Pub Date : 2020-01-01DOI: 10.37532/2041-6792.2020.10(3).172
Tharun C. Varghese, A. Paul, Santhosh T. Soans
Aim: Pain management in newborn infants especially for mild to moderate pain is underused. The use of sucrose and glucose are found to be effective. This study is to find the effect of oral dextrose solution on pain relief in term neonates. Methodology: In a randomized controlled clinical trial, 124 term neonates were enrolled in the study. They were randomized to receive oral dextrose (25%) or breast milk two minutes before venipunctures. Pain reactions were scored with the NIPS pain scoring system, heart rate, and oxygen saturation after venipunctures was recorded. Results: There were significantly lower pain score in dextrose group after venipunctures (NIPS pain score: 4.67+1.04 and 6.62+0.82 at 1st minute, 2.04 ± 1.45 and 4.08 ± 1.05 at 2nd minutes and 1.63+0.76 and 3.02+1.08 at 3rd minute respectively) The mean heart rate of the group I (166.57± 12.25/min) was high compared to the group II (144.8 ± 12.44/min). There was desaturation noted in both the groups. Conclusion: Using 2 ml of 25% oral dextrose solution is a useful, easy, non-expensive, and non-pharmacologic method for managing mild to moderate pain in neonates.
{"title":"Oral dextrose v/s breast milk for the pain relief of newborn infants","authors":"Tharun C. Varghese, A. Paul, Santhosh T. Soans","doi":"10.37532/2041-6792.2020.10(3).172","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(3).172","url":null,"abstract":"Aim: Pain management in newborn infants especially for mild to moderate pain is underused. The use of sucrose and glucose are found to be effective. This study is to find the effect of oral dextrose solution on pain relief in term neonates. Methodology: In a randomized controlled clinical trial, 124 term neonates were enrolled in the study. They were randomized to receive oral dextrose (25%) or breast milk two minutes before venipunctures. Pain reactions were scored with the NIPS pain scoring system, heart rate, and oxygen saturation after venipunctures was recorded. Results: There were significantly lower pain score in dextrose group after venipunctures (NIPS pain score: 4.67+1.04 and 6.62+0.82 at 1st minute, 2.04 ± 1.45 and 4.08 ± 1.05 at 2nd minutes and 1.63+0.76 and 3.02+1.08 at 3rd minute respectively) The mean heart rate of the group I (166.57± 12.25/min) was high compared to the group II (144.8 ± 12.44/min). There was desaturation noted in both the groups. Conclusion: Using 2 ml of 25% oral dextrose solution is a useful, easy, non-expensive, and non-pharmacologic method for managing mild to moderate pain in neonates.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"341 1","pages":"90-94"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79742420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.37532/2041-6792.2019.9(2).152
M. Malik, Waseem Shaukat, A. Hussain
Introduction: Obese persons with BED have compromised functioning mostly in psycho-social aspects of Health-Related Quality of Life (HRQoL) as poor physical functioning is related to obesity. Despite the higher prevalence of BED compared with other eating disorders, lack of understanding of BED by physicians and inadequate physician-patient communication regarding BED may result in it’s under diagnosis. Objective: The objective of the study was to assess binge eating disorder among overweight/obese in two major cities of Pakistan. Method: A descriptive cross-sectional study design was used. A pre-validated data collection tool Binge Eating Disorder Screener-7 (BEDS-7) was distributed to a sample of 382 obese/overweight individuals. Binge Eating Disorder Screener-7 (BEDS-7) questionnaires is comprised of seven questions that directly evaluate the patient’s eating patterns and behaviors for binge eating disorder. Convenient sampling technique was used to select the respondents. After data collection, the data was cleaned, coded and entered in SPSS version-21. Chi-square test (p ≥ 0.05) was performed to find out the association between different variables. Results: The results revealed that nearly half of the respondents of the overweight/obese had an eating disorder among them. Out of the total sample 35.1% (n=134) respondent, agreed that they had episodes of excessive overeating during the last 3 months. The results highlighted that 64.9% (n=248) had no binge eating disorder while 15.7% (n=60) of the respondents had moderate binge eating disorder and 14.9% (n=57) had severe binge eating disorder. Conclusion: The current study concluded that moderate binge eating disorder was seen among most of the obese individuals but BED in most of the cases goes undiagnosed. Binge eating disorder was more common among students and non-smokers. Early detection and evidence-based treatment strategies can help the patients to recover on initial stages and prevent from a further complication of binge eating disorder.
