Assessment of Pharmacological Prophylaxis for Acute Pancreatitis Following ERCP in Patients with Choledoholithiasis

2015 ◽  
Vol 87 (12) ◽  
Author(s):  
Ewa Łubowska-Pająk ◽  
Krzysztof Kołomecki

AbstractEndoscopic retrograde cholangiopancreatography (ERCP) is an effective tool in the diagnostics and treatment of bile duct diseases. Although minimally invasive, the procedure is associated with a risk of complications, with acute pancreatitis being the most serious. In recent years, high hopes have been placed on pharmacological prevention of acute pancreatitis after ERCP.The aim of the study was assessment of the efficacy of low-molecular-weight heparin and somatostatin in combination with diclofenac in the prevention of acute pancreatitis after ERCP.Material and methods. The study enrolled three groups of 30 patients diagnosed with cholelithiasis; group I: patients who received low-molecular-weight heparin prior to ERCP, group II: patients who received somatostatin and diclofenac, group III: control group. The study assessed the incidence of acute pancreatitis, hyperamylasemia and increased CRP levels.Results. Acute pancreatitis was observed in 13.3% of group I patients, 10% of group II patients and 16.7% of group III patients (no statistical significance). Hyperamylasemia was observed in 16.7% of group I patients, 16.7% of group II patients and 43.3% of group III patients. These differences were statistically significant. No significant differences were found in the occurrence of increased CRP levels among the study groups.Conclusions. No significant reduction in the occurrence of acute pancreatitis after ERCP was observed in patients who received pharmacological prophylaxis. A significant reduction in the occurrence of hyperamylasemia was found in drug-treated patients.

2018 ◽  
Vol 33 (1) ◽  
pp. 22-27
Author(s):  
Tariq Ahmed Chowdhury ◽  
Mustafizul Aziz ◽  
Iftekhar Alam ◽  
Abuduz Zaher ◽  
Sayed Azizul Haque ◽  
...  

This prospective observational study was carried out in the Department of Cardiology of national institute of cardiovascular diseases (NICVD), Dhaka to assess the safety of low molecular weight heparin (LMWH) in patients undergoing percutaneous coronary intervention (PCI). Safety of low molecular weight heparin in comparison to unfractionated heparin (UFH) was observed in this study. In total data from 100 patients undergoing elective PCI was evaluated. Among them 50 patients in group I received I mg/kg intra-arterial LMWH and rest in group II received UFH. Demographic profile of individuals in both groups was almost similar. There was no significant difference in major coronary risk factors between the two groups. Patients were monitored during their stay in hospital for any complications like bleeding, haematoma, myocardial infraction and death. No death was observed in any group. Minor bleeding in group I and II (6% vs 105), Major bleeding (2% vs4%) and haematoma (6% vs 10%). Myocardial infraction no incidence in group I and 4% in group II. So complications was more prevalent in group II who were treated with UFH, but those were not statistically significant. The intra-arterial administration of LMWH in patients undergoing PCI is safe. The risk of acute and sub-acute coronary events and bleeding complications are similar in both groups and in hospital outcome there is less complication with LMWH used during PCI.Bangladesh Heart Journal 2018; 33(1) : 22-27


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Gianni Belcaro ◽  
Maria Rosaria Cesarone ◽  
Umberto Cornelli

LONFLIT studies have observed that in subjects at high-risk (HRS) for deep venous thrombosis (DVT) during/after long (>10 hours) flights, the incidence DVT (by ultrasound scans) may be between 4% and 6% (including subclinical thrombi), This study evaluated DVT prevention in HRS: 886 subjects were approached and 600 were included. They were divided into 3 groups and advised to use during the flights: a:exercise only (no pharmacological prophylaxis) b: aspirin (400 mg tablets, soluble aspirin; one dose daily for 3 days, starting 24 hours before flights) c: low-molecular-weight heparin (LMWH; enoxaparine - Lovenox - injected 2– 4 hours before flights. The single dose was weight-adjusted (1000 IU - equivalent to 0.1 ml per 10kg of weight). Subjects with possible problems due to aspirin or LMWH, using anticoagulants and other drugs (at risk of interactions) were excluded. High-resolotion ultrasound scans included femoral,popliteal and soleal veins and were performed within 24 hours after the second flight. The time separation between the two flights was <8 days (average 6.5;SD1.1). 458 subjects completed the two-flights study. Dropouts were due to low compliance or traveling/connections problems. Age/sex and risk distribution were comparable in the three groups. Mean age was 44.7 (range, 24 – 66; SD 7.1; 54% males). In the control group (160), there were 6.87% of subjects with DVT plus 2 superficial thromboses (SVT)(total events 8.1%). Of 142 subjects in the aspirin treatment group, there were 4.9% of subjects with DVT plus 3 SVTs (total 7% of subjects with a thrombotic event). In the LMWH group (156) there were no cases of DVT and 2 superficial thrombosis (1.28%); (P<0.002 in comparison with the other two groups). DVT was asymptomatic in 64% of subjects; D-dimer was elevated in 78% o subjects with events and in 28% of subjects without events. Mild gastrointestinal symptoms were reported in 15% of patients using aspirin. No side-effects were observed in the LMWH group. In conclusion, one dose of LMWH is an important option to consider for HRS during long-haul flights.


