scholarly journals OPIOID-FREE ANESTHESIA FOR EXTRACRANIAL BYPASS SURGERIES IN PATIENTS WITH POLYVASCULAR DISEASE

2018 ◽  
Vol 7 (3) ◽  
pp. 94-101
Author(s):  
M. A. Evseev ◽  
E. D. Chumachenko ◽  
G. P. Plotnikov ◽  
D. L. Shukevich
Keyword(s):  
Neuropsychological Testing ◽  
S100 Protein ◽  
Group Versus ◽  
Early Mobilization ◽  
Perioperative Period ◽  
Study Groups ◽  
Neurological Status ◽  
Cognitive Status ◽  
Control Group ◽  
Study Group

Aim. To assess safety and effectiveness of opioid-free anesthesia in patients with polyvascular disease undergoing carotid endarterectomy for early mobilization and hemodynamic stability in the perioperative period.Methods. 28 consecutive male patients with polyvascular disease and internal carotid artery stenoses were included in a single-center, randomized observational study. The control group (n = 12) received conventional intravenous anesthesia of fentanyl 0.1 mg bolus every 20 minutes with continuous sedation with propofol at a rate of 4 mg / kg / h. The study group (n = 16) received conventional anesthesia followed by introvenous nefopam 20 mg with continuous infusion of 40 mg/h. Invasive monitoring of blood pressure, sedation depth, and the analgesia nociception index were measured. The marker of brain damage, S100 protein, was measured in blood plasma. All patients underwent neuropsychological testing in the perioperative period.Results. There were no reliable hemodynamic derangements during anesthesia in both study groups. There were no cases with worsening of the initial coronary circulation according to the ECG. No alterations in the initial neurological status were registered. BIS values were maintained at 56±19 in both groups without increasing the dose of propofol. All patients in the study group versus 5 patients (41.7%) in the control group were extubated in the OR unit.Conclusion. Opioid-free anesthesia in patients with polyvascular disease undergoing CEA allows achieving adequate pain management in the perioperative period, ensuring early extubation in the OR unit and postoperative mobilization while maintaining stable hemodynamic parameters and ensuring safe cognitive status.

scholarly journals Trabeculectomy with Healaflow versus Trabeculectomy for the Treatment of Glaucoma: A Case-Control Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Dimitris Papaconstantinou ◽  
Andreas Diagourtas ◽  
Petros Petrou ◽  
Alexandros Rouvas ◽  
Athanasios Vergados ◽  
...  
Keyword(s):  
Case Control Study ◽  
Group Versus ◽  
Study Groups ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Safe Procedure ◽  
Mean Values ◽  
Control Study

Purpose. To compare the outcomes of trabeculectomy with and without Healaflow (Anteis S.A, Geneva, Switzerland), a high molecular weight viscoelastic gel, in patients requiring glaucoma surgery.Methods. This was a retrospective, comparative, interventional case-control study. Forty patients formed two matched study groups and were analyzed (trabeculectomy alone (control) versus trabeculectomy with Healaflow (study)).Results. The postoperative levels of mean IOP were statistically significantly lowerP<0.05than preoperatively in both groups, for all time intervals. There was no statistical difference, at the end of the follow-up period, between the two groups in the mean values of the IOP (14.9 ± 3.2 mmHg for the study group versus 14.8 ± 3.3 mmHg for the control group). The number of antiglaucoma drugs used in the study group was reduced from a preoperative mean of 3.4 ± 0.75 to a 6-month postoperative mean of 0.6 ± 0.8P<0.001and in the control group from 3.6 ± 0.59 to 0.55 ± 0.9P<0.001.Conclusions. Although trabeculectomy with Healaflow appears to be a safe procedure, we failed to identify any significant advantages in the use of Healaflow when compared with trabeculectomy alone, at the end of the 6-month follow-up period.

scholarly journals A randomised, open label comparative study of hydroxychloroquine with betamethasone oral mini pulse in the management of patients with alopecia areata

2021 ◽  
Vol 10 (2) ◽  
pp. 187
Author(s):  
Jeyasudha Jambusayee ◽  
Kulur Mukhyaprana Sudha
Keyword(s):  
Alopecia Areata ◽  
Life Quality ◽  
Autoimmune Disorder ◽  
Study Groups ◽  
Pulse Therapy ◽  
The Body ◽  
Control Group ◽  
Study Group ◽  
Open Label ◽  
Significant Difference

