scholarly journals Efficacy of Colchicine and Budesonide in Improvement Outcomes of Patients with Coronavirus Infection 2019 in Damascus, Syria: A Randomized Control Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mohammad Alsultan ◽  
Ameer Obeid ◽  
Omar Alsamarrai ◽  
Mohamed Taher Anan ◽  
Aliaa Bakr ◽  
...  

COVID-19 was reported in China in 2019 and has spread worldwide. Transmission occurs through respiratory secretions and, less commonly, through contaminated surfaces. The severity of the disease can range from asymptomatic to acute respiratory distress syndrome (ARDS). In this study, we aim to investigate the efficacy of two agents (oral colchicine and budesonide inhaler) in COVID-19 infection management, compared with supportive care alone. 77 patients were admitted to the isolation section of Al Assad University Hospital, between the 1st of August and the 30th of August. A total of 49 patients were included in this randomized control trial, after excluding ineligible patients. The random sample was divided into three groups; the first group was supportive care plus colchicine, the second group was supportive care plus budesonide inhaler, and the control group was supportive care alone. PaO2/FiO2 was improved in the budesonide group, higher than the supportive and colchicine groups. The median hospitalization days were shorter when using colchicine or budesonide, opposed to supportive care alone (8 vs 10 days, respectively). 34 patients (69.3%) were discharged, and 27 patients (55.1%) were followed up until they were weaned from oxygen and made a complete recovery. There was a significant decrease in mortality with colchicine (3 patients; 21.4%) compared with supportive care (7 patients; 33.3%) and the budesonide group (5 patients; 35.7%).

Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Xiao Tang ◽  
Ying-Mei Feng ◽  
Ji-Xiang Ni ◽  
Jia-Ying Zhang ◽  
Li-Min Liu ◽  
...  

<b><i>Background:</i></b> There is still no clinical evidence available to support or to oppose corticosteroid treatment for coronavirus disease 2019 (COVID-19) pneumonia. <b><i>Objective:</i></b> To investigate the efficacy and safety of corticosteroid given to the hospitalized patients with COVID-19 pneumonia. <b><i>Methods:</i></b> This was a prospective, multicenter, single-blind, randomized control trial. Adult patients with COVID-19 pneumonia who were admitted to the general ward were randomly assigned to either receive methylprednisolone or not for 7 days. The primary end point was the incidence of clinical deterioration 14 days after randomization. <b><i>Results:</i></b> We terminated this trial early because the number of patients with COVID-19 pneumonia in all the centers decreased in late March. Finally, a total of 86 COVID-19 patients underwent randomization. There was no difference of the incidence of clinical deterioration between the methylprednisolone group and control group (4.8 vs. 4.8%, <i>p</i> = 1.000). The duration of throat viral RNA detectability in the methylprednisolone group was 11 days (interquartile range, 6–16 days), which was significantly longer than that in the control group (8 days [2–12 days], <i>p</i> = 0.030). There were no significant differences between the 2 groups in other secondary outcomes. Mass cytometry discovered CD3<sup>+</sup> T cells, CD8<sup>+</sup> T cells, and NK cells in the methylprednisolone group which were significantly lower than those in the control group after randomization (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> From this prematurely closed trial, we found that the short-term early use of corticosteroid could suppress the immune cells, which may prolong severe acute respiratory syndrome coronavirus 2 shedding in patients with COVID-19 pneumonia. <b><i>Trial Registration:</i></b> ClinicalTrials.gov, NCT04273321.


2021 ◽  
pp. 28-31
Author(s):  
Urja S. Vaidya ◽  
Roshani S. Patel

Background: Sciatica is a radiating pain which is treated with manual accupressure and after a time electro accupressure came into introduction. Aim And Objective: Aim: To nd out the effectiveness of accupressure pen to improve the distance variable To nd out the effect of Objective: accupressure pen on pain and distance variable in sciatica patient To compare the experimental group to the control group On the basis of Method: inclusion and exclusion criteria 30 participants were selected. They were treated with electro accupressure pen for 3 alternative days / week for 3 weeks, after that re-assessment was taken with NPRS, Slump and Distance variables. The data was analyzed using SPSS Version Results: 21.Parametric test was used .In Group A improvement was seen Accupressure Conclusions: pen is effective to reduce pain and improve step length and stride length in Sciatica Patients


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Selam Deksiyous Muluye ◽  
Tefera Belachew Lemma ◽  
Tona Zema Diddana

