scholarly journals Comparison of Lower Limb Arterial Pulsatility and Ankle Brachial Indices (PI and ABI) in Diabetic Subjects with and Without Neuropathy

2012 ◽  
Vol 2 (2) ◽  
pp. 89-92
Author(s):  
Sharmistha Dey ◽  
Kanta Das ◽  
Shamse Ara Begum ◽  
Akhtar Uddin Ahmed ◽  
Abu Saleh Mohiuddin
Keyword(s):  
Diabetic Neuropathy ◽  
Lower Limb ◽  
Pulsatility Index ◽  
Ankle Brachial Index ◽  
Doppler Imaging ◽  
Diabetic Patients ◽  
Colour Doppler ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objectives: This study was performed to find out the extent and nature of arterial flow abnormality in diabetic patients with peripheral neuropathy compared to diabetic patients without neuropathy, using duplex colour Doppler technique. Materials and method: This cross sectional study was performed on diabetic subjects in the Department of Radiology and Imaging, BIRDEM from July 2008’ to May 2009. Patients were referred from Department of neurology and preventive foot care OPD, BIRDEM, for colour Doppler imaging of lower limb arteries. Total 88 consecutive diabetic patients were included in this study. Out of them 48 were diagnosed cases of diabetic neuropathy (group I) and 40 were diabetic without neuropathy (Group II). In all patients the Ankle Brachial Index (ABI) and Pulsatility Index (PI) were recorded on both left and right lower limb arteries, by using duplex colour Doppler technique. Total no. of patients were 88. 48 had neuropathy. They were 27-57 yrs of age. Result: Unpaired‘t’ test was used to find out relationship between the variables.P value <o.o5 was considered as statistically significant. The mean ABI was 1.44±0.07, ranged from 1.30 to 1.59 in group I (diabetic neuropathy) and 1.17±0.06, ranged from 1.05 to 1.26 in group II (diabetic without neuropathy). The mean ABI difference was found statistically significant (p<0.05) between group I and group II. The mean PI was 3.0±0.69, ranged from 1.18 to 3.68 and 7.97±2.29,ranged from 5.50 to 13.0 in group I (diabetic neuropathy) and group II (diabetic without neuropathy) respectively. The mean PI difference was found statistically significant (p<0.05) between group I (diabetic neuropathy) and group II (diabetic without neuropathy). Conclusion: In this study it was observed that Pulsatility Index (PI) decreased and Ankle Brachial Index (ABI) increased in diabetic neuropathic group. There was significant difference of Pulsatility Index (PI) and Ankle Brachial Index (ABI) found between diabetic subjects with and without neuropathy. So, from the finding of the present work, it can be said that diabetic neuropathy affect the arterial flow detected by non invasive duplex colour Doppler imaging may help in proper patient management and may prevent neuropathic arterial complications. But for any definine conclusion, bigger appropriate study should be done.DOI: http://dx.doi.org/10.3329/birdem.v2i2.12309 (Birdem Med J 2012; 2(2): 89-92)

Aspirin, Dipyridamole and Platelet Survival in Patients with Diabetes Mellitus

1982 ◽  
Vol 63 (2) ◽  
pp. 205-209 ◽  
Author(s):  
Hilary Tindall ◽  
R. Colin Paton ◽  
George P. McNicol
Keyword(s):  
Diabetic Patients ◽  
High Dose ◽  
Double Blind ◽  
Regeneration Time ◽  
Dose Aspirin ◽  
Platelet Survival ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
High Dose Aspirin

1. Platelet survival in 27 insulin-dependent diabetic patients with severe retinopathy was studied in a double-blind cross-over trial using placebo, aspirin (990 mg/day) and a combination of dipyridamole (225 mg/day) with aspirin at two dosage levels (330 mg and 990 mg/day). 2. Twenty patients (group I) had 51Cr-labelled-platelet survival after treatment with placebo and the high-dose-aspirin/dipyridamole combination. The remaining seven patients (group II) had platelet-regeneration times measured after each of the four treatment periods. 3. Treatment of group I patients with the high-dose-aspirin/dipyridamole combination resulted in significant (P < 0·001) prolongation of platelet survival from 7·3 ± 0·2 (mean ± sem) days to 8·4 ± 0·1 days. 4. In group II patients, when compared with the mean placebo result of 7·2 ± 0·2 days, the mean aspirin-labelled-platelet-regeneration time was significantly (P < 0·01) longer only after high-dose-aspirin/dipyridamole (9·8 ± 0·5 days) but not after low-dose-aspirin/dipyridamole (8·3 ± 0·5 days) or aspirin alone (7·3 ± 0·3 days). 5. These results suggest that it may be premature to consider reducing the dose of aspirin in aspirin/dipyridamole combinations below 1 g/day when used as antithrombotic therapy.

