Pub Date : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/11854d
Kanishk Singh, Sanjeev Kumar
Ocular hypertension is a term in which the pressure inside the eye is higher than its normal. Individuals with IOP higher than 21mm of Hg with normal visual fields, normal optic discs, open angles, and without any ocular or systemic disorders contributing to the elevated IOPs are considered as ocular hypertensive. The chances to develop Glaucoma in these persons are high and they are aslo considered as Glaucoma suspect. Individuals with thin corneas, vertical cupping of optic disc (>0.6), myopic and old aged individuals are more prone for elevated intra ocular pressure. Glaucoma progression is the main source of ocular morbidity and mortality in ocular hypertensive patients. Hence, these individual requires periodic examinations, which include tonometry, perimetry and optic disc assessment. It is also recommended to start therapy for individuals with intraocular pressure in the upper to middle 20s. Pressure lowering agents such as latanoprost, brimonidine, adrenergic antagonists, and topical carbonic anhydrase inhibitors are some commonly used drug, monotherapy is desirable and maximum two drugs can be used if required. Patient education and counseling is also essential to prevent possible progression to glaucoma, which can further reduce the ocular morbidity and mortality in ocular hypertensive individuals.
{"title":"Ocular Hypertension and the Risk Factor","authors":"Kanishk Singh, Sanjeev Kumar","doi":"10.9734/bpi/nfmmr/v7/11854d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/11854d","url":null,"abstract":"Ocular hypertension is a term in which the pressure inside the eye is higher than its normal. Individuals with IOP higher than 21mm of Hg with normal visual fields, normal optic discs, open angles, and without any ocular or systemic disorders contributing to the elevated IOPs are considered as ocular hypertensive. The chances to develop Glaucoma in these persons are high and they are aslo considered as Glaucoma suspect. Individuals with thin corneas, vertical cupping of optic disc (>0.6), myopic and old aged individuals are more prone for elevated intra ocular pressure. Glaucoma progression is the main source of ocular morbidity and mortality in ocular hypertensive patients. Hence, these individual requires periodic examinations, which include tonometry, perimetry and optic disc assessment. It is also recommended to start therapy for individuals with intraocular pressure in the upper to middle 20s. Pressure lowering agents such as latanoprost, brimonidine, adrenergic antagonists, and topical carbonic anhydrase inhibitors are some commonly used drug, monotherapy is desirable and maximum two drugs can be used if required. Patient education and counseling is also essential to prevent possible progression to glaucoma, which can further reduce the ocular morbidity and mortality in ocular hypertensive individuals.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"130 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128560043","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/3128f
S. Patil, V. Kundargi, A. Jebaraj
We report a case of a congenital penile cyst in a old male without any history of penile surgery and injury. An epidermal cyst can appear anywhere on the body. It arises as a result of epidermal elements being implanted in the dermis during foetal development, trauma, or procedures such as penoplasty and circumcision. A 22 years old male presented with a mass over the penis since birth, which was painless and gradually increasing in size. The mass was excised and it was found to be penile epidermal cyst. Epidermal cyst is one of the most common benign tumors occurring in the body, which commonly occurs either congenitally or following trauma or surgery, where the epidermal elements get trapped within closed space. But here this case had no trauma and surgeries in the past and the mass present since birth-a case of congenital penile epidermal cyst.
