The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
—Gestational Diabetes Mellitus (GDM) is a problem which may occur during pregnancy. For treatment of GDM either the Metformin or Insulin is used. So this prospective randomized multicenter trial in women with GDM was conducted to compare the treatment outcomes of metformin and insulin. This study was conducted at Rajkiya Mahila Chikitsalaya, in Obstetrics & Gynaecology Department of Jawaharlal Nehru Medical College, Ajmer. This study was done on 110 women who were diagnosed GDM by DIPSI criteria with a singleton pregnancy and meet entry criteria are randomized to insulin or metformin treatment (55 cases in each group).It was observed that metformin is equally efficacious and safe as insulin with a lot of advantages like less costly, better compliance, less weight gain, less change of hypoglycaemic attack and more feasible as insulin require several daily injection with not much difference in perinatal outcome except statistically significant difference in baby weight, mean cord blood sugar level at birth, large for gestation age. So it can be concluded that Metformin treatment is suitable for non-obese as well as obese type 2 diabetes patients in pregnancy without complications. Metformin is a safer alternate to insulin in GDM management with no adverse maternal and fetal outcome.
Neonatal Outcome In Pregnancy Induced Hypertensive Mothers – A Tertiary Care ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study compared the analgesic efficacy of intravenous paracetamol versus intramuscular pethidine for labor pain in primigravid women undergoing normal vaginal delivery. 80 women were randomly assigned to receive either 1000mg intravenous paracetamol or 50mg intramuscular pethidine for labor pain. Pain levels were assessed after delivery using a visual analogue scale. The average pain score was significantly lower in the paracetamol group compared to the pethidine group. No significant complications occurred in either group. The study concluded that intravenous paracetamol provides more effective labor pain relief than intramuscular pethidine for normal vaginal deliveries.
Oral antihypertensive therapy for severe hypertension in pregnancy and postp...Ant Guzman
Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review
This systematic review identified 15 randomized controlled trials involving 914 pregnant women and one postpartum trial with 38 women evaluating oral antihypertensive agents for treating severe hypertension. Most trials compared oral/sublingual nifedipine capsules to parenteral hydralazine or labetalol. Nifedipine achieved similar treatment success rates as hydralazine or labetalol with fewer side effects. Target blood pressure was achieved about 50% of the time with oral labetalol or methyldopa with no differences in maternal or fetal outcomes between these agents. The review concluded that oral nifedip
Introduction true vertigo is a type of vertigo identifieniraj57
This study compared the effectiveness of hyoscine and diazepam in treating true vertigo in 69 patients in an emergency department. Patients were randomly assigned to receive either 5 mg of hyoscine or 10 mg of diazepam. Vertigo severity was assessed before and 1 and 2 hours after drug administration in different positions. Diazepam was significantly more effective at relieving vertigo in all positions compared to hyoscine based on treatment success rates. Complete relief of vertigo occurred in 40-63% of patients given diazepam but only 2.6-12.5% of those given hyoscine. The study suggests that diazepam is a better option than hyoscine for
The profile of infants born to mothers with subclinical hypothyroidism in a t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Exenatide is a synthetic version of exendin-4, a peptide found in the saliva of the Gila monster lizard. It mimics the effects of the human incretin hormone GLP-1, leading to glucose-dependent insulin secretion and suppression of glucagon secretion. Exenatide is administered via subcutaneous injection twice daily. It effectively lowers blood glucose levels when used in combination with metformin and/or sulfonylureas. Common side effects include nausea and vomiting.
This clinical study evaluated various maternal factors, biomarkers and uterine Doppler ultrasound findings to predict hypertension during pregnancy in a low-resource setting. The study found that higher maternal body mass index, mean arterial pressure, uterine artery pulsatility index and lower pregnancy-associated plasma protein A levels were significantly associated with later development of hypertension. Combining these various predictors into a model achieved a sensitivity of 76%, specificity of 80% and negative predictive value of 93% for identifying women who developed hypertension during pregnancy.
—Gestational Diabetes Mellitus (GDM) is a problem which may occur during pregnancy. For treatment of GDM either the Metformin or Insulin is used. So this prospective randomized multicenter trial in women with GDM was conducted to compare the treatment outcomes of metformin and insulin. This study was conducted at Rajkiya Mahila Chikitsalaya, in Obstetrics & Gynaecology Department of Jawaharlal Nehru Medical College, Ajmer. This study was done on 110 women who were diagnosed GDM by DIPSI criteria with a singleton pregnancy and meet entry criteria are randomized to insulin or metformin treatment (55 cases in each group).It was observed that metformin is equally efficacious and safe as insulin with a lot of advantages like less costly, better compliance, less weight gain, less change of hypoglycaemic attack and more feasible as insulin require several daily injection with not much difference in perinatal outcome except statistically significant difference in baby weight, mean cord blood sugar level at birth, large for gestation age. So it can be concluded that Metformin treatment is suitable for non-obese as well as obese type 2 diabetes patients in pregnancy without complications. Metformin is a safer alternate to insulin in GDM management with no adverse maternal and fetal outcome.
Neonatal Outcome In Pregnancy Induced Hypertensive Mothers – A Tertiary Care ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study compared the analgesic efficacy of intravenous paracetamol versus intramuscular pethidine for labor pain in primigravid women undergoing normal vaginal delivery. 80 women were randomly assigned to receive either 1000mg intravenous paracetamol or 50mg intramuscular pethidine for labor pain. Pain levels were assessed after delivery using a visual analogue scale. The average pain score was significantly lower in the paracetamol group compared to the pethidine group. No significant complications occurred in either group. The study concluded that intravenous paracetamol provides more effective labor pain relief than intramuscular pethidine for normal vaginal deliveries.
Oral antihypertensive therapy for severe hypertension in pregnancy and postp...Ant Guzman
Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review
This systematic review identified 15 randomized controlled trials involving 914 pregnant women and one postpartum trial with 38 women evaluating oral antihypertensive agents for treating severe hypertension. Most trials compared oral/sublingual nifedipine capsules to parenteral hydralazine or labetalol. Nifedipine achieved similar treatment success rates as hydralazine or labetalol with fewer side effects. Target blood pressure was achieved about 50% of the time with oral labetalol or methyldopa with no differences in maternal or fetal outcomes between these agents. The review concluded that oral nifedip
Introduction true vertigo is a type of vertigo identifieniraj57
This study compared the effectiveness of hyoscine and diazepam in treating true vertigo in 69 patients in an emergency department. Patients were randomly assigned to receive either 5 mg of hyoscine or 10 mg of diazepam. Vertigo severity was assessed before and 1 and 2 hours after drug administration in different positions. Diazepam was significantly more effective at relieving vertigo in all positions compared to hyoscine based on treatment success rates. Complete relief of vertigo occurred in 40-63% of patients given diazepam but only 2.6-12.5% of those given hyoscine. The study suggests that diazepam is a better option than hyoscine for
The profile of infants born to mothers with subclinical hypothyroidism in a t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Exenatide is a synthetic version of exendin-4, a peptide found in the saliva of the Gila monster lizard. It mimics the effects of the human incretin hormone GLP-1, leading to glucose-dependent insulin secretion and suppression of glucagon secretion. Exenatide is administered via subcutaneous injection twice daily. It effectively lowers blood glucose levels when used in combination with metformin and/or sulfonylureas. Common side effects include nausea and vomiting.