scholarly journals PROFIL ASAM LAKTAT PENDERITA DIABETES MELLITUS TERKENDALI (KONTROL) DAN TIDAK TERKENDALI (KONTROL)

2018 ◽  
Vol 14 (3) ◽  
pp. 97
Author(s):  
Laily Indrayanti ◽  
Harjo Mulyono
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acid ◽  
Hba1c Level ◽  
Acid Level ◽  
Pearson Correlation ◽  
Diabetic Patients ◽  
Lactic Acid Level ◽  
Group I ◽  
The Mean ◽  
Group Ii

Lactic acid is an intermediate product of carbohydrate metabolism. Increment of plasma lactic acid level usually correlated withaerobic metabolism defect which caused by hypoperfusion or hypoxia, that can be happened in DM (Diabetes Mellitus) patients. DiabetesMellitus is a risk factor of lactic acidosis. Determination of glycated Hb (HbA1c) is a parameter to monitor the blood glucose. The aimof this study is to compare the mean lactic acid level between uncontrolled and controlled DM) patients and their correlation betweenlactic acid and HbA1c level. The research carried out by cross sectional study which was done at the Clinical Pathology Laboratory ofSardjito Hospital between September–October 2007. Inclusion criteria of samples were diabetic patients who had HbA1c examination.Statistical analysis was done by independent t test and Pearson correlation test. Twenty one patients were included in this research.They were divided into two (2) groups, group I are those who had HbA1c ≤ 7%, they consist of 10 patients, group II are patients whohad HbA1c ≥ 7.1%, they consist 11 patients. The mean of lactic acid of group I was 1.85 mmol/L and group II was 1.74 mmol/L (p = 0.574). There wasn’t any significant correlation between HbA1c level and lactic acid. (r = -0.179, p = 0.437). The mean of lacticacid level in uncontrolled DM was lower than the controlled one but not significant, and there was no significant correlation betweenHbA1c level and lactic acid. It is suggested to continue this study but with larger sample to know the correlation between lactic acid andHbA1c in DM patients who had metformin therapy.

scholarly journals Efficiency of nalbuphine as an adjuvant to bupivancaine in lower limb orthopaedic surgery-a prospective study

2017 ◽  
Vol 5 (2) ◽  
pp. 623
Author(s):  
Kanhya Lal Gupta ◽  
Amit Gupta ◽  
. Neeraj
Keyword(s):  
Postoperative Analgesia ◽  
Normal Saline ◽  
Lower Limb ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
The Difference ◽  
Preservative Free

Background: Spinal Anaesthesia is a well-known technique of performing lower limb orthopaedic surgeries. It has a shorter duration of action and early arising postoperative pain due to which various adjuvant needs to be added and their roles are being evaluated in various studies. Intrathecal opioids act synergistically with local anaesthetics and thus intensifying the sensory block without having any effect on sympathetic blockage. The main aim of present study is to investigate and evaluate the effectiveness of intrathecal nalbuphine (preservative free) as an adjuvant and also the efficacy of nalbuphine for postoperative analgesia and its complications if there are any.Methods: A total of 60 patients were included in this study belonging to ASA I and ASA II score with normal coagulation profile. Patients were randomly divided into 2 groups of 30 patients each. Group I receiving 3 ml of hyperbaric bupivacaine 0.5%+1.0mgm of nalbuphine (preservative free) injection made in 0.5 ml normal saline intrathecally. Group II received 3 ml of hyperbaric bupivacaine 0.5%+0.5 ml injection Normal saline intrathecally. The following criteria were noted. The onset of sensory blockade and complete motor blockade highest level of sensory blockade, duration of sensory blockade, duration of motor and duration of effective analgesia were recorded. Any hemodynamic alterations were also noted.Results: The mean time for the onset of sensory blockage was 56 sec in Group I and 59 sec in Group II (control). The difference were statistically insignificant (p>0.05). The mean onset of motor blockage was 106 sec in Group I and 208 sec in Group II (control). The difference was statically insignificant. The peak onset time in Group I and Group II was 372 sec and 220 sec respectively (p>0.05). Two segment regression times for sensory blockage was prolonged in Group I (118.20±8.56 min) compared to Group II (104.56±15.20 mins).Conclusions: The duration of postoperative analgesia was 6-8 hours in Group I compared to 3-4 hours in Group II (p value= 0.0001, statistically significant).

scholarly journals Usefulness of 0.5% Hyperbaric Bupivacaine with Dexmedetomidine on Spinal Anaesthesia in Lower Limb Orthopaedic Patients

2020 ◽  
Vol 5 (2) ◽  
pp. 30-34
Author(s):  
N R Arjun ◽  
Nischala Reddy G ◽  
K. Narayana Prasad ◽  
Uthkala B Hegde
Keyword(s):  
Heart Rate ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Infusion Pump ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Mean Heart Rate

Background: The present study was conducted to assess the usefulness of 0.5% hyperbaric bupivacaine with dexmedetomidine on spinal anesthesia in lower limb orthopedic patients. Subjects and Methods: This study involved 50 patients with ASA Grade I and II of both genders. Patients were randomly allocated into group I (n=25) Patients received Dexmedetomidine 0.5 µ g/kg over 15 minutes using an infusion pump 20 minutes prior to SAB and group II (n=25) Intraoperatively HR, BP and SpO2 were measured and noted. Results: The mean heart rate at baseline was 80.00 8.49 in group I and 81.80 8.74 in group II. The mean heart rate at 5 minutes was 73.80 13.38 in group I which was significantly higher (p=0.02) compared to 65.63 12.45 in group II. The mean arterial pressure at baseline was 97.64  5.24 in group I and 97.73  6.96 in  group II suggesting MAP in both groups was comparable. The MAP at 5 minutes was 90.73 14.65 in group I which was significantly higher (p=0.01) compared to 81.22 11.64 in group II, suggesting a greater fall from the baseline in group II compared to group I. The MAP in both groups was found to be comparable at 15, 30, 45, 60, 75, 90, 105, 120 minutes (p>0.05). The oxygen saturation in both groups was found        to be comparable at all time intervals. The duration of onset of sensory blockade (Time is taken to reach T10 level) in 53.33% of patients in Group I is between 1 to 2 minutes (60 to 120 seconds) and less than 1 minute (60 seconds) in 46.67% of patients. The average mean time and standard deviation of onset of sensory blockade in Group I is 66 44.14 seconds. Conclusion: Authors found that dexmedetomidine was given intravenously as premedication before spinal anaesthesia using injection bupivacaine results in a quicker onset of analgesia, prolonged duration of sensory, motor block and well balanced hemodynamic parameters.

Assessment of Acute Kidney Injury in Patients Undergoing Elective Coronary Angiography and Percutaneous Coronary Intervention

2012 ◽  
Vol 5 (1) ◽  
pp. 37-43
Author(s):  
ABMM Alam ◽  
M Moniruzzaman ◽  
MB Alam ◽  
N Islam ◽  
F Khatoon ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Contrast Media ◽  
Creatinine Level ◽  
Ace Inhibitor ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Group I ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Group Ii

Background: CIN has gained increased attention in the clinical setting, particularly during cardiac intervention but also in many other radiological procedures in which iodinated contrast media are used. There is at present good clinical evidence from well-controlled randomized studies that CIN is a common cause of acute renal dysfunction.Methodology: This was a prospective study conducted among the patients who underwent coronary angiography and percutaneous coronary intervention in the Department of Cardiology, Dhaka Medical College Hospital during January 2010 to December 2010. A total of 111 patients age range from 25 to 75 years were included in the study. Serum creatinine level at baseline and at the end of 48 hours was done in all these patients. Study population was divided into two groups according to development of acute kidney injury (AKI). Group-I = AKI, Group II = Not developed AKI. Results: AKI developed 11.7% of the study patient. DM and Preexisting renal insufficiency were significantly higher in group I patients. HTN was (61.5% Vs 44.9%) higher in group I but not significantly. History of ACE inhibitor/ARB, NSAID intake and LVEF <40% were significantly higher in group I patients. The mean±SD volume of CM (Contrast Media) were 156.9±44.8 ml and 115.4±30.0 ml in group I and group II respectively, which was significant. The mean±SD of serum creatinine after 48-72 hours of CAG/PCI was 1.4±0.37 mg/dl and 1.1±0.2 mg/dl in group I and group II respectively. The serum creatinine level increased significantly (p<0.05) after 48-72 hours of CAG/PCI in group I. In group II, S. creatinine level increased but not significant (p>0.05). Impaired renal function was found 76.9% and 2.0% in group I and group II respectively. DM, HTN, preexisting renal insufficiency, ACE inhibitor/ARB, NSAIDs, contrast volume (>150 ml), eGFR (<60 ml/min/ 1.73m2) and LVEF (<40%) are significantly (p0.05) associated for CIN development.Conclusion: CIN is an iatrogenic but preventable disorder results from the administration of contract media. Although rare in the general population, CIN occurs frequently in patients with underlying renal dysfunction and diabetes. In patients with pre angiographic normal renal function, the prevalence is low but in pre-existing renal impairment it may pose a serious threat. Thus risk factors are synergistic in their ability to predispose to the development of CIN. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patients at risk for CIN. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12227 Cardiovasc. j. 2012; 5(1): 37-43