{"title":"Case Report on Congenital Penile Epidermal Cyst in a Rare Location","authors":"S. Patil, V. Kundargi, A. Jebaraj","doi":"10.9734/bpi/nfmmr/v7/3128f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/3128f","url":null,"abstract":"We report a case of a congenital penile cyst in a old male without any history of penile surgery and injury. An epidermal cyst can appear anywhere on the body. It arises as a result of epidermal elements being implanted in the dermis during foetal development, trauma, or procedures such as penoplasty and circumcision. A 22 years old male presented with a mass over the penis since birth, which was painless and gradually increasing in size. The mass was excised and it was found to be penile epidermal cyst. Epidermal cyst is one of the most common benign tumors occurring in the body, which commonly occurs either congenitally or following trauma or surgery, where the epidermal elements get trapped within closed space. But here this case had no trauma and surgeries in the past and the mass present since birth-a case of congenital penile epidermal cyst.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123161071","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/11960d
M. Sarkar, P. Desai, Shantaram Pawaskar, S. Sarkar
Background: Acute pain in the perioperative setting is detrimental to post operative outcome and adequate analgesia leads to better outcome. It increases sympathetic response of the body with subsequent rise in oxygen consumption of body, risk of deep vein thrombosis due to immobility and consequent pulmonary embolism. Methods: Sixty ASA I/II patients between 18- 65 years undergoing laparoscopic cholecystectomy and appendicectomy were included and randomly divided into 2 groups. ASA III/IV patients, previous opioid and alpha 2 agonist treatment and patients requiring extensive surgical dissection were excluded. Group D received IV Dexmedetomidine 1 (mu)g/kg over 10 min followed by 0.2-0.7 (mu)g /kg/hr and Group P received IV Paracetamol 15 mg/kg prior to extubation. Patients were monitored for hemodynamics and VAS score was assessed after extubation till 24 hours. Rescue analgesia (IV tramadol 1 mg/kg) was given and the time interval till the requirement of first dose of rescue analgesia was recorded. Results: In group D, 12 patients required rescue analgesia as compared to 4 Patients in group P (40% vs13.3%; P=0.02). VAS scores were similar in both groups with group P showing trend towards low score. Median time at which the first dose of rescue analgesia was administered in group P was longer (134.42 + 12.67 vs 82.76 + 9.38 min; P=0.001). Incidence of bradycardia and hypotension was higher in group D (20% vs 3.3%; P=0.04). Conclusion: Paracetamol is a superior to Dexmedetomidine for analgesia in short surgical procedures and should form a part of multimodal analgesia.
背景:围手术期急性疼痛不利于术后预后，适当的镇痛可获得较好的预后。它增加了身体的交感神经反应，随后增加了身体的耗氧量，增加了由于不活动而形成深静脉血栓的风险，并导致肺栓塞。方法:选取年龄在18 ～ 65岁之间行腹腔镜胆囊阑尾切除术的ASA I/II级患者60例，随机分为2组。排除ASA III/IV患者、既往阿片类药物和α 2激动剂治疗和需要广泛手术解剖的患者。D组静脉滴注右美托咪定1 (mu) g/kg，持续10 min，随后滴注0.2 ～ 0.7 (mu) g/kg /hr, P组拔管前静脉滴注扑热息痛15 mg/kg。拔管后24小时监测患者血流动力学及VAS评分。给予静脉曲马多1 mg/kg抢救镇痛，记录到需要第一次抢救镇痛的时间间隔。结果:D组12例患者需要抢救性镇痛，P组4例患者需要抢救性镇痛% vs13.3%; P=0.02). VAS scores were similar in both groups with group P showing trend towards low score. Median time at which the first dose of rescue analgesia was administered in group P was longer (134.42 + 12.67 vs 82.76 + 9.38 min; P=0.001). Incidence of bradycardia and hypotension was higher in group D (20% vs 3.3%; P=0.04).Conclusion: Paracetamol is a superior to Dexmedetomidine for analgesia in short surgical procedures and should form a part of multimodal analgesia.
{"title":"Intravenous Dexmedetomidine Versus Paracetamol for Postoperative Pain Relief in Laparoscopic Surgery: A Comparative Study","authors":"M. Sarkar, P. Desai, Shantaram Pawaskar, S. Sarkar","doi":"10.9734/bpi/nfmmr/v7/11960d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/11960d","url":null,"abstract":"Background: Acute pain in the perioperative setting is detrimental to post operative outcome and adequate analgesia leads to better outcome. It increases sympathetic response of the body with subsequent rise in oxygen consumption of body, risk of deep vein thrombosis due to immobility and consequent pulmonary embolism.