{"title":"Binge eating disorder among obese/overweight in Pakistan: Under-diagnosed, undertreated and misunderstood","authors":"M. Malik, Waseem Shaukat, A. Hussain","doi":"10.37532/2041-6792.2019.9(2).152","DOIUrl":"https://doi.org/10.37532/2041-6792.2019.9(2).152","url":null,"abstract":"Introduction: Obese persons with BED have compromised functioning mostly in psycho-social aspects of Health-Related Quality of Life (HRQoL) as poor physical functioning is related to obesity. Despite the higher prevalence of BED compared with other eating disorders, lack of understanding of BED by physicians and inadequate physician-patient communication regarding BED may result in it’s under diagnosis. Objective: The objective of the study was to assess binge eating disorder among overweight/obese in two major cities of Pakistan. Method: A descriptive cross-sectional study design was used. A pre-validated data collection tool Binge Eating Disorder Screener-7 (BEDS-7) was distributed to a sample of 382 obese/overweight individuals. Binge Eating Disorder Screener-7 (BEDS-7) questionnaires is comprised of seven questions that directly evaluate the patient’s eating patterns and behaviors for binge eating disorder. Convenient sampling technique was used to select the respondents. After data collection, the data was cleaned, coded and entered in SPSS version-21. Chi-square test (p ≥ 0.05) was performed to find out the association between different variables. Results: The results revealed that nearly half of the respondents of the overweight/obese had an eating disorder among them. Out of the total sample 35.1% (n=134) respondent, agreed that they had episodes of excessive overeating during the last 3 months. The results highlighted that 64.9% (n=248) had no binge eating disorder while 15.7% (n=60) of the respondents had moderate binge eating disorder and 14.9% (n=57) had severe binge eating disorder. Conclusion: The current study concluded that moderate binge eating disorder was seen among most of the obese individuals but BED in most of the cases goes undiagnosed. Binge eating disorder was more common among students and non-smokers. Early detection and evidence-based treatment strategies can help the patients to recover on initial stages and prevent from a further complication of binge eating disorder.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"21 1","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78130988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.37532/2041-6792.2019.9(1).147
H. Nishikawa, R. Takata, Kazunori Yoh, H. Enomoto, N. Ishii, Y. Iwata, Takashi Nishimura, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Kunihiro Hasegawa, Yukihisa Yuri, Tomoyuki Takashima, H. Iijima, S. Nishiguchi
Purpose: Examining the clinical significance of Mac-2-binding protein glycosylation isomer (M2BPGi), which was recently introduced as a novel liver fibrotic biomarker in chronic liver disease patients with unique fibrosis associated glycol chain protein alteration, other than liver fibrotic marker appears to be of importance. We sought to examine the relevance between M2BPGi and the Controlling Nutrition (CONUT) score in hepatitis B and C viruses-related patients (the HBVrelated cohort (Br-cohort, n=249) and the HCV-related cohort (Cr-cohort, n=386)) comparing with other liver fibrotic markers. Patients and Methods: We checked the correlation between the CONUT score and four liver fibrotic markers (M2BPGi, FIB-4 index, hyaluronic acid, and platelet count) in the two cohorts. Receiver operating characteristics (ROC) analyses associated with elevated CONUT score (CONUT score ≥ 1,2,3,4 or 5) were also conducted. Results: The median CONUT score (range) were 1 (0-5) in the Br-cohort and 2 (0-8) in the Crcohort (P<0.0001). In the Br-cohort, advanced fibrosis or more (F3 or F4) was noted in 60 patients (24.1%), while in the Cr-cohort, it was noted in 212 patients (54.9%). In the Br-cohort, the highest correlation coefficient was identified in the FIB-4 index (r=0.436, P<0.0001), followed by M2BPGi (r=0.376, P<0.0001). In the Cr-cohort, the highest correlation coefficient was noted in M2BPGi (r=0.690, P<0.0001), followed by the FIB-4 index (r=0.598, P<0.0001). For the ROC analyses linked to the elevated CONUT score, in the Cr-cohort, M2BPGi yielded the highest AUC in all ROC analyses, whereas in the Br-cohort, such tendencies were not noted. Conclusion: M2BPGi can be a useful marker for predicting nutritional condition as determined by the CONUT score especially in chronic hepatitis C patients.
