RIFAXIMIN EFFECTIVENESS IN PREVENTING THE RECURRENCE OF HEPATIC ENCEPHALOPATHY AMONG PATIENTS WITH LIVER CIRRHOSIS

Objective: To determine the effectiveness of rifaximin in reducing the frequency of recurrence of hepatic encephalopathy among patients with liver cirrhosis. Study Design: Descriptive case series. Place and Duration of Study: Outpatient department of Combined Military Hospital Peshawar from Jan to Jun 2017. Methodology: We included one hundred patients of either gender having liver cirrhosis with child Pugh B or C class with at least two previous episodes of hepatic encephalopathy. Patients were followed for six months to have any recurrence of hepatic encephalopathy. Conventional group was defined as having standard regimen including lactulose. Rifaximin treatment was defined as a 550mg BD daily dosing along with standard prescription. Results: Fifty patients were on conventional treatment to prevent recurrence of hepatic encephalopathy while 50 patients were using rifaximin in addition to standard prescription. The average age of 54.8 ± 6.1 years with 58% male patients and 48% in child-pugh B class. Thirty (30%) patients developed hepatic encephalopathy among the study population. 14 patients with recurrence belong to rifaximin group while 16 were on conventional treatment (p-value >0.05) showing a non-significant difference. Post stratification revealed only age as a significant predictor of recurrence of hepatic encephalopathy in our study population (p<0.05). Conclusion: Frequency of hepatic encephalopathy is similar in conventional treatment with Lactulose over six months of follow up as compared with rifaximin.

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STABLE ANGINA

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.01.2989 ◽

2009 ◽

Vol 16 (01) ◽

pp. 94-99

Author(s):

SHAFIQUE AHMED ◽

MUHAMMAD BILAL AHSAN ◽

EHSAN ULLAH ◽

Raees Abbas

Keyword(s):

Coronary Artery ◽

Stable Angina ◽

Coronary Artery Stenosis ◽

Case Series ◽

Artery Stenosis ◽

P Value ◽

Significant Difference ◽

History Of ◽

Male Patients ◽

Artery Disease

Objective: To see the frequency of coronary artery stenosis in the patients of stable angina having left bundle branchblock, and to see the effects of gender and age on this correlation. Design: Experimental case series. Setting: Bahawal Victoria Hospital,Bahawalpur. Period: June 2006 to May 2008. Methods: One hundred and forty one (141) patients of Stable Angina presenting with atypicalchest pain, both male and female of 30—70 years age, positive for LBBB and with normal Cardio-Thoracic Ratio, normal echocardiographyand negative for conventional risk factors and family history of Coronary Artery Disease were taken. All patients were angiographied .Results: A total of 141 patients were investigated through coronary angiogram to see the frequency of coronary artery stenosis in thesepatients. Ninety five (67.4%) patients proved to have coronary artery stenosis. The male patients showed higher frequency (87.4%) ofharboring coronary vessel blockade as compared to that (35.2%) in females (P value <0.0005). There was no relation between age and thefrequency of coronary stenosis (P value >0.05). Conclusions: There is significant difference (P value <0.0005) in coronary artery stenosisamong men and women having LBBB.

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Over-expression of IL-6 coding gene in the peripheral blood of migraine with aura patients

Human Antibodies ◽

10.3233/hab-210442 ◽

2021 ◽

pp. 1-5

Author(s):

Mahdi Ramezani ◽

Alireza Komaki ◽

Mohammad Mahdi Eftekharian ◽

Mehrdokht Mazdeh ◽

Soudeh Ghafouri-Fard

Keyword(s):

Migraine With Aura ◽

Peripheral Blood ◽

Healthy Subjects ◽

Migraine Without Aura ◽

P Value ◽

Healthy Controls ◽

Over Expression ◽

Significant Difference ◽

Male Patients ◽

Years Lived With Disability

Migraine is a common disorder which is placed among the top ten reasons of years lived with disability. Cytokines are among the molecules that contribute in the pathophysiology of migraine. In the current study, we evaluated expression levels of IL-6 coding gene in the peripheral blood of 120 migraine patients (54 migraine without aura and 66 migraine with aura patients) and 40 healthy subjects. No significant difference was detected in expression of IL-6 between total migraine patients and healthy controls (Posterior beta = 0.253, P value = 0.199). The interaction effect between gender and group was significant (Posterior beta =-1.274, P value = 0.011), therefore, we conducted subgroup analysis within gender group. Such analysis revealed that while expression of this gene is not different between male patients and male controls (Posterior beta =-0.371, P value > 0.999), it was significantly over-expressed in female patients compared with female controls (Posterior beta = 0.86, P= 0.002). Expression of IL-6 was significantly higher in patients with aura compared with controls (Posterior beta = 0.63, adjusted P value = 0.019). However, expression of this cytokine coding gene was not different between patients without aura and healthy subjects (Posterior beta = 0.193, adjusted P value = 0.281). Therefore, IL-6 might be involved in the pathophysiology of migraine among females and migraine with aura among both sexes.