This clinical study evaluated various maternal factors, biomarkers and uterine Doppler ultrasound findings to predict hypertension during pregnancy in a low-resource setting. The study found that higher maternal body mass index, mean arterial pressure, uterine artery pulsatility index and lower pregnancy-associated plasma protein A levels were significantly associated with later development of hypertension. Combining these various predictors into a model achieved a sensitivity of 76%, specificity of 80% and negative predictive value of 93% for identifying women who developed hypertension during pregnancy.
This document discusses asthma management during pregnancy. It begins by describing how pregnancy can affect asthma severity, noting that prior asthma severity predicts severity during pregnancy. It then explains how asthma can impact pregnancy outcomes like preterm delivery. The rest of the document covers general asthma care during pregnancy, including monitoring, education, trigger avoidance, and medications. It notes most asthma medications are category B or C but are generally considered safe in pregnancy with monitoring. Inhaled short-acting beta agonists are recommended for acute exacerbations. The goal is preventing acute episodes and optimizing lung function to reduce risks.
This study investigated cardiovascular and gastrointestinal outcomes in clopidogrel users who were also taking proton pump inhibitors (PPIs) using a large cohort of patients in the Netherlands. The study found that clopidogrel users who were also taking PPIs had a 75% higher risk of cardiovascular events compared to clopidogrel-only users. However, the study had limitations such as channeling bias since PPI users had more risk factors, and residual confounding since important risk factors could not be adjusted for. While providing useful insights, the study's findings on the risks of PPI co-administration should be interpreted cautiously due to its limitations.
Prevalence of Low Birth Weight in Maternal Pregnancy Induced Hypertension in ...paperpublications3
Abstract: Pregnancy induced hypertension is one of the common conditions of unknown aetiology which increases the risk of maternal and perinatal morbidity and mortality. The aim of the study was to determine the prevalence of low birth weight in maternal pregnancy induced hypertension in patients of kashmiri origin. An observational study was carried out in the Postgraduate Department of Gynaecology and Obstetrics, Lalla Ded Hospital, Government Medical College Srinagar w.e.f September 2014 to February 2015. Methods: The study included all patients of PIH BP≥140/90 mm Hg after 20 weeks of gestation. Necessary information was collected such has detailed history, clinical examination, investigation performed, mode of delivery and neonatal birth weight Results: 37.5% had systolic blood pressure > 160 mmHg and 42.10% had a DBP > 110 mmHg. The frequency of caesarean section was 53% and 42% for normal birth. Low birth weight (<2.5 kg) was seen in (42.10%) when associated with severe diastolic hypertension and (37.5%) when severe systolic hypertension was taken into account Conclusion: DBP i.e. 110 mmHg or more was associated with low birth weight.
Desvenlafaxine Succinate: Is it a New Promise and Hope for Management of Vaso...Apollo Hospitals
Natural menopause, specifically, is confirmed after 12
consecutive months of amenorrhea in the absence of any
obvious, pathologic cause.1 These 12 months of amenorrhea and beyond, characterize a woman as postmenopausal. This can further be divided into early postmenopause (4 years after the FMP) and late postmenopause (>5 years since the FMP)
Interdisciplinary care plan7 class nur3400ssuser47f0be
This document summarizes a systematic review that analyzed 48 studies on patient engagement strategies to improve quality of care. The review identified techniques to enhance patient engagement in design, recruitment, involvement and leadership. Engagement strategies ranged from low-level consultation to high-level co-design partnerships. Outcomes included educational tools, policies, and care process improvements. Higher engagement levels led to more impactful outcomes. Some patients felt tokenistic involvement despite positive experiences. Overall, engagement informed various outcomes, but more evidence is needed on its impact on quality and patients' experiences.
This document describes a randomized controlled trial comparing oral nifedipine to intravenous labetalol for acute blood pressure control in hypertensive emergencies during pregnancy. The study aims to compare the efficacy and adverse effects of the two drugs. 100 pregnant women with blood pressure over 160/110 mmHg were randomized to receive either oral nifedipine or IV labetalol until their blood pressure was reduced to 150/100 mmHg or lower. The time taken to reduce blood pressure, number of doses required, maternal and neonatal outcomes, and adverse effects were recorded and statistically analyzed. Preliminary results found nifedipine achieved the target blood pressure more rapidly than labetalol with fewer doses on average. Both
This document summarizes a clinical presentation on the basal insulin degludec and barriers to achieving optimal glycemic control. It discusses that hypoglycemia and glucose variability are barriers, and that current basal insulins have limitations like needing to be dosed at the same time daily and intra-patient variability. Insulin degludec was developed to address these barriers with properties like an ultra-long half-life of over 25 hours, very low day-to-day variability in glucose-lowering effect, and the ability to reach steady-state in 3 days. Large clinical trials showed degludec was as effective as glargine at reducing A1c and had a similar or lower risk of hyp
anti oxidant & anti inflammatory from pine bark to help improving on cardiovascular health, diabetes, erectile dysfunction, melasma, muscle cramp, osteoarthritis, retinopathy
Nice Sugar Study - Glycemic control in the ICUshivabirdi
The NICE-SUGAR study was a large randomized controlled trial that compared intensive glucose control (80-108 mg/dL) to conventional glucose control (≤180 mg/dL) in over 6,000 critically ill patients. The study found that intensive control was associated with a higher mortality rate (27.5% vs 24.9%) and more episodes of severe hypoglycemia. No differences were seen in other outcomes like length of stay. This significant study challenged prior evidence supporting tight glucose control in the ICU and suggests current practice of more moderate control is safest.
Indiana university department of kinesiology clinical exerssuser47f0be
This document contains three case studies of patients with diabetes who are beginning an exercise program. It provides details of each patient's medical history and current condition and asks a series of questions to develop an appropriate individualized exercise prescription and safety precautions for each case. The questions cover assessing readiness for exercise, selecting an appropriate facility or location, developing guidelines for frequency, intensity, duration and mode of exercise, and addressing precautions related to timing of medication, meals and activity based on blood sugar levels to prevent hyperglycemia or hypoglycemia. Additional adjustments are discussed if patients present with common diabetes-related complications.