\u0000Methods: Sixty ASA I/II patients between 18- 65 years undergoing laparoscopic cholecystectomy and appendicectomy were included and randomly divided into 2 groups. ASA III/IV patients, previous opioid and alpha 2 agonist treatment and patients requiring extensive surgical dissection were excluded. Group D received IV Dexmedetomidine 1 (mu)g/kg over 10 min followed by 0.2-0.7 (mu)g /kg/hr and Group P received IV Paracetamol 15 mg/kg prior to extubation. Patients were monitored for hemodynamics and VAS score was assessed after extubation till 24 hours. Rescue analgesia (IV tramadol 1 mg/kg) was given and the time interval till the requirement of first dose of rescue analgesia was recorded.\u0000Results: In group D, 12 patients required rescue analgesia as compared to 4 Patients in group P (40% vs13.3%; P=0.02). VAS scores were similar in both groups with group P showing trend towards low score. Median time at which the first dose of rescue analgesia was administered in group P was longer (134.42 + 12.67 vs 82.76 + 9.38 min; P=0.001). Incidence of bradycardia and hypotension was higher in group D (20% vs 3.3%; P=0.04).\u0000Conclusion: Paracetamol is a superior to Dexmedetomidine for analgesia in short surgical procedures and should form a part of multimodal analgesia.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125094099","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/11547d
S. Krishnamoorthy, Ashwin Muthukumar, P. Sai, N. Kumaresan
Sub-clinical varicocele (SCV) is characterized by normal clinical examination and diagnosed mainly by Doppler Ultrasound imaging. About 10 – 15% of infertility cases were found to be SCV. SCV is one of the common causes of primary infertility and major cause in males with secondary infertility. Presence of sub-clinical varicocele in case of pediatric patients is considered a risk factor as it progresses to palpable clinical varicocele. Despite various imaging modalities being tried to diagnose SCV, Colour Doppler Ultrasound is considered the gold standard imaging for diagnosis of SCV, having a sensitivity and specificity of nearly 100%. Diagnostic criteria parameters of SCV includes measurement of diameter of scrotal veins in supine, upright & after valsalva maneuver along with sum of venous diameter, venous blood flow volume and retrograde flow direction during valsalva. SCV exerts a significant impact on spermatogenesis. Of all the theories proposed, the most accepted one is the oxidative stress theory. In many instances, SCV is the only abnormality associated with oligospermia. Various meta-analyses have shown a significant improvement in seminal parameters following surgical intervention but pregnancy rate did not improve much when compared to the non-intervened group. Controversies in surgical management are all centered on the pregnancy rate. This leaves the treating andrologists and urologists even more confused on how to go about managing these patients with SCV. The American society of Reproductive Medicine and American Urological Association do not recommend surgical repair for SCV, if the indication for varicocelectomy is to improve the pregnancy rate. The management of adolescent varicocele carries even more challenges, in view of the ethical issues involved in treating a boy who is young and immature. Guidelines have been framed to summarize the indications for surgical intervention in such patients. Both laparoscopic and open techniques have yielded equally good results.
{"title":"Subclinical and Adolescent Varicocele","authors":"S. Krishnamoorthy, Ashwin Muthukumar, P. Sai, N. Kumaresan","doi":"10.9734/bpi/nfmmr/v7/11547d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/11547d","url":null,"abstract":"Sub-clinical varicocele (SCV) is characterized by normal clinical examination and diagnosed mainly by Doppler Ultrasound imaging. About 10 – 15% of infertility cases were found to be SCV. SCV is one of the common causes of primary infertility and major cause in males with secondary infertility. Presence of sub-clinical varicocele in case of pediatric patients is considered a risk factor as it progresses to palpable clinical varicocele. \u0000Despite various imaging modalities being tried to diagnose SCV, Colour Doppler Ultrasound is considered the gold standard imaging for diagnosis of SCV, having a sensitivity and specificity of nearly 100%. Diagnostic criteria parameters of SCV includes measurement of diameter of scrotal veins in supine, upright & after valsalva maneuver along with sum of venous diameter, venous blood flow volume and retrograde flow direction during valsalva. \u0000SCV exerts a significant impact on spermatogenesis. Of all the theories proposed, the most accepted one is the oxidative stress theory. In many instances, SCV is the only abnormality associated with oligospermia. \u0000Various meta-analyses have shown a significant improvement in seminal parameters following surgical intervention but pregnancy rate