scholarly journals MANAGEMENT OF HUMUZAT-E-MEDA (HYPERACIDITY) WITH JAWARISH AMLA & HABB-E-PAPITA- A MULTI CENTRIC STUDY

2021 ◽  
pp. 119-121
Author(s):  
Abdul Raheem ◽  
Ishtiyaq Ahmad ◽  
Parvez Khan ◽  
Arjumand Shah ◽  
Tamanna Nazli ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Gastric Surgery ◽  
Duodenal Ulcers ◽  
Safety And Efficacy ◽  
Zollinger Ellison Syndrome ◽  
Before And After ◽  
Lactating Females ◽  
Cardiac Disorders ◽  
Laboratory Investigations ◽  
Crohn’S Diseases

Background – Hyperacidity is one of the most common diseases seen in all ages. Hyperacidity simply means an increased level of acid in the stomach. Unani system of medicine has a treasure of formulations for the treatment of hyperacidity. Methods- Present open labeled,multi-centric, single arm validation was conducted to evaluate the safety and efficacy of Unani pharmacopeial drug Jawarish Amla and Habb-e-Papita in Humuzat-e-Meda (Hyperacidity). Patients with symptoms of hyperacidity like retro-sternal burning,epigastric pain with retro-sternal heaviness,acidic brash,anorexia, nausea and vomiting were included. Patients with known duodenal ulcers, peptic ulcer, gastric surgery gastric carcinoma, Crohn's Diseases, Zollinger Ellison Syndrome, cardiac disorders, respiratory ailments, Diabetes Mellitus, pregnant and lactating females were excluded. Unani formulations,Jawarish Amla 10 g and Habb e Papita 2 tablets were given twice daily after meals for 6 weeks. Clinical & haematological parameters were assessed before and after the treatment to evaluate the safety and efficacy of the drug. Results– No significant changes are observed after 28 days and 84 days during the therapy in the safety profiles of laboratory investigations such as complete haemogram, LFT, KFT. There is significant improvement in the sign and symptoms associated withHumuzat-e-Meda (Hyperacidity). Conclusion- Unani compound formulations Jawarish Amla and Habb-e-Papita are safe and effective in the management ofHumuzat-e-Meda (Hyperacidity).

scholarly journals Eosinophilic Cholecystitis Associated with Eosinophilic Granulomatosis with Polyangiitis

2020 ◽  
Vol 14 (3) ◽  
pp. 668-674
Author(s):  
Hiroyuki Ito ◽  
Yusuke Mishima ◽  
Tsubomi Cho ◽  
Naoki Ogiwara ◽  
Yoshimasa Shinma ◽  
...  
Keyword(s):  
Cerebral Hemorrhage ◽  
Granulomatosis With Polyangiitis ◽  
Epigastric Pain ◽  
White Blood Cells ◽  
Gallbladder Wall ◽  
Antineutrophil Cytoplasmic Antibodies ◽  
Eosinophilic Granulomatosis With Polyangiitis ◽  
Test Results ◽  
Laboratory Investigations ◽  
Eosinophilic Granulomatosis

We report a case of eosinophilic cholecystitis associated with eosinophilic granulomatosis with polyangiitis (EGPA) complicated by cerebral hemorrhage. A 60-year-old man presented to a local hospital with a diagnosis of acute cholecystitis, with persistent fever and epigastric pain for 2 weeks. His symptoms persisted despite 3-week hospitalization; therefore, he was transferred to our hospital for further evaluation. Laboratory investigations upon admission showed white blood cells 26,300/µL and significant eosinophilia (eosinophils 61%). Abdominal computed tomography revealed no gallbladder enlargement but a circumferentially edematous gallbladder wall. Additional blood test results were negative for antineutrophil cytoplasmic and perinuclear antineutrophil cytoplasmic antibodies; however, immunoglobulin (Ig)G and IgE levels were high at 1,953 mg/dL and 3,040/IU/mL, respectively. He improved following endoscopic transnasal gallbladder drainage for cholecystitis and was diagnosed with EGPA and received corticosteroid and immunosuppressant combination therapy. The eosinophil count decreased immediately after treatment, and abdominal pain and numbness resolved. He returned with left-sided suboccipital hemorrhage likely attributed to EGPA 6 months after discharge. EGPA is characterized by inflammation of small blood vessels and clinically manifests with an allergic presentation of bronchial asthma, as well as renal dysfunction, interstitial pneumonia, enteritis, and cerebral hemorrhage. Few reports have described cholecystitis as a presenting symptom of EGPA. We report a rare case of such a presentation with added considerations.

scholarly journals Normalizing the Abnormal: Do Antipsychotic Drugs Push the Cortex Into an Unsustainable Metabolic Envelope?

2019 ◽  
Vol 46 (3) ◽  
pp. 484-495 ◽  
Author(s):  
Federico E Turkheimer ◽  
Pierluigi Selvaggi ◽  
Mitul A Mehta ◽  
Mattia Veronese ◽  
Fernando Zelaya ◽  
...  
Keyword(s):  
Psychotic Symptoms ◽  
Antipsychotic Treatment ◽  
Long Term Effects ◽  
Extrapyramidal Syndrome ◽  
Before And After ◽  
Cardiac Disorders ◽  
Positive Symptoms Of Psychosis ◽  
The Brain ◽  
Novel Model

Abstract The use of antipsychotic medication to manage psychosis, principally in those with a diagnosis of schizophrenia or bipolar disorder, is well established. Antipsychotics are effective in normalizing positive symptoms of psychosis in the short term (delusions, hallucinations and disordered thought). Their long-term use is, however, associated with side effects, including several types of movement (extrapyramidal syndrome, dyskinesia, akathisia), metabolic and cardiac disorders. Furthermore, higher lifetime antipsychotic dose-years may be associated with poorer cognitive performance and blunted affect, although the mechanisms driving the latter associations are not well understood. In this article, we propose a novel model of the long-term effects of antipsychotic administration focusing on the changes in brain metabolic homeostasis induced by the medication. We propose here that the brain metabolic normalization, that occurs in parallel to the normalization of psychotic symptoms following antipsychotic treatment, may not ultimately be sustainable by the cerebral tissue of some patients; these patients may be characterized by already reduced oxidative metabolic capacity and this may push the brain into an unsustainable metabolic envelope resulting in tissue remodeling. To support this perspective, we will review the existing data on the brain metabolic trajectories of patients with a diagnosis of schizophrenia as indexed using available neuroimaging tools before and after use of medication. We will also consider data from pre-clinical studies to provide mechanistic support for our model.

scholarly journals Zollinger-Ellison syndrome. Case report

Case reports ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. 28-35
Author(s):  
Juan Felipe Rivillas-Reyes ◽  
Juan Leonel Castro-Avendaño ◽  
Héctor Fabián Martínez-Muñoz
Keyword(s):  
Peptic Ulcer ◽  
Epigastric Pain ◽  
Perforated Peptic Ulcer ◽  
Whipple Procedure ◽  
Ulcer Disease ◽  
Zollinger Ellison Syndrome ◽  
Standard Management ◽  
Effective Option ◽  
Low Incidence ◽  
Emergency Surgical Intervention

Introduction: The Zollinger-Ellison syndrome (ZES) is a pathology caused by a neuroendocrine tumor, usually located in the pancreas or the duodenum, which is characterized by elevated levels of gastrin, resulting in an excessive production of gastric acid.Case presentation: A 42-year-old female patient with a history of longstanding peptic ulcer disease, who consulted due to persistent epigastric pain, melena and signs of peritoneal irritation.  Perforated peptic ulcer was suspected, requiring emergency surgical intervention. Subsequently, a tumor lesion in the head of the pancreas was documented and managed with Whipple procedure. The pathology results reported a tumor suggestive of neuroendocrine neoplasm.Discussion: The Zollinger-Ellison syndrome occurs in 0.1 to 3 people per 1 000 000 inhabitants worldwide and is predominant in women between 20 and 50 years of age. It usually appears as a refractory acid-peptic disease or as a complication of gastric acid hypersecretion. Medical therapy is the standard management, being proton pump inhibitors (PPI) the most effective option. Surgery is recommended for sporadic ZES.Conclusions: ZES has a low incidence rate. It is rarely considered in the differential diagnosis of chronic epigastric pain and high clinical suspicion is required to achieve adequate management. This article is highly relevant as it presents a confirmed clinical case of ZES in Colombia, highlighting the importance of producing local scientific literature to improve the diagnosis and treatment of this pathology.