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EFFECT OF SUBCUTANEOUS RECOMBINANT HUMAN ERYTHROPOIETIN ON BLOOD PRESSURE IN PRE-DIALYSIS CHRONIC KIDNEY DISEASE (CKD) PATIENTS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i1.2489 ◽

2021 ◽

Vol 71 (1) ◽

pp. 261-65

Author(s):

Muhammad Sajid Hussain ◽

Qasim Raza ◽

Muhammad Omer Aamir ◽

Nadia Murtaza ◽

Sadia Naureen ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Body Weight ◽

Kidney Disease ◽

Recombinant Human Erythropoietin ◽

Case Series ◽

Military Hospital ◽

P Value ◽

Human Erythropoietin ◽

Age Range

Objective: To determine the effect of subcutaneous recombinant human erythropoietin on blood pressure in predialysis chronic kidney disease (CKD) patients. Study Design: Case-series descriptive study. Place and Duration of Study: Combined Military Hospital Peshawar, from Mar 2016 to Sep 2016. Methodology: A total of 100 cases were enrolled. Inclusion criteria was patients of 18 to 60 years of both gender & estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m2 having Hb <10g/dL and pre-dialysis while Exclusion Criteria was pregnancy or lactation, BP more than 140/90 mmHg, patients on Haemodialysis and worsening renal function. Baseline BP, body weight and eGFR of anaemic chronic kidney disease patients were recorded prior to EPO Alpha therapy. Erythropoiesis-stimulating agents (ESAs) i.e. EPO Alpha (50-100 Units/kg thrice or once weekly) was administered subcutaneously. Subsequent blood pressure, body weight and eGFR monitoring was done after 2 and 4 weeks post EPO Alpha injection. Results: Mean age range was 46.71 years with range of 20-60 years, 73 (73%) were male while 27 (27%) werefemales. Mean ± SD for other quantitative variables like eGFR was 23.12 ± 5.28, Hb levels (g/dL) was 8.62 ± 0.85,Weight (kg) was 56.66 ± 6.62 and duration of CKD was 9.87 ± 4.02. Frequency of Hypertension (post EPO) was 2(2%) and p-value was 0.453. Conclusion: We concluded that the frequency of hypertension in pre-dialysis patients with chronic kidney disease (CKD) receiving recombinant human erythropoietin (rhEPo) subcutaneously (SC) in low doses, is very low, so rhEPo can be used subcutaneously......................

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The Role of L-ornithine-L-aspartate in the Management of Minimal Hepatic Encephalopathy among Patients with Liver cirrhosis: a Systemic review and Meta-analysis

Acta Medica Philippina ◽

10.47895/amp.v52i1.487 ◽

2018 ◽

Vol 52 (1) ◽

Author(s):

Henry Winston C. Li ◽

Maria Ana Louise M. Naidas ◽

Karen Anjela M. Mondragon ◽

Ruter M. Maralit

Keyword(s):

Liver Cirrhosis ◽

Hepatic Encephalopathy ◽

Meta Analysis ◽

Block Design ◽

Cochrane Collaboration ◽

Minimal Hepatic Encephalopathy ◽

Systemic Review ◽

Cochrane Library ◽

P Value ◽

Picture Completion

Objective. To evaluate the efficacy of L-ornithine-L-aspartate (LOLA) in improving minimal hepatic encephalopathy in adult patients with liver cirrhosis. Methods. A search in PubMed, Cochrane Library, Google Scholar, and Medline was made obtaining four qualified randomized controlled trials. Studies included adult cirrhotic patients with minimal hepatic encephalopathy measured by the number connection test (NCT-A, B), figure connection test (FCT-A, B), picture completion, block design test, and critical flicker frequency (CFF) testing with a cut-off score of <39Hz. Methodologic assessment of studies was performed using Cochrane Collaboration Risk of Bias Tool and Review Manager (RevMan) version 5.3 for statistical analysis. Results. Of the 29 studies identified, 4 fulfilled the inclusion criteria, which entailed analysis of 238 participants (LOLA: 116, Control: 122). Three out of the four studies were used in meta-analysis and one study was analyzed separately due to a difference in the neuropsychometric measure. The metaanalysis favored experimental group (LOLA), with a mean difference of 2.29 (95% CI 0.72 – 3.86), p-value = 0.004, and an I2 of 18%. Conclusion. LOLA provided great potential in managing encephalopathy since treating earlier related to better survival and prevention of disease progression. The results of our study supported such evidence and its use may be encouraged.