Recently, several novel glucose-lowering targets have had drugs developed. This has resulted in several new drugs that have been approved for the local market to treat hyperglycaemia in patients with type 2 diabetes.
This presentation will attempt to provide:
A concise summary of these drugs for an Intensive Care Physician.
A pragmatic framework for what the non-Endocrinology Doctor should do with these drugs whilst the patient is in, and being discharged from, the Intensive Care Unit.
An outline of current trials evaluating glycaemia in the Intensive Care Unit.
Postpartum management of hypertensive disorders in pregnancychaimingcheng
This document discusses postpartum hypertension, which remains a challenge even after childbirth. It notes that hypertension was the fourth leading cause of maternal death in Malaysia from 2006-2008, accounting for 15.4% of deaths. It emphasizes the need for close monitoring and treatment of postpartum hypertension to prevent complications like cerebral hemorrhage. Effective treatment and management both in the hospital and after discharge are important to reduce maternal morbidity and mortality from postpartum hypertensive disorders.
This document summarizes a study that compared two different phenylephrine (PE) infusion rates for preventing hypotension during spinal anesthesia for elective cesarean sections. The study randomized 117 patients to receive either a PE infusion of 50 mcg/min (Group 50) or 100 mcg/min (Group 100). The results found that a PE rate of 50 mcg/min was as effective as 100 mcg/min at maintaining blood pressure within normal ranges. Group 50 also had significantly less maternal bradycardia (1.8% vs 17.4%) compared to Group 100. Neonatal outcomes were similar between the two groups, including Apgar scores, umbilical cord blood gases, and acid-
Ormeloxifene is an effective and safe treatment for dysfunctional uterine bleeding. A study of 60 women found that ormeloxifene significantly reduced menstrual blood loss and increased hemoglobin levels after both 3 and 6 months of treatment. It also significantly decreased endometrial thickness. The majority of women reported marked improvement in symptoms and found ormeloxifene acceptable with minimal side effects. Ormeloxifene is thus a good alternative for managing dysfunctional uterine bleeding.
This Medication Use Evaluation reviewed 31 patients who received parenteral nutrition at Palms West Hospital between November 2014 and January 2015. The objectives were to evaluate appropriate use of parenteral nutrition and determine if it was prescribed and used appropriately. The summary found that while parenteral nutrition was appropriately initiated in some patients, it was prescribed for too short a duration in others and in some patients who could have received nutrition orally or enterally. Recommendations included requiring nutrition and GI consults prior to prescribing, prioritizing NPO status, explaining risks to non-critically ill patients, consulting pharmacy during therapy, ordering specialized formulations for diabetics, and monitoring for and treating hyperglycemia.
Treat the Patient: Not the Pregnancy April 2015PASaskatchewan
This document provides information on safely managing common medical conditions during pregnancy and lactation. It discusses medication classification systems and factors affecting drug transfer across the placenta and into breastmilk. Guidelines are presented for treating depression, diabetes, thyroid disorders, infections, pain, nausea, and other issues. Many prescription and over-the-counter drugs are deemed safe to use when necessary, such as most antibiotics, acetaminophen, ranitidine, and antidepressants. Untreated medical conditions pose greater risks than potential side effects of approved medications. Resources for further information and guidance are also referenced.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Gdm rcog diagnosis and treatment of gestational diabetes 2011Diabetes for all
This document summarizes recent evidence on the diagnosis and treatment of gestational diabetes. It finds that:
1) Several large studies including HAPO have demonstrated a linear relationship between maternal glucose levels and fetal growth outcomes like birthweight.
2) Two major trials, ACHOIS and MFMU Network, showed treating gestational diabetes according to different diagnostic criteria significantly reduced adverse outcomes.
3) While lifestyle changes are usually effective, 7-20% of women require medication like metformin or insulin to control glucose.
This study investigated the effects of omega-3 fatty acids, vitamin C, and zinc supplementation individually and combined on asthma control in children. 76 children with moderate persistent asthma were randomly assigned to receive normal diet plus placebo, omega-3, zinc, vitamin C, or a combination of all three supplements over 5 phases. Asthma control was assessed using ACT scores, pulmonary function tests, and sputum inflammation markers. The combination phase showed the greatest improvement in ACT scores, lung function, and reduction of inflammatory markers compared to placebo or single supplements. This study suggests children with asthma may benefit from dietary supplementation with omega-3s, vitamin C, and zinc.
The document summarizes 3 journal articles on the treatment of severe hypertension during pregnancy. The first article recommends intravenous labetalol and hydralazine as first-line therapies. It also recommends oral nifedipine and close monitoring of maternal and fetal status. The second article finds that low-dose aspirin initiated before 16 weeks of gestation reduces the risk of severe preeclampsia but not mild preeclampsia. The third article finds that oral nifedipine is as effective as intravenous antihypertensives for treating severe hypertension during pregnancy and postpartum, with similar safety profiles.
This document discusses asthma management during pregnancy. It begins by describing how pregnancy can affect asthma severity, noting that prior asthma severity predicts severity during pregnancy. It then explains how asthma can impact pregnancy outcomes like preterm delivery. The rest of the document covers general asthma care during pregnancy, including monitoring, education, trigger avoidance, and medications. It notes most asthma medications are category B or C but are generally considered safe in pregnancy with monitoring. Inhaled short-acting beta agonists are recommended for acute exacerbations. The goal is preventing acute episodes and optimizing lung function to reduce risks.
This study investigated cardiovascular and gastrointestinal outcomes in clopidogrel users who were also taking proton pump inhibitors (PPIs) using a large cohort of patients in the Netherlands. The study found that clopidogrel users who were also taking PPIs had a 75% higher risk of cardiovascular events compared to clopidogrel-only users. However, the study had limitations such as channeling bias since PPI users had more risk factors, and residual confounding since important risk factors could not be adjusted for. While providing useful insights, the study's findings on the risks of PPI co-administration should be interpreted cautiously due to its limitations.
