scholarly journals RIFAXAMIN VS LACTULOSE

2016 ◽  
Vol 23 (07) ◽  
pp. 817-821
Author(s):  
Irfan Younis ◽  
Zamir Butt ◽  
Malik Irfanullah Yasir ◽  
Syed Muhammad Ali Shah
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Hepatitis C ◽  
Controlled Trial ◽  
Similar Efficacy ◽  
P Value ◽  
Decompensated Liver Disease ◽  
Group A ◽  
Group B ◽  
Disease Study

Objectives: To compare Rifaxamin and Lactulose in improving the gradesof hepatic encephalopathy in patients with decompensated liver disease. Study design:Randomized controlled trial comparing the use of rifaxamin and Lactulose. Place and durationof study: 1st July 2014 to 30th June 2015 in Department of Medicine, Aziz Bhatti ShaheedTeaching Hospital Gujarat. Results: 1st July 2014 to 30th June 2015 in medical departmentof Aziz Bhatti Shaheed Teaching Hospital Gujarat. Results: 400 cases were divided in twoequal groups: Group A took Rifaximin & Group B Lactulose. Improvement in grades of hepaticencephalopathy were calculated on weekly bases. Monitoring was done by checking bloodammonia levels, number connection tests, flapping tremors and mental status. 40 patients(10%) did not stay in ward for one week. In ninety percent etiology of decompensated liverdisease was hepatitis C virus. Improvement was noted in 76.96% (n=137) in Group-A and72.52% (n=132) in Group-B, p value was found insignificant (>0.05). Conclusions: Rifaximinand lactulose had similar efficacy in the treatment of mild to moderate hepatic encephalopathy.

Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

2021 ◽  
Vol 15 (5) ◽  
pp. 1134-1135
Author(s):  
M. A. Chhutto ◽  
A. H. Mugheri ◽  
A. H. Phulpoto ◽  
I. A. Ansari ◽  
A. Shaikh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
P Value ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

scholarly journals Role of Rifaximin for the Treatment of Hepatic Encephalopathy in Chronic Liver Disease

2017 ◽  
Vol 7 (3) ◽  
pp. 205-211
Author(s):  
Ranjit Kumar Paul ◽  
Indrajit Kumar Datta ◽  
Habib Ahmed ◽  
Mohammad Reazul Karim ◽  
Md Nazmul Haque ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Hospital Stay ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Controlled Study ◽  
End Of Treatment ◽  
Group A ◽  
Group B ◽  
Ctp Score

Background: Hepatic encephalopathy (HE) is a common problem in patients with chronic liver disease (CLD) and is characterized by diminished mentation and neuromuscular abnormalities. Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe and other countries. It is unknown whether rifaximin is effective for the treatment of hepatic encephalopathy in Bangladeshi patients.Methods: A prospective, randomized, single blind, placebo controlled study was conducted to evaluate the efficacy of rifaximin among patients with cirrhosis of liver with hepatic encephalopathy. A total sixty patients of HE fulfilling inclusion criteria were randomly enrolled among those admitted under Gastrointestinal, Hepatobiliary and Pancreatic Disorders (GHPD) department of BIRDEM General Hospital during August 2012 to April 2013. Patients were divided into two groups: group A (receiving Tab. rifaximin with lactulose), the total number of patients were 31(51.7%) and group B (receiving placebo with lactulose), it was 29(48.3%). Enrolled patients were followed up for 10 days or up to discharge from the hospital or death. At enrollment and at the end of treatment, gradation of HE and estimation of portosystemic encephalopathy (PSE) index was done.Results: In this study between two groups, mean age difference (p=0.404), gender difference (p=0.668) and CLD duration difference (p=0.555) were not statistically significant between two groups. At enrollment, prognostic scores e.g. Child-Turcotte-Pugh (CTP) score (p=0.489) and PSE index (p=0.934) were not significantly different between two groups. At the end of treatment, group A patients showed significantly lower HE grade (P=0.045) and PSE index (P<0.05) than group B. CTP score (p=0.552) was also lower in rifaximin treated group than placebo group but no significant difference was observed. The mean duration of hospital stay was significantly lower in group A than group B (p<0.05).Conclusions: Hepatic encephalopathy patients treated with rifaximin plus lactulose have better outcome and less hospital stay than those treated with placebo plus lactulose.Birdem Med J 2017; 7(3): 205-211

scholarly journals Comparison of efficacy of internal sphincterotomy versus topical 0.2 % glyceryl trinitrate ointment after hemorrhoidectomy.

