scholarly journals A Comparative Evaluation on the effect of Zinc-Probiotic combination versus Zinc alone therapy in children (3month-5year) with acute watery diarrhea attending the outpatient clinic of Sub-District hospital, Uttarakhand

2021 ◽  
Vol 9 (4) ◽  
pp. 263-268
Author(s):  
Dr. Mamta Nikhurpa ◽  
◽  
Dr. Renu Agnihotri ◽  

Background: Diarrhea is the major cause of morbidity and mortality among children worldwide.Various studies were done on the role of zinc therapy and probiotic therapy in reducing the durationand severity of acute watery diarrhea. This study aimed to compare the effect of Zinc –probioticcombination versus Zinc only therapy in acute watery diarrhea in pediatric patients. Material andMethods: This was an open, randomized control trial in the pediatric outpatient department of Sub-District Female Hospital, Haldwani (Uttarakhand), from June 2020 till August 2020 for three months.Total 104 children aged six months to 5 years with acute diarrhea who met the inclusion criteriawere enrolled and divided into 52 patients each. 1stGroup A (n=52) received Zinc-Probioticscombination therapy, and 2ndGroup B (n=52) received Zinc only. Measurement of disease severitywas based on the frequency of diarrhea (times/day) and duration of diarrhea (hours) after initialdrug consumption. The resolution was assessed in mean remission time (time required to form solidstool from watery stool).Result: Among the study population in group A, 62% were male, 38%were female, and in group B, 65% were male & 35% were female. Male predominance was observedin both groups. The mean frequency of diarrhea before treatment in Group A was 7.46 ± 4.1times/day as compared to 6.69 ± 3.6 times/day in Group B. Mean duration of diarrhea in Group Awas 53.5 ± 30.5 hours as compared to 57.6 ± 34.3 hours in Group B. Conclusion: Combinationtherapy was more effective than Zinc only therapy in early remission and resolution of acute waterydiarrhea in children.

2021 ◽  
pp. 112972982110154
Author(s):  
Raffaella Mauro ◽  
Cristina Rocchi ◽  
Francesco Vasuri ◽  
Alessia Pini ◽  
Anna Laura Croci Chiocchini ◽  
...  

Background: Arteriovenous fistula (AVF) for hemodialysis integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes. Aim of this study is to determine the role of Ki67, a well-established proliferative marker, related to AVF, and its relationship with time-dependent histological morphologic changes. Materials and methods: All patients were enrolled in 1 year and stratified in two groups: (A) pre-dialysis patients submitted to first AVF and (B) patients submitted to revision of AVF. Morphological changes: neo-angiogenesis (NAG), myointimal thickening (MIT), inflammatory infiltrate (IT), and aneurysmatic fistula degeneration (AD). The time of AVF creation was recorded. A biopsy of native vein in Group A and of arterialized vein in Group B was submitted to histological and immunohistochemical (IHC) analysis. IHC for Ki67 was automatically performed in all specimens. Ki67 immunoreactivity was assessed as the mean number of positive cells on several high-power fields, counted in the hot spots. Results: A total of 138 patients were enrolled, 69 (50.0%) Group A and 69 (50.0%) Group B. No NAG or MIT were found in Group A. Seven (10.1%) Group A veins showed a mild MIT. Analyzing the Group B, a moderate-to-severe MIT was present in 35 (50.7%), IT in 19 (27.5%), NAG in 37 (53.6%); AD was present in 10 (14.5%). All AVF of Group B with the exception of one (1.4%) showed a positivity for Ki67, with a mean of 12.31 ± 13.79 positive cells/hot spot (range 0–65). Ki67-immunoreactive cells had a subendothelial localization in 23 (33.3%) cases, a myointimal localization in SMC in 35 (50.7%) cases. The number of positive cells was significantly correlated with subendothelial localization of Ki67 ( p = 0.001) and with NA ( p = 0.001). Conclusions: Native veins do not contain cycling cells. In contrast, vascular cell proliferation starts immediately after AVF creation and persists independently of the time the fistula is set up. The amount of proliferating cells is significantly associated with MIT and subendothelial localization of Ki67-immunoreactive cells, thus suggesting a role of Ki-67 index in predicting AVF failure.


2021 ◽  
Vol 8 (2) ◽  
pp. 321-325
Author(s):  
Dinesh Kumar Singh ◽  
B B Baj ◽  
Vipin Goyal

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.


2014 ◽  
Vol 5 (4) ◽  
pp. 21-24
Author(s):  
Mosin Mushtaq ◽  
Abid H Wani ◽  
Faud Sadiq ◽  
Mudasir Mushtaq ◽  
Sameena Tabassum ◽  
...  

Background and study aims: Hypertriglyceridemia can be a primary cause for acute pancreatitis or secondary to other factors prior to the increase of lipid levels, or both. The aim of our study was to assess the severity of acute pancreatitis with elevation in serum triglyceride levels and report the outcomes of our series. Patients and methods: One hundred twenty?six patients of acute pancreatitis were admitted within 72 hours of onset of symptoms, out of whom 26 patients were excluded during the course of study due to preexisting comorbidities. 100 patients in the study population were divided into group A having serum triglyceride levels ≥500 mg/dl (n = 30) and group B having <500 mg/dl (n = 70) at the time of admission. Results: The mean age of group A was similar to group B (50.2 ± 17.1 vs 49.26 ± 17.2 years; p = 0.860). Most common etiological factor of acute pancreatitis was found to be gall stones (56%) in both groups. Ranson's score at admission in group A was 2.93 ± 0.22 and in group B it was 1.34 ± 0.99. Mortality below two weeks was noted in (12/30, 40%) of group A and (6/70, 8%) of group B patients, which was statistically significant, (p = 0.015). Conclusions: The final conclusion of this study was that patients of acute pancreatitis with elevated triglyceride levels form a morbid group and these should be monitored aggressively for the development of any complications. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9971 Asian Journal of Medical Sciences 2014 Vol.5(4); 21-24


2020 ◽  
Vol 24 (1) ◽  
pp. 8-13
Author(s):  
Md Nurullah ◽  
Md Arif Hossain Bhuyan ◽  
Syed Ariful Islam ◽  
Md Shah Alam

Background: Functional endoscopic sinus surgery (FESS), effective control of bleeding is essential to maintain a clear operative field and to minimize complications. Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objective: The objective of study was role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery and designed to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia. Methods: Prospective randomized study includes a total of 60 ASA I-II patients who underwent elective FESS surgery. Patients randomly assigned in two groups the hypotension group (Group A) and the normotension group (Group B). Intraoperative mean arterial pressure (MAP), heart rate (HR) were recorded. Results : This study shows the mean ages of the patients of group A group B were 33.36±7.61 and 32.46±7.73 years respectively. No statistically significant difference was observed among groups at 0.05 level in term of age. The mean heart rate pre-anaesthesia and preoperative among the patients of different groups in different follows up period. Significance differences were observed among groups in term of heart rate at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. The mean arterial mean blood pressure before pre-anaesthesia and preoperative estimation among the patients of different groups in different follows up period. Significance differences were observed among groups at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. Conclusion: This study demonstrated that Controlled hypotension can be achieved equally and effectively by nitroglycerin and labetalol reduced significantly intraoperative hemorrhage and produce hypotensive anesthesia. Both are equally effective in providing ideal surgical field during functional endoscopic sinus surgery (FESS). Bangladesh J Otorhinolaryngol; April 2018; 24(1): 8-13


PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 190-195
Author(s):  
Daniel Pizarro ◽  
Bernardita Castillo ◽  
Gloria Posada ◽  
Cecilia Lizano ◽  
Leonardo Mata

In a randomized trial, 62 infants 2 to 35 months of age with dehydration due to acute watery diarrhea were allocated to one of two groups: group A received solution A (World Health Organization-recommended oral rehydration solution), which contained (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate3- 10, and glucose 110; group B received solution B (Pedialyte RS; Abbott Laboratories, North Chicago), which contained (in mmol/L): Na+ 75, K+ 20, Cl- 65, citrate3- 10, and glucose 139. Oral therapy was given until clinical signs of hydration status were normal. During the 48-hour trial, the following laboratory data were collected: blood gases, serum electrolytes, glucose, urea, and creatinine values and sodium and potassium concentrations in stool and urine; serial weights and clinical signs were also reported. Six of the 62 infants, three in each group, required intravenous fluids because of high stool output. Results of clinical outcome and normalization of altered serum electrolyte values were similar in both groups. During the 48-hour trial, eight patients in group A and four in group B had mild, asymptomatic hypernatremia. Pedialyte RS was found to be a safe glucose/electrolyte solution for oral rehydration therapy.


2020 ◽  
Vol 19 (1) ◽  
pp. 74-77
Author(s):  
Md Anwarul Azim ◽  
Badrud Doza ◽  
Shahed Iqbal ◽  
Farah Chowdhury ◽  
Sanjoy Kanti Biswas

Background: Acute watery diarrhea in under 5 children is still a major healthburden worldwide despite all available efforts that have been made to reduce itsincidence and prevalence. Mortality rate is still high among under 5 children.Therefore, appropriate and comprehensive management of diarrhea is essential.There are lot of studies on the role of zinc and probiotic in reducing the duration andseverity of acute watery diarrhea. This study emphasized on compared effect ofusing a combination zinc –probiotic and zinc in pediatric acute gastroenteritis. Materials and methods: This was a randomized controlled trial type study,conducted at Department of Pediatric Gastroenterology at Chattogram Maa-OShishuHospital Medical College from November 2018 to March 2019. A total of 100numbers of children ages 3 months to 5 years with acute watery diarrhea wereenrolled those who were fulfilled the selection criteria. They were divided into twogroups. Group A (n=50) received zinc-probiotics combination therapy and group B(n=50) received zinc only. Measurement of disease severity was based on thefrequency of diarrhea (Times/day) and duration of diarrhea (Hours) after initial drugconsumption. Results: Among the study population 63.5% male & 32.7% female in group A and56.4% male & 34.5% female in group B. Duration of acute watery diarrhea wassignificantly reduced in group A than group B (56.4 hours versus 70.80 hoursrespectively). We also observed significant difference in length of hospital stay inGroup A and Group B (68.16 hours vs 83.04 hours) respectively. Conclusion: Combination therapy was more effective in reducing the severity ofacute watery diarrhea than zinc alone therapy in under 5 children. Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 74-77


KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Dewi Karlina Rusly

<p><strong>Aim:</strong> To observe the effect of Dydrogesterone administration in pregnancy on PlGF level</p><p><strong>Methods:</strong> This is a randomized controlled clinical trial. Study population has been divided into two groups. Group A consists of 20 women who receive only Folic acid 5 mg a day for 4 weeks time. Group B consists of 20 women who receive Dydrogesterone 2x10 mg a day and Folic acid 5 mg a day for 4 weeks. PlGF has been measured twice. First measurement was done before drug administration, while the second measurement has been done during 18<sup>th</sup> weeks of pregnancy. The changes on PlGF level before and after treatment from each group has been analyzed using SPSS 17.</p><p><strong>Results:</strong> 40 pregnant women have been recruited for this study. There are no differences based on the patient’s age, number of pregnancy and parity, gestational age and body weight between each group.  The mean levels of PlGF in both groups before intervention shows no significant difference (p = 0091 or p&gt; 0.05), 40.80 pg/mL vs.  25.95 pg / mL. The mean levels of PlGF in group A after 4 weeks administration of Folic acid is 89.60 pg / mL. It shows the escalation of 48.8 pg / mL. The elevation of PlGF level in group A shows significant difference (p = 0.000 or p &lt;0.05) after 4 weeks Folic acid treatment.The mean levels of PlGF in group B after 4 weeks administration of Dydrogesterone and Folic acid is 212.15 pg / mL. It shows the escalation of 186.20 pg / mL. The elevation of PlGF level in group B shows significant difference (p = 0.000 or p &lt;0.05) after 4 weeks Dydrogesterone and Folic acid treatment.</p><p><strong>Conclusion:</strong> Dydrogesterone treatment can increase the level of PlGF.</p>


2017 ◽  
Vol 126 (5) ◽  
pp. 1702-1713 ◽  
Author(s):  
Christina Iosif ◽  
Philipp Berg ◽  
Sebastien Ponsonnard ◽  
Pierre Carles ◽  
Suzana Saleme ◽  
...  

OBJECTIVEThe outcome for jailing arterial branches that emerge near intracranial aneurysms during flow-diverting stent (FDS) deployment remains controversial. In this animal study, the authors aimed to elucidate the role of collateral supply with regard to the hemodynamic changes and neointimal modifications that occur from jailing arteries with FDSs. To serve this purpose, the authors sought to quantify 1) the hemodynamic changes that occur at the jailed arterial branches immediately after stent placement and 2) the ostia surface values at 3 months after stenting; both parameters were investigated in the presence or absence of collateral arterial flow.METHODSAfter an a priori power analysis, 2 groups (Group A and Group B) were created according to an animal flow model for terminal and anastomotic arterial circulation; each group contained 7 Large White swine. Group A animals possessed an anastomotic-type arterial configuration to supply the territory of the right ascending pharyngeal artery (APhA), while Group B animals possessed a terminal-type arterial configuration to supply the right APhA territory. Subsequently, all animals underwent FDS placement, thereby jailing the right APhAs. Mean flow rates and velocities inside the jailed branches were quantified using time-resolved 3D phase-contrast MR angiography before and after stenting. Three months after stent placement, the jailed ostia surface values were quantified on scanning electron micrographs. The data were analyzed using descriptive statistics and group comparisons with parametric and nonparametric tests.RESULTSThe endovascular procedures were feasible, and there were no findings of in situ thrombus formation on postprocedural optical coherence tomography or ischemia on postprocedural diffusion-weighted imaging. In Group A, the mean flow rate values at the jailed right APhAs were reduced immediately following stent placement as compared with values obtained before stent placement (p = 0.02, power: 0.8). In contrast, the mean poststenting flow rates for Group B remained similar to those obtained before stent placement. Three months after stent placement, the mean ostia surface values were significantly higher for Group B (527,911 ± 306,229 μm2) than for Group A (89,329 ± 59,762 μm2; p < 0.01, power: 1.00), even though the initial dimensions of the jailed ostia were similar between groups. A statistically significant correlation was found between groups (A or B), mean flow rates after stent placement, and ostia surface values at 3 months.CONCLUSIONSWhen an important collateral supply was present, the jailing of side arteries with flow diverters resulted in an immediate and significant reduction in the flow rate inside these arteries as compared with the prestenting values. In contrast, when competitive flow was absent, jailing did not result in significant flow rate reductions inside the jailed arteries. Ostium surface values at 3 months after stent placement were significantly higher in the terminal group of jailed arteries (Group B) than in the anastomotic group (Group A) and strongly correlated with poststenting reductions in the velocity value.