{"title":"Mac-2-binding Protein Glycosylation isomer well correlates with the Controlling Nutritional Status Score in Hepatitis Viruses-related Liver Diseases","authors":"H. Nishikawa, R. Takata, Kazunori Yoh, H. Enomoto, N. Ishii, Y. Iwata, Takashi Nishimura, Nobuhiro Aizawa, Yoshiyuki Sakai, Naoto Ikeda, Kunihiro Hasegawa, Yukihisa Yuri, Tomoyuki Takashima, H. Iijima, S. Nishiguchi","doi":"10.37532/2041-6792.2019.9(1).147","DOIUrl":"https://doi.org/10.37532/2041-6792.2019.9(1).147","url":null,"abstract":"Purpose: Examining the clinical significance of Mac-2-binding protein glycosylation isomer (M2BPGi), which was recently introduced as a novel liver fibrotic biomarker in chronic liver disease patients with unique fibrosis associated glycol chain protein alteration, other than liver fibrotic marker appears to be of importance. We sought to examine the relevance between M2BPGi and the Controlling Nutrition (CONUT) score in hepatitis B and C viruses-related patients (the HBVrelated cohort (Br-cohort, n=249) and the HCV-related cohort (Cr-cohort, n=386)) comparing with other liver fibrotic markers. Patients and Methods: We checked the correlation between the CONUT score and four liver fibrotic markers (M2BPGi, FIB-4 index, hyaluronic acid, and platelet count) in the two cohorts. Receiver operating characteristics (ROC) analyses associated with elevated CONUT score (CONUT score ≥ 1,2,3,4 or 5) were also conducted. Results: The median CONUT score (range) were 1 (0-5) in the Br-cohort and 2 (0-8) in the Crcohort (P<0.0001). In the Br-cohort, advanced fibrosis or more (F3 or F4) was noted in 60 patients (24.1%), while in the Cr-cohort, it was noted in 212 patients (54.9%). In the Br-cohort, the highest correlation coefficient was identified in the FIB-4 index (r=0.436, P<0.0001), followed by M2BPGi (r=0.376, P<0.0001). In the Cr-cohort, the highest correlation coefficient was noted in M2BPGi (r=0.690, P<0.0001), followed by the FIB-4 index (r=0.598, P<0.0001). For the ROC analyses linked to the elevated CONUT score, in the Cr-cohort, M2BPGi yielded the highest AUC in all ROC analyses, whereas in the Br-cohort, such tendencies were not noted. Conclusion: M2BPGi can be a useful marker for predicting nutritional condition as determined by the CONUT score especially in chronic hepatitis C patients.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"47 1","pages":"21-32"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88556836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.37532/2041-6792.2019.9(3).157
Shinya Tajima, I. Maeda, K. Kishimoto, S. Naruki, A. Endo, M. Doi, M. Chosokabe, K. Tsugawa, M. Takagi, J. Koike
Intraductal papilloma is a common disease in the breast with clinical manifestation of nipple discharge. Hence many Core Needle Biopsy (CNB) is done in suspected intraductal papilloma. However, in the CNB specimen, sometimes it is difficult to determine whether the tumor is benign or malignant. In such situations, myoepithelial markers of p63 and calponin are useful immunostaining. And also high-molecular weight cytokeratins of CK5/6 and CK14 are helpful staining. Recently the report of two cases entitled “Nuclear inverse polarity papillary lesion lacking myoepithelial cells” is reported. This lesion resembles intraductal papilloma and thought to be at the most a tumor of uncertain malignant potential. Hence to diagnose intraductal papilloma, one should be careful even though problematic cases.