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Relationship of Psychological well-being with Depression and Anxiety among Heart Patients

10.53350/pjmhs2115113101 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3101-3102

Author(s):

Babar Javaid ◽

Abrar Ahmed ◽

Gohar Ali Arshad ◽

M Shoaib Akhtar ◽

Shazia Taj ◽

...

Keyword(s):

Null Hypothesis ◽

Well Being ◽

Military Hospital ◽

P Value ◽

Depression And Anxiety ◽

Psychological Well Being ◽

Heart Patients ◽

Significant Difference ◽

Relationship Of ◽

The Relationship

The study was designed to investigate the relationship of psychological well-being with depression and anxiety among heart patients.1 For this purpose, a sample of 200 patients was taken, including 100 men and 100 women, educated uneducated, employed and unemployed volunteers. The sample was taken from Nishtar Hospital, Combined military hospital and other private hospitals in Multan. The age range from 25 to 60 (mean age 43.085).2,3 Objective: To observe the effect of demographic variables (age, education, gender and source of finance) on psychological well-being and depression, anxiety in heart patients. Methods: 1. Low psychological well-being would be positively correlated with depression and anxiety. 2. Older age (above 50) heart patients would have low sense of psychological well-being as compared to younger age (above 35) heart patients. Results: Different statistical procedures were used to determine the relationship of psychological well-being with depression and anxiety among heart patients. Correlation was computed to see the relationship among variables. It was found that there is negative correlation between psychological well-being with depression and anxiety. Since the p-value in less than α (p-value < 0.01), so we reject null hypothesis Ho, and conclude that low psychological well-being is positively correlated with depression and anxiety. Conclusion: This study also finds out important findings on the role of stresses, feeling of worthlessness in depression and anxiety disorder. It is concluded that psychological well-being, depression and anxiety are not significant correlated with each other. Source of income or job and sex of the heart patients have significant effect on psychological well being. However there is no significant difference between men and women regarding the rate of depression and anxiety. Keywords: P-Value, Correlation, Null Hypothesis , Depression

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Systematic Functional Assessment of Nasal Dyspnea

Otolaryngology ◽

10.1177/0194599811415811 ◽

2011 ◽

Vol 145 (5) ◽

pp. 845-850 ◽

Cited By ~ 2

Author(s):

Daniel A. Larson ◽

Benjamin W. Cilento

Keyword(s):

Success Rate ◽

Preoperative Evaluation ◽

Tertiary Care ◽

Case Series ◽

Predictive Ability ◽

Preoperative Assessment ◽

Military Hospital ◽

Significant Difference ◽

Vas Scores ◽

Outcome Of Surgery

Objective. Evaluate the ability of a systematic preoperative evaluation to determine the most appropriate procedures for patients undergoing functional septorhinoplasty and to accurately predict postoperative outcomes. Study Design. Case series with chart review. Setting. Tertiary care military hospital. Subjects and Methods. Fifty-nine consecutive patients from a quality control database who underwent functional rhinoplasties for nasal dyspnea were evaluated. All patients underwent a full preoperative assessment using intranasal manipulation to determine the area(s) contributing to their nasal dyspnea. Rates of success for the predictive ability and for the functional outcome were determined for each side of the nose by comparing preoperative visual analog scale (VAS) scores (1-10) to postoperative scores. Results. Overall there was a 91% success rate in predicting the outcome of surgery and a 95% success rate in improving nasal dyspnea at 1 year. There was no statistically significant difference in improvement between different surgical groups (septoplasty ± alar strut grafts ± spreader grafts) or between primary surgeries and revisions. Conclusion. Using a systematic approach to evaluate patients for nasal dyspnea, it is possible to predict and improve outcomes by choosing the most appropriate surgery for each individual.

