scholarly journals A RANDOMIZED COMPARATIVE CLINICAL EVALUATION OF HARIDRADI LEHA AND VASADI KASHAYA IN THE MANAGEMENT OF TAMAKA SHWASA (BRONCHIAL ASTHMA)

2021 ◽  
Vol 12 (3) ◽  
pp. 3-12
Author(s):  
Rashmi Mutha ◽  
Ajay Kumar Sahu ◽  
Jai Prakash Singh ◽  
Ram Kishor Joshi ◽  
Shankar Gautam

Tamaka Shwasa in Ayurveda is analogous to Bronchial Asthma due to similarity in causative and precipitating factors, onset, pathogenesis and symptoms. An estimated 300 million people worldwide suffer from asthma, with 250,000 annual deaths attributed to the disease. The Objective is to evaluate and compare the efficacy of Haridradi Leha with and without Vasadi Kashaya in the management of Tamaka Shwasa. Total 30 patients were registered for the present study. The patients of group A were administered Haridradi Leha in a dose of 20 grams BD (Bis in die i.e., twice daily) in empty stomach orally with lukewarm water for 21 days. The patients of group B were administered Haridradi Leha (20 grams BD) and Vasadi Kashaya (50 ml BD) with Anupana (co-administers with medicine) of honey orally for 21 days. There are highly significant results (p value: p<0.01, p<0.001) in breathlessness, cough, body position, wheezing in a day, wheezing in night, heart rate in both group but quantity of sputum, respiratory rate, use of accessory muscle and mental status shows highly significant result only in Group B. Both groups have highly significant result in peak expiratory flow rate (PEFR) and forced expiratory volume in one second (FEV1). Both the Haridradi Leha and Vasadi Kashaya are highly effective in the management of Tamaka Shwasa. Haridradi Leha along with Vasadi Kashaya provided better relief than Haridradi Leha alone in most of the sign and symptom of the disease at significant level.

2021 ◽  
pp. 112067212110233
Author(s):  
Marcelina Sobczak ◽  
Magdalena Asejczyk ◽  
Malwina Geniusz

Objectives: The main goal of this research was to determine the differences between the values of intraocular pressure (IOP) in the supine and sitting positions, and to assess the effect of age and cardiovascular parameters. Methods: Seventy-two healthy adults were enrolled and classified into age groups: 20–30 years (group A), 31–40 years (group B), and 41–71 years (group C). Corneal biometry and cardiovascular parameters, such as heart rate (HR), were measured. IOP measurements were taken in the sitting position (IOPS) and in the supine position (IOPL) using the iCare® Pro tonometer. Results: A significant difference between the IOPS and IOPL in the entire cohort was found ( p < 0.001). Regarding the age subgroups, a significant difference ( p < 0.001) between the IOPS and IOPL was obtained in group A (2.6 ± 1.6 mmHg) and group C (1.5 ± 1.3 mmHg). There were no significant differences in the IOPS between groups. The highest IOP values were obtained for group A. The correlations between HR and IOPS are statistically significant for group A and group B, and for HR and IOPL-S for group B only. Multivariate analysis showed that HR has a significant influence on the difference in IOP in the two body positions. Conclusion: A statistically significant difference between the effect of age and the values of IOPS and IOPL was shown. Cardiovascular parameters showed some relevant statistical dependencies, but with a rather marginal significance in young people. The influence of body position for the measurement of IOP for healthy subjects does not seem to matter, despite the fact that there are some dependencies that are statistically significant.