Prevalence of Low Birth Weight in Maternal Pregnancy Induced Hypertension in ...paperpublications3
Abstract: Pregnancy induced hypertension is one of the common conditions of unknown aetiology which increases the risk of maternal and perinatal morbidity and mortality. The aim of the study was to determine the prevalence of low birth weight in maternal pregnancy induced hypertension in patients of kashmiri origin. An observational study was carried out in the Postgraduate Department of Gynaecology and Obstetrics, Lalla Ded Hospital, Government Medical College Srinagar w.e.f September 2014 to February 2015. Methods: The study included all patients of PIH BP≥140/90 mm Hg after 20 weeks of gestation. Necessary information was collected such has detailed history, clinical examination, investigation performed, mode of delivery and neonatal birth weight Results: 37.5% had systolic blood pressure > 160 mmHg and 42.10% had a DBP > 110 mmHg. The frequency of caesarean section was 53% and 42% for normal birth. Low birth weight (<2.5 kg) was seen in (42.10%) when associated with severe diastolic hypertension and (37.5%) when severe systolic hypertension was taken into account Conclusion: DBP i.e. 110 mmHg or more was associated with low birth weight.
Desvenlafaxine Succinate: Is it a New Promise and Hope for Management of Vaso...Apollo Hospitals
Natural menopause, specifically, is confirmed after 12
consecutive months of amenorrhea in the absence of any
obvious, pathologic cause.1 These 12 months of amenorrhea and beyond, characterize a woman as postmenopausal. This can further be divided into early postmenopause (4 years after the FMP) and late postmenopause (>5 years since the FMP)
Interdisciplinary care plan7 class nur3400ssuser47f0be
This document summarizes a systematic review that analyzed 48 studies on patient engagement strategies to improve quality of care. The review identified techniques to enhance patient engagement in design, recruitment, involvement and leadership. Engagement strategies ranged from low-level consultation to high-level co-design partnerships. Outcomes included educational tools, policies, and care process improvements. Higher engagement levels led to more impactful outcomes. Some patients felt tokenistic involvement despite positive experiences. Overall, engagement informed various outcomes, but more evidence is needed on its impact on quality and patients' experiences.
This document describes a randomized controlled trial comparing oral nifedipine to intravenous labetalol for acute blood pressure control in hypertensive emergencies during pregnancy. The study aims to compare the efficacy and adverse effects of the two drugs. 100 pregnant women with blood pressure over 160/110 mmHg were randomized to receive either oral nifedipine or IV labetalol until their blood pressure was reduced to 150/100 mmHg or lower. The time taken to reduce blood pressure, number of doses required, maternal and neonatal outcomes, and adverse effects were recorded and statistically analyzed. Preliminary results found nifedipine achieved the target blood pressure more rapidly than labetalol with fewer doses on average. Both
This document summarizes a clinical presentation on the basal insulin degludec and barriers to achieving optimal glycemic control. It discusses that hypoglycemia and glucose variability are barriers, and that current basal insulins have limitations like needing to be dosed at the same time daily and intra-patient variability. Insulin degludec was developed to address these barriers with properties like an ultra-long half-life of over 25 hours, very low day-to-day variability in glucose-lowering effect, and the ability to reach steady-state in 3 days. Large clinical trials showed degludec was as effective as glargine at reducing A1c and had a similar or lower risk of hyp
anti oxidant & anti inflammatory from pine bark to help improving on cardiovascular health, diabetes, erectile dysfunction, melasma, muscle cramp, osteoarthritis, retinopathy
Nice Sugar Study - Glycemic control in the ICUshivabirdi
The NICE-SUGAR study was a large randomized controlled trial that compared intensive glucose control (80-108 mg/dL) to conventional glucose control (≤180 mg/dL) in over 6,000 critically ill patients. The study found that intensive control was associated with a higher mortality rate (27.5% vs 24.9%) and more episodes of severe hypoglycemia. No differences were seen in other outcomes like length of stay. This significant study challenged prior evidence supporting tight glucose control in the ICU and suggests current practice of more moderate control is safest.
Indiana university department of kinesiology clinical exerssuser47f0be
This document contains three case studies of patients with diabetes who are beginning an exercise program. It provides details of each patient's medical history and current condition and asks a series of questions to develop an appropriate individualized exercise prescription and safety precautions for each case. The questions cover assessing readiness for exercise, selecting an appropriate facility or location, developing guidelines for frequency, intensity, duration and mode of exercise, and addressing precautions related to timing of medication, meals and activity based on blood sugar levels to prevent hyperglycemia or hypoglycemia. Additional adjustments are discussed if patients present with common diabetes-related complications.
Recently, several novel glucose-lowering targets have had drugs developed. This has resulted in several new drugs that have been approved for the local market to treat hyperglycaemia in patients with type 2 diabetes.
This presentation will attempt to provide:
A concise summary of these drugs for an Intensive Care Physician.
A pragmatic framework for what the non-Endocrinology Doctor should do with these drugs whilst the patient is in, and being discharged from, the Intensive Care Unit.
An outline of current trials evaluating glycaemia in the Intensive Care Unit.
Postpartum management of hypertensive disorders in pregnancychaimingcheng
This document discusses postpartum hypertension, which remains a challenge even after childbirth. It notes that hypertension was the fourth leading cause of maternal death in Malaysia from 2006-2008, accounting for 15.4% of deaths. It emphasizes the need for close monitoring and treatment of postpartum hypertension to prevent complications like cerebral hemorrhage. Effective treatment and management both in the hospital and after discharge are important to reduce maternal morbidity and mortality from postpartum hypertensive disorders.
This document summarizes a study that compared two different phenylephrine (PE) infusion rates for preventing hypotension during spinal anesthesia for elective cesarean sections. The study randomized 117 patients to receive either a PE infusion of 50 mcg/min (Group 50) or 100 mcg/min (Group 100). The results found that a PE rate of 50 mcg/min was as effective as 100 mcg/min at maintaining blood pressure within normal ranges. Group 50 also had significantly less maternal bradycardia (1.8% vs 17.4%) compared to Group 100. Neonatal outcomes were similar between the two groups, including Apgar scores, umbilical cord blood gases, and acid-
Ormeloxifene is an effective and safe treatment for dysfunctional uterine bleeding. A study of 60 women found that ormeloxifene significantly reduced menstrual blood loss and increased hemoglobin levels after both 3 and 6 months of treatment. It also significantly decreased endometrial thickness. The majority of women reported marked improvement in symptoms and found ormeloxifene acceptable with minimal side effects. Ormeloxifene is thus a good alternative for managing dysfunctional uterine bleeding.
This Medication Use Evaluation reviewed 31 patients who received parenteral nutrition at Palms West Hospital between November 2014 and January 2015. The objectives were to evaluate appropriate use of parenteral nutrition and determine if it was prescribed and used appropriately. The summary found that while parenteral nutrition was appropriately initiated in some patients, it was prescribed for too short a duration in others and in some patients who could have received nutrition orally or enterally. Recommendations included requiring nutrition and GI consults prior to prescribing, prioritizing NPO status, explaining risks to non-critically ill patients, consulting pharmacy during therapy, ordering specialized formulations for diabetics, and monitoring for and treating hyperglycemia.
