LYMPHEDEMA DURATION AS A PREDICTIVE FACTOR OF EFFICACY OF COMPLETE DECONGESTIVE THERAPY

Lymphedema is a common condition with global impact and a multitude of complications, however, only a few professionals specialize in its management. A retrospective analysis of 105 subjects with unilateral lymphedema upper or lower limb was performed to investigate whether the duration of lymphedema constitutes an important factor associated with the efficacy of complete decongestive therapy (CDT). Subjects were classified into two groups according to the duration of lymphedema, prior to CDT: group A (≤1 year) and group B (>1 year). Both groups were treated daily according to the same CDT protocol for four weeks. The CDT efficacy was determined based on the percent reduction of excess volume (PREV) measurements. Lymphedema was significantly reduced in both groups of subjects, but significantly more in group A (p<0.001). In subjects with upper limb lymphedema, median value of PREV was 80.8% (interquartile range, 79.1-105.0%) in group A and 62.0% (interquartile range, 56.7-66.5%) in group B (p<0.001). In subjects with lower limb lymphedema PREV was 80.7% (interquartile range, 74.9-85.2%) and 64.5% (interquartile range, 56.0-68.1%) for groups A and B, respectively (p<0.001). Duration of lymphedema was found to be a strong predictive factor that may significantly impact CDT efficacy. Therapeutic effects were increased in subjects who were detected and treated earlier for lymphedema.

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A Randomized Clinical Trial of Proton Pump Inhibitors Combined with Traditional Chinese Medicine in the Treatment of Laryngopharyngeal Reflux Disease

Acupuncture & Electro-Therapeutics Research ◽

10.3727/036012921x16321477053845 ◽

2021 ◽

Author(s):

Feng Pei ◽

Wei Jia Hu ◽

Yi Nan Mao ◽

Yu Liang Zhao

Keyword(s):

Proton Pump ◽

Reflux Disease ◽

Laryngopharyngeal Reflux ◽

Short Form ◽

Therapeutic Effects ◽

Reflux Symptom Index ◽

Symptom Index ◽

Laryngopharyngeal Reflux Disease ◽

Group A ◽

Group B

Background:To explore whether combined with TCM based on classical proton pumpinhibitors PPIs therapy can achieve better efficacy for patients withlaryngopharyngeal reflux disease. Methods: There were 150 laryngopharyngeal refluxpatients enrolled and divided into three groups randomly, with 50 cases in each group.Patients in group A were treated with the proton pump inhibitor (PPI) lansoprazole.Patients in group B were treated with lansoprazole combined with Banxia Houpudecoction, and patients in group C were treated with acupuncture treatments and acombination of Chinese and Western medicine. The reflux symptom index (RSI), refluxfinding score (RFS), and quality of life (36 item short form health survey questionnaire)were assessed before and 4 and 8 weeks after treatment. Results: The RSI and RFSscores of the three groups were significantly reduced after treatment (P < 0.001). Ingroup B and C, they were lower than in group A at 8 weeks (P < 0.01). The SF 36 scoreof 3 groups increased after treatment. At both 4 and 8 weeks (P < 0.001), and patientsin groups B and C scored higher than patients in group A (P < 0.001). The total effectiverate of group B and group C was higher than that of group A (P < 0.05). Conclusion:All three treatments have therapeutic effects on the disease, but the efficacy of a PPIalone is not as good as the combined treatments’ efficacies. Moreover, PPI combinedwith Banxia Houpu decoction and/or acupuncture treatment substantially affects lifeimprovement.