2018 ◽  
Vol 30 (2) ◽  
pp. 32-38
Author(s):  
Mst Musarrat Sultana ◽  
Md Shafiqul Islam ◽  
Shahana Akhter ◽  
Md Belal Hossain ◽  
Md Sanaul Haque Mia

Objective: Diarrhea is a common problem in our country especially children. There were many treatment options for acute watery diarrhea in addition to oral rehydration saline for reducing the severity of acute watery diarrhea. The aim of this study was to compare the efficacy of zinc & probiotics combination therapy to zinc alone therapy in reducing the severity of acute diarrhea.Method: This was a randomized controlled trial type study, conducted at department of pediatrics Rajshahi Medical College Hospital from July 2014 to June 2016. A total of 110 numbers of children ages 6 months to 5 years with acute watery diarrhea were enrolled those who were fulfilled the selection criteria. They were divided into two groups. Group A (n=55) received zinc-probiotics combination therapy and group B (n=55) received zinc only. Measurement of disease severity was based on the frequency of diarrhea (times/day) and duration of diarrhea (hours) after initial drug consumption.Result: Among the study population 56% male &44% female in group A and 58% male & 42% female in group B. Duration of acute watery diarrhea was significantly reduced in group A than group B(56.22 versus 70.69 hours respectively), (P-0.002)and frequency of stool also reduced in group A than group B(3.92 versus 7.15 times/day) on day 2 (P-0.002). Consistency of stool also improved in group A than group B[liquid stool12(21.8%) versus 25(45.5%), (P-0.015) on day 1, semi-liquid stool 4 (8.2%) versus 16 (30.8%), (P-0.004) on day 2, formed stool 29 (52.73%) versus 16(29.09%), P-0.004 on day 2 respectively].Conclusion: Combination therapy was more effective in reducing the severity of acute watery diarrhea than zinc alone therapy in children.TAJ 2017; 30(2): 32-38


1978 ◽  
Vol 89 (2) ◽  
pp. 284-295 ◽  
Author(s):  
J. L. Schlienger ◽  
M. Hasselmann ◽  
M. Imler

ABSTRACT Serum concentrations of thyroid hormones (T3, T4) and the TSH response to TRH administered iv were measured by radioimmunoassay in 21 patients with advanced cirrhosis and compared to 20 control patients without liver disease (group A). While the mean T4 values (8.6±0.3 μg/100 ml) were similar for the two groups, the mean T3 values were significantly lower in patients with liver disease (123 ± 12 vs. 156 ± 10 ng/100 ml). The mean baseline TSH levels and the magnitude of the peak were normal but very scattered in these patients. The TSH response to TRH appeared independant of nutritional status, T4 and T3, anaemia, hypoalbuminaemia, transaminasaemia and bilirubinaemia. The TSH release after TRH injection seemed however to be markedly elevated in cirrhotic patients with hyperammonaemia. Therefore, patients with liver disease were separated into two groups according to the absence (group B; n = 11) or the presence (group C; n = 10) of hyperammonaemia. Mean T4 values and the free thyroxine index were lower in group C (7.2 ± 0.6 vs. 9 ± 0.6 μg/100 ml and 1.87 ± 0.16 vs. 2.49 ± 0.15) but mean T3 and basal TSH values did not differ in group B and C. The TSH response was slightly dispersed in B and lower than that observed in A or in C (P < 0.01). A hyperresponsiveness in 4 patients and a hyperresponsiveness in 2 other patients was noted in group C without any correlation with the basal TSH value or T3 or T4 Since hyperammonaemia has been considered as a biological parameter of hepatic encephalopathy, it is suggested that the THS release which is neuraminergic controlled may be altered by this situation resulting in a cerebral aminergic mediators depletion.


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