scholarly journals Low dose magnesium sulphate regimen and maternal outcome of patients with eclampsia

Palvi Banotra

Background: Preeclampsia, a serious pregnancy complication which is commonly characterized by high blood pressure, presence of protein in the urine and sometimes swelling in women's feet, legs and hands. With this condition, patient’s high blood pressure often results in seizures. Generally, the outcome remains good, however, eclampsia can be life threatening and disastrous.Methods: This cross-sectional study considered 114 patients who meet inclusion criteria and agreed to will-fully participate in the study were evaluated for different parameters. Patients who developed eclampsia during intra-natal and postnatal period were included in the study. The aim of the study was to evaluate the maternal outcome among all patients of eclampsia treated with low magnesium sulphate dosage therapy.  Results: The present study revealed, very low fit recurrence rate, low mortality rate, zero treatment failure rate, no toxicity and (99.12%) success rate.Conclusions: Apart from zero percent treatment failure rate, Low maternal mortality and fit recurrence rate encouraged us to continue the treatment with low dose MGSO4 regimen. Thus, low dose magnesium sulphate has been found very effective in treating the eclmpsia and at the same time maintains the high safety margin.

2016 ◽  
Vol 54 (4) ◽  
pp. 443-448 ◽  
Yoshihisa Watanabe ◽  
Hitoshi Higuchi ◽  
Minako Ishii-Maruhama ◽  
Yuka Honda ◽  
Akiko Yabuki-Kawase ◽  

2018 ◽  
Vol 53 (2) ◽  
pp. 159-164
Ling Yin ◽  
Dennis Dubovetsky ◽  
Patricia Louzon-Lynch

Background: Intradialytic hypotension (IDH) is the most commonly reported complication of hemodialysis (HD) treatment. At our institution, dialysis patients often have both 25% albumin and normal saline ordered as rescue options for management of IDH, without specification of which agent to use first. Objective: The purpose of this study was to determine the effect of an algorithm for IDH management. Methods: A retrospective study was conducted in HD patients who experienced IDH. The primary end point was to evaluate albumin use. Secondary end points included albumin costs, study fluid use per dialysis session, compliance with algorithm, efficacy of hypotension reversal to mean arterial pressure (MAP) ⩾60 mm Hg, percentage of target ultrafiltration achieved, time required to restore systolic blood pressure ⩾90 mm Hg, blood pressure post–study fluids, IDH treatment failure rate, and early termination of dialysis as a result of persistent IDH. Results: Implementation of the algorithm was observed in 94% of patients (n = 90). Total albumin use was significantly reduced from 11 400 to 4700 mL in the pre– (n = 90) and post–algorithm implementation group (n = 90; P < 0.001). The associated total cost of albumin was reduced by 59% ($10 534 vs $4343; P < 0.001). No statistical differences were observed between the 2 groups regarding efficacy of hypotension reversal to MAP ⩾60 mm Hg, early HD termination, or treatment failure rates (all P = 0.99). Conclusion and Relevance: Implementation of an evidence-based, standardized algorithm and pharmacy education to nursing staff can result in a reduction in albumin use and its associated drug costs for IDH management without compromising efficacy of IDH reversal.

2020 ◽  
Bruno Alves Rudelli ◽  
Pedro Nogueira Giglio ◽  
Vladimir Cordeiro Carvalho ◽  
Jose Ricardo Pecora ◽  
Henrique Melo Campos Gurgel ◽  

Abstract BACKGROUND: debridement, antibiotics and implant retention (DAIR) with the exchange of modular components is the most widely used option for the treatment of acute periprosthetic joint infections. The objective of this study is to evaluate the effect of bacteria drug resistance profile on the success rates of DAIR. METHODS: All early acute periprosthetic infections in hip and knee arthroplasties treated with DAIR at our institution over the period from 2011 to 2015 were retrospectively analyzed. The success rate was evaluated according to the type of organism identified in culture: multidrug-sensitive (MSB), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Gram-negative bacteria (MRB) and according to other risk factors for treatment failure. The data were analyzed using univariate and multivariate statistics.RESULTS: Fifty-seven patients were analyzed; there were 37 in the multidrug-sensitive bacteria (MSB) group, 11 in the methicillin-resistant Staphylococcus aureus (MRSA) group and 9 in the other multidrug-resistant Gram-negative bacteria (MRB) group. There was a statistically significant difference (p<0.05) in the treatment failure rate among the three groups: 8.3% for the MSB group, 18.2% for the MRSA group and 55.6% for the MRB group (p=0.005). Among the other risk factors for treatment failure, the presence of inflammatory arthritis presented a failure rate of 45.1 (p<0.05).CONCLUSION: DAIR showed a good success rate in cases of early acute infection by multidrug-sensitive bacteria. In the presence of infection by multidrug-resistant bacteria or association with rheumatic diseases the treatment failure rate was higher and other surgical options should be considered in this specific population. The MRSA group showed intermediate results between MSB and MRB and should be carefully evaluated.

1987 ◽  
Vol 7 (1) ◽  
pp. 31-33 ◽  
David Bennett-Jones ◽  
Val Wass Penny ◽  
Mawson David Taube ◽  
Guy Neild Chisholm ◽  
Ogg J Stewart Cameron ◽  

Eighty patients with CAPD peritonitis were randomised to receive either intraperitoneal (IP) vancomycin and tobramycin, or intravenous (IV) van-comycin and tobramycin followed by oral antibiotics, depending on the results of culture and sensitivity. Five patients were withdrawn, and, of the remaining patients, 39 were in the IP group and 36 in the IV group. When all episodes of bacterial peritonitis are considered, the treatment failure rate was higher in the IV group (34.1%), than in the IP group (10.3%) (p < 0.02). This was also the case when gram-positive organisms resistant to tobramycin were considered separately (p < 0.05), but not for vancoinycin-resistant organisms. We conclude that vancomycin should be administered by the intraperitoneal route: the case for intraperitoneal tobramycin is “not proven”.

2020 ◽  
Vol 14 (7) ◽  
pp. 888-895 ◽  
M E de Jong ◽  
L J T Smits ◽  
B van Ruijven ◽  
N den Broeder ◽  
M G V M Russel ◽  

Abstract Background and Aims There is paucity of data on safety and efficacy of anti-tumour necrosis factor [TNF] in elderly inflammatory bowel disease [IBD] patients. We aimed to compare the long-term treatment failure rates and safety of a first anti-TNF agent in IBD patients between different age groups [&lt;40 years/40–59 years/≥60 years]. Methods IBD patients who started a first anti-TNF agent were identified through IBDREAM, a multicentre prospective IBD registry. Competing risk regression was used to study treatment failure, defined as time to drug discontinuation due to adverse events [AEs] or lack of effectiveness, with discontinuation due to remission as a competing risk. Results A total of 895 IBD patients were included; 546 started anti-TNF at age &lt;40 [61.0%], 268 at age 40–59 [29.9%], and 81 at age ≥60 [9.1%]. Treatment failure rate was higher in the two older groups (subhazard rate [SHR] age ≥60 1.46, SHR age 40–59 1.21; p = 0.03). The SHR in the elderly [&gt;60] was 1.52 for discontinuation due to AEs and 1.11 for lack of effectiveness. Concomitant thiopurine use was associated with a lower treatment failure rate (SHR 0.78, 95% confidence interval [CI] 0.62–0.98, p = 0.031). Serious adverse event [SAE] rate, as well as serious infection rate, were significantly higher in elderly IBD patients [61.2 versus 16.0 and 12.4 per 1000 patient-years, respectively] whereas the malignancy rate was low in all age groups. Conclusions Elderly IBD patients starting a first anti-TNF agent showed higher treatment failure rates, but concomitant thiopurine use at baseline was associated with lower failure rates. Elderly IBD patients demonstrated higher rates of SAEs and serious infections.

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