did not improve much when compared to the non-intervened group. Controversies in surgical management are all centered on the pregnancy rate. This leaves the treating andrologists and urologists even more confused on how to go about managing these patients with SCV. The American society of Reproductive Medicine and American Urological Association do not recommend surgical repair for SCV, if the indication for varicocelectomy is to improve the pregnancy rate. \u0000The management of adolescent varicocele carries even more challenges, in view of the ethical issues involved in treating a boy who is young and immature. Guidelines have been framed to summarize the indications for surgical intervention in such patients. Both laparoscopic and open techniques have yielded equally good results.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"189 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122394002","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/11919d
G. Kastanis, G. Magarakis, P. Kapsetakis, Ioannis M Stavrakakis, A. Pantouvaki
DRF (distal radius fractures) are the most prevalent type of upper extremity fracture, accounting for 44 percent of all forearm and hand fractures. The goal of surgical treatment for unstable DRF is to restore wrist function. There are proponents in literature suggesting that volar locking plates are the most optional surgical methods in treatment of these fractures. The aim of this study is to answer the question: Is the volar locking plate the only surgical method treating all types of distal radius fractures and decreasing the rate of postsurgical complication? Materials & Methods: 104 fractures in 98 patients with an average age of 48,5 years were treated with a volar locking plate for unstable distal radius fractures. All fractures classified by AO/OTA in A2-3 27 cases, B1-3 in 45 and C1-3 in 32 cases. Most patients operated within 48-72 hours after injury. A volar locking device was used in all DRFs and an extended flexor carpi radialis approach was used in all cases. Low profile locking plates were employed in sixteen cases with base of ulnar styloid fractures, whereas Kirschner wires were used in the other patients. Postoperatively, all patients completed a typical rehabilitation regimen that included passive and active finger and wrist mobility. Results: Complications, time to fracture union, range of motion, Visual Analogue Scale, Quick Dash Score, and Patients-Rated Wrist Evaluation score were all taken into consideration when evaluating patients. Patients under 60 years old with type A2-3 and B1-3 fractures had a superior range of motion and grip strength than those over 65. When comparison to the unilateral side, ROM and grip strength reduced in subjects with type fractures C1-3 and age over 65.In comparison to the other two types of fractures, the percentage of complications and reoperation looked to be higher in type C1-3. Finally, the rates of Quick-DASH, PRWE and range of motion were better in type A, B and C1 than type C2-3, compared with uninjured hand. Conclusion: In recent years, unstable fractures required surgery treatment, with the volar locking plate serving as the gold standard. Unfortunately, VPL has postoperative difficulties linked to plate and screw position with comminuted fracture or soft tissue injury that cannot be overlooked, and it may be insufficient for all forms of distal radius fractures for these reasons.
{"title":"An Advanced Study on Volar Locking Plate as a Surgical Procedure for Distal Radius Fracture","authors":"G. Kastanis, G. Magarakis, P. Kapsetakis, Ioannis M Stavrakakis, A. Pantouvaki","doi":"10.9734/bpi/nfmmr/v7/11919d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/11919d","url":null,"abstract":"DRF (distal radius fractures) are the most prevalent type of upper extremity fracture, accounting for 44 percent of all forearm and hand fractures. The goal of surgical treatment for unstable DRF is to restore wrist function. There are proponents in literature suggesting that volar locking plates are the most optional surgical methods in treatment of these fractures. The aim of this study is to answer the question: Is the volar locking plate the only surgical method treating all types of distal radius fractures and decreasing the rate of postsurgical complication? \u0000Materials & Methods: 104 fractures in 98 patients with an average age of 48,5 years were treated with a volar locking plate for unstable distal radius fractures. All fractures classified by AO/OTA in A2-3 27 cases, B1-3 in 45 and C1-3 in 32 cases. Most patients operated within 48-72 hours after injury. A volar locking device