scholarly journals The effect of coenzyme Q10 on cognitive status in chronic hemodialysis patients; a double-blind, randomized, clinical trial

2018 ◽  
Vol 7 (2) ◽  
pp. 149-155
Author(s):  
Mohammad Reza Tamadon ◽  
Majid Mirmohammadkhani ◽  
Shahb Rafaati

Introduction: Renal failure is a stressful process that has several complications, including neurological disorders such as cognitive disorder, which can lead to the incidence of psychological disorders. Objectives: Given the reduced coenzyme Q10 levels in patients with chronic renal failure and the known role of this coenzyme in cognitive disorders, the present study was conducted to assess the effect of CoQ10 supplementation in the treatment of cognitive disorder in hemodialysis patients in Semnan, Iran. Patients and Methods: The present double-blind, randomized, clinical trial was conducted on patients with chronic renal failure undergoing hemodialysis at Kosar Hospital of Semnan. The participants underwent a cognitive assessment using the Mini-Mental State Examination (MMSE). They were then randomly divided into two groups; group one received CoQ10 supplement and group two received placebo for 90 days, after which period they underwent another cognitive assessment using the MMSE. The Kolmogorov-Smirnov test and Levene’s test were used to verify the normal distribution of the data. Data were analyzed using the t test and Mann–Whitney U test at a significance level of P<0.05. Results: There were no statistically significant differences between the two groups in terms of their personal details. The mean (± standard deviation) of the MMSE1 score was 21.29±6.5 in the control group and 21.09±5.4 in the case group. The mean (± standard deviation) of the MMSE2 score was 20.62±6.5 in the control group and 23.29±5.8 in the case group. A significant difference between the two groups in terms of their pre- and post-intervention MMSE scores was observed, suggesting the positive effect of the medication (P<0.001). Conclusion: The daily intake of CoQ10 100-mg led to a significant change in the cognitive status of chronic hemodialysis patients compared to the group that received only the placebo. Conducting a similar study but with the addition of a healthy control group is recommended in order to establish a base measure for the healthy population and to thus enable the better interpretation of the effect of this supplement.

2018 ◽  
Vol 71 (7-8) ◽  
pp. 222-226
Author(s):  
Aleksandra Jakovljevic ◽  
Vojkan Nestorovic ◽  
Mirjana Dejanovic ◽  
Zoran Bukumiric ◽  
Aleksandar Jakovljevic ◽  
...  

Introduction. Hemodialysis patients with chronic renal failure, suffer from affective dysfunction to a variable extent. The aim of our study was to evaluate the cognitive and affective status in patients before and after hemodialysis. Apart from this, the goal of the study was to examine and compare the cognitive status of patients on dialysis in relation to the control group, but also in relation to laboratory parameters. Material and Methods. This research was a prospective study including 30 hemodialysis patients with chronic renal failure treated at the Department of Nephrology of the Health Center in Kosovska Mitrovica. The cognitive status of the subjects was evalueted by determining the simple reaction time to auditory and visual stimuli before and after hemodialysis sessions and using the Mini Mental Status Examination, while the affective status was evalueted by using the Beck Depression Inventory. Results. The analysis of the obtained results showed a statistically significantly lower auditory and visual simple reaction times (p = 0.014) after dialysis (p = 0.023). The results have confirmed a statistically significantly decreased simple reaction time to visual stimuli (p = 0.001), while a statistical significance (p = 0.137) was not obtained for the auditory stimuli when compared to the control group. The Mini Mental Status Examination and the Beck Depression Inventory did not indicate a significant cognitive status damage or presence of depression. Conclusion. The importance of hemodialysis in the improvement of cognitive function is clearly evident, even though the general state of cognitive status in patients on hemodialysis is lower compared to the healthy population. Evaluation of the cognitive and affective status using simple reaction time, Folstein?s Mini Mental State Examination and the Beck Depression Inventory, should be used on daily basis in hemodialysis patients.