Treat the Patient: Not the Pregnancy April 2015PASaskatchewan
This document provides information on safely managing common medical conditions during pregnancy and lactation. It discusses medication classification systems and factors affecting drug transfer across the placenta and into breastmilk. Guidelines are presented for treating depression, diabetes, thyroid disorders, infections, pain, nausea, and other issues. Many prescription and over-the-counter drugs are deemed safe to use when necessary, such as most antibiotics, acetaminophen, ranitidine, and antidepressants. Untreated medical conditions pose greater risks than potential side effects of approved medications. Resources for further information and guidance are also referenced.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Gdm rcog diagnosis and treatment of gestational diabetes 2011Diabetes for all
This document summarizes recent evidence on the diagnosis and treatment of gestational diabetes. It finds that:
1) Several large studies including HAPO have demonstrated a linear relationship between maternal glucose levels and fetal growth outcomes like birthweight.
2) Two major trials, ACHOIS and MFMU Network, showed treating gestational diabetes according to different diagnostic criteria significantly reduced adverse outcomes.
3) While lifestyle changes are usually effective, 7-20% of women require medication like metformin or insulin to control glucose.
This study investigated the effects of omega-3 fatty acids, vitamin C, and zinc supplementation individually and combined on asthma control in children. 76 children with moderate persistent asthma were randomly assigned to receive normal diet plus placebo, omega-3, zinc, vitamin C, or a combination of all three supplements over 5 phases. Asthma control was assessed using ACT scores, pulmonary function tests, and sputum inflammation markers. The combination phase showed the greatest improvement in ACT scores, lung function, and reduction of inflammatory markers compared to placebo or single supplements. This study suggests children with asthma may benefit from dietary supplementation with omega-3s, vitamin C, and zinc.
The document summarizes 3 journal articles on the treatment of severe hypertension during pregnancy. The first article recommends intravenous labetalol and hydralazine as first-line therapies. It also recommends oral nifedipine and close monitoring of maternal and fetal status. The second article finds that low-dose aspirin initiated before 16 weeks of gestation reduces the risk of severe preeclampsia but not mild preeclampsia. The third article finds that oral nifedipine is as effective as intravenous antihypertensives for treating severe hypertension during pregnancy and postpartum, with similar safety profiles.
Relative Efficacies of Nitroglycerine Infusion, Sublingual Nifedipine, and In...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Longitudinal hemodynamics in acute phase of treatment with labetalol in hypertensive pregnant women to predict need for vasodilatory therapy
D. Stott, M. Bolten, D. Paraschiv, I. Papastefanou, J.B. Chambers and N.A. Kametas
Volume 49, Issue 1, Date: January (pages 85–94)
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.17335/full
Serial hemodynamic monitoring to guide treatment of maternal hypertension leads to reduction in severe hypertension
D. Stott, I. Papastefanou, D. Paraschiv, K. Clark and N.A. Kametas
Volume 49, Issue 1, Date: January (pages 95–103)
Read the free-access article here: http://onlinelibrary.wiley.com/doi/10.1002/uog.17341/full
Slides prepared by Dr Katherine Goetzinger (UOG Editor for Trainees)
Safety of Mebendazole Use During Lactationmothersafe
This case series study evaluated the safety of mebendazole use in 45 lactating women and their infants. Mebendazole was administered using single or repeated doses and was well tolerated by both the mothers and infants, with no adverse effects observed in infants. Mild GI irritability occurred in two treated mothers. This study provides the first evidence that mebendazole is safe for use in breastfeeding.
Therapeutic startegies for human papillomavirus infection and associated cancersAdeniyiAkiseku
Human papillomavirus (HPV) infection is linked to development of cancer of cervix, vagina, vulva, penis, ano-genital and non-genital oro-pharyngeal sites. HPV being a sexually transmitted virus infects both genders equally but with higher chances of pathological outcome in women. In the absence of organized screening programs, women report HPV-infected lesions at relatively advanced stages where they are subjected to standard treatments that are not HPV-specific. HPV infection-driven lesions usually take 10–20 years for malignant progression and are preceded by well-characterized pre-cancer stages. Despite availability of window for pharmacological intervention, therapeutic that could eradicate HPV from infected lesions is currently lacking. A variety of experimental approaches have been made to address this lacuna and there has been significant progress in a number of lead molecules which are in different stages of clinical and pre-clinical development. Present review provides a brief overview of the magnitude of the problem and current status of research on promising lead molecules, formulations and therapeutic strategies that showed potential to translate to clinically-viable HPV therapeutics to counteract this reproductive health challenge
only definitive treatment for pre-eclampsia and
eclampsia. However, antihypertensive drugs are
often needed to control blood pressure and prevent
complications until delivery can occur. The choice of
which antihypertensive to use can be controversial
due to concerns about fetal safety. For severe
hypertension, hydralazine and labetalol given
intravenously are commonly used due to their
ability to lower blood pressure quickly. Magnesium
sulfate is the treatment of choice for eclampsia and
seizure prophylaxis in preeclampsia."
This study compared neonatal and maternal outcomes following administration of fentanyl and midazolam or placebo to 60 pregnant women prior to Cesarean section under spinal anesthesia. The study found:
1) No significant differences between groups in neonatal Apgar scores, neurobehavioral scores, or continuous pulse oximetry measurements over three hours.
2) Mothers who received fentanyl and midazolam were more likely to report finding the study medication helpful, but both groups showed no difference in recall of the birth.
3) Maternal catecholamine levels and neonatal cord blood gas values were similar between groups.
The study concluded that a single dose of fentanyl and mid
This study analyzed blood pressure data from ambulatory blood pressure monitoring of 205 normotensive pregnant women. The data was divided by parity (nulliparous vs multiparous), age (≤25, 26-30, 31-35, ≥36), and trimester of gestation. The study found:
1) There was no significant difference in 24-hour mean blood pressure between nulliparous and multiparous women at any age or stage of pregnancy.
2) Systolic blood pressure did not change significantly with age. Diastolic blood pressure increased slightly but significantly with age, though differences were less than 1.5 mmHg.