Undernutrition and hidden hunger threaten the survival, growth, and development of children, young people, economies, and nations. Inappropriate complementary feeding practice due to poor maternal knowledge and awareness in combination with low income and infectious disease is the contributing factor for child undernutrition. Hence, this study was aimed at determining the effect of nutrition education on improving the knowledge and practice of complementary feeding of the mothers with 6- to 23-month old children in daycare centers of Hawassa Town, Southern Ethiopia. An institution-based randomized control trial design was employed. Daycare centers were randomly allocated for the intervention group and the control group. Among the total daycare centers in the town, five were assigned to receive nutrition education and the rest five for the control group (CG). The simple random sampling technique used to select individual participants from each daycare center. Two hundred (200) mother-child pairs (100 for each group) were recruited. Sociodemographic and economic variables were collected by the structured questionnaire. Knowledge of appropriate complementary feeding was assessed by seven knowledge questions. Appropriate complementary feeding practice was assessed by adapting Alive and Thrive Infant and Young Child Feeding (IYCF) practice guidelines. Nutrition education was given for four consecutive months by using Alive and Thrive IYCF guidelines. Data were analyzed by the SPSS software program version 20. The chi-squared test was used to test the significant differences in the proportion of good knowledge and good practice of complementary feeding and good dietary diversity between two groups. The independent t test was used to test the significant differences in mean dietary diversity between two groups. At 95% confidence interval, p<0.05 was considered statistically significant. The results revealed that the proportion of mothers with good knowledge of appropriate complementary feeding was increased from 59% at pretest to 96% at posttest and the appropriate complementary feeding practice was improved from 54% at pretest to 86% at posttest in IG. There was no change in the knowledge and practice of complementary feeding practice in CG after four months. The proportion of mothers with good complementary knowledge was 54% both at pretest and at posttest and good complementary feeding practice was 51% and 52% at pre- and posttest in CG, respectively. There was no significant difference (p>0.05) on complementary feeding knowledge and practice between two groups at pretest, while the difference was highly significant (p<0.05) at the posttest. In conclusion, providing nutrition education improved the appropriate complementary feeding knowledge and practice of mothers. In recommendation, government and other partners working on sustainable child nutrition reduction should focus on the nutrition education to improve the knowledge and appropriate complementary feeding practice including daycare centers.


Author(s):  
Deasy Mediawaty ◽  
Pujo Widodo ◽  
Dian Ayu Ruspita

Latar belakang : Otitis media kronik atau sering disebut Otitis Media Supuratif Kronik (OMSK) adalah otitis media yang berlangsung > 12 minggu. Prevalensi OMSK di seluruh dunia sebanyak 65-330 juta dan 60% di antaranya menderita kurang pendengaran yang signifikan. Angka kejadian OMSK aktif mencapai 3,8% dari pasien THT-KL. Gejala OMSK aktif berupa banyaknya discaj, kurang pendengaran, nyeri, pusing berputar, telinga tidak nyaman. Tanda OMSK aktif berupa discaj di liang telinga, perforasi membran timpani, dan gangguan pendengaran. World Health Organization (WHO) mencanangkan strategi untuk mengatasi OMSK secara serius berkaitan dengan komplikasi yang dapat disebabkan. Pilihan terapi medikamentosa yang tepat diperlukan untuk mengatasi OMSK aktif. Ofloksasin topikal dan ciprofloksasin oral adalah antibiotik golongan fluorokuinolon yang banyak digunakan. Efektivitas diantaranya dibuktikan dengan perbaikan gejala dan tanda klinis. Tujuan : Membuktikan efektifitas ofloksasin topikal, ciprofloksasin oral dan efektifitas ofloksasin topikal dibanding ciprofloksasin oral terhadap perbaikan gejala dan tanda klinis. Metode :  Penelitian intervensi dengan rancangan pretest and posttest control group design, randomized control trial Klinik THT-KL BKIM Semarang pada bulan Juni-Agustus 2016. Penderita OMSK aktif dilakukan anamnesis lalu dilakukan pemeriksaan fisik dan pemeriksaan pendengaran dilanjutkan randomisasi. Penderita diberi ofloksasin topikal 10 tetes/12 jam atau ciprofloksasin tablet 500 mg/12 jam per oral. Hari ke 4, 10 dan 14 setelah terapi penderita kontrol. Analisis uji komparatif menggunakan uji parametrik dan non parametrik. Hasil : Jumlah subyek penelitian 108 orang ; ofloksasin topikal 54 orang (50%) dan ciprofloksasin oral 54 orang  (50 %). Gejala dan tanda klinis setelah terapi lebih rendah dibanding sebelum terapi pada kelompok ofloksasin topikal dan ciprofloksasin oral dengan nilai kemaknaan p < 0,05. Gejala klinis kelompok ofloksasin lebih baik dibanding ciproloksasin secara bermakna (p<0,05). Tanda klinis kedua kelompok terdapat perbedaan yang tidak bermakna (p>0,05). Simpulan : Ofloksasin topikal dan ciprofloksasin oral terbukti efektif memperbaiki gejala dan tanda klinis penderita OMSK aktif. Ofloksasin topikal efektif memperbaiki gejala klinis dibandingkan ciprofloksasin oral. Kata kunci : Otitis media supuratif kronik, ofloksasin, ciprofloksasin, gejala dan tanda klinis