2016 ◽  
Vol 12 (36) ◽  
pp. 164
Author(s):  
Kane Yaya ◽  
Leye Mamadou Mokhtar Mbacké ◽  
Zeinabou Maiga Moussa Tondi ◽  
Lemrabott Ahmed Tall ◽  
Faye Maria ◽  
...  

Hemodialysis has made numerous and significant progress in recent decades resulting in life expectancy increase (thirty or forty years). The aim of our study was to assess the treatment of acute and chronic hemodialysis in the reference center of Tambacounda. Patients and methods: This was a prospective study over a one-year period (April 2013 to March 2014) in the hemodialysis center of the regional hospital of Tambacounda, 450km away from Dakar. The study focused on epidemiological, clinical, paraclinical and scalable data. Results: Fifty-nine patients were involved in the study. The sex ratio was 0.85 (32F/ 27M). The mean age was 41.3 years [12-72 years old]. Nineteen patients were on dialysis treatment for acute renal failure (ARF) (32.2%) and 40 were chronic hemodialysis patients (67.79%). Fifty patients were under emergency dialysis (84.7%) including 17 in intensive care (28.8%). Most chronic hemodialysis patients had 3 sessions per week (98.3%). Only 9 patients were monitored in nephrology prior to dialysis (22%). Thirty-two patients had a femoral double-lumen catheter (54.23%), 6 patients used ordinary double- lumen jugular catheters (10.17%) and 3 received tunneled jugular catheters (5.09%). Eighteen patients had functional arteriovenous (AV) fistula (18.51%). The mean hemoglobin was 7 g/dl. Only 11 patients had erythropoietin-based therapy. In acute renal impairment there were 8 deaths (42.10%), whereas in chronic renal failure the fatality rate was 18.8% (n = 9). Conclusion: Our study has demonstrated the benefits of decentralizing dialysis treatment in the provinces. However there is a need to implement the accompanying measures, such as the availability of some essential medicines for all hemodialysis patients, and equipment of intensive care units.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Moslem Sedaghattalab ◽  
Marzieh Razazan ◽  
Mohsen Shahpari ◽  
Nahid Azarmehr ◽  
Rozina Abbasi Larki ◽  
...  

Introduction. Chronic kidney disorder is a main public health concern. Inflammatory processes and oxidative stress are common in end-stage renal disease patients. We aimed to evaluate the effect of the hydroalcoholic extract of watercress (WC) on the inflammatory cytokines and protein carbonyl (PCO) contents in chronic hemodialysis patients. Methods. This was a double-blind randomized clinical trial performed on 46 hemodialysis patients. The participants were randomly divided into two groups: intervention group (500 mg hydroalcoholic extract of WC every day for 4 weeks) and control group (500 mg of white flour every night for 4 weeks). The blood samples were taken to determine the levels of vitamin E, PCO, and inflammatory cytokines at baseline and the end of treatment. Results. Forty-five patients completed the study (22 patients in the intervention group and 23 patients in the control group). There was a significant reduction in the PCO level (20.33 ± 4.40 vs. 15.06 ± 6.41, P = 0.001 ) in the intervention group; also, this change was statistically significant relative to the control group. Furthermore, there were significant reductions in hs-CRP (8953.30 ± 5588.06 vs. 7249.86 ± 5091.62, P = 0.007 ) and IL-6 (60.10 (55.99, 73.10) vs. 55.21 (53.39, 60.48), P = 0.050 ) in the intervention group, but these changes were not significant in comparison with the control group. Conclusion. We conclude that the hydroalcoholic extract of WC reduced the PCO content in hemodialysis patients via inhibition of protein oxidation. Although WC administration had caused a significant reduction in IL-6 and CRP levels, these differences were not statistically significant relative to the control group. Further research is needed to identify the antioxidant and anti-inflammatory effects of WC in hemodialysis patients.


2020 ◽  
Author(s):  
Vahid Zand ◽  
Abolfazl Mollasadeghi ◽  
Mohammad Ansari ◽  
Mohammad Hossein Baradaranfar ◽  
Amir Houshang Mehrparvar

Chronic tinnitus is a disturbing condition that may affect different aspects of life. In this study, the therapeutic effect of electrical stimulation on chronic tinnitus was assessed. This was a clinical trial on 49 patients with persistent tinnitus for more than 6 months without a proper response to routine treatments. They were randomly allocated into two groups: the case group was treated with electrical stimulation for 6 sessions over 6 consecutive days, and the control group received a placebo. Before the intervention, one week and three months after the treatment sessions, patients were evaluated by comprehensive audiological assessments and hearing tests. The mean age of the participants was 40.37±9.32 and 41.35±9.24 in treatment and placebo groups, respectively. Tinnitus intensity was significantly decreased in the case group one week and three months after the treatment (P<0.05). Tinnitus handicap inventory score significantly decreased in the treatment group one week and three months after the treatment (P<0.05). There was no significant difference in tinnitus intensity after treatment, considering gender, age, tinnitus duration, and tinnitus type. Electrical stimulation could significantly reduce the severity of the tinnitus regardless of age, gender, duration, and type of tinnitus. © 2020 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2020;58(1):4-8.


Author(s):  
Seyyed Ali Mousavi Kiasari ◽  
Monir Nobahar ◽  
Raheb Ghorbani ◽  
Mohammad Reza Tamaddon

Background & Aim: Anemia is one of the most common complications of chronic renal failure, which is associated with increased fatigue, dyspnea, depression, malaise, prolonged hospitalization and mortality. Some patients are resistant to erythropoietin therapy. Therefore, the purpose of this study was to determine the effect of thyme honey on anemia in hemodialysis patients. Methods & Materials: The present clinical trial was conducted in 2018 at Kowsar Hospital of Semnan on hemodialysis patients randomly selected with convenience sampling method within two groups of case (n=28) and control (n=27). The case group received thyme honey (33 g) daily for one month. The control group did not consume thyme honey. Blood samples were taken from the patients before and after the intervention with 10-hour fasting and then blood parameters were assessed. Results: The mean ±SD reduction rate in hemoglobin level was 0.46±0.96 in the case group and 0.23±3.15 g/dl in the control group, but no significant difference using independent t-test (P=0.758). The mean±SD reduction rate in hematocrit percentages was 1.20±2.78 in the case group and 0.11±8.53 in the control group, but there is no significant difference between the two groups using independent t-test (P=0.590). Conclusion: Results showed that daily administration of 33 grams of thyme honey had no effect on anemia in hemodialysis patients. Further studies are recommended with modification of the methodology regarding the type, dose, duration and instructions of honey consumption for better results.


Author(s):  
Evgeniy Evdoshenko ◽  
Kristina Laskova ◽  
Maria Shumilina ◽  
Ekaterina Nekrashevich ◽  
Maria Andreeva ◽  
...  

Abstract Objective: Cognitive dysfunction is common in multiple sclerosis (MS). The Brief International Cognitive Assessment for MS (BICAMS) battery of tests has been suggested as a measure for the evaluation of the cognitive status of MS patients. This study aims to validate the BICAMS battery in the Russian population of MS patients. Methods: Age- and sex-matched MS patients (n = 98) and healthy individuals (n = 86) were included in the study. Symbol Digit Modalities Test (SDMT), California Verbal Learning Test, 2nd edition (CVLT-II) and the Brief Visuospatial Memory Test – Revised (BVMT-R) were administered to all participants. The battery was readministered 1 month later to 44 MS patients to investigate the test–retest reliability. Results: MS patients exhibited a significantly lower performance in testing with BICAMS than the control group in all three neuropsychological tests. Test–retest reliability was good for SDMT and CVLT-II (r = .82 and r = .85, respectively) and adequate for BVMT-R (r = .70). Based on the proposed criterion for impairment as z score below 1.5 SD the mean of the control group, we found that 34/98 (35%) of MS patients were found impaired at least in one cognitive domain. Patients with Expanded Disability Status Scale score ≥3.5 performed significantly worse than controls (SDMT, p < .0001; CVLT–II, p = .03; BVMT-R, p = .0004), while those with ≤3.0 scores did not. Conclusion: This study demonstrates that the BICAMS battery is a valid instrument to identify cognitive impairment in MS patients and it can be recommended for routine use in the Russian Federation.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Asmaa Ali ◽  
Mona Hasan ◽  
Shaimaa Hamed ◽  
Amir Elhamy

Abstract Background Around 25% of the world population was affected by the metabolic-related fatty liver disorder. Hepatic steatosis is frequently observed in conjunction with hypertension, obesity comorbidities, and diabetes. We evaluate the hepatic steatosis frequency found in chest CT exams of COVID-19-positive cases compared to non-infected controls and evaluate the related increased prevalence and severity of COVID. Results Our research includes 355 subjects, 158 with positive PCR for COVID-19 (case group) and 197 with negative PCR and negative CT chest (control group). The mean age in the positive group was 50.6 ± 16 years, and in the control, it was 41.3 ± 16 years (p < 0.001). Our study consists of 321 men (90.5%) and 34 women (9.5%). The number of males in both cases and control groups was greater. In the case group, 93% men vs. 6.9% women, while in controls, 88.3% men vs.11.6% women, p < 0.001. CT revealed normal results in 55.5% of individuals (i.e., CORADs 1) and abnormal findings in 45.5% of participants (i.e., CORADs 2–5). In abnormal scan, CO-RADs 2 was 13.92%, while CO-RADs 3–4 were 20.89% of cases. CO-RADs 5 comprised 65.19% of all cases. Approximately 42.6% of cases had severe disease (CT score ≥ 20), all of them were CO-RADs 5. The PCR-positive class had a greater prevalence of hepatic steatosis than controls (28.5% vs.12.2%, p < 0.001). CO-RADs 2 represented 11.1%, CO-RADs 3–4 represented 15.6%, and CO-RADs 5 represented 73.3% in the hepatic steatosis cases. The mean hepatic attenuation value in the case group was 46.79 ± 12.68 and in the control group 53.34 ± 10.28 (p < 0.001). When comparing patients with a higher severity score (CT score ≥ 20) to those with non-severe pneumonia, it was discovered that hepatic steatosis is more prevalent (73.2% vs. 26.8%). Conclusions Steatosis was shown to be substantially more prevalent in COVID-19-positive individuals. There is a relation among metabolic syndrome, steatosis of the liver, and obesity, as well as the COVID-19 severity.


2020 ◽  
Vol 09 (03) ◽  
pp. 201-206
Author(s):  
Surabhi Chandra ◽  
Sahil Goel ◽  
Ritika Dawra

AbstractPediatric acute respiratory distress syndrome (PARDS) is a challenging problem with high mortality. Role of neuromuscular blockade in the management of ARDS to date has been controversial, and this study was done to study the role of neuromuscular blockade in children having PARDS and development of associated complications, if any. This was a prospective, case–control study conducted in the pediatric intensive care unit (PICU) of a tertiary care teaching hospital, over a period of 24 months. Patients of age 1 to 18 years who presented with or developed PARDS during their course of hospitalization were included after written informed consent was obtained from their parents and/or guardians. Patients with PARDS requiring invasive mechanical ventilation were partitioned into a case group and a control group. Case group patients were sedated and paralyzed using midazolam (1 µg/kg/min) and vecuronium (1 µg/kg/min), respectively, along with institution of definitive management. Control group patients were given definitive and supportive therapy, but no neuromuscular blocking agents (NMBAs). All patients were followed up for signs and symptoms of myopathy or neuropathy during the entire duration of hospital stay and up to 3 months after discharge. During the study period, 613 patients were admitted to the PICU of which 91 patients qualified as having PARDS. Sepsis was the main etiology in 67 of the 91 patients (73.6%) with PARDS. Fifty-nine patients were included in the study, of which 29 patients were included in the case group and 30 patients were included in the control group. Among the 29 case group patients, 25 patients (86.2%) were successfully extubated. Four patients from the case group expired, while 14 out of 30 control group patients (46.7%) expired. Hypotension was present in 26 case group patients (89.6%), of which all showed resolution within 48 hours of definitive treatment. The mean time to resolution of hypotension was 41.6 hours (standard deviation [SD]: 5.759; range: 24–48) for case group patients, significantly lower (p < 0.0001) than the mean time to resolution of 103 hours (SD: 18.995; range: 90–126) for the 10 control group patients with hypotension that survived. Mean oxygenation index (OI) following 48 hours of vecuronium therapy was significantly lower (p < 0.0001; 95% confidence interval: 5.9129–9.9671) than mean OI at admission for case group patients. None of the patients receiving vecuronium exhibited neuromuscular deficit during their hospital stay, at time of discharge, or at follow-up evaluation up to 3 months after discharge. In this study, pediatric cases diagnosed with PARDS and managed with mechanical ventilation and vecuronium therapy had improved mean OI following 48 hours of NMBA therapy and a lower mortality when compared with matched control group patients. Incidence of NMBA-related weakness was not commonly observed in these patients.


2021 ◽  
Vol 2 (1) ◽  
pp. 15-25
Author(s):  
Muhammad Anggun ◽  
Titik Kusumawinakhyu ◽  
Irma Finurina Mustikawati ◽  
Wiharto Wiharto

Hemodialysis is a routinely performed therapy on chronic kidney patients, leading to psychological problems among subjects who undergo hemodialysis, such as anxiety and depression. One of the efforts to overcome anxiety and depression is with the dhikr intervention. Dhikr presents hearts to remember and be obedient to Allah followed by the words and actions in various conditions.  Discover dhikr's influence on the level of anxiety and depression in patients on hemodialysis in  Purwokerto Islamic Hospital. It was a quantitative study using quasi experiment with a non-quivalent control group design. The number of samples was 12 subjects consisting of 6 subjects in the control group and six subjects in the intervention group with the purposive sampling technique. Instruments were used to measure anxiety and depression are the HADS ( Hospital Anxiety and Depression Scale ) before and after dhikr intervention as much as 12 times. Research is carried out in Hemodialysis Unit of  Purwokerto Islamic Hospital. Test statistics on research are used paired t-test and independent t-tests. This study showed a decrease in the mean level of anxiety from 5, 83 to 1.67 in the experimental group ( p = 0.003). The mean level of depression experienced a decline of 9, 67 becomes 4.67 on a group experiment ( p = 0.003). Dhikr reduces the level of anxiety and depression in hemodialysis patients at the Purwokerto Islamic Hospital.


Author(s):  
Maryam Sadeghi ◽  
Naeimeh Moheb ◽  
Marziyeh Alivandi Vafa

Introduction: The aim of current paper was to compare the effectiveness of acceptance and commitment group therapy (ACT) and group cognitive therapy (GCT) on Alexithymia and marital boredom (MB) among women affected by marital infidelity in Mashhad. Method: This clinical trial was a double- blind study with a pretest-posttest design in which two intervention groups and one control group were investigated. The study performed on women who realized their spouse infidelity and referred to Azad University Counseling Center in Mashhad in 2018. The sample consisted of 30 women who were selected by purposive sampling and were randomly assigned to two intervention groups and a control group (n=10 per group). The intervention groups were put under ACT training (twelve 90-minute sessions) and GCT training (twelve 90-minute sessions), but the control group did not receive any intervention. Data was obtained by the Toronto Alexithymia Scale-20 and Pines Marital Boredom Scale and was analyzed by multivariate analysis of covariance with SPSS (version 22) software. Results: The results showed a significant reduction in the mean score of MB in the ACT group, also there was a significant reduction in the mean score of Alexithymia in the GCT group (P <0.05). So comparing both therapies, ACT was more influential on reducing marital boredom whereas GCT was more effective on reducing alexithymia. Conclusion: Although both intervention methods were effective on Alexithymia and Marital Boredom in women affected by marital infidelity, it was demonstrated that ACT and GCT have more effect on Marital Boredom and Alexithymia, respectively.


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