3) Circadian blood pressure patterns followed previously
Albumin versus fresh frozen plasma in managing diuretic resistant edema in ch...iosrphr_editor
This study was carried out to compare the efficacy, cost effectiveness and outcome of albumin with fresh frozen plasma (FFP) in the treatment of diuretic resistant edema in childhood idiopathic nephrotic syndrome.Methods: Fifty four patients with idiopathic NS were enrolled in this prospective analytic study. Patients with moderate to severe edema with serum albumin <15 gm/L were given albumin and FFP dividing into two groups. Group-A, received intravenous albumin- 1 gm/kg/day and Group-B intravenous FFP 15ml/kg/day. Total number of albumin and FFP infusion were determined by edema reduction. Cost effectiveness was also calculated. Results: Diagnosis of NS and biochemical parameters were same in both groups. Dry weight was achieved in Group-A in 6.66± 3.710 days and in Group-B 6.66± 3.038 days. In Group-A the number of albumin infusion required was 1.44±0.697 and Group-B FFP infusion required was 3.11± 1.5 (p=0.0001). Group A needed 4608.00 ($57.6) taka for albumin whereas Group B needed only 2177.00($ 27.2) taka for FFP (p=0.0001). No significant complications were observed in both the groups.Conclusion: FFP costs half than albumin and same duration required reducing edema but the cost-effectiveness may place FFP as a better choice especially in developing countries of the world.
This study examined the effects of restricting polyphenol-rich foods in the diets of pregnant women in their third trimester on fetal ductal flow dynamics. 46 pregnant women consuming high levels of polyphenols were asked to restrict these foods for 2 weeks or more. Their fetuses showed significant decreases in ductal blood flow velocities and right ventricular size, as well as an increase in ductal pulsatility index. A control group of 26 women showed no significant changes. The study suggests that restricting maternal polyphenol intake in the third trimester can improve fetal ductal flow and right heart dimensions in normal pregnancies, as seen previously in cases of ductal constriction.
1) This study evaluated the efficacy and safety of levosimendan, a positive inotropic drug with vasodilator effects, in 700 patients hospitalized for acutely decompensated heart failure.
2) The study found that levosimendan provided more rapid and durable symptomatic relief compared to placebo, with fewer patients experiencing clinical worsening. However, levosimendan was also associated with more hypotension, arrhythmias, and possibly increased risk of death.
3) While levosimendan provided short-term benefits, its risks require careful consideration in the treatment of acutely decompensated heart failure.
The herbal formulation Hyponidd was found to be as effective as metformin in managing anovulatory PCOS women with insulin resistance by lowering insulin resistance and hyperandrogenemia without side effects. A comparison study found that both Hyponidd and metformin significantly reduced fasting insulin levels, insulin resistance indicators, and hyperandrogenemia markers. However, Hyponidd resulted in fewer side effects like nausea and diarrhea than metformin.
This study tested the hypothesis that restricting a pregnant woman's intake of polyphenol-rich foods for at least two weeks improves ductus arteriosus blood flow dynamics in healthy third-trimester fetuses, as was previously shown in fetuses with ductal constriction. 46 pregnant women restricted their polyphenol intake from an average of 1277 mg/day to 126 mg/day. Their fetuses showed significant decreases in ductal velocities and RV/LV ratio, and an increase in ductal pulsatility index. A control group of 26 women showed no significant changes. The study suggests that reducing maternal polyphenol intake improves fetal ductal hemodynamics in normal pregnancies.
The document provides an executive summary of recommendations from the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Key points include:
1) Hypertensive disorders of pregnancy remain a major health issue and can cause serious maternal-fetal morbidity and mortality.
2) The task force reviewed evidence and provides guidelines for classifying, diagnosing, predicting, preventing, and managing hypertension during pregnancy, including preeclampsia.
3) Recommendations address topics like low-dose aspirin prevention for high risk women, monitoring and treatment approaches, and emphasize that preeclampsia is a progressive condition that can worsen rapidly.
The document summarizes research on treatments for idiopathic pulmonary fibrosis (IPF). It describes IPF as a fatal lung disease characterized by lung scarring. Two drugs are discussed: pirfenidone and nintedanib. Regarding pirfenidone, the document outlines clinical trials that demonstrated its ability to reduce lung function decline in IPF patients. For nintedanib, two replicate trials found it significantly reduced the rate of lung function decline compared to placebo and reduced the risk of acute exacerbations, though it commonly caused diarrhea. Both drugs represent new treatment options for slowing the progression of IPF.
Discussion #1Is there any additional subjective or objective inf.docxcuddietheresa
- Ms. Johnston, a 60-year-old woman, presented with complaints of intermittent chest pain for the past 3 months on exertion. She has a history of hypertension, hyperlipidemia, and a family history of diabetes and cardiac disease.
- Physical exam and diagnostic testing, including EKG, labs, chest X-ray, stress test, and cardiac cath with stent placement, were performed. Labs showed an ASCVD score of 7.2%, increasing her risk for cardiac events.
- The treatment plan includes medication compliance monitoring, diet and lifestyle counseling, referral to cardiology, and follow-up in 6-12 weeks to recheck lipids. The importance of health education and literacy is discussed
This study characterized the population pharmacokinetics of imatinib in patients with severe pulmonary arterial hypertension. It found that imatinib increased the concentrations of co-administered drugs bosentan and sildenafil on average by 51% and 64%, respectively, indicating drug-drug interactions. However, imatinib showed intrinsic efficacy in improving clinical outcomes regardless of the concentrations of co-medications. Additionally, higher concentrations of imatinib and bosentan did not increase the risk of liver toxicity.
Congenital Agenesis Of The Corpus Callosum With Intracerebral Lipoma And Fron...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
“Hemodynamic and recovery profile with Dexmedetomidine and Fentanyl in intrac...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Correlation of Estrogen and Progesterone Receptor expression in Breast Canceriosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Analytical Study of Urine Samples for Epidemiology of Urinary Tract Infection...iosrphr_editor
The current study was carried out in District Abbottabad aimed to determine the common urinary
tract infections in local community to determine the epidemiology of significant diseases in asymptomatic patients
of renal disorder. In this study a total of 1000 urine samples were examined during 3rd February to 1st April 2015
from patients attending Ayub Teaching Hospital Abbottabad by using dipstick and microscopic analysis of urine.
There were 638 females and 362 males patients examined during this period. The range of age groups is between
1.5 years to 80 years. Results of this study was reported as Pyuria 11%, Proteinuria 21.1%, Hematuria 10.4%,
Epithelial Cells 8.2%, pH 7.8 %, Granular casts 7.3%, Triple phosphate 6.6%, Calcium oxalate 6.4%, Glycosuria
6.3%, Bacteria 6.2% and mucous 4.1%. This study concludes that routing urinalysis should be performed for all
individuals to diagnose the asymptomatic diseases that will help in simple therapeutic measurements as urinalysis
is a simple step to determine the root of Urinary tract disorders.
Chest sonography images in neonatal r.d.s. And proposed gradingiosrphr_editor
BACKGROUND : Lung sonography has been used to monitor the patients of R.D.S. in
N.I.C.U. in recent times.
AIMS : To Describe and Grade the changes of R.D.S. by lung sonography.
SETTING & DESIGN : Tertiary care institutional set up in a rural medical college.