{"title":"Intraductal papilloma of the breast: Short-review","authors":"Shinya Tajima, I. Maeda, K. Kishimoto, S. Naruki, A. Endo, M. Doi, M. Chosokabe, K. Tsugawa, M. Takagi, J. Koike","doi":"10.37532/2041-6792.2019.9(3).157","DOIUrl":"https://doi.org/10.37532/2041-6792.2019.9(3).157","url":null,"abstract":"Intraductal papilloma is a common disease in the breast with clinical manifestation of nipple discharge. Hence many Core Needle Biopsy (CNB) is done in suspected intraductal papilloma. However, in the CNB specimen, sometimes it is difficult to determine whether the tumor is benign or malignant. In such situations, myoepithelial markers of p63 and calponin are useful immunostaining. And also high-molecular weight cytokeratins of CK5/6 and CK14 are helpful staining. Recently the report of two cases entitled “Nuclear inverse polarity papillary lesion lacking myoepithelial cells” is reported. This lesion resembles intraductal papilloma and thought to be at the most a tumor of uncertain malignant potential. Hence to diagnose intraductal papilloma, one should be careful even though problematic cases.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"1 1","pages":"107-110"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91248878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/Clinical-Investigation.1000138
Trinh Le Huy, Bui My Hanh
Background: In recent years, the new trend in treatment of colorectal cancer is the use of target drug. We conduct the study to evaluate efficacy of triplet combination chemotherapy of 5-fluorouracil/leucovorin, oxapilatin, and irinotecan (FOLFOXIRI) in the treatment of stage IV colorectal cancer patients. Method: Uncontrolled clinical trial carried on 39 stage IV colorectal cancer patients Results: The overall response rate of the treatment was 75%. Mean of progression free survival was 13.4 ± 9 months. The overall survival rate at 12th month and 24th month were 90% and 76%, respectively. The proportion of granulocytopenia was 48.9%, no grade 3 or 4. Side effect beyond hematology was most seen in hepatic toxicity with 52.5%, mainly at grade 1. Vomiting was 18.3%, all at grade 1. Other toxicity was very low at percentage. Conclusion: The triplet combination FOLFOXIRIN chemotherapy improves the outcome of patient with metal colorectal cancer in term of response rate, overall survival rate and progression free survival, and the level of toxicity was acceptable..
{"title":"Research on the treatment of metastatic colon cancer patients treated by FOLFOXIRI: Efficacy and toxicity of first-line treatment in stage IV metastatic colorectal cancer patients","authors":"Trinh Le Huy, Bui My Hanh","doi":"10.4172/Clinical-Investigation.1000138","DOIUrl":"https://doi.org/10.4172/Clinical-Investigation.1000138","url":null,"abstract":"Background: In recent years, the new trend in treatment of colorectal cancer is the use of target drug. We conduct the study to evaluate efficacy of triplet combination chemotherapy of 5-fluorouracil/leucovorin, oxapilatin, and irinotecan (FOLFOXIRI) in the treatment of stage IV colorectal cancer patients. Method: Uncontrolled clinical trial carried on 39 stage IV colorectal cancer patients Results: The overall response rate of the treatment was 75%. Mean of progression free survival was 13.4 ± 9 months. The overall survival rate at 12th month and 24th month were 90% and 76%, respectively. The proportion of granulocytopenia was 48.9%, no grade 3 or 4. Side effect beyond hematology was most seen in hepatic toxicity with 52.5%, mainly at grade 1. Vomiting was 18.3%, all at grade 1. Other toxicity was very low at percentage. Conclusion: The triplet combination FOLFOXIRIN chemotherapy improves the outcome of patient with metal colorectal cancer in term of response rate, overall survival rate and progression free survival, and the level of toxicity was acceptable..","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"45 1","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80033815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/CLINICAL-INVESTIGATION.1000143
M. Suleiman, J. Olajide, J. Omale, O. Abbah, D. Ejembi
Fresh Tigernut (Cyperus esculentus) was investigated for its proximate and mineral composition using the various methods described by the Association of Official Analytical Chemist (AOAC), 2010. Vitamin A and C contents were determined by the methods described by Rutkowsi et al and Rahman et al., respectively. The proximate analysis of 100 g of fresh tigernut revealed that moisture content has the highest value followed by carbohydrate, crude fat, crude fiber, crude protein, and lowest ash content. The outcome of the mineral analysis showed the highest value of potassium (K), followed by phosphorus (P), magnesium (Mg), calcium (Ca) sodium (Na), iron (Fe), zinc (Zn) and lowest copper (Cu) content. The result also showed that tigernut contains high levels of vitamin C than A. This result implies that this edible tuber which has been underutilized in the world can go a long way in providing most of the nutrients needed for life and can be used as supplement in the treatment of diseases that are caused primarily by deficiencies of minerals and vitamins.
