Transitional Hypoglycaemia Management in Small for Gestational Age Neonates with Sucrose Enriched Expressed Breastmilk in Resource Poor Setting

2019 ◽  
Vol 66 (3) ◽  
pp. 267-274
Author(s):  
Reeta Bora ◽  
Sumon Deori
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Therapy Group ◽  
Resource Poor Setting ◽  
Oral Supplementation ◽  
Resource Poor ◽  
Calculated Dose ◽  
Group A ◽  
Feed Intolerance ◽  
Group B

Abstract Aim To find out if oral sucrose is as efficacious as intravenous dextrose (IVDx) in treating hypoglycaemia in small for gestational age (SGA) neonates and to compare risk of feed intolerance (FI) and necrotizing enterocolitis (NEC) in oral therapy with IVDx therapy. Methods Eighty SGA haemodynamically stable hypoglycaemic [blood sugar (BS) < 40 mg/dl] neonates of ≥32 to ≤36 week gestational age were randomized to receive oral sugar enriched expressed breastmilk (EBM; Group A) or IV dextrose therapy (Group B; 40 in each group) in similar calculated doses. BS at 6 h after treatment, incidence of recurrence of hypoglycaemia, FI and NEC were compared. Results Mean BS level at 6 h after treatment in oral supplementation group was 63.53 ± 22.12 mg/dl [3.52 ± 1.22 mmol/l (IQR 49.2–82 mg/dl, 2.7–4.5 mmol/l) vs. 71.28 ± 31.76 mg/dl [3.96 ± 1.76 mmol/l (IQR 48.5–73 mg/dl, 2.69–4 mmol/l) in IVDx group, p = 0.209. Relative risk (RR) of recurrence of hypoglycaemia in oral vs. IV treatment was 1.5 with 95% CI 0.4578–4.9151. Incidence of FI (p = 0.49, RR 1, 95%CI 0.3–3.1) and NEC (p = 0.4, RR 0.2, 95%CI 0.01–4.2) was comparable Conclusion In resource poor setting in haemodynamically stable hypoglycaemic SGA neonates, EBM enriched with calculated dose of sucrose given orally maintains euglycaemia (BS 40–125mg/dl, 2.2–6.9 mmol/l) without increased incidence of FI and NEC. This method also prevents lactational failure.

scholarly journals Utility of paperless partogram in labor management

2020 ◽  
Vol 9 (3) ◽  
pp. 1045
Author(s):  
Nazli Tarannum ◽  
Nishat Akhtar
Keyword(s):  
Perinatal Outcome ◽  
Analytical Study ◽  
Obstetric Care ◽  
Resource Poor Setting ◽  
Delivery Time ◽  
Labor Management ◽  
Resource Poor ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Partograph use in labor has revolutionized the obstetric care. WHO recommends universal use of WHO modified partograph, which in clinical setup is less often used. Debdas (2006) proposed the paperless partogram which is designed for use by clinician/nurses/midwives as it is very simple and low skill method. The present study is proposed to evaluate the effectiveness of paperless partogram as a bedside tool and its comparison with WHO modified partograph.Methods: It was a prospective analytical study done in department of obstetrics and gynecology, JNMCH, AMU, Aligarh from September 2017 to July 2019 and included 400 pregnant women at term, divided into 2 groups of 100 each Group A (paperless partogram) and Group B (WHO modified partograph) and their labor events were followed.Results: Out of 200 women that were included in each group, maximum women were multigravida, 58.5% in group A and 61.5% women in Group B. Mean age in Group A was 24.68±3.8years and Group B was 24.93±3.75 years. The mean duration of labor in Group A was 3.57±2.20 hours and Group B was 3.40±2.03 hours. There were 87.5% of women who delivered before alert ETD, likewise in Group B; women who delivered before alert line are 88.5%. These differences were statically not significant. Perinatal outcome was also similar in both groups.Conclusions: In our study, the paperless study was found to be as efficient as WHO modified partograph for management of labor. The mean delivery time was 3.57 hours similar to WHO partograph of difference between alert and action line. Thus, for resource poor setting like India with overburdened population paperless partogram can be used as an alternative to WHO modified partograph which is complex and time consuming.

scholarly journals High Serum Levels of Growth Hormone (GH) and Insulin-Like Growth Factor-I (IGF-I) during High-Dose GH Treatment in Short Children Born Small for Gestational Age