was used in all DRFs and an extended flexor carpi radialis approach was used in all cases. Low profile locking plates were employed in sixteen cases with base of ulnar styloid fractures, whereas Kirschner wires were used in the other patients. Postoperatively, all patients completed a typical rehabilitation regimen that included passive and active finger and wrist mobility. Results: Complications, time to fracture union, range of motion, Visual Analogue Scale, Quick Dash Score, and Patients-Rated Wrist Evaluation score were all taken into consideration when evaluating patients. Patients under 60 years old with type A2-3 and B1-3 fractures had a superior range of motion and grip strength than those over 65. When comparison to the unilateral side, ROM and grip strength reduced in subjects with type fractures C1-3 and age over 65.In comparison to the other two types of fractures, the percentage of complications and reoperation looked to be higher in type C1-3. Finally, the rates of Quick-DASH, PRWE and range of motion were better in type A, B and C1 than type C2-3, compared with uninjured hand. \u0000Conclusion: In recent years, unstable fractures required surgery treatment, with the volar locking plate serving as the gold standard. Unfortunately, VPL has postoperative difficulties linked to plate and screw position with comminuted fracture or soft tissue injury that cannot be overlooked, and it may be insufficient for all forms of distal radius fractures for these reasons.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115657354","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/8739d
Qian Chen, C. W. Parker, I. Devine, Regina M Ondrasik, Tsion Habtamu, Kyle D Bartol, B. Casey, Harsh Patel, W. Chau, T. Kuhn, R. Barsotti, L. Young
Ischemia/reperfusion results in cardiac contractile dysfunction and cell death partly due to increased reactive oxygen species and decreased endothelial-derived nitric oxide bioavailability. Ischemia/reperfusion injury is initiated in part by endothelial dysfunction, which occurs within 5 min of reperfusion. NADPH oxidase normally produces reactive oxygen species to facilitate cell signalling and differentiation; however, excessive release of such species following ischemia exacerbates cell death. Thus, administration of an NADPH oxidase inhibitor, apocynin, may preserve cardiac function and reduce infarct size following ischemia. Apocynin dose-dependently (40 (mu)M, 400 (mu)M and 1 mM) attenuated leukocyte superoxide release by 87 ± 7%. Apocynin was also given to isolated perfused hearts after ischemia, with infarct size decreasing to 39 ± 7% (40 (mu)M), 28 ± 4% (400 (mu)M; p < 0.01) and 29 ± 6% (1 mM; p < 0.01), versus the control’s 46 ± 2%. This decrease correlated with improved final post-reperfusion left ventricular end-diastolic pressure, which decreased from 60 ± 5% in control hearts to 56 ± 5% (40 (mu)M), 43 ± 4% (400 (mu)M; p < 0.01) and 48 ± 5% (1 mM; p < 0.05), compared to baseline. Functionally, apocynin (13.7 mg/kg, I.V.) significantly reduced H2O2 by nearly four-fold and increased endothelial-derived nitric oxide bioavailability by nearly four-fold during reperfusion compared to controls (p < 0.01), which was confirmed in in vivo rat hind limb ischemia/reperfusion models. These results suggest that apocynin attenuates ischemia/reperfusion-induced cardiac contractile dysfunction and infarct size by inhibiting reactive oxygen species release from NADPH oxidase.
缺血/再灌注导致心脏收缩功能障碍和细胞死亡，部分原因是活性氧增加和内皮源性一氧化氮生物利用度降低。缺血/再灌注损伤部分是由内皮功能障碍引起的，内皮功能障碍发生在再灌注后5分钟内。NADPH氧化酶通常产生活性氧，促进细胞信号传导和分化;然而，缺血后这些物质的过度释放会加剧细胞死亡。因此，给药NADPH氧化酶抑制剂，罗布麻碱，可能保持心脏功能和减少缺血后梗死面积。罗布麻素剂量依赖性(40 (mu) M, 400 (mu) M和1 mM)可使白细胞超氧化物释放降低87±7%. Apocynin was also given to isolated perfused hearts after ischemia, with infarct size decreasing to 39 ± 7% (40 (mu)M), 28 ± 4% (400 (mu)M; p < 0.01) and 29 ± 6% (1 mM; p < 0.01), versus the control’s 46 ± 2%. This decrease correlated with improved final post-reperfusion left ventricular end-diastolic pressure, which decreased from 60 ± 5% in control hearts to 56 ± 5% (40 (mu)M), 43 ± 4% (400 (mu)M; p < 0.01) and 48 ± 5% (1 mM; p < 0.05), compared to baseline. Functionally, apocynin (13.7 mg/kg, I.V.) significantly reduced H2O2 by nearly four-fold and increased endothelial-derived nitric oxide bioavailability by nearly four-fold during reperfusion compared to controls (p < 0.01), which was confirmed in in vivo rat hind limb ischemia/reperfusion models. These results suggest that apocynin attenuates ischemia/reperfusion-induced cardiac contractile dysfunction and infarct size by inhibiting reactive oxygen species release from NADPH oxidase.