STUDY DURATION : September 2014 to May 2015. Follow-up variable, upto 2 weeks.
PROSPECTIVE, ANALYTICAL STUDY.
MATERIALS AND METHODS -This was a single institute study approved by the institutional ethics
committee. Prior informed consent was obtained from the parents. 100 consecutive patients admitted in
N.I.C.U. WITH gestational age < 36 weeks with respiratory complaints were enrolled. Chest x-ray was
obtained within few hours of admission and lung sonography was performed within 24 hours. Follow – up
sonography was performed as and when necessary. Sonography image was graded and correlated with chest
xray and clinical picture
The Comprehensive Review on Fat Soluble Vitaminsiosrphr_editor
This review article deals with brief description of fat soluble vitamins with figures and tables
showing statistical analytical data duly quoting the references wherever necessary. The word “soluble” actually
means “able to be dissolved.” Whether a vitamin is classified as 'fat-soluble' or 'water-soluble' has to do with
how the vitamin is absorbed, stored and removed from the body. Vitamins are tiny organic compounds with a
huge impact on the health and well-being of the body. The body needs a small amount of fat soluble vitamins in
order to stay in optimal health. Fat soluble vitamins play an important role in keeping the body healthy and
functioning from immune system and muscle and heart function, easy flow and clotting of blood as well as eye
health. They are critical to health and wellness–particularly reproductive health and wellness. Low-fat, no-fat
and vegan diets are woefully lacking in fat soluble vitamins. However a diet based on traditional foods can
naturally provide these vitamins. Science is still learning about many of the functions of vitamins. "Too much
vitamin A, D, or K can lead to increased levels that are unhealthy and can cause serious health consequences.
Diseased conditions leading to decreased fat absorption leads to decreased absorption of vitamins. The fatsoluble
vitamins work most safely and effectively when obtained them from natural foods within the context of a
diet rich in all their synergistic partners. If fat soluble vitamins are stored for lengthy time they generate threat
for toxicity than water soluble vitamins and such situation even aggravated, provided they are consumed in
excess. Vitamin products, above the legal limits are not considered food supplements and must be registered as
prescription or non-prescription (over-the-counter drugs) due to their potential side effects. Vitamin A and E
supplements do not provide health benefits for healthy individuals, instead they may enhance mortality, and it is
held proved that beta-carotene supplements can be harmful to smokers
Sulphasalazine Induced Toxic Epidermal Necrolysis A Case Reportiosrphr_editor
The document describes a case study of an 18-year-old female patient who developed toxic epidermal necrolysis as a severe adverse reaction to the drug sulfasalazine, which she had been taking for ankylosing spondylitis. She was admitted to the intensive care unit and treated with high dose corticosteroids, fluid replacement, and supportive care. She improved with treatment and was discharged with only post-inflammatory hypopigmentation.
Evaluation the efficacy of IVIgG in treatment of Hemolytic Disease of Newborniosrphr_editor
Hemolytic disease of newborn (HDN) is an important cause of hyperbilirubinemia in the
neonatal period,and delayed diagnosis and treatment may lead to permanent brain damage. Traditional
neonatal treatment of HDN is intensive phototherapy and exchange transfusion.Intravenous
immunoglobulin(IVIgG) has been introduced as an alternative therapy to exchange transfusion. This study was
conducted to assess the effect of IVIG in HDN .
FIBROLIPOMATOUS HAMARTOMA OF ULNAR NERVE: A RARE CASE REPORT.iosrphr_editor
Nervous fibrolipomatous hamartoma is said to be a rare tumor-like condition involving the peripheral
nerves,in which the epineurium and perineurium are enlarged and distorted by excess of fatty and fibrous tissue
s that infiltrate between and around nerve boundaries. The median nerve is more likely to develop a hamartoma
than other nerves with a predilection for the carpal tunnel.
A fibrolipomatous hamartoma – is a rare, benign, congenital lesion most commonly found in the median nerve,
usually at the level of the wrist or hand.
We report a case of this rare condition in ulnar nerve.
SELF MEDICATION PRACTICES FOR ORAL HEALTH PROBLEMS AMONG DENTAL PATIENTS IN B...iosrphr_editor
This study examined self-medication practices for oral health problems among dental patients in Bangalore, India. The study found that 100% of the 175 dental patients surveyed practiced self-medication. Toothache was the most common triggering factor reported. Analgesics and herbal remedies were commonly used for self-treatment. Most participants consulted pharmacists for advice on self-medication and would see a dentist only if problems persisted after self-medicating. The high prevalence of self-medication indicates a need for education programs to increase awareness of risks.
Clinico-haematological Profile of Falciparum Malaria in a Rural Hospital of T...iosrphr_editor
Aim: To study the clinico-haematological profile malaria in a rural hospital of Tripura.
Material and methods: A cross-sectional hospital-based study was done from at Kulai District
Hospital,Tripura. This hospital based cross sectional study was done on 60 confirmed cases of falciparum
malaria (either by peripheral smear or rapid diagnostic test) admitted in Kulai District Hospital. A case sheet
proforma was prepared and data (demographic profile,clinical feature, investigation, treatment, and
complication) from all indoor patients was collected and analyzed.
Result: Out of 60 patients, 40(66.6%) were males and 20 (33.4%) were females. Most of the patients were
between the age group 21-40 years with the highest prevalence between the age group of 21-30. Fever was the
most common symptom. Anemia was present in 42(70%) patients, out of which 6(10%) patients had severe
anemia. Thrombocytopenia was present in 36(60%) patients.Abnormal liver function tests were observed in
26(43.3%) subjects while abnormal kidney function tests were observed in16(26.6%) patients. All the 60
patients received Artemisinin based antimalarial drugs.
Conclusion: Early detection, prompt management, and adequate supportive therapy may reduce mortality due
to falciparum cerebral malaria.
Indonesian Wild Ginger (Zingiber sp) Extract: Antibacterial Activity against ...iosrphr_editor
The document summarizes a study that tested the antibacterial activity of extracts from three species of wild ginger plants from Indonesia (Zingiber zerumbet, Zingiber amaricans, and Zingiber aromaticum) against Mycoplasma gallisepticum, a pathogen that causes respiratory disease in chickens. Phytochemical analysis revealed the presence of alkaloids, flavonoids, tannins, and terpenoids in the plant extracts. Disc diffusion and minimum inhibitory concentration assays showed that ethanol extracts of dried rhizomes had the strongest inhibitory effects against the pathogen, with minimum inhibitory concentrations ranging from 7.8 to 31.2 mg/ml. The results suggest that extracts from these wild ginger plants
A case of allergy and food sensitivity: the nasunin, natural color of eggplantiosrphr_editor
Abstract: Allergies and food sensitivities can both be considered as "adverse reactions individualistic" to food.
