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Author(s):  
Flora Tzifi ◽  
Alexandra Iliadi ◽  
Antonis Voutetakis ◽  
Dimitris Platis ◽  
Panagiotis Girginoudis ◽  
...  

Abstract Objectives The aim of the current prospective randomized control study was to assess efficacy, safety, and non-inferiority of a new liquid L-thyroxine formulation dissolved in glycerol and water (T4® drops, produced by a Greek pharmaceutical Company, Uni-Pharma, Athens, Greece) in comparison to the standard Tablets form (T4® tablets, Uni-Pharma, Athens, Greece) in the substitutive treatment of children with congenital hypothyroidism (CH). Methods Thirty-nine children with CH, aged 3–12 years old, were enrolled in the study, after parental Informed Consent has been obtained, while three patients were lost from follow-up. At baseline, all participants had normal thyroid-stimulating hormone (TSH) and Free T4 values. Patients were randomly subdivided according to the assigned treatment in Group A (n=17)-Tablet Form and Group B (n=19)-Liquid Form. TSH and Free T4 levels were evaluated at 0, 2, 4, and 6 months. Results TSH values showed a statistically significant difference (p=0.017) between groups only at six months (Group A having higher TSH levels than Group B, albeit within the normal range), while Free T4 levels had no statistical difference throughout the six month study period and were always within the normal range. Moreover, dose adjustments were more frequent in Group A (p=0.038) during the six months. Liquid L-thyroxine substitutive treatment exhibited no statistically significant adverse effects in comparison to the widely used tablets. Conclusions Levothyroxine (LT4) as liquid solution formulation is safe and noninferior to the widely used L-thyroxine Tablets, with less need for dose adjustment, and can therefore be safely used in the treatment of children with CH.


2023 ◽  
Vol 83 ◽  
Author(s):  
M. U. Asghar ◽  
A. Rahman ◽  
Z. Hayat ◽  
M. K. Rafique ◽  
I. H. Badar ◽  
...  

Abstract The current study aimed to determine the effects of different levels of Zingiber officinale as a herbal feed additive on growth performance, carcass characteristic, serum biochemistry, total bacterial count (TBC), gut morphology, and immunological parameters of broilers. A total of 1500, day-old broiler chicks (Hubbard) were equally accredited to five treatment groups, each with six replicates (50 birds/replicate). Five experimental diets were prepared using basal diet i.e. with antibiotics positive control (PC), 3 g/kg ginger (group A), 6 g/kg ginger (group B), 9 g/kg ginger (group C) and without antibiotics negative control (NC). Group A and C showed significantly (p<0.05) higher feed intake (FI) as compared to other groups. Group C showed significantly (p<0.05) lower Total bacterial count (TBC) followed by group B as compared to NC. Carcass characteristics showed non-significant effects among different treatments. Mean villi length and width were significantly (p <0.05) higher in all ginger supplemented groups as compared to the control groups. Blood serum parameters including cholesterol, triglycerides, and low-density lipoproteins (LDL) were significantly (p<0.05) lower in groups B and C in comparison with the control groups. Whereas high-density lipoproteins (HDL) was significantly higher in group B as compared to the others. In conclusion, ginger supplementation @0.6% in the basal diet significantly improved growth performance and gut morphometry of broilers. It also showed a positive impact on cholesterol, triglycerides and gut microbes. Therefore, ginger could be a better substitute for antibiotic growth promoters.


2021 ◽  
Vol 7 (3) ◽  
pp. 135-144
Author(s):  
V Shakuntala Soujanya ◽  
Abhishek Reddy ◽  
K Kranthi ◽  
Dilip Pantham ◽  
Durga Keerthi P