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A Comparison of Oral Gabapentin and Oral Pregabalin as Preemptive Analgesia for Orthopedic Surgery Under Spinal Anaesthesia

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0901.15 ◽

2021 ◽

Vol 9 (1) ◽

pp. 74-78

Author(s):

Neena Jain ◽

Rahul Bankapur ◽

Preeti Lamba ◽

saurav Singh

Keyword(s):

Side Effects ◽

Postoperative Pain ◽

Spinal Anesthesia ◽

Spinal Anaesthesia ◽

Orthopedic Surgery ◽

Lower Limb ◽

Analgesic Efficacy ◽

Double Blind Study ◽

Group A ◽

Group B

Background and Aims: Gabapentin and pregabalin, by decreasing noxious stimulus induced excitatory neurotransmitter release at central nervous system, may attenuate central sensitization and eventually decrease development of postoperative pain. We evaluated preemptive analgesic efficacy of single dose of oral gabapentin 600 mg and pregabalin 75mg for postoperative pain in patients undergoing lower limb orthopedic surgery under spinal anesthesia. Material and methods: A prospective, randomized, double blind study was conducted on 70 patients aged between 18 to 60 years with ASA grade 1 and 2 posted for lower limb surgeries under spinal anaesthesia. Patients were allocated into Group A and Group B receiving oral gabapentin(600mg) and oral pregabalin (75mg) respectively 1.5 hours before surgery. Primary objective was assessing duration and quality of analgesia by Visual Analogue Scale (VAS) score at 2,4,6,8,10,12,16,20 and 24 hours.Secondary objective was to assess total dose of rescue analgesic in first 24 hours, perioperative hemodynamic change and various side effects. Statistical Analysis used: Categorical data was compared using Chi- square test. Quantitative parametric data was analysed using unpaired student t-test. P value < 0.05 was considered statistically significant. Results: Mean duration of analgesia in Group A (10.53 ± 2.686 hours) was longer than Group B (7.943±3.199hr) (P = 0.0006).Mean number of analgesic dosesrequired in first 24 hourswere less in Group A (1.429 ± 0.5021) ascompared to Group B (1.771±0.6897) (P = 0.0202).All patients remained hemodynamically stable with no significant side effects noted in either group. Conclusion: We conclude that preemptive analgesic efficacy of oral gabapentin 600mg is better in comparison to oral pregabalin 75 mg for patients posted for lower limb orthopedic surgeries under spinal anesthesia.

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COMPARATIVE STUDY BETWEEN EPIDURAL BUPIVACAINE WITH BUPRENORPHINE AND EPIDURAL BUPIVACAINE FOR POST-OPERATIVE ANALGESIA IN ABDOMINAL AND LOWER LIMB SURGERY

10.36106/3029748 ◽

2021 ◽

pp. 29-31

Author(s):

Anant Prakash ◽

Rahul Kumar ◽

Chandeshwar Choudhary ◽

Debarshi Jana

Keyword(s):

Comparative Study ◽

Lower Limb ◽

Heart Beat ◽

Epidural Administration ◽

Visual Analogue Pain ◽

Post Operative Period ◽

Epidural Bupivacaine ◽

Lower Limb Surgery ◽

Group A ◽

Group B

Background: Epidural administration of various analgesics gained increasing popularity following the discovery of opioid receptors in the spinal cord capable of producing potent analgesia. This effect seems to be greatest when epidural anaesthesia in continued in the post-operative period as epidural analgesia. It is now clear that epidural administration of opioids. Ours was a comparative study between epidural bupivacaine with buprenorphine and epidural bupivacaine for post-operative analgesia in abdominal and lower limb surgery. Methods: 60 patients undergoing lower abdominal and lower limb surgeries of either sex with ASA grade 1 and 2 aged between 20 and 60 years for divided into two groups. After completion of the surgery and when the effect of local anaesthetic wears of and the patients complains of pain the intended study drugs were given when visual analogue pain score touched 5 cm mark. Group – A: Patients received 8ml of 0.25% bupivacaine + 0.15mg of buprenorphine. Group – B: patients received 0.25% of bupivacaine alone. In the post-operative period the following parameters were studied, 1. Onset of analgesia, 2. Duration of analgesia, 3. Vital parameters such as heart beat, blood pressure, respiratory rate, sedation score and visual analogue score were recorded, 4. Side effects like nausea, vomiting, hypotension, respiratory depression, and pruritus allergic reaction were looked for. Results: It is observed that onset of analgesia in Group A (0.25% bupivacaine + 0.15mg buprenorphine) was 7.35 min. When compared to Group B which 15.5 min, which is statically signicant (P<0.05). Duration of analgesia in Group A is 17.23 hrs compared to Group B, which is 5.2 hrs, this is statically signicant (P<0.05). Visual analogue scale was reduced in Group A compared to Group B Conclusions: Addition of buprenorphine to bupivacaine by epidural injection for post-operative analgesia improves the onset, The duration and the quality of analgesia

