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To Study Efficacy of Blood Pressure Management Program (BPMP) in Male Elderly Patients with Known Case of Hypertension: An Observational Study
Rohit Sane,
Sagar Patil,
Nita Hinge,
Nilesh Kulthe,
Swati Ambulkar,
Rahul Mandole
Issue:
Volume 2, Issue 3, September 2018
Pages:
49-54
Received:
19 July 2018
Accepted:
30 July 2018
Published:
12 October 2018
Abstract: Around 20% of the population are in prehypertension stage, and nearly 40% of the adult population from Hypertension (HTN). Blood Pressure Management Program (BPMP) is an Ayurvedic treatment strategy using Panchakarma. This study was conducted to evaluate the effect of BPMP on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), body mass index (BMI) and dependency on conventional therapy in elderly male patients of HTN. This observational study was conducted from January 2017 to February 2018, wherein the data of HTN patients who attended Madhavbaug clinics in Maharashtra, India were identified. Data of patients who were administered BPMP (60-75 minutes) with minimum 6 sittings over 90 days (± 15 days) were considered. Variables were compared between day 1 and day 90 of BPMP. Out of 29 enrolled patients, 24 were finally selected for analysis. BPMP showed significant improvement in SBP by 24.66 (from 150.67 ±12.97 to 126 ± 13.01; p<0.001), DBP by 10.8 (from 87.7917 ±7.72 to 76.917 ±7.59, p< 0.001), MAP by 15.4 (from 108.75 ±7.14 to 93.25 ±8.72, p<0.001). BMI (25.7275 ±2.63 kg/m2 to 24.91 ±2.32 kg/m2), also showed significant reduction. Dependency on concomitant medicines was reduced, with the number of patients on no concomitant medicines increasing from 19% to 29%. BPMP can serve as an effective therapeutic regiment to combat HTN in elderly male patients.
Abstract: Around 20% of the population are in prehypertension stage, and nearly 40% of the adult population from Hypertension (HTN). Blood Pressure Management Program (BPMP) is an Ayurvedic treatment strategy using Panchakarma. This study was conducted to evaluate the effect of BPMP on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arter...
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Contrast-Induced Nephropathy Among Patients Undergoing Cardiac Catheterization
Safauldeen Ahmed Alhajim,
Ahmed Sami Jebur
Issue:
Volume 2, Issue 3, September 2018
Pages:
55-60
Received:
25 August 2018
Accepted:
20 September 2018
Published:
17 October 2018
Abstract: Contrast-induced nephropathy is an important complication after cardiac catheterization, and is associated with accelerated renal disease, increased costs, mortality rate, need for dialysis and prolonged hospital stay. This study aim is to find its incidence and risk factors. It is a cross-sectional study on 160 patients admitted for diagnostic or therapeutic percutaneous coronary intervention in Basra Cardiac Center, from March to September 2016. Data collected were a complete history, examination, blood pressure, Echo study, fasting blood sugar, lipid profile, blood urea, serum creatinine and estimated glomerular filtration rate, the type and duration of procedure, volume of contrast, and after 48 hours renal function tests were repeated. Contrast-induced nephropathy has developed in 7 (8.3%) men and 5 (6.6%) women; 11 (10.8%) from 102 patients with dyslipidemia (P = 0.03); 8 (22.2%) from 36 with preexisting renal impairment (P = 0.01); 11 (10.9%) from 101 with hypertension (P = 0.02); 9 (13.6%) from 66 diabetic (P = 0.016); 9 (17.3%) from 52 smoker (P = 0.002); 4 (23.5%) from 17 alcohol drinkers (P = 0.026); 11 (11.2%) from 98 with ischemic heart disease (P = 0.02); and 9 (25.7%) from 35 with heart failure (P = <0.001). Also found in 1 (1.6%) from 64 diagnostic procedures; 11 (11.5%) from 96 therapeutic procedures (P = 0.016); 5 (3.7%) from 135 patients received < 300 ml of contrast; and 7 (28%) from 25 received ≥ 300 ml (P = 0.001). In conclusion contrast-induced nephropathy is aggravated by increasing age, diabetes mellitus, heart failure, ischemic heart disease, renal impairment, hypertension, dyslipidemia, smoking and alcohol use. The type of procedure (therapeutic vs. diagnostic), and large volume of contrast agent are important risk factors. Gender had no significant effect.
Abstract: Contrast-induced nephropathy is an important complication after cardiac catheterization, and is associated with accelerated renal disease, increased costs, mortality rate, need for dialysis and prolonged hospital stay. This study aim is to find its incidence and risk factors. It is a cross-sectional study on 160 patients admitted for diagnostic or ...
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To Evaluate the Efficacy of Heart Failure Reversal Therapy Using NT-Probnp Levels in Patients with Chronic Heart Failure
Sane Rohit,
Mandole Rahul
Issue:
Volume 2, Issue 3, September 2018
Pages:
61-64
Received:
19 August 2018
Accepted:
10 October 2018
Published:
30 October 2018
Abstract: Heart failure is considered as a life-threatening epidemic disorder affecting about 26 million world's population and associated with considerable morbidity, mortality and healthcare expenses. Despite the availability of a range of advanced treatments and sophisticated therapies the prevalence of heart failure represents a herculean challenge. To address the challenge, the current investigation was conducted by evaluating the efficacy of Heart Failure Reversal Therapy (HFRT) in reducing left ventricular distress by assessing N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in congestive heart failure (CHF) patients. Total 76 CHF patients with NYHA Class II and III were screened from March to May 2017 and 15 CHF patients with NT-proBNP = 300-1500 pg/ml were selected for the study. NT-proBNP is measured as a marker, the value of which increases with an increase in severity of CHF. The study therapy, HFRT comprises of traditional procedure of panchkarma that includes snehana (external oleation), swedana (passive heat therapy), hrudaydhara (concoction dripping treatment) and basti (medicated enema) was administered twice daily for 7 days. Post-HFRT, ARJ kadha was administered for next 12 weeks follow-up. NT-proBNP levels were measured after a follow-up period of 90 days along with some other parameters like BMI, VO2peak (evaluated by cardiac stress test with modified Bruce protocol) and weight. The findings of the investigation revealed significant reduction in NT-proBNP levels (42.46%, p = 0.009), weight (4.82%, p = 0.0007) and BMI (3.67%, p = 0.034) at the end of the follow-up period. The study also yielded significant improvements in VO2peak (50.96%, p = 0.004). The overall results suggest that HFRT can possibly be explored as add-on therapy or a feasible alternative for the effective management of CHF.
