Hyperbaric oxygenation in prevention of amputations of diabetic foot

Background/Aim. Diabetic foot is the term for the pathological changes on foot in patients with diabetes. It is caused by diabetic angiopathy, polyneuropathy and osteoarthropathy. The treatment is complex and long-term and often leads to the loss of the extremity. The appliance of hyperbaric oxygen therapy (HBOT) has a lot more important place in adjuvant treatment of this disease. The aim of this study was to determine the influence of HBOT on the wound healing in comparison with the conventional treatment, the possibility of shortening the time of the treatment in patients with diabetic foot. Methods. In a fiveyear period a retrospective-prospective multicentric study, involving 60 patients with diabetic foot divided into two groups, was performed. The first group (group A) consisted of 30 patients treated by combined therapy (with medications, surgical therapy and HBOT). All the patients were receiving HBOT in the Special Hospital for Hyperbaric Medicine, CHM Hollywell-Neopren in Belgrade. The control group (group B) also consisted of 30 patients treated with medications and surgical therapy, but without HBOT. Results. The demographic data, the types of diabetes, as well as the Wagner classification stage of diabetic ulcers and radiography scans of changes in bones were equal in both groups. The median healing time of the Wagner grade III ulcer in the group A was 37.36 days [mean ? standard deviation (SD) = 65.6 ? 45.8 days], and in the group B 99.78 days (mean ? SD = 134.8 ? 105.96 days) and it was statistically significant (p = 0.074). The median time of recovery in patients of the group A with the Wagner grade IV was 48.18 days (mean ? SD = 49.7 ? 33.8 days), and in the group B 85.05 days (mean ? SD = 86.7 ? 71.6 days) and that was statistically significant (p = 0.121). The foot amputations were performed in both groups in 3 (10%) patients. In the group A there were no high amputations, whereas in the group B there were 4 (13.33%) below-knee amputations and 4 (13.33%) above-knee amputations which was highly statistically significant (p < 0.0001). Conclusion. In this study, HBOT definitely showed positive adjuvant role in the treatment of diabetic foot. For the good treatment result it is essential the timely and successful surgical treatment of the ulcer and the use of bandage with the healing dressings. In case of the clear signs of local infection, the antibiotic therapy according to the antibiogram is necessary.

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The Comparative Effects of Listening to Prayer Recitation and Music Therapy Intraoperatively on Postoperative Pain

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v17i2.277 ◽

2020 ◽

Vol 17 (2) ◽

Cited By ~ 1

Author(s):

Farah Syaza Rahman ◽

Nurlia Yahya ◽

Nor Mohammad Md Din ◽

Azarinah Izaham ◽

Wan Rahiza Wan Mat

Keyword(s):

Blood Pressure ◽

Postoperative Pain ◽

Music Therapy ◽

Demographic Data ◽

Control Group ◽

Pharmacological Interventions ◽

Heart Rates ◽

Pain Scores ◽

Group A ◽

Group B

Introduction: Non-pharmacological interventions are considered as successful adjuncts to manage pain. We are studying the comparative effects of listening to prayer recitation and music therapy intraoperatively as non-pharmacological interventions on postoperative pain and intraoperative haemodynamics. Materials and Methods: Seventy two muslim patients with acute appendicitis requiring open, emergency appendicectomies under general anaesthesia were recruited and randomised into three groups: Group A: patients who listened to prayer recitation, Group B: patients who listened to music, Group C: control group - patients who did not listen to any prayer or music. Intraoperative blood pressure, heart rate and postoperative pain scores were monitored. Results: The demographic data, pre- and post-headphones application haemodynamics were compared. There were significantly lower heart rates at 10, 20, 30, 40, 50, 60 minutes for Group A and at 50 and 60 minutes for Group B patients when compared to Group C. Significant reduction in postoperative pain scores were seen in Group A patients at 30 minutes and 8 hours as compared to Group C patients. No significant differences in pain scores were seen between Group B and C patients. No significant differences in additional analgesic requirements postoperatively were seen in all three groups. Conclusion: Listening to prayer recitation or music intraoperatively significantly lowered intraoperative heart rates, however only prayer recitation significantly reduced postoperative pain scores as compared to the control group.

