scholarly journals Comparison of central venous oxygen saturation and serum lactate clearance as predictors of outcome in septic shock patients: a prospective control trial

2018 ◽  
Vol 6 (2) ◽  
pp. 653
Author(s):  
Gagan Kumar Narula ◽  
Ajit Kumar Singh ◽  
Anish Adya
Keyword(s):  
Early Recognition ◽  
Serum Lactate ◽  
Therapeutic Interventions ◽  
Average Hospital ◽  
Mortality And Morbidity ◽  
Prospective Control Trial ◽  
Icu Stay ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Sepsis is the leading causes of mortality and morbidity in ICU. Early recognition and intervention ensures speedy recovery and early discharge. It’s possible only if good predicting parameters indicating optimum resuscitation are available. Lactate level reduction and ScvO2 level in the jugular vein can be utilized as predictors.Methods: In this prospective study after applying exclusion inclusion criteria, 99 patients were selected and randomized into 2 groups. In one group reduction in lactate levels and in other ScVo2 levels were used as a predictor of resuscitation. Therapeutic interventions, Hospital stay, ICU Stay and 28-day mortality were compared in both groups. Statistical analysis was carried out by SPSS software.Results: On comparison of demographic profile, morbidity, SOFA score and hemodynamic parameters, there was insignificant difference (P >0.05). No significant difference in the number of vasopressors, Average Hospital or ICU Stay (Group A is 10.68±21.46 while Group B is 9.49±17.22) and 28-day mortality rate (in Gp A 60% vs group B 57.1) was observed. Mean crystalloids administered in group A was 4.93±1.11 liters, significantly more than group B i. e. 4.19±1.17 liters. (P<0.05) which was statistically significant.Conclusions: Although both parameters of resuscitation are used widely and sometimes simultaneously, in this study lactate and ScvO2 both used and compared in a similar set of patients, appeared to be equivocal in term of 28-day mortality, except the volume of crystalloids required was more in ScvO2 Group.

scholarly journals The Clinical Outcome in Patients with Peritoneal Metastasis

2020 ◽  
pp. 1-3
Author(s):  
Spiliotis J ◽  
◽  
Farmakis D ◽  
Raptis A ◽  
Kopanakis N ◽  
...  
Keyword(s):  
Systemic Chemotherapy ◽  
Treatment Options ◽  
Survival Rates ◽  
Peritoneal Metastases ◽  
Mortality And Morbidity ◽  
Chemotherapy Group ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

Cytroreductive surgery (CRS) and HIPEC are controversial effective treatment options for selected patients with peritoneal metastases. We retrospectively examined 4.500 patients with peritoneal metastases from different tumors from 2005 to 2020. Patients were divided in 4 groups, surgery plus HIPEC and then systemic chemotherapy: Group A n=730, Group B n=700, R0 surgery plus systemic chemotherapy, Group C n=870, palliative surgery plus systemic chemotherapy and Group D n=2.200, palliative care and best support. The postoperative outcomes, morbidity, mortality were compared between the 4 groups. The mean survival rates Group A=24,4+10,2m, Group B= 18,4+6,3m, Group C=12,3+5,7m, Group D=5,8+2,3m (p<0.05 between Gr A vr Gr B). There was no statistically significant difference in the 30-day mortality and morbidity. In conclusion CRS + HIPEC are feasible in 16% of our patients with peritoneal metastases and are associated with pro-longed survival.

Bilateral Use of Iliac Branch Devices for Aortoiliac Aneurysms Is Safe and Feasible, and Procedural Volume Does Not Seem to Affect Technical or Clinical Effectiveness: Early and Midterm Results From the pELVIS International Multicentric Registry

2021 ◽  
pp. 152660282110164
Author(s):  
Mario D’Oria ◽  
Georgios A. Pitoulias ◽  
Giovanni F. Torsello ◽  
Apostolos G. Pitoulias ◽  
Stefano Fazzini ◽  
...  
Keyword(s):  
Study Groups ◽  
Primary Patency ◽  
Type I ◽  
Mortality And Morbidity ◽  
Procedural Volume ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Objective To evaluate early and follow-up outcomes following bilateral use of iliac branch devices (IBD) for aortoiliac endografting and assess the impact of center volume. We used data from the pELVIS international multicentric registry. Methods For the purpose of this study, only those patients receiving concomitant bilateral IBD implantation were analyzed. To assess the impact that procedural volume of bilateral IBD implantation could have on early and follow-up outcomes, participating institutions were classified as Site(s) A if they had performed >10 and/or >20% concomitant bilateral IBD procedure, otherwise they were classified as Site(s) B. Endpoints of the analysis included early (ie, 30-day) mortality and morbidity, as well as all-cause and aneurysm-related mortality during follow-up. Additional endpoints that were evaluated included IBD-related reinterventions, IBD occlusion or stenosis requiring reintervention (ie, loss of primary patency), and IBD-related type I endoleak. Results Overall, 96 patients received bilateral IBD implantation (out of 910 procedures collected in the whole pELVIS cohort), of whom 65 were treated at Site A (ie, Group A) and 31 were treated at Site(s) B (ie, Group B). In total, only 1 death occurred within 30 days from bilateral IBD implantation, and 9 patients experienced at least 1 major complication without any significant difference between subjects in Group A versus those in Group B (10.8% vs 6.5%, p=0.714). In the overall cohort, the 2-year freedom from IBD-related type I endoleaks and IBD primary patency were 96% and 92%, respectively; no significant differences were seen in those rates between Group A or Group B (95% vs 100%, p=0.335; 93% vs 88%, p=0.470). Freedom from any IBD-related reinterventions was 83% at 2 years, with similar rates between study groups (85% vs 83%, p=0.904). Conclusions Within the pELVIS registry, concomitant bilateral IBD implantation is a safe and feasible technique for management of aortoiliac aneurysms in patients with suitable anatomy. Despite increased technical complexity, effectiveness of the repair is satisfactory with low rates of IBD-related adverse events at mid-term follow-up. Procedural volume does not seem to affect technical or clinical outcomes after bilateral use of IBD, which remains a favorable treatment option in selected patients.

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 A comparative study of collagenase ointment versus povidone-iodine dressing in non-healing ulcers

2017 ◽  
Vol 4 (6) ◽  
pp. 1992
Author(s):  
Amul Bhedi ◽  
Mithun Panchal ◽  
Hitesh Patel ◽  
Arnab Sarkar
Keyword(s):  
Hospital Stay ◽  
Povidone Iodine ◽  
Age Distribution ◽  
Complete Healing ◽  
Chi Square ◽  
Average Hospital ◽  
Female Ratio ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: The aim of the study was to evaluate effect of collagenase ointment and povidone-iodine on non-healing ulcer in the form of duration of ulcer covered with red granulation tissue and total hospital stay.Methods: The Study was conducted on 80 patients admitted in Surgery Department, SSG Hospital and Medical College Baroda, Gujarat, India during November 2006 to October 2008. All ulcers due to trauma, chronic ulcer or infected ulcer following debridement and incision and drainage were included in this study. In group A were wounds dressed in collagenase ointment and in group B were wounds dressed in povidone-iodine ointment till second surgery or complete healing. All data from both groups were collected and analyzed by chi-square test.Results: In this study, there was no difference in age distribution (p=0.62, p>0.05) with similar male to female ratio in both groups and also no significant difference in distribution of wounds size in both groups (p=0.92, p>0.05). Average size of wound in group A was 43 sq. cm and group B was 44 sq. cm. The significant difference was seen on floor of ulcer by healthy granulation which came on an average of within 11days in group A and within 18 days in group B (p=0.005, p<0.05). There was also a significant difference in average hospital stay, which was 25 days in group A and 35 days in group B (p=0.01, p<0.05).Conclusions:Collagenase ointment is clinically more efficient as a topical dressing and lowers the morbidity by reducing the hospital stay and the duration of dressing by promoting healing in non-healing wounds than povidine-iodine ointment. 

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 Bedside Surgery to Treat Patent Ductus Arteriosus in Low-Birth-Weight Premature Infants

2014 ◽  
Vol 7 ◽  
pp. OJCS.S16156
Author(s):  
Gökhan Albayrak ◽  
Koray Aykut ◽  
Mustafa Karacelik ◽  
Ramazan Soylar ◽  
Kemal Karaarslan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Medical Treatment ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Patent Ductus

Background Patent ductus arteriosus (PDA) is commonly seen in premature infants with low birth weights (LBW). It is a condition that has high mortality and morbidity rates. Early closure of the ductus arteriosus may require surgery or medical treatment. However, the decision of first medical approach for symptomatic PDA closure is still debated. In this study, we compared the surgical and medical treatments for the closure of PDA in premature LBW infants. Methods This study included 27 premature infants whose birth weights were lower than 1500 g, who were born in the period between 2011 and 2013 and had symptomatic PDA. Patients were separated into two groups: groups A and B. Group A included patients whose PDAs were closed with medical treatment ( n = 16), and group B included patients who had undergone surgical operations for PDA closure ( n = 11). Results There were no statistically significant differences between groups A and B when the groups were compared in terms of birth weight, gestational age, respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), sepsis, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and pneumothorax. Although the mortality rate was determined to be lower in group B (2 out of 11, 18.1%) than in group A (7 out of 16, 43.7%), no statistically significant difference was found between the two groups. A statistically significant increase was determined in the incidence of kidney function loss in patient group that received Ibuprofen, a medical treatment, in comparison to the patients who had surgery. Conclusion In conclusion, surgery is a safe method to repair PDA in premature LBW infants. Although there is no remarkable difference between surgery and medical treatment, we suggest that a surgical approach may be used as a first choice to repair PDA considering the lower rate of mortality and morbidity and higher rate of closure compared to medical treatment.

scholarly journals A comparative study of vacuum assisted closure dressing with conventional dressings in the management of infected wounds

2020 ◽  
Vol 8 (1) ◽  
pp. 97
Author(s):  
Karanvir Singh ◽  
Gurlal Singh Puar ◽  
Vikas Kakkar ◽  
Rana Ranjit Singh
Keyword(s):  
Hospital Stay ◽  
Wound Management ◽  
Vacuum Assisted Closure ◽  
Average Hospital ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Infected Wounds ◽  
Group A ◽  
Group B ◽  
Day By Day

Background: In the whole world including India, incidence of infected wounds is increasing day by day. Trauma is the most common cause of wounds and number of other factors contribute to wound infection there on. Wound management and care thus carry an important role for such patients in the form of dressings, debridement etc. Many conventional dressings are being used these days, but vacuum assisted closure (VAC) dressing as widely gained acceptance now.Methods: Our study was conducted on 60 patients divided in 2 groups of 30 each to compare VAC dressing with conventional dressings.Results: There was significant difference in total hospital stay, no. of debridement done, granulation tissue fill up and graft take up in both groups, for example, the average hospital stay in group A was 21.8±7.61 and in group B was 26.47±9.55.Conclusions: So, VAC dressing was found to be more beneficial and patient friendly with lesser hospital stay and thus lesser cost than conventional dressings.

scholarly journals Negative nasopharyngeal SARS-CoV-2 PCR conversion in Response to different therapeutic interventions

2020 ◽  
Author(s):  
Mohammed Hassan Shabrawishi ◽  
Abdallah Y Naser ◽  
Hassan Alwafi ◽  
Ahmad Mansoor Aldobyany ◽  
Abdelfattah Ahmed Touman
Keyword(s):  
Supportive Care ◽  
Median Time ◽  
Tertiary Hospital ◽  
Convincing Evidence ◽  
Therapeutic Interventions ◽  
Care Group ◽  
Significant Difference ◽  
Secondary Endpoints ◽  
Group A ◽  
Group B

ABSTRACTBACKGROUNDDespite lack of convincing evidence of the efficacy of hydroxychloroquine, it has been suggested to be used for the treatment of SARS-CoV-2 to accelerate the negative virus conversion. We aimed to explore the association between negative nasopharyngeal SARS-CoV-2 PCR clearance and different therapeutic interventions.METHODOLOGYThis was a retrospective cohort study of 93 patients who were admitted to medical ward with a PCR confirmed diagnosis of COVID-19 and met the inclusion criteria in a tertiary hospital in Mecca, Saudi Arabia. There were three interventional subgroups (group A (n=45): who received antimalarial drug only classified as (A1), combined with azithromycin (A2) or combined with antiviral drugs (A3)), and one supportive care group (group B) (n=48). The primary and secondary endpoints of the study were achieving negative SARS-CoV-2 nasopharyngeal PCR sample within five days or less from the start of the intervention and 12 days or less from the diagnose, respectively.RESULTSThe mean age of the patients was 43.9 years (SD:15.9). A median time of 3.00 days (IQR:2.00-6.50) needed from the time of starting the intervention/supportive care to the first negative PCR sample. There was no statistically significant difference neither between the percentage of patients in the interventional group and the supportive care group who achieved the primary or the secondary endpoint, nor in the median time needed to achieve the first negative PCR sample (p>0.05).CONCLUSIONPrescribing antimalarial medications was not shown to shorten the disease course nor to accelerate the negative PCR conversion rate.

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

Sign in / Sign up

Export Citation Format

Share Document