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Knowledge and Self-Perceived Confidence Level in Oral and Maxillofacial Surgery among Dental Interns in Riyadh

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47691.14746 ◽

2021 ◽

Author(s):

Alhanouf Alhulayyil ◽

Lujain Alsaleh ◽

Saba Alshareef ◽

Lubna Elsayed ◽

Mamata Hebbal

Keyword(s):

Saudi Arabia ◽

Informed Consent ◽

Surgical Procedures ◽

Confidence Level ◽

Maxillofacial Surgery ◽

P Value ◽

Cross Sectional ◽

Significant Difference ◽

Study Population ◽

Dental Schools

Introduction: Minor oral surgical procedures are practiced in dental teaching. Interns are required to be competent, well-prepared and acknowledge its basics before their practice. Lack of training and knowledge could lead to serious consequences during clinical practice. Aim: To assess the knowledge and confidence level between male and female dental interns in private and governmental Riyadh dental schools in performing simple dento-alveolar procedures. Materials and Methods: A cross-sectional observational study was conducted at Princess Nourah bint Abdulrahman University in Riyadh, Saudi Arabia in January 2020 among dental interns from all Riyadh dental schools. A cross-sectional survey containing 23 items was used. The first part included the informed consent and demographic data (item 1-3). The second part consisted of 10 case scenarios to assess the knowledge level (item 4-13), and the third part was developed to self-rate their confidence level (item 14-23). Around 300 participants belonging to five Riyadh dental schools comprised the study population. All interns were included in the study after obtaining informed consent. All statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) version 21.0 and Microsoft Excel 16.16. Groups were compared using Pearson chi-square and unpaired sample t-test. The p-value of <0.05 was considered statistically significant. Results: Out of 300 interns invited to participate, 210 submitted the electronic survey (70%). The final study population included 117 (56%) females and 93 (44%) males. A total of 111 (53%) belonged to governmental college, and 99 (47%) belonged to private college. There was no statistically significant difference between females and males in total knowledge (p<0.272) and confidence score (p<0.850), respectively. However, a statistically significant difference in knowledge and confidence between government and private colleges was found (p<0.001). A weakly positive significant correlation (r=0.217, p=0.002) was found between the total score of knowledge and the total score of confidence in performing surgical procedures. Conclusion: The study provides baseline data on the knowledge and perceived confidence of dental interns in Saudi Arabia about certain clinical procedures in oral surgery, where respondents were most knowledgeable in prescribing an appropriate medication. They were confident in giving effective local anaesthesia. All in all, interns had a superficial knowledge about the classification of impacted teeth and they were least confident in managing cases of an intraoral abscess.

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Effects of Low Molecular Weight and Unfractionated Heparin on Lipoprotein Lipase and Lipid Profile in haemodialysis patients

Rehman Journal of Health Sciences ◽

10.52442/rjhs.v3i1.110 ◽

2021 ◽

Vol 3 (1) ◽

pp. 56-59

Author(s):

Ahmad Jan ◽

Shah Jahan ◽

Nighat Aziz ◽

Sikandar Ali Khan ◽

Asia Asia ◽

...

Keyword(s):

Molecular Weight ◽

Lipid Profile ◽

Lipoprotein Lipase ◽

Low Density Lipoprotein ◽

Age Distribution ◽

Density Lipoprotein ◽

P Value ◽

Low Molecular Weight ◽

Significant Difference ◽

Study Population

Introduction: In haemodialysis patients, mortality from cardiovascular disease is much greater than in the general population. The current study aimed to evaluate the effects of two different types of heparin, low molecular weight heparins (LMWH) and high molecular weight heparin (HMWH), on lipid profile in patients undergoing haemodialysis.Material & Methods: A total of 60 patients on haemodialysis were selected from two main hospitals of Lahore, Pakistan and were divided into two major groups based on the type of heparin used. A 5 ml blood sample was taken from the dialysis machine to get the serum and was kept frozen at -20ºC for analysis of total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein. Comparison of lipoprotein lipase activity between groups were evaluated by using the student t-test. A P-value of ? 0.05 was considered statistically significant.Results: Gender wise distribution of study population (n=60) was 67% (n=40) males and 33% (n=20) females. The age distribution of individuals varied from 39-43 years. Moreover, use of HMWH was high in males (73%) as compared to female (27%) with an average age of 39 ± 12 years where duration of haemodialysis was 4.44 ± 2.83. A significant difference in LPL activity related to different times in all patients was observed. A clearer difference observed in case of LDL where LPL activity was markedly different in both groups. Our data showed that individuals using LMWH had less chances of dyslipidaemia as compared to those using HMWH.Conclusion: LMWH is a useful and safe anticoagulant during haemodialysis as compared to HMWH.

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Quality of Life for Children with Cystic Fibrosis in Gaza Strip

10.47363/jbbr/2020(2)114 ◽

2020 ◽

pp. 1-13

Author(s):

Yaser Hamdouna ◽

Keyword(s):

Quality Of Life ◽

School Performance ◽

Emotional Health ◽

Clinical Severity ◽

P Value ◽

Common Disease ◽

Organ Systems ◽

Significant Difference ◽

Study Population

Background: CF is a chronic, multisystem genetic disease with a wide variability in clinical severity. CF is a disease of exocrine gland function that involves multiple organ systems but chiefly results in chronic respiratory infections, pancreatic enzyme insufficiency, and associated complications in untreated patients. Many studies explained the lower QOL among adults with CF. in GS there is no previous studies concerned with measuring QOL among CF children Aim of the Study: The aim of this study was to assess the QOL among children with CF. Methodology: The study was descriptive, analytical and cross sectional studies. The study involves all 36 children with CF (less than 12 years old) who attained CF friends center; community based center in Gaza. The researchers uses the questionnaire which included demographic & illness related variables and Quality of life domains (physical, emotional, social and school). Reliability coefficient for the questionnaire was good (Cronbach alpha =0.833). Results and Conclusion: About 61% of the study population were males and 39% were females. Approximately 47% of them were less than 9 years and 53% were more than 9 years. About 41.7% of the study population from Gaza, 25.0% from middle zone, 13.9% from Rafah, 11.1% from Khanyounis and 8.3% from North of Gaza. Housing classification was 38.9%, 33.3% and 27.8 % for property house, renting house and family house respectively. Most of their parents had low educational levels and the majority of them were unemployed and have a monthly income less than 1200 NIS. About 61% of them have another sibling with CF. the majority of them receive Creon at a regular basis. The most common disease associated with them was Respiratory problem with 43.2%, 38.3% had gastrointestinal disease, 14.8% had heart disease and 3.7% had Diabetes Mellitus. The overall perception of the children regarding QOL was low (55%). The social functions was the highest (61.6%), physical functions (55.2%), school function (50.6%), and emotional function (48.8%). The result presented below show that no significant difference in QOL between socio-demographic data (p-value > 0.05) except the difference for QOL between age groups) p-value =0.001). Children older than 9 years old (2.95±0.3) have QOL more than children under nine years of age (2.53±0.4) and this difference was statistically significant as (P value = 0.02 < 0.05). It is also clear that QOL in males are more than female but this difference was not statistically significant. There is a positive correlation with a highly significant difference between QOL and the 4 domains and between domains with each other. Social performance was high correlated with school performance (r = 0.706) while the lowest correlation was between physical and school performance with no significant (p-value =0.065). Recommendations: The study recommend the importance of initiating a program to enhance the QOL for children with CF and focusing on the emotional health for those children as it was the least one perceived.

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Estradiol Level and Psychosocial Stress in Perimenopausal Women

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v7i2.622 ◽

2019 ◽

pp. 122-125

Author(s):

Lucia L Levita ◽

Hadiprodjo Hadiprodjo ◽

Nusratuddin Abdullah ◽

Nugraha U Pelupessy

Keyword(s):

Stress Level ◽

Psychosocial Stress ◽

Cross Sectional Study ◽

P Value ◽

Cross Sectional ◽

Significant Difference ◽

Perimenopausal Women ◽

Study Population ◽

Cortisol Levels ◽

Estradiol Levels

Objective : To determine the relationship between estradiol levels and psychosocial stress in the perimenopausal women. Methods : Sixty perimenopausal included in a cross-sectional study from July to December 2016. Blood samples obtained from the women to measure the estradiol and the cortisol levels. Stress level measured with visual. Data presented as the mean and standard deviation (mean±SD) with p-value <.05 was considered statistically significant. Results : There was no significant difference between the estradiol levels and the stress level (p=0.27) during perimenopause period. The estradiol levels were higher compared with the cortisol levels. The non parametrik correlations analysis show the estradiol levels were not correlated with the cortisol levels (p=0.352). However, the cortisol levels were correlated with the stress levels (p<0.05). Conclusion : Estradiol does not cause psychosocial stress during perimenopause period in our study population Keywords : Estradiol, psychosocial stress, perimenopause

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