2020 ◽  
Vol 27 (12) ◽  
pp. 2541-2547
Author(s):  
Muhammad Arif ◽  
Sabih Nofal ◽  
Ahsan Khan ◽  
Mariam Tariq Awana ◽  
Anum Arif
Keyword(s):  
Glyceryl Trinitrate ◽  
Controlled Trial ◽  
P Value ◽  
Chi Square ◽  
Male Predominance ◽  
Internal Sphincterotomy ◽  
Open Hemorrhoidectomy ◽  
Group A ◽  
Group B ◽  
Glyceryl Trinitrate Ointment

Objectives: To compare the efficacy of 0.2% glyceryl trinitrate ointment versus internal sphincterotomy after hemorrhoidectomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery Unit III, at Lahore General Hospital, Lahore. Period: 6 months (August 2017 to February 2018). Material & Methods: The OPD of the Department of Surgery included 124 patients who satisfied the inclusion criteria. There were two groups of patients, Group A and Group B. Group-A was told to use gloved finger three times daily for 0.2 percent GTN ointment topically. For Group B, lateral internal sphincterotomy was performed as day care procedure. On visit, patients were assessed for pain relief by using VAS. All data was collected using a pre-designed (attached) proforma. In SPSS v23.0 the data were input and analyzed. It was stratified for age, sex, disease duration and hemorrhoid stage. The effectiveness of both groups was compared by using a p-value of 0.05 as significant for a chi-square test. Results: Male predominance; in group-A, 41(66.1%) patients were male and 21(33.9%) were female, while in group-B, 52(83.9%) patients were male and 10(16.1%) were females. Efficacy was found in 11(17.7%) patients in group-A (0.2% GTN) while in 25(40.3%) patients in group-B (Internal sphincterotomy) with p-value of 0.006 which is statistically significant. Conclusion: Open hemorrhoidectomy internal sphincterotomy is an effective method to reduce pain after hemorrhoidectomy in contrast to Glyceryl Trinitrate (GTN) topical cream of 0.2 percent.

scholarly journals Comparison of Recovery Time of Propofol and Midazolam with Propofol Alone for Sedation in Endoscopic Retrograde Cholangiopancreatography

2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Recovery Time ◽  
Controlled Trial ◽  
P Value ◽  
Time Data ◽  
Endoscopic Retrograde ◽  
Intravenous Anesthetic ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.

Comparison of letrozole and clomiphene citrate efficacy in terms of ovulation induction and pregnancy rate.

2021 ◽  
Vol 28 (05) ◽  
pp. 749-754
Author(s):  
Nadia Sharif ◽  
Uzma Manzoor ◽  
Saadia Bano ◽  
Uzma Shahzaad
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Epidemiological Data ◽  
P Value ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of Letrozole and clomiphene citrate in Patients of Anovulation polycystic ovarian syndrome with Infertility. Study Design: Randomized Controlled Trial Setting: Department of Obstetrics and Gynecology Independent Medical College Faisalabad. Period: 30-09-2019 to 29-6-2020. Material & Methods: This study included 100 patients with 50 patients in each group. Group A received 2.5 to 5mg letrozole in each cycle from day 3 to 7. Group B received clomiphene citrate 50 to 100 mg incremental dose depending on ovarian response. Both Drugs were given for consecutive 3 to 6 cycles to see response. Main outcome Measure included optimal follicle size (> 18mm), endometrial thickness, and pregnancy rate. Epidemiological data and efficacy outcome measures were recorded on a Performa. Statistical analysis was done using SPSS version 13. Chi-square test applied and p-value <o.o5 was considered significant. Both group included primary infertility patients. Results: The mean age of patients was 28.03+ 3.02 years. Mean age of group A patients was 29.04+3.44 and 28.47+3.90 group B patients. Mono ovulation in group A patients (88.9%) and 27 in group b patients (60.0%). The mean endometrial thickness was 9.6mm + 1.6 in letrozole group and 6.9mm + 1.2 in clomiphene citrate group A. In group A 18% got pregnant from Letrozole group and 1.1% from the group B. Conclusion: Efficacy was significantly higher in group A Patients received letrozole as compared to patients echo received clomiphene citrate. The effects of Letrozole showed better outcome in terms of Ovulation Induction Endometrial Thickness and Pregnancy rate.

Comparison of harmonic scalpel versus Milligan Morgan technique in haemorrhoidectomy patients

2021 ◽  
Author(s):  
Muhammad Ahmad ◽  
Syed Tatheer Abbas ◽  
Amna Javaid ◽  
Naveed Arshad ◽  
Falak Shair
Keyword(s):  
Wound Healing ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Controlled Trial ◽  
P Value ◽  
Randomized Controlled ◽  
Group A ◽  
The Mean ◽  
Complete Wound Healing ◽  
Group B

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in  Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...

scholarly journals SINONASAL POLYPOSIS

2018 ◽  
Vol 25 (10) ◽  
pp. 1581-1586
Author(s):  
Farhan Salam ◽  
Ejaz Ahmad ◽  
Muhammad Salman Haider Qureshi ◽  
Muhammad Aslam Khan
Keyword(s):  
Nasal Polyposis ◽  
Controlled Trial ◽  
Chronic Inflammatory Disease ◽  
P Value ◽  
Entire Study ◽  
Sense Of Smell ◽  
Study Duration ◽  
Group A ◽  
Group B ◽  
Sinonasal Polyposis

Introduction: Nasal polyposis (NP) is a chronic inflammatory disease involvingmucous membrane in paranasal sinuses and nose. It presents as gelatinous, semitranslucent,smooth, pedunculated pear or round shaped masses comprising of inflamed mucosa thatout-pouches into nose. The available surgical options are Functional Endoscopic SinusSurgery (FESS) and Conventional Intranasal Polypectomy (CIP). The study aims to compareFESS and CIP in sinonasal polyposis patient in term of symptomatic improvement. StudyDesign: Randomized controlled trial. Setting: Department of head n’ neck surgery andOtorhinolaryngology, Pakistan Institute of Medical Sciences, Islamabad. Period: 01-01-2015 to20-08-2015. Methodology: A total of 84 patients presenting with nasal polyposis were enrolled.Out of these 84 patients, 42 patients were randomly selected for FESS (Group-A). Rest of the42 patients were selected for CIP (Group-B). All the information recorded on the Performawas entered and analysed using SPSS version 17. The entire study duration was 31 weeks.Regarding ethical consideration, the study was approved from ethics committee of hospital.Informed consent was obtained from the study participants. Moreover, confidentiality andanonymity of subjects was assured. The patients were followed-up for 2 months duration. Theentire study duration was about 8 months. Results: On the basis of scoring of nasal obstruction,in FESS Group-A, 32 (76.19%) patients had completely patent nose after two months and only10 (23.81%) patients had partially blocked nose. On the other hand in CIP Group-B, only 16(38.10%) patients had completely patent nose while 26 (60.90%) patients had partially blockednose after two months. The comparison of sense of smell between both groups also showedthat the outcome of Group-A was significantly (p-value = 0.000) better as compared to Group-B.The complete sense of smell was found present in 37 (88.10%) patients in group A in contrastwith 19 (45.23%) patients in group B. Conclusion: FESS seems to be a better treatment optionfor sinonasal polyposis than conventional intranasal polypectomy. However study with largerpopulation size and longer follow up duration is recommended to rationalize the results.