A Symptom-Triggered Benzodiazepine Protocol Utilizing SAS and CIWA-Ar Scoring for the Treatment of Alcohol Withdrawal Syndrome in the Critically Ill

2016 ◽  
Vol 51 (2) ◽  
pp. 101-110 ◽  
Author(s):  
Soumitra Sen ◽  
Philip Grgurich ◽  
Amanda Tulolo ◽  
Andrew Smith-Freedman ◽  
Yuxiu Lei ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Critically Ill ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Limited Data ◽  
Safety And Efficacy ◽  
Icu Length Of Stay ◽  
Before And After ◽  
Before And After Study

Background: There are limited data on the efficacy of symptom-triggered therapy for alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU). Objective: To evaluate the safety and efficacy of a symptom-triggered benzodiazepine protocol utilizing Riker Sedation Agitation Scale (SAS) scoring for the treatment of AWS in the ICU. Methods: We performed a before-and-after study in a medical ICU. A protocol incorporating SAS scoring and symptom-triggered benzodiazepine dosing was implemented in place of a protocol that utilized the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale and fixed benzodiazepine dosing. Results: We enrolled 167 patients (135 in the preintervention and 32 in the postintervention group). The median duration of AWS was shorter in the postintervention (5, interquartile range [IQR] = 4-8 days) than in the preintervention group (8, IQR = 5-12 days; P < 0.01). Need for mechanical ventilation (31% vs 57%, P = 0.01), median ICU length of stay (LOS; 4, IQR = 2-7, vs 7, IQR = 4-11 days, P = 0.02), and hospital LOS (9, IQR = 6-13, vs 13, IQR = 9-18 days; P = 0.01) were less in the postintervention group. There was a reduction in mean total benzodiazepine exposure (74 ± 159 vs 450 ± 701 mg lorazepam; P < 0.01) in the postintervention group. Conclusion: A symptom-triggered benzodiazepine protocol utilizing SAS in critically ill patients is associated with a reduction in the duration of AWS treatment, benzodiazepine exposure, need for mechanical ventilation, and ICU and hospital LOS compared with a CIWA-Ar–based protocol using fixed benzodiazepine dosing.

scholarly journals Heat Shock Lipolysis: Radiofrequency Combined with Cryolipolysis for the Reduction of Localized Subcutaneous Fat

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
S. Abboud ◽  
J. P. Hachem
Keyword(s):  
Retrospective Study ◽  
Heat Shock ◽  
Subcutaneous Fat ◽  
Single Session ◽  
Safety And Efficacy ◽  
Before And After ◽  
Good Improvement ◽  
The Mean

Introduction. Noninvasive procedures such as cryolipolysis, noncontact selective radiofrequency (RF), and laser selective fat heating have been shown to be safe and effective for the reduction of localized subcutaneous fat. Material and Methods. In this retrospective study, we describe the safety and efficacy of combining RF with cryolipolysis for localized unwanted fat after one single session. 69 patients, 61 females, and 8 males for a total of 75 treatments were included in this study. All patients underwent RF prior to and following cryolipolysis. Pictures (n = 24), taken before and after treatment, were used to clinically assess the physician Global Aesthetic Improvement Scale (PhGAIS). In parallel, patients were asked to subjectively evaluate the efficacy of the treatment using the same scale (PaGIAS). Results. PhGIAS showed an improvement in 18 patients (73.46%), 5 (22.44%) were unchanged, and 1 (4.08%) worsened their appearance after treatment. The mean PaGIAS scored as “good improvement.” Conclusion. In conclusion, combining RF with cryolipolysis in one single session is safe and effective.

