scholarly journals A Comparative Study to Evaluate Efficacy and Safety of Daily Dosing versus Alternate-Day Atorvastatin Therapy in Patients with Dyslipidemia

2021 ◽  
Vol 6 (2) ◽  
pp. 75
Author(s):  
Allen J. Rodrigues ◽  
Syed S. Farookh ◽  
Laxminarayana Kamath ◽  
Raveendra K.R

  Dyslipidemia is a well-recognized risk factor for the development of diseases associated with atherosclerosis, including coronary artery disease and stroke. Statins are the first choice hypolipidemic drug which are the most effective and best tolerated agents for treating dyslipidemia. Atorvastatin confers an HMG-CoA reductase inhibition up to 20-30 hours which makes it even effective on the next day. The present study is randomized open labeled study done at Victoria Hospital - Bangalore to compare efficacy and safety of daily dosing versus alternate-day atorvastatin therapy in patients with dyslipidemia. A total of 86 patients with dyslipidemia were randomized into 2 groups. Group A received 10 mg of atorvastatin daily (DS) and group B received 10 mg of atorvastatin on alternate day (AS) for six weeks. Among the 86 patients included in the study, mean age of the participants in the AS group was 53.12 ± 10.32 whereas that in the DS group was 52.26 ± 11.13. LDL-C decreased by 25.3% versus 22.4% (CI 0.95, P = 0.35) on daily and alternate-day dosing, respectively. Also 12.5% versus 15% (CI 0.95, P= 0.83) improvement was seen with HDL-C. Both dosage regimens provided reductions in total cholesterol (20.7% versus 20.2%) and triglyceride (20.7% versus 21.2%). There was no statistically significant difference in reduction in lipid parameters between two groups. Adverse effects were found less occurred in alternate day therapy than daily therapy. Gastrointestinal disturbances and myalgia were most commonly reported in both groups. Hence this study concludes alternate-day atorvastatin is as effective as daily atorvastatin in dyslipidemia. 

2020 ◽  
Author(s):  
Xiaoxia Gu ◽  
Jingjing Wang ◽  
Huihua Liao ◽  
Jian Mo ◽  
Weiming Huang ◽  
...  

Abstract Background: To compare the efficacy and safety of different compatibility schemes in the prevention of visceral pain after gynecological laparoscopic surgery. Methods: from April 2019 to April 2020, patients undergoing elective gynecological laparoscopic surgery in our hospital were randomly divided into four groups: group A: sufentanil 3 μ g / kg; group B: low-dose nalbuphine group: 0.1 mg / kg of nabufen + 3 μ g / kg of sufentanil; group C: medium dose of nabufen group: 1 mg / kg of nabufen + 2 μ g / kg of sufentanil; group D: high-dose nabufen 2 There were 30 cases in each group. The degree of pain and the number of adverse reactions at 2, 4, 8, 12, 24 and 48 hours after operation were observed and recorded. The number and dosage of morphine used as a remedial analgesic were recorded. The pain degree was assessed by visual analogue scale (VAS). The total amount of analgesic pump used, the total number of times of pressing and the effective times of pressing were recorded. The adverse reactions included respiratory depression, nausea and vomiting, drowsiness, restlessness and skin The skin itches. Results: the analgesic effect of group B was similar to that of group A, and there was no significant difference in the number of invalid pressing, total pressing times and rescue analgesia rate (P > 0.05), while the invalid pressing times, total pressing times and remedial analgesia rate of group C and group D were significantly lower than those of group A (P < 0.05). There was no significant difference between group C and group D in the number of invalid compressions, the total number of compressions and the rate of remedial analgesia (P > 0.05), suggesting that increasing the dose of nalbuphine could not significantly increase the analgesic effect. The incidence of postoperative nausea and vomiting, skin pruritus, lethargy and Ramsay Sedation score in group B and group C were significantly lower than those in group A (P < 0.05). Ramsay Sedation score and incidence of drowsiness were lower than those in group D, which indicated that the incidence of adverse reactions was higher in group D than group B and group C.Conclusion: the combination of 1 mg / kg nabufen and 2 μ g / kg sufentanil is a safe and effective combination scheme for the prevention of visceral pain after gynecological laparoscopic surgery with small adverse reactions.Trial registration: http://www.chictr.org.cn/showproj.aspx?proj=40635Registration number:ChiCTR1900025076 . Prospectively registered on 10 August 2019.