scholarly journals EFFECTIVENESS OF NEURAL MOBILIZATION AND STRETCHING EXERCISE FOR THE MANAGEMENT OF SCIATICA

2014 ◽  
Vol 3 (2) ◽  
pp. 11-15
Author(s):  
Sidra Zahid ◽  
Ghazala Noor Nizami
Keyword(s):  
Conventional Therapy ◽  
Controlled Trial ◽  
Treatment Options ◽  
Tertiary Care ◽  
P Value ◽  
Below The Knee ◽  
Pain Disability ◽  
Before And After ◽  
Group A ◽  
Group B

OBJECTIVE To find out the effectiveness of neural mobilization and stretching exercise for the management of sciatica BACKGROUND Sciatica is described as pain, radiating to the leg below the knee joint and caused by irritation of the sciatic nerve or nerve trunk. There are many treatment options for the management of sciatica, including stretching exercise and neural mobilization. MATERIAL AND METHODS This study was a Randomized Controlled Trial. 94 patients from physical therapy OPD of tertiary care hospitals, were participated in this study. Hence, 47 patients were randomly allocated into each group A and B. Before and after the nine treatment sessions, both groups were assessed with VAS, SLR ROM and Quebec back pain disability scale. In group A, neural mobilization with conventional therapy (heat and TENS) was applied, while stretching exercise with same conventional therapy was applied to group B. RESULTS It was observed that both treatments were helpful in reducing the symptoms. The analysis showed significant improvement (p-value <0.05) in the SLR to 60.851o±6.86oand Quebec score to 23.617±3.125, after the stretching exercise. Hence, both treatments were equally effective in reducing pain (p-value >0.05). CONCLUSION Stretching exercise is more effective in the improvement of SLR and disability. Furthermore, both techniques are helpful in the management of pain. KEY WORDS Sciatica, Stretching, Neural Mobilization, Straight Leg Raising, Visual Analogue Scale, TENS.

scholarly journals Open VS Closed Techniques for Laparoscopic Abdominal Surgeries

2021 ◽  
pp. 296-302
Author(s):  
Obaid Ul Haseeb ◽  
Haris Rashid ◽  
Afrin Ahmed ◽  
Mir Arsalan Ali ◽  
Shakil Alam ◽  
...  
Keyword(s):  
Controlled Trial ◽  
P Value ◽  
Open Approach ◽  
Chi Square ◽  
Closed Technique ◽  
Chi Square Test ◽  
Group A ◽  
Classic Technique ◽  
Group B ◽  
Surgery Department

Background: Laparoscopic surgery or "minimally invasive" surgery is a type of specialist surgery. The most crucial, demanding, and risky part of the laparoscopy is the creation of pneumoperitoneum. The two most prevalent methods for creating a pneumoperitoneum are the closed and open approaches. Despite the fact that there is no universal consensus on the best approach to gain access to the peritoneal cavity in order to create a pneumoperitoneum. The aim of present study was to compare the operative time and post-operative outcome associated with closed technique and open classic technique. Methods: This randomized controlled trial was carried out by recruiting patients presented in surgery department of Ziauddin Hospital North campus. The samples were divided into two equal groups A and B. Group A was operated for Laparascopic abdominal surgery by open technique while group B operated through closed technique. Effectiveness of procedures was measured by number of complications occurred during and after surgery. Chi-square test and independent T-test were applied for association. P-value of < 0.05 was considered as significant. Results: Mean age was found to be 45.5±16 years and mean weight was 68±10.5 kilograms. Mean time of operations was 84.5±18.5 minutes. 60 (69.8%) of patients included underwent the laparoscopic cholecystectomy while 15 (17.4%) patients had laparoscopic appendectomy. 13/86: 15.1% of patients had the minor complication including 12/43: 27.9% in group B and 1/43: 2.3% in group A. The comparative analysis between the two groups in terms of effectiveness of either method compared by means of development of the complications was found to be highly significant with p value 0.002. Conclusion: The open approach to laparoscopic entrance has been linked to fewer surgical problems than the closed approach.

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