Background: Alopecia areata is an autoimmune disorder causing patchy hair loss on scalp and other parts of the body and leading to poor self-esteem and anxiety in patients. Treatment with topical or systemic drugs like steroids or other immunosuppressants is associated with adverse effects. Hydroxychloroquine is an antimalarial drug, with T cell modulating function. This study was undertaken to assess the safety, efficacy and tolerability of Hydroxychloroquine in Alopecia areata compared to betamethasone oral mini pulse (OMP) therapy. Methods: 60 patients with alopecia areata were randomized into two groups of 30 each. Control group received tab. betamethasone 5 mg/day on two consecutive days of week for 12 weeks and Study group received tab. hydroxychloroquine 200 mg/day for 12 weeks. They were followed-up for further 12 weeks. Scale of alopecia tool, dermatology life quality index and global assessment at baseline, 12 weeks and 24 weeks were used to assess the outcome.Results: 94 patients were screened and 60 patients were included. All patients completed the study. At the end of 12 weeks, there was a statistically significant reduction in SALT and DLQI scores in both control and study groups. But at the end of 24 weeks, the study group showed an increase in the scores. Relapses were more in the study group. No significant difference in the incidence of adverse events was noted between the two groups.Conclusions: Hydroxychloroquine 200 mg/day is less efficacious in the management of alopecia areata in comparison to betamethasone oral mini pulse therapy.

VEGFR2 expressions in Th1 and CD8+ cytotoxic T lymphocytes (CTL) in colon cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15535-e15535
Author(s):  
Mehmet Artac ◽  
Ayca Ceylan ◽  
Melek Karakurt Eryılmaz ◽  
Murat Araz ◽  
Mustafa Karaagac ◽  
...  
Keyword(s):  
Colon Cancer ◽  
T Cell ◽  
Cancer Patients ◽  
Study Groups ◽  
T Cell Subsets ◽  
Control Group ◽  
Study Group ◽  
Metastatic Colon Cancer ◽  
Vegf Receptors ◽  
Cancer History

e15535 Background: VEGF receptors have an important role for inhibiting adaptive immun response in colon cancer. Therefore, we analyzed VEGF receptors in circulating T cell subsets according to stage in colon cancer patients. Methods: The prospective study group consisted of 50 patients with histologically confirmed colon cancer and 30 person without any cancer history as a control group. Peripheral blood specimens were collected from the patients after the diagnosis before inducing chemotherapy and radiotherapy. Patients with active infections or autoimmune disorders, who were treated with steroids and antibiotics in the last four weeks before the study enrollment were excluded from the study group. VEGFR2 expressions in circulating T cell subsets (Th1, Th2, Th17, CTL) were analyzed by flow cyctometry. Results: Age and gender were not different between the all study groups. Mean circulating CD4+ folicullar cells were less in colon cancer patients (9.54%±3.99) than the control group (12.03%±4.34), (p < 0.01). Mean circulating CD8+ follicular cells were higher in metastatic colon cancer (n = 26) 2.48% ± 1.68, than the non-metastatic colon cancer patients (n = 24) 1.63% ± 1.37, (p = 0.02). Mean VEGFR2 expressions in Th1 cells were higher in colon cancer patients 248.8 (Mean Flourescein intensity-MFI) than the control group 224.6, (P = 0.006). Mean VEGFR2 expressions in CTL were higher in colon cancer patients (381.8) than the control group (284.7), (p < 0.001). PD-1 expressions were not different between the colon cancer patients and the control group in all circulating T cell subsets. Mean VEGFR2 expressions in Th17 cells were higher non-metastatic colon cancer patients than the metastatic colon cancer patients (326.5 and 268.4 MFI, respectively, p = 0.02). Conclusions: VEGFR2 expressions are increased in circulating Th1 and CTL subsets in colon cancer patients. Whereas PD-1 expressions were not different in circulating T cell subsets than the control. VEGFRs may play an important role for the inhibition of circulating T cell subsets in colon cancer.

scholarly journals Therapeutic benefit of aripiprazole-olanzapine combination in the treatment of senile Alzheimer’s disease complicated by mental disorders

2020 ◽  
Vol 19 (2) ◽  
pp. 441-446
Author(s):  
Na Zheng ◽  
Ning Wang ◽  
Ji-Min Jia
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mental Disorders ◽  
Clinical Efficacy ◽  
Lower Incidence ◽  
Adverse Reactions ◽  
Study Groups ◽  
Therapeutic Benefit ◽  
Control Group ◽  
Study Group