1. To compare efficacy of 2mm locking plates with 2mm miniplates in the fixation of mandible fractures and 2. To evaluate and compare the biomechanical function by measuring the bite force at 1st week, 3rd week, 6th week and 3rd month postoperatively in 20 patients divided equally into two study groups.A prospective randomized study was carried out at Department of Oral and Maxillofacial Surgery, Meghna Institute of Dental Sciences, Nizamabad from 2019 to 2021 to treat consecutive mandibular fractures where patients were randomly divided into two groups each composed of 10 patients where Group A were treated with single 4 holed stainless-steel locking miniplates and Group B with two 4 holed stainless steel conventional mini plates both maintaining a gap of 2.0 mm system. Later assessment was done using bite force recording postoperatively at 1st week, 3rd week, 6th week and 3rd month and with the associated complications like Swelling, Infection, Paresthesia, Mobility between fracture fragments and Hardware failure.When the mean bite force values in right molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared to group B at 1st week and 3rd week (P&#60;0.05). But no statistically significant differences were observed at 6th week and 3rd month (P&#62;0.05).When the mean bite force values in the central incisor region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A compared to group B at 1st week and 3rd week (P&#60;0.05). But no statistically significant differences were observed at 6th week and 3rd month (P&#62;0.05).When the mean bite force values in left molar region of group A and group B were compared at 1st week, 3rd week, 6th week and 3rd month, there was statistically significant increase in bite force noted in group A when compared group B at 3rd week (P&#60;0.05). But no statistically significant differences were observed at 1st week, 6th week and 3rd month (P&#62;0.05).The study signifies that both the fixation systems were able to provide stability to fracture segments, but locking plate system has provided better stability when compared to miniplates system, hence recommending for more elaborative studies to arrive at definitive conclusion.


2021 ◽  
Author(s):  
Song Shen ◽  
Jing Liang ◽  
Jianhui Li ◽  
Xue Bao ◽  
Jun Xie ◽  
...  

Abstract Objective We aim to assess the left ventricular strain in patients with ventricular aneurysm(VA) after myocardial infarction(MI) using cardiac magnetic resonance-feature tracking (CMR-FT) and to evaluate its value for long term prognosis of patients.Methods Sixty-five patients who underwent CMR with VA after MI from January 2018 to December 2019 in Drum Tower Hospital Affiliated Hospital of Nanjing University School of Medicine were selected for the study. They were divided into two groups based on New York Heart Association (NYHA): 25 cases of NYHA I as group A and 40 cases of NYHA II-IV as group B. CMR was performed in both groups to quantify the parameters of overall and segmental left ventricular myocardial strain in patients with aneurysm. 37 of whom underwent a second CMR 3-12 months after cardiac infarction to investigate the effects of aneurysm on patients' left ventricular strain and left ventricular cardiac function.Results Patients from group B have larger VA basilar transverse diameter and significant more impaired LV Global longitudinal strain(GLS)、Global circumferential strain(GCS)、Global radial strain(GRS) (-12.34±7.31 vs. -7.68±6.11;p=0.0072, -21.31±13.49 vs. -14.93±10.44;p=0.0361, 37.13±27.87 vs. 22.00±20.05;p=0.0135) without change in infarct size. GLS, GCS, GRS were significant indicators of NYHA classification after AMI by multivariate regression analysis.Conclusions Myocardial strain assessed by CMR-FT may be an independent predictor of NYHA of patients with aneurysm after MI and could be used for identifying high-risk patients with VA.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liping Yu ◽  
Bikang Yang ◽  
Qinyang Xu ◽  
Yincheng Teng ◽  
Zhuowei Xue