2006 ◽  
Vol 91 (4) ◽  
pp. 1390-1396 ◽  
Author(s):  
Marije van Dijk ◽  
Paul Mulder ◽  
Mieke Houdijk ◽  
Jaap Mulder ◽  
Kees Noordam ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Serum Levels ◽  
High Serum ◽  
High Dose ◽  
Gh Treatment ◽  
Igf I ◽  
Group A ◽  
Group B ◽  
Igfbp 3

Context: Epidemiological studies have indicated that high serum levels of GH and IGF-I are associated with long-term risks. Objective: The objective of the study was to evaluate the changes in serum levels of GH during overnight profiles, IGF-I, and IGF binding protein 3 (IGFBP-3) in short small for gestational age (SGA) children during GH treatment with two doses. Patients: Thirty-six prepubertal short SGA children were the subjects of this study. Intervention: Subjects received 1 (group A) or 2 (group B) mg GH/m2·d. Main Outcome Measures: At baseline and after 6 months of GH treatment, overnight GH profiles were performed, and serum IGF-I and IGFBP-3 levels were measured. Results: After 6 months, group B had significantly higher GH levels during the profile (mean, maximum, and area under the curve above zero line) than group A (P < 0.009). In group B, maximum GH levels increased from 43.9–161 mU/liter (P < 0.0002), and in group A, from 57.2–104 mU/liter (P = 0.002). During the profile (i.e. 12 h per day), children of group B had mean GH levels of 64.4 vs. 34.8 mU/liter in group A (P = 0.001). The IGF-I and IGF-I to IGFBP-3 ratio sd scores increased significantly in both groups, but were higher in group B than A [1.5 vs. 0.2 (P = 0.002) and 1.4 vs. 0.3 (P = 0.007), respectively]. In group B, 74% of the children had IGF-I levels in the highest quintile during GH treatment compared with 19% in group A. Conclusion: Our study shows that high-dose GH treatment in short SGA children results in high serum GH and IGF-I levels in most children. We recommend monitoring IGF-I levels during GH therapy to ensure that these remain within the normal range.

Randomized trial of medical compression stockings versus two-layer short-stretch bandaging in the management of venous leg ulcers

Phlebologie ◽  
2009 ◽  
Vol 38 (04) ◽  
pp. 157-163 ◽  
Author(s):  
A. Franek ◽  
L. Brzezinska-Wcislo ◽  
E. Blaszczak ◽  
A. Polak ◽  
J. Taradaj
Keyword(s):  
Drug Therapy ◽  
Randomized Clinical Trials ◽  
Therapy Group ◽  
Long Term Results ◽  
Leg Ulcers ◽  
Compression Stockings ◽  
Venous Leg Ulcers ◽  
Group A ◽  
Group B ◽  
Medical Compression Stockings

SummaryA prospective randomized clinical trial was undertaken to compare a medical compression stockings with two-layer short-stretch bandaging in the management of venous leg ulcers. Study endpoints were number of completely healed wounds and the clinical parameters predicting the outcome. Patients, methods: Eighty patients with venous leg ulcers were included in this study, and ultimately allocated into two comparative groups. Group A consisted of 40 patients (25 women, 15 men). They were treated with the compression stockings (25–32 mmHg) and drug therapy. Group B consisted of 40 patients (22 women, 18 men). They were treated with the short-stretch bandages (30–40 mmHg) and drug therapy, administered identically as in group A. Results: Within two months the 15/40 (37.50%) patients in group A and 5/40 (12.50%) in group B were healed completely (p = 0.01). For patients with isolated superficial reflux, the healing rates at two months were 45.45% (10/22 healed) in group A and 18.18% (4/22 healed) in group B (p = 0.01). For patients with superficial plus deep reflux, the healing rates were 27.77% (5/18 healed) in group A and 5.55% (1/18 healed) in group B (p = 0.002). Comparison of relative change of the total surface area (61.55% in group A vs. 23.66% in group B), length (41.67% in group A vs. 27.99% in group B), width (46.16% in group A vs. 29.33% in group B), and volume (82.03% in group A vs. 40.01% in group B) demonstrated difference (p = 0.002 in all comparisons) in favour of group A. Conclusion: The medical compression stockings are extremely useful therapy in enhancement of venous leg ulcer healing (both for patients with superficial and for patients who had superficial plus deep reflux). Bandages are less effective (especially for patients with superficial plus deep reflux, where the efficiency compared to the stockings of applied compression appeared dramatically low). These findings require confirmation in other randomized clinical trials with long term results.

