scholarly journals Effect of N-acetylcysteine against Vancomycin-Induced Nephrotoxicity: A Randomized Controlled Clinical Trial

2020 ◽  
Vol 23 (6) ◽  
pp. 397-402
Author(s):  
Shirinsadat Badri ◽  
Rasool Soltani ◽  
Mina Sayadi ◽  
Farzin Khorvash ◽  
Mohsen Meidani ◽  
...  

Background: The proposed mechanism of vancomycin-induced nephrotoxicity (VIN) is indirect production of reactive oxygen species in the kidney tissue. This study aimed to investigate the effectiveness of N-acetylcysteine (NAC), an anti-oxidant agent, in the prevention of VIN. Methods: Patients who received vancomycin for any indication were randomly divided to drug (NAC) and control groups. The patients in the drug group received oral NAC 600 mg every 12 hours for 10 days, starting concurrently with vancomycin. Serum creatinine (SCr) levels and blood urea nitrogen (BUN) as well as creatinine clearance (CrCl) and 12-hour urine volume were recorded at baseline, every other day during the study, and 12 hours after the last dose of vancomycin on the 10th day. Furthermore, the cases of acute kidney injury (AKI; ≥ 0.5 mg/dL or at least 50% increase in serum creatinine from baseline) were recorded in the two groups. Results: Over the study period, 84 and 95 patients completed the study in drug and control groups, respectively. SCr and CrCl were significantly lower and higher, respectively, at all-time points (except for baseline) in the NAC compared to the control group. Furthermore, although not statistically significant, 12 cases of vancomycin-induced AKI were observed in the control group (12.63%), while 4 cases (4.76%) were reported from drug group (P = 0.066; relative risk [RR] = 0.377, 95% CI: 0.126–1.124). Conclusion: NAC has the potential for reduction of VIN. However, more studies are necessary to confirm this effect.

2020 ◽  
Vol 44 ((E0)) ◽  
pp. 14-20
Author(s):  
Aamir M. Al-ghareebaw

This study aimed to investigate the protective influence of olive leave extract zinc oxidenanoparticles (OLEZnONPs) complex against gentamicin–induced kidney dysfunctions ingoats. Twenty five adult female goats were randomly divided into five equal groups andtreated as follows: control group (C) administered sterile distilled water (IM) for 10 days,group G administered 25 mg/kg BW gentamicin (IM) for 7 days, group Z administered 10μg/kg BW of OLEZnONPs (IP) for 3 days, group GTZ administered 25 mg/kg BW gentamicin(IM) for 7 days and then 10 μg/kg BW of OLEZnONPs (IP) for 3 days, group GWZadministered 25 mg/kg BW gentamicin (IM) and 10 μg/kg BW of OLEZnONPs (IP) togetherfor first 3 days and then followed by gentamicin only for 4 days. After seven days of theexperiment, the gene expression of kidney injury molcule-1(KIM-1) and neutrophilgelatinase-association lipocalin (NGAL) gene expression of kidney tissue were measured. Inaddition, samples of kidney were obtained for histopathological examination. Gentamicinmedication induced a marked elevation in kidney tissue KIM-1 and NGAL gene expressionin G and GTZ groups compared to control and other groups. Intraperitoneal treatment ofgoats with OLEZnONPs did not significantly affect NGAL and KIM-1 gene expression in Z,GWZ, and control groups. Histologically, in contrast to control, gentamicin induced moreextensive kidney damages such as necrotized glomeruli, atrophic glomeruli, and renaltubular epithelial necrosis, while it was found that these alterations in kidney tissues wereimproved in goats given OLEZnONPs with gentamicin compared to group G. In conclusion,our results demonstrate that OLEZnONPs reduce the deleterious effects of gentamicin withsignificantly decreasing of KIM-1 and NGAL gene expression and remodeling the histologicalchanges of kidney in goats


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2604
Author(s):  
Jin-Young Park ◽  
Kyung-A Ko ◽  
Ji-Yeong Lee ◽  
Jae-Woon Oh ◽  
Hyun-Chang Lim ◽  
...  