Changes in Platelet Function and Platelet Counts During Substitution Therapy in Haemophiliacs and Produced by Plasmapheresis in Patients Suffering from Inhibitors

1979 ◽  
Author(s):  
E. Dumitrescu ◽  
I. Ambrus ◽  
Kh. Nienhaus ◽  
B. Podolsak ◽  
E. Wenzel
Keyword(s):  
Factor Viii ◽  
Platelet Function ◽  
Clinical Signs ◽  
Bleeding Complications ◽  
Substitution Therapy ◽  
Drug Induced ◽  
Platelet Counts ◽  
Before And After ◽  
Factor Viii Concentrates ◽  
Laboratory Investigations

We noticed a systematic increase in small platelets (evaluated by electronical analysis of platelet volune distribution, using the Coulter Counter equipment, Wenzel 1977) during substitution therapy in patients suffering from haemophilia (N = 60). Laboratory investigations on these patients were performed before substitution and then 30 min., 60 min., 120 min. and 24 hours after infusion of factor-VIII-concentrationa (Inmuno, Schwab, Behring, factor-VIII-concentrates 20 U/kg b.w.). The same investigations were performed before and after plasmapheresis using a Hemonetric cell separator (N = 7}. in 48 of the patients, the clinical signs were insignificant (bleeding time, according to Duke, was found to be normall, although the platelet changes ware considerable (decrease in platelet count and increase of the percentage of platelets smaller than 4.5 μ3). However, significant test results were noticed in a haemophiliac patient suffering from inhibitory- and drug-induced platelet disorders during and after plasmapheresis. We observed bleeding complications only in 2 cases (Duke; 7 min. and 9 min.). Yet, a coneiderable decrease in platelet counts was observed as well as a significant increase in the percentages of small platelets (4.5 μ3, N = 48) in all cases. Controlling platelet function in haemophiliacs following substitution therapy could be essential as well as controlling the usual hemolysis parameters after plasmapheresis.

scholarly journals Safety and efficacy of combined use of sildenafil, bosentan, and iloprost before and after liver transplantation in severe portopulmonary hypertension

2008 ◽  
Vol 14 (3) ◽  
pp. 287-291 ◽  
Author(s):  
Mark J. Austin ◽  
Neil I. McDougall ◽  
Julia A. Wendon ◽  
Elizabeth Sizer ◽  
Alex S. Knisely ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Portopulmonary Hypertension ◽  
Safety And Efficacy ◽  
Combined Use ◽  
Before And After

scholarly journals Impact of nutritional rehabilitation on enzymatic antioxidant levels in protein energy malnutrition

2002 ◽  
Vol 8 (2-3) ◽  
pp. 290-297
Author(s):  
S. Y. Shaaban
Keyword(s):  
Superoxide Dismutase ◽  
Glutathione Peroxidase ◽  
Protein Energy Malnutrition ◽  
Enzymatic Antioxidants ◽  
Nutritional Rehabilitation ◽  
Protein Energy ◽  
Before And After ◽  
Nutrition Rehabilitation ◽  
Laboratory Investigations

To assess the role of enzymatic antioxidants in the pathogenesis of protein energy malnutrition [PEM] and the effect of nutritional rehabilitation, we studied 30 infants with PEM [mean age 10.63 +/- 4.39 months: 10 marasmic; 8 with kwashiorkor; 12 with marasmic kwashiorkor] and 15 controls. All underwent clinical examination and laboratory investigations, including superoxide dismutase [SOD] and glutathione peroxidase [GPx] estimation before and after nutrition rehabilitation. SOD and GPx were significantly lower in all malnourished infants compared to controls, and significantly increased after nutritional rehabilitation. These significant correlations suggest that antioxidants could be introduced during PEM nutritional rehabilitation to decrease morbidity and mortality.

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