2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin


2018 ◽  
Vol 25 (12) ◽  
pp. 1892-1898
Author(s):  
Brig (Retd) Muhammad Boota ◽  
Sohail Nasir ◽  
Imran Hyder

Introduction: There have been several methods used to prevent or attenuate the adverse hemodynamic changes following endotracheal intubation, but not many studies have been done for the same purpose in patients undergoing nasotracheal intubation. Deepening of anaesthesia, omitting cholinergic premedication, pre-treatment with vasodilators such as nitroglycerine, beta blockers, calcium channel blockers and opioids are few of the different techniques used when trachea is intubated orally or nasally, to blunt significant swings in hemodynamic parameters. We assessed the effectiveness of oral gabapentin to determine changes in hemodynamic response in normotensive patients following nasotracheal intubationwith or without laryngoscopy for elective maxillofacial surgeries. Study Design: Randomized double blind, placebo-controlled clinical trial. Setting: Department of Anesthesia & Intensive Care, Fauji Foundation Hospital Rawalpindi. Period: 18 months after approval from the ethical committee. Material & Methods: Total 130 patients were included in the study. These patients were randomly divided into 2 groups. In Group-A patients were given 800 mg gabapentin and in Group-B patients were given placebo. Heart rate and mean arterial pressures were recorded just before intubation as base line values, and then average readings were taken at 1 minute, 3 minutes, 5 minutes and 10 minutes after intubation. Bradycardia and hypotension were adequately treated with intravenous atropine and vasopressors. Data entry and analysis was done by using SPSS 17. Results: Total 130 patients who underwent elective surgeries were included in the study and divided into 2 groups each group containing 65 patients each. At 1st minute MAP in Group-A (oral gabapentin) and in Group-B (Placebo) was 86.89±4.36 and 98.70±4.39. At 3rd minute MAP in Group-A, in Group-B was 83.40±4.05 and 92.93±4.79. At 5th minute MAP was 82.50±5.00 and 88.03±4.22 and lastly at 10th minute MAP was 79.81±5.37 in Group-A and 83.18±4.77 in Group-B respectively. P-value at 1st, 3rd, 5th and at 10th minutes showed that statistically MAP was different in both treatment groups at the above mentioned time intervals. 1st minute: p-value=0.042, 3rd minute: p-value=0.000, 5th minute: p-value=0.000 and at 10th minute: p-value=0.000. At 1st minute heart rate in Group-A and Group-B was 87.89±1.39 and 93.47±6.88 respectively. At 3rd minute heart rate in Group-A and Group-B was 83.47±5.47 and 89.70±6.76. At 5th minute heart rate was 82.10±5.01 and 84.60±5.91 and lastly at 10th minute heart rate was 78.09±6.79 in Group-A and 77.27±5.34 in Group-B respectively. P -value at 1st, 3rd and 5th minutes showed that statistically heart rate was different in both treatment groups at the above mentioned time intervals. But at 10th minute heart rate was statistically same in both treatment groups. 1st minute: p-value=0.144, 3rd minute: p-value=0.000, 5th minute: p-value=0.011 and at 10th minute: p-value=0.448. Conclusion: According to the results of this study it was observed that oral gabapentin is effective in modifying hemodynamic response to nasotracheal intubation in normotensive patients undergoing elective maxillofacial surgeries. MAP (10th Minute: Group-A vs. Group-B: 0.000) & Heart Rate (10th Minute: Group-A vs. Group-B:0.448)


2020 ◽  
Vol 27 (06) ◽  
pp. 1103-1107
Author(s):  
Saima Jabeen Joiya ◽  
Muhammad Azam Khan ◽  
Farhan ul Haq ◽  
Zahid Ahmad