Background: Mangosteen and propolis extracts (MAEC) have been potential therapeutic agents known to exhibit powerful antioxidant and anti-inflammatory properties. The aim of the current study was to evaluate the clinical and immunological efficacy of MAEC as well as safety and patient-reported outcomes (PROMs) on gingivitis and incipient periodontitis. Methods: This study was performed on 104 patients diagnosed with gingivitis or incipient periodontitis. At baseline, the participants were randomly allocated to either the test group, with daily intake of a single capsule containing 194 mg of MAEC for eight weeks, or control group, with placebo. Clinical periodontal evaluation and immunological parameters from saliva and gingival sulcular fluid were assessed at baseline, four, and eight weeks. Individual PROMs were assessed by OHIP-14 questionnaires. Results: There was a significant difference of modified gingival index at four and eight weeks between the test and control groups. In the test group, crevicular interleukin (IL)-6 was reduced, and the salivary matrix metalloproteinase (MMP)-9 was increased after eight weeks. PROMs were improved up to four weeks compared to placebo. Conclusion: Oral administration of MAEC would have a potential to reduce gingival inflammation clinically and immunologically in the patients with gingivitis and incipient periodontitis.


Author(s):  
Sneha Puri ◽  
Mahvash Fatema ◽  
Akhilesh Shewale ◽  
Rashmi Bele

Introduction: Herbal antiseptic or antibiotic agents are introduced very widely that are effective against plaque microorganisms for the healing of gingival and periodontal tissue. However, none of literature has shown antibacterial effect of coriandrum sativum, clove and mint on the levels of dental plaque when used as a mouthwash. Aim: To assess the efficacy of a newly formulated mouthwash containing Coriandrum sativum, mint and clove to reduce plaque and inflammation to maintain the oral hygiene. Methodology: Twenty systemically healthy patients were randomly allocated to either the test group [G1(coriandrm sativum, mint,clove = 10 patients)] or the control group [G2 (Placebo gel = 10 patients]. Full mouth Gingival Index (GI); Full mouth Plaque Index (PI) was evaluated at baseline and on 14 and 21st day.   Result: The mean reduction in PI from 2.28 to 0.85 and 2.13 to 1.21 was noted in the experimental and control groups, respectively. The experimental group (2.21–0.76) comparatively showed better reduction in mean PBI than the control group (2.17–1.29). The results obtained were statistically significant at baseline and 14th and 21st day in all the groups. Remarkable improvement was noted from baseline to 14th and 21st day in all the groups. Conclusion: The encouraging results of our study suggest that the newly formulated mouthwash containing coriandrum Sativum, mint and clove demonstrates anti-inflammatory properties, which may be useful as an adjunctive to mechanical therapy in the prevention and treatment of gingivitis.


2021 ◽  
Author(s):  
parvaneh sharifipour ◽  
Masoomeh Kheirkhah ◽  
Mojgan Rajati ◽  
hamid haghani

Abstract Background Childbirth is a unique experience that affects women’s life. Therefore, this study was performed to determine the effect of delivery ball and warm shower on the childbirth experience of primiparous women. Methods This study is a clinical trial that was carried out on primiparous pregnant women referred to Motazedi Hospital in Kermanshah, Iran. Sampling was done by continuous method and pregnant women were divided into three groups of delivery ball-warm shower (n = 33), delivery ball (n = 33) and control (n = 33). Exercise with ball at the dilation of 4 cm was similar in the two groups of delivery ball-warm shower and delivery ball, but the first group also used warm shower at the dilatation of 7 cm. The control group only received the routine delivery care. Demographic information form consisting of pregnancy history and information about the mother and infant were completed and the childbirth experience questionnaire (CEQ) were completed by the women two hours after the childbirth. Results There was a statistically significant difference in the mean score of childbirth experience after the intervention between the two groups of delivery ball-warm shower and control (P = 0.001), and also between the delivery ball and control groups (P = 0.001). There was a statistically significant difference in the mean scores of professional support between the two groups of delivery ball-warm shower and control (P = 0.02) and also between the delivery ball and control groups (p = 0.02). There was a statistically significant difference in the mean scores of participation between the two groups of delivery ball-warm shower and control (P = 0.003) and also between the delivery ball and control groups (P = 0.01). There was also a statistically significant difference in the mean scores of sense of security between the two groups of delivery ball-warm shower and control (P = 0.01). Conclusion Delivery ball and warm shower were effective interventions to create a positive childbirth experience. This method was more effective than using delivery ball alone in childbirth experience. To achieve a positive experience of childbirth in mothers, the use of both intervention (delivery ball and warm shower) is recommended.