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Increased Severity of Complications After Therapeutic ERCP in Geriatric Patients With Chronic Pancreatitis: An Observational Study

10.21203/rs.3.rs-183025/v1 ◽

2021 ◽

Author(s):

Ji-Yao Guo ◽

Wen-Bin Zou ◽

Jia-Hui Zhu ◽

Nan Ru ◽

Jun Pan ◽

...

Keyword(s):

Chronic Pancreatitis ◽

Observational Study ◽

Success Rate ◽

Geriatric Patients ◽

Demographic Data ◽

Female Gender ◽

Control Group ◽

Group A ◽

Therapeutic Ercp ◽

Group B

Abstract Background: Studies of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in geriatric patients have mainly examined patients with biliary diseases, rather than chronic pancreatitis (CP). This study aimed to evaluate the safety and success rate of therapeutic ERCP in geriatric patients with CP. Methods: This was an observational study from prospectively collected data. The medical records of patients with CP aged over 65 years (Group A) were collected in a tertiary hospital from January 2013 to December 2018. Sex-matched CP patients under 65 years (Group B) were randomly selected into the control group (matching ratio = 1:2). Collected data included demographic data, endoscopic findings, interventions, success, and complications. The success rate and the complication rate of therapeutic ERCP in two groups were compared with chi-square test. The risk factors for post-ERCP pancreatitis were investigated by univariate and multivariate analysis.Results: A total of 268 ERCPs were performed in 179 patients of Group A and 612 ERCPs in 358 patients of Group B. The success rate of ERCP in Group A was similar to that of Group B (92.16% vs 92.32%; P=0.936). The overall incidence of post-ERCP complications was 7.09% (19/268) and 5.72% (35/612) in Group A and B, respectively (P=0.436). However, geriatric patients had a significantly increased occurrence of moderate to severe complications (2.61% vs 0.16%; P=0.002). Female gender (OR=3.40; 95% CI, 1.02-11.31; P=0.046), pancreas divisum (OR=7.15; 95% CI, 1.01-50.62; P=0.049), dorsal pancreatogram (OR=7.40; 95% CI, 1.63-33.64; P=0.010), and lithotripsy (OR=0.15; 95% CI, 0.03-0.70; P=0.016) were significantly associated with risk of post-ERCP pancreatitis in geriatric patients.Conclusions: Therapeutic ERCP is safe and feasible in elderly patients with CP. However, occurrence of moderate to severe complications after ERCP increased in geriatric patients.Trial registration: retrospectively registered.

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COMPARATIVE ANALYSIS OF CLOSED REDUCTION AND EXPERT TIBIA NAILING WITH OPEN REDUCTION AND PLATE & SCREW FIXATION IN THE TREATMENT OF PROXIMAL TIBIA EXTRAARTICULAR FRACTURES

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v2i6.38 ◽

2018 ◽

Author(s):

Anil Pandey ◽

Setul Shah ◽

Deepak S Maravi ◽

S Uikey

Keyword(s):

Intramedullary Nailing ◽

Closed Reduction ◽

Proximal Tibia ◽

Plate Fixation ◽

Surgical Site Infections ◽

Delayed Union ◽

Large Sample Size ◽

Multicentric Study ◽

Group A ◽

Group B

Introduction:- Extra-articular proximal tibial fractures account for 5–10 % of all tibial shaft fractures and it result from high-velocity trauma. Closed reduction with minimally invasive plating and locked intramedullary nailing have been widely used for treatment of proximal tibia extraarticular fractures. Our pupose is to compare the pros and cons of these two methods. Materials and methods:- 22 patients were included in this study for a period of 2 years. Patients treated with IMN were kept in group A patients treated with percutaneus plating were kept in group B. Standard approach of nailing and plating were used and proper follow up were taken for next upcoming 1 year. Results:- Combined average age was 38years. Male were more commonly affected than female (13:8). Majority of fracture were of type A33. Operative time was < 2 hours in both groups. Less blood loss occurred during intramedullary nailing as compared to locking plate fixation. Surgical site infections (SSIs) were seen in two patients in the PTP group. Delayed union occurred in two patients in the IMN group. The average range of motion was 119.7(range 90-150, SD= 19.18) in group A and 115.2(range 80-150, SD = 17.28) in group B. Conclusion:- in treatment of proximal tibia extra articular fracture use of IMN and PTLCP gives comparable results. To validate this issue further a large sample size multicentric study is recommended Key words: intramedullary nailing (IMN), Extraarticular tibialn fracture, Surgical site infection.

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Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

Current Clinical Pharmacology ◽

10.2174/1574884715666200302122800 ◽

2020 ◽

Vol 15 ◽

Author(s):

Arash karimi ◽

Jahanbakhsh Nejadi ◽

Mahnaz Shamseh ◽

Nooshin Ronasi ◽

Mehdi Birjandi

Keyword(s):

Cesarean Section ◽

Spinal Anesthesia ◽

Postoperative Nausea ◽

Demographic Data ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Elective Cesarean Section ◽

Double Blind ◽

Group A ◽

Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

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Clinical effect of Suvarna Bindu Prashan

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i3.8203 ◽

2017 ◽

Vol 2 (3) ◽

Cited By ~ 1

Author(s):

Patil Aniket ◽

Dindore Pallavi ◽

Arbar Aziz ◽

Kadam Avinash ◽

Saroch Vikas

Keyword(s):

Physical Health ◽

Eating Habits ◽

Control Group ◽

Inform Consent ◽

Significant Difference ◽

Group A ◽

Group B ◽

Immune Booster ◽

Mental And Physical Health ◽

Apparently Healthy

The quest for excellence in mental and physical health is not new. We find various references and formulations in Ayurvedic classics meant for promoting mental and physical health of a child. Suvarna Prashan is one of the formulations explained in age old Ayurvedic classic Kashyap Samhita. This formulation is very widely used now days as a memory and immune booster for children. But there is very little systematic documented study which can be used to evaluate the efficacy of the formulation. Suvarna Bhasma was prepared in Ayurved Rasayani Pharmacy, Pune. Madhu and Ghrita were collected from KLE Ayurveda Pharmacy, Belgaum. Suvarna Bindu Prashan was prepared in KLE Ayurved pharmacy, Belgaum. It contains Suvarna Bhasma, Ghrita and Madhu. Twenty apparently healthy male and female children with age group of three to four years were ready to sign inform consent form were selected into two groups each. Subjects in Group A received Suvarna Bindu Prashan where as Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in Suvarna Bindu Prashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of event of illness. However there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage.

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Microecological preparation combined with an modified low-carbon diet improves glucolipid metabolism and cardiovascular complication in obese patients

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00697-6 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Jianguo Liu ◽

Liehui Xiao ◽

Hezhongrong Nie ◽

Yong Pan ◽

Yan Liu ◽

...

Keyword(s):

Intestinal Barrier ◽

Intestinal Barrier Function ◽

Control Group ◽

Obese Patients ◽

Carotid Atherosclerotic Plaque ◽

Low Carbon ◽

Balanced Diet ◽

Group A ◽

Group B ◽

Control Group Group

Abstract Objective To investigate the impact of microecological preparation combined with modified low-carbon diet on the glucolipid metabolism and cardiovascular complication in obese patients. Methods From August 2017 to July 2020, 66 obese patients were recruited, and administrated with an modified low-carbon diet with (group A) or without (Group B) microecology preparation and a balanced diet in control group (group C) for 6 months. Meanwhile, 20 volunteers administrated with a balanced diet were recruited as the healthy control group (group D). Results After 6-month intervention, obese subjects in group A and B showed significant improvement of body and liver fat mass, reduction of serum lipid levels, intestinal barrier function markers, insulin resistance index (IRI), high blood pressure (HBP) and carotid intima thickness, as compared with subjects in group C. More importantly, subjects in group A had better improvement of vascular endothelial elasticity and intimal thickness than subjects in group B. However, these intervention had no effect on carotid atherosclerotic plaque. Conclusion Administration of microecological preparation combined with modified low-carbon diet had better improvement of intestinal barrier function, glucose and lipid metabolism, and cardiovascular complications than low-carbon diet in obese patients, but the effect of a simple low-carb diet on carotid atherosclerotic plaque need to be further addressed.

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Effects of different thermal insulation methods on the nasopharyngeal temperature in patients undergoing laparoscopic hysterectomy: a prospective randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-021-01324-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Guanyu Yang ◽

Zefei Zhu ◽

Hongyu Zheng ◽

Shifeng He ◽

Wanyue Zhang ◽

...

Keyword(s):

Thermal Insulation ◽

Primary Outcome ◽

Controlled Trial ◽

Laparoscopic Hysterectomy ◽

Control Group ◽

Prospective Randomized Controlled Trial ◽

Warming Blanket ◽

Group A ◽

Insulation Effect ◽

Group B

Abstract Background This study explored the comparison of the thermal insulation effect of incubator to infusion thermometer in laparoscopic hysterectomy. Methods We assigned 75 patients enrolled in the study randomly to three groups: Group A: Used warming blanket; group B: Used warming blanket and infusion thermometer; group C: Used warming blanket and incubator. The nasopharyngeal temperature at different time points during the operation served as the primary outcome. Results The nasopharyngeal temperature of the infusion heating group was significantly higher than that of the incubator group 60 min from the beginning of surgery (T3): 36.10 ± 0.20 vs 35.81 ± 0.20 (P<0.001)90 min from the beginning of surgery (T4): 36.35 ± 0.20 vs 35.85 ± 0.17 (P<0.001). Besides, the nasopharyngeal temperature of the incubator group was significantly higher compared to that of the control group 60 min from the beginning of surgery (T3): 35.81 ± 0.20 vs 35.62 ± 0.18 (P<0.001); 90 min from the beginning of surgery (T4): 35.85 ± 0.17 vs 35.60 ± 0.17 (P<0.001). Regarding the wake-up time, that of the control group was significantly higher compared to the infusion heating group: 24 ± 4 vs 21 ± 4 (P = 0.004) and the incubator group: 24 ± 4 vs 22 ± 4 (P = 0.035). Conclusion Warming blanket (38 °C) combined infusion thermometer (37 °C) provides better perioperative thermal insulation. Hospitals without an infusion thermometer can opt for an incubator as a substitute. Trial registration This trial was registered with ChiCTR2000039162, 20 October 2020.

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The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants

Biology ◽

10.3390/biology10010012 ◽

2020 ◽

Vol 10 (1) ◽

pp. 12

Author(s):

David Chavarri-Prado ◽

Aritza Brizuela-Velasco ◽

Ángel Álvarez-Arenal ◽

Markel Dieguez-Pereira ◽

Esteban Pérez-Pevida ◽

...

Keyword(s):

Dental Implants ◽

Mechanical Loading ◽

Bone Growth ◽

Bone Matrix ◽

Test Group ◽

Control Group ◽

Group A ◽

Bone To Implant Contact ◽

The Stability ◽

Group B

Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.

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Glycine and L-Arginine supplementation ameliorates gastro-duodenal toxicity in a rat model of NSAID (Diclofenac)-gastroenteropathy via inhibition of oxidative stress

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2020-0307 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Akinleye Stephen Akinrinde ◽

Halimot Olawalarami Hameed

Keyword(s):

Oxidative Stress ◽

Total Protein ◽

Therapeutic Index ◽

Control Treatment ◽

Control Group ◽

Protective Effects ◽

Serum Total Protein ◽

Significant Amelioration ◽

Group A ◽

Group B

Abstract Objectives This study examined the possible protective roles of exogenous glycine (Gly) and L-Arginine (l-Arg) against Diclofenac (DIC)-induced gastro-duodenal damage in rats. Methods Rats were divided into Group A (control), Group B (DIC group) and Groups C–F which were pre-treated for five days with Gly1 (250 mg/kg), Gly2 (500 mg/kg), l-Arg1 (200 mg/kg) and l-Arg2 (400 mg/kg), respectively, before co-treatment with DIC for another three days. Hematological, biochemical and histopathological analyses were then carried out. Results DIC produced significant (p<0.05) reduction in PCV (13.82%), Hb (46.58%), RBC (30.53%), serum total protein (32.72%), albumin (28.44%) and globulin (38.01%) along with significant (p<0.05) elevation of serum MPO activity (83.30%), when compared with control. In addition, DIC increased gastric H2O2 and MDA levels by 33.93 and 48.59%, respectively, while the duodenal levels of the same parameters increased by 19.43 and 85.56%, respectively. Moreover, SOD, GPx and GST activities in the DIC group were significantly (p<0.05) reduced in the stomach (21.12, 24.35 and 51.28%, respectively) and duodenum (30.59, 16.35 and 37.90%, respectively), compared to control. Treatment with Gly and l-Arg resulted in significant amelioration of the DIC-induced alterations although l-Arg produced better amelioration of RBC (29.78%), total protein (10.12%), albumin (9.93%) and MPO (65.01%), compared to the DIC group. The protective effects of both amino acids against oxidative stress parameters and histological lesions were largely similar. Conclusions The data from this study suggest that Gly or l-Arg prevented DIC-induced gastro-duodenal toxicity and might, therefore be useful in improving the therapeutic index of DIC.

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Clinical and Microbiological Evaluation of Local Doxycycline and Antimicrobial Photodynamic Therapy during Supportive Periodontal Therapy: A Randomized Clinical Trial

Antibiotics ◽

10.3390/antibiotics10030277 ◽

2021 ◽

Vol 10 (3) ◽

pp. 277

Author(s):

Raluca Cosgarea ◽

Sigrun Eick ◽

Ionela Batori-Andronescu ◽

Søren Jepsen ◽

Nicole B. Arweiler ◽

...

Keyword(s):

Photodynamic Therapy ◽

Bacterial Species ◽

Periodontal Therapy ◽

Local Drug Delivery ◽

Control Group ◽

Periodontal Pathogens ◽

Supportive Periodontal Therapy ◽

Group A ◽

Group B ◽

Attachment Level

The aim of this study was to evaluate the clinical and microbiological effects of subgingival instrumentation (SI) alone or combined with either local drug delivery (LDD) or photodynamic therapy (PDT) in persistent/recurrent pockets in patients enrolled in supportive periodontal therapy (SPT). A total of 105 patients enrolled in SPT were randomly treated as follows: group A (n = 35): SI +PDT and 7 days later 2nd PDT; group B (n = 35): SI+LDD; group C (n = 35): SI (control). Prior intervention, at 3 and 6 months after therapy, probing pocket depths, clinical attachment level, number of treated sites with bleeding on probing (n BOP), full mouth plaque and bleeding scores (gingival bleeding index, %BOP) were recorded. At the same time points, 8 periodontopathogens were quantitatively determined. All three treatments resulted in statistically significant improvements (p < 0.05) of all clinical parameters without statistically significant intergroup differences (p > 0.05). Several bacterial species were reduced in both test groups, with statistically significantly higher reductions for LDD compared to PDT and the control group. In conclusion, the present data indicate that: (a) In periodontal patients enrolled in SPT, treatment of persistent/recurrent pockets with SI alone or combined with either PDT or LDD may lead to comparable clinical improvements and (b) the adjunctive use of LDD appears to provide better microbiological improvements for some periodontal pathogens than SI alone or combined with PDT.

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