使用官方分析化学家协会(AOAC) 2010年描述的各种方法，研究了新鲜虎坚果(Cyperus esculentus)的近似和矿物组成。维生素A和C的含量分别采用Rutkowsi et al和Rahman et al描述的方法测定。对100 g鲜核桃进行近似分析，水分含量最高，其次是碳水化合物、粗脂肪、粗纤维、粗蛋白质，灰分含量最低。矿物分析结果显示，钾(K)含量最高，其次是磷(P)、镁(Mg)、钙(Ca)、钠(Na)、铁(Fe)、锌(Zn)，铜(Cu)含量最低。结果还表明，虎坚果中维生素C的含量高于维生素a。这一结果表明，这种在世界上尚未得到充分利用的可食用块茎在提供生命所需的大部分营养方面有很大的作用，可以作为治疗主要由矿物质和维生素缺乏引起的疾病的补充。
{"title":"Proximate composition, mineral and some vitamin contents of tigernut (Cyperus esculentus)","authors":"M. Suleiman, J. Olajide, J. Omale, O. Abbah, D. Ejembi","doi":"10.4172/CLINICAL-INVESTIGATION.1000143","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000143","url":null,"abstract":"Fresh Tigernut (Cyperus esculentus) was investigated for its proximate and mineral composition using the various methods described by the Association of Official Analytical Chemist (AOAC), 2010. Vitamin A and C contents were determined by the methods described by Rutkowsi et al and Rahman et al., respectively. The proximate analysis of 100 g of fresh tigernut revealed that moisture content has the highest value followed by carbohydrate, crude fat, crude fiber, crude protein, and lowest ash content. The outcome of the mineral analysis showed the highest value of potassium (K), followed by phosphorus (P), magnesium (Mg), calcium (Ca) sodium (Na), iron (Fe), zinc (Zn) and lowest copper (Cu) content. The result also showed that tigernut contains high levels of vitamin C than A. This result implies that this edible tuber which has been underutilized in the world can go a long way in providing most of the nutrients needed for life and can be used as supplement in the treatment of diseases that are caused primarily by deficiencies of minerals and vitamins.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"1 1","pages":"161-165"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76079172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/Clinical-Investigation.1000131
R. Ruiz, J. Jukemura, P. Alves, M. Santos
Objective: The main objective of the study is to compare gastric volume and pH values after the ingestion of mannitol three hours versus six hours before a colonoscopy procedure. Methods: This study is a parallel randomized controlled trial with a 1:1 allocation ratio, involving ambulatory patients scheduled to undergo a colonoscopy procedure, not having previous gastric surgeries, with an American Society of Anesthesiology risk of less than III, older than 18 years of age, and with a fasting period for solid food of over eight hours. All participants underwent a bowel preparation with mannitol, being randomized to start the preparation either three or six hours before the colonoscopy procedure. Outcomes of interest were pH and gastric residual volume. Results: The study sample included 102 subjects with subjects in the three-hour group being significantly older than individuals in the six-hour group (59.73 (± 18.69) vs. 51.71 (± 20.46); p=0.041) and subjects in the six-hour group presented higher BMI than individuals in the three-hour group (28.55 (± 5.15) vs. 26.35 (± 5.78); p=0.046). When evaluating study outcomes adjusting for baseline imbalances in age and BMI, we found no statistically significant differences between the three and the six-hour arms. In a subgroup analysis among the subgroup of patients with Diabetes Mellitus, the six-hour arm presented a significantly higher gastric volume when compared to the three-hour arm (127 versus 43.4 and 116 versus 37.8), respectively. Conclusion: Our results are in line with the notion that a three-hour fasting period is safe to prevent aspiration from gastric content during bowel preparation with mannitol. Considering that long fasting protocols may result in adverse outcomes such as dehydration and electrolyte imbalance, we provide evidence to support the practice of short fasting periods.
