scholarly journals Prebiotic prophylaxis of ventilator-associated pneumonia: A randomized clinical trial

2018 ◽  
Vol 5 (5) ◽  
pp. 2287-2295 ◽  
Author(s):  
Akram Kooshki ◽  
Zaher Khazaei ◽  
Azam Zarghi ◽  
Mojtaba Rad ◽  
Yaser Tabaraie
Keyword(s):  
Treatment Plan ◽  
Routine Care ◽  
Primary Component ◽  
Wilcoxon Test ◽  
Repeated Measure ◽  
Ventilator Associated Pneumonia ◽  
Chi Square ◽  
Fenugreek Seeds ◽  
Group 2 ◽  
Group 1

Introduction: There is evidence of the curing effects of prebiotics in promoting growth of bifid bacterium in the digestive system and the central role of bacteria colonization in the pathogenesis of ventilator-associated pneumonia (VAP). The purpose of this study was to evaluate the effects of administration of a prebiotic, namely fenugreek seeds, on VAP prevention and clinical outcomes in critically ill patients. Methods: In this study, 60 mechanically ventilated patients were randomly divided into 2 groups (n=30 per group). Group 1 was given fenugreek seed powder by gavage, twice a day in addition to routine care, while group 2 received only routine care. Demographic and clinical data were recorded and clinical responses to the primary component (prevalence of VAP) and secondary component (other clinical factors) were interpreted. Data were analyzed via SPSS v.20, using student t-test, chi-square test, repeated measure ANOVA, and Wilcoxon test. Result: There was a significant reduction of patients diagnosed with VAP, as well as clostridium difficileassociated diarrhea and some complications of mechanical ventilation, in group 1 when compared to group 2. In addition, improvement in VAP was significantly greater for group 1 as compared with group 2. Mortality rates were not different between the two groups. Conclusion: The present study demonstrated that daily diet with fenugreek seeds can be used as an add-on therapy with other medications in prevention of VAP. As a result, the use of fenugreek seeds in the treatment plan of patients undergoing long-term intubation is recommended.

scholarly journals Effects of fenugreek seed powder on enteral nutrition tolerance and clinical outcomes in critically ill patients: A randomized clinical trial

2018 ◽  
Vol 5 (7) ◽  
pp. 2528-2537
Author(s):  
Akram Kooshki ◽  
Zaher Khazaei ◽  
Azam Zarghi ◽  
Mojtaba Rad ◽  
Hadi Gholam Mohammadi ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Routine Care ◽  
Fenugreek Seeds ◽  
Mechanically Ventilated ◽  
Fenugreek Seed ◽  
Group 2 ◽  
Group 1

Background: Enteral nutrition (EN) intolerance is a common complication in critically ill patients that contributes to morbidity and mortality. Based on the evidence of curing effects of fenugreek seeds in some gastrointestinal disorders, this study aimed to determine the effects of fenugreek seed powder on enteral nutrition tolerance and clinical outcomes in critically ill patients. Materials & Methods: A randomized, double-blinded clinical trial of 5-day duration was conducted on 60 mechanically ventilated patients divided in 2 groups (n=30). Group 1 was given fenugreek seed powder by gavage, twice a day in addition to routine care, while Group 2 received only routine care. Enteral nutrition tolerance and clinical outcomes were measured throughout the study. Demographic and clinical data were recorded and clinical responses to the primary outcome (enteral nutrition tolerance) and secondary outcome (other clinical factors) were interpreted. Data were analyzed using the independent t-test, Chi-squared test, covariance analysis, and repeated measure ANOVA via SPSS statistical software (v. 20); statistical significance was set at p< 0.05. Results: Patients who were fed with the fenugreek seed powder showed a significant improvement in enteral nutrition tolerance, as well as some complications of mechanical ventilation for Group 1, as compared with Group 2. The mortality rates were not different between the two groups. Conclusion: This study shows the beneficial effects of fenugreek seeds on food intolerance in critically ill patients and that the seed powder can be used as an add-on therapy with other medications. Thus, the use of fenugreek seeds to treat mechanically ventilated patients is recommended.