2020 ◽  
Author(s):  
Tian-qiao Huang ◽  
Ru Wang ◽  
Ju-gao Fang ◽  
Shi-zhi He ◽  
Qi Zhong ◽  
...  

Abstract Background: The aim of this study was to evaluate the potential of induction chemotherapy as an indicator of the management of advanced hypopharyngeal carcinoma with cervical oesophageal invasion. Methods: Sixty-eight patients admitted to our hospital between February 2003 and November 2016 with stage IVB hypopharyngeal carcinoma with cervical oesophageal invasion were retrospectively analysed. Patients were divided into two groups according to the treatment they selected following an explanation of the different treatments available. Patients in Group A received induction chemotherapy and had (1) complete/partial remission following chemotherapy and radiotherapy/concurrent chemoradiotherapy or (2) stable disease following chemotherapy and surgery. Patients in Group B underwent surgery followed by adjuvant radiotherapy/concurrent chemoradiotherapy. Survival analyses were performed using the Kaplan–Meier method, and differences between the groups were evaluated using the log-rank test. Laryngeal and oesophageal retention rates were compared using the cross-tabulation test. Results: The 3- and 5-year overall survival rates were 22.86% and 11.43% in Group A and 24.25% and 6.06% in Group B, respectively (all P > 0.05). The laryngeal and oesophageal retention rates were 40.0% and 74.3% in Group A and 0.0% and 27.3% in Group B, respectively (all P < 0.01). There was no statistically significant difference in the incidence of post-operative complications between the two groups (Group A: 8.6%, Group B: 12.1%; P > 0.05). Conclusions: Induction chemotherapy may be an appropriate first choice to ensure laryngeal and oesophageal preservation in the individualised treatment of advanced hypopharyngeal carcinoma with cervical oesophageal invasion.


Author(s):  
Kiranpreet Kaur ◽  
Anjleen Kaur ◽  
Prabhsimran Singh ◽  
Amandeep Singh Bakshi

Background: Osteoarthritis is a chronic and debilitating disease. Management of disease is a big challenge. NSAIDS play an important role but have many adverse reactions. So, this study was designed to evaluate the efficacy and safety of natural compound rosehip versus glucosamine and chondroitin sulphate in patients of osteoarthritis.Methods: An open label, randomized, parallel group comparative study, conducted on patients of either sex with confirmed diagnosis of osteoarthritis on standard NSAIDs therapy, attending the outpatient department of orthopedics in a tertiary care centre.  150 patients were enrolled and divided into three groups (group A, group B and group C) of 50 each. Patients of group A were given Glucosamine plus chondroitin sulphate for 12 weeks. Group B was given rosehip for 12 weeks and group C placebo.  These supplements were given as add on therapy.  Patients were monitored and adverse drug reactions were noted. The data was analysed statistically using t- test for efficacy and descriptive stats for assessing the safety.Results: Efficacy was assessed by comparing mean reduction in the pain intensity between group A and B, group B gives highly significant results as compared to group A. While comparing joint tenderness, swelling around joint, mean functional capacity and improvement in the overall assessment, group B gives significant results as compared to group A. It was also observed that group A and group B were better than group C in all the efficacy parameters. All the drugs were well tolerated and systemically safe.Conclusions: There was significant difference in efficacy of rosehip compared with glaucosamine and chondroitin sulphate in patients of osteoarthritis. In comparison there was no significant difference in safety of two drugs and both were considered safe in patients.


2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Tian-Qiao Huang ◽  
Ru Wang ◽  
Ju-Gao Fang ◽  
Shi-Zhi He ◽  
Qi Zhong ◽  
...  