Are pathological and individual forms because they affect a few individuals in way rather serious; immediate
or delayed reactions occur instead with simple effects histamine, or, in severe cases with respiratory and
anaphylactic shock
The eggplant (Solanum melongena L.) is known to cause food allergies in some Asian countries, but detailed
studies on allergies caused by eggplant are lacking, however, it was highlighted the presence of allergens in
edible parts of eggplant with preponderance in the peel .
The purpose of this study was to propose an extraction method rapid, efficient and cost of natural dye from
waste products from the food industry, such as the peels of eggplant, from which it was extracted, isolated and
purified the nasunin,a colored molecule in red-fuchsia.
Nasusin was tested on 58 patients to evaluate the potential sensitizing effect on the skin. The results demonstrate
that allergenic effects are negligible and therefore the nasunin can be used as a colorant in various industrial
sectors with a certain safety margin
Complete NMR Assignment of MogrosidesII A2, II E andIII A1Isolated from Luo H...iosrphr_editor
NMR analysis allowed complete assignments of three known mogrol glycosides, Mogroside IIA2 (1),
II E (2)and IIIA1 (3), isolated from the extracts of Luo Han Guo. Herein, complete 1H and 13C NMR
assignmentsof all threemogrosidesare described based on NMR experiments (1H NMR, 13C NMR, COSY,
HSQC-DEPT, HMBC, NOESY and 1DTOCSY) and mass spectral data.
Nanoemulsion and Nanoemulgel as a Topical Formulationiosrphr_editor
: Nanoemulsion is referred type of emulsion with uniform and extremely small droplet size in the range
of 20-200 nm. Nanoemulsion provides numerous advantages over other carrier such as polymeric nanoparticle
and liposomes, including low cost preparation procedure, high hydrophilic and lipophilic drug loading system
to enhance the longer shelf live upon preserving the therapeutic agents. Incorporating the preparation of
nanoemulsion with hydrogel matrix to produce nanoemulgel exhibited by the two separate systems that forming
it. Nanoemulgel possesses the properties of thixotropic, non-greasy, effortlessly spreadable, easily be removed,
emollient, not staining, soluble in water, longer shelf life, bio-friendly, translucent and agreeable appearance.
Pharmacokinetics of High-Dose Methotrexate in Egyptian Children with Acute Ly...iosrphr_editor
Aim:Since several factors have been shown to influence the clearance of methotrexate, the purpose of this study
was to identify potential relationships between patient covariates and the methotrexate clearance estimates and
deduce a pharmacokinetic model for the estimation of methotrexate clearance in Egyptian pediatric ALL
patients that may help dosage adjustment and achieve target steady-state plasma concentrations in a similar
sittings.
Patients and methods: A total of 94 pediatric patients with B-cell ALL, of whom 70 were the studied population
and 24 were the test population, were treated with four courses of HDMTX doses 2.5 gm/m2
(low-risk arm) or 5
gm/m2
(standard-/high-risk arm) given every other week by intermittent intravenous infusions over 24 hours as
a part of their treatment protocol. Patients were monitored for the 24 hour MTX concentration and the systemic
methotrexate clearance was calculated for each methotrexate dose
Epidemiology of Tuberculosis (TB) in Albania 1998-2009iosrphr_editor
Abstract : In Albania, many people erroneously think that tuberculosis (TB) is a disease of the past-an illness
that no longer constitutes a public health threat. Surveillance is an integral part of tuberculosis (TB) control.
Albania has a highTB notification rate and there are doubts about underreporting. The evolution of the
incidence of tuberculosis is presented, together with more detailed figures over the period 1998-2009. These
figures were obtained by the monthly forms (called 14/Sh) compared with the individual notification data.
Objective: To examine the distribution and sources of increased tuberculosis (TB) morbidity and reporting
system deficiencies in the Albania from 1998 through 2009. Metodology: The study is descriptive one conductet
during the period 1998-2009. The statistical analysis is based on data reported from regional level (regional
epidemiological departments) to the central level (Public Health Institute). Results: The main findings were:
discordance between the collected data (individual form) and reported data (monthly form); tuberculosis
incidence rate shows little oscillations which ranges from 6.67 to 9.2 cases/100.000 population; 50% of the
regions show a lack of information on the confirmation of diagnosis and laboratory examination type used for
confirmation. Conclusion: TB disease in high-risk populations where it is difficult to detect, diagnose, and treat;
limitations of current control measures and the need for new tests and treatments, including an effective
vaccine; improving information system, regulation of individual form and personnel training.
Total Phenol and Antioxidant from Seed and Peel of Ripe and Unripe of Indones...iosrphr_editor
Study on total phenol and antioxidantactivity ofsugar apple fruits of various solvent, part of fruits, and level of ripening. Solvent extraction used were 80% (v/v) methanol, 50% (v/v) acetone, boiling water, and 50% (v/v) ethanol. Part of fruits thatbeen used for samples were seed and peel which are normally by products of sugar apple processing, level of ripening were unripe, and ripe sugar apple fruits. Total phenol was determined by Folin-ciocalteau method. Total antioxidant was quantified by 1,1-diphenyl-2-picrylhydrazyl(DPPH) method.Therewas a difference in type of solvent, part of fruits, and level of ripeningon total phenol and antioxidant concentration of sugar apple fruits. Seeds have higher total phenol concentration than peels of this fruits. Unripe sugar apple fruits have higher total phenol and antioxidant than ripe fruit. The best solvent for phenol extraction was ethanol 50%butthe best solvent for antioxidant extraction was acetone 50%.
A Review on Step-by-Step Analytical Method Validationiosrphr_editor
When analytical method is utilized to generate results about the characteristics of drug related samples it is essential that the results are trustworthy. They may be utilized as the basis for decisions relating to administering the drug to patients. Analytical method validation required during drug development and manufacturing and these analytical methods are fit for their intended purpose. To comply with the requirements of GMP pharmaceutical industries should have an overall validation policy which documents how validation will be performed. The purpose of this validation is to show that processes involved in the development and manufacture of drug, production and analytical testing can be performed in an effective and reproducible manner. This review article provides guidance on how to perform validation characteristics for the analytical method which are utilized in pharmaceutical analysis.
A Cross Sectional Study of Ethnic Differences in Occurrence and Severity of A...iosrphr_editor
Non-steroidal anti-inflammatory drugs are the most widely used "over the counter" medication all over the world despite their complications in different major organs. Present studies envisaged for knowing the occurrence and severity of adverse drug reactions from NSAIDs in different ethnic communities of Sikkim. A cross sectional study was undertