A prospective study to compare the efficacy of noradrenaline verses terlipressin in hepatorenal syndrome in patients with advanced cirrhosis

Background: Hepatorenal syndrome (HRS) is functional renal failure occurring in advanced stage liver disease associated with poor prognosis. The best treatment is liver transplantation. Terlipressin is effective in treatment of HRS but noradrenaline has been suggested as cheaper and readily available alternative and we aimed to compare the efficacy of noradrenaline and terlipressin in patients with HRS.Methods: 30 patients were allocated to each group and group A received infusion of noradrenaline at dose of 0.5 mg/hr (maximum 3 mg/hr) and group B received terlipressin at dose 1 mg intravenously 6 hourly until reversal of HRS or completion of 7 days of therapy. Intravenous albumin (20 g/day) was given to both groups. Decrease in serum creatinine and increase in daily urine output and mean arterial pressure (MAP) helped us in comparison.Results: Out of 60 cirrhotics screened, 51 were randomised into group A (N=22) or group B (N=29). Baseline characteristics of both groups were similar. In group A, 0% showed complete response while 31.8% showed partial response but majority (68.2%) showed no response. In group B, 89.7% showed complete response and 6.9% showed partial response. Decrease in serum creatinine in both groups (group A- 3.91±1.58 mg/dl to 3.07±1.68 mg/dl; group B- 3.21±1.24 mg/dl to 1.36±0.87 mg/dl). Both groups showed an increase in MAP (group A- 76.93±6.18 mmHg to 89.49±6.93 mmHg; group B- 75.54±5.51 mmHg to 89.92±5.07 mmHg).Conclusions: Noradrenaline was not as effective as terlipressin in treatment of HRS.

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COMPARATIVE STUDY IN BETWEEN INTRALESIONAL VITAMIN D3 AND INTRALESIONAL BLEOMYCIN IN THE TREATMENT OF CUTANEOUS VERRUCAE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1372 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Shrikant . ◽

R.D. Mehta ◽

B.C. Ghiya

Keyword(s):

Partial Response ◽

Comparative Study ◽

Recurrence Rate ◽

Vitamin D3 ◽

Complete Response ◽

Recurrence Rates ◽

Additional Advantage ◽

Cost Effective Treatment ◽

Group A ◽

Group B

Background: Verruca is one of the common dermatopathologies which has multiple therapeutic options but with variable success rates, refractory cases and high recurrence rates. Nowadays, treatment with intralesional injections has gained recognition due to its effectiveness in clearing verrucae. These act by stimulating the cell-mediated immunity. Out of scores of options available for intralesional therapeutics, Vitamin D3 appears to be more promising but least evaluated. Therefore, we planned to evaluate the efficacy of intralesional Vitamin D3 in various types of cutaneous verrucae. Simultaneously the results were compared with intralesional bleomycin, also. Methods: A total of 200 patients of cutaneous verrucae with varying size and duration were included in the experimental randomized comparative study. We divided them into two groups. Group A, comprising of 100 patients, received 0.2-0.5 ml intralesional Vitamin D3 (600,000 IU, 15mg/ml) and Group B, also of hundred subjects, received intralesional Bleomycin (1 mg/ml) into the base of verrucae. A maximum of 5 verrucae were injected per session at 3 weeks interval until resolution or for a maximum of 4 sessions. Patients were followed up for 6 months after the last injection to assess the clearance status and detect any recurrence. Results: In Group A (Vitamin D3), 'Complete response', 'Partial response' and 'No response' were observed in 85.07%, 6.74% and 8.17% respectively after 4 sessions. Recurrence rate was 0.81% after 6 months. In Group B (Bleomycin), 'Complete response', 'Partial response' and 'No response' were found in 77.99%, 10.47% and 11.53% in the series. Recurrence rate was 1.71%, comparatively higher in group B. Conclusion: The efficacy of intralesional Vitamin D3 was found significantly higher as compared to intralesional Bleomycin in the treatment of cutaneous verrucae with less recurrence rates. Vitamin D3 has an additional advantage of cost-effective treatment over Bleomycin. We purpose its use, as a primary mode of treatment in various types of cutaneous verrucae. Keywords: Bleomycin, Vitamin D3, Verrucae.

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Comparative clinical evaluation of effect of topical verses systemic anti -allergic drug in allergic rhinitis: a prospective study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175615 ◽

2017 ◽

Vol 4 (1) ◽

pp. 141 ◽

Cited By ~ 1

Author(s):

Sunil Kumar Singh Bhadouriya ◽

Mohit Srivastava ◽

Rohit Saxena ◽

Abhinav Srivastava

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Nasal Spray ◽

Complete Response ◽

Group A ◽

Group B ◽

A Prospective Study ◽

Histopathological Results ◽

Post Therapy

Background: Nasal passages form one of the chief sources of contact of the human with his environment. Hence, it is natural that the mucosa of the area is the victim of assault with multitudes of potential allergens. Allergic rhinitis is an inflammatory disease with worldwide prevalence of 10-40%. Allergic rhinitis is a disease with low mortality but significantly lowers the quality of life and functioning. Both oral and intranasal antihistamines are approved for the first-line treatment of allergic rhinitis and both formulations result in a reduction in symptoms and an improvement in quality of life. Methods: The following study was designed to assess the efficacy and safety of the azelastine nasal spray in comparison to levocetrizine in patients with allergic rhinitis. Out of the 68 patients, 34 cases were treated with topical azelastine (group A), while remaining 34 with systemic levocetrizine (group B). The effects of anti-allergic drugs have been studied on the basis of relief of symptoms and change in histopathology. Results: The effect of levocetrizine has been studied on the basis of relief of symptoms and change in histopathology and found to have complete response in 58% and fair response in 23.5% patients of allergic rhinitis. The effect of topical azelastine nasal spray have complete response in 70.5% and fair response in 23.5% patients of allergic rhinitis. Conclusions: Comparing the post therapy clinical and histopathological results in this study, azelastine nasal spray was found to be more effective and safe in the treatment of allergic rhinitis than levocetrizine.

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Comparison of the efficacy of 3-weekly chop with CHOEP for treatment of patients with aggressive non-Hodgkin’s lymphoma.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.03.4104 ◽

2020 ◽

Vol 27 (03) ◽

pp. 631-634

Author(s):

Tahir Mehmood ◽

Muhammad Khalid ◽

Nasir Mehmood ◽

Shahbaz Ahmed ◽

Saeed Ahmed ◽

...

Keyword(s):

Partial Response ◽

Hodgkin’S Lymphoma ◽

Complete Response ◽

Hodgkin's Lymphoma ◽

Female Patients ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Group A ◽

Group B

Objectives: To compare the efficacy of 3-weekly CHOP with CHOEP for the treatment of patients with aggressive Non-Hodgkin’s Lymphoma. Study Design: Randomized control trial. Setting: Department of Medical Oncology, Jinnah Hospital Lahore. Period: From January 2016 to June 2016. Material & Methods: Conducted on 200 patients of biopsy confirmed aggressive non-Hodgkin’s lymphoma. The cases were allocated into two groups by using random numbers table i.e. group A & B having 100 patients each. Group A received CHOP-21 regimen which is defined as cyclophosphamide (750mg/m2 intravenously), doxorubicin (50mg/m2 intravenously), vincristine (2mg i/v) & prednisone (100mg/m2 d1-5 PO). Group B received CHOEP-21 regimen which is defined same as CHOP-21 but with the addition of etoposide 100mg/m2 intravenously for day 1-3. Observation regarding efficacy was including all the number of cases in which complete remission of disease was noted one month after completion of chemotherapy. Results: The mean age of the patients in group A was 44.6±13.9 years and in group B was 45.6±11.5 years. In group A, 74 (74%) male and 26 (26%) female patients and in group B, 72 (72%) male and 28 (28%) female patients. In the distribution of patients by complete response after 6 cycles, in group A, 66 (66%) patients had complete response, 30 (30%) patients had partial response, 1 (1%) patient expired, 2 (2%) patients had progressive disease (shifted to salvage therapy) and 1 (1%) patient lost the follow up. In group B, 80 (80%) patients had complete response, 16 (16%) patients had partial response, 2 (2%) patients expired, and 2 (2%) patients lost the follow up. Conclusion: It is concluded from this study that viability was accomplished in a greater number of patients treated with CHOEP-21 than those treated with CHOP-21 in the management of patients with aggressive Non hodgkin's lymphoma.

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Combined radiation and chemotherapy for invasive transitional-cell carcinoma of the bladder: a prospective study.

Journal of Clinical Oncology ◽

10.1200/jco.1993.11.11.2150 ◽

1993 ◽

Vol 11 (11) ◽

pp. 2150-2157 ◽

Cited By ~ 224

Author(s):

M Housset ◽

C Maulard ◽

Y Chretien ◽

B Dufour ◽

S Delanian ◽

...

Keyword(s):

Bladder Cancer ◽

Radiation Therapy ◽

Conservative Treatment ◽

Prospective Study ◽

Transitional Cell ◽

Complete Response ◽

Invasive Bladder Cancer ◽

Group A ◽

Group B ◽

A Prospective Study

PURPOSE To improve the results obtained by cystectomy alone and to determine the possibilities of conservative treatment in invasive bladder cancer, we designed a prospective study using a combination of fluorouracil (5-FU) plus cisplatin and concomitant radiation therapy, followed by either cystectomy or additional chemoradiotherapy. PATIENTS AND METHODS Fifty-four patients with stage T2 to T4 operable untreated invasive bladder cancer were entered onto the study. Treatment was begun in all patients by transurethral resection (TUR) and followed by the 5-FU-cisplatin combination with concomitant bifractionated split-course radiation therapy. A control cystoscopy was performed 6 weeks after completion of the neoadjuvant program. Patients with persistent tumor underwent cystectomy. Complete responders were treated by either additional chemoradiotherapy (group A) or cystectomy (group B). RESULTS At control cystoscopy, 40 of 54 patients (74%) had a histologically documented complete response. Four responders developed recurrent pelvic disease after a mean follow-up time of 27 +/- 12 months (three in group A and one in group B). Metastatic disease, which developed in 16 patients, occurred more frequently in the nonresponders (71%) than in responders (15%). The disease-free survival rate at 3 years was 62%; it was significantly better in responders (77%) than in nonresponders (23%). There was no difference in survival between groups A and B. CONCLUSION This neoadjuvant chemoradiotherapy combination, easy to implement and well tolerated even in elderly patients, provides a high complete response rate. It may prove to be effective in inoperable patients and may be proposed as conservative treatment in patients with a complete response to the initial course of chemoradiation.

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ML-07 R-MPV-A THERAPY FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA IN THE ELDERLY: OUTCOME AND PROBLEM

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.149 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii33-ii33

Author(s):

Hirotaka Fudaba ◽

Yasutomo Momii ◽

Kouhei Onishi ◽

Daigo Asou ◽

Minoru Fujiki

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Partial Response ◽

Central Nervous System Lymphoma ◽

Whole Brain Radiotherapy ◽

Complete Response ◽

The Other ◽

Brain Radiotherapy ◽

Group A ◽

Group B

Abstract PURPOSE R-MPV-A therapy has recently been reported to improve the outcomes of primary central nervous system lymphoma (PCNSL). Our patients have received R-MPV-A therapy since 2017 and elderly patients have only been treated with whole brain radiotherapy when they do not show a complete response after induction chemotherapy. We report the therapeutic outcomes and problems of elderly PCNSL patients treated with R-PMV-A. MATERIALS & METHODS Eight newly diagnosed PCNSL patients received R-MPV therapy from September 2017 to June 2019. We retrospectively reviewed the cycles of R-MPV therapy, radiotherapy, consolidation high-dose Ara-C (HD-Ara-C) therapy, and the G8 score (a geriatric assessment). RESULTS Patients were divided into three groups: Group A (71–75 years; n=2), Group B (76–80 years; n=4), and Group C (>81 years; n=2). All Group A patients finished 5 cycles of R-MPV therapy, showed a complete response, and underwent consolidation HD-Ara-C therapy. Two Group B patients showed a complete response on R-MPV therapy. One of the other patients showed a partial response after 3 cycles of R-MPV therapy, and a >3 kg reduction in body weight. The patient’s G8 score was 12 points. Whole brain radiotherapy (23.4 Gy) was administered followed by local radiotherapy (21.6 Gy). One patient showed a partial response after 7 cycles of R-MPV therapy and started radiotherapy. One Group C patient received radiotherapy after 3 cycles of R-MPV because of a new lesion. The other Group C patient showed acute renal damage after 3 cycles of R-MPV. CONCLUSION R-MPV-A therapy was relatively safe for our elderly PCNSL patients. Notably, patients >76 years of age sometimes had severe adverse effect with increased R-MPV cycles. A promising therapeutic strategy based on age and geriatric assessment is needed.

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AB0393 EFFICACY OF HYDROXYCHLOROQUINE FOR LUPUS NEPHRITIS IN MAINTENANCE PHASE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5378 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1496.2-1496

Author(s):

M. Watanabe ◽

Y. Haji ◽

M. Kato ◽

T. Ito ◽

Y. Banno ◽

...

Keyword(s):

Lupus Nephritis ◽

Lupus Erythematosus ◽

Therapeutic Option ◽

Maintenance Phase ◽

Base Line ◽

Prednisolone Dose ◽

Daily Urine ◽

Group A ◽

The Mean ◽

Group B

Background:Hydroxychloroquine (HCQ) is an essential drug for systemic lupus erythematosus. But in Japan, chloroquine and HCQ remain unavailable until mid 2015 because of a series of lawsuits about its retinal toxicity in the 1970s. There is insufficient knowledge regarding renal protective effect of HCQ.Objectives:We aimed to investigate its efficacy of adding HCQ for Lupus nephritis (LN) as a maintenance-phase therapy.Methods:We conducted an observational retrospective cohort study included patients with LN (n=42) in maintenance-phase in Japan. We reviewed medical records of LN patients aged > 18 years who were initiated HCQ from May 2015 to May 2018. Maintenance phase was defined as stabilization in serum creatinine and urinary segment after induction therapy and who achieved complete or partial remission. The annual change of proteinuria was compared between patients on HCQ who have proteinuria (>0.5g/gCr) or not. Other outcome measures were disease flare, dose of steroids, renal and immunologic features.Results:A total of 42 patients were analyzed and allocated to two groups based on their amount of daily urine protein level: HCQ with proteinuria as group A (>0.5g/gCr, n=14) and HCQ without proteinuria as group B(≦0.5g/gCr, n=28). Both groups were comparable, with mean (SD) age of 36.1 (12.9) years and 37.5 (13.8), female 78.6% and 92.9% in each group, mean (SD) disease duration until HCQ of 3.5 (3.25) and 3.3 (2.9) years in group A and group B, with prednisolone dose at base line of 10.3 (7.1) mg and 7.9 (4.4) mg, respectively. The mean (SD) proteinuria at base line was 1.38 (1.11) g/gCr in group A and 0.20 (0.09) g/gCr in group B and after 12 months, proteinuria decreased in group A (-1.34 g/gCr in group A vs +0.03 g/gCr in group B; p<.001;95% CI,0.305-0.736). No relapse was experienced in group A during the study period.Conclusion:In patients with clinically stable LN but with proteinuria, hydroxychloroquine is a good therapeutic option for achievement of complete remission.Disclosure of Interests:None declared

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CLINICAL OUTCOME AND COST COMPARISON OF CARPAL TUNNEL WOUND CLOSURE WITH MONOCRYL® AND ETHILON®: A PROSPECTIVE STUDY

Hand Surgery ◽

10.1142/s0218810413500226 ◽

2013 ◽

Vol 18 (02) ◽

pp. 189-192 ◽

Cited By ~ 1

Author(s):

Anis Dosani ◽

Sameer K. Khan ◽

Sheila Gray ◽

Steve Joseph ◽

Ian A. Whittaker

Keyword(s):

Carpal Tunnel ◽

Wound Closure ◽

Unit Cost ◽

Cost Effective ◽

Cost Comparison ◽

Absorbable Suture ◽

Significant Difference ◽

Group A ◽

Group B ◽

A Prospective Study

This prospective non-randomised two-cohort study compares the use of an absorbable suture (Poliglecrapone [Monocryl]: Group A) and a non-absorbable suture (Polyamide [Ethilon]: Group B) in wound closure after elective carpal tunnel decompression. The primary outcome was scar cosmesis as assessed by the Stonybrook Scar Evaluation Scale (SBSES); the financial cost of wound closure was compared as a secondary outocome. All fifty patients completed follow-up. At six weeks, there was no significant difference in the two groups regarding scar tenderness (p = 0.5), although residual swelling was more evident in the absorbable group (p = 0.2). The mean SBSES score at six weeks was 4.72 in Group A, and 4.8 in Group B (p = 0.3). The unit cost per closed wound of Monocryl was three times than Ethilon (p < 0.05). Ethilon is thus cost-effective without compromising the cosmetic outcome, and we recommend using this as the preferred suture for closure of carpal tunnel wounds.

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A PROSPECTIVE STUDY TO ANALYSE THE SIDE EFFECTS OF OLMESARTAN MEDOXOMIL AND ENALAPRIL IN HYPERTENSIVE SUBJECTS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i12.25460 ◽

2018 ◽

Vol 11 (12) ◽

pp. 258

Author(s):

Parminderpal Singh ◽

Kiranjit Kiranjit

Keyword(s):

Drug Therapy ◽

Side Effects ◽

Postural Hypotension ◽

Olmesartan Medoxomil ◽

National Commission ◽

Group A ◽

Group B ◽

Taste Alteration ◽

A Prospective Study

Objective: The present study was aimed to analyze the side effects of olmesartan medoxomil and enalapril in hypertensive subjects.Methods: The study consisted of newly diagnosed hypertension categorized according to 7th report of Joint National Commission on prevention, detection, evaluation, and treatment of high blood pressure. The subjects were divided into two groups. The Group A subjects received olmesartan, and Group B subjects received enalapril. Pressure was recorded both in supine and sitting positions. The appearance of side effects was observed in the follow-up, i.e., dry cough, headache, postural hypotension, angioedema, dizziness, skin rashes, taste alterations, and urticaria. A statistical data were prepared on the basis of information obtained and analyzed thoroughly for antihypertensive effects and side effects of olmesartan and enalapril. SPSS software was used for analysis.Results: There was observed an increase in the incidence of taste alteration with drug therapy in Group B (Enalapril). There was observed an increase in the incidence of postural hypotension with drug therapy in both groups. In Group A (Olmesartan), the incidence of postural hypotension at the beginning of trial, 4 weeks, and 8 weeks was 0%, 2%, and 2%, respectively. In Group A (Olmesartan), there was no incidence of a headache at the beginning of trial, at 4 weeks and 8 weeks.Conclusion: From the study, it can be concluded that both olmesartan and enalapril are effective in Stage I and Stage II hypertension, but olmesartan is tolerated well with lesser side effects.

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Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins

Twin Research and Human Genetics ◽

10.1375/twin.14.5.457 ◽

2011 ◽

Vol 14 (5) ◽

pp. 457-462 ◽

Cited By ~ 21

Author(s):

Boaz Weisz ◽

Liat Hogen ◽

Yoav Yinon ◽

Liat Gindes ◽

Alon Shrim ◽

...

Keyword(s):

Perinatal Outcome ◽

Umbilical Artery ◽

Perinatal Outcomes ◽

Monochorionic Twins ◽

Group A ◽

Umbilical Artery Doppler ◽

Group B ◽

A Prospective Study ◽

Gestational Age At Birth ◽

Twin Pregnancies

Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.

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Phase I/II Study of Ipilimumab for Patients With Metastatic Melanoma

Journal of Clinical Oncology ◽

10.1200/jco.2008.16.1927 ◽

2008 ◽

Vol 26 (36) ◽

pp. 5950-5956 ◽

Cited By ~ 313

Author(s):

Jeffrey S. Weber ◽

Steven O’Day ◽

Walter Urba ◽

John Powderly ◽

Geoff Nichol ◽

...

Keyword(s):

Phase I ◽

Metastatic Melanoma ◽

Complete Response ◽

Pharmacokinetic Profile ◽

Maximum Tolerated Dose ◽

Primary Objective ◽

Clinical Activity ◽

Multiple Doses ◽

Group A ◽

Group B

PurposeThe primary objective of this phase I/II study was to determine the safety and pharmacokinetic profile of either transfectoma- or a hybridoma-derived ipilimumab. Secondary objectives included determination of a maximum-tolerated dose and assessment of clinical activity.Patients and MethodsEighty-eight patients with unresectable stage III or IV melanoma with at least one measurable lesion were treated. Mean age was 59 years, with 65% male and 35% female patients, and 79% of patients had received prior systemic therapy. Single doses of ipilimumab up to 20 mg/kg (group A, single dose), multiple doses up to 5 mg/kg (group A, multiple dose), and multiple doses up to 10 mg/kg (group B) were administered.ResultsSingle dosing up to 20 mg/kg of transfectoma antibody was well tolerated, as were multiple doses up to 10 mg/kg without a maximum-tolerated dose. In group B, dose-limiting toxicity was seen in six of 23 melanoma patients. Grade 3 or 4 immune-related adverse events (irAEs) were observed in 14% of patients (12 of 88 patients), and grade 1 or 2 irAEs were seen in an additional 58%. The half-life of ipilimumab was 359 hours. In group B, there was one partial response (23+ months), one complete response (21+ months), and seven patients with stable disease (SD), for a disease control rate of 39%. Two patients in group B with SD had slow, steady decline in tumor burden that was ongoing at 1 year of observation.ConclusionIpilimumab has activity in patients with metastatic melanoma. Late responses were observed in patients with prolonged SD.

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