THE ROLE OF MANUAL THERAPY IN THE TREATMENT OF CHRONIC CERVICAL PAINS

2020 ◽  
pp. 1-4
Author(s):  
George-Sebastian Iacob ◽  
Constantin Munteanu
Keyword(s):  
Manual Therapy ◽  
Therapy Group ◽  
Neck Disability Index ◽  
Initial Assessment ◽  
Visual Analogue Pain Scale ◽  
Rehabilitation Protocol ◽  
Visual Analogue Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B

Cervical back pain is one of the most important and common musculoskeletal disorders in medical recovery clinics and clinics. The main objective of the study was to highlight the effectiveness of an individualized therapeutic program adapted to the particularities of 22 subjects, which combines physical exercise with manual therapy. Subjects were randomly assigned to two equal groups. Group A - rehabilitation protocol consisting of therapeutic exercises (specific to the head, neck and upper limbs). Group B - rehabilitation protocol that included both therapeutic exercises and manual therapy (specific maneuvers of vertebral mobilization, massage, myofascial techniques, stretching and manipulations). The Visual Analogue Pain Scale (VAS) and the Neck Disability Index (NDI) were used to monitor the evolution of the research subjects, both of which have a specific applicability character to chronic pain. According to VAS (p <0.001), Group B showed mean values reduced to 2.2 ± 0.9 at week 12, compared to 7.3 ± 0.92, following the initial assessment. NDI values indicate better functional status after 12 weeks of treatment for both groups of subjects. NDI showed a beneficial decrease for Group B (13.2 ± 2.2 after 12 weeks, compared to 25.8 ± 2.3 in the first week). The mean results of VAS and NDI indicated a better evolution of symptoms in the case of the protocol that combined exercise and manual therapy (group B), but there were no statistically significant differences (compared to group A).

An Efficacy and Safety Study of Remogliflozin in Obese Indian Type 2 Diabetes Mellitus Patients Who Were Inadequately Controlled on Insulin glargine plus other oral hypoglycemic agents

2020 ◽  
Vol 17 ◽  
Author(s):  
Anand Shankar
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Glargine ◽  
Therapy Group ◽  
Insulin Dose ◽  
Blood Glucose Control ◽  
Hypoglycemic Agents ◽  
Oral Drug ◽  
Group A ◽  
Group B

Aim & Objective: The objective of this retrospective study was to investigate the efficacy of adding remogliflozin to current insulin glargine plus two oral drug i.e. metformin and teneligliptin therapy in poorly controlled Indian type 2 diabetes. Material and Methods: 173 study participants were initially selected from patient database who continued on their insulin glargine or received an increased dose of insulin glargine along with other OHA based therapy (Group A) and 187 were selected who had received remogliflozin (100 mg BD) (Group B) in addition to insulin glargine along with other OHA based therapy. Glycated haemoglobin (HbA1c), total daily insulin dose, body weight, and the number of hypoglycemic events were recorded at weeks 0, 12 and 24. Result: During the study, mean values of HbA1c, FBG and P2BG were significantly reduced in both groups. Insulin requirements decreased from 45.8 ± 16.7 IU/day to 38.5 ± 13.5 IU/day (P < 0.001) and at week 24 even further decreased to 29.5 ± 14.5 IU/Day . Twenty three patients in group B were able to cease insulin treatment altogether after 24 week treatment. It has been observed to attain tight blood glucose control we need to increase insulin dose in group A from 45.5 ± 16.5 IU/Day to 51.5 ± 14.5 at week 12 (P<0.01) and which further increased to 53.8 ± 12.8 IU/Day at week 24 (P<0.01). Adding remogliflozin showed significant effect on blood pressure (P < 0.001) and weight reduction (P < 0.001). It has been observed that 38% patients has achieves targeted HbA1c (≤7%) in group B where it was 22% in group A. Conclusion: Results demonstrate that in uncontrolled T2DM patients remogliflozin 100 mg BD can successfully lay a foundation for prolonged good glycemic control. Early addition of remogliflozin with insulin glargine plus OHAs may be an alternative compare to intensive up titration of insulin daily dose in people with uncontrolled T2DM. Clinical Trial Registration Number: A 2358

Moxifloxacin Based Triple Therapy as Alternative to Standard Therapy in Helicobacter Pylori Eradication.

2020 ◽  
Vol 18 ◽  
Author(s):  
Mohammed Hussien Ahmed ◽  
Sherief Abd-Elsalam ◽  
Aya Mohammed Mahrous
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Therapy Group ◽  
Low Cost ◽  
High Rate ◽  
Helicobacter Pylori Eradication ◽  
Treatment Regimens ◽  
Group A ◽  
H Pylori ◽  
Group B

Introduction: Helicobacter pylori eradication remains a problematic issue. We are in an urgent need for finding a treatment regimen that achieves eradication at a low cost and less side effect. Recent published results showing a high rate of resistance and with clarithromycin-based treatment regimens. The aim of the study was to compare moxifloxacin therapy and classic clarithromycin triple therapy in H. pylori eradication. Methods: This was a pilot study that enrolled 60 patients with helicobacter pylori associated gastritis. Diagnosis was done by assessment of H. pylori Ag in the stool. The patients were randomly assigned to receive either moxifloxacin based therapy (Group A), or clarithromycin based therapy (Group B) for two weeks. We stopped the treatment for another two weeks then reevaluation for cure was done. Results: 90 % of patients had negative H. pylori Ag in the stool after 2 weeks of stoppage of the treatment in group A versus 66.7 % in Group B. None of the patients in both groups had major side effects. Conclusion: Moxifloxacin-based therapy showed higher eradication power and less resistance when compared to clarithromycin triple therapy.

scholarly journals Blood asymmetric dimethylarginine and nitrite/nitrate concentrations in short-stature children born small for gestational age with and without growth hormone therapy

2017 ◽  
Vol 46 (2) ◽  
pp. 761-772 ◽  
Author(s):  
Hironori Nagasaka ◽  
Ichiro Morioka ◽  
Mayuko Takuwa ◽  
Mariko Nakacho ◽  
Mayumi Yoshida ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Growth Hormone ◽  
Asymmetric Dimethylarginine ◽  
Therapy Group ◽  
Adma Level ◽  
Gh Therapy ◽  
Normal Children ◽  
Group A ◽  
Group B ◽  
Nitrite Nitrate

Objective To investigate the basal amino acid metabolism and impact of growth hormone (GH) therapy in short-stature children born small for gestational age (short SGA children). Methods In this age-matched case-control study, the basal blood levels of amino acids, asymmetric dimethylarginine (ADMA), and nitrite/nitrate (NOx) were compared between 24 short SGA children and 25 age-matched normal children. Changes in these parameters were assessed for 12 months in 12 short SGA children initiating GH therapy (Group A) and 12 age-matched short SGA children without GH therapy (Group B). Results The arginine levels were significantly lower in the short SGA than in normal children. The ADMA levels were significantly higher and NOx levels were significantly lower in the short SGA than normal children. In Group A, the ADMA level was significantly lower and NOx level was significantly higher at 6 months than at baseline. At 12 months, the ADMA level in Group A began to increase, but the NOx level remained the same. Group B showed no significant changes. Conclusions This study is the first to show that ADMA is promoted and nitric oxide is suppressed in short SGA children and that GH therapy affects the production of ADMA and nitric oxide.

scholarly journals EFFECTIVENESS OF C1-C2 SUSTAINED NATURAL APOPHYSEAL GLIDE COMBINED WITH DRY NEEDLING ON PRESSURE POINT THRESHOLD AND HEADACHE DISABILITY IN CERVICOGENIC HEADACHE.

2018 ◽  
Vol 11 (1) ◽  
pp. 171 ◽  
Author(s):  
Ramesh Chandra Patra ◽  
Patitapaban Mohanty ◽  
Ajay P Gautam
Keyword(s):  
Therapy Group ◽  
Combined Treatment ◽  
Cervicogenic Headache ◽  
Dry Needling ◽  
Pressure Point ◽  
Cervicogenic Headaches ◽  
Group A ◽  
The Mean ◽  
Headache Disability ◽  
Group B

 Objective: The main objective of this study was to evaluate the effectiveness of dry needling and mulligan C1-C2 sustained natural apophyseal glides (SNAGs) in increasing pressure point threshold and reducing headache disability in patients with CGH.Methods: This study was conducted on 150 patients. They were divided into three groups for the purpose of the study. Group A was referred to as the dry needling group. They were subjected to dry needling for treating the pain. Group B was the manual therapy group. The patients in this group were subjected to C1-C2 SNAGs. Group C was the combined group. Patients belonging to this group were given C1-C2 SNAGs along with dry needling.Results: Statistical analysis paired t-test was used for comparison of the mean within every group where it showed significant improvement in all the parameter (p<0.05).Conclusion: There was a consistent reduction in tenderness and improvement in disability of the patients belonging to all groups. However, Group C, where the patients were subjected to combined treatment, showed better results. Results of this study indicate that dry needling along with mulligan C1-C2 SNAGs is more beneficial in patients suffering from cervicogenic headaches.

scholarly journals Manual Vacuum Aspiration (M.V.A) Versus Conventional Evacuation and Curettage in Early Pregnancy Loss

2021 ◽  
Vol 15 (8) ◽  
pp. 2213-2215
Author(s):  
Uzma Shaheen ◽  
Sumaira Yasmin ◽  
Nazia Liaqat ◽  
Sonia Rafique
Keyword(s):  
Early Pregnancy ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Cervical Ripening ◽  
Early Pregnancy Loss ◽  
Vacuum Aspiration ◽  
Manual Vacuum Aspiration ◽  
Group A ◽  
Randomized Control ◽  
Group B

Objective: The aim of this study is to compare the efficacy of manual vacuum aspiration and conventional evacuation and curettage in early pregnancy loss Study Design: Randomized control trial Place and Duration: Study was conducted at department of obstetrics and gynecology Lady Reading Hospital Peshawar from 1st January 2019 to 31st August 2020. Methods Patients were early pregnancy loss (12 weeks or lesser gestational age) were enrolled. Patients were divided into two groups by lottery method. Group A were the patients who had conventional evacuation and curettage treatment. Group B were patient in which MVA was used. Patients’ demographics were recorded after taking written consent. Gestational age was calculated from first day of last menstrual cycle and by ultrasound. Cervical ripening was done by (misoprostol 400mcg) two hours before procedure. Procedure was carried out under aseptic measures. Complete uterine evacuation by either procedure was assessed by ultrasound after procedure and complications were noted. Data was analyzed by SPSS 24.0. Results: mean age in Group A was 29 years with SD ± 8.65 while mean age in Group B mean age was 30 years with SD ±7.62. Group B (Manual Vacuum Aspiration) was effective in 96% patients while Group A(Conventional Evacuation and Curettage) was effective in 89% patients. Complications were fewer in MVA as compared to conventional evacuation and curettage Keywords: MVA, Evacuation and curettage , Early pregnancy loss.

scholarly journals The Effect of non-Surgical Periodontal Treatments on the Severity of Arthritis Rheumatoid

2021 ◽  
Vol 3 (4) ◽  
pp. 01-05
Author(s):  
Elham Atabati
Keyword(s):  
Therapy Group ◽  
Reduction Rate ◽  
Control Group ◽  
Tooth Cleaning ◽  
Antibiotic Group ◽  
Group A ◽  
Time Periods ◽  
Cleaning Intervention ◽  
Group B ◽  
Arthritis Rheumatoid

Background: periodontal disease with alveoli bone degeneration and losing teeth is seen in many people, including those with arthritis rheumatoid. Objective This study aims to evaluate the effect of non-surgical periodontal treatments on the severity of arthritis rheumatoid. Methods: this randomized control clinical trial was conducted on 60 patients who concurrently had arthritis and mild to moderate periodontitis. Patients divided into three groups of 20 subjects (group C had tooth cleaning and antibiotic therapy, group B had only tooth cleaning and group A was control). DAS28 questionnaire was filled out for all three groups at the beginning of the study. After ending the treatment and improvement, patients were examined in days 45 and 90 in terms of improvement indicators for arthritis rheumatoid. Data were finally analyzed by SPSS18. Results: the highest reduction rate of ESR, DAS28, CRP and RF was in different time periods in tooth cleaning intervention +antibiotic group and then, teeth cleaning group. The lowest reduction was seen in control group. RF, CRP and DAS28 indices showed significant differences in different time periods in tooth cleaning group and tooth cleaning+ antibiotic group (P<0.05). Conclusion: non-surgery periodontal treatment and RA indices, without considering the medicines used for treatment, had positive effect on the treatment of this disease.

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