Abstract: Heart failure is considered as a life-threatening epidemic disorder affecting about 26 million world's population and associated with considerable morbidity, mortality and healthcare expenses. Despite the availability of a range of advanced treatments and sophisticated therapies the prevalence of heart failure represents a herculean challenge. To a...
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Ebstein Anomaly in a 60 Years Patient: A Lucky Finding
Randa Tabbah,
Raffy Karaminissian
Issue:
Volume 2, Issue 3, September 2018
Pages:
65-67
Received:
13 September 2018
Accepted:
27 September 2018
Published:
30 October 2018
Abstract: Ebstein anomaly is a rare congenital disease of the tricuspid valve (<1%) diagnosed at all ages. A single case of an 85 y old patient was reported in 1979 as the longest survival with ebstein anomaly who had no cardiac symptoms until 79 years old. The aim of this case report is to highlight the need for an early echocardiographic diagnosis of this disease to prevent sudden death from arrhythmias or other complications because as we see patients with ebstein anomaly can live a healthy long life asymptomatic. The patient described in this case is a 60 years old male diabetic and heavy smoker, who presented to the cardiology department with fatigue and atypical angina with dyspnea on moderate effort. Cardiac ultrasound was in favor of an isolated Ebstein anomaly type A, with partial atrialization of the right ventricle (RV) with an adequate volume of the right ventricle (17cm2) and no specific other associated anomalies. Symptoms described by the patient were purely pulmonary due to a mild obstructive disease. Patient was diagnosed with chronic obstructive lung disease due to his smoking habits. Reaching this age and being asymptomatic with conserved RV and LV function is a sign of good outcome. This case was an interesting lucky finding. It was astonishing to see a patient surviving this anomaly at 60 years old asymptomatically.
Abstract: Ebstein anomaly is a rare congenital disease of the tricuspid valve (<1%) diagnosed at all ages. A single case of an 85 y old patient was reported in 1979 as the longest survival with ebstein anomaly who had no cardiac symptoms until 79 years old. The aim of this case report is to highlight the need for an early echocardiographic diagnosis of this disease to prevent sudden death from arrhythmias or other complications because as we see patients with ebstein anomaly can live a healthy long life asymptomatic. The patient described in this case is a 60 years old male diabetic and heavy smoker, who presented to the cardiology department with fatigue and atypical angina with dyspnea on moderate effort. Cardiac ultrasound was in favor of an isolated Ebstein anomaly type A, with partial atrialization of the right ventricle (RV) with an adequate volume of the right ventricle (17cm2) and no specific other associated anomalies. Symptoms described by the patient were purely pulmonary due to a mild obstructive disease. Patient was diagnosed with chronic obstructive lung disease due to his smoking habits. Reaching this age and being asymptomatic with conserved ...
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Predictors of no-Reflow in Patients with ST-Segment Elevation Acute Myocardial Infarction after Primary Percutaneous Coronary Intervention
Mohammed Ismail Ali,
Wala Farid Abd El-Aziz,
Adel Imam Abd El-Magid,
Neveen Ibrahim Samy
Issue:
Volume 2, Issue 3, September 2018
Pages:
68-74
Received:
28 August 2018
Accepted:
15 October 2018
Published:
5 November 2018
Abstract: Background: Primary percutaneous coronary intervention (PCI) is the preferred method of ST-segment elevation acute myocardial infarction (STEMI) management but no-reflow phenomenon is one of its major complications that affects patient's outcome. Objective: Identification of possible clinical, angiographic and procedural predictors for no-reflow in patients with AMI after primary percutaneous coronary intervention (PCI). Methods: A total of hundred patients with AMI who had been treated by primary PCI at the National heart institute (NHI) and cardiology department, Menoufia University hospital were enrolled in this study, according to thrombolysis in myocardial infarction (TIMI) flow grade, patients were divided into a reflow group (TIMI 3) and a no-reflow group (TIMI ≤ 2). The clinical, angiographic and procedural data were compared between both groups. Discussion: Sixteen patients (16%) developed no-reflow phenomenon after primary PCI. Statistical analysis showed that time from onset to reperfusion, low initial TIMI flow grade, high thrombus burden, long lesion length and large reference luminal diameter were correlated with no-reflow (P < 0.05 for all) and were considered to be independent predictors of no-reflow. Conclusion: The occurrence of no-reflow after primary PCI for acute myocardial infarction can be predicted by certain clinical, angiographic and procedural features.
Abstract: Background: Primary percutaneous coronary intervention (PCI) is the preferred method of ST-segment elevation acute myocardial infarction (STEMI) management but no-reflow phenomenon is one of its major complications that affects patient's outcome. Objective: Identification of possible clinical, angiographic and procedural predictors for no-reflow in...
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