{"title":"Apocynin Exerts Dose-Dependent Cardioprotective Effects by Attenuating Reactive Oxygen Species in Ischemia/Reperfusion: A Recent Study","authors":"Qian Chen, C. W. Parker, I. Devine, Regina M Ondrasik, Tsion Habtamu, Kyle D Bartol, B. Casey, Harsh Patel, W. Chau, T. Kuhn, R. Barsotti, L. Young","doi":"10.9734/bpi/nfmmr/v7/8739d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/8739d","url":null,"abstract":"Ischemia/reperfusion results in cardiac contractile dysfunction and cell death partly due to increased reactive oxygen species and decreased endothelial-derived nitric oxide bioavailability. Ischemia/reperfusion injury is initiated in part by endothelial dysfunction, which occurs within 5 min of reperfusion. NADPH oxidase normally produces reactive oxygen species to facilitate cell signalling and differentiation; however, excessive release of such species following ischemia exacerbates cell death. Thus, administration of an NADPH oxidase inhibitor, apocynin, may preserve cardiac function and reduce infarct size following ischemia. Apocynin dose-dependently (40 (mu)M, 400 (mu)M and 1 mM) attenuated leukocyte superoxide release by 87 ± 7%. Apocynin was also given to isolated perfused hearts after ischemia, with infarct size decreasing to 39 ± 7% (40 (mu)M), 28 ± 4% (400 (mu)M; p < 0.01) and 29 ± 6% (1 mM; p < 0.01), versus the control’s 46 ± 2%. This decrease correlated with improved final post-reperfusion left ventricular end-diastolic pressure, which decreased from 60 ± 5% in control hearts to 56 ± 5% (40 (mu)M), 43 ± 4% (400 (mu)M; p < 0.01) and 48 ± 5% (1 mM; p < 0.05), compared to baseline. Functionally, apocynin (13.7 mg/kg, I.V.) significantly reduced H2O2 by nearly four-fold and increased endothelial-derived nitric oxide bioavailability by nearly four-fold during reperfusion compared to controls (p < 0.01), which was confirmed in in vivo rat hind limb ischemia/reperfusion models. These results suggest that apocynin attenuates ischemia/reperfusion-induced cardiac contractile dysfunction and infarct size by inhibiting reactive oxygen species release from NADPH oxidase.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124785342","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/1778c
A. Tacón
Aims: The purpose here was to newly investigate a five-weeks complementary medicine intervention, mindfulness-based intervention (MBSR), in breast cancer patients with chronic pain. Pain is the most persistent and incapacitating symptom experienced by cancer patients. Psychological pain inflexibility, pain self-efficacy, and expressive suppression were investigated for the first time in breast cancer patients with cancer-related pain. Study Design: One group pre-post intervention design. Place and Duration of Study: Lubbock, Tx medical center, spring 2010. Methodology: Sample: The sample consisted of 46 participants with 36 women in stage II (78%) and 10 (22%) in stage III with a mean age of 55 years. The MBSR intervention was held in a hospital counseling center for 1.5 hours/week for eight-weeks, with preliminary data collected at five weeks (reported here), at the end of the full program three weeks later, and three months post the 8-week program. Preliminary data here were collected on standardized instruments before (pre) and after (post) the five-week point of the eight-week MBSR program to evaluate intervention effects on the following: Psychological inflexibility in pain, pain self-efficacy, emotional regulation of suppressive expression, and pain intensity. Results: Psychological inflexibility in pain scores prior to the program (M=60.05, SD=14.22) decreased significantly by the end of five-weeks of the program (M=57.68, SD=13.46) (t=3.76, P = 0.01); Pain self-efficacy prior to the program (M=20.61, SD=11.47) increased significantly by the end of the five-week period of the complementary mindfulness intervention (M=22.47, SD=10.63) (t=3.11, P .05). Conclusion: These findings after the complementary mindfulness intervention should be interpreted cautiously, for replication and future research need to be conducted at this time period. The results, however, provide data for women with breast cancer-related pain and the possibility of complementary mind-body interventions.
目的:这里的目的是研究一种为期五周的补充药物干预，基于正念的干预(MBSR)，对患有慢性疼痛的乳腺癌患者。疼痛是癌症患者经历的最持久和最丧失能力的症状。本文首次对乳腺癌癌症相关疼痛患者的心理疼痛不灵活性、疼痛自我效能和表达抑制进行了研究。研究设计:一组干预前后设计。研究地点和时间:拉伯克，德克萨斯州医疗中心，2010年春季。方法:样本:样本包括46名参与者，其中36名女性处于II期(78%)，10名女性处于III期(22%)，平均年龄为55岁。正念减压干预在医院咨询中心进行，每周1.5小时，持续8周，5周时收集初步数据(见此处)，3周后完整项目结束，8周后3个月。本研究的初步数据是在八周正念减压计划的五周前(前)和五周后(后)用标准化仪器收集的，以评估干预对以下方面的影响:疼痛的心理不灵活性、疼痛自我效能、抑制性表达的情绪调节和疼痛强度。结果:治疗前心理不灵活性疼痛评分(M=60.05, SD=14.22)在治疗5周后显著降低(M=57.68, SD=13.46) (t=3.76, P = 0.01);计划前的疼痛自我效能(M=20.61, SD=11.47)在补充正念干预五周结束时显著增加(M=22.47, SD=10.63) (t=3.11, P .05)。结论:补充正念干预后的这些发现应谨慎解读，在此期间需要进行复制和未来的研究。然而，研究结果为患有乳腺癌相关疼痛的女性提供了数据，并提供了补充身心干预的可能性。
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Pub Date : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/3625f
Nazreen Ansari, J. Paul, J. D’lima, S. Parackal
The world of medicine has recently been flummoxed by the discovery of inflammasomes which are assumed to regulate the host immuno-inflammatory responses. They are believed to have a multitude of purposes in the process, many of which, still remain to be elucidated. It has been observed that certain sensor proteins are required to assemble these inflammasomes in response to microbial components called PAMPs (pathogen associated molecular patterns) or endogenous molecules called DAMPs (damage associated molecular patterns). In most cases, inflammasomes have been demonstrated to undergo a process consisting of two steps to get activated. Furthermore, according to research, this involves various families of sensor proteins which play a part in the pathogenesis of many diseases, including periodontal disease through a number of corresponding pathways. This piece of information, thereby, affords us the opportunity to explore further and search for new targets to modulate host responses to microbial challenges.