1997 ◽  
Vol 77 (01) ◽  
pp. 057-061 ◽  
Author(s):  
Dennis W T Nilsen ◽  
Lasse Gøransson ◽  
Alf-Inge Larsen ◽  
Øyvind Hetland ◽  
Peter Kierulf

SummaryOne hundred patients were included in a randomized open trial to assess the systemic factor Xa (FXa) and thrombin inhibitory effect as well as the safety profile of low molecular weight heparin (LMWH) given subcutaneously in conjunction with streptokinase (SK) in patients with acute myocardial infarction (MI). The treatment was initiated prior to SK, followed by repeated injections every 12 h for 7 days, using a dose of 150 anti-Xa units per kg body weight. The control group received unfractionated heparin (UFH) 12,500 IU subcutaneously every 12 h for 7 days, initiated 4 h after start of SK infusion. All patients received acetylsalicylic acid (ASA) initiated prior to SK.Serial blood samples were collected prior to and during the first 24 h after initiation of SK infusion for determination of prothrombin fragment 1+2 (Fl+2), thrombin-antithrombin III (TAT) complexes, fibrinopeptide A (FPA) and cardiac enzymes. Bleeding complications and adverse events were carefully accounted for.Infarct characteristics, as judged by creatine kinase MB isoenzyme (CK-MB) and cardiac troponin T (cTnT), were similar in both groups of patients.A comparable transient increase in Fl+2, TAT and FPA was noted irrespective of heparin regimen. Increased anti-Xa activity in patients given LMWH prior to thrombolytic treatment had no impact on indices of systemic thrombin activation.The incidence of major bleedings was significantly higher in patients receiving LMWH as compared to patients receiving UFH. However, the occurrence of bleedings was modified after reduction of the initial LMWH dose to 100 anti-Xa units per kg body weight.In conclusion, systemic FXa- and thrombin activity following SK-infusion in patients with acute MI was uninfluenced by conjunctive LMWH treatment.


2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.


2016 ◽  
Vol 94 (4) ◽  
pp. 359-362 ◽  
Author(s):  
Fatma H. Rizk ◽  
Samah A. Elshweikh ◽  
Amira Y. Abd El-Naby

Irisin is a new myokine that is suspected to influence metabolic syndrome (MetS). However, there is a great controversy with respect to its level in cases of MetS and its correlation with different metabolic parameters. The present study assesses irisin levels in MetS patients and studies its relationship to metabolic and liver functions to evaluate the possible role of the liver in regulation of this level. Sixty subjects were included in this experiment, who were divided into 3 groups: group I (normal control), group II (MetS patients with normal liver enzymes), and group III (MetS with elevated liver enzymes and fatty liver disease). Serum irisin levels showed significant increases in groups II and III compared with group I, and significant increases in group III compared with group II. Also, irisin levels were positively correlated with body mass index, serum triglycerides, homeostatic model assessment of insulin resistance index (HOMA-IR), and liver enzymes. We concluded that serum irisin levels increased in patients with MetS, especially those with elevated liver enzymes, and had a positive correlation with parameters of lipid metabolism and glucose homeostasis with the possibility of hepatic clearance to irisin.


2021 ◽  
Vol 9 (3) ◽  
pp. 87-90
Author(s):  
A. Jyoth ◽  

The effect of fiber rich product on child hood obesity studied with 60 sample which were collected randomly among 10-12 years and categorized into 2 groups i.e, experimental group and control group. Experimental group further categorized into three groups i.e, supplementation with exercise (n=15), only supplementation group (n=15), only exercise group (n=15) and control group consists of (n=15).Anthropometric, and diet survey conducted as parameters. A fiber rich product was prepared and supplemented for 2 months to the selected subjects and it consists of whole Bengal gram, whole green gram, green peas, barley and jaggery. Positive results were obtained in three experimental groups. Significant decrease observed inweight, and BMI, Total cholesterol, Triglycerides, LDL, VLDL significant increase observed in HDL in group I II and III. The results were (51.60-48.26kg, 24.7-23.1, 195.2-152.3 mg/dl, 168.2-145.0 mg/dl, 52.2-54.13 mg/dl, 109.4- 69.4mg/dl, 33.6-28.7mg/dl) in group I, In group II the results are (50.3-49.86kg, 23.7-23.4, 168.6-161.0mg/dl, 145.4-129.6mg/dl, 44.2-45.2 mg/dl, 95.3-90.0mg/dl, 29.1-28.3mg/dl).In group III the tesults aere (50.7-49.6kg, 24.5-23.9, 143.2-139.3mg/dl, 139-134.5mg/dl, 38.2-38.7mg/dl 76.8-74.1 mg/dl, 25.6-28.1mg/dl) .From the results it was clear that when compared to group II and III group I has shown better results.