Abstract Background Cesarean scar pregnancy (CSP) remains a sporadic and special form of ectopic pregnancy in which the fertilized ovum is implanted on a previous cesarean scar within 12 weeks. This study aims to evaluate the optimal time interval between uterine artery embolization (UAE) and curettage modalities in order to provide the best clinical outcomes. Methods From January 2018 to December 2020, we recruited 61 patients with CSP. They were randomly divided into two groups depending on whether the time interval between UAE and dilatation and curettage (D&C) requires additional hospitalization: 31 patients received prophylactic UAE followed by D&C on the same day (0–12 h; group A) and 30 patients need hospitalization (12–72 h; group B). The clinical characteristics, diagnostic data, and outcomes of the two groups were compared and analyzed. Results A total of 59 (96.72%) cases had responded well to the first treatment. One patient in each arm undergone retreatment, but none of the 61 patients needed additional hysterectomy. There was no considerable relationship between the two groups with respect to the intraoperative hemorrhage during D&C, serum index (containing β-hCG, hemoglobin, CRP, and D-dimer) on the first day after D&C, side effects (containing fever and abdominal pain), renal, hepatic, and coagulation function, time of CSP residual mass disappearance, and hospitalization cost. The time of serum β-hCG resolution after surgery was 41.22 ± 14.97 days in group A and 66.67 ± 36.64 days in group B (P = 0.027), and group A treatment resulted in a shorten hospital stay as compared with group B (4.81 ± 2.74 days vs. 6.80 ± 2.14 days, P <  0.001). However, the average hourly serum β-hCG decrease rate within 24 h and the leukocytes on the first day after D&C in group B were superior than in group A (P <  0.050). Conclusion For patients with CSP, UAE followed by D&C on the same day (0–12 h) appears to have more advantages in hospitalization and recovery time, while the long time interval (12–72 h) may have a lower risk of inflammation and a more rapid decrease in serum β-hCG level within 24 h after D&C surgery. The treatment of CSP should be individualized based on the conditions of patients.


2021 ◽  
Vol 8 (3) ◽  
pp. 235-240
Author(s):  
Farzana Mustafa ◽  
Abdul Hai Mohammed

QT interval abnormalities are the best predictors of cardiovascular deaths. Microalbuminuria is an independent marker for cardiovascular disease in diabetes mellitus. Hence QT interval abnormalities in diabetics with or without microalbuminuria were evaluated in this study. To study QT interval abnormalities in asymptomatic type 2 diabetic patients with or without microalbuminuria. : Open label controlled study with 214 subjects of either sex. Group A healthy subjects (n=100), group B asymptomatic, type 2 diabetics with no clinical evidence of cardiac disease. Group B subdivided into B with microalbuminuria (n=62), Bwithout microalbuminuria (n=52). Corrected QT interval (QTC), microalbuminuria, and blood pressure were measured for all subjects. QTC was calculated by using Bazzet's formula. QTC more than 440msec was considered prolonged. QTC was within normal range in diabetic patients(415+25msec). Highly significant (p&#60;0.0001) prolongation was observed in diabetics, compared to healthy subjects. Both B(p&#60;0.0001) and B(p&#60;0.001) groups showed a significant increase in QTC than in healthy subjects. Among Band Bgroups QTC was not statistically significant. Prolongation of QTC is indicative of CAN. CAN is often under-recognised and undiagnosed cardiac complication.QTC was more in asymptomatic type 2 diabetics irrespective of microalbuminuria compared to healthy individuals, though values were within normal range. This denotes high risk for future cardiovascular complications in diabetic patients.


2021 ◽  
Author(s):  
Wenshu Jin ◽  
Huaqiang Sun ◽  
Xudong Duan ◽  
Yange Gu ◽  
zhang zhao ◽  
...  

Abstract Objective: To introduce a surgical technique (the ‘Y’ line technique) which is to control the leg length discrepancy (LLD) after total hip arthroplasty.Methods: A total of 350 patients were selected; 134 patients who were used the ‘Y’ line technique to control lower limb length were included in Group A and 166 patients treated with free hand methods to control lower limb length were included in Group B. 50 patients who were taken standard anteroposterior X-ray of bilateral hips preoperatively and used the ‘Y’ line technique during the operation were included in Group C. Results: The postoperative LLD of the three groups was statistically significant (p < 0.001). There were significant differences statistically in comparison between any two groups (P<0.01). Severe unequal length rates of the lower extremities (LLD > 10 mm) were 5.97% (8/134) in Group A, 14.3% (24/166) in Group B and 0% (0/50) in Group C – the difference was statistically significant (p < 0.001). There were significant differences between Group A and Group B, Group B and Group C (P < 0.05), but there was no significant difference between Group A and Group C (P = 0.078).Conclusion: The ‘Y’ line technique, which does not increase the operation time, can effectively reduce postoperative LLD. Insufficient internal rotation of the healthy lower extremity and the low projection position in the preoperative anteroposterior X-ray of bilateral hips were important factors affecting the accuracy of the ‘Y’ line technique.


2021 ◽  
Vol 12 ◽  
Author(s):  
Huihui Xu ◽  
Shen Zhao ◽  
Xinxing Gao ◽  
Xian Wu ◽  
Lan Xia ◽  
...  

ObjectiveTo evaluate the efficiency and validity of cessation of cetrorelix on trigger day during gonadotropin releasing hormone antagonist (GnRH-ant)-controlled ovarian stimulation of in vitro fertilization (IVF) cycles.MethodsIn this retrospective study, a total of 1271 patients undergoing initial IVF cycles following the GnRH-ant protocol were enrolled; 832 patients received cetrorelix on trigger day (Group A) and 439 patients ceased cetrorelix on trigger day (Group B). We compared demographic characteristics, embryological and clinical outcomes between the two groups. A Poisson regression model was used to identify factors that significantly affected embryological outcomes. Patients were further divided into subgroups according to anti-Mullerian hormone (AMH) and age, to assess associations between ceasing cetrorelix on trigger day and embryological outcomes.ResultsThere was a significant improvement on embryological outcomes in patients who ceased cetrorelix on trigger day, and there were no significant differences in clinical outcomes or preovulation rates between the two groups. Furthermore, for patients with 1.1 ≤ AMH ≤ 4.7 ng/ml, all embryological outcomes were significantly higher in Group B compared with Group A. For patients with AMH &gt; 4.7 ng/ml, the number of oocytes retrieved, fertilization rate (2PN) of IVF cycles and proportion of day 3 good quality embryos were all significantly higher in Group B. For patients with age &lt; 35 years, all the embryological outcomes, besides the number of available embryos, were significantly higher in Group B than in Group A. There were no differences in embryological outcomes between the two groups when patients were stratified based on age &gt; 35 years or AMH &lt; 1.1 ng/ml.ConclusionGnRH-ant protocol with cessation of cetrorelix on trigger day improved embryological outcomes for young patients or patients with sufficient ovarian reserve, and was effective at preventing preovulation.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takao Koiso ◽  
Masayuki Goto ◽  
Toshitsugu Terakado ◽  
Yoji Komatsu ◽  
Yuji Matsumaru ◽  
...  

AbstractThe number of patients with traumatic intracranial hemorrhage (tICH) that are taking antithrombotics (ATs), antiplatelets (APs) and/or anticoagulants (ACs), has increased, but the influence of it for outcome remains unclear. This study aimed to evaluate an influence of AT for tICH. We retrospectively reviewed all patients with tICH treated between 2012 and 2019, and analyzed demographics, neurological status, clinical course, radiological findings, and outcome data. A total of 393 patients with tICH were included; 117 were on AT therapy (group A) and 276 were not (group B). Fifty-one (43.6%) and 159 (57.6%) patients in groups A and B, respectively, exhibited mRS of 0–2 at discharge (p = 0.0113). Mortality at 30 days was significantly higher in group A than in group B (25.6% vs 16.3%, p = 0.0356). Multivariate analysis revealed that higher age (OR 32.7, p < 0.0001), female gender (OR 0.56, p = 0.0285), pre-injury vitamin K antagonist (VKA; OR 0.42, p = 0.0297), and hematoma enlargement (OR 0.27, p < 0.0001) were associated with unfavorable outcome. AP and direct oral anticoagulant were not. Hematoma enlargement was significantly higher in AC-users than in non-users. Pre-injury VKA was at high risk of poor prognosis for patients with tICH. To improve outcomes, the management of VKA seems to be important.


Cureus ◽  
2021 ◽  
Author(s):  
Yara Alamri ◽  
Samera Albasri ◽  
Ghalia H Abduljabbar ◽  
Hajar Alghamdi ◽  
Albatool M Balkhair ◽  
...  

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