2020 ◽  
Author(s):  
fahimeh sehhatie shafaei ◽  
mojgan mirghafourvand ◽  
shiva havizari

Abstract Background: Breastfeeding is one of the most important interfering factors in infants’ health. Monitoring mothers’ performance and providing them with the feedback helps to increase their self-efficacy, interest in learning, and level of performance. The present research evaluates the effect of prenatal counseling on the breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding.Methods: This randomized controlled clinical trial was conducted on 108 pregnant women with unsuccessful breastfeeding in Tabriz health centers during 2017-2018. The participants were randomly assigned to intervention and control groups. The intervention group had four prenatal counseling sessions and the controls only received routine care. Then, the mothers who gave birth to their children received a counseling session up to 4 months after the delivery. The Breastfeeding Self-Efficacy (BSES) questionnaire and the frequency of breast feeding problems checklist on the 15th day, and 2nd and 4th month were completed both by the intervention and control groups.Results: The mean (SD) of breastfeeding self-efficacy was 119.3 (10.5), 128.3 (8.3) and 133.8 (10.3) in the intervention group and 105.3 (16.1), 105.7 (19.7) and 109.4 (24.7) in the control group on the 15th day, 2nd and 4th month after the delivery, respectively. There was a significant difference in terms of breastfeeding self-efficacy between intervention and control group on the 15th day (p<0.001), and 2nd (p<0.001) and 4th (p<0.001) month after the delivery. The frequency of breastfeeding problems on the 15th (p=0.008), 2nd (p<0.001) and 4th (p<0.001) after the delivery was significantly different in most cases of the intervention group when compared to the controls.Conclusion: The results indicated that prenatal counseling can increase mothers’ breastfeeding self-efficacy and solves most breastfeeding problems during postpartum period.Trial registration: IRCT20100109003027N19


2019 ◽  
Vol 8 (5) ◽  
pp. 713 ◽  
Author(s):  
Ji-Yeon Bang ◽  
Sae-Gyeol Kim ◽  
Jimi Oh ◽  
Seon-Ok Kim ◽  
Yon-Ji Go ◽  
...  

Although remote ischemic preconditioning (RIPC) has been shown to have renoprotective effects, few studies have assessed the effects of RIPC on renal function in living kidney donors. This study investigated whether RIPC performed in living kidney donors could improve residual renal function in donors and outcomes in recipients following kidney transplantation. The donors were randomized into a control group (n = 85) and a RIPC group (n = 85). The recipients were included according to the matched donors. Serum creatinine (sCr) concentrations and estimated glomerular filtration rate (eGFR) were compared between control and RIPC groups in donors and recipients. Delayed graft function, acute rejection, and graft failure within one year after transplantation were evaluated in recipients. sCr was significantly increased in the control group (mean, 1.13; 95% confidence interval (CI), 1.07–1.18) than the RIPC group (1.01; 95% CI, 0.95–1.07) (p = 0.003) at discharge. Donors with serum creatinine >1.4 mg/dL at discharge had higher prevalence of chronic kidney disease (n = 6, 26.1%) than donors with a normal serum creatinine level (n = 8, 5.4%) (p = 0.003) after one year. sCr concentrations and eGFR were similar in the RIPC and control groups of recipients over the one-year follow-up period. Among recipients, no outcome variables differed significantly in the RIPC and control groups. RIPC was effective in improving early renal function in kidney donors but did not improve renal function in recipients.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paria Amiri ◽  
Mojgan Mirghafourvand ◽  
Khalil Esmaeilpour ◽  
Mahin Kamalifard ◽  
Reyhaneh Ivanbagha

Abstract Background Pain control and the stress associated with labor and delivery are among the most important issues of health care system. Use of distraction techniques during childbirth is reported to reduce pain and stress of labor. However, there is a limited publication that looked on the effect of distraction techniques on labor pain and stress. Thus, the aim of this study was to determine the effect of distraction techniques on labor pain and stress (primary outcomes), fear of childbirth, length of delivery stages, first minute Apgar score and oxytocin consumption (secondary outcomes). Methods A randomized controlled clinical trial was conducted on 68 pregnant women. Participants were allocated into two groups (intervention and control groups) by blocked randomization. Participants in the intervention group received distraction techniques in four sessions. Questionnaires of Fear of Childbirth (W-DEQ version A) and PSS once were completed before intervention and again at the 36th week for the W-DEQ and in the active phase for the PSS through interviews. The pain was assessed through VAS during active phase per hour. The length of delivery stages was recorded in the partograph chart. Data were analyzed by independent t-test and ANCOVA. Results The mean of perceived stress during labor in the intervention group was significantly less than that of the control group (AMD: -3.2; 95% CI: − 0.8 to − 6.0; P = 0.01). The mean (SD) of pain intensity during labor was less than in the intervention and control groups compare to the control group (6.2 vs 7.5; P < 0.001). There was no significant difference between the two groups in terms of fear of childbirth score (AMD: 5.3; 95% CI: 13.0 to − 6.0; P = − 2.3). Moreover, there was no statistically significant difference between the two groups in terms of the active phase of labor (P = 0.504), second stage of delivery (P = 0.928), total length of delivery (P = 0.520), Apgar score (P = 1.000) and frequency of oxytocin consumption (P = 0.622). Conclusion According to the results, distraction techniques can reduce the pain and stress of labor, but further studies by using the distraction techniques are needed to reach a decisive conclusion. Trial registration IRCT2017042910324N39; Name of registry: Iranian Registry of Clinical Trials; Registered 11 September 2017. URL of registry: https://fa.irct.ir/user/trial/10814/view. Date of enrolment of the first participant to the trial: September 2017.


2010 ◽  
Vol 30 (7) ◽  
pp. 535-540 ◽  
Author(s):  
Hassan Solhi ◽  
Babak Mostafazadeh ◽  
Hamid Reza Khoddami Vishteh ◽  
Ali Reza Ghezavati ◽  
Ali Shooshtarizadeh

Background: Naloxone, as a low-priced and available drug, may be useful in improvement of signs and symptoms of benzodiazepines intoxication. The aim of this study was assessment of its effect on benzodiazepines poisoning. Methods: In this clinical-trial study, patients with typical signs and symptoms of benzodiazepines poisoning, who were referred to a poisoning center in Tehran in 2008, were selected. After recording of patients’ characteristics, supportive treatment was initiated and patients were randomly assigned to the case group with intravenous (IV) injection of two 0.4 mg naloxone ampules or to the control group. Their signs and symptoms were evaluated again 0.5 hour later. Each of diazepam, clonazepam and alperazolam drug group had 30 patients and lorazepam drug group had 26 patients, half of which patients in each drug group received naloxone. Results: Most of the participants were female and the mean age was 28 years. There were no significant differences between case and control groups in age, sex, time of drug consumption, tablet counts, signs and symptoms and level of consciousness at the admission time in each drug types. After naloxone injection in case groups, all signs and symptoms significantly improved in all drug types in comparison to control groups except nystagmus. In addition, level of consciousness significantly improved in case groups in all drug types except lorazepam. Conclusion: Findings of the study showed that naloxone is effective in management of benzodiazepines poisoning. However, future clinical trials with greater sample size are recommened.


