Use of a disposable vascular pressure device to guide balloon inflation of resuscitative endovascular balloon occlusion of the aorta: a bench study

Resuscitative endovascular balloon occlusion of the aorta (REBOA) for rapid hemorrhage control is increasingly being used in trauma management. Its beneficial hemodynamic effects on unstable patients beyond temporal hemostasis has led to growing interest in its use in other patient populations, such as during cardiac arrest from nontraumatic causes. The ability to insert the catheters without fluoroscopic guidance makes the technique available in the prehospital setting. However, in addition to correct positioning, challenges include reliably achieving aortic occlusion while minimizing the risk of balloon rupture. Without fluoroscopic control, inflation of the balloon relies on estimated aortic diameters and on the disappearing pulse in the contralateral femoral artery. In the case of cardiac arrest or absent palpable pulses, balloon inflation is associated with excess risk of overinflation and adverse events (vessel damage, balloon rupture). In this bench study, we examined how the pressure in the balloon is related to the surrounding blood pressure and the balloon's contact with the vessel wall in two sets of experiments, including a pulsatile circulation model. With this data, we developed a rule of thumb to guide balloon inflation of the ER-REBOA catheter with a simple disposable pressure-reading device (COMPASS). We recommend slowly filling the balloon with saline until the measured balloon pressure is 160 mmHg, or 16 mL of saline have been used. If after 16 mL the balloon pressure is still below 160 mmHg, saline should be added in 1-mL increments, which increases the pressure target about 10 mmHg at each step, until the maximum balloon pressure is reached at 240 mmHg (= 24 mL inflation volume). A balloon pressure greater than 250 mmHg indicates overinflation. With this rule and a disposable pressure-reading device (COMPASS), ER-REBOA balloons can be safely filled in austere environments where fluoroscopy is unavailable. Pressure monitoring of the balloon allows for recognition of unintended deflation or rupture of the balloon.

Acomparative study on the effect of cross legged sitting with flat feet sitting position on blood pressure reading among normotensive young adults in selected college, Guwahati, Assam

Blood pressure(BP) measurement is a basic clinical procedure and perhaps the most frequently performed clinical procedure in any health care setting, it strongly depends both on the number of measurements and the body position during the procedure. Many important therapeutic decisions rely on the accuracy of assessment ,Unfortunately , blood pressure measurement is one of the most inaccurately performed procedure done by healthcare provider. Inspire of studies having shown that many errors are made while recording BP, crucial decisions about treatment are made based on these inaccurate measurements. Efforts have continuously been made to standardize the procedure, but remain difficult to reach a consensus among different official guidelines for BP measurementA comparative study on the effect of cross legged sitting with flat feet sitting position on blood pressure reading among normotensive young adults in selected college, Guwahati, Assam. Army Institute of Nursing ,C/O- 151 Base Hospital, Basistha, Guwahati, Assam. Descriptive comparative design.A descriptive comparative design was adopted for the study ,sixty normotensive young adults were selected using purposive sampling technique from the selected college of Guwahati, Assam. The data was collected by a questionnaire and blood pressure measurements were documented.Automated sphygmomanometer (OMRON HEM -8712 ,SERIAL NO 20190604417VG). The measurement was taken 5 minutes elapse before the first reading and then one minute gap between next three readings in flat feet and cross legs at knee level. The data were analysed using percentage, frequency, mean, SD Statistical significance was set at p<.05.The data were coded and organized in a master sheet and were analyzed by using the SPSS Version 24. Total of sixty normotensive young adults were included in the BP measurements taken from flat feet sitting position and cross-legged sitting position and results indicates systolic blood pressure increases significantly (p<.05)with the cross-legged sitting position.Cross legged sitting position can affect systolic blood pressure reading significantly among normotensive young adults.

Therapeutic Inertia in the Management of Proteinuria Among Type 2 Diabetes Patients in Hong Kong Primary Care Setting: Prevalence and Associated Risk Factors

Background: Proteinuria is a well-known predictor of poor renal and cardiovascular outcomes in T2DM patientsMethods: Objectives: To explore the prevalence of Therapeutic inertia (TI) on proteinuria management among T2DM patients in primary care and possible patients’ and doctors’ factors.Study design: Cross-sectional studySubjects: T2DM patients with microalbuminuria and macroalbuminuria from 1/1/2014 to 31/12/2015.Outcome assessments: The prevalence of TI on proteinuria management and its association patients’ factors and the working profile of the attending doctors.Results: 5, 163 (26.4%) patients had diabetic nephropathy (DMN) with micro- or macroalbuminuria. Among the sampled 385 patients with DMN, TI was found to be 40.3%. Doctor factors for higher TI rate include male sex and doctors with longer duration of clinical practice and who have never received any form of Family Medicine training. Patients factors include lower average systolic (SBP) and diastolic blood pressure reading. Patients’ SBP reading and microalbuminuria were negative association factor whereas doctor’s year of clinical practice being over 21 years and patients being treated with submaximal dose of medication were positive association factors to TI. Conclusions: TI is commonly present on proteinuria management among T2DM patients managed in the primary care. Patient’s systolic blood pressure reading, microalbuminuria level, Dr’s year of clinical practice and dose of ACEI/ARB were found to be associated with the presence of TI. Further study on the barriers and strategies to combat TI is needed to improve the clinical outcome among T2DM patients.

IoT blood pressure monitoring system

<p>The number of patients in hospital keep increasing every year and, some patients’s blood pressure must be measured by medical staff regularly. This means that the medical staff need to attend to the patient routinely and several readings are required in each session to make sure the results are accurate. Therefore, there is a need to simplify the monitoring process inside hospital in Malaysia. In this work, IoT Blood Pressure Monitoring System (IBPMS) is designed to monitor patient’s blood pressure remotely. This project use Raspberry Pi as a gateway to view the value of blood pressure online. Result showed that the design is capable to transfer data from blood pressure detector through the network using USB TTL serial cable which is directly attached to the Raspberry Pi. User can also view the blood pressure reading continuously from Telegram application and email service. Furthermore, the system can measure the value of blood pressure accurately when user is in sitting position.</p>

Prevalence of hypertension and its significant correlates among Bangladeshi adults: a quantitative analysis from City Corporation Rangpur, Bangladesh

Background: Hypertension (HTN) is a common medical problem and the premier risk factor for cardiovascular disease. Hypertension is growing at a faster rate among all aged population. Therefore, this study aimed to investigate the prevalence of hypertension and to identify the significant risk factors of hypertension among the respondents.Methods: The sample of 1302 randomly selected respondents of various government offices at Rangpur City Corporation, Bangladesh are taken for this study. Hypertension was defined by the systolic blood pressure reading above 140 or the diastolic reading above 90 mmHg. Pre-hypertension was defined by the systolic blood pressure reading 120-139 or the diastolic reading 80-89 mmHg. Prevalence and risk factors of hypertension are presented as percentages. The significant association between the categorical variables is measured using Chi-square test.Results: It is found that the prevalence of hypertension and pre-hypertension (stage-1 HTN) among the respondents are 25% and 54%, respectively. Most of the respondents are in the pre-HTN stage, and at any time they may fall under hypertension. Respondent’s age, gender, residence, smoking habit, and physical activity are found as significant factors of hypertension.Conclusions: Reliable information about the prevalence of hypertension and its associated risk factors is very essential for growing awareness, treatment, and control of hypertension. Prevalence of hypertension is high among the study subjects. The male respondents who are at the higher age group, residing in the urban area, not taking regular physical exercise, and having smoking habit are found more prevalent cases of hypertension than the other counterparts.

Non-compliance and its associated factors among hypertensive patients taking anti-hypertensive treatment visiting Gimbi general hospital,Western Ethiopia:cross-sectional study

Objective: Hypertension is defined as a persistent systolic blood pressure reading of 140 mm Hg or greater and/or a diastolic blood pressure reading of 90 mm Hg or greater. Poor adherence to anti-hypertensive therapy is one of the biggest obstacles in therapeutic control of high blood pressure and usually associated with bad outcome of the disease and wastage of limited health care resources. The study was aimed to assess the patient compliance and associated factors of anti-hypertensive treatments Result: The study showed that the overall level of compliance was 106(83.46%) and non-compliance level was 21(16.54%). Among 127 respondents 52 (40.95%) were males and 75 (59.05%) were females. Majority of respondents 113(88.98%) were taking treatments as prescribed and 106(83.36%) had regular follow up. In this study 45 patients never forget to take their medication and 82(64 57%) respondents were stopped their medication due to different reason from this, 64(34.8%) were due to improvement from illness and 37(20.1%) due to lack of money. Keywords: Hypertension, Hypertensive treatment, Adherence, Compliance

Evaluation of the Undrained Shear Strength in Preconsolidated Cohesive Soils Based on the Seismic Dilatometer Test

The undrained shear strength in cohesive soils can be evaluated based on measurements obtained from the standard dilatometer test (DMT) using single- and multi-factor empirical relationships. However, the empirical relationships presented in the literature may sometimes show relatively high values of the maximum relative error. The add-on seismic module to the seismic dilatometer test (SDMT) extends parameters measurable in a standard dilatometer test by the shear wave velocity Vs as an independent variable. Therefore, a method for evaluating the undrained shear strength in cohesive soils based on data obtained from the seismic dilatometer test is presented in this study. In the method proposed, the two-factor empirical relationship for evaluating the normalized undrained shear strength τfu/σ’v is used based on independent variables: The normalized difference between the corrected second pressure reading and the corrected first pressure reading (p1 − po)/σ’v and the normalized shear wave velocity Vs/100. The proposed two-factor empirical relationship provides a more reliable evaluation of the undrained shear strength in the tested Pleistocene and Pliocene clays in comparison to the empirical relationships presented in the literature, with a maximum relative error max RE at about ±20% and the mean relative error RE at about 8%.