Purpose: To determine the clinical efficacy of aripiprazole-olanzapine combination treatment in elderly Alzheimer’s disease complicated with mental disorders. Methods: Ninety-two elderly patients with Alzheimer’s disease and mental disorders who were admitted to Binzhou People's Hospital, were enrolled in the study. They were randomized into control and study groups. Control group was treated with olanzapine, while the study group was treated with aripiprazole as an adjuvant therapy in addition to olanzapine. The clinical efficacy, scores on different scales (MMSE, ADAS-cog, CDR, ADL, NPI and CMAI), and incidence of adverse reactions were determined. Results: The overall degree of response was significantly higher in the study group than in the control group (p < 0.05). There were no significant differences in MMSE, ADAS-cog, CDR, ADL, NPI and CMAI scores between the two groups before treatment (p > 0.05). The MMSE score of the study group was significantly higher than that of the control group, and the scores in the other scales in the study group were significantly lower after treatment (p < 0.05). The study group had significantly lower incidence of adverse reactions than control group (p < 0.05). Conclusion: Aripiprazole-olanzapine combination has significant therapeutic benefit in the treatment of elderly Alzheimer’s disease patients complicated with mental disorders. It promotes recovery of neurological function, as well as produces a lower incidence of adverse reactions. Keywords: Aripiprazole, Olanzapine, Alzheimer’s disease, Mental disorders

Maternal Outcome with Discontinuation of Magnesium Sulfate immediately Postpartum in Severe Preeclampsia

2017 ◽  
Vol 9 (2) ◽  
pp. 84-87 ◽  
Author(s):  
Imam Bano ◽  
Pramod R Gade ◽  
Yasir Alvi
Keyword(s):  
Magnesium Sulfate ◽  
Primary Outcome ◽  
Randomized Study ◽  
Study Groups ◽  
Maternal Outcome ◽  
Severe Preeclampsia ◽  
Control Group ◽  
Study Group ◽  
Medical College ◽  
Jawaharlal Nehru

ABSTRACT Objective To assess the effectiveness of discontinuation of magnesium sulfate (MgSO4) infusion in patients with severe preeclampsia immediately postdelivery. Materials and methods In a prospective-randomized study, women with severe preeclampsia attending the Jawaharlal Nehru Medical College, Aligarh, India, between January 2013 and September 2014 were enrolled. The inclusion criteria were blood pressure of at least 160/110 mm Hg after 24 weeks and either of the following: Proteinuria (dipstick value. 1), platelet <100,000, and serum transaminase levels twice as normal. Participants were assigned to control and study groups according to the time of enrollment (6-month blocks). All patients received MgSO4 loading dose (4 gm intravenously), followed by maintenance doses (1 gm/hour) until delivery (study group) and 24 hours (control group). The primary outcome was occurrence of convulsions after completion of MgSO4 therapy. Patients with treatment failure were excluded from analyses. Results Analyses included 48 patients in the study group and 43 patients in the control group. No convulsions occurred in either group after the completion of treatment. Conclusion: For women with severe preeclampsia, discontinuing MgSO4 immediately after delivery could effectively prevent convulsions. How to cite this article Anjum S, Gade PR, Garg N, Bano I, Alvi Y. Maternal Outcome with Discontinuation of Magnesium Sulfate immediately Postpartum in Severe Preeclampsia. J South Asian Feder Obst Gynae 2017;9(2):78-81.

scholarly journals Autonomic Nervous System Dysregulation in Response To Postural Change in Patients with Pectus Excavatum in Taiwan: A Pilot Study

2021 ◽  
Author(s):  
Yu-Ting Hsu ◽  
Yeung-Leung Cheng ◽  
Yi-Wei Chang ◽  
Chou-Chin Lan ◽  
Yao-Kuang Wu ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Sleep Quality ◽  
Pectus Excavatum ◽  
Study Groups ◽  
Control Group ◽  
Study Group ◽  
Postural Change ◽  
Psychological Function ◽  
Autonomic Nervous