{"title":"The Inflammasomes: Revamping Periodontal Pathogenesis","authors":"Nazreen Ansari, J. Paul, J. D’lima, S. Parackal","doi":"10.9734/bpi/nfmmr/v7/3625f","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/3625f","url":null,"abstract":"The world of medicine has recently been flummoxed by the discovery of inflammasomes which are assumed to regulate the host immuno-inflammatory responses. They are believed to have a multitude of purposes in the process, many of which, still remain to be elucidated. It has been observed that certain sensor proteins are required to assemble these inflammasomes in response to microbial components called PAMPs (pathogen associated molecular patterns) or endogenous molecules called DAMPs (damage associated molecular patterns). In most cases, inflammasomes have been demonstrated to undergo a process consisting of two steps to get activated. Furthermore, according to research, this involves various families of sensor proteins which play a part in the pathogenesis of many diseases, including periodontal disease through a number of corresponding pathways. This piece of information, thereby, affords us the opportunity to explore further and search for new targets to modulate host responses to microbial challenges.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121536477","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/11962d
M. Sarkar
Off-pump coronary artery bypass has emerged as a popular method of coronary revascularization to mitigate the harmful effects of cardiopulmonary bypass. It requires surgical and anesthetic expertise for good results. Newer minimally invasive approaches to off pump coronary bypass provide attractive alternatives to conventional off pump surgery, especially in achieving better cosmetic results and early extubation. They require good perioperative pain management, with epidural and paravertebral block being good choices. Emergency conversion of off-pump bypass to on-pump bypass is associated with poor outcomes, so preventive measures to avoid it should be employed.
{"title":"Study on Anesthetic Implications during Off-Pump Coronary Artery Bypass Surgery","authors":"M. Sarkar","doi":"10.9734/bpi/nfmmr/v7/11962d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/11962d","url":null,"abstract":"Off-pump coronary artery bypass has emerged as a popular method of coronary revascularization to mitigate the harmful effects of cardiopulmonary bypass. It requires surgical and anesthetic expertise for good results. Newer minimally invasive approaches to off pump coronary bypass provide attractive alternatives to conventional off pump surgery, especially in achieving better cosmetic results and early extubation. They require good perioperative pain management, with epidural and paravertebral block being good choices. Emergency conversion of off-pump bypass to on-pump bypass is associated with poor outcomes, so preventive measures to avoid it should be employed.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128605765","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 : 2021-08-12DOI: 10.9734/bpi/nfmmr/v7/11961d
P. Desai, S. Mahure, M. Sarkar, Sanjeeta R Umbarkar
Background: Central venous and pulmonary artery catheter are integral part of hemodynamic monitoring during off pump coronary artery bypass grafting surgery. Methods: In this prospective randomized trial, sixty patients were divided equally into two groups, to receive either central venous or pulmonary artery catheter after induction of anesthesia with high dose of opioid and Inj pancuronium. Patients between 35-65 years with ejection fraction 40-60% undergoing elective off pump coronary artery bypass surgery were included while those with left ventricular dysfunction were excluded. All patients were operated by same team of surgeons. Systolic blood pressure (SBP) and/or mean arterial pressure (MAP) was kept above 90 and 60 mm Hg respectively throughout perioperative period by fluid volume expansion and inotropic support. Nitroglycerine was used for blood pressure control and coronary vasodilation. Both groups were compared with respect to intervention requiring inotropes and its duration, ICU stay and any complications occurred. Results: Significant number of patients in CVP group were started on inotropes than PAC group (66.6% vs 40%, P=0.038). Among these, 75% in Gr. A needed it for less than 24 hours compared to 65% in Gr. B. Both groups needed similar trials of fluid challenge [40% vs 53.33%; P=0.30] and showed similar duration of intensive care unit stay (more than 48 hrs) [66.67% vs 53.3%; p=0.29, chi square test]. More number of patients developed complications in CVP group [6.6 vs 16.6%; P=0.22]. One patient in each group had mortality. Conclusion: PA catheter guided management does not provide additional benefit over CVP guided management alone during OPCAB surgery in patients with preserved LV function.