Objectives: Asthma affects about 15% of children while it is one of the commonest reason for admissions in pediatric emergencies and wards. We aimed this study to determine outcome of Salbutamol alone and salbutamol in combination with Ipratropium Bromide in acute asthma in children. Study Design: Randomized Controlled trial (RCT). Setting: Unit-II Department of Pediatric Medicine, Nishtar Medical College and Hospital, Multan. Period: 20th Nov 2017 to 30th June 2018. Material & Methods: The study consisted of 104 children, with 52 children each in Group ‘A’ and ‘B’ who were subjected to salbutamol alone and salbutamol in combination with Ipratropium bromide respectively. In both groups oxygen was administered via nasal prongs at a flow rate of 3L/minute. These children was monitored at 30 minutes interval for 2 hours (least value out of these 4 values was taken). Both groups were compared for outcome in terms of mean heart rate, respiratory rate, accessory muscle score, peak expiratory flow rate (PERF) percentage and SPO2. Results: Of these 104 study cases, 61 (58.7%) were boys while 43 (41.3%) were girls. Mean age of our study cases was noted to be 9.92 ± 3.01 years. Mild level of asthma severity was noted in 35 (33.7%) and moderate severity in 69 (66.3%). Mean heart rate in group A was noted to be 119.40 ± 12.22 and in group was 119.29 ± 8.51 beats per minute. (p=0.956). Mean respiratory rate in group A was 29.98 ± 4.00 while in group B was 27.88 ± 3.85 (p=0.000). Mean accessory muscle score in group  A was 0.537 ± 0.336 while in group B was 0.130 ± 0.030 (p = 0.000). Mean PEFR percentage in group A was 68.69 ± 18.64 while in group B was 87.12 ± 17.10 (p = 0.000). Mean SPO2 in group A was 96.15 ± 1.05 while it was 95.94 ± 1.29 (p = 0.362). Conclusion: Our study results have shown that nebulization of salbutamol in combination with Ipratropium Bromide is more effective in the management of children with acute asthma. It was safe, effective and reliable as there was no adverse side effect noted in our study. We recommend the use of this combination nebulization therapy in children with acute asthma.


2021 ◽  
Vol 71 (6) ◽  
pp. 2126-30
Author(s):  
Abdul Raafeh Jamal ◽  
Bilal Yaseen ◽  
Mohammad Saeed ◽  
Rao Ali Shan Khan ◽  
Syed Hamid Ali Shah ◽  
...  

Objective: To compare the efficacy of Dexmedetomidine (Precedex) in addressing the mean haemodynamic stress response to laryngoscopy and endotracheal intubation (L&I). Study Design: Quasi-experimental study. Place and Duration of Study: Anesthesiology Department, Combined Military Hospital, Rawalpindi, from Jun 2019 Jun 2020. Methodology: The patients were divided into two groups. Group A was given Inj. Dexmedetomidine and group B (placebo). Operation theatre assistant randomly assigned the patients to either group A or group B each day. The second person administered the drug or placebo. The third person (researcher) recorded all the parameters mentioned in the proforma. Results: There were 100 patients with an age range of 18-60 years. The majority of the patients were ASA-I physical status. The main surgical procedure was laparoscopic cholecystectomy. Recording of heart rate and systolic blood pressure during laryngoscopy and intubation, after administration of drug or placebo, showed mean heart rate less than mean basal value in group-A and 22% above mean basal value in group-B, and it was statistically highly significant (p-value <0.001). Whereas mean systolic blood pressure in group-A was 122.42 ± 14.91 (less than the mean basal value) as compared to group B, 155.00 ± 18.32/min (20% above mean basal value). This change was also statistically highly significant (p-value <0.001). Conclusion: It is concluded that dexmedetomidine showed statistically significant stabilizing effects on the expected changes of the hemodynamic stress response.


2021 ◽  
Vol 28 (05) ◽  
pp. 677-681
Author(s):  
Versha Rai ◽  
Muhammad Nadeem Chohan ◽  
Nazimuddin ◽  
Khuda Bux ◽  
Saadullah Chacher

Objective: To compare therapeutic response between Montelukast versus Montelukast plus inhaled corticosteroid (Budesonide) in children having mild persistent asthma. Study Design: Randomized Controlled Trial. Setting: Department of Pediatrics Medicine, National Institute of Child Health, Karachi. Period: 1st April 2016 to 30th September 2016. Material & Methods: Children aged 2 years to 14 years having mild persistent asthma for more than 6 months were included. After treatment Good response was considered when, forced expiratory volume in first second (FEV1) became >7.5% from baseline. Group A was given montelukast as monotherapy once daily and Group B was given Montelukast along with inhaled corticosteroid (Budesonide.  At 6 weeks followup change in FEV1 was recorded. Result: Mean age of the patients in montelukast alone (Group A) was 6.77+/-2.16 years while in montelukast with Inhaled Corticosteroid (Group B) was 6.97+/-2.17 years. Duration of disease in Group A was 18.32+/-6.12 months while in montelukast with ICS group was 18.50 +/-6.08 months. Baseline FEV1 in Group A was 81.83+/-0.85% while in Group B was 82.05 +/-0.63%. Males were higher with 131 (61.8%). Family history was positive in 82 (38.70%) patients. After 6 weeks mean FEV1 was 89.49 +/-0.87% in Group A while in Group B was 89.53+/-0.86%. Overall good responses were found in 21 (9.09%) patients. In Group A, good response was found in 5 (4.7%) patients while in Group B was in 16 (15.1%) with significant p-value. Conclusion: In our study montelukast along with inhaled steroids had better response than montelukast alone in mild persistent asthma.


Author(s):  
Ritu Bala ◽  
Harminder Singh ◽  
. Rupali ◽  
Kuhu Verma

Background: Hypertension is the most prevalent cardiovascular disease and the relevant data suggest that the burden, risk factors and co-morbidities associated with the essential hypertension is increasing with every passing day. It is one of the major chronic diseases resulting in high mortality and morbidity in today’s world. Aim: The aim of the study was to compare effects of cilnidipine and amlodipine on the blood pressure (BP), heart rate and proteinuria among patients of hypertension with chronic kidney disease.Methods: 100 patients were included in this study. Patients were randomly assigned into two groups Group A and Group B (50 each). Group A: Patients received Cilnidipine (5-10mg/day). Group B: Patients received amlodipine (5-10mg/day).Results: No significant difference in SBP, DBP, MBP and proteinuria while comparing both the groups of patients taking cilnidipine and amlodipine at baseline i.e. 0 to 12 week, 12 to 24 weeks and 0 to 24 weeks. Cilnidipine caused decrease in HR 0 to 12 week (p value 0.001), 12 to 24 weeks (p value 0.001) and 0 to 24 weeks (p value 0.0001). Amlodipine had increased heart rate from baseline to 12 weeks (p value 0.0001), 12 to 24 weeks (p value 0.051) and 0 to 24 weeks (p value 0.001). No significant difference was seen in any biochemical readings.Conclusions: There was a significant change in all the parameters including BP, heart rate, proteinuria and other biochemical tests when they compared within the group but no significant difference while comparing both the groups.


2015 ◽  
Vol 14 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Farzana Hamid ◽  
Syed Moosa MA Quaium ◽  
Azizur Rahman ◽  
AT Reza Ahmad ◽  
Shahariar Khan ◽  
...  

Background: Bronchiolitis is the most common reason for hospitalization of children in many countries.Though Respiratory Syncytial Virus (RSV) is the most common organism causing bronchiolitis, but antibiotics are used widely.So the aim of the present study is to establish whether antibiotic has any role in bronchiolitis management along with supportive treatment. Methods:This retrospective study included 100 infants and children between 2-24 months of age admitted with clear cut sign symptoms of bronchiolitis. Patients were divided into Group A (supportive + antibiotic Rx) comprised 72 patients and group B (supportive Rx only) comprised 28 patients.After 3-5 days of hospital stay, clinical responses were evaluated in terms of improvement in symptoms and clinical parameters- respiratory rate, heart rate and oxygen saturation. Results: Mean age of patients was 6.6 (±5.6) months in Group A and 6.3 (±4.8) months in Group B. Most of the patients in both study groups were male (M: F=1.6:1). All the cases in both groups presented with cough, running nose, and respiratory distress. Fever and feeding difficulty were present in 83.3% & 90.3% in Group A and 82.1% & 89.3% in Group B respectively. Majority of cases were from lower socioeconomic status and lived in urban area. In Group A, after therapy mean respiratory rate 53.7 (±4.3) and oxygen saturation 97.9 (±1.9) had significantly improved in comparison to respiratory rate 65.6 (±4.8) and oxygen saturation 89.7 (±4.4) before therapy (p=<.001 in all parameter). Heart rate also significantly increased after therapy (149.4 ±10.2 versus 104.5 ±8.7) (p=<.001). In Group B, after therapy mean respiratory rate 53.5 (±4.1) and oxygen saturation 97.8 (±1.7) had also significantly improved in comparison to respiratory rate 65.3 (±4.1) and oxygen saturation 88.8 (±2.8) before therapy (p=<.001 in all parameter). Heart rate also significantly increased after therapy (150.8 ±9.8 versus 105.0 ±6.2) (p=<.001). In comparison between two modalities of treatment, no significant difference was found (p value=>.05 in all parameters). No statistical significant difference was observed in the length of hospital stay in two groups. Conclusion: The study highlighted the importance of supportive treatment in bronchiolitis management. Antibiotics should not be used without clinical and laboratory evidence of bacterial infection. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22871 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 6-10


