scholarly journals Benefits of bloodletting procedure among Bad-mKhris-mGo-Nad patients: A prospective observational study

2020 ◽  
Vol 6 (1) ◽  
pp. 1-5
Author(s):  
Karma Ugyen ◽  
Karma Tenzin ◽  
Tempa Gyeltshen
Keyword(s):  
Data Collection ◽  
Observational Study ◽  
Prospective Study ◽  
Traditional Medicine ◽  
Prospective Observational Study ◽  
Primary Headaches ◽  
Bloodletting Therapy ◽  
Point Test ◽  
Before And After ◽  
Pain Duration

Introduction: Bad-mKhris-mGo-Nad is a type of headache caused by imbalance of bile and phlegm humor. In gSo-ba-Rig-pa, headache is categorized in two categories such as primary headaches and secondary headaches. In total there are 14 types of headaches and Bad-mKhris-mGoNad is one among the principal headaches. The gSo-ba-Rig-pa based bloodletting therapy for Bad-mKhris-mGo-Nad has been practiced by the traditional medicine practitioners since the inception of gSo-ba-Rig-pa more than 2500 years ago. Bloodletting is also believed to be one of the most important and effective therapy in the treatment regime of gSo-ba-Rig-pa. The Subsequent Tantra (last tantra) states that the bloodletting is the best remedy for all types of bile and blood-related disorders. This study was conducted to observe the effectiveness of bloodletting procedure among diagnosed cases of Bad-mKhris-mGo-Nad. Methods: It was an observational prospective study conducted at the National Traditional Medicine Hospital, Kawangjansa, Thimphu. The three main parameters measured were frequency, duration, and severity of the headaches. The samples consisted of 31 patients with 23 females and 8 males. Data collection was carried out over the span of seven months (June - December, 2018) Results: The association test between before and after 10 days, before and after 30 days of bloodletting was conducted on 30 patients by using Mid-Point test in Open Epi and the result was observed to be statistically significant at p< 0.05. Conclusion: This study shows that the bloodletting therapy on Tshoksang reduces the pain duration and frequencies of headaches. Moreover, it was also established to be effective in reducing the severity of the headache caused by Bad-mKhrismGo-Nad.

scholarly journals Pain during Cast Wedging of Forearm Shaft and Distal Forearm Fractures in Children Aged 3 to 12 Years—A Prospective, Observational Study

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 229
Author(s):  
Florian Freislederer ◽  
Tobias Berberich ◽  
Thomas O. Erb ◽  
Johannes Mayr
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Forearm Fracture ◽  
Lateral View ◽  
Oxygen Mixture ◽  
Forearm Fractures ◽  
Vas Score ◽  
Fractures In Children ◽  
Before And After ◽  
Multicenter Prospective Observational Study

Background: Although fracture displacement in children is easily treated by cast wedging, no data on pain associated with the procedure are available. We hypothesized that there is no clinically relevant difference in pain before and after cast wedging in children between 3 and 12 years of age. Patients and Methods: This international, multicenter, prospective, observational study included 68 children (39 male, 29 female) aged 3 to 12 years (median age 8 years) with forearm fractures. Cast wedging was performed 5 to 10 days after the injury. Before starting the procedure, we administered a single oral dose of sodium metamizole (10 mg/kg body weight), and the children inhaled a nitrous oxide/oxygen mixture (50%/50%) during the wedging procedure. Pain was rated on a visual analog scale (VAS) 5 to 10 min before incision of the cast as well as 3 to 5 min and 30 min (maximum remembered pain) after inhalation stop. The degree of bending was judged either by the surgeon or was determined on the basis of first signs of pain expressed by the patient. We assessed the effectiveness of the procedure by obtaining X-ray images in two planes after 3 to 9 days. Results: Among the 68 patients, median VAS score before cast wedging was 0. This increased to a score of 1 (p = 0.015) at 3 to 5 min after the procedure. Median VAS score for the maximum remembered pain measured after 30 min was 0. Median differences in angulation between proximal and distal bone fragments before and after the intervention were 0° (p < 0.0001) in the a.p. view and 8.4° (p < 0.0001) in the lateral view. Conclusion: Cast wedging improved the position of forearm fracture fragments at the expense of minimal short-term pain.

scholarly journals A New Therapeutic Application of Platelet-Rich Plasma to Chronic Breast Wounds: A Prospective Observational Study

2020 ◽  
Vol 9 (10) ◽  
pp. 3063
Author(s):  
Juan de Dios Berná-Serna ◽  
Florentina Guzmán-Aroca ◽  
José A. García-Vidal ◽  
Dolores Hernández-Gómez ◽  
Ana Azahara García-Ortega ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Observational Study ◽  
Prospective Study ◽  
Prospective Observational Study ◽  
Wound Closure ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Therapeutic Application ◽  
History Of ◽  
A Prospective Study