scholarly journals Can the cytokine adsorber CytoSorb® help to mitigate cytokine storm and reduce mortality in critically ill patients? A propensity score matching analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christina Scharf ◽  
Ines Schroeder ◽  
Michael Paal ◽  
Martin Winkels ◽  
Michael Irlbeck ◽  
...  
Keyword(s):  
Propensity Score ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Wilcoxon Test ◽  
Relative Reduction ◽  
Cytokine Storm ◽  
Saps Ii ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background A cytokine storm is life threatening for critically ill patients and is mainly caused by sepsis or severe trauma. In combination with supportive therapy, the cytokine adsorber Cytosorb® (CS) is increasingly used for the treatment of cytokine storm. However, it is questionable whether its use is actually beneficial in these patients. Methods Patients with an interleukin-6 (IL-6) > 10,000 pg/ml were retrospectively included between October 2014 and May 2020 and were divided into two groups (group 1: CS therapy; group 2: no CS therapy). Inclusion criteria were a regularly measured IL-6 and, for patients allocated to group 1, CS therapy for at least 90 min. A propensity score (PS) matching analysis with significant baseline differences as predictors (Simplified Acute Physiology Score (SAPS) II, extracorporeal membrane oxygenation, renal replacement therapy, IL-6, lactate and norepinephrine demand) was performed to compare both groups (adjustment tolerance: < 0.05; standardization tolerance: < 10%). U-test and Fisher’s-test were used for independent variables and the Wilcoxon test was used for dependent variables. Results In total, 143 patients were included in the initial evaluation (group 1: 38; group 2: 105). Nineteen comparable pairings could be formed (mean initial IL-6: 58,385 vs. 59,812 pg/ml; mean SAPS II: 77 vs. 75). There was a significant reduction in IL-6 in patients with (p < 0.001) and without CS treatment (p = 0.005). However, there was no significant difference (p = 0.708) in the median relative reduction in both groups (89% vs. 80%). Furthermore, there was no significant difference in the relative change in C-reactive protein, lactate, or norepinephrine demand in either group and the in-hospital mortality was similar between groups (73.7%). Conclusion Our study showed no difference in IL-6 reduction, hemodynamic stabilization, or mortality in patients with Cytosorb® treatment compared to a matched patient population.

scholarly journals Do Camels (Camelus dromedarius) Need Shaded Areas? A Case Study of the Camel Market in Doha

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 480
Author(s):  
Martina Zappaterra ◽  
Laura Menchetti ◽  
Leonardo Nanni Costa ◽  
Barbara Padalino
Keyword(s):  
Ad Hoc ◽  
The Sun ◽  
Chi Square ◽  
Chi Square Test ◽  
Variable Space ◽  
Group 2 ◽  
Sun And Shade ◽  
Poor Welfare ◽  
Group 1

This study aimed at documenting whether dromedary camels have a preference for shade and how their behavior would change depending on the presence of shade and variable space allowance. A total of 421 animals kept in 76 pens (66 with shelter (Group 1), and 10 without shelter (Group 2)) at the camel market in Doha (Qatar) were recorded for 1 min around 11:00 a.m. when the temperature was above 40 °C. The number of animals in the sun and shade and their behaviors were analyzed using an ad libitum sampling method and an ad hoc ethogram. The results of a chi-square test indicated that camels in Group 1 had a clear preference for shade (p < 0.001). The majority of Group 1 camels were indeed observed in the shade (312/421; 74.11%). These camels spent more time in recumbency and ruminating, while standing, walking, and self-grooming were more commonly expressed by the camels in the sun (p < 0.001). Moreover, locomotory stereotypic behaviors (i.e., pacing) increased as space allowance decreased (p = 0.002). Based on the findings of this pilot study, camels demonstrated a preference for shade; shade seemed to promote positive welfare, while overcrowding seemed to trigger stereotypy and poor welfare. Overall, our preliminary results are novel and provide evidence that shaded areas are of paramount importance for camel welfare. Further research, involving designed studies at multiple locations is needed to confirm these results.

scholarly journals KIC 2557430: A Triple System Containing One γ Dor and Two Flaring Components?

2017 ◽  
Vol 34 ◽  
Author(s):  
Ceren Kamil ◽  
Hasan Ali Dal
Keyword(s):  
Triple System ◽  
Primary Component ◽  
Mass Ratio ◽  
Third Body ◽  
Period Analysis ◽  
Active Star ◽  
Group 2 ◽  
Different Sources ◽  
Flare Frequency ◽  
Group 1

AbstractThe results are presented for eclipsing binary KIC 2557430. The mass ratio was computed as 0.868 ± 0.002, while the inclination (i) was found as 69°.75 ± 0°.01 with T2 = 6271±1 K. 50 frequencies were found in the period analysis. 48 frequencies of them are caused due to the primary component, a γ Doradus star, while two of them are caused by the cool spots. 69 flares were detected in the analyses. Two OPEA models were derived for flares, which indicates that the flares were come from two different sources. The Plateau value was found to be 1.4336 ± 0.1104 s for Source 1, which is seen as possible the secondary component and 0.7550 ± 0.0677 s for Source 2, which is seen as possible third body. The half-life value was computed as 2278.1 s for Group 1 and 1811.2 s for Group 2. The flare frequency N1 was found to be 0.02726 h−1 and N2 was computed as 0.00002 for Group 1, while N1 was found to be 0.01977 h−1 and N2 was computed as 0.00001 for Group 2. In a results, KIC 2557430 is a possible triple system consisting of a γ Doradus-type star, a chromospherically active star, and also a flaring third body.

scholarly journals Effect of vitamin A on severity of acute diarrhea in children

2013 ◽  
Vol 53 (3) ◽  
pp. 125
Author(s):  
Marlisye Marpaung ◽  
Supriatmo Supriatmo ◽  
Atan Baas Sinuhaji
Keyword(s):  
Vitamin A ◽  
Acute Diarrhea ◽  
Vitamin A Deficiency ◽  
Stool Consistency ◽  
Chi Square ◽  
Vitamin A Supplementation ◽  
Body Weights ◽  
Group 2 ◽  
Stool Volume ◽  
Group 1

Background Vitamin A deficiency may increase the risk or bea cause of diarrhea. Many studies have been conducted on theefficacy of vitamin A in the management of acute diarrhea, butthe outcomes remain inconclusive.Objective To determine the effectiveness of vitamin A in reducingthe severity of acute diarrhea in children.Methods We performed a single􀁈blind􀁈randomized controlledtrial in the Secanggang District, Langkat Regency, North ofSumatera, from August 2009 to January 2010 in children aged6 months to 5 years, who had diarrheas. Subjects were dividedinto two groups. Group 1 received a single dose of vitamin A(100,000 IU for subjects aged 6 to 11 month old or with bodyweights :s 10 kg, or 200,000 IU for subjects aged 2: 12 month oldor with body weights> 10 kg). Group 2 received a single doseof placebo. The establishment of severity was based on changesin diarrheal frequency, stool consistency, volume and durationof diarrhea after treatment. We performed independent T􀁈testand Chi square tests for statistical analyses. The study was anintention􀁈to􀁈treat analysis.Results We enrolled 120 children who were randomized intotwo groups of 60 subjects each. Group 1, received vitamin Aand group 2 received a placebo. The results showed significantdifferences between the two groups in stool volume starting onthe first day (95%CI 192.30 to 3237.51; P􀁉O.OOI), as well asdiarrheal frequency (P=O.OOl) and stool consistency (P=O.OOl)on the second day observation and duration of diarrhea followingtreatment (95%CI - 40.60 to - 25.79; P􀁉O.OOI;).Conclusions Vitamin A supplementation is effective in reducingthe severity of acute diarrhea in children under five years of age.[Paediatr lndones. 2013;53:125-31.]

scholarly journals Sealing ability of two commonly used root canal sealers with and with out smear layer

2014 ◽  
Vol 2 (4) ◽  
pp. 327
Author(s):  
Nazish Fatima ◽  
Mehwish Hussain
Keyword(s):  
Smear Layer ◽  
Repeated Measure ◽  
Time Interval ◽  
Sealing Ability ◽  
Nail Polish ◽  
Ah Plus ◽  
Time Periods ◽  
Group 2 ◽  
Crown Roots ◽  
Group 1

AIM: The aim of current research was to find out the sealing ability of two commonly used sealers in the presence and absence of smear layer at different time interval. MATERIAL AND METHODS: Total of 180 single rooted vital teeth were used. Transversal section was made with the help of digital slow speed cutting saw to divide the root and crown part. After removal of crown roots part was instrumented and prepared. The 180 teeth were randomly divided into two equal groups (n=90) 1 and 2. In group 1 the smear layer was kept intact but it was removed from group 2 with EDTA (17%). Group 1 was then divided into two sub-groups, A1, A2. Group 2 was again separated into two sub-groups, B1 and B2. Each sub-group contained of 45 samples. In sub-groups A1 and B1, AH Plus sealer, in sub-groups A2 and B2, Ketac-endo sealer and cold lateral condensation technique was used for obturation with gutta percha. All samples were kept in an incubator at 37°C for 24 hours, with help of nail polish/varnish all samples root surfaces was painted only excluding apical area after words each sub group were further divided in to three groups of 15 to represent immersion periods of 7,15 and 30 days. All samples were then kept in 5 % methylene blue dye solution at 37o c for their respective time periods. After specific time period, the roots of every group were cut longitudinally and evaluate under a stereomicroscopes to evaluate apical micro leakage in millimeter. Data was subjected to Repeated measure ANOVA with post-hoc analysis using Tukey and bonferroni tests. RESULTS: Overall analysis indicated significant reduction in sealing ability canals in with and without smear layer over different time periods (p <0.0001). CONCLUSION: Current study has concluded that AH plus sealer provides significantly better seal in the absence of smear layer than in the presence of smear layer in addition it gave better seal than Ketac-Endo sealer in the absence and presence of smear layer.

scholarly journals Stimulasi Magnetik Lebih Meningkatkan Kemampuan Fungsional pada Pasien Nyeri Punggung Bawah Dibanding Stimulasi Elektris

2020 ◽  
Vol 5 (1) ◽  
pp. 21-27
Author(s):  
Aditya Johan Romadhon
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Functional Activity ◽  
Magnetic Stimulation ◽  
Wilcoxon Test ◽  
Low Back ◽  
Group 2 ◽  
Pain Patients ◽  
Group 1

AbstractIntroduction : A long with the development of physical agents modalities, there are many recent modalities that has many beneficial for physical therapy practice, generally physical agents modalities are suit for musculoskeletal cases, one of beneficial effect for musculoskeletal case is maintaining of muscle’s physiology, electrical stimulations are familiar modalities we find in physiotherapy practice, this modality is use to inhibit pain signal and produce muscle contraction. Recently a new physical agent modality such as magnetic stimulation also has smiliar effect such as electrical stimulations, however there are less evidence to compare magnetic and electrical stimulation for musculoskeletal problems. Objective : Purpose of this study to compare magnetic and electrical stimulation effect for reducing pain and improve functional activity in low back pain patients. Methods : 60 low back pain patients recruited as subjects, devided into two groups, Group 1 given magnetic stimulation and Group 2 given electrical stimulation, after four mounth intervention two days in every weeks, pain index and functional activity measured with Oswestry instrument. Result : After 4 mounth intervention we find reducing pain index and improvement of functional activity in two groups, Group 1 the Oswestry score is 0.2 ± 0.08, while Group 2 the Oswestry score is 0.3 ± 0.05, based on the result we analyzed with Wilcoxon test, we find significant different between two groups, the significant value is 0.001 (p<0.05). Conclussion : magnetic stimulation is more effective to reduce pain index and improve functional activity by using Oswestry instrument than electrical stimulation. Keyword : Magnetic, Electrical, Stimulation, C fiber, A delta fiber

Abstract 111: Exclusive Involvement of Interventional Cardiologist in the Decision Making Process Improves Door-to-balloon Time by Significant Shortening of Decision-to-balloon Time Instead of EKG-to-decision Time In ST Elevation Myocardial Infarction

