VKA was at high risk of poor prognosis for patients with tICH. To improve outcomes, the management of VKA seems to be important.

scholarly journals Conventional treatment versus vacuum therapy for diabetic foot ulcers treatment

2017 ◽  
Vol 5 (1) ◽  
pp. 49 ◽  
Author(s):  
Vigna Sai Potula
Keyword(s):  
Therapy Group ◽  
Vacuum Therapy ◽  
College Hospital ◽  
Medical College ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Group A ◽  
Randomized Controlled Trail ◽  
The Mean ◽  
Group B

Background: This study compares the efficacy of vacuum therapy against conventional iodine povidone dressing with respect to area and time of ulcer.Methods: This study is a randomized controlled trail which was conducted in Meenakshi Medical College hospital and research institute Enathur Kanchipuram. The number of patients selected were 50, which were divided into 2 groups, Group A which consisted of 25 and received vacuum therapy, Group B which consisted of 25 and received povidone-iodine solution.Results: This study was a 16 days study, mean area of ulcer on day 0 was 11.25 cm2 in group B, 10.89 cm2 in group A. On day 6, mean area of ulcer was 10.44 cm2 in group B, 8.98 cm2 in group A. Mean area of ulcer was 10.39 cm2 in group B, 7.66 cm2 in group A on the end of the day 16. The results show that both the groups showed decrease in the area of ulcers, but patients in group A who underwent vacuum therapy have shown greater decrease in the mean area of ulcer. The decrease in surface area of ulcer was statistically significant i.e. p=0.025. There was a greater decrease in infection in group A on 16th day compared to group A on 16th day. On day 0, 48% and 60% growth of microorganisms was observed in patients of group B and group A respectively (p=0.428). On day 16, 28% and 8% growth of microorganisms was observed in patients of group B and group A respectively (p=0.034).Conclusions: Vacuum therapy was more effective compared to conventional method of povidone-iodone solution dressing in rate of healing and time of healing.

scholarly journals Early or delayed sigmoid resection in complicated diverticular disease? A single center experience

2020 ◽  
Author(s):  
Peter Tschann ◽  
Daniel Lechner ◽  
Benedikt Feurstein ◽  
Stephanie Adler ◽  
Paolo Girotti ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Therapy Group ◽  
Operation Time ◽  
Sigmoid Resection ◽  
Complicated Diverticulitis ◽  
Western World ◽  
First Episode ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Abstract Background:Diverticular disease appears to be one of the most common conditions in the western world. The standard approach in treatment of diverticular disease is a laparoscopic resection, usually after an inflammation free time of 4 to 6 weeks. The aim of this study was to evaluate the timing of operation.Methods:61 patients underwent left-sided colonic resection because of diverticular disease between January 2017 and February 2020. 37 patients were treated because of complicated diverticulitis (CDD stage 2a or 2b) either early within 7 days after first symptoms (group A: n = 17) or delayed about 6 weeks after the first contact and conservative therapy (group B: n = 20).Results:Overall mortality was 0%. The average operation time was shorter in the early elective group (Group A: 140,4 min vs. Group B: 151,2 min (p = 0,29). The hospital stay (group A: 9,9 d vs. group B: 16,9 d) and the postoperative stay (group A: 4,8 d vs. group B: 8,1 d) was significantly longer in group B (p = 0,01). We observed – although not reliable due to low number of patients - more postoperative complications in the delayed group (group A: 5,9% vs. group B: 15,0%) (p = 0,61).Conclusion:The data in this study confirm the early operation as safe and efficient due to lower costs. We can recommend an early approach in selected cases with the first episode of a complicated diverticulitis.

scholarly journals Early or delayed sigmoid resection in complicated diverticular disease? A single-center experience