2019 ◽  
Author(s):  
Paria Amiri ◽  
Mojgan Mirghafourvand ◽  
Khalil Esmaeilpour ◽  
Mahin Kamalifard ◽  
Reyhaneh Ivanbagha

Abstract Background: Pain control and the stress associated with labor and delivery are among the most important issues of health care system. Use of distraction techniques during childbirth is reported to reduce pain and stress of labor. However, there is a limited publication that looked on the effect of distraction techniques on labor pain and stress. Thus, the aim of this study was to determine the effect of distraction techniques on labor pain and stress (primary outcomes), fear of childbirth, length of delivery stages, first minute Apgar score and oxytocin consumption (secondary outcomes). Methods: A randomized controlled clinical trial was conducted on 68 pregnant women. Participants were allocated into two groups (intervention and control groups) by blocked randomization. Participants in the intervention group received distraction techniques in four sessions. Questionnaires of Fear of Childbirth (W-DEQ version A) and PSS once were completed before intervention and again at the 36th week for the W-DEQ and in the active phase for the PSS through interviews. The pain was assessed through VAS during active phase per hour. The length of delivery stages was recorded in the partograph chart. Data were analyzed by independent t-test and ANCOVA . Results: The mean of perceived stress during labor in the intervention group was significantly less than that of the control group (AMD: -3.2; 95% CI: -0.8 to -6.0; P= 0.01). The mean (SD) of pain intensity during labor was less than in the intervention and control groups compare to the control group (6.2 vs 7.5; P<0.001). There was no significant difference between the two groups in terms of fear of childbirth score (AMD: 5.3; 95% CI: 13.0 to -6.0; P= -2.3). Moreover, there was no statistically significant difference between the two groups in terms of the active phase of labor (P= 0.504), second stage of delivery (P= 0.928), total length of delivery (P= 0.520), Apgar score (P= 1.000) and frequency of oxytocin consumption (P= 0.622). Conclusion: According to the results, distraction techniques can reduce the pain and stress of labor, but further studies by using the distraction techniques are needed to reach a decisive conclusion .


Rheumatology ◽  
2020 ◽  
Author(s):  
Olga L Kukuy ◽  
Pazit Beckerman ◽  
Dganit Dinour ◽  
Ilan Ben-Zvi ◽  
Avi Livneh

Abstract Objective Amyloid A nephropathy of FMF usually progresses over many years to end-stage renal disease (ESRD). We aim to describe an acute condition, termed here ‘amyloid storm’, typically manifesting with a rapid (≤2 weeks) increase in serum creatinine and urine protein, that has never been characterized in FMF amyloidosis. Methods This retrospective analysis features amyloid storm by comparing between FMF amyloidosis patients who have experienced an episode of amyloid storm (study group) and matched patients who have not (control group). The primary outcome was ESRD or death within 1 year from study entry. Featured data were retrieved from hospital files. Results The study and control groups, each comprising 20 patients, shared most baseline characteristics. However, they differed on the time from FMF onset to reaching serum creatinine of 1.2 mg/dl [26.5 years (s.d. 15.15) vs 41.55 (10.98), P = 0.001] and the time from the onset of proteinuria to study entry [8.8 years (s.d. 6.83) vs 15.75 (13.05), P = 0.04], culminating in younger age at study entry [39.95 years (s.d. 16.81) vs 48.9 (9.98), respectively, P = 0.05] and suggesting an accelerated progression of kidney disease in the study group. Within 1 year from study entry, 16 patients in the study and 3 in the control groups reached the primary endpoint (P = 0.000). The major triggers of amyloid storm were infections, occurring in 17 of 20 patients. Conclusion Amyloid storm is a complication of FMF amyloidosis, induced by infection and associated with poor prognosis and death.


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