scholarly journals Role of magnesium sulphate in ischemic stroke

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Nabeel Ahmed Aman ◽  
Zafar Niaz ◽  
Anjum Razzaq ◽  
Ssain Shah Z Hussain ◽  
Aziz B ◽  
...  

Objective: To evaluate the role of magnesium sulphate in patients presenting with ischaemic stroke. Methods: This experimental type of interventional study was carried out at Mayo Hospital, Lahore. Within 24 hours of onset of clinically diagnosed stroke, which was later confirmed by CT scan, patients were randomized to receive either magnesium sulphate (16mmol IV over 15 minutes and 65mmol over 24 hours) or placebo. Their disability was measured by Barthel score at presentation and outcome measured after three months by death and disability and the results were compared between the two groups. Those patients who had a Barthel score of = 12 at three months were considered independent and those with a score of < 12 were considered disabled. The results were analyzed by SPSS. Results: Fifty patients were recruited in the study. 25 patients were randomized to receive MgSO4 and 25 received placebo. The Barthel score improved from 5.13.3 at presentation to 13.53.4 after three months in all the patients so the re was improvement whether MgSO4 was given or not. Patients who were randomized to receive MgSO4 had a lower Barthel score of 4.22.9 as compared to controls 5.9 3.5, but after three months they improved more than the controls gaining a score of 15.71.9 versus 11.33.2 (p=0.000). The mortality rate was not statistically different in the two groups. 88% patients had a Barthel score of > 12 at three months in the MgSO4 and 30% in the control/placebo group. Combined death and disability was 8% in MgSO4 group and 60% in the control group. Moreover MgSO4 was well tolerated. Conclusion: Magnesium sulphate therapy was safe in patients presenting with ischaemic stroke irrespective of the site of infarct. It improves prognosis regarding Barthel score at three months as well as the difference in the Barthel score at presentation and at three months. A greater percentage of magnesium treated patients led independent lives after three months.

Author(s):  
Uma H. Chourasia ◽  
Mudita Kamlesh Jain ◽  
Juzar I. Fidvi

Background: Planned induction of labor is an established part of modern obstetrics and is used as a definite form of treatment where continuation of pregnancy would be detrimental to the health of mother or fetus. The objective of this study was to evaluate the effect of mifepristone in pre-induction cervical ripening and labor induction.Methods: A total of 200 pregnant women at term with Bishop Score 4 or less were selected for this prospective randomized placebo-controlled study. The sample was equally divided into study group to receive 200 mg of mifepristone and control group to receive placebo orally for 2 days. Bishop score was assessed at every 24 hours interval till patient entered in spontaneous labor or 72 hours after 1st dose. Women who did not enter labor spontaneously, labor induction was planned with per vaginal insertion of prostaglandin (PG) E2 analogue, Dinoprostone gel 2.5 mg or PGE1 analogue Tab. Misoprostol 25 µg.Results: Ninety-six subjects in the study group and eighty-one in the control achieved successful ripening of cervix and the difference was statistically significant. Sixty-eight of study group and thirty-nine of placebo group entered in spontaneous active labor within 72 hours. Requirement of oxytocin as adjuvant treatment was significantly lower in the study group. Nineteen women of study group and fifteen of control group delivered within 24 hours, and eighty-one of study group and sixty-two of placebo delivered in 48 hours. The mean induction delivery interval was 35.53±13.67 hours in the study group, whereas it was significantly prolonged in the placebo group 50.49±20.92 hours. Eighty-two subjects of study group and seventy-eight of the control group delivered vaginally, the differences were statistically not significant.Conclusions: Mifepristone was found to be an effective agent for cervical priming prior to labor induction in women at term and significantly reduces the induction delivery interval compared with placebo.


2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.


1990 ◽  
Vol 104 (10) ◽  
pp. 801-802 ◽  
Author(s):  
P. S. Wilson ◽  
D. G. Snow ◽  
J. O'Connel ◽  
D. W. Proops ◽  
M. Barrow

AbstractIt has been suggested that children undergoing tonsillectomy would benefit from an intravenous infusion, to counteract the period of pre-operativefasting combined with the blood loss at operation.A prospective study of 50 children undergoing tonsillectomy was undertaken. The children were randomly allocated into two groups, one to receive an infusion and a control group.There were no significant differences between the two groups, although the children with an infusion had a longer mean post-operative stay.There would seem to be no role for routine intravenous fluid replacement in children undergoing uncomplicated tonsillectomy.


2021 ◽  
Vol 26 (3) ◽  
pp. 45-47
Author(s):  
Peter Michael Reil ◽  
Teodor Traian Maghiar ◽  
Karlheinz Seidl ◽  
Claudia Teodora Judea Pusta ◽  
Ciprian Borza ◽  
...  

Abstract Septic cardiomyopathy remains a difficult medical problem to manage in critically ill patients. With all currently available therapeutic options, the mortality rate in these patients remains high. Our study included 29 patients diagnosed clinically with sepsis. A control group was used to compare the results. In all patients, p53 expression was assessed in cardiac tissue obtained from these patients and a statistical correlation was made with clinical data. The different expression rates of p53 do not correlate with patient’s age, having appropriate means in years, but with an increasing tendency with increasing expression (p=0.2110). The pulmonary infections are responsible for the majority of the septic state in the study group (over 55%). The difference between the infection sites is statistically significant (p<0.0001).


Author(s):  
Morteza Saeb ◽  
Ali Mousapour ◽  
Alireza Shafiee ◽  
Seyyed Saeed Khabiri ◽  
Roya Safari-Faramani ◽  
...  

Background: The purpose of this study was to evaluate the effect of intravenous tranexamic acid (TXA) on the blood loss volume during surgery and surgeon's satisfaction in intertrochanteric fracture surgery. Methods: A total of 62 patients with intertrochanteric fracture were involved in the study and accidentally categorized into two groups. In the control or first group, patients were medicated with placebo (age: 69.2 ± 6.1 years old) and in the second group or intervention, they received 1 g injection of TXA (age: 69.7 ± 6.4 years old). Intraoperative bleeding was measured by the amount of blood in the suction bottle and amount of gauze utilized and postoperative blood loss was measured by the amount of blood in the drain 48 hours after surgery. Also, hemoglobin (Hb) levels were compared before and after surgery. In the end, the surgeon’s satisfaction was measured by Likert scale. Results: The difference in the amount of intra-operative bleeding was significant between the groups (P < 0.050). The mean number of utilized gauze in the intervention group was meaningfully less than the placebo group (P < 0.050). The mean Hb in the control group was considerably inferior to the intervention group (P < 0.050). The respect of patients in need of transfusion in the placebo group was outstandingly superior to the intervention group (P < 0.005). Surgeon satisfaction in the intervention group was considerably greater than the control group (P < 0.050). Conclusion: The use of intravenous TXA during intertrochanteric fracture surgery can reduce hemorrhage during surgery, reduce the need for blood products, and finally improve the surgeon’s satisfaction.


2008 ◽  
Vol 126 (2) ◽  
pp. 107-111 ◽  
Author(s):  
João Guilherme Bezerra Alves ◽  
Natália Dornelas Câmara Marques de Almeida ◽  
Camila Dornelas Câmara Marques de Almeida

CONTEXT AND OBJECTIVE: The role of tepid sponging to promote fever control in children is controversial. We did not find any studies reporting on the effectiveness of tepid sponging in addition to dipyrone. The aim of this study was to compare the effects of tepid sponging plus dipyrone with dipyrone alone for reducing fever. DESIGN AND SETTING: A randomized clinical trial was undertaken at Instituto Materno-Infantil Professor Fernando Figueira, Recife, Pernambuco. METHODS: Children from six months to five years old with axillary temperature greater than 38 ºC in the emergency ward between January and July 2006 were eligible. One hundred and twenty children were randomly assigned to receive oral dipyrone (20 mg/kg) or oral dipyrone and tepid sponging for 15 minutes. The primary outcome was mean temperature reduction after 15, 30, 60, 90 and 120 minutes. Secondary outcomes were crying and irritability. RESULTS: 106 children finished the study. After the first 15 minutes, the fall in axillary temperature was significantly greater in the sponged group than in the control group (p < 0.001). From 30 to 120 minutes, better fever control was observed in the control group. Crying and irritability were observed respectively in 52% and 36% of the sponged children and in none and only two of the controls. CONCLUSIONS: Tepid sponging plus dipyrone cooled faster during the first 15 minutes, but dipyrone alone presented better fever control over the two-hour period. Tepid sponging caused mild discomfort, crying and irritability for most of the children.


1952 ◽  
Vol 4 (1) ◽  
pp. 27-45 ◽  
Author(s):  
James A. Dinsmoor

Twelve white rats learned to press a bar or lever when this act was intermittently followed by pellets of food. Once a stable rate of pressing had been established, the animals were subjected to electric shock as a punishment for each response during alternate five minute periods within the experimental session. A difference in rates during the safe and punished phases was manifested both by the experimental group (8 rats), who were provided with a light as a signal when it was safe to respond, and also, contrary to expectation, by the control group (4 rats), who continued in darkness throughout the session. The differential responding by the control group was greatly reduced, however, when the duration of each phase was reduced from five minutes to one. The investigation was then continued to determine the role of some of the other factors in the situation. Increasing the severity of the shock increased the difference between the light and the dark rates. Withholding the pellets of food reduced the overall rates but did not affect the light-dark discrimination. Withholding the shock, on the other hand, permitted an increase in rate and caused the animals to lose their discrimination; when food had previously been withheld, however, so that the rate of response was relatively low, this deterioration in the discrimination was not as rapid as before. Restoration of the discrimination training under a lower hunger drive confirmed the finding that the formation of the discrimination was quite rapid and showed that the level of drive did not affect the proportionality between the rates in the light and in the darkness. These findings were interpreted by comparing the current procedure with those previously used in studies of avoidance reactions and conflict.


Author(s):  
L. I. Mostovaya ◽  
E. P. Krivoschekov ◽  
E. B. Elshin ◽  
V. E. Romanov ◽  
M. Y. Khoroshilov

Purpose. Study of the influence of psychotherapeutic assistance on the rehabilitation of persons who have undergone limb amputation.Materials and methods. A study of the psychological characteristics of 48 patients who underwent amputation of the lower extremity was carried out on the basis of the departments of vascular surgery and traumatology of the Samara Seredavin Regional Clinical Hospital. The control group included 25 people (16 men, 9 women), aged 45 to 70 years. Amputations of the extremities were performed by him in connection with the developed gangrene due to obliterating vascular diseases. The main group consisted of 23 people (14 men, 9 women) aged 35 to 60 years with a stable and prosperous social status, who received an acute sudden injury that ended in amputation of one or both lower extremities. The examination was carried out on the 3-5th day of the postoperative period, depending on the patient's condition. For the study, the following psychodiagnostic methods and techniques were used: 1) clinical conversation; 2) coping test by R. Lazarus, S. Folkman; 3) methodology for diagnosing the type of attitude to the disease; 4) Hamilton Depression Scale; 5) S. Rosenzweig's test of drawing frustration.Results. The difference between the group of patients and the control group was statistically confirmed in terms of “seeking social support” (higher in the control group), “confrontation” and “flight – avoidance” (higher in the group of patients) (p < 0.05). In the control group, depression is absent in 85% of the subjects, in 15% of patients there is a mild depressive state (p < 0.05). According to S. Rosenzweig's method, the predominance of extrapunitive reactions was revealed in both groups (E = 59.6 in the main group of patients and 44.1 in the control group) due to reactions of the ego-protective type (ED = 56.2 in the main group of patients and 46.3 – in the control group).Conclusion. Patients who underwent surgery for limb amputation and who took a conscious and active part in individual and group psychotherapy by the time of discharge from the hospital showed a decrease in anxiety and depressive manifestations, a decrease in the manifestations of outward aggression, the construction of optimistic prospects) than in patients who categorically refuse to receive psychological help and support. The provision of psychotherapeutic assistance to persons after amputation of limbs should begin in the first days after the operation. 


2012 ◽  
Vol 8 (1) ◽  
pp. 12-14
Author(s):  
Ashia Ali ◽  
Md Kamrul Hassan ◽  
Mostofa Nuruzzaman ◽  
Sumsu Zzaman ◽  
Mostafizur Rahman ◽  
...  

To assess the role of magnesium sulphate infusion after coronary artery bypass graft (CABG) surgery in  preventing atrial arrhythmias that may occur following CABG operation. Cardiac anaesthesia wing of   Bangabandhu Sheik Mujib Medical University, Dhaka from 2007 to 2009. Design: Prospective randomized  non blined. All patients under going primary CABG surgery and having sinus rhythm before surgery were alternatively randomized into the study or control group. Patient with history of Atrial Fibrillation (AF), Left   Atrial (LA) dysfunction, renal-impairment and implanted pace maker were excluded from the study. The patients in the study group received 10 mmol of magnesium (2.47gm) in 10 ml saline intravenously over 10 min after termination of Cardio Pulmonary Bypass (CPB). The end point was development 0f AF for 10 min   or if an episode of AF had to be treated because of symptoms. A total of 60 patients were included in the study 30 in each group. The incident of AF was 14% in patients who received single dose of magnesium. The  patients without magnesium had an AF incidence of 20% (p=0.353) not significant. Single dose magnesium infusion does not prevent AF statistically, but the haemodynamic parameters in patients receiving magnesium were more stable during the whole period of observation. DOI: http://dx.doi.org/10.3329/uhj.v8i1.11661 University Heart Journal Vol. 8, No. 1, January 2012


2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Alijan Ahmadi Ahangar ◽  
Payam Saadat ◽  
Sona Niroomand ◽  
Shayan Alijanpour ◽  
Reza Sohrabnezhad ◽  
...  

Background. Stroke is the second leading cause of death worldwide. The role of zinc as a new predictor of stroke was considered. Methods. This prospective study was conducted in Ayatollah Rouhani Hospital within a year on 100 stroke and 100 control patients. Findings. The difference in zinc serum level in two groups was significant (deficiency: 3 (3%) in patients versus 20 (20%) in control group, normal: 25 (25%) versus 54 (54%), and increased level: 72 (72%) versus 26 (26%); p<0.001). Difference in zinc serum levels was statistically significant with ischemic heart disease (deficiency: 0 cases (0%), normal: 8 cases (24%), increased level: 24 cases (75%), p=0.003). Increases in zinc serum level were significantly correlated with the frequency of hemorrhagic and ischemic patients (deficiency: 3 (3.3%) hemorrhagic versus 0 (0%) ischemic; normal: 19 (21%) versus 6 (60%), increased level: 68 (75.6%) versus 4 (40%); p=0.025). Regression logistics showed that ischemic heart disease (p<0.001; OR = 28.29, %95 CI: 5.53; 144.87), hyperlipidemia (p<0.001; OR = 0.26, %95 CI: 0.12; 0.56), and zinc serum level (p<0.001, OR = 15.53, %95 CI: 4.03; 59.83) each had a significant role. Conclusions. Babol stroke patients are prone to increased zinc serum level as a new parameter. Ischemic heart disease, increased levels of zinc, and hyperlipidemia were found to be probable predictor factors for stroke in Babol.


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