Abstract Background This study aimed to evaluate the potential of induction chemotherapy as an indicator of the management of advanced hypopharyngeal carcinoma with cervical oesophageal invasion. Methods Sixty-eight patients admitted to our hospital between February 2003 and November 2016 with stage IVB hypopharyngeal carcinoma with cervical oesophageal invasion were retrospectively analysed. Patients were divided into two groups according to the treatment they selected following an explanation of the different treatments available. Patients in group A received induction chemotherapy and had (1) complete/partial remission following chemotherapy and radiotherapy/concurrent chemoradiotherapy or (2) stable disease following chemotherapy and surgery. Patients in group B underwent surgery followed by adjuvant radiotherapy/concurrent chemoradiotherapy. Survival analyses were performed using the Kaplan–Meier method, and differences between the groups were evaluated using the log-rank test. Laryngeal and oesophageal retention rates were compared using the cross-tabulation test. Results The 3- and 5-year overall survival rates were 22.86% and 11.43% in group A and 24.25% and 6.06% in group B, respectively (all P > 0.05). The laryngeal and oesophageal retention rates were 40.0% and 74.3% in group A and 0.0% and 27.3% in group B, respectively (all P < 0.01). There was no statistically significant difference in the incidence of post-operative complications between the two groups (group A 8.6%, group B 12.1%; P > 0.05). Conclusions Induction chemotherapy may be an appropriate first choice to ensure laryngeal and oesophageal preservation in the individualised treatment of advanced hypopharyngeal carcinoma with cervical oesophageal invasion.


BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nanning Lv ◽  
Rui Geng ◽  
Feng Ling ◽  
Zhangzhe Zhou ◽  
Mingming Liu

Abstract Background To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases. Methods The medical records of patients with spinal metastatic tumor admitted to our hospital from January 2016 to December 2018 were retrospectively analyzed. Based on different surgical methods, the patients were divided into groups A (treated with RFA combined with bone cement) and B (treated with bone cement only). Group A included 35 patients with 47 segments of diseased vertebral bodies. Group B consisted of 52 patients with 78 vertebral segments. Pain, quality of life score, vertebra height, bone cement leakage, postoperative tumor recurrence, and complications were assessed 3 days and 1 and 6 months after surgery. Results All the patients had smooth operation without paraplegia, spinal cord injury, and perioperative death. Visual analogue scales (VAS) and Oswestry Disability Index (ODI) scores of the two groups significantly improved 3 days and 1 month after surgery compared with those before surgery (P < 0.05), but no significant difference was observed between the two groups (P > 0.05). Six months after surgery, the VAS and ODI scores of patients in group A were lower than those in group B, with statistically significant differences (P < 0.05). The postoperative vertebral body height of the two groups significantly increased compared with that before surgery, and the difference was statistically significant (P < 0.05). Meanwhile, no significant difference was observed between the two groups (P > 0.05). Postoperative bone cement permeability in group A was 6.4%, and postoperative tumor recurrence rate was 11.4%. The permeability of bone cement in group B was 20.5%, and the tumor recurrence rate was 30.8%. The bone cement permeability and tumor recurrence rate in group A were lower than those in group B, with statistically significant differences (P < 0.05). Conclusions Bone cement combined with RFA for the treatment of spinal metastases can achieve good efficacy, desirable analgesic effect, low incidence of complications, small surgical trauma, and high safety. The proposed method has the value of clinical popularization and application.


2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Moses Man-Lung Li ◽  
Jojo Yan-Yan Kwok ◽  
Kwong-Yin Chung ◽  
Kin-Wing Cheung ◽  
Kwok-Hing Chiu ◽  
...  

Abstract Background Total knee arthroplasty (TKA) is associated with significant perioperative blood loss and postoperative allogenic blood transfusion. Tranexamic acid (TXA) reversibly blocks lysine binding sites on plasminogen molecules and inhibits plasmin formation. Comparisons of the efficacy and safety of intra-articular and intravenous TXA in primary TKA have not previously been reported. Methods A prospective randomized trial was conducted in 150 patients who underwent TKA, and these patients were randomized into three groups. Patients in Group A were injected by intra-articular TXA according to body weight (20 mg/kg). Patients in Group B received a standard dose of intra-articular TXA (2000 mg), and those in Group C were infused with TXA according to body weight (20 mg/kg) before tourniquet deflation and again 3 h later. Baseline characteristics and data collected at blood transfusion were compared. Differences among four time points (baseline, day 0, day 2, and day 5) were carried out using ANOVA. Results The hemoglobin levels at postoperative day 5 were 10.6 g/dL for Group A, 10.6 g/dL for Group B, and 10.7 g/dL for Group C. The drain output was 399 ml for Group A, 314 ml for Group B, and 305 ml for Group C (p = 0.03). Group C had significantly less drain output than Group A after post hoc comparisons (p = 0.05), whereas no significant difference was observed between Group A and B (p = 0.09) or between Group B and C. Conclusion The weight-adjusted dose of TXA administered intravenously significantly reduced the drain output but not the total blood loss when compared with the weight-adjusted dose of TXA administered intra-articularly. No significant difference was observed in the other parameters among the three groups. Trial registration The Joint CUHK-NTEC CREC, CRE-2013.644-T. Registered 1 March 2014.


2021 ◽  
Author(s):  
Xixian Ruan ◽  
Zinan Zhang ◽  
Xiuyan Long ◽  
Ning Fang ◽  
Xiaoyu Yu ◽  
...  

Abstract Background & Aims: To compare the feasibility and safety between multimode endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) and conventional chemotherapy in unresectable pancreatic ductal adenocarcinoma (PDAC).Methods: All the pathologically confirmed unresectable PDAC located in the head of the pancreas patients who underwent multimode EUS-RFA or conventional chemotherapy were retrospectively enrolled from June 2018 and April 2019. Patients who underwent multimode EUS-RFA (Group A) was performed through HybridTherm probe(HTP). Patients in Group B accepted nab-Paclitaxel plus Gemcitabine or S-1 plus Gemcitabine. The comparison between efficacy and safety of multimode EUS-RFA and conventional chemotherapy were analyzed by T test and MannWhitney test. A multivariate analysis was performed for each prognostic factor using the Cox proportional hazards model.Results: A total of 10 unresectable PDAC patients were retrospectively enrolled in Group A (mean size 9.46±5.94 cm3, range 2.00-21.09 cm3) and 9 patients in Group B (mean size 14.02±5.81cm3, range 4.60–24.62 cm3). The tumor size was significantly reduced before and after undergoing multimode EUS-RFA (P = 0.005), with an average tumor volume reduction of 38.1%.The tumor size was not significantly changed in Group B (P = 0.452). Statistically significant difference was observed in tumor size between Group A and Group B after treatment (P = 0.033). All patients died because of the progress of the tumor. The median lifetime from Group A&B was 9 months ranged 3-18 months VS 7 months ranged 1-7 months (P = 0.001). Overall no severe adverse events occurred in both groups.Conclusion: EUS-guided multimode ablation has the more feasibility in the treatment of unresectable pancreatic cancer than conventional chemotherapy. In this article, the limited data seems to show the trend of tumor shrinkage, pain relief, lifetime prolongation. Further studies are needed, such as expanding the sample size of patients and comparing the feasibility and safety among all the treatment.


2020 ◽  
Author(s):  
Derong Xu ◽  
Yongming Xi ◽  
Chuanli Zhou ◽  
Kai Zhu ◽  
Xuexiao Ma

Abstract Background: Symptomatic aggressive vertebral hemangioma often requires clinical treatment; however, there is great controversy over the treatment plan. We aimed to evaluate the efficacy and safety of different methods including preoperative emobilization, vertebroplasty, decompression and internal fixation in the treatment of aggressive hemangioma.Methods: A retrospective clinical review of patients diagnosed with aggressive vertebral hemangiomas was conducted. All the patients were assigned to 3 groups according to the treatment strategies: patients in Group A underwent embolization before decompression, patients in Group B underwent decompression with vertebroplasty, patients in Group C received all three treatments. Clinical indexes were compared within 3 groups.Results: There were 6 patients received embolization and decompression (Group A), 9 patients underwent decompression with vertebroplasty (Group B) and 6 patients in Group C. The operative duration of patients in group A (198.33±38.43 min) were less than another two groups (P=0.001). The intra-operative blood loss of patients in group C was 713.33±165.13ml, which was significantly less than group A and group B (P=0.045). Patients in group C exhibited the lowest volume of drainage on POD 1 (178.33±66.76ml), which showed significant difference compared with group A (368.33±191.15ml, P=0.01). There was no significant difference of pre-operative and post-operative VAS and JOA score among 3 groups, as well as drainage on POD 2, total volume and hospital duration.Conclusion: The treatment strategy of combined embolization, vertebroplasty and decompression fixation is efficient and safe. For special patients, if such a strategy cannot be adopted, simple embolization plus decompression or vertebroplasty plus decompression is also competent.


2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199399
Author(s):  
Derong Xu ◽  
Meng Kong ◽  
Kai Zhu ◽  
Xing Han ◽  
Wenwei Zhang ◽  
...  

Objective: To evaluate the efficacy and safety of preoperative embolization and vertebroplasty in the treatment of aggressive hemangioma. Methods: A retrospective clinical review of patients diagnosed with aggressive vertebral hemangiomas was conducted. All the patients were assigned to three groups according to the treatment strategies: patients in Group A underwent embolization and decompression with internal fixation, patients in Group B underwent vertebroplasty and decompression with internal fixation, patients in Group C received all three treatments. Clinical indexes were compared within three groups. Results: There were 16 patients received embolization and decompression (Group A), 19 patients underwent decompression with vertebroplasty (Group B) and 16 patients in Group C. The operative duration of patients in group A (198.33 ± 38.43 min) were less than another two groups ( p = 0.001). The intraoperative blood loss of patients in group C was 713.33 ± 165.13 mL, which was significantly less than group A and group B ( p = 0.045). Patients in group C exhibited the lowest volume of drainage on POD 1 (178.33 ± 66.76 mL), which showed significant difference compared with group A (368.33 ± 191.15 mL, p = 0.01). There was no significant difference of preoperative and postoperative VAS and JOA score among three groups, as well as drainage on POD 2, total volume and hospital duration. Conclusion: Both embolization and vertebroplasty are efficient and safe measures to reduce blood loss in the surgical treatment of aggressive vertebral hemangiomas, combination of all three methods is also competent.


2020 ◽  
Author(s):  
Tian-qiao Huang ◽  
Ru Wang ◽  
Ju-gao Fang ◽  
Shi-zhi He ◽  
Qi Zhong ◽  
...  

Abstract Background: This study aimed to evaluate the potential for induction chemotherapy to be an indicator for the management of advanced hypopharyngeal carcinoma with cervical oesophageal invasion.Methods: Sixty-eight patients (admitted to our department between February 2003 and November 2016) with stage IVB hypopharyngeal cancer with cervical oesophageal invasion were retrospectively analysed. Patients were divided into two groups depending on the treatment they selected following an explanation they received on the different treatments. Group A patients received induction chemotherapy and had (1) complete or partial remission following chemotherapy combined with radiotherapy or concurrent chemoradiotherapy or (2) stable disease following chemotherapy combined with surgery. Group B patients underwent surgery and received adjuvant radiotherapy or concurrent chemoradiotherapy following surgery. Survival analyses were performed using the Kaplan–Meier method, differences between the two groups were tested using the log-rank test, and the laryngeal and oesophageal retention rates were compared using the cross-tabulation test. Results: The 3- and 5-year overall survival rates of patients in Group A were 22.86% and 11.43%, respectively; in Group B, the rates were 24.25% and 6.06%, respectively (P > 0.05 for all). The laryngeal retention rates in Group A and B patients were 40% and 0%, respectively, whereas the oesophageal retention rates in Group A and B patients were 74.3% and 27.3%, respectively (P < 0.01 for all). There was no statistically significant difference in the incidence of postoperative complications between the two groups (Group A: 8.6%, Group B: 12.1%, P > 0.05). Conclusions: For patients with advanced hypopharyngeal cancer with cervical oesophageal invasion, induction chemotherapy could be the appropriate first choice for individualized treatment to ensure laryngeal and oesophageal cancer preservation.


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