Abstract Background Pectus excavatum (PE) negatively impacts psychological function, but its effect on autonomic nervous system (ANS) function has not been investigated. We evaluated ANS function following postural changes in patients with PE.Methods The participants were 14 healthy men (control group) and 20 men with PE (study group). Psychological function was assessed using the visual analog scale for pain, Brief Symptom Rating Scale-5, and Beck Depression Inventory-II. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). ANS regulation in response to postural change was measured in the supine position and immediately after sitting. All measurements were compared between the control and study groups at baseline and between the study groups before and after Nuss surgery.ResultsAt baseline, upon postural change, symptomatic activity increased in the control group (50.3% to 67.4%, p=0.035) but not in the study group (55.0% to 54.9%, p=0.654); parasympathetic activity decreased in the control group (49.7% to 32.6%, p=0.035) but not in the study group (45.1% to 45.1%, p=0.654); and overall ANS regulation increased in the control group (1.02 to 2.08, p=0.030) but not in the study group (1.22 to 1.22, p=0.322). In response to postural change after Nuss surgery in the study group, sympathetic activity increased (48.7% to 70.2%, p=0.005), parasympathetic activity decreased (51.3% to 29.8%, p=0.005), and overall ANS regulation increased (0.95 to 2.36, p=0.012).Conclusion ANS function in response to postural change is dysregulated in patients with PE, which improved after Nuss surgery.Trial registration: ClinicalTrials.gov, ID: NCT03346876, November 15, 2017, retrospectively registered,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007KGI&selectaction=Edit&uid=U0003JZU&ts=2&cx=cstxeg

scholarly journals EFFECT OF SELECTED YOGA TECHNIQUES ALONG WITH ASHWAGANDHA AND VACHA IN DEPRESSION IN THE AGE GROUP 65–75 YEARS

2021 ◽  
pp. 65-68
Author(s):  
SOUMYA MELEPPURAKKAL ◽  
SUNITHA K ◽  
JAYAN D
Keyword(s):  
Combined Therapy ◽  
Holistic Approach ◽  
Study Groups ◽  
Warm Water ◽  
Treatment Modalities ◽  
Control Group ◽  
Study Group ◽  
Age Group ◽  
Study Population

Objective: The study was done to compare the effect of selected yoga techniques, drugs, and combined therapy in depression in geriatrics. Methods: 75 patients between 65 and 75 years of age with depression were included in the study which was assessed by HAM D Score. The study population was randomly allocated to one control group and two study groups. The control group was given Aswangandha and Vacha churna with warm water as anupana after food, selected yoga techniques in the first study group, and combined yoga and the drug were given to the second study group. Outcome variables were assessed for the groups after the 30th day and follow-up after 45 days. Results: The results obtained in the study were analyzed using the ANOVA test. Yoga along with drug experienced a comparatively greater reduction in HAM-D score after treatment and follow-up (p<0.05) than other groups. Conclusion: Holistic approach can bring a better and static result than applying the treatment modalities alone.

scholarly journals Efficacy of Tranexamic Acid in Reducing Blood Loss during and After Caesarean Section: A Case control Study

2020 ◽  
Vol 18 (1) ◽  
pp. 22-25
Author(s):  
Kavita Sinha ◽  
Subhash Pandey ◽  
Dipendra Khadka
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Apgar Score ◽  
Postpartum Haemorrhage ◽  
Group Versus ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section

Introduction: The incidence of caesarean section is increasing day by day. One of the most common complications is primary or secondary postpartum haemorrhage. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion in varieties of surgery. Aims: To study the efficacy of tranexamic acid in reducing blood loss during and after the lower segment caesarean section. Methods: Arandomized, case controlled, prospective study was conducted on 100 women undergoing lower segment caesarean section carried out in the Department of Obstetrics and Gynaecology, Nepalgunj Medical College, Kohalpur from Sept 2019 to Feb 2020.Fifty of them were given tranexamic acid immediately before lower segment caesarean section and were compared with 50 others to whom tranexamic acid was not given. Blood loss was collected and measured during two different time interval. The first period was considered from placental delivery to end of lower segment caesarean section and second from the end of lower segment caesarean section to 2 hours postpartum period. Vital signs at time of delivery, at 1 hour and 2 hour postpartum and APGAR score at 1 min and 5 min were studied in both the groups. Results: Tranexamic acid significantly reduced the quantity of blood loss from the placental delivery to 2 hours post-partum: 360.9 ml in the study group, versus 443 ml in the control group (p=0.0008).It also significantly reduced the quantity of blood loss from the end of  lower segment caesarean section to 2 hours postpartum:71.5 ml in the study group versus 112.6 ml in the control group (p=0.0002).There was 18% less incidence of postpartum haemorrhage , who received tranexamic acid(p=0.02).There were no significant adverse drug reaction and difference in APGAR score in both the groups. No complications or side effects were reported in either group. Conclusion: Tranexamic acid is safe and effective in reducing blood loss among women undergoing lower segment caesarean section.

scholarly journals Efficacy and safety of oral mifepristone for cervical priming and induction of labor in term pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2766 ◽  
Author(s):  
Abhilasha Gupta ◽  
Aruna Verma ◽  
Iti Madan ◽  
Monika Kashyap
Keyword(s):  
Controlled Trial ◽  
Group Versus ◽  
Perinatal Outcomes ◽  
Active Phase ◽  
Cervical Ripening ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Bishop Score ◽  
Term Pregnancy