背景:中心静脉和肺动脉导管是冠状动脉旁路移植术中血流动力学监测的重要组成部分。方法:本前瞻性随机试验将60例患者平均分为两组，分别在大剂量阿片类药物和泮库溴铵诱导麻醉后接受中心静脉或肺动脉导管插管。年龄在35-65岁、射血分数40-60%、接受非体外循环冠状动脉搭桥手术的患者被纳入研究，而有左心室功能障碍的患者被排除在外。所有患者均由同一组外科医生进行手术。围手术期通过扩液和肌力支持使收缩压(SBP)和/或平均动脉压(MAP)分别保持在90和60 mm Hg以上。硝酸甘油用于血压控制和冠状动脉舒张。比较两组患者对肌力的干预需求、持续时间、ICU住院时间和并发症发生情况。结果:CVP组患者开始使用肌力药物的比例明显高于PAC组(66.6% vs 40%， P=0.038)。其中，75%的A组需要的补液时间少于24小时，而65%的b组需要类似的补液试验[40%对53.33%;P=0.30]，重症监护病房停留时间相似(大于48小时)[66.67% vs 53.3%;P =0.29，卡方检验]。CVP组出现并发症的患者较多[6.6 vs 16.6%;P = 0.22)。每组均有1例患者死亡。结论:在保留左室功能的患者进行OPCAB手术时，PA导管引导管理并不比单独CVP引导管理提供额外的益处。
{"title":"Pulmonary Artery Catheter Versus Central Venous Catheter in Patients Undergoing Beating Heart Coronary Artery Bypass Surgery: A Comparative Approach","authors":"P. Desai, S. Mahure, M. Sarkar, Sanjeeta R Umbarkar","doi":"10.9734/bpi/nfmmr/v7/11961d","DOIUrl":"https://doi.org/10.9734/bpi/nfmmr/v7/11961d","url":null,"abstract":"Background: Central venous and pulmonary artery catheter are integral part of hemodynamic monitoring during off pump coronary artery bypass grafting surgery. \u0000Methods: In this prospective randomized trial, sixty patients were divided equally into two groups, to receive either central venous or pulmonary artery catheter after induction of anesthesia with high dose of opioid and Inj pancuronium. Patients between 35-65 years with ejection fraction 40-60% undergoing elective off pump coronary artery bypass surgery were included while those with left ventricular dysfunction were excluded. All patients were operated by same team of surgeons. Systolic blood pressure (SBP) and/or mean arterial pressure (MAP) was kept above 90 and 60 mm Hg respectively throughout perioperative period by fluid volume expansion and inotropic support. Nitroglycerine was used for blood pressure control and coronary vasodilation. Both groups were compared with respect to intervention requiring inotropes and its duration, ICU stay and any complications occurred. \u0000Results: Significant number of patients in CVP group were started on inotropes than PAC group (66.6% vs 40%, P=0.038). Among these, 75% in Gr. A needed it for less than 24 hours compared to 65% in Gr. B. Both groups needed similar trials of fluid challenge [40% vs 53.33%; P=0.30] and showed similar duration of intensive care unit stay (more than 48 hrs) [66.67% vs 53.3%; p=0.29, chi square test]. More number of patients developed complications in CVP group [6.6 vs 16.6%; P=0.22]. One patient in each group had mortality. \u0000Conclusion: PA catheter guided management does not provide additional benefit over CVP guided management alone during OPCAB surgery in patients with preserved LV function.","PeriodicalId":231604,"journal":{"name":"New Frontiers in Medicine and Medical Research Vol. 7","volume":"42 1-8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116548647","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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