scholarly journals Role of antihypertensives drugs on proteinuria in patients with chronic kidney disease and hypertension

2017 ◽  
Vol 6 (10) ◽  
pp. 2522
Author(s):  
Ritu Bala ◽  
Harminder Singh ◽  
. Rupali ◽  
Kuhu Verma
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
P Value ◽  
Biochemical Tests ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Hypertension is the most prevalent cardiovascular disease and the relevant data suggest that the burden, risk factors and co-morbidities associated with the essential hypertension is increasing with every passing day. It is one of the major chronic diseases resulting in high mortality and morbidity in today’s world. Aim: The aim of the study was to compare effects of cilnidipine and amlodipine on the blood pressure (BP), heart rate and proteinuria among patients of hypertension with chronic kidney disease.Methods: 100 patients were included in this study. Patients were randomly assigned into two groups Group A and Group B (50 each). Group A: Patients received Cilnidipine (5-10mg/day). Group B: Patients received amlodipine (5-10mg/day).Results: No significant difference in SBP, DBP, MBP and proteinuria while comparing both the groups of patients taking cilnidipine and amlodipine at baseline i.e. 0 to 12 week, 12 to 24 weeks and 0 to 24 weeks. Cilnidipine caused decrease in HR 0 to 12 week (p value 0.001), 12 to 24 weeks (p value 0.001) and 0 to 24 weeks (p value 0.0001). Amlodipine had increased heart rate from baseline to 12 weeks (p value 0.0001), 12 to 24 weeks (p value 0.051) and 0 to 24 weeks (p value 0.001). No significant difference was seen in any biochemical readings.Conclusions: There was a significant change in all the parameters including BP, heart rate, proteinuria and other biochemical tests when they compared within the group but no significant difference while comparing both the groups.

scholarly journals Comparative Study of Propofol and Etomidate on the Haemodynamic Effects During Induction and Endotracheal Intubation

2019 ◽  
Vol 18 (2) ◽  
pp. 7-15
Author(s):  
Mallika Rayamajhi ◽  
Puja Thapa ◽  
Anjan Khadka ◽  
Biswa Ram Amatya ◽  
Udaya Bajracharya
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Comparative Study ◽  
Endotracheal Intubation ◽  
Arterial Blood ◽  
Significant Difference ◽  
Group A ◽  
Blood Pressures ◽  
Group B ◽  
Induction Agents

Introduction: While most intravenous induction agents decrease arterial blood pressure, laryngoscopy and endotracheal intubation increase the heart rate and blood pressure. Propofol causes a decrease in systemic blood pressure whereas etomidate has minimal effects on the cardiovascular system. This study aims to evaluate and compare the hemodynamic effects of propofol and etomidate during induction and endotracheal intubation. Methods: 62 ASA I and II patients, 20-60 years of age, scheduled for elective surgery were enrolled in this prospective, randomised and double blind comparative study. Group A received inj. Propofol (2 mg/kg) and group B received inj. Etomidate (0.3 mg/kg), as induction agents. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded after induction and after intubation at one, three, five and ten minutes and intergroup comparisons were made. Results: After induction the decrease in systolic, diastolic and the mean arterial pressures were more in group A compared to group B (p = 0.003, 0.004 and 0.002). After 1 minute of intubation all haemodynamic parameters increased from the baseline with no significant differences between the two groups (p >0.05). At three minutes the decrease in heart rate, diastolic blood pressure and mean arterial pressure was more in group A than group B with p values of 0.001, 0.002 and 0.05, however systolic blood pressures showed no significant difference (p = 0.144). The decrease in blood pressures showed significant difference between the two groups (p <0.05) at five and ten minutes but the decrease in heart rate remained significant only at five minutes of intubation (p = 0.001). Conclusions: Propofol and etomidate are both effective in preventing the haemodynamic changes due to induction and endotracheal intubation, with etomidate providing more haemodynamic stability.

scholarly journals EVALUATION OF DEXMEDETOMIDINE ON HEMODYNAMIC STRESS RESPONSE DURING LARYNGOSCOPY AND INTUBATION

2021 ◽  
Vol 71 (6) ◽  
pp. 2126-30
Author(s):  
Abdul Raafeh Jamal ◽  
Bilal Yaseen ◽  
Mohammad Saeed ◽  
Rao Ali Shan Khan ◽  
Syed Hamid Ali Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Stress Response ◽  
Systolic Blood Pressure ◽  
Military Hospital ◽  
P Value ◽  
Hemodynamic Stress ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Dexmedetomidine (Precedex) in addressing the mean haemodynamic stress response to laryngoscopy and endotracheal intubation (L&I). Study Design: Quasi-experimental study. Place and Duration of Study: Anesthesiology Department, Combined Military Hospital, Rawalpindi, from Jun 2019 Jun 2020. Methodology: The patients were divided into two groups. Group A was given Inj. Dexmedetomidine and group B (placebo). Operation theatre assistant randomly assigned the patients to either group A or group B each day. The second person administered the drug or placebo. The third person (researcher) recorded all the parameters mentioned in the proforma. Results: There were 100 patients with an age range of 18-60 years. The majority of the patients were ASA-I physical status. The main surgical procedure was laparoscopic cholecystectomy. Recording of heart rate and systolic blood pressure during laryngoscopy and intubation, after administration of drug or placebo, showed mean heart rate less than mean basal value in group-A and 22% above mean basal value in group-B, and it was statistically highly significant (p-value <0.001). Whereas mean systolic blood pressure in group-A was 122.42 ± 14.91 (less than the mean basal value) as compared to group B, 155.00 ± 18.32/min (20% above mean basal value). This change was also statistically highly significant (p-value <0.001). Conclusion: It is concluded that dexmedetomidine showed statistically significant stabilizing effects on the expected changes of the hemodynamic stress response.

scholarly journals Audit on the Management of Bronchiolitis: A Single Centre Real World Experience in Bangladesh Can We do Better ?

2015 ◽  
Vol 14 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Farzana Hamid ◽  
Syed Moosa MA Quaium ◽  
Azizur Rahman ◽  
AT Reza Ahmad ◽  
Shahariar Khan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Hospital Stay ◽  
Respiratory Rate ◽  
P Value ◽  
Supportive Treatment ◽  
Significant Difference ◽  
Group A ◽  
Syncytial Virus ◽  
Group B

Background: Bronchiolitis is the most common reason for hospitalization of children in many countries.Though Respiratory Syncytial Virus (RSV) is the most common organism causing bronchiolitis, but antibiotics are used widely.So the aim of the present study is to establish whether antibiotic has any role in bronchiolitis management along with supportive treatment. Methods:This retrospective study included 100 infants and children between 2-24 months of age admitted with clear cut sign symptoms of bronchiolitis. Patients were divided into Group A (supportive + antibiotic Rx) comprised 72 patients and group B (supportive Rx only) comprised 28 patients.After 3-5 days of hospital stay, clinical responses were evaluated in terms of improvement in symptoms and clinical parameters- respiratory rate, heart rate and oxygen saturation. Results: Mean age of patients was 6.6 (±5.6) months in Group A and 6.3 (±4.8) months in Group B. Most of the patients in both study groups were male (M: F=1.6:1). All the cases in both groups presented with cough, running nose, and respiratory distress. Fever and feeding difficulty were present in 83.3% & 90.3% in Group A and 82.1% & 89.3% in Group B respectively. Majority of cases were from lower socioeconomic status and lived in urban area. In Group A, after therapy mean respiratory rate 53.7 (±4.3) and oxygen saturation 97.9 (±1.9) had significantly improved in comparison to respiratory rate 65.6 (±4.8) and oxygen saturation 89.7 (±4.4) before therapy (p=<.001 in all parameter). Heart rate also significantly increased after therapy (149.4 ±10.2 versus 104.5 ±8.7) (p=<.001). In Group B, after therapy mean respiratory rate 53.5 (±4.1) and oxygen saturation 97.8 (±1.7) had also significantly improved in comparison to respiratory rate 65.3 (±4.1) and oxygen saturation 88.8 (±2.8) before therapy (p=<.001 in all parameter). Heart rate also significantly increased after therapy (150.8 ±9.8 versus 105.0 ±6.2) (p=<.001). In comparison between two modalities of treatment, no significant difference was found (p value=>.05 in all parameters). No statistical significant difference was observed in the length of hospital stay in two groups. Conclusion: The study highlighted the importance of supportive treatment in bronchiolitis management. Antibiotics should not be used without clinical and laboratory evidence of bacterial infection. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22871 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 6-10

scholarly journals Evaluation of the safety and efficacy of beta blockers in septic patients: a randomized control trial

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Raouf Ramzy Gadallah ◽  
Eman Mohamed Kamal Aboseif ◽  
Dalia Ahmed Ibrahim ◽  
Hany Victor Zaki ◽  
Mohamed Nabil Mohamed Abdelmaksoud
Keyword(s):  
Heart Rate ◽  
Host Response ◽  
Beta Blockers ◽  
Myocardial Depression ◽  
Icu Stay ◽  
Significant Difference ◽  
Group A ◽  
Randomized Control ◽  
Group B

Abstract Background Sepsis is a common fatal complication of an infection. As part of the host response, sympathetic stimulation can result in many serious complications such as septic myocardial depression and metabolic, hematological, and immunological dysfunction. Treatment with beta blockers may reduce this pathophysiological response to infection, but the clinical outcomes are not clear. Results Our study showed a significant difference as regards decrease in heart rate in group B with P value < 0.001 compared to group A, besides a reduction in 28-day mortality (P value 0.0385) and ICU stay (P value < 0.001) in group B compared to group A. Conclusion This study supports the role of intravenous beta blockers in sepsis patients by decreasing heart rate without affecting the hemodynamics, in addition to decreasing 28-day mortality and ICU stay.

scholarly journals Evaluation of Intranasal Administration of Dexmedetomidine during Therapeutic Extraction

2020 ◽  
pp. 112-119
Author(s):  
Soya Alfred Xavier ◽  
Abdul Wahab ◽  
M. Sivakumar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Local Anesthesia ◽  
Intranasal Administration ◽  
Rating Scale ◽  
Maxillofacial Surgery ◽  
Lower Quadrant ◽  
Significant Difference ◽  
Group A ◽  
Group B

Aim: The purpose of this study was to evaluate the effectiveness of intranasal administration of dexmedetomidine during therapeutic extraction.Materials and Methods: The study design is a split mouth double blinded randomized control trial. Patients who visited the department of oral and maxillofacial surgery for the therapeutic extraction of premolars were assessed for enrollment. Each subject participated in two surgical sessions, with the extraction of premolars of the upper and lower quadrant of the same side during a single session. A week later subjects were asked to report back for the extraction of the upper and lower premolar on the contralateral side. The patients were randomized by a computer generated number into two groups. Group A received intranasal dexmedetomidine (100 mcg/ml) and group B received intranasal saline at the first session. An alternate regimen was used during the second session during which group A received intranasal saline and in group B intranasal dexmedetomidine was administered. A mucosal atomization device was used to deliver the drug. Pain from local anesthesia infiltration was rated on the numerical rating scale from 0 (no pain) to 10 (worst pain imaginable). Sedation status was measured using the Observer's Assessment of Sedation. Blood pressure and heart rate of the patient were also monitored.Original Research ArticleXavier et al.; JPRI, 32(18): 112-119, 2020; Article no.JPRI.59782113Results: A total of 14 patients were involved in the study. Observer assessment scale indicated that significant sedation was obtained in group A when compared to group B. Compared to group B there was a significant reduction in heart rate and blood pressure in group A at the end of 10 minutes and 40 minutes. These parameters were normalized to the baseline at the end of 60 minutes. There was no significant difference in pain score noted during the local anesthesia infiltration. None of the patients had bradycardia, hypotension, and respiratory depression in this trial.Conclusion: In this study, we conclude that the intranasal administration of dexmedetomidine controls the patient's fear and anxiety during the therapeutic extraction but not the pain during the administration of local anesthesia.

scholarly journals High Basal Maximal Standardized Uptake Value (SUVmax) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2876
Author(s):  
Giovanni Manfredi Assanto ◽  
Giulia Ciotti ◽  
Mattia Brescini ◽  
Maria Lucia De Luca ◽  
Giorgia Annechini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Follicular Lymphoma ◽  
Standardized Uptake Value ◽  
Metabolic Tumor Volume ◽  
Late Relapse ◽  
Prognostic Role ◽  
Pet Ct ◽  
Group A ◽  
Group B

Background: Despite that the unfavorable prognostic role of a high Total Metabolic Tumor Volume (TMTV) in Follicular Lymphoma has been demonstrated, the role of SUVmax alone at baseline PET/CT could have a different prognostic role. Patients and Methods: We performed a retrospective observational monocentric cohort study. All patients affected by FL who underwent a basal PET/CT were included. Two subgroups were identified and compared in terms of PFS and OS: (A) Basal SUVmax ≤ 6; and (B) Basal SUVmax > 6. Results: Ninety-four patients were included, 34 in group A (36.2%) and 60 in group B (63.8%). The PFS at two years was comparable in the two groups (97%). The five-year PFS was 73.5% for group A and 95% for group B (p 0.005). The five-year PFS in the whole cohort was 87.5%. A clear advantage was confirmed in group A in the absence of other risk factors. Patients with SUVmax ≤ 6 and no risk factors showed a 5-year PFS of 73% against 83% for patients with SUVmax > 6 and at least two risk factors. Conclusion: A high FDG uptake favorably correlated with PFS. A low basal SUVmax reflected a higher rate of late relapse requiring a prolonged follow-up. The basal SUVmax is an approachable parameter with prognostic implications.

Does body position, age, and heart rate induce IOP’s changes?

2021 ◽  
pp. 112067212110233
Author(s):  
Marcelina Sobczak ◽  
Magdalena Asejczyk ◽  
Malwina Geniusz
Keyword(s):  
Heart Rate ◽  
Body Position ◽  
Age Groups ◽  
Cardiovascular Parameters ◽  
Entire Cohort ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Effect Of Age

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.

scholarly journals Caudal bupivacaine - midazolam for post operative analgesia in children

2014 ◽  
Vol 23 (1) ◽  
pp. 8-13
Author(s):  
Idris Ali ◽  
Amirul Islam ◽  
Golam Morshed ◽  
Nurul Islam ◽  
Ashia Ali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Anaesthetic Agent ◽  
Caudal Block ◽  
Arterial Blood ◽  
Post Operative Period ◽  
Caudal Analgesia ◽  
Significant Difference ◽  
Group B

Background: Adjuvant used with local anaesthetic agent in caudal is more effective for post operative analgesia in children . Aim and objective: To find out the duration and quality of caudal analgesia in children undergoing genitourinary surgery by combination of bupivacaine and midazolam. Methods: A total number of sixty patients ASA grade I&II were selected randomly as per inclusion & exclusion criteria in two groups. Thirty in each group. In group A, caudal block was given by bupivacainemidazolam mixture and in group B, caudal block was given by bupivacaine in lateral decubitus position, just after completion of surgery before reversed from GA. In post operative period arterial blood pressure, heart rate, and duration of analgesia were recorded. Results: There was no significant difference between the groups of blood pressure, heart rate, and pain score up to 30 min but after one hour of post operative period pain scores were significant(p<0.05). Conclusion: Midazolam improves the duration and quality of analgesic effect of bupivacaine. DOI: http://dx.doi.org/10.3329/jbsa.v23i1.18152 Journal of BSA, 2010; 23(1): 8-13

scholarly journals Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain

2015 ◽  
Vol 16 (12) ◽  
pp. 939-943 ◽  
Author(s):  
Leena Alsomadi ◽  
Riyad Al Habahbeh
Keyword(s):  
Pain Scale ◽  
Prophylactic Antibiotics ◽  
Post Treatment ◽  
Endodontic Treatment ◽  
Significant Difference ◽  
Group A ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Group B

ABSTRACT Aim To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. Materials and methods After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Results Peak postoperative pain occurred at 16 hours posttreatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Conclusion Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Clinical significance Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients. How to cite this article Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015;16(12):939-943.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

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