The aim of this study was to investigate the usefulness of platelet-rich plasma (PRP) treatment for chronic wounds (CWs) of the breast. A prospective study was performed in 23 patients with CW of the breast who were treated with PRP. The procedure was repeated until the wound was closed completely. The study included patients with a history of breast cancer (n = 8) and patients without cancer (n = 15). The treatment with PRP was successful in all cases and observed in ≤4 weeks in 82.6% (19/23) of patients. The patients without breast cancer showed significantly less time for wound closure than the patients with a history of breast cancer. Moreover, a greater number of PRP treatments were necessary to achieve wound closure in patients undergoing conservative breast treatment. No patients had complications associated with the application of PRP. Conclusions: To the best of our knowledge, this is the first study to reveal that PRP treatment for CWs of the breast is safe, simple, useful and well-tolerated by patients.

Antimicrobial Use in Outpatient Hemodialysis Units

2013 ◽  
Vol 34 (4) ◽  
pp. 349-357 ◽  
Author(s):  
Graham M. Snyder ◽  
Priti R. Patel ◽  
Alexander J. Kallen ◽  
James A. Strom ◽  
J. Kevin Tucker ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Observational Study ◽  
Prospective Study ◽  
Prospective Observational Study ◽  
Chronic Hemodialysis ◽  
Fourth Generation ◽  
Antimicrobial Use ◽  
National Guidelines ◽  
Surgical Prophylaxis ◽  
Narrow Spectrum

Objective.To quantify and characterize overall antimicrobial use, including appropriateness of indication, among patients receiving chronic hemodialysis.Design.Retrospective and prospective observational study.Setting.Two outpatient hemodialysis units.Patients.All patients receiving chronic hemodialysis.Methods.The rate of parenteral antimicrobial use (number of doses per 100 patient-months) was calculated retrospectively from September 2008 through July 2011. Indication and appropriateness of antimicrobial doses were characterized prospectively from August 2010 through July 2011. Inappropriate administration was defined as occasions when criteria for infection based on national guidelines were not met, failure to choose a more narrow-spectrum antimicrobial on the basis of culture data, or occasions when indications for surgical prophylaxis were not met.Results.Over the 35-month retrospective study period, the rate of parenteral antimicrobial use was 32.9 doses per 100 patient-months. Vancomycin was the most commonly prescribed antimicrobial, followed by cefazolin and third- or fourth-generation cephalosporins. Over the 12-month prospective study, 1,003 antimicrobial doses were prescribed. Among the 926 (92.3%) doses for which an indication for administration was available, 276 (29.8%) were classified as inappropriate. Of these, a total of 146 (52.9%) did not meet criteria for infection, 74 (26.8%) represented failure to choose a more narrow-spectrum antimicrobial, and 56 (20.3%) did not meet criteria for surgical prophylaxis. The most common inappropriately prescribed antimicrobials were vancomycin and third- or fourth- generation cephalosporins.Conclusions.Parenteral antimicrobial use was extensive, and as much as one-third was categorized as inappropriate. The findings of this study provide novel information toward minimizing inappropriate antimicrobial use.

Acupuncture in a Rheumatology Clinic

2000 ◽  
Vol 18 (2) ◽  
pp. 100-103 ◽  
Author(s):  
Rosemary Alexander ◽  
Adrian White
Keyword(s):  
Observational Study ◽  
Financial Support ◽  
Prospective Observational Study ◽  
Trigger Point ◽  
X Rays ◽  
Rheumatology Clinic ◽  
Analgesic Medication ◽  
Pain Duration ◽  
The Mean ◽  
Limited Period

An acupuncture clinic was established, for a limited period, within a rheumatology department of Barnet and Chase Farm Hospital Trust. Courses of six to eight sessions of traditional and trigger-point acupuncture were offered for a specified range of conditions. Pain and use of analgesics were measured routinely. A prospective observational study is presented of the outcome for a series of 41 patients, who had a mean age of 57 years and pain duration of 3 years. The mean score for daytime pain fell from 6.8 (SD 1.2) to 4.9 (2.5) points which is highly significant (p < 0.001). A total of 30 patients (73%) had reduction in pain of at least 33% and 22 patients (54%) had a reduction in pain of at least 50%. Analgesic intake (without distinguishing between different analgesic medication) was reduced from a mean of 17 (15.3) tablets per week to a mean of 6 (7.9). Patients with normal X-rays had a much better response to acupuncture than those whose X-rays showed significant degenerative changes. In response to these findings, financial support has been provided to continue the acupuncture clinic.