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Comparing the Analgesic Efficacy of Intrathecal Bupivacaine Alone with Intrathecal Bupivacaine Midazolam or Magnesium Sulphate Combination in Patients Undergoing Elective Infraumbilical Surgery

Journal of Anesthesiology ◽

10.1155/2016/6148782 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Josef Attia ◽

Amany Abo Elhussien ◽

Mostafa Zaki

Keyword(s):

Side Effects ◽

Magnesium Sulphate ◽

Lower Limb ◽

Analgesic Efficacy ◽

Motor Blockade ◽

Sensory Blockade ◽

Lower Limb Surgery ◽

Group A ◽

Group B ◽

Limited Duration

Background. Spinal anaesthesia, which is one of the techniques for infraumbilical surgeries, is most commonly criticized for limited duration of postoperative analgesia. Aim of the Work. The aim of this study was to decrease bupivacaine dose used in spinal anesthesia in patients undergoing orthopedic lower limb surgery and reduce its possible side effects. Patient and Methods. Sixty adult patients of both sexes, divided into three. Group C received 2.5 mL bupivacaine and 0.5 mL saline 0.9%. Group A received 2.5 mL bupivacaine and 0.5 mL midazolam. Group B received 2.5 mL bupivacaine and 0.5 mL magnesium sulphate. Results. As regards onset of both motor and sensory blockade, there are a significant decrease in group A and a significant increase in group B as compared to group C, with a significant decrease in duration of motor blockade and significant increase in duration of sensory blockade in both group A and group B, respectively, as compared to group C, with a significant decrease in the duration of sensory blockade in group B as compared to group C. Conclusions. These results suggested that intrathecal midazolam as an adjuvant for bupivacaine increases the duration of both sensory and motor blockade more than that of magnesium sulphate.

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The Effects of Moxibustion on Serum Interleukins and T Cell Subset in H.polyri Infected Rats

Journal of Acupuncture and Herbs ◽

10.1515/tcm-2015-0005 ◽

2015 ◽

Vol 3 (1) ◽

pp. 38-45

Author(s):

Jing Shen ◽

Yan Peng ◽

Dong-Mei Shi ◽

Yin-Shuai Feng ◽

Yan-Ling Hou ◽

...

Keyword(s):

Gastric Mucosa ◽

Control Group ◽

Intragastric Administration ◽

Therapeutic Effects ◽

Model Group ◽

Tnf Α ◽

Group A ◽

Histomorphological Changes ◽

Group B ◽

Group D

Abstract Objective: to observe the effects of moxibustion on histomorphological changes of gastric mucosa, as well as on serum IL-6、IL-8、TNF-α，Hp IgG、CD3+、CD4+、CD8+ in helicobacter pylori (Hp) infected rats, so that to better understand how the moxibustion repairs the Hp- induced gastric mucosal injury. Methods: 40 SD rats were randomly assigned to four groups: group A (blank control), group B (Hp infection model), group C (moxibustion plus model), group D (electro-acupuncture plus model), 10 for each group. The “NaHCO3 plus Indometacin and Hp intragastric administration” method was employed to make gastritis model. Acupoints selected for “repair” purpose were Zu San Li (ST36), Zhong Wan (CV12), Guan Yuan (RN4), Pi Shu (BL20), Wei Shu(BL21). The histomorphological changes of gastric mucosa in rats were observed under light microscope after HE stain; IL-6, IL-8, TNF-α, Hp IgG values were evaluated by ELISA method; values of CD3+、CD4+、CD8+、CD4+/CD8+ were measured by flow cytometry method. Results: compared with group A, the values of IL-6, IL-8, TNF-α, Hp IgG and CD8+ in group B were increased（P＜0.01）, whereas the values of CD3+、CD4+、CD4+/CD8+ were decreased（P＜0.01）. Compared with group B, the values of IL-8（P＜0.05）,TNF-α（P＜0.05）, IL-6（P＜0.01）, Hp IgG（P＜0.01） and CD8+ （P＜0.05） in group C were decreased, whereas the values of CD3+（P＜0.05）,CD4+（P＜0.05）,CD4+/CD8+ （P＜0.05） were increased, meanwhile such values in group D had no significant changes. Compared with group D, the values of IL-6（P＜0.05）,IL-8 （P＜0.05）and Hp IgG （P＜0.01）in group C were decreased, whereas CD4+/CD8+（P＜0.05）were increased, all those changes had statistical significance. Conclusion: the preventive and therapeutic effects of moxibustion on Hp related gastritis might be realized by two ways- to inhibit the secretion of proinflammatory cytokines such as IL-6, IL-8 and TNF-α, or to regulate the production of immune factors (such as up-regulation of CD3+, CD4+ and down-regulation of CD8+).

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A comparison of epidural analgesia provided by Bupivacaine plus Pethidine, Bupivacaine plus Morphine, or Bupivacaine plus Morphine plus Midazolam for lower limb Orthopaedic surgery

Journal of Chitwan Medical College ◽

10.3126/jcmc.v4i1.10842 ◽

2014 ◽

Vol 4 (1) ◽

pp. 19-21

Author(s):

NR Sharma ◽

U Rai ◽

S Panthee ◽

P Shrestha

Keyword(s):

Epidural Anaesthesia ◽

Lower Limb ◽

Orthopaedic Surgery ◽

Epidural Morphine ◽

P Value ◽

Medical College ◽

Group A ◽

Group B ◽

Good Patient Satisfaction

Epidural anaesthesia and analgesia in orthopaedic surgeries helps to prevent thromboembolic phenomenon by increasing venodynamics. Adequate post operative analgesia with good patient satisfaction has been observed with this technique. The objective of this study was to assess the duration of postoperative analgesia and complications in patients receiving epidural anesthesia with morphine, midazolam and pethidine in combination with bupivacaine. We prospectively studied 75 Patients who were scheduled for elective lower limb orthopaedic surgery with epidural anaesthesia. This study was conducted from March 2010 to March 2012 at Lumbini Medical College Palpa. They were randomly divided by lottery method into three equal groups. Group ‘A’ (BP) received 50 mg epidural pethidine (3 ml) with 0.5 % bupivacaine 13 ml. Group ‘ B’ (BM) received 5 mg (3 ml) epidural morphine with 13 ml of 0.5% bupivacaine and Group’ C’ (BMM) received 5 mg (1 ml) epidural morphine with 13 ml 0.5% bupivacaine and 2 mg (2 ml) epidural midazolam. All the patients were observed for 24 hours for quality of analgesia and other side effects like nausea vomiting, and pruritus. Data were analysed by SPSS-16.0 software. The result of the study shows the duration of analgesia was prolonged in BMM group than BM, and BP group and was statistically significant (P value <0.001). Incidence of nausea and vomiting in BMM group was lower than that of BP and BM group but was statistically insignificantly (P value 0.489). Pruritus was absent in BP group and was more with BM and BMM group (P value 0.007). In conclusion the use of epidural morphine and midazolam in combination with bupivacaine is the satisfactory method of post operative analgesia. By adding midazolam, duration of analgesia can be increased with decrease in incidence of nausea, vomiting and pruritus. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10842 Journal of Chitwan Medical College 2014; 4(1): 19-21

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A Comparative Study of Efficacy of Povidone Iodine Versus Super Oxidized Solution in Lower Limb Ulcers

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/654 ◽

2021 ◽

Vol 10 (37) ◽

pp. 3220-3224

Author(s):

Nyna Sindhu Akula ◽

Navaneeth Krishna ◽

Sreedhar Sathu

Keyword(s):