{"title":"Ph and residual gastric volume after mannitol preparation: A randomized controlled study comparing ingestion three versus six hours prior to the procedure","authors":"R. Ruiz, J. Jukemura, P. Alves, M. Santos","doi":"10.4172/Clinical-Investigation.1000131","DOIUrl":"https://doi.org/10.4172/Clinical-Investigation.1000131","url":null,"abstract":"Objective: The main objective of the study is to compare gastric volume and pH values after the ingestion of mannitol three hours versus six hours before a colonoscopy procedure. Methods: This study is a parallel randomized controlled trial with a 1:1 allocation ratio, involving ambulatory patients scheduled to undergo a colonoscopy procedure, not having previous gastric surgeries, with an American Society of Anesthesiology risk of less than III, older than 18 years of age, and with a fasting period for solid food of over eight hours. All participants underwent a bowel preparation with mannitol, being randomized to start the preparation either three or six hours before the colonoscopy procedure. Outcomes of interest were pH and gastric residual volume. Results: The study sample included 102 subjects with subjects in the three-hour group being significantly older than individuals in the six-hour group (59.73 (± 18.69) vs. 51.71 (± 20.46); p=0.041) and subjects in the six-hour group presented higher BMI than individuals in the three-hour group (28.55 (± 5.15) vs. 26.35 (± 5.78); p=0.046). When evaluating study outcomes adjusting for baseline imbalances in age and BMI, we found no statistically significant differences between the three and the six-hour arms. In a subgroup analysis among the subgroup of patients with Diabetes Mellitus, the six-hour arm presented a significantly higher gastric volume when compared to the three-hour arm (127 versus 43.4 and 116 versus 37.8), respectively. Conclusion: Our results are in line with the notion that a three-hour fasting period is safe to prevent aspiration from gastric content during bowel preparation with mannitol. Considering that long fasting protocols may result in adverse outcomes such as dehydration and electrolyte imbalance, we provide evidence to support the practice of short fasting periods.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"7 1","pages":"75-85"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84242005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/CLINICAL-INVESTIGATION.1000128
J. Bindhu, Arunava Das
Pleurotus ostreatus is drawn into lime light for the treatment of Diabetes mellitus for the last few years, but now it is evidently proven for the recovery of the diabetes mellitus-induced memory impairments in streptozoticin induced diabetic rats. Oxidative stress, neurological disorders, cognitive and spatial learning associated to Diabetic-Alzheimer’s is irreversibly inhibited by P. ostreatus. The availability and cost effectively makes a stepping stone for the middle to low income people to rely on P. ostreatus rather than of costly medications for the treatment of neurological and cognitive disorders associated with Diabetes. The research was done to identify a potent free radical bioactive compound against cognitive impairment in streptozotocin –diabetic rats. Five weeks after diabetic induction, P. ostreatus extract was administered orally (2 mg/lt). The cognitive, cerebral and perceptive behaviour was examined with T Maze (Radial Arm Maze), Morris Water Maze (MWM), Novel object recognition task in wistar rats (male). Besides oxidative stress parameters like Lipid peroxidation (LPO), FRAP (Ferric reducing ability of plasma), antioxidant assay and Thiol assay to determine total Thiol group in the blood was carried out to determine the neurological disorders associated with brain. P. ostreatus showed significant improvements in Spatial and Cognitive disorders when compared to the diabetic and healthy control. Also the FRAP and thiol group in blood showed tremendous increase due to the P. ostreatus proving the effectiveness of Pleurotus extract on Cognitive impairment and Oxidative stress in Diabetic mellitus.
平菇在治疗糖尿病方面的研究近年来一直受到人们的关注，但目前已证实平菇能恢复链脲霉素诱导的糖尿病大鼠的记忆障碍。与糖尿病-阿尔茨海默氏症相关的氧化应激、神经障碍、认知和空间学习被P. ostreatus不可逆转地抑制。可获得性和成本效益为中低收入人群提供了一个跳板，使他们能够依靠P. ostreatus而不是昂贵的药物来治疗与糖尿病相关的神经和认知障碍。本研究旨在鉴定一种有效的自由基生物活性化合物，以对抗链脲佐菌素糖尿病大鼠的认知障碍。糖尿病诱导后5周，口服白藜芦醇提取物(2 mg/lt)。采用T型迷宫(Radial Arm Maze)、Morris水迷宫(Morris Water Maze)、新型物体识别任务(Novel object recognition task)对雄性wistar大鼠的认知、大脑和感知行为进行了研究。除脂质过氧化(LPO)、血浆铁还原能力(FRAP)等氧化应激参数外，还进行抗氧化测定和测定血液中总硫醇含量的硫醇测定，以确定脑相关神经系统疾病。与糖尿病患者和健康对照组相比，绿腹蛇在空间和认知障碍方面有显著改善。平菇提取物对糖尿病患者的认知功能障碍和氧化应激有显著的改善作用，血液中FRAP和硫醇含量明显升高。
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Pub Date : 2018-01-01DOI: 10.4172/CLINICAL-INVESTIGATION.1000139
M. Shariat, N. Abedinia, F. Haghollahi, A. Noorbala, A. Karimi, J. Zebardast
Exclusive breastfeeding (EBF) in the first six months of life has many benefits for mother and newborn. The purpose of the present study was to investigate the effect of medical staff communication skills training on breastfeeding in nulliparous mothers. This is a clinical trial study. One hundred- seventy nulliparous pregnant women were selected from Vali-e-Asr Hospital of Tehran. The samples were divided into two groups of intervention (n=85) and control (n=85) by randomized blocks method. The intervention in this study was in the form of therapeutic communication training to the ten nurses in delivery emergency department ward on how to communicate with mothers. The Therapeutic communication skills training course consisted of four communication skills (Empathy skills, Interpersonal skills, Stress and emotional management). Chi-square test and analysis of variance were used to analyze the data and compare the groups. There was a significant difference between the two groups regarding the exclusive breastfeeding for 6 months (P=0.046).The frequency of exclusive breastfeeding in interventional group was higher than the control group (37.5% vs. 23.5%). At six months old, the babies in the study group grew more than the control group (8218.82 ± 2308.57 vs. 7442.23 ± 1923.27 gr, p=0.018) The professional therapeutic relationship of medical staff with the mothers led to an increase in exclusive breastfeeding and continuation of breastfeeding in the first 6 months of childbirth. It seems that breastfeeding is associated with the higher baby growth and lower use of formula feeding.
生命最初六个月的纯母乳喂养(EBF)对母亲和新生儿有许多好处。本研究旨在探讨医护人员沟通技巧训练对未产妇母乳喂养的影响。这是一项临床试验研究。从德黑兰Vali-e-Asr医院挑选了170名未分娩的孕妇。采用随机分组法将样本分为干预组(n=85)和对照组(n=85)。本研究以治疗性沟通培训的形式对10名分娩急诊科病房护士进行如何与母亲沟通的培训。治疗性沟通技巧训练课程包括四项沟通技巧(共情技巧、人际关系技巧、压力与情绪管理)。采用卡方检验和方差分析对资料进行分析和组间比较。两组纯母乳喂养6个月差异有统计学意义(P=0.046)。干预组纯母乳喂养频次高于对照组(37.5% vs. 23.5%)。6月龄时，研究组婴儿的生长高于对照组(8218.82±2308.57 gr vs. 7442.23±1923.27 gr, p=0.018)。医护人员与母亲的专业治疗关系使纯母乳喂养增加，并在分娩前6个月继续母乳喂养。母乳喂养似乎与较高的婴儿生长和较低的配方喂养有关。
{"title":"The effect of nurses' communication skills with Nulliparous mothers on exclusive breastfeeding: A Clinical Trial Study","authors":"M. Shariat, N. Abedinia, F. Haghollahi, A. Noorbala, A. Karimi, J. Zebardast","doi":"10.4172/CLINICAL-INVESTIGATION.1000139","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000139","url":null,"abstract":"Exclusive breastfeeding (EBF) in the first six months of life has many benefits for mother and newborn. The purpose of the present study was to investigate the effect of medical staff communication skills training on breastfeeding in nulliparous mothers. This is a clinical trial study. One hundred- seventy nulliparous pregnant women were selected from Vali-e-Asr Hospital of Tehran. The samples were divided into two groups of intervention (n=85) and control (n=85) by randomized blocks method. The intervention in this study was in the form of therapeutic communication training to the ten nurses in delivery emergency department ward on how to communicate with mothers. The Therapeutic communication skills training course consisted of four communication skills (Empathy skills, Interpersonal skills, Stress and emotional management). Chi-square test and analysis of variance were used to analyze the data and compare the groups. There was a significant difference between the two groups regarding the exclusive breastfeeding for 6 months (P=0.046).The frequency of exclusive breastfeeding in interventional group was higher than the control group (37.5% vs. 23.5%). At six months old, the babies in the study group grew more than the control group (8218.82 ± 2308.57 vs. 7442.23 ± 1923.27 gr, p=0.018) The professional therapeutic relationship of medical staff with the mothers led to an increase in exclusive breastfeeding and continuation of breastfeeding in the first 6 months of childbirth. It seems that breastfeeding is associated with the higher baby growth and lower use of formula feeding.