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Daming Zhu ◽  
Yuanyuan Zhang ◽  
Nowwar Mustafa ◽  
Angela Hoban ◽  
Dan Murphy ◽  
...  
Keyword(s):  
Decision Making ◽  
Decision Time ◽  
Decision Making Process ◽  
Primary Pci ◽  
Chi Square ◽  
Comprehensive Strategy ◽  
Interventional Cardiologist ◽  
Group 2 ◽  
Door To Balloon ◽  
Group 1

Background: We have had a “one call activation system” for primary PCI at our regional academic center since 1999. The ED physician initiated the system with the decision for primary PCI made by cardiologist (interventional or non-interventional) on call. But since July 1, 2009, only interventional cardiologists are involved in the decision making process. Otherwise, the comprehensive strategy remained the same. As we have reported previously, this new strategy resulted in a shortened door-to-balloon (D2B) time. In the present study, we analyzed the D2B timeline intervals to determine where the major gains were achieved. Methods: We conducted a retrospective analysis of 665 consecutive patients presenting to our institution with suspicion of acute STEMI during a 30-month period. Group 1 consisted of patients in the 12 months (July 1 2008-June 30 2009) before and Group 2 consisted of patients in the 18 months (July 1 2009-Dec. 31 2010) after the system change was instituted. Mann-Whitney U test and chi-square test were used for statistical analysis. Results: 218 patients in group 1 were taken to the cath lab of which 180 received primary PCI. 349 patients in group 2 were taken to the cath lab of which 275 received primary PCI. The results were presented in the table. Conclusions: Comprehensive strategy with exclusive involvement of interventional cardiologist resulted in a significant decrement in decision-to-balloon time. The EKG-to-decision time did not decrease, contrary to our expectation.

350 EFFECT OF DIFFERENT SUB-DOSES OF EQUINE CHORIONIC GONADOTROPIN ON PREGNANCY AND TWINNING RATES OF CYCLIC ZEBU COWS SUBMITTED TO FIXED-TIME ARTIFICIAL INSEMINATION

2015 ◽  
Vol 27 (1) ◽  
pp. 263 ◽  
Author(s):  
R. H. Alvarez ◽  
F. L. N. Natal ◽  
R. M. L. Pires ◽  
K. M. R. Duarte ◽  
C. A. Oliveira
Keyword(s):  
Artificial Insemination ◽  
Ovarian Response ◽  
Fixed Time ◽  
Sao Paulo ◽  
São Paulo ◽  
Chi Square ◽  
Group 3 ◽  
Group 2 ◽  
Twin Pregnancies ◽  
Group 1

The injection of a low dose of eCG has the potential to induce multiple ovulation and pregnancies in cattle. The present study aimed to evaluate the ovarian response, conception rate and incidence of twin pregnancies of cyclic cows receiving 1 of 2 low doses of eCG. Multiparous Nellore (Bos t. indicus) cows with plasma progesterone levels >1 ng∙mL–1 on at least one of 2 blood samples collected at 10-day intervals (Day –10 and Day 0) received an intramuscular (IM) injection of 2 mg of oestradiol benzoate (EB; Estrogin®, AUSA, São Paulo, Brazil) and a vaginal device (DIP) containing 1 g of progesterone (Primer®, Tecnopec, São Paulo, SP, Brazil) on Day 0. On Day 8, the DIP was removed and cows received an IM injection of 150 μg of cloprostenol (Veteglan®, Hertape Calier, Juatuba, MG, Brazil). At this time, the animals were randomly distributed into 3 groups. Group 1 (n = 30) received an IM injection of 2 mL of saline, whereas groups 2 (n = 41) and 3 (n = 23) received 600 IU and 900 IU of eCG (Novormon® MSD Saude Animal, São Paulo, Brazil), respectively. Twenty-four hours later (Day 9), all groups received 1 mg of EB and were submitted to fixed-time artificial insemination (FTAI) 30 h later (i.e. 54 h after DIP removal). Oestrus observation was performed daily from the time of the withdrawal of the DIP until the day of FTAI. Ovaries were examined ultrasonically at the time of FTAI, the following day and 7 days after FTAI. Pregnancy diagnosis was done by ultrasonography 30 days after FTAI and the incidence of twin or single calves was recorded at birth. Data were analysed by chi-square test. The rate of expression of oestrus was 70.0% (group 1), 82.9% (group 2), and 78.2% (group 3; P = 0.25). Cows that had 2 or more large follicles at the time of FTAI was 0% (group 1), 14.6% (group 2), and 34.8% (group 3; P < 0.05). The ovulation rate of cows in group 1 (80.0%) was higher than cows in groups 2 (48.8%) and 3 (52.2%; P < 0.05). The conception rates for groups 1, 2, and 3 were 50.0, 26.8, and 39.1%, respectively (P < 0.05). Two animals in group 3, one in group 2, and none of group 1 had twin pregnancies on Day 30 after FTAI. Only one of these cows (group 3) had a twin calving. It was concluded that the injection of 600 or 900 IU eCG, in an oestradiol/progestogen FTAI protocol does not result in an increase in the rate of twin calvings, but may negatively affect pregnancy rates of cyclic Nellore cows.Financial support was provided by FAPESP (proc. 2011/13096–0).