2020 ◽  
pp. 1-5
Author(s):  
Aliya Ishaq ◽  
Abida Parveen ◽  
Aliya Ishaq ◽  
Mariya Ishaq ◽  
Muhammad Jamshaid Hussain Khan ◽  
...  

Objective: The study aimed to determine the efficacy of single dose of glucocorticoid (125 mg of Solumedrol intravenous) in terms of seroma formation after mastectomy in patient with carcinoma of breast. Study Design: Randomized control trial. Place and Duration of Study: Study was conducted in the Department of General Surgery, Liaquat National Hospital Karachi, Pakistan from july 1 to dec 31, 2010. Patients and Methods: Patients were randomly divided in two groups (study and control) each group consisting of 30 patients. Randomization was done by opening of a sealed envelope which had a slip bearing the name of study medication (solumederol or saline as placebo) to be administered. The study group received a single dose of inj 125mg solumedrol IV half an hour prior to surgery by resident scrub in surgery. A similar procedure was applied to the control group and patients in controlled group were administered an equal volume of saline intravenously. After drain removal patients in both groups were observed for a duration of 2 weeks for sermoa formation. Detection of seroma formation was based on clinical grounds by absence of any fluid collection at mastectomy bed as detected by manual palpation. SPSS 10 was used for analysis. Results: Seroma formation was observed in 66.7% (40/60) women 2 weeks post drain removal. Rate of seroma formation was significantly low in study groups than control groups (33.3% vs. 100%; p=0.0001). Conclusion: Single dose of steroid is efficacious in reducing the post mastectomy seroma formation.


Author(s):  
Bibi Haleema ◽  
Huma Riaz

Abstract Objective: The objective of study was to determine the effects of thoracic spine manipulation on interscapular pain and pain pressure sensitivity, thoracic mobility and disability due to active myofascial trigger points in rhomboid muscle. Methods: A randomized control trial was conducted at Women Institute of Rehabilitation Sciences Abbottabad, from July to December 2019.Ethical permission was taken fromResearch ethical committee of Riphah international university Islamabad. Participants were selected through non-probability purposive sampling technique as per inclusion criteria. It consisted of 60 participants with forward head posture having active trigger points in rhomboid muscle, with age ranging from 18 to 30 years. The participants were randomly allocated through sealed envelope method into two groups that are experimental and control. Experimental group has received thoracic manipulation along with conventional physical therapy (CPT) whereas control group has only received CPT including manual pressure release and therapeutic exercise. Intervention was applied with 2 sessions / week with 3 weeks in total. Pre and Post assessment was done with outcome measurement tools comprised of Numeric pain rating scale (NPRS) for pain severity, Algometry for pain pressure threshold(PPT), Inclinometer for Range of movement(ROM) and Neck disability index (NDI) for associated disability. Data analysis was done using SPSS-20 version. Results: Between group analysis has shown significant improvement of pain & pain pressure sensitivity with p value <0.01 and <0.05 respectively. All outcome measures have shown significant difference in pre post treatment (p<.000) in both groups. Continuous...


2017 ◽  
Vol 5 (3) ◽  
pp. 155-163 ◽  
Author(s):  
Shahinul Alam ◽  
SKM Nazmul Hasan ◽  
Golam Mustafa ◽  
Mahabubul Alam ◽  
Mohammad Kamal ◽  
...  

AbstractBackground and ObjectivesTo observe the effect of Pentoxifylline for 1 year on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis (NASH).Materials and MethodsA single center, open label Randomized Control Trial. Patients were included if they had ultrasonographic evidence of fatty liver and nonalcoholic fatty liver disease activity score (NAS) ≥ 5 on liver histology. A total of 35 patients were selected; 25 of PL (Experimental) group and 10 of L (Control) group. PL group received 400 mg pentoxifylline thrice daily along with lifestyle modification and there was only lifestyle modification for the L group. After one year, NAS and fibrosis was compared in both groups.ResultsIn PL group, NAS improved 2.10 ± 1.07; whereas in L group, NAS was 0.90 ± 0.99 (P = 0.006). As per the protocol analysis, NAS ≥ 2 improved in 15/20 (75%) in PL group and in 3/10 (30%) in L group (P = 0.018). In PL group, the individual component of NAS, steatosis improved from 2.30 ± 0.66 to 0.95 ± 0.76 (P = 0.000), lobular inflammation from 1.65 ± 0.59 to 1.05 ± 0.51 (P = 0.002) and hepatocyte ballooning from 1.50 ± 0.51 to 1.30 ± 0.57 (P = 0.258). In L group, steatosis improved from 2.30 ± 0.68 to 1.40 ± 1.08 (P = 0.01), lobular inflammation and hepatocyte ballooning did not improve. The fibrosis score did not improve in any group. In PL group, NAS improved significantly (P = 0.027; OR=22.76, CI=1.43-362.40) independent of weight reduction.ConclusionPentoxifylline for 1 year improves the hepatic histological activity but not fibrosis of NASH patients.


2019 ◽  
Vol 31 (1) ◽  
pp. 203-217 ◽  
Author(s):  
Howard Steele ◽  
Anne Murphy ◽  
Karen Bonuck ◽  
Paul Meissner ◽  
Miriam Steele

AbstractThis paper reports on a randomized control trial involving children less than 3 years old and their mothers who were regarded at risk of maltreating their children by referral agencies. Mothers’ risk status derived from a heavy trauma burden (average exposure over the first 18 years of their lives to 10 possible adverse childhood experiences [ACEs] was >5), mental health challenges (15%–28% had experienced a prior psychiatric hospitalization), and prior removal of a child to foster care (20%). Mothers were randomly assigned to either a widely used parenting class known as Systematic Training for Effective Parenting (STEP) or the Group Attachment-Based Intervention (GABI), a multifamily 26-week treatment. The resulting mother–child pairs available for consideration in this baseline versus end-of-treatment report were 35 families in the STEP arm and 43 families in the GABI arm. The focus of this paper is the outcome measure of observed parent–child relationship assessed with the Coding of Interactive Behavior (Feldman, 1998) collected at baseline and end of treatment. In comparison to STEP, results indicated that GABI was linked to significant improvements in maternal supportive presence and dyadic reciprocity, and significant declines in maternal hostility and dyadic constriction (proxies for risk of child maltreatment). These medium-to large-sized effects remained significant even after controlling for mothers’ prior ACEs in analysis of covariance procedures. In addition, two small interaction effects of ACEs by treatment type were found, underlining the need for, and value of, treatments that are sensitive to parents’ traumatic histories.


2003 ◽  
Vol 112 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Sara Axelsson ◽  
Sven Lindberg ◽  
Anna Stjernquist-Desatnik

Idiopathic facial paralysis, or Bell's palsy, shows a nonepidemic pattern that might indicate reactivation of a latent microorganism such as herpes simplex type I as a causative agent. Thirty percent of patients with Bell's palsy given no treatment will not recover completely, and 5% will have severe sequelae. The aim of this study was to find out whether treatment with an antiviral drug in combination with corticosteroids is more effective than no medical treatment at all in patients with Bell's palsy. Fifty-six consecutive adult patients attending the otorhinolaryngology department of the University Hospital of Lund from 1997 to 1999 were treated with 1 g of valacyclovir hydrochloride 3 times per day for 7 days and 50 mg of prednisone daily for 5 days, with the dose being reduced by 10 mg daily for the next 5 days. Fifty-six adult patients with Bell's palsy attending the same department between 1995 and 1996 who were given no medical treatment were studied retrospectively and used as the control group. Forty-nine patients (87.5%) in the treatment group recovered completely, as compared with 38 patients (68%) in the control group (p <.05). One patient (1.8%) in the treatment group displayed severe sequelae, defined as a House-Brackmann score of IV or worse, as compared with 10 of 56 patients (18%) in the control group (p <.01). Among patients over 60 years old, 10 of 10 in the treatment group had complete recovery, as compared with 5 of 12 patients in the control group (p <.01). The present study showed a significantly better outcome in patients with Bell's palsy treated with valacyclovir and prednisone as compared with patients given no medical treatment. This difference in outcome was especially pronounced among elderly patients.


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