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"35 1","pages":"131-137"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84562874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/CLINICAL-INVESTIGATION.1000123
Mohd. Mahmood, R. C. Reddy, J. Lahari, S. Fatima, P. Shinde, S. An, Reddy, P. PranaliS.
Background: The treatment options for Diabetes mellitus and their prescribing has increased over years. This needs appropriate selection of drugs. The main objective of this study was to highlight the current prescribing trends in Diabetes mellitus patients with other co-morbid conditions. Methods: A prospective observational study was conducted on inpatients admitted to various wards in a tertiary care hospital for period of 6 months between October 2016- March 2017. Prescriptions of the patients are collected in a designed questionnaire form and the relevant information is recorded and analysed. Results: 235 patient prescription patterns were studied, out of which 62.97% were males and 37.02% were females. Most of the patients were in the age group of 41-60. Hypertension was the most commonly found co-morbid condition. Rapid acting insulin was mostly prescribed during hospital stay. Metformin was the commonly prescribed oral hypoglycemic agent followed by glimeperide. Conclusion: The adverse drug reactions can be minimized by replacing the drugs with novel therapeutic agents like Glucagon-like peptide agonist, Dipeptidyl peptidase inhibitors and Sodium-glucose transport inhibitors. The management of drug interactions should be done by clinical significance and correlation
{"title":"Prescription Pattern Analysis of Antidiabetic Drugs in Diabetes Mellitus and Associated Comorbidities","authors":"Mohd. Mahmood, R. C. Reddy, J. Lahari, S. Fatima, P. Shinde, S. An, Reddy, P. PranaliS.","doi":"10.4172/CLINICAL-INVESTIGATION.1000123","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000123","url":null,"abstract":"Background: The treatment options for Diabetes mellitus and their prescribing has increased over years. This needs appropriate selection of drugs. The main objective of this study was to highlight the current prescribing trends in Diabetes mellitus patients with other co-morbid conditions. Methods: A prospective observational study was conducted on inpatients admitted to various wards in a tertiary care hospital for period of 6 months between October 2016- March 2017. Prescriptions of the patients are collected in a designed questionnaire form and the relevant information is recorded and analysed. Results: 235 patient prescription patterns were studied, out of which 62.97% were males and 37.02% were females. Most of the patients were in the age group of 41-60. Hypertension was the most commonly found co-morbid condition. Rapid acting insulin was mostly prescribed during hospital stay. Metformin was the commonly prescribed oral hypoglycemic agent followed by glimeperide. Conclusion: The adverse drug reactions can be minimized by replacing the drugs with novel therapeutic agents like Glucagon-like peptide agonist, Dipeptidyl peptidase inhibitors and Sodium-glucose transport inhibitors. The management of drug interactions should be done by clinical significance and correlation","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"21 2 1","pages":"4-12"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90921925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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