scholarly journals A prospective study on effectiveness of drotaverine in acceleration of labor

2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal
Keyword(s):  
Prospective Study ◽  
Drug Administration ◽  
Active Phase ◽  
Delivery Mode ◽  
Normal Delivery ◽  
Group I ◽  
Vacuum Delivery ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
Group Ii

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  

Anterior bone cement augmentation in anterior lumbar interbody fusion and percutaneous pedicle screw fixation in patients with osteoporosis

2010 ◽  
Vol 12 (5) ◽  
pp. 525-532 ◽  
Author(s):  
Kyeong Hwan Kim ◽  
Sang-Ho Lee ◽  
Dong Yeob Lee ◽  
Chan Shik Shim ◽  
Dae Hyeon Maeng
Keyword(s):  
Vertebral Body ◽  
Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Cement Augmentation ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Group I ◽  
Cage Subsidence ◽  
The Mean ◽  
Group Ii

Object The purpose of the present study was to evaluate the efficacy of anterior polymethylmethacrylate (PMMA) cement augmentation in instrumented anterior lumbar interbody fusion (ALIF) for patients with osteoporosis. Methods Sixty-two patients with osteoporosis who had undergone single-level instrumented ALIF for spondylolisthesis and were followed for more than 2 years were included in the study. The patients were divided into 2 groups: instrumented ALIF alone (Group I) and instrumented ALIF with anterior PMMA augmentation (Group II). Sixty-one patients were interviewed to evaluate the clinical results, and plain radiographs and 3D CT scans were obtained at the last follow-up in 46 patients. Results The mean degree of cage subsidence was significantly higher in Group I (19.6%) than in Group II (5.2%) (p = 0.001). The mean decrease of vertebral body height at the index level was also significantly higher in Group I (10.7%) than in Group II (3.9%) (p = 0.001). No significant intergroup differences were observed in the incidence of radiographic adjacent-segment degeneration (ASD) or in terms of pain and functional improvement. The incidences of clinical ASD (23% in Group I and 10% in Group II) were not significantly different. There was 1 case of nonunion and 3 cases of screw migration in Group I, but none resulted in implant failure. Conclusions Anterior PMMA augmentation during instrumented ALIF in patients with osteoporosis was useful to prevent cage subsidence and vertebral body collapse. In addition, PMMA augmentation did not increase the nonunion rate and incidence of ASD.

Genoprotective role of vitamin E and selenium in rabbits anaesthetized with sevoflurane

2004 ◽  
Vol 23 (8) ◽  
pp. 413-419 ◽  
Author(s):  
Cetin Kaymak ◽  
Ela Kadioglu ◽  
Hulya Basar ◽  
Semra Sardas
Keyword(s):  
Dna Damage ◽  
Vitamin E ◽  
Comet Assay ◽  
Antioxidant Supplementation ◽  
Group Iii ◽  
Sevoflurane Anaesthesia ◽  
Group I ◽  
The Mean ◽  
Group Ii

In this study, genotoxic effects of repeated sevoflurane anaesthesia were investigated in rabbits with or without antioxidant supplementation. Twenty-one New Zealand male rabbits were included in the study and randomized into three groups as: placebo treated (Group I), vitamin E supplemented (Group II) and selenium supplemented (Group III). Vitamin E and selenium were given intraperitoneally for 15 days before anaesthesia treatment. Anaesthesia was administered using 3% sevoflurane in 4 L/min oxygen for a 3-hour period and continued for 3 days. Blood samples were collected before anaesthesia (Sample 1), after the first, second and third days of sevoflurane administration (Sample 2, Sample 3 and Sample 4 respectively) and the last samples were taken 5 days after the last sevoflurane administration (Sample 5). Genotoxic damage was examined using the comet assay. The degree of damage is assessed by grading the cells into three categories of no migration (NM), low migration (LM) and high migration (HM) depending on the fraction of DNA pulled out into the tail under the influence of the electric field. The number of comets in each sample was calculated (1 × number of comets in category NM + 2 × number of comets in category LM + 3 ×number of comets in category HM) and expressed as the total comet score (TCS), which summarizes the damage frequencies. In Group I, a significant increase in the mean TCSs was observed for Samples 3 and 4 as compared with Sample 1. However, there were no significant differences between Samples 1, 2 and 5. The mean TCS of Sample 4 was significantly higher than Sample 1, 2 and 3 in Group II. Group III demonstrated no significant mean TCSs for any experimental conditions. Statistical differences were also observed between the groups with significant P values. This experimental study points out the presence of DNA damage with repeated sevoflurane anaesthesia and the genoprotective role of antioxidant supplementation on DNA damage in mononuclear leukocytes of rabbits by highly sensitive comet assay.

Bone mineral density and spongiosa architecture in correlation to vertebral body insufficiency fractures

1998 ◽  
Vol 39 (5) ◽  
pp. 538-542 ◽  
Author(s):  
R. Andresen ◽  
S. Radmer ◽  
D. Banzer
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Vertebral Body ◽  
Unknown Etiology ◽  
Insufficiency Fractures ◽  
Mineral Density ◽  
Group Iii ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: the clinical value of spinal quantitative CT (sQCT) and the structural patterns of the vertebral bone were studied Material and Methods: sQCT was performed on 246 patients with a mean age of 57 years for whom conventional lateral radiographies of the thoracic and lumbar spine were available. All patients were suffering from back pain of unknown etiology. the bone mineral density (BMD) of the midvertebral section of 3 lumbar vertebral bodies was determined by means of single-energy-(SE)-weighted QCT (85 kV). Spongiosa architecture and density profile analyses were made in the axial images. This was contrasted to BMD values ascertained in SE QCT. the mean BMD was compared to the number of fractures and the patients were divided into three groups: group I — no fracture; group II — one fracture; and group III 1 fracture Results: the mean BMD was: 134.3 (74.1–187.5) mg hydroxyapatite (HA)/ml in group I; 79.6 (58.6–114.3) mg HA/ml in group II; and 52.4 (13.1–79.1)mg HA/ml in group III. A significant deterioration in spongiosa structure was found with increasing demineralization: strongly rarefied patterns predominated in the fracture groups II and III Conclusion: sQCT provides a good risk assessment of the occurrence of vertebral body insufficiency fractures

Seasonal variations in wool growth and heat tolerance of sheep. I. Wool growth

1960 ◽  
Vol 11 (1) ◽  
pp. 75 ◽  
Author(s):  
M Wodzicka
Keyword(s):  
Body Weight ◽  
Day Treatment ◽  
The Other ◽  
Seasonal Rhythm ◽  
Group Iii ◽  
Wool Growth ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
The Difference

The monthly wool growth of three groups of rams was studied at Beltsville, Maryland. Group I received natural daylight (at 38° 53' N.) and was shorn monthly. Group II had a 7:17 hours of daylight to hours of darkness rhythm and was shorn every 6 months, once in winter and once in summer. Group III received natural daylight and was likewise shorn every 6 months. The rams of all groups produced more wool in summer than in winter. This difference was significant (P<0.001). The mean body weight and food intake were both greater in the winter months, which indicated that the seasonal rhythm of wool growth was not a consequence of poorer feeding in winter. The rams which were shorn monthly (group I) grew considerably more wool than the other two groups, but the difference was not statistically significant. The short-day treatment of group II did not increase the annual wool production nor decrease the seasonal rhythm of wool growth. The balance of evidence from this and other experiments indicates that temperature rather than light controls the seasonal rhythm of wool growth.

Sign in / Sign up

Export Citation Format

Share Document