Comparative Study ◽

Lower Limb ◽

Povidone Iodine ◽

Wound Care ◽

Wound Management ◽

Average Percentage ◽

Wound Size ◽

Group A ◽

Group B ◽

A Prospective Study

BACKGROUND Wounds and their management are important in the practice of surgery. Super oxidised solution is a recent concept in wound management. It is an aqueous solution which is electrochemically processed which is non-toxic, non-irrigating and is having a neutral pH. Povidone iodine is the most common topical wound care product used in surgical practice. Both are affordable solutions for the patients. There are very few studies comparing the efficacy. In this study, we wanted to compare the efficacy of super oxidised solution and povidone iodine in the management of lower limb ulcers. METHODS A prospective study was conducted on 100 patients who were randomized into two groups. Group A was treated with super oxidized solution and Group B were treated with povidone iodine. Assessments of wounds were done on various days (1, 3, 5, 7, 9, 12, 15, 18, 21). Various outcomes of data were analysed using statistical analysis. RESULTS The average percentage reduction in wound size on day 21 was 47 % in Group A compared to 24 % in Group B. Early appearance of granulation tissue, disinfection, decrease in wound size, and less duration of hospital stay was achieved in Group A. CONCLUSIONS The results were more favourable towards super oxidised solution than povidone iodine. In this comparative study, super oxidized solution had faster efficacy and wound healing in patients than povidone iodine. KEY WORDS Super Oxidized Solution, Ulcer, Povidone Iodine.

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Curative Effects of Ethanol Extract of Prosopis Farcta (Syrian Mesquite) Against Ethylene Glycol Induced Urolithiasis in Male Albino Rats

Science Journal of University of Zakho ◽

10.25271/sjuoz.2021.9.2.802 ◽

2021 ◽

Vol 9 (2) ◽

pp. 89-96

Author(s):

Kowan M. Ahmed ◽

Sarbast A. Mahmud

Keyword(s):

Ethylene Glycol ◽

Tap Water ◽

Control Group ◽

Albino Rats ◽

Therapeutic Effects ◽

Fruit Extract ◽

Kidney Weight ◽

Prosopis Farcta ◽

Group A ◽

Group B

The present study was designed to evaluate the antiurolithiatic activity of Prosopis farcta (P. farcta) ethanol fruit extract in ethylene glycol (EG) induced urolithiasis in male albino rats. Lithiasis was induced by oral administration of EG 1% in male albino rats for 28 days. Seventy eight male albino rats weighing 250-300g were used and divided into six experimental groups. Group A is a control group received standard rat chow and tap water ad libitum, while, rest of groups namely group B, C, D, E, F animals received 1% EG in water for 28 days, then from day 15 to day 28 in addition to EG administration, group C received cystone, group D, E and F received 100, 200 and 300 mg/kg body weight (B.W.) of ethanol fruit extract of P. farcta respectively. On day 28, blood was collected for serum biochemical (serum uric acid, creatinine, urea, electrolytes measurements, malondialdehyde (MDA) and superoxide dismutase (SOD)) determinations. While urine was collected to microscopic analysis of formed crystals besides the kidney weight/ B.W. ratio and B.W. gain/ loss values were determined. Intermediate dose (200mg/kg B.W.) of P. farcta extract significantly decreased serum creatinine, urea, MDA and non-significantly recovered SOD toward control value in group E as compared to group B, also significant elevation in kidney weight/ B.W. ratio and reduction in B.W. gains in group B occurred as compared with group A. In conclusion: P. farcta fruit extract has potentially therapeutic effects on EG induced kidney stone which can be used as effective antiurolithiatic agent rather than cystone.

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Outcome of Early Surgical Intervention in Acute Lower Limb Ischemia due to Thromboembolism

Cardiovascular Journal ◽

10.3329/cardio.v7i1.20799 ◽

2014 ◽

Vol 7 (1) ◽

pp. 38-43

Author(s):

QA Azad ◽

NAK Ahsan ◽

AM Asif Rahim ◽

SAN Alam ◽

M Rahman

Keyword(s):

Lower Limb ◽

Surgical Intervention ◽

Limb Ischemia ◽

Artery Occlusion ◽

Arterial Embolism ◽

Vascular Flow ◽

Femoral Artery Occlusion ◽

Group A ◽

Group B ◽

Early Surgical Intervention

Background: Acute lower extremity ischemia is a common vascular disease and considered limb- and life- threatening. The present study evaluated and compared the outcome of early and late surgical intervention in acute lower limb ischemia due to thromboembolism. Methodology: This non randomized comparative parallel study was conducted at the Department of Cardiovascular Surgery, NICVD, Dhaka, Bangladesh from January 2007 to December 2008 for duration of two year. Total 80 patients were enrolled in this study. The patients were divided into equal two groups, Group A, for early surgical intervention (with in 24 hours) and Group B, late surgical intervention (more than 24 hours). Results: Mean (±SD) age of both Group A and Group B was 51.93 (±11.73) and 47.00 (± 11.01) years. Male and female ratio of the total study population was 1.76:1 Pain and absence of pulse distal to occlusion was common for all. Cold extremity, sensory deficit, motor deficit, diminish vascular flow was the commonest findings of both group. In Group A, 57.5% had superficial femoral artery occlusion, 22.5% had iliac artery and 20.0% popliteal artery occlusion. In Group B, 42.5% had superficial femoral artery occlusion, 32.5% had popliteal artery occlusion and 25.0% had iliac artery occlusion. Fasciotomy was performed in 15.0% patients of Group A and in 22.0% patients of Group B. After Fogarty embolectomy in group A and group B had warm extremity (80.0% vs. 65.0%), pulsation distal to occlusion (90.0% vs. 75.0%), intact sensory function (82.5% vs. 67.5%), intact motor function (80.0% vs. 65.0%), and normal vascular flow by Doppler US (80.0% vs. 65.0%). During postoperative period history of bleeding, infection, reperfusion injury, muscle necrosis and limb amputation were 12.5% vs. 10.0%, 5.0% and 7.5%, 17.5% vs. 35.0%, 15.0% vs. 12.5% and 37.5% vs. 32.5% respectively. Conclusion: Duration of embolism may be the significant factor determining the outcomes of the management of acute arterial embolism in the lower extremities. The 24- hour duration of arterial embolism is a crucial factor influencing the surgical the management and early diagnosis and shifting of patients to specified centre as early as possible to save limb as well as life. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20799 Cardiovasc. j. 2014; 7(1): 38-43

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Therapeutic Effects of Sansevieria Trifasciata Ointment in Callosities of Toes

Global Journal of Health Science ◽

10.5539/gjhs.v9n2p264 ◽

2016 ◽

Vol 9 (2) ◽

pp. 264 ◽

Cited By ~ 1

Author(s):

Hamidollah Afrasiabian ◽

Reza Hododi ◽

Mohammad Hadi Imanieh ◽

Alireza Salehi

Keyword(s):

Recovery Time ◽

Lesion Size ◽

Therapeutic Effects ◽

Double Blind ◽

Dermatology Clinic ◽

Double Blind Clinical Trial ◽

Group A ◽

Spss Software ◽

Group B ◽

Methods Of Treatment

Currently study was a double-blind clinical trial in terms of ointments with different contents and the variables such as sex, drug charges, occupation, age, number of lesions, patients, lesions location, time of manifestation, lesion size and methods of treatment and recovery time. In addition, total patients under studied were 100 people in dermatology clinic of Farshchian hospital of Hamadan in Iran that they were divided into two groups. The first group (A) contained of 68 individual who were divided into three groups which used sanseveria extract with different percentage of containing 5, 10, and 20%. Further, the second group (B) included 32 patients who used from other methods of treatment were divided into three groups. In one group12 patients have been treated by using salicylic acid, in the other groups 12 individuals used from electro cautery and 8 patients were used of the corn plasters method. In addition, 116 patients in this study were in the range of 7 to 57 years of age. In fact 100 of them have used the drug correctly while 16 patients were excluded due to wrong usage. Also the plant (Sansevieria Trifasciata) was prepared in Hamedan Research Center from plant by dried extracts method. Finally, the results were analyzed statistically using SPSS software. In conclusion, based on the results of significant impact on the treatment of corns, all patients (100%) in the first group have been treated, additionally all participants in the study were improved within 4 weeks such that the recovery time for the 5% ointment was 25 days, while for 10% and 20% ointment was 15 and 10 days respectively.

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