Abstract 17102: Lower Rate of Device-Related Thrombosis in Watchman Patients Undergoing a Genotype-Tailored Antithrombotic Strategy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Domenico G Della Rocca ◽  
Rodney Horton ◽  
Carola Gianni ◽  
Luigi Di Biase ◽  
CHINTAN G TRIVEDI ◽  
...  
Keyword(s):  
Control Group ◽  
P Value ◽  
Loss Of Function ◽  
Group I ◽  
Novel Oral Anticoagulant ◽  
Cytochrome P450 2C19 ◽  
Half Dose ◽  
Cyp2c19 Gene ◽  
Group Ii ◽  
Group 1

Introduction: Loss-of-function (LOF) polymorphisms of the cytochrome P450 2C19 (CYP2C19) gene are associated with reduced hepatic bioactivation of clopidogrel. Hypothesis: To evaluate the prevalence of LOF polymorphisms of CYP2C19 and the incidence of device-related thrombosis (DRT) when clopidogrel is replaced with half dose novel oral anticoagulant (NOAC) in patients with reduced clopidogrel metabolism. Methods: Consecutive Watchman patients were genotyped for CYP2C19 polymorphisms. Patients with reduced clopidogrel metabolism received half dose NOAC plus aspirin during the “dual antiplatelet therapy (DAPT) phase” post-Watchman implantation (between 45 days and 6 months). The incidence of DRT among genotyped patients (Group I, n=401) and a control group without genotypization (Group II, n=357) which received standard DAPT is reported. Results: Overall, 758 Watchman patients were included (mean age: 75±8 yrs, 63% males, CHA 2 DS 2 -VASc: 4.6±1.5; HAS-BLED: 3.2±1.1). Of the 401 Group 1 patients, 25.69% (n=103) were reduced clopidogrel metabolizers. In 87.4% of them, clopidogrel was replaced with half-dose NOAC during the “DAPT phase” post-Watchman implantation whereas 12.6% received ASA plus full-dose NOAC due to the presence of a significant peri-device leak. During the “DAPT phase”, DRT was documented in 1 (0.2%) patient of Group I and 7 (1.96%) patients of Group II (p=0.029). On multivariate analysis, a genotype-tailored antithrombotic strategy was associated with a significant reduction in DRT (odds ratio: 0.11; 95% confidence interval: 0.01 - 0.98; p-value: 0.048). Conclusions: Approximately 25% of our Watchman patients had clopidogrel resistance. Substitution of clopidogrel with half dose NOAC in reduced clopidogrel metabolizers significantly reduced the incidence of DRT.

scholarly journals Comparison of tolterodine and Solifancine in treatment of female with overactive bladder

2021 ◽  
Vol 10 (6) ◽  
pp. 2138
Author(s):  
Nermeen Mohamed Hefila ◽  
Tamer Mamdouh And el dayem ◽  
Hisham Adel Elfazari
Keyword(s):  
Overactive Bladder ◽  
Maternity Hospital ◽  
P Value ◽  
Detrusor Muscle ◽  
Urinary Urgency ◽  
Urinary Frequency ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Group 1

Background: OAB (overactive bladder) is primarily a neuromuscular problem in which the detrusor muscle contracts inappropriately during bladder filling (i.e., storage phase). These contractions often occur regardless of the amount of urine in the bladder. The aim of this work is to study the effect of Solifenacin in comparison to Tolterodine in treatment of females with idiopathic over active bladder.Methods: This study included 50 patients who presented between March 2020 and February2021 to the outpatients clinic at El-Shatby maternity Hospital, Alexandria university. The patients were complaining of urinary urgency usually with urinary frequency, nocturia with or without urge incontinence. All cases were divided in two groups one of them receive Solifenacin5mg twice daily and the otherreceiveTolterodine2mg twice daily.Results: Both groups showed significant decrease in frequency number per day with p value <0.001ingroup I with Solifenacin which mean statistically significant difference between two groups. When the percentage of symptoms severity were compared between both groups, group 1 showed 53% reduction in symptoms severity while group II showed 6.67% reduction which cleared significant difference statistically in group I (p=0.001). The percentage of reduction of severity of symptoms was compared between the two groups, it showed about 60%reduction in symptoms severity in group 1while in group II only 9.7% reduction. This was statistically significant with (p<0.001) in group I with Solifenacin.Conclusions: This study suggests that Solifenacin10mg/day is more effective than Tolterodine4mg/day in reducing OAB incontinence episodes.

Evaluating the Effect of Probiotic Containing Milk on Salivary mutans streptococci Levels

2012 ◽  
Vol 37 (1) ◽  
pp. 9-14 ◽  
Author(s):  
A Juneja ◽  
A Kakade
Keyword(s):  
Lactobacillus Rhamnosus ◽  
Post Treatment ◽  
Mutans Streptococci ◽  
Control Group ◽  
P Value ◽  
Group I ◽  
Probiotic Lactobacillus ◽  
Group Ii ◽  
The Difference

Purpose: To evaluate the changes in mutans streptococci counts in saliva after short term probiotic intervention and its delayed effects on salivary mutans streptococci count. Methods: 40 children in the age group of 12-15 years with medium to high caries activity were randomly divided into Group I Control (plain milk group) and Group II Experimental (probiotic supplemented milk group). Duration of the study was 9 weeks; which was evenly divided into three phases: baseline, intervention and post-treatment period; each phase consisting of three weeks. After baseline period of 3 weeks, children in group I were given plain milk and in group II milk containing probiotic Lactobacillus rhamnosus hct 70 for 3 weeks; followed by a 3 weeks follow up period. After every phase saliva samples were collected to estimate salivary mutans streptococci counts. Results: The difference in the post follow up mutans streptococci count of group I and group II, was highly significant with p value &lt; 0.001. In the control group, the difference in the mean salivary baseline, post treatment and post follow up mutans streptococci counts was not statistically significant (p = 0.001). In the experimental probiotic group, the difference in mean salivary baseline, post treatment and post follow up mutans streptococci counts was statistically highly significant ( p = 0.000, p ≤ 0.001). Conclusions: Statistically significant reduction in salivary mutans streptococci counts immediately after consumption of probiotic Lactobacillus rhamnosus hct 70 containing milk suggest a beneficial effect of probiotic Lactobacillus rhamnosus hct 70 in the prevention of dental caries.

scholarly journals Evaluation of the serum biochemistry and histopathology of kidney and bladder of dogs with Leishmania sp. in their urine

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Joilson Ferreira Batista ◽  
Barbara Laurice Araújo Verçosa ◽  
Michel Muálem de Moraes Alves ◽  
Fernanda Samara Barbosa Rocha ◽  
Rayssa Maria de Araújo Carvalho ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Serum Biochemistry ◽  
Control Group ◽  
P Value ◽  
Nested Polymerase Chain Reaction ◽  
Bladder Tissue ◽  
Hydropic Degeneration ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

The visceral establishment of Leishmania infantum in dogs may result in kidney and bladder tissue injury, with L. infantum ending up in urine. This study therefore aimed at investigating the presence of Leishmania sp. in urinary sediments, and correlating the results with those from renal and bladder serum biochemistry and histopathology. Thirty dogs with negative Nested-Polymerase Chain Reaction (PCR) for E. canis were used in the experiment, and were divided into three groups: control group (10 dogs), neither leishmaniasis nor clinical changes; group I (15 dogs), leishmaniasis but no Leishmania sp. in urine; and group II (5 dogs), leishmaniasis, as well as Leishmania sp. in urine. All animals were submitted to clinical, serological, and parasitological diagnosis for leishmaniasis, biochemical exams, and kidney and bladder histopathology. The parasite was also detected in the bladder imprint of one group II dog. Group II dogs presented with very low albumin concentrations, low albumin/globulin ratios, and kidney and bladder lesions. In the kidneys, hydropic degeneration, thickened Bowman's capsule, and thickening of the tubular capsule were detected in all dogs with positive urinary sediment. However, no significant difference in these renal changes was observed between groups. The intensity and distribution of bladder inflammatory infiltrates were significantly (p-value < 0.05, Kruskal-Wallis’ and Dunn’s tests) higher in group II dogs, compared with those of the other groups. The presence of Leishmania sp. in the urine of infected dogs appeared to be related to low serum albumin concentrations and more severe bladder lesions.

scholarly journals Protective Effect of Morus Nigra Leaf Extract on Diazinon-Induced Hepatotoxicity in Rats

2020 ◽  
Vol 9 (3) ◽  
pp. 175-181
Author(s):  
Hina Majid ◽  
Salman Shahid ◽  
Sadia Shakeel ◽  
Mariam Ashraf ◽  
Muhammad Yasoob Ali ◽  
...  
Keyword(s):  
Leaf Extract ◽  
Hepatic Tissue ◽  
Medical Institute ◽  
Control Group ◽  
P Value ◽  
Central Vein ◽  
Group Iii ◽  
Morus Nigra ◽  
Group I ◽  
Group Ii

Background: Diazinon is a globally used pesticide. Morus nigra (Black Mulberry) possesses flavonoids and phenols, which act as antioxidants. The objective of this study was to determine the possible protective effects of Morus nigra leaf extract on Diazinon-induced hepatotoxicity in rats. Material and Method: It was an experimental study conducted in the Department of Anatomy, Postgraduate Medical Institute, Lahore. A total of 36 healthy male Wistar albino rats were divided into three groups with 12 rats in each group. Group I was the control group. Group II was treated with 60 mg/kg body weight (bw) Diazinon daily for 4 weeks through orogastric intubation. Group III was treated with Diazinon 60 mg/kg bw daily along with 350 mg/kg bw of Morus nigra extract daily for 4 weeks through orogastric intubation. Blood samples were collected through cardiac puncture, for estimation of alanine transaminase (ALT) and aspartate transaminase (AST) levels. Liver dissection was done, slides of the hepatic tissue were prepared and studied under light microscope. The histology of hepatocytes, portal lobule, portal vein and sinuosoids was observed. SPSS 20 was used for data analysis. One-way ANOVA followed by Tukey’s test was applied to establish difference among groups with P-value ≤0.05 considered as statistically significant. Results: Histology of Liver tissue in group I showed normal morphology while group II revealed hypertrophy and vacuolization of hepatocytes, congested central vein and sinusoids and presence of necrotic foci. These toxic effects were reversed by the co-administration of Diazinon with Morus nigra in group III which showed normal histology of the hepatic tissue. Similarly, Diazinon administration resulted in significant elevation of ALT and AST levels (P-value<0.05), while, Morus nigra resulted in a considerable decline in the levels of these enzymes (P-value <0.05). Conclusion: Morus nigra extract has hepatoprotective effects against liver toxicity induced by Diazinon.

scholarly journals Application of P4 rapid test and exogenous source of progesterone in prevention of early embryonic death in dairy cows

2021 ◽  
pp. 24-27
Author(s):  
G. Bonev
Keyword(s):  
Pregnancy Rate ◽  
Rapid Test ◽  
Control Group ◽  
Group I ◽  
Group Ii ◽  
And Control ◽  
Intravaginal Device ◽  
Exogenous Source ◽  
Group 1 ◽  
Embryonic Death

Abstract. The objectives of this study were: 1) to determine the percent of cows with low P4 at Day 7-8 post-AI; 2) to treat the animal with low progesterone for 14 days with a P4-releasing intravaginal device (PRID DELTA); 3) to analyze the influence of P4 exogenous supplementation on pregnancy rate in treated and non-treated cows and 4) to create a protocol using “P4 Rapid” test allowing increased pregnancy rate under farm conditions. For this purpose, the current study has been conducted on 155 repeat breeding Holstein cows (<3 artificially inseminated – AI) with prolonged estrus cycle (<26 days). At day 7 and 8 post-AI, the milk progesterone levels were measured (P4 Rapid test). The cows with low P4 (n=104 or 67%) were divided into two groups each n=52. In Group I the progesterone devices were inserted for two weeks and control Group II without progesterone devices. At days 40 and 50 post artificial insemination (AI) all animals (n=104) were submitted to ultrasound pregnancy detection. Pregnancy was registered in 27 animals (51.9%) for Group 1, and in 16 cows (30.7%) for Group II. P4 Rapid is a quick, easy and practically applicable test to measure milk progesterone levels in dairy farms. The method is highly accurate and detects animals with low or high P4 at Day 7-8 after insemination. It also allows identification of conditions such as ovarian cysts, ovarian hypofunction and distinguishing of cycling and non-cycling cows. The combination of P4 measurement by P4 Rapid test and treatment with exogenous P4 to increase circulating concentrations in the first few days after conception can prevent embryo death and improve reproductive efficiency in dairy cattle.

scholarly journals Xerosis meter-an electro-physiological device for quick screening of dry eyes

1970 ◽  
Vol 1 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Y Gupta ◽  
M Gupta ◽  
R Maheshwari ◽  
T Mittal
Keyword(s):  
Dry Eye ◽  
Large Population ◽  
Control Group ◽  
P Value ◽  
Schirmer Test ◽  
Schirmer’S Test ◽  
Group I ◽  
Significant Difference ◽  
Break Up ◽  
Group Ii

Aim: To study the role of ‘Xerosis Meter' in screening of dry eye cases in a large population and compare its results with Schirmer's test and tear break-up time. Materials and method: In a cross sectional study with a control group dry eye was evaluated with Xerosis Meter, Schirmer test and tear film break-up time (TBUT). Cases included in the study were divided into two groups. Group I (Control Group) comprised of asymptomatic patients while Group II (Test Group) had patients showing symptoms and signs of dry eye. The Group II was further divided into two subgroups. Group IIa had cases showing positive result with either of the two tests Schirmer test or TBUT. Group IIb had cases which showed positive results with Xerosis Meter but normal results with the other two tests. Statistics: All the observations were statistically analyzed using SPSS version 11.5 software. The results obtained were compared statistically using unpaired t-test and chi-square test. The p value of < 0.05 was considered as significant. Results: There was a statistically significant difference between the means of Xerosis Meter, Schirmer test and TBUT of the two groups: Group I and Group IIa (p value < 0.001). On comparing Group I and Group IIb the difference was found to be statistically significant with Xerosis Meter (p value < 0.001). The sensitivity and specificity of Xerosis Meter were 85.7% and 80.2% respectively. This was higher than that of the Schirmer's test (81.3% and 74.9%) and TBUT (73.2% and 68.7%). Conclusion: The "Xerosis Meter" is an effective alternate in screening of dry eye cases. It is more effective than the TBUT and as effective as the Schirmer's test in detecting both the normal and dry eye patients. DOI: 10.3126/nepjoph.v1i2.3687 Nep J Oph 2009;1(2):123-128

scholarly journals ACTIVE ONE LEG STANDING EXERCISE LEBIH EFEKTIF DARIPADA CONTACTUAL HAND ORIENTATING RESPONSE (CHOR)EXERCISE UNTUK MENINGKATKAN KEMAMPUAN MOBILITAS PASIEN PASCA STROKE

2017 ◽  
Author(s):  
Bambang Widayanto ◽  
Alex Pangkahila ◽  
Muh Irfan ◽  
Ida Bagus Ngurah ◽  
I Putu Adiartha Griadhi ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Mobility Impairment ◽  
Control Group Design ◽  
Group I ◽  
Significant Difference ◽  
Post Test ◽  
Group Ii

Stroke is a syndrome caused by circulatory disorders of the brain (CVA) with acute onset, accompanied by clinical manifestations in the form of neurological deficit and not as a result of tumor, trauma or infection of the central nervous system. Perfomance Mobility impairment is the consequences caused by stroke. The purpose of this study was to compare a Active One Leg Standing and Contactual Hand Orientating Response (CHOR) Exercise in order to improve performance mobility instroke patients. This research used experimental methods with pre-test and post-test control group design. The number of samples per group is 7 people. Group I was gaveActive One Leg Standing Exercise, group II was gaveContactual Hand Orientating Response (CHOR) Exercise. Each group is given an exercise with an hour duration, 3 times a week for 6 weeks. Mobility perfomance measured using POMA-TinettiTest. It was concluded that Active One Leg Standing and contactual Hand orientating Response (CHOR) exercise can improve perfomance mobility in post-stroke patients. There is a significant difference in perfomance mobility level between Active One Leg Standing and contactual Hand orientating Response (CHOR) exercise.Result: (1) The result of t-test related showed mean ± SB pre test (15.57 ± 2.29) and post test (21.42 ± 2.50) with p value <0.05. (2) The result of t-test related showed mean ± SB pre test (13.85 ± 3.93) and post test (18.14 ± 3.89) with p value <0.05. (3) The result of comparation test showed the mean ± SB group I (6.85 ± 1.06) and group II (4.28 ± 0.75) with p value <0.05.

scholarly journals Comparison of continuous versus interrupted abdominal fascia closure using polydioxanone suture in laparotomy

2019 ◽  
Vol 6 (8) ◽  
pp. 2832
Author(s):  
Avinash Chandra Sharma ◽  
Akhil Kumar Gupta ◽  
Nitin Singh ◽  
Arvind Kumar Maurya ◽  
Mamta Singla
Keyword(s):  
Hospital Stay ◽  
Major Complication ◽  
Fascial Closure ◽  
Control Group ◽  
Group I ◽  
Abdominal Fascia ◽  
Group Ii ◽  
Group 2 ◽  
Fascia Closure ◽  
Group 1

Background: Laparotomy is a major surgical procedure in emergency settings. There is paucity of data regarding abdominal fascia closure in emergency laparotomies in Indian population. This study was planned to compare two techniques of fascial closure namely continuous and interrupted using polydioxanone in patients undergoing midline emergency laparotomies in our institute.Methods: This prospective study was conducted in Surgery Department, MMC&H, Muzaffarnagar, from January 2017 to June 2018. 60 patients undergoing emergency laparotomies were divided into two groups of 30 each. Group I (study group) patients underwent interrupted suture abdominal closure; Group II (control group) patients underwent continuous suture closure.Results: Commonest diagnoses were duodenal and enteric perforations. Mean closure time in Group 1 was 31.6 minutes and in Group 2 -17.3 minutes. Mean hospital stay in Group I and II were 12.88 and13.76 days respectively. 4 Group I patients developed wound discharge versus 6 patients in Group II. Burst abdomen occurred in 3 out of 60 patients. One Group I patient had localised fascial burst. One Group II patient had localized while one had complete fascial burst. One incisional hernia was observed in each group at 3rd month of follow up. Three patients in Group 1 and one in Group 2 developed suture sinus.Conclusions: Major complication is wound dehiscence leading to increased morbidity, hospital stay and cost. In our study, we used continuous and interrupted PDS sutures and found that interrupted suturing method of abdominal wall closure is better, though it takes more time.

scholarly journals PRIMARY POSTPARTUM HEMORRHAGE

2016 ◽  
Vol 23 (10) ◽  
pp. 1178-1182
Author(s):  
Rozina Yasir ◽  
Mumtu Bai Lakhwani ◽  
Shaista Naz ◽  
Zain Ali
Keyword(s):  
Blood Loss ◽  
Tertiary Care ◽  
Active Management ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Group I ◽  
Third Stage ◽  
Uterine Massage ◽  
Group Ii

Objectives: The aim of our study is to determine the effectiveness of uterinemassage with active management and compare it with active management alone, in primarypostpartum hemorrhage prevention. Study Design: Randomized control trial. Period: 8months from September 2014 to April 2015. Setting: Tertiary Care Hospital in Karachi, Pakistan.Method: The study population consists of n=118 patients, both emergency and elected cases,who came to the gynecology and obstetrics ward at our hospital. The patient population wasdivided into two groups, group I received active management of labor ( third stage ) while groupII received active management of labor (third stage) in addition to the uterine massage (for a 2hrduration), the outcome was measured by measuring the amount of blood loss and the need foruterotonic agents. A p value of less than 0.05 was considered significant. Results: The studypopulation consisted of n=118 patients, undergoing spontaneous labor, and divided into twogroups, the mean blood loss in group I (control group) was 211.4mls and in group II (massagegroup) was 167.8mls (p value= 0.015). In group I n=15 patients required additional uterotonicsupport, while in group II only n=3 patients required it (p value= 0.00058). Conclusion:According to the results of our study, uterine massage in addition to the active managementof labor reduces post-partum hemorrhage, and it also reduces the requirement for additionaluterotonic agents for the control of hemorrhage.

scholarly journals STIMULATION ATTITUDIONAL REFLEX EXERCISE LEBIH BAIK DIBANDINGKAN DENGAN PRONE POSITION WEDGE EXERCISE TERHADAP HEAD CONTROL PADA ANAK CEREBRAL PALSY SPASTIK QUADRIPLEGI DI RS RAJAWALI CITRA BANTUL, YOGYAKARTA

2019 ◽  
Author(s):  
Damha Al Banna ◽  
I Putu Gede Adiatmika ◽  
M. Irfan ◽  
I Putu Adiartha Griadhi ◽  
Luh Putu Ratna Sundari ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Prone Position ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Group I ◽  
Head Control ◽  
Group Ii ◽  
Better Than

ABSTRACTBackground: Head control is a disorder of the cerebral palsy (CP) spastic quadriplegi due to central nervous system problems that serve as the basis of movement to be achieved for further development. Physiotherapy actions that can be given are stimulation attitudional reflex exercise (SARE) and prone position wedge exercise (PPWE). Purpose: This study aims to determine whether SARE is better than PPWE for head control in CP spastic quadriplegi. Methods: This research uses experimental pre and post test control group design is done at Rajawali Citra Bantul Hospital. Subjects were 24 children with CP spastic quadriplegi divided into 2 groups, group I was given SARE for 3 repetitions in 1 hour of therapy sessions and group II was given PPWE for 30 minutes. All groups were given treatment 1 time a week for 6 weeks as a refresher intervention and educated the family to do every day at home. Increased head control is measured by gross motor functional measurement. Result: Statistical test of paired sample t-test in group I and group II p value = 0.001 where (p < 0.05) there was an increase of head control. From independent t-test p value = 0.001 where (p < 0.05), it can be concluded that there are significant differences between group I with group II. Based on the mean values in both treatment groups, the group I have larger head control improvement of 33.19% than group II which only 16.96%. Conclusion: SARE is better than PPWE to increase head control on CP spastic quadriplegiKeywords: Head control, SARE, PPWE

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