scholarly journals Pharmacokinetics of a New Pharmaceutical Form of Vitamin D3 100,000 IU in Soft Capsule

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 703 ◽  
Author(s):  
Romuald Mentaverri ◽  
Jean-Claude Souberbielle ◽  
Gilles Brami ◽  
Christelle Daniel ◽  
Patrice Fardellone
Keyword(s):  
Single Dose ◽  
Vitamin D3 ◽  
Oral Solution ◽  
Wilcoxon Test ◽  
Late Winter ◽  
Reference Drug ◽  
Significant Difference ◽  
Group 2 ◽  
New Formulation ◽  
Group 1

Vitamin D deficiency is frequent in the general population and both subjects and health professionals could benefit from a broader range of vitamin D3 formulations. We conducted a single-dose, open-label, parallel-group, randomized bioequivalence study to compare a single dose of a newly developed vitamin D3 100,000 IU in a soft capsule (Group 1) with the reference drug vitamin D3 100,000 IU oral solution in ampoule (Group 2) in healthy volunteers over a four-month period. The primary endpoint was the area under the curve (AUC) of serum 25-hydroxyvitamin-D (25(OH)D) concentrations on Day 112. This study was conducted in France from February to June 2014 in 53 young adults with a mean age of 26.9 years. At baseline, low mean serum 25(OH)D levels were observed in both groups (10.6 ng/mL in Group 1 and 9.0 ng/mL in Group 2). On Day 112, the AUC of serum 25(OH)D concentration was 2499.4 ± 463.8 nmol/mL (7.8 ± 0.2 for LogAUC) for Group 1 and 2152.3 ± 479.8 nmol/mL (7.6 ± 0.2 for LogAUC) for Group 2. Bioequivalence of the two treatments was not demonstrated. Superiority of vitamin D3 100,000 IU soft capsule was observed with p = 0.029 for AUC and p = 0.03 for LogAUC using a non-parametric Wilcoxon test. The profile of the serum 25(OH)D concentration showed a significant difference in favor of Group 1 on Days 1, 3, 7, 14 and 90. Mean serum 25(OH)D concentrations in Group 1 were between 20 and 30 ng/mL during the four-month period and under 20 ng/mL throughout the study in Group 2, except on Day 112. Mean Cmax for Group 1 was significantly higher (p = 0.002). Fourteen days were needed to reach Tmax by more than half the subjects in Group 1 compared to 45 days in Group 2. Both treatments were well tolerated, with no severe or related adverse events reported. In conclusion, the pharmacokinetic profile of the new formulation of vitamin D3 100,000 IU soft capsule is superior to that of the oral solution in ampoule. The new formulation increased serum 25(OH)D levels to above 20 ng/mL and maintained levels from 20 ng/mL to 30 ng/mL for four months in late winter and spring.

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