The real-world benefit of novel androgen receptor-targeting agents (ARTA) before and after docetaxel in CRPC with bone metastases in Japan: A subanalysis of the PROSTAT-BSI, a prospective observational study before and after approval of novel ARTAs.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 43-43
Author(s):  
Atsushi Mizokami ◽  
Rie Fukuda ◽  
Taiki Kamijima ◽  
Kouji Izumi ◽  
Yoshifumi Kadono ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Observational Study ◽  
Hormonal Therapy ◽  
Real World ◽  
Prospective Observational Study ◽  
Favorable Effect ◽  
The Real ◽  
Significant Difference ◽  
Before And After ◽  
Psa Progression

43 Background: ARTAs (enzalutamide and abiraterone) have been approved for relapse of prostate cancer in Japan since 2014. However, the efficacy of ARTAs for overall survival (OS) has not yet been proven in Japanese real-world clinical practice. Bone Scan Index (BSI), amount of bone metastasis in a unit of %, has become available for bone scintigraphy using software of BONENAVI (EXINIbone) in Japan. To confirm the benefit of BSI, we conducted a prospective observational study from 2012 to 2017 on mHSPC and mCRPC prior to docetaxel (presented at ASCO-GU 2020). Then we conducted this subanalysis to investigate the real-world benefit of ARTAs on OS before and after docetaxel. Methods: Patients enrolled as the mHSPC (N = 148) and mCRPC (N = 99) groups in the PROSTAT-BSI registry over a 3-year observation period were analyzed with or without ARTAs or flutamide. Patients were evaluated for PSA progression, BSI progression, and OS during hormonal therapy or chemotherapy. Results: In the mHSPC group, 123 patients were treated with combined androgen blockade (androgen deprivation + 80 mg bicalutamide) as an initial hormonal therapy. Thirty-seven patients were treated with flutamide after PSA progression. Thirty-seven patients were also treated with ARTAs as 2nd or later. Docetaxel was used in 25 patients. There was no significant difference in PSA (median: 265.5 and 248.0 ng/mL; P = 0.877) and BSI (median: 1.28% and 1.68%; P = 0.131) between the ARTA (-) and ARTA (+) groups at the start of hormonal therapy, respectively. Despite a median PSA-PFS disadvantage of 16 months in the ARTA (+) group compared to the ARTA (-) group (median: 8.9 and 25.2 months), OS of both groups were comparable (3-year survival rate: 84.0% and 75.7%; HR [95% CI]:0.556 [0.238-1.299], P = 0.232), respectively, indicating favorable effect of ARTA on OS. Furthermore, OS tended to be more extended in patients who received flutamide prior to ARTAs (N = 21) (HR [95% CI]:0.3175 [0.050-2.026], P = 0.225). In the mCRPC group, 8 patients who used ARTA prior to docetaxel were excluded from this analysis. ARTAs were used to treat relapse after docetaxel in 44 patients. Cabazitaxel was used in 14 patients. There was no significant difference in PSA (median: 16.8 and 26.8 ng/mL; P = 0.240) and BSI (median: 2.43% and 1.48%; P = 0.105) between the ARTA (-) and ARTA (+) groups at the start of docetaxel, respectively. There was no significant difference in PSA-PFS between the ARTA (-) and ARTA (+) groups (median PSA-PFS: 4.3 months and 7.0 months; P = 0.999), but OS was significantly better in the ARTA (+) group in the ARTA (-) group (median OS: 28.9 months vs 21.1 months; HR [95% CI]: 0.484 [0.264-0.888]; P = 0.019). Conclusions: This subanalysis demonstrates the benefit of ARTAs for OS before and after docetaxel in clinical practice.

scholarly journals Anti-JCV antibody index does not change during ocrelizumab-treatment

2020 ◽  
Vol 6 (3) ◽  
pp. 205521732096051
Author(s):  
Torge Rempe ◽  
Aaron Carlson ◽  
Augusto Miravalle ◽  
Tirisham Victoria Gyang
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Antibody Index ◽  
Before And After ◽  
Significant Change ◽  
Immunoglobulin Levels

Objective To prospectively assess anti-JCV antibody index (AI) and its relationship to immunoglobulin levels in ocrelizumab-treated MS patients. Methods Monocentric prospective observational study over 24 months assessing anti-JCV AI and immunoglobulin levels in MS patients before and after initiation of ocrelizumab. Results No significant change in anti-JCV AI titers was observed 458 ± 300 days after initiation of ocrelizumab (n = 45, 0.7 ± 2.21 vs. 0.6 ± 2.06, p = 0.8). Seroconversion occurred in 1/20 initially anti-JCV seronegative patients. There was no correlation between changes in anti-JCV AI and immunoglobulins. Conclusion Treatment with ocrelizumab is not associated with an increase in anti-JCV AI titers.

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