scholarly journals Evaluation of Flexural Strength of Polymethylmethacrylate Denture Base Resin Incorporated with Alkali and Heat-Treated Teak Wood Fibers and Ultra High Molecular Weight Polyethylene Fibers

2021 ◽  
Vol 10 (28) ◽  
pp. 2051-2055
Author(s):  
Puja Harie Priya M.S ◽  
Brintha Jei J. ◽  
Murugesan Krishnan ◽  
Muthukumar Balasubramanium
Keyword(s):  
Flexural Strength ◽  
Natural Fibres ◽  
P Value ◽  
Denture Base ◽  
Heat Treated ◽  
Wood Fibres ◽  
Teak Wood ◽  
Group A ◽  
Group B ◽  
Group D

BACKGROUND Polymethyl-methacrylate (PMMA) resin is the most commonly used denture base material which satisfies colour stability, aesthetic demands, accurate fit, affordable cost, and ease in manipulation. The common disadvantages are incomplete flow, impact strength, transverse strength and fatigue resistance. The fracture of denture base is mainly due to flexural fatigue failure which can be minimised by reinforcing with various artificial and natural fibres. There are very few studies which have incorporated natural fibres to enhance the strength of PMMA resin. So, in this study both natural and artificial fibres were used to enhance the property and find the best fibres to strengthen the denture base. METHODS A total of 80 samples were prepared using a standardized stainless steel metal die and these samples were grouped into Group A as control group, Group B PMMA samples reinforced with raw teak wood fibres, Group C reinforced with alkali treated teak wood fibres, Group D reinforced with heat treated teak wood fibres and Group E samples were reinforced with Ultra-High molecular weight (UHMW) polyethylene fibres and processing was carried out by conventional method. The flexural strength of each sample was calculated. RESULTS The mean flexural strength of Group A, Group B, Group C, Group D and Group E were 82.338, 58.680, 62.259, 105.878, 90.2263 respectively with a P value of 0.001. Group D samples showed a P value < 0.001 which was statistically significant when compared to other groups. The obtained values were statistically analysed by oneway ANOVA and Tukey’s HSD test using statistical software SPSS 17. CONCLUSIONS This in-vitro study infers that the samples of Group D incorporated with heat treated teak fibres had shown increased flexural strength, which could be a good replacement for various synthetic and natural fibres to enhance the strength of denture base resins. KEY WORDS Teakwood Fibres, Heat Treatment, Alkali Treatment, Sandwich Technique, Polyethylene Fibres

scholarly journals Effects of Aqueous Extract of Basella alba L. leaves on Blood Cell Count in Rats

2019 ◽  
Vol 22 (1) ◽  
pp. 73-78
Author(s):  
Farhana Sabrin ◽  
AF Mohammed Shafiqul Alam ◽  
Muhammad Rashedul Islam ◽  
Md Elias Al Mamun ◽  
Jakir Ahmed Chowdhury
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Aqueous Extract ◽  
Control Group ◽  
P Value ◽  
Blood Cell Count ◽  
Basella Alba ◽  
Group A ◽  
Group B ◽  
Group D

The effect of aqueous extract of Basella alba (puishak) leaves on blood cell count of rats was studied. Forty rats of both sexes weighing between 100-150 gm were used. The rats were divided into four groups (7 rats in each group), with group A as the control group and experimental groups were denoted as B, C and D. With all aseptic precautions, aqueous extract of Basella alba (Puishak) leaves was administered into the three different doses (For group B: 60 mg/kg bw, group C: 80 mg/kg bw and group D: 100 mg/kg bw). Control group A also received distilled water as a placebo at the dose of 10 mg/kg bw for 14 days. At day 15, blood samples were collected and sent for haematological analysis. Data analysis of blood count profile of 28 rats revealed that there is an increased number of RBC, WBC and platelet count in experimental groups than in control group. ANOVA test revealed that increased blood cell counts following administration of aqueous leaves extract of keeves of B. alba were statistically significant (p value for each case was .0001<.05) than control group. Paired samples t test was performed to compare between baseline hematological parameters and parameters after 14 days of intervention. Then comparison between Group A & Group B, between Group A & Group C and between Group A & Group D were done. In all cases, probability (p) value < 0.05 was considered as statistically significant.This it is clearly evident that aqueous extract of B.alba has positive stimulant effect on blood cells count of rats. Moreover, it was found that increment of doses also increases the cell count that is positively correlated with the hypothesis. Bangladesh Pharmaceutical Journal 22(1): 73-78, 2019

scholarly journals Antiulcerogenic Activity of Vitamin E on Gastric Ulcers produced by Indomethacin