2020 ◽  
Author(s):  
Peter Tschann ◽  
Daniel Lechner ◽  
Benedikt Feurstein ◽  
Stephanie Adler ◽  
Paolo Girotti ◽  
...  
Keyword(s):  
Diverticular Disease ◽  
Therapy Group ◽  
Operation Time ◽  
Sigmoid Resection ◽  
Complicated Diverticulitis ◽  
Western World ◽  
First Episode ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Summary Background Diverticular disease appears to be one of the most common conditions in the Western world. The standard approach in treatment of diverticular disease is a laparoscopic resection, usually after an inflammation-free time of 4 to 6 weeks. The aim of this study was to evaluate the timing of operation. Materials and methods A total of 61 patients underwent left-sided colonic resection because of diverticular disease between January 2017 and February 2020. Because of complicated diverticulitis (CDD stage 2a or 2b) 37 patients were treated either early within 7 days after first symptoms (group A: n = 17) or delayed about 6 weeks after the first contact and conservative therapy (group B: n = 20). Results Overall mortality was 0%. The average operation time was shorter in the early elective group (group A: 140.4 min vs. group B: 151.2 min; p = 0.29). The hospital stay (group A: 9.9 days vs. group B: 16.9 days) and the postoperative stay (group A: 4.8 days vs. group B: 8.1 days) were significantly longer in group B (p = 0.01). We observed—although not reliable due to the low number of patients—more postoperative complications in the delayed group (group A: 5.9% vs. group B: 15.0%; p = 0.61). Conclusion The data in this study confirm the early operation as safe and efficient due to lower costs. We can recommend an early approach in selected cases with the first episode of a complicated diverticulitis.

Randomized trial of medical compression stockings versus two-layer short-stretch bandaging in the management of venous leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (04) ◽  
pp. 157-163 ◽  
Author(s):  
A. Franek ◽  
L. Brzezinska-Wcislo ◽  
E. Blaszczak ◽  
A. Polak ◽  
J. Taradaj
Keyword(s):  
Drug Therapy ◽  
Randomized Clinical Trials ◽  
Therapy Group ◽  
Long Term Results ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Group A ◽  
Group B ◽  
Medical Compression Stockings

SummaryA prospective randomized clinical trial was undertaken to compare a medical compression stockings with two-layer short-stretch bandaging in the management of venous leg ulcers. Study endpoints were number of completely healed wounds and the clinical parameters predicting the outcome. Patients, methods: Eighty patients with venous leg ulcers were included in this study, and ultimately allocated into two comparative groups. Group A consisted of 40 patients (25 women, 15 men). They were treated with the compression stockings (25–32 mmHg) and drug therapy. Group B consisted of 40 patients (22 women, 18 men). They were treated with the short-stretch bandages (30–40 mmHg) and drug therapy, administered identically as in group A. Results: Within two months the 15/40 (37.50%) patients in group A and 5/40 (12.50%) in group B were healed completely (p = 0.01). For patients with isolated superficial reflux, the healing rates at two months were 45.45% (10/22 healed) in group A and 18.18% (4/22 healed) in group B (p = 0.01). For patients with superficial plus deep reflux, the healing rates were 27.77% (5/18 healed) in group A and 5.55% (1/18 healed) in group B (p = 0.002). Comparison of relative change of the total surface area (61.55% in group A vs. 23.66% in group B), length (41.67% in group A vs. 27.99% in group B), width (46.16% in group A vs. 29.33% in group B), and volume (82.03% in group A vs. 40.01% in group B) demonstrated difference (p = 0.002 in all comparisons) in favour of group A. Conclusion: The medical compression stockings are extremely useful therapy in enhancement of venous leg ulcer healing (both for patients with superficial and for patients who had superficial plus deep reflux). Bandages are less effective (especially for patients with superficial plus deep reflux, where the efficiency compared to the stockings of applied compression appeared dramatically low). These findings require confirmation in other randomized clinical trials with long term results.

THE ROLE OF MANUAL THERAPY IN THE TREATMENT OF CHRONIC CERVICAL PAINS

2020 ◽  
pp. 1-4
Author(s):  
George-Sebastian Iacob ◽  
Constantin Munteanu
Keyword(s):  
Manual Therapy ◽  
Therapy Group ◽  
Neck Disability Index ◽  
Initial Assessment ◽  
Visual Analogue Pain Scale ◽  
Rehabilitation Protocol ◽  
Visual Analogue Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B

Cervical back pain is one of the most important and common musculoskeletal disorders in medical recovery clinics and clinics. The main objective of the study was to highlight the effectiveness of an individualized therapeutic program adapted to the particularities of 22 subjects, which combines physical exercise with manual therapy. Subjects were randomly assigned to two equal groups. Group A - rehabilitation protocol consisting of therapeutic exercises (specific to the head, neck and upper limbs). Group B - rehabilitation protocol that included both therapeutic exercises and manual therapy (specific maneuvers of vertebral mobilization, massage, myofascial techniques, stretching and manipulations). The Visual Analogue Pain Scale (VAS) and the Neck Disability Index (NDI) were used to monitor the evolution of the research subjects, both of which have a specific applicability character to chronic pain. According to VAS (p <0.001), Group B showed mean values reduced to 2.2 ± 0.9 at week 12, compared to 7.3 ± 0.92, following the initial assessment. NDI values indicate better functional status after 12 weeks of treatment for both groups of subjects. NDI showed a beneficial decrease for Group B (13.2 ± 2.2 after 12 weeks, compared to 25.8 ± 2.3 in the first week). The mean results of VAS and NDI indicated a better evolution of symptoms in the case of the protocol that combined exercise and manual therapy (group B), but there were no statistically significant differences (compared to group A).

An Efficacy and Safety Study of Remogliflozin in Obese Indian Type 2 Diabetes Mellitus Patients Who Were Inadequately Controlled on Insulin glargine plus other oral hypoglycemic agents

2020 ◽  
Vol 17 ◽  
Author(s):  
Anand Shankar
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Therapy Group ◽  
Insulin Dose ◽  
Blood Glucose Control ◽  
Hypoglycemic Agents ◽  
Oral Drug ◽  
Group A ◽  
Group B

Aim & Objective: The objective of this retrospective study was to investigate the efficacy of adding remogliflozin to current insulin glargine plus two oral drug i.e. metformin and teneligliptin therapy in poorly controlled Indian type 2 diabetes. Material and Methods: 173 study participants were initially selected from patient database who continued on their insulin glargine or received an increased dose of insulin glargine along with other OHA based therapy (Group A) and 187 were selected who had received remogliflozin (100 mg BD) (Group B) in addition to insulin glargine along with other OHA based therapy. Glycated haemoglobin (HbA1c), total daily insulin dose, body weight, and the number of hypoglycemic events were recorded at weeks 0, 12 and 24. Result: During the study, mean values of HbA1c, FBG and P2BG were significantly reduced in both groups. Insulin requirements decreased from 45.8 ± 16.7 IU/day to 38.5 ± 13.5 IU/day (P < 0.001) and at week 24 even further decreased to 29.5 ± 14.5 IU/Day . Twenty three patients in group B were able to cease insulin treatment altogether after 24 week treatment. It has been observed to attain tight blood glucose control we need to increase insulin dose in group A from 45.5 ± 16.5 IU/Day to 51.5 ± 14.5 at week 12 (P<0.01) and which further increased to 53.8 ± 12.8 IU/Day at week 24 (P<0.01). Adding remogliflozin showed significant effect on blood pressure (P < 0.001) and weight reduction (P < 0.001). It has been observed that 38% patients has achieves targeted HbA1c (≤7%) in group B where it was 22% in group A. Conclusion: Results demonstrate that in uncontrolled T2DM patients remogliflozin 100 mg BD can successfully lay a foundation for prolonged good glycemic control. Early addition of remogliflozin with insulin glargine plus OHAs may be an alternative compare to intensive up titration of insulin daily dose in people with uncontrolled T2DM. Clinical Trial Registration Number: A 2358

Moxifloxacin Based Triple Therapy as Alternative to Standard Therapy in Helicobacter Pylori Eradication.

2020 ◽  
Vol 18 ◽  
Author(s):  
Mohammed Hussien Ahmed ◽  
Sherief Abd-Elsalam ◽  
Aya Mohammed Mahrous
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Therapy Group ◽  
Low Cost ◽  
High Rate ◽  
Helicobacter Pylori Eradication ◽  
Treatment Regimens ◽  
Group A ◽  
H Pylori ◽  
Group B

Introduction: Helicobacter pylori eradication remains a problematic issue. We are in an urgent need for finding a treatment regimen that achieves eradication at a low cost and less side effect. Recent published results showing a high rate of resistance and with clarithromycin-based treatment regimens. The aim of the study was to compare moxifloxacin therapy and classic clarithromycin triple therapy in H. pylori eradication. Methods: This was a pilot study that enrolled 60 patients with helicobacter pylori associated gastritis. Diagnosis was done by assessment of H. pylori Ag in the stool. The patients were randomly assigned to receive either moxifloxacin based therapy (Group A), or clarithromycin based therapy (Group B) for two weeks. We stopped the treatment for another two weeks then reevaluation for cure was done. Results: 90 % of patients had negative H. pylori Ag in the stool after 2 weeks of stoppage of the treatment in group A versus 66.7 % in Group B. None of the patients in both groups had major side effects. Conclusion: Moxifloxacin-based therapy showed higher eradication power and less resistance when compared to clarithromycin triple therapy.

scholarly journals Blood asymmetric dimethylarginine and nitrite/nitrate concentrations in short-stature children born small for gestational age with and without growth hormone therapy

2017 ◽  
Vol 46 (2) ◽  
pp. 761-772 ◽  
Author(s):  
Hironori Nagasaka ◽  
Ichiro Morioka ◽  
Mayuko Takuwa ◽  
Mariko Nakacho ◽  
Mayumi Yoshida ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Growth Hormone ◽  
Asymmetric Dimethylarginine ◽  
Therapy Group ◽  
Adma Level ◽  
Gh Therapy ◽  
Normal Children ◽  
Group A ◽  
Group B ◽  
Nitrite Nitrate

Objective To investigate the basal amino acid metabolism and impact of growth hormone (GH) therapy in short-stature children born small for gestational age (short SGA children). Methods In this age-matched case-control study, the basal blood levels of amino acids, asymmetric dimethylarginine (ADMA), and nitrite/nitrate (NOx) were compared between 24 short SGA children and 25 age-matched normal children. Changes in these parameters were assessed for 12 months in 12 short SGA children initiating GH therapy (Group A) and 12 age-matched short SGA children without GH therapy (Group B). Results The arginine levels were significantly lower in the short SGA than in normal children. The ADMA levels were significantly higher and NOx levels were significantly lower in the short SGA than normal children. In Group A, the ADMA level was significantly lower and NOx level was significantly higher at 6 months than at baseline. At 12 months, the ADMA level in Group A began to increase, but the NOx level remained the same. Group B showed no significant changes. Conclusions This study is the first to show that ADMA is promoted and nitric oxide is suppressed in short SGA children and that GH therapy affects the production of ADMA and nitric oxide.

scholarly journals EFFECTIVENESS OF C1-C2 SUSTAINED NATURAL APOPHYSEAL GLIDE COMBINED WITH DRY NEEDLING ON PRESSURE POINT THRESHOLD AND HEADACHE DISABILITY IN CERVICOGENIC HEADACHE.

2018 ◽  
Vol 11 (1) ◽  
pp. 171 ◽  
Author(s):  
Ramesh Chandra Patra ◽  
Patitapaban Mohanty ◽  
Ajay P Gautam
Keyword(s):  
Therapy Group ◽  
Combined Treatment ◽  
Cervicogenic Headache ◽  
Dry Needling ◽  
Pressure Point ◽  
Cervicogenic Headaches ◽  
Group A ◽  
The Mean ◽  
Headache Disability ◽  
Group B

 Objective: The main objective of this study was to evaluate the effectiveness of dry needling and mulligan C1-C2 sustained natural apophyseal glides (SNAGs) in increasing pressure point threshold and reducing headache disability in patients with CGH.Methods: This study was conducted on 150 patients. They were divided into three groups for the purpose of the study. Group A was referred to as the dry needling group. They were subjected to dry needling for treating the pain. Group B was the manual therapy group. The patients in this group were subjected to C1-C2 SNAGs. Group C was the combined group. Patients belonging to this group were given C1-C2 SNAGs along with dry needling.Results: Statistical analysis paired t-test was used for comparison of the mean within every group where it showed significant improvement in all the parameter (p<0.05).Conclusion: There was a consistent reduction in tenderness and improvement in disability of the patients belonging to all groups. However, Group C, where the patients were subjected to combined treatment, showed better results. Results of this study indicate that dry needling along with mulligan C1-C2 SNAGs is more beneficial in patients suffering from cervicogenic headaches.

scholarly journals INTRAVENOUS REGIONAL ANESTHESIA (BIERS BLOCK);

2012 ◽  
Vol 19 (05) ◽  
pp. 710-714
Author(s):  
Muhammad ASGHER ◽  
ASIM GHAURI ◽  
MUHAMMAD ABDULLAH ◽  
Tariq Abassi
Keyword(s):  
Regional Anaesthesia ◽  
Military Hospital ◽  
P Value ◽  
Complete Evaluation ◽  
Intravenous Regional Anesthesia ◽  
Number Of Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intravenous Regional Anaesthesia

Objective: To compare the analgesic effects of combination of 0.5% Lidocaine plus Ketorolac in intravenous regionalanaesthesia technique with those of Lidocaine (0.5%) alone to prevent post operative pain after intravenous regional anaesthesia (Biersblock). Study design: Randomized Control Trial. Place and duration of study: The study was carried out at Department of Anaesthesiology,Intensive Care and pain management, Combined Military hospital, Rawalpindi from July 2008 to February 2009. Patients and Methods: Thestudy was conducted after complete evaluation of risk / benefit ratio to the patients. On the basis of random number method the patients weredivided into two equal groups (group A and group B). The number of patients in each group was 75. Group A was assigned Lidocaine in a dose of200mg 40ml of 0.5% solution and group B was assigned injection Ketorolac 30mg added to Lidocaine in a dose of 200mg 40ml of 0.5% solution.The patients were kept in post anaesthesia care unit for two hours and pain intensity was measured by visual analogue scale(VAS) on 15,30minutes,1hour, 1.5 and at 2 hours after the cuff deflation. The analgesic efficacy recorded on the basis of visual analog scale of two groups, wascompared using student’s t - test. p value of less than 0.05 was considered statistically significant. Results: In group A 33 males and 42 femaleswere enrolled for the study while in group B there were 38 males and 37 females. The mean age of the patients in group A was 34.31 ± 6.03years while in group B was 32.99 ± 6.08 years. Patients were also classified according to ASA classification in which 87 patients were classifiedas ASA – I and 63 patients as ASA – II. Group B which received Ketorolac in addition to Lidocaine for Bier’s block had low visual analogue scoresas compared to group A which received only Lidocaine for Bier’s block. P values obtained after the comparison of the mean VAS of two groupsat 15 minutes, 30 minutes, 1 hour, 1.5 hours and 2 hours were all less than 0.05 (0.002 for 15 minutes, 0.004 for 30 minutes, 0.001 for 1 hour,0.004 for 1.5 hours and 0.001 for 2 hours). Conclusions: Ketorolac improves the postoperative analgesia markedly when used with Lidocainein intravenous regional anaesthesia.

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