Author(s):  
Sharad Chadda ◽  
Mushtaq Ahmed ◽  
Tajinder Kaur ◽  
Prashant Singh ◽  
Amit Kumar Mehto

Background: This study was undertaken because of paucity of literature regarding outcomes of inhaled formeterol/fluticasone versus formoterol/mometasone in asthmatic patients.Methods: Fifty newly (male/female) recruited cases of bronchial asthma were diagnosed on the basis of spirometry. The patients were allocated to two groups viz group A and B. Group-A received mometasone furoate/formoterol (200/10 μg OD) and Group-B received fluticasone/formoterol (200/10 μg OD) respectively. The drugs were administered through metered-dose inhaler (MDI).Results: The mean FEV1/FVC ratio recorded (64.40±9.01) before starting the treatment has significantly changed to (68.92±8.58) after starting the treatment. Mean forced expiratory volume (47.56±14.73%) noted before the use of bronchodilator also changed to mean FEV1 63.98±15.17. Mean forced expiratory volume recorded before treatment (55.02±5.01) in a group who were treated with formoterol/mometasone combination changed to (72.06±5.86) after treatment. However, the mean forced expiratory volume recorded before treatment 54.92±4.47 in a group who were treated with formoterol/fluticasone combination changed to 75.48±5.03 after the treatment. While comparing the two treatment regimens, it is evident from the results that there is no significant difference in FEV1 between the groups. However, the post bronchodilator FEV1 was significantly (p<0.001) higher among the patient group which were treated with fluticasone/formoterol combination than the group who were treated with mometasone/formoterol combination. No significant adverse effect of either of two regimens was observed thus showing that both the combinations are comparatively safe for use.Conclusions: This study reveals that both the treatment regimens showed a significant improvement in lung functions without any significant adverse event.


2018 ◽  
Vol 7 (1) ◽  
pp. 35-41
Author(s):  
Muhammad Usman Khan ◽  
Ghazala Noor Nizami ◽  
Ali Farhad

OBJECTIVE To compare the effectiveness of mobilization and self-exercises in the management of adhesive capsulitis of shoulder STUDY DESIGN Randomized Control Trial SAMPLE SELECTION 30 patients of adhesive capsulitis of shoulder from physiotherapy department of tertiary care hospitals of Karachi were selected through simple random sampling technique. PROCEDURE Treatment was continued for 5 days per week for the period of 3 weeks followed by assessment. Patients were randomly divided into two equal groups. Group A was treated with midrange mobilization while group B performed self-exercises. Both groups received TENS and hot pack prior to the exercises. Mean ± SD, frequencies and percentages were used for descriptive analysis. ROM via goniometry and pain intensity through VAS was analyzed by paired t-test within the groups and by independent t-test between the groups, using SPSS. P-value of less than 0.05 was considered significant. RESULTS 60% were females (n=18) and 40% were males (n=12) with mean age of 50.17±6.37 years. Significant improvement (p-value <0.05) in pain and shoulder ROM was observed among patients of Group A as compared to Group B. Pain intensity was decreased to 1.67 ± 0.62 in group A, whereas ROMs in these patients were also better than other group.


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