Background: The objectives of the study was to assess the efficacy of mifepristone in priming the cervix/inducing labor over next 96 hrs in term pregnancy.Methods: In this single blind randomized controlled trial 200 women with term pregnancy beyond 39 weeks and Bishop’ score <6 were randomly allocated into two groups. Tab Mifepristone 400 mg orally was given to women in study group (n=100) and no intervention in control group (n=100). On follow up one case was lost in control group. All women were observed for change in the bishop’s score or onset of labor in next 96 hrs. If Bishop’s score was <6, the choice of induction was left on the clinician/patient.Results: Mean induction to delivery interval, duration of active phase and improved Bishop score were 79.35±53.43 hr, 2.47±1.23 hr, 6.68±1.69 for study group versus 148±65.66 hr, 3.09±1.45 hr, 5.8±2.15  for control group (p value is <0.001) respectively.  Seventy one (71%) women in study group and 39 (39.3%) women in control group delivered vaginally within 96 hrs without any need of augmentation. There were 9 (9%) caesareans in study group and 24 (24.2%) caesareans in control group but no instrumental delivery in both groups. There was no statistically difference in perinatal outcomes between two groups.Conclusions: Mifepristone is an effective drug for cervical ripening and initiation of labor when given in term pregnancy beyond 39 weeks with poor Bishop’s score (<6) and appearing to reduce need for other agent for augmentation of labor.

scholarly journals Effectiveness of ASA for VTE Prophylaxis in Arthroscopic Rotator Cuff Repair

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0017
Author(s):  
Luke Austin ◽  
Charles Dante Wowkanech ◽  
Bret Cypel ◽  
Eric Gordon Alyea ◽  
Tara Gaston ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Shoulder Arthroscopy ◽  
Early Mobilization ◽  
Control Group ◽  
Study Group ◽  
Mechanical Prophylaxis ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Chemical Prophylaxis

Objectives: Venous thromboembolic disease (VTED) is a rare complication following arthroscopic rotator cuff repair (RCR). Historical rates of symptomatic VTED after arthroscopic shoulder surgery, DVT and PE, are 0.26%, and 0.01-0.21%, respectively. At present, the American Academy of Orthopaedic Surgeons (AAOS) and American College of Chest Physicians (ACCP) have no prophylaxis guidelines specific to shoulder arthroscopy. Despite this, many surgeons prescribe Aspirin (ASA) for chemical prophylaxis following RCR. The efficacy of ASA as a thromboprophylaxis after shoulder arthroscopy is unknown, but there are risks associated with its’ use. The purpose of this study is to evaluate the effectiveness of chemical prophylaxis (ASA) and mechanical prophylaxis vs. mechanical prophylaxis alone in preventing VTED following RCR. Methods: A total of 914 patients underwent RCR between the months of January 2010 and January 2015. A retrospective case control study was performed. The control group (n=484) consisted of patients treated with perioperative mechanical VTED prophylaxis (compression boots) and early mobilization. The study group (n=430) also utilized perioperative mechanical prophylaxis and early mobilization, and added chemical prophylaxis (ASA 81 mg daily) for four weeks after surgery. The primary outcome was symptomatic VTED (DVT/PE). Chart records were collected and evaluated for six months after surgery. Patient demographics and other surgical complications were also analyzed. Results: A total of 7 VTED events occurred during the study period, 6 DVTs and 1 PE. The total rate of VTED was 0.88%, DVT was 0.77%, and PE was 0.11%. There was no significant different between DVT (p=0.88, 95% CI= -1.36% - 1.65%) or PE (p=0.45, 95% CI = -0.77% - 1.50%) between the control and study groups. The control group (no ASA) recorded an incidence of 0.62% DVT and 0.00% PE. As compared to the study group (ASA), which recorded an incidence of 0.47% DVT and 0.23% PE. The control group had significantly greater number of documented current smokers (8.68% vs 3.72%, p= 0.0003). The study group had a statistically significant higher mean age of subject (59.1 vs 57.7, p=0.0055), as well as more subjects undergoing revision RCR surgery (4.67% vs 1.86%, p= 0.021). Conclusion: Based on our study of 914 patients, ASA does not provide a clinically significant reduction in VTED rates in patients undergoing RCR. We conclude that the use of mechanical prophylaxis and early mobilization is a sufficient method of VTED prophylaxis in this low risk population.

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