2021 ◽  
Vol 25 (1) ◽  
pp. 122-127
Author(s):  
Ayesha Yousaf ◽  
Ifra Saeed ◽  
Tehzeeb Ul Hassan ◽  
Rana Fahd Intisar ◽  
Mohammad Amin Shiekh
Keyword(s):  
Vitamin E ◽  
Gastric Ulcers ◽  
P Value ◽  
Ulcerogenic Effect ◽  
Group A ◽  
Mean Dimension ◽  
The Mean ◽  
Group B ◽  
Group D ◽  
Antiulcerogenic Activity

Objective: To study the morphological and histological effects of vitamin E on gastric lesions produced by indomethacin.Materials and Methods: This was an animal interventional study, 48 adult healthy albino mice were selected and were split into four groups A, B, C and D. Number of animals in each group was 12. Group A was categorized as control. Evion 400mg/kg was administered to Group B. Indocid 25mg/kg was given to group C. Indocid and Evion both (25mg/kg &400 mg/kg respectively) were administered to Group D. In all group, six animals were selected and treated for three days and rest for eight days with calculated doses of drugs. Mice were sacrificed and dissection was done 24 hours after the last dose. The stomach was identified, washed, and observed under dissecting microscope to study the number and shape of ulcers. The dimension of ulcers was measured under a compound microscope.Results: No ulcers were seen in groups A and B. 35 and 10 ulcers were observed in groups C and D respectively. The mean number of ulcers in groups C and D was statistically significant (p-value=0.000). In comparison to group D, Pindot, linear, Irregular, and punched-out ulcers were more prevalent in group C and were statistically significant (p-value < 0.05). The mean linear dimension of ulcers in group C was much greater than in group D. The mean dimension of ulcers in group C1 and C2 was 262.50µm and 232.5µm respectively. Whereas in group D1 and D2 given both Indocid and vitamin E the dimensions were 56.5µm and 50µm.Conclusion: Vitamin E has an anti-ulcerogenic effect on stomach mucosa by reducing the number and dimension of ulcers.

Load-to-fracture Value of Different All-ceramic Crown Systems

2005 ◽  
Vol 6 (4) ◽  
pp. 54-63 ◽  
Author(s):  
Mark David Snyder ◽  
Kyle Douglas Hogg
Keyword(s):  
Static Load ◽  
Testing Machine ◽  
P Value ◽  
Universal Testing ◽  
All Ceramic ◽  
Group A ◽  
Group B ◽  
Ceramic Crown ◽  
Group D ◽  
Adhesive Cement

Abstract Objectives The purpose was to investigate the potential difference in the load-to-fracture values of several all-ceramic crown systems. Five different coping-reinforced all-ceramic crown systems were selected. Ten crowns from each system were fabricated and luted to standardized titanium dies. Methods The study consisted of five groups of ten samples each, all luted using G.C. Link Max resin adhesive cement. Group A: IPS Eris®, Group B: Cerac® In-lab Alumina coping, Group C: Cerac® In- lab Zirconia coping, Group D: Procera® AllCeram Alumina coping, and Group E: Procera® Zirconia coping. Following cementation, the samples were placed under a 5 Kg static load for 10 minutes insuring proper seating and stored in 100% humidity for one week. All samples were visually inspected prior to testing and were loaded to fracture at the rate of 0.5 mm/min using a universal-testing machine. Results Group A = 321.49 KgF ± 113.69 (S.D.), Group B = 288.63 ± 102.82 (S.D.), Group C = 266.58 ± 69.17 (S.D.), Group D = 295.49 ± 80.54 (S.D.), and Group E = 420.37 ± 82.45 (S.D.). The data were analyzed using an unpaired t-test; this indicated a statistical difference between group E and all of the others (P-value ≤0.039). Conclusions We concluded under these conditions, the Procera® Zirconia crown system has significant higher load-to-fracture value than several other all-ceramic crown systems. Citation Snyder MD, Hogg KD. Load-to-fracture Value of Different All-ceramic Crown Systems. J Contemp Dent Pract 2005 November;(6)4:054-063.

Advanced cancer patients' priorities regarding wishes at the end of life: A randomized controlled study.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 44-44
Author(s):  
Marvin Omar Delgado-Guay ◽  
Alfredo Rodriguez-Nunez ◽  
Vera J De la Cruz ◽  
Susan Frisbee-Hume ◽  
Janet L. Williams ◽  
...  
Keyword(s):  
End Of Life ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
P Value ◽  
Advanced Cancer Patients ◽  
Randomized Controlled ◽  
Group A ◽  
Important People ◽  
Group B ◽  
Group D

44 Background: Conversations about wishes around the end-of-life(EOL) are challenging for clinicians. There is limited literature about the type and stability of patient’s reported EOL planning priorities. We compared a set of 36 cards (“Go-wish-Game”: GWG) v. a paper list of statements (LOS) to assist patients in establishing priorities. Methods: Randomized controlled study. Pts. were randomized to the GWG or to 36 LOS and were asked to categorize them as very, somewhat, or not important; Group A received LOS followed by LOS 4-24 hours later; group B: GWG-GWG; group C: GWG-LOS, and group D: LOS-GWG. The State-Trait Anxiety inventory for Adults(STAI) was done after the first set of questionnaires. Results: 100 pts. Median age (IQR): 56 (27-83) years. 60% female. 68% White, 17% Hispanic, and 9% African-American. 62% married. Age, marital status, religion, education and cancer diagnosis were not significant different among groups. All pts. were able to complete the GWG. 43/50 (88%) agreed that instructions of GWG were clear. 45/50 (92%) agreed that GWG was easy to understand. 31/50 (64%) patients exposed to both tools, preferred GWG. 39/50 (79%) expressed that GWG did not increased their anxiety. 31/50 (63%) expressed that having conversations about priorities near EOL is beneficial to them (p=NS). STAI median (IQR) score after GWG was 48 (39-59) v. 47 (27-63) for LOS, p=0.2952. The 10 most common “Very important” wishes expressed by pts. the first and second time they received the test (%; Spearman, p-value) were: to be at peace with God(74% v. 71%; r=0.73, p<0.0001), to pray(62% v. 61%, r=0.53, p<0.0001), to have my family with me(57% v. 61%; r=0.23, p=0.02), to be free from pain(54% v. 60%, r=0.31, p=0.001), not being a burden to my family(48% v. 49%, r=0.23, p=0.02), to trust my doctor(44% v. 45%; r=0.49, p<0.0001), to keep my sense of humor(41% v. 45%; r=0.53, p<0.0001), to say goodbye to important people in my life(41% v. 37%; r=0.46, p<0.0001); to have my family prepared for my death(40% v. 49%; r=0.48, p<0.0001). Conclusions: EOL wishes were similar and persistent using both GWG and LOS. Completing both GWG and LOS did not increase anxiety. All patients were able to complete and most preferred GWG.

scholarly journals PEDIATRIC APPENDICITIS: AGE DOES MAKE A DIFFERENCE

2019 ◽  
Vol 37 (3) ◽  
pp. 318-324
Author(s):  
Belén Aneiros ◽  
Indalecio Cano ◽  
Araceli García ◽  
Pedro Yuste ◽  
Eduardo Ferrero ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Clinical Presentation ◽  
P Value ◽  
Age Group ◽  
Atypical Symptoms ◽  
Group Methods ◽  
Perforated Appendix ◽  
Group A ◽  
Group B ◽  
Group D

ABSTRACT Objective: To investigate the influence of patient age on the diagnosis and management of appendicitis, as well as to evaluate the rate of complications according to the age group. Methods: We undertook a retrospective analysis of 1,736 children who underwent laparoscopic appendectomy in our center between January 2000 and December 2013. Patients were divided in groups taken into account their age: group A were infants, group B were preschoolers, group C were those ones older than five years old, and group D were those ones younger than five years old. A p value of 0.05 was considered statistically significant. Results: We found higher incidence of misdiagnosis and atypical symptoms in the youngest patients. The rate of perforation was similar between group A and B (p=0.17). However, it was higher in group D than in group C (p<0.0001). The incidence of postoperative complications was higher in the youngest patients too (p=0.0002). Conclusions: The age does make a difference in acute appendicitis. Because of its unusual presentation in children younger than five years old, it is often misdiagnosed, which leads to an increased morbidity. Although clinical presentation varies between infants and preschoolers, no statistically significant differences were observed in the rate of perforated appendix or postoperative complications.

scholarly journals Pain during intravenous Propofol injection and its prevention in the pediatric population. A randomized controlled trial.

2020 ◽  
Vol 27 (01) ◽  
pp. 185-190
Author(s):  
Hamid Raza ◽  
Maqsood Ahmed Siddiqui ◽  
Ahmed Uddin Soomro ◽  
Kamlaish
Keyword(s):  
Adverse Events ◽  
Incidence Rate ◽  
Normal Saline ◽  
Pediatric Population ◽  
Injection Pain ◽  
P Value ◽  
Care Hospital ◽  
Group A ◽  
Group B ◽  
Group D

Objectives: The aim of our study is to observe the pain difference as experienced by the pediatric patient when administered different preparations of propofol utilizing the verbal rating scale. Study Design: Prospective double-blind randomized control trial. Setting: A large tertiary care hospital in Karachi, Pakistan. Period: 6 months from June 2016 to November 2016. Material & Methods: The final patient population included in the study was n= 180 and were divided into six groups. These patients received general anesthesia and underwent surgery. Patients in Group A received 2ml of normal saline and a mixture of propofol and normal saline after waiting for half a minute. Group B patients received 0.5mg/kg Lidocaine followed by normal saline after waiting for half a minute. Group C received 2ml of normal saline followed by a mixture of propofol and Lidocaine after half a minute. Group D received 0.2mg/kg of Ketamine followed by a mixture of normal saline and propofol. Group E patients received 2ml of normal saline followed by a mixture of propofol and Ketamine half a minute later. And finally, patients belonging to group F received 2ml of normal saline followed by a mixture of propofol M/LCT and normal saline half a minute later respectively. Results: The gender, age, body weight and ASA grade of all the pediatric patients were similar having a P value of >0.05. The incidence rate of propofol injection pain in the groups were found to be Group A= 76.66%, Group B= 66.66%, Group C= 50%, Group D= 60%, Group E= 63.33%, Group F= 60% respectively. The incidence rate for adverse events was significantly lower in all the groups as compared to Group A that is the normal saline and propofol group having a p-value of less than 0.01. And the incidence rate of adverse events was lower in Groups C, D, E, and F were significantly lower than Group B having a p-value of less than 0.05. All the experimental groups had significantly lower scores of the VRS scale as compared to the control group (Group A) and the intergroup differences were found to be statistically significant having a p-value of less than 0.01. Conclusion: In our study, we found that the injection pain of propofol administration in the pediatric population was significantly reduced when using M/LCT pre-injection, 0.5mg/kg lidocaine or 0.2mg/kg of Ketamine. Another good combination is mixing 180mg propofol with 40mg of lidocaine or mixing propofol with 16mg of Ketamine.

scholarly journals Knowledge Gaps in the Management of Hemophilia Among Hematologists/Oncologists

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4831-4831 ◽  
Author(s):  
Emily S Van Laar ◽  
Charlotte Warren ◽  
Jayashri Desai ◽  
Patrick F. Fogarty
Keyword(s):  
Clinical Practice ◽  
Best Practices ◽  
Research Funding ◽  
Joint Disease ◽  
P Value ◽  
Knowledge Gaps ◽  
Community Group ◽  
Group A ◽  
Group B ◽  
Group D

Abstract Hemophilia is an orphan disease whose management requires specialized knowledge of complications and treatments, which adds to the challenge of caring for patients. Knowledge gaps among hematologists, hematologist-oncologists and pediatric oncologists regarding management of hemophilia could negatively impact patient outcomes. Utilizing the National Hemophilia Foundation and the World Federation of Haemophilia guidelines and best practices, a global, hemophilia-specific continuing medical education-accredited clinical practice assessment survey was developed and completed by unselected hematologists and oncologists in order to define current education gaps and assess areas of deviation from guideline and best practices. The assessment included both knowledge- and case -based, multiple-choice questions that healthcare providers completed confidentially on-line between March 21, 2014 and July 2, 2014. Topics ranging from hemophilia severity to management/prevention of bleeds were assessed. Responses from clinicians were de-identified and aggregated prior to analyses. 354 hematologist (51%), hematologist/oncologist (34%) or pediatric oncologists (14%) completed the survey, from the following locales: North America (30%), Europe (25%), Asia (18%), Central/South America (9%), Middle East (7%), Africa (8%), and Australia (2%). Practice settings of participants were academic (53%), community hospital (22%), private practice (12%), hemophilia treatment center (HTC) (5%), community clinic (3%), and other (5%). Respondents demonstrated knowledge (> 88% correct responses) in topics such as: definition of severe hemophilia, identifying life-threatening bleeds, primary prophylaxis dose/schedule, adolescence transitioning, and monitoring after initiating prophylaxis. In contrast, knowledge gaps included: prophylaxis duration; incidence of inhibitors; role of physiotherapy; managing joint bleeds (Table 1). For most responses, the proportion of correct responses appeared to be consistent regardless of physician specialty (hematologists (Group A) versus hematologists/oncologists + pediatric oncologists (Group B)) or practice setting (academic + HTC (Group C) versus community (Group D)). A low level of confidence in ability to identify when to use prophylaxis was reported among 20% [95% CI: 16.74% to 23.26%] of all respondents. Knowledge gaps permeate clinical practice in the care of persons with hemophilia. Most significant gaps were related to incidence of inhibitor development, continuance of prophylaxis, and use of physiotherapy for hemophiliac joint disease. These data support the development and implementation of educational tools for clinicians involved in hemophilia care across a range of practice settings. Abstract 4831. Table 1. Hemophilia Knowledge Gaps for Hematologists, Hematologist/Oncologists, Pediatric Oncologists (% Correct Responses) Survey Assessment Topic All Group A Group B Group A vs Group B p-value Group C Group D Group C vs Group D p-value Prophylaxis Duration 35.9% 34.8% 38.3% 0.55 42.0% 28.4% 0.03 Incidence of Inhibitors 48.3% 51.4% 44.0% 0.20 43.4% 54.3% 0.08 Physiotherapy for Joint Disease 47.4% 50.4% 45.2% 0.40 51.0% 43.3% 0.27 Managing Joint Bleeds 74.2% 73.1% 75.6% 0.64 75.8% 72.2% 0.60 Disclosures Van Laar: Medscape LLC: Employment. Warren:Medscape LLC: Employment. Desai:Medscape LLC: Employment. Fogarty:CSL Behring: Research Funding; Biogen Idec Inc.: Research Funding; Baxter: Research Funding; Pfizer Inc: Consultancy; Chugai Pharma USA: Consultancy; Biogen Idec Inc.: Consultancy; Baxter: Consultancy; Bayer HealthCare Pharmaceuticals: Consultancy; Amgen Inc: Consultancy; Pfizer Inc: Research Funding; Medscape LLC: Honoraria; VindicoMed: Honoraria.

scholarly journals Comparative Evaluation of Bond Strength between Ridge Lap Surface of Acrylic Teeth and Denture Base Resin: An In Vitro Study

2019 ◽  
Vol 07 (01) ◽  
pp. 012-018 ◽  
Author(s):  
Eeshita Sharma ◽  
Manjit Kumar ◽  
Rohit Sharma ◽  
Ajay Bansal ◽  
Sumit Katoch
Keyword(s):  
Bond Strength ◽  
Aluminum Oxide ◽  
Acrylic Resin ◽  
Control Group ◽  
Denture Base ◽  
Denture Teeth ◽  
Base Resin ◽  
Group A ◽  
Group B ◽  
Group D

Abstract Statement of Problem Acrylic teeth are preferred to porcelain teeth in dentures as they unite chemically with denture base resin, but their fracture from denture is common. Purpose The purpose of this study was to improve the bond strength of denture teeth to acrylic resin denture base by chemical or mechanical modification of the ridge lap surface of denture teeth. Materials and Methods Total 100 artificial cross-linked acrylic resin central incisors were divided into five groups: group A, 20 samples without modification (control group); group B, 20 samples (ridge lap surface of teeth treated with monomer); group C, 20 samples (ridge lap surface of teeth treated with monomer and the glaze layer removed with aluminum oxide abrasive stone); group D, 20 samples (ridge lap surface of teeth treated with dichloromethane); and group E, 20 samples (dichloromethane application followed by abrasion with aluminum oxide stone on ridge lap surface of teeth). They were mounted on wax blocks, and the blocks were acrylized. The bond strength values were obtained by subjecting the samples to shear compressive load under universal testing machine. Result The results were subjected to statistical analysis by applying analysis of variance and Bonferroni test for multiple group comparisons, and graphs were plotted. The mean value of bond strength was highest for group E (modified by aluminum oxide abrasion prior to dichloromethane application), followed by group C (modified by aluminum oxide abrasion prior to monomer application), group D (modified by dichloromethane application), group B (modified by monomer application), and lastly group A (control group). Significantly improved bond strength values were obtained in modified groups as compared with the control group. Conclusion Dichloromethane application followed by aluminum oxide abrasion provided the highest bond strength and is recommended to prevent debonding of the teeth from the denture base.

scholarly journals LAGENARIA SICERARIA;

2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Saima Qureshi ◽  
Khadija Qamar ◽  
Tassaduq Hussain
Keyword(s):  
Body Weight ◽  
Sodium Arsenite ◽  
Control Group ◽  
P Value ◽  
Lagenaria Siceraria ◽  
Sprague Dawley ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Experimental Group

Objectives: To observe the effect of lagenaria siceraria on inflammation and fibrosis brought about by arsenic in liver of Sprague Dawley rat. Study Design: Laboratory based randomized control trial. Place and Duration of Study: This experiment was performed at Department of Anatomy, Army Medical College Rawalpindi in co-operation with National Institute of Health (NIH) Islamabad for eight weeks (1st March 2017 to 25th April 2017). Material and Methods: Fifty Sprague Dawley rats (both male and females housed separately) were carefully chosen and distributed randomly into five groups, each consisting of 10 animals. A and B were the control groups whereas C, D and E served as experimental groups. During the first four weeks, experiment groups C, D and E were given a dosage of 5milligram/kilogram body weight of sodium arsenite. At the end of four weeks, animals from control group A and experimental group C were dissected and liver samples were processed for microscopic studies. In the next 4 weeks, group D animals were set aside without any further intervention. At that time, sodium arsenite at a dose of 5 milligram/kilogram body weight and lagenaria siceraria at a dose of 100 milligram/kilogram bodyweight were administered to group E animals. Group B animals served as control for experimental groups D and E. At the end of these 4 weeks animals of groups B, D and E were dissected. Liver was processed, fixed and stained for microscopic study. Area of portal triad as well as liver lobules were studied for inflammation and fibrosis and results were analysed. Statistical tool used to analyse the data was SPSS v 22. Results were considered to be significant when p-value is ≤ 0.05. Results: Experimental group C developed moderate grade fibrosis and inflammation (grade 2 to 3) as compared to group A. Degree of inflammation and fibrosis was mild to moderate (grade 1 to 2) in group D. There was no inflammation and fibrosis (Grade 0 to 1) in group E. Group B served as a control for group D and E. Conclusion: Inflammation and fibrosis developed in the liver of adult rats when they were subjected to sodium arsenite even for a brief calculated period. Simultaneous administration of lagenaria siceraria can shield and diminish the toxic effects of arsenic. Oxidative potential and immunomodulatory properties and presence of flavonoid like substances renders lagenaria siceraria to act as ameliorative against this fibrosis and inflammation in liver lobules and surrounding area of portal triads.

scholarly journals Evaluation of the use of Hypertonic Saline 3% Nebulizer versus Intravenous Hypertonic Saline 3% to Attenuate the Manifestations of Acute Respiratory Distress Syndrome

2020 ◽  
Vol 14 (1) ◽  
pp. 52-61
Author(s):  
Amr Sobhy ◽  
Abdelkarem Hussiny ◽  
Mohammed Kamal
Keyword(s):  
Mortality Rate ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Distress Syndrome ◽  
Control Group ◽  
P Value ◽  
Icu Stay ◽  
Group A ◽  
Group B ◽  
Group D

Background: A well-known disease, Acute Respiratory Distress Syndrome (ARDS) presents a daunting challenge to the medical community with alarmingly high mortality rates. Initiation of hypertonic saline (HTS) nebulization therapy for patients with early ARDS appears to be tolerable and may be beneficial. However, using a nebulizer is cumbersome and less efficient. This study aims to assess the efficacy of using HTS3% in a nebulizer in comparison with intravenously injecting it to attenuate the manifestation of ARDS. The study analyses factors such as the severity of the disease, need and duration of mechanical ventilation (MV), ICU stay, and mortality rate in the comparative analysis. Materials and Methods: The randomized, comparative, and controlled study included patients of both genders from an age bracket of 18-60 years. The patients fulfilled the Berlin definition of ARDS. Additionally, the whole sample was divided into four groups (26 patients each): Group A received standard pharmacotherapy [methylprednisolone 1mg/kg/day intravenously and salbutamol nebulizer 2.5 mg (1 ml) + 3 ml normal saline/8hr] and normal saline 0.9% (5ml) nebulizer /8hr: Group B received standard pharmacotherapy + HTS2.7% (5ml) nebulizer/8hr: Group C also received standard pharmacotherapy and 500ml normal saline intravenously over 24 hours: Group D received standard pharmacotherapy and 500 ml HTS 3% intravenously over 24 hours. The following parameters were recorded: Lung injury score (Murray Score, calculated every 24 hours), the incidence of the need for MV, duration of MV, length of ICU stay, and mortality rate. Results: Group B (HTS nebulizer group) and group D (HTS IV group) showed the most rapid improvement in the Murray score with a 50% decrease in the score from its initial value (D50%) by day 4 with P-values of 0.013 and 0.022 respectively. Subjects from Group D (HTS IV) and Group B (HTS Nebulizer) were the least in need of MV as only 38.5% needed MV with a P-value <0.001. In comparison, 69.2% subjects from group A (control) and 73.1% from group C required MV, with a P-value <0.001. The shortest duration of MV care was found in group D (median 3.12 days), followed by group B (median 4.21 days). The results were highly significant, with P-value 0.004 when compared with group A (control group) and group C. In addition, the longest duration of MV care was reported in group A (median 5.37 days). There was significant variation in all groups regarding the length of ICU stay: group D required the least number of days (median 6.76 days), followed by group B (median 7.08 days). The result was statistically significant, with a P-value of 0.004 when compared with the control group (median 9.1 days) and group C(longest duration of MV with a median of 10.13 days). However, no significant difference was found in the mortality rate (P-value >0.05). Conclusion: The use of hypertonic saline 3% intravenously has a comparable effect as the use of hypertonic saline 3% via nebulizer to attenuate the manifestations of (ARDS) and even superior in the mechanically ventilated patient.

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