1960 ◽  
Vol 34 (3-4) ◽  
pp. 347-348 ◽  
Author(s):  
L. F. Taffs

It has been shown that guineapigs can be effectively protected against re-infection by the subcutaneous inoculation of embryonated Ascaris eggs (Soulsby, 1957). The purpose of this communication is to report a successful attempt to immunize guineapigs against a lethal oral challenge dose of eggs by the intravenous inoculation of third stage larvae of A. suum.Three groups, each containing nine guineapigs, were infected with Ascaris as follows: Group I was given 10,000 eggs by mouth. Group II Was inoculated intravenously with 2,000 third stage Ascaris larvae which had been obtained from the lungs of other guineapigs on the sixth day of infection. Both groups were challenged at the same time with 250,000 eggs by mouth, along with a control group (Group III) which had no previous infection. The guineapigs in Group I were re-infected after 18 days and those in Group II after 12 days.


1988 ◽  
Vol 16 (5) ◽  
pp. 359-366 ◽  
Author(s):  
E. Chiapuzzo ◽  
G. B. Orengo ◽  
G. Ottria ◽  
A. Chiapuzzo ◽  
E. Palazzini ◽  
...  

The prophylactic antithrombotic efficacy of a low molecular weight heparin was compared with a traditional unfractionated calcium heparin after orthopaedic surgery in 140 patients. Deep vein thromboses were detected in legs either by Doppler sonography or [125I]fibrinogen uptake tests in five (7.1%) and seven (10%) patients, respectively. The capacity of both drugs to prevent deep vein thrombosis was demonstrated. Compared with the control group, those who used low molecular weight heparin showed a significant increase of activated factor X inhibition and smaller increases in activated partial thromboplastin times. Tolerability of both drugs was good, with a low incidence of local side-effects.


2021 ◽  
Vol 15 (11) ◽  
pp. 2951-2953
Author(s):  
Sameer Ahmed ◽  
Muhammad Tahir ◽  
Attiya Munir ◽  
Amtul Hafeez ◽  
Sher Afghan Khan ◽  
...  

Background: Nephrotoxicity is characterized by raised serum urea and creatinine levels and kidneys being one of the primary organs of drug concentration and excretion are vulnerable to many widely used marketed drugs, including anti-cancer drugs, antibiotics, immunosuppressants, and radio contrast agents, are nephrotoxic. Aim: To determine the nephroprotective effect of ethanolic extract of Carica papaya seeds in Aminoglycoside induced acute nephrotoxicity. Study design: Quasi Experimental study. Methodology: Thirty Sprague Dawley rats were sub divided into 3 groups i.e., I, II and III with 10 rats in each group. Group II and III were administered Aminoglycoside drug; Gentamycin in 80 mg/kg) via intraperitoneal route once daily for 5 consecutive days to induce acute nephrotoxicity. At day 6, nephrotoxicity was confirmed by measuring serum urea and creatinine. Ethanolic extract of Carica papaya seeds (1000 mg/kg) was started once daily through oral route in group III for 5 consecutive days to see the nephroprotective effects of seed extract after causing acute kidney injury. All animals were given standard diet pellets manufactured at NIH. Results: Mean serum urea and creatinine for Group I (Control Group) at day 0 were 24.90 mg/dL ± 1.633 and .750 mg/dL ± .0619 respectively. Mean serum urea and creatinine for Group II (Disease Control Group) was 81.00 mg/dL ± 1.247 and 1.980mg/dL ± .0467 at day 6th. This suggested induction of nephrotoxicity by Gentamycin. Mean serum urea and creatinine for Group III (Ethanolic Extract Treated Group) at 11 day was 72.40mg/dL± .991 and 1.680 mg/dL± .0467 after 5 days treatment with ethanolic extract of Carica papaya seeds. Conclusion: We concluded that ethanolic extract of Carica papaya seeds has significant nephroprotective effects on Aminoglycoside induced acute nephrotoxicity in rats. Keywords: COVID-19, Vaccination, Awareness and Adverse Effects


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