scholarly journals Clinical significance of late diastolic tissue doppler parameters after onset of STEMI: from the view point of the timing of the echocardipography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Iwahashi ◽  
J Kirigaya ◽  
M Horii ◽  
T Abe ◽  
E Akiyama ◽  
...  
Keyword(s):  
Tissue Doppler ◽  
Atrial Function ◽  
Diastolic Velocity ◽  
Long Time ◽  
Group A ◽  
St Elevation ◽  
Group B ◽  
First Time

Abstract Background The early transmitral flow velocity (E) divided by the early diastolic velocity of the mitral valve annulus (e') is referred to as the “E/e' ratio,” is useful even for ST elevation acute myocardial infarction (STEMI). However, the role of late diastolic velocity (a') which reveals the atrial function for STEMI is still unclear. Objectives We evaluated the clinical usefulness of tissue Doppler including atrial function for a first-time STEMI by long time follow up. Furthermore, we evaluated the meaning of each parameters by performing immediately after PCI or 2 weeks later. Methods We treated consecutive 571 first-time STEMI patients by immediate PCI within 12 hours after onset, and we examined 270 patients at immediately after PCI (GroupA, 65 years, 250 male) and 301 patients at 2 weeks after onset (GroupB, 64 years, 243 male). We examined trans mitral flow and TDI, then defined E/e' as LV filling pressure and A/a' as left atrial function. We followed them for a long time (>5 years). The primary end point (PE) was cardiac death or re-admission for heart failure (HF). Results We followed the patients in Group A for 10 years, Group B for 5 years. PE occurred in 64 patients in GroupA during 10 years, and 45 patients in GroupB during 5 years. We analyzed the univariate and multivariate Cox hazard analyses and we compared e' and a', E/e' and A/a' (Table). In GroupA, a' and A/a' were the independent predictors, on the other hand neither a' nor A/a' were the predictors in GroupB. E/e' was an independent predictor both in GroupA and B. Conclusion TDI parameters have different meanings by the timing of echocardiography after onset of a first-time STEMI. These results demonstrated that atrial dysfunction immediately after onset of STEMI suggests the poor prognosis after STEMI. Cox Hazard Proportional Analysis Funding Acknowledgement Type of funding source: None

scholarly journals Role of Panchamooladya Choorna in Grahani Roga (irritable bowel syndrome)-pilot study

2020 ◽  
Vol 4 (06) ◽  
Author(s):  
Akshaya Patil
Keyword(s):  
Irritable Bowel Syndrome ◽  
Dietary Habits ◽  
Modern Medicine ◽  
Disturbed Sleep ◽  
Principal Factors ◽  
Group A ◽  
Irritable Bowel ◽  
Group B

Lifestyle disorders like unhealthy dietary habits, physical habits, disturbed sleep and rest patterns are the principal factors that cause many digestion related disease. Irritable bowel syndrome (IBS) is also one such disease which occurs due to the ingestion of unwholesome diet causing disturbances in Agni. According to Ayurvedic science, this disease can be considered as a Grahani roga. So we may consider IBS as Grahani roga. Various herbal medications and panchakarma (biopurification) procedures are described in the treatment of Grahani roga though there is no reliable medical treatment for IBS in modern medicine; various efforts have been made to overcome this problem by the virtue of Ayurvedic therapy. The present study was done to assess the efficacy of Panchmooladya choorna with Takra(buttermilk) as anupan in Group A(10Patients) and Group B(10Patients)with luke warm water as anupan in management of Grahani roga in total of 20patients.The results of therapy were assessed by various parameters after 1month with follow up of 15days.The result concluded that Panchmooladya choorna with Takra as anupan reduced the symptoms of Grahani rog as compared to Group B.

scholarly journals LASIK-induced Corneal Changes after Correction of Hyperopia with and without Application of Mitomycin-C

2019 ◽  
Author(s):  
Ehab M. Moawad ◽  
Ahmed A. Abd Elghany ◽  
Amr A. Gab-Alla ◽  
Osama M. Elbassiouny ◽  
Mohsen S. Badawy
Keyword(s):  
Mitomycin C ◽  
Clinical Trial Registry ◽  
Uncorrected Distance Visual Acuity ◽  
Group A ◽  
Randomized Control ◽  
One Year ◽  
Group B ◽  
Control Study

Abstract Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.

Role of Radiation Therapy in the Management of Meningioma

Neurosurgery ◽  
1982 ◽  
Vol 10 (3) ◽  
pp. 332-339 ◽  
Author(s):  
Richard J. Carella ◽  
Joseph Ransohoff ◽  
Joseph Newall
Keyword(s):  
Radiation Therapy ◽  
Tumor Necrosis ◽  
Medical Center ◽  
Case Reports ◽  
Primary Treatment ◽  
New York University ◽  
Group A ◽  
Group B

Abstract Surgery is the accepted form of treatment of meningioma; the role of radiotherapy has not been clearly established. With this in mind, we have reviewed our experience with radiation therapy in the management of meningiomas at New York University Medical Center. Sixty-eight patients fell into three groups. Forty-three (Group A) underwent operation followed by radiation therapy, 14 patients (Group B) had radiation for recurrence after operation, and 11 patients (Group C) had radiation therapy as the primary treatment. In Group A, 41 of 43 are alive. During a follow-up of 1 to 10 years, only 2 have deteriorated. Five of 14 Group B patients showed neurological improvement and 7 showed deterioration, including 5 who died of tumor. All 11 patients in Group C are alive with follow-up periods of 3 to 6 years; 9 of these show improvement in neurological function. Eleven patients had malignant meningioma, of whom 8 are alive and stable. We present 4 case reports, including computed tomographic scans that show evidence of tumor necrosis after radiation therapy. Pathological verification of tumor necrosis is presented in 1 case. We believe that radiation therapy has an established role in the treatment of incompletely excised, recurrent, or malignant meningiomas and, in some cases, as the initial management of meningiomas. Indications for treatment and guidelines are presented.

scholarly journals LASIK-induced Corneal Changes after Correction of Hyperopia with and without Application of Mitomycin-C

2019 ◽  
Author(s):  
Ehab M. Moawad ◽  
Ahmed A. Abd Elghany ◽  
Amr A. Gab-Alla ◽  
Osama M. Elbassiouny ◽  
Mohsen S. Badawy
Keyword(s):  
Mitomycin C ◽  
Clinical Trial Registry ◽  
Uncorrected Distance Visual Acuity ◽  
Group A ◽  
Randomized Control ◽  
One Year ◽  
Group B ◽  
Control Study

Abstract Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.

scholarly journals LASIK-induced Corneal Changes after Correction of Hyperopia with and without Application of Mitomycin-C

2019 ◽  
Author(s):  
Ehab M. Moawad ◽  
Ahmed A. Abd Elghany ◽  
Amr A. Gab-Alla ◽  
Osama M. Elbassiouny ◽  
Mohsen S. Badawy
Keyword(s):  
Mitomycin C ◽  
Clinical Trial Registry ◽  
Uncorrected Distance Visual Acuity ◽  
Group A ◽  
Randomized Control ◽  
One Year ◽  
Group B ◽  
Control Study

Abstract Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.

scholarly journals 614 Implantable cardiac monitors predict arrhythmic events in post-infarction patients with mildly reduced left ventricular ejection fraction

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Vincenzo Riverso ◽  
Antonio Curcio ◽  
Alessia Tempestini ◽  
Emilia De Luca ◽  
Sabrina La Bella ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Cardiac Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
St Segment ◽  
Group A ◽  
Group B

Abstract Aims Complications of acute myocardial infarction (MI) can be life-threatening leading to sudden cardiac death. While guidelines recommend prompt revascularization and prolonged intensive care hospitalization, predictors of major adverse cardiovascular outcomes are yet poorly understood. The role of implantable cardioverter-defibrillators, even in cases of non-sustained arrhythmias is still debated. To date, it is unknown how to follow-up patients with mild cardiac dysfunction after MI. Implantable cardiac monitors (ICMs) can be helpful for stratifying patients in the early discharge period, and remote monitoring might speed up arrhythmia recognition and treatment. We investigated the role of remote monitoring of ICMs to detect arrhythmic events in post-MI patients without overt cardiac dysfunction. Methods and results We enrolled 13 patients (9 males; 69.8 years) after either ST-segment (N = 7) or non-ST-segment elevation (N = 6) MI with a left ventricular ejection fraction (LVEF) >35%, admitted to our coronary care unit for urgent revascularization between September 2019 and September 2021. Twelve patients underwent percutaneous myocardial revascularization, whereas one was treated with medical therapy only. All patients received an ICM during hospitalization according to echo and EKG parameters. We considered LVEF ≤ 40% as sole risk factor or LVEF between 40% and 50% in addition to either PQ length prolongation, or QRS widening, or pathologic heart rate variability, or non-sustained ventricular tachycardia/paroxysmal advanced second degree atrioventricular block. Patients with multiple revascularization procedures and several hospital admissions were excluded. Implanted ICM were frequently monitored both remotely and in-office when required. During follow-up, brady- and tachy-arrhythmias were recorded in four patients (30.8%). The remote monitoring of the ICM documented new-onset atrial fibrillation, high-degree atrioventricular block, severe bradycardia, and sustained ventricular tachycardia. Three patients required hospitalization and upgrade of the implanted device with pacemakers and cardioverter/defibrillator. For arrhythmic risk stratification, patients were divided into two subgroups; group A included patients with LVEF 40% associated with heart rate > 60 b.p.m., PQ length >160 ms and QRS width >86 ms (N = 4); group B included patients with EF 41%/50%, PQ length <159 and QRS width <85 ms (N = 10). First group experienced more advanced rhythm disorders than group B (P < 0.05). Device implantation was significantly higher in group A (P < 0.05%). Conclusions OFF-label implementation of ICMs coupled with remote device monitoring may be effective for early detection of serious adverse cardiac rhythm alterations in patients after MI and LVEF higher than 35%. Further monitoring is ongoing for assessing the occurrence of multiple arrhythmias or their increased occurrence.

scholarly journals Role of Zinc in Patients Presenting with Recurrent Hepatic Encephalopathy in Medical Unit of Tertiarycare Hospital Lahore

Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Asma Kamal ◽  
Asifa Kamal ◽  
Naeem Afzal ◽  
Shazia Siddique ◽  
Khadija Tahir
Keyword(s):  
Hepatic Encephalopathy ◽  
Zinc Supplementation ◽  
Mean Value ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Improved Outcome

Abstract Objective: To observe the effects of zinc replacement on hepatic encephaopahty. To reducce hospital admission and heath burden by reducing episodes of recurrent hepatic encephalopathy. Methods: This study was carried out on 160 patients presenting with hepatic encephalopathy in medical ward of services hospital Lahore. The aim of the study was to assess the role of zinc in the improvement of encephalopathy. Results: The mean age of patients in group A was 55.78 and that in group B was 56.88years.There was significant difference in mean value of hepatic encephalopathy grade in both groups A and B after 3 months of follow up (p.value 0.027) indicating zinc is beneficial in treatment of hepatic encephalopathy. Conclusion: Our study showed that zinc replacement improved outcome in patients with Hepatic encephalopathy. Key words: Hepatic encephalopathy, zinc supplementation, chronic liver disease.

scholarly journals The role of cytomegalovirus infection in ischemic heart failure progression

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Grakova ◽  
S.N Shilov ◽  
E.N Berezikova ◽  
K.V Kopeva ◽  
A.A Popova ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ischemic Heart ◽  
Interleukin 1Β ◽  
Ischemic Heart Failure ◽  
Tnf Α ◽  
Heart Failure Progression ◽  
Group A ◽  
Group B

Abstract Objective To study an association between cytomegalovirus infection (CMV) and molecular biomarkers (NT-proBNP, tumor necrosis factor (TNF-α), Interleukin-1β) and evaluate prognostic role of CMV infection in ischemic heart failure (HF) progression during the 12-month follow-up period. Methods A total of 104 patients (61.5% men, median age of 59 [53; 62.5] years) with stable coronary artery disease and baseline left ventricular ejection fraction (LVEF) of 43% [36; 57]% were enrolled in the study. At baseline evaluation HF patients were of New York Heart Association (NYHA) class I (7.7%), class II (61.0%), and class III (31.3%). Sixty five percent of patients had prior myocardial infarction and 70.2% received prior myocardial revascularization (coronary artery bypass graft/stent). Cytomegalovirus DNA concentrations in EDTA whole-blood samples were measured using a polymerase chain reaction baseline and at 12 months of follow-up period. Serum levels of NT-proBNP, Interleukin-1β, TNF-α were measured baseline using an enzyme immunoassay. Two-dimensional transthoracic echocardiography was performed at baseline and at the 12 months. Results At baseline, all patients were divided into 2 groups: group A comprised CMV seropositive patients (n=52); group B comprised CMV seronegative patients (n=52). Plasma concentration of cytomegalovirus DNA was 1709.4 [615; 3176] copies/mL. The values of cytomegalovirus DNA significantly correlated with NT-proBNP (r=0.781), TNF-α (r=0.799) and Interleukin-1β (r=0.756). Levels of NT-proBNP were higher (p=0.0001) in group A by 36.6% than in group 2 (559 [364; 756] vs. 354.5 [279; 545.5] pg/mL, respectively). Levels of TNF-α were also higher (p<0,001) by 35.3% (8.5 [6.5; 10.9] vs. 5.5 [4.1; 7.3] ng/mL, respectively) and levels of Interleukin-1β (p<0,001) by 17.6% (19.3 [15.8; 23.75] vs. 15.9 [13.15; 18.7] ng/mL, respectively) in group A than in group B. During the 12-month follow-up period in group A the rate of HF progression was 51.6% cases, and in group B 26.9% (p=0.009). Based on ROC-analysis, baseline plasma concentration of cytomegalovirus DNA ≥2020 copies/mL (AUC=0.798; specificity 67%, sensitivity 82%; p<0.001) were identified as a cut-off values predicting development of HF progression during the 12-month follow-up period. 12-month levels of cytomegalovirus DNA did not differ (p=0,678) in comparison to baseline ones and were 1737.9 [321; 3384] copies /mL. In group A LVEF significantly increased by 18.8% from 50.5 [36.5; 56.0] to 41.0 [35.0; 50.0]%, end-systolic dimension significantly increased by 7.3%, end-diastolic dimension by 9.6% (p<0,0001), while in group B these parameters did not change. Conclusion Our data suggest that values of cytomegalovirus DNA are associated with NT-proBNP, TNF-α, Interleukin-1β levels, and may be considered as non-invasive biomarker for prediction of ischemic heart failure progression during the 12-month follow-up period. FUNDunding Acknowledgement Type of funding sources: None.

Postoperative Epileptic Seizures in Children: Is the Brain Incision a Risk Factor?

Neurosurgery ◽  
2017 ◽  
Vol 82 (4) ◽  
pp. 465-472 ◽  
Author(s):  
Luca Massimi ◽  
Domenica Battaglia ◽  
Federico Bianchi ◽  
Simone Peraio ◽  
Elisabetta Peppucci ◽  
...  
Keyword(s):  
Risk Factor ◽  
Surgical Planning ◽  
Epileptic Seizures ◽  
Postoperative Management ◽  
The Other ◽  
Group A ◽  
Group B ◽  
The Brain

Abstract BACKGROUND Postoperative seizures (PSs) after neurosurgical operations are common but little is known about the role of surgical brain incision on their genesis. This topic has not been addressed so far. OBJECTIVE To verify if the corticotomy affects the risk of PSs and postoperative epilepsy (PE) in children. METHODS One hundred forty-three consecutive pediatric cases operated on for supratentorial lesions at the same institution in the last 15 yr have been retrospectively reviewed by dividing them into group A, 68 children who required brain corticotomy mainly for hemispheric tumors, and group B, 75 children treated through extracortical approaches mainly for suprasellar and optic tumors. Patients with possible “epileptic” biases, like preoperative seizures, were excluded. RESULTS No significant differences have been found between group A and B as far as incidence of PSs (11.7% vs 14.5%) and PE (4.5% vs 6.5%), timing, and type of seizures are concerned after a mean 6.8 yr follow-up. The size of corticotomy in group A (<3 cm2 vs >3 cm2) had no impact on epileptogenesis as well as the other variables considered in both groups (age, sex, extent of lesion resection). CONCLUSION This study shows that the surgical cortical “trauma” would not represent a risk factor for PSs and PE. According to the present analysis and the literature, other causes seem to be involved (namely, electrolytic imbalance and brain gliosis). This information is important for preoperative surgical planning and postoperative management. A validation by both adult series and prospective studies is needed.

scholarly journals A COMPARATIVE CLINICAL STUDY ON THE ROLE OF KOISHORE GUGGULU WITH OR WITHOUT NITYA VIRECHANA IN THE MANAGEMENT OF VATARAK-TA W.S.R TO GOUT

2020 ◽  
Vol 08 (11) ◽  
pp. 4955-4959
Author(s):  
Alpana Majumder ◽  
P. B. Kar Mahapatra
Keyword(s):  
Clinical Study ◽  
Severe Pain ◽  
Signs And Symptoms ◽  
Medical System ◽  
The World ◽  
Comparative Clinical Study ◽  
Long Time ◽  
Group A ◽  
Group B

Objectives: Nowadays, so many diseases are found all over the world related to lifestyle disorder; Gout is one of them. According to different Ayurvedic books, Gout has been compared with ‘Vatarakta’, which is characterized by severe pain, redness, and tenderness in the joints. In other medical system, the medicine for this very disease is to be continued for a long time with so many side effects. Method: Total 40 patients of Gout with the evidence of Hyper Uricemia were selected for this trial and randomly categorized into two groups, Group A and Group B. Group A patients were treated with Koishore Guggul-500mg twice daily and Group B patients were treated with Koishore Guggul- 500mg twice daily along with Nitya Vrechan by Trivritavaleha 10gm daily at night. Trial was continued for 3 weeks. Result: Both groups showed highly significant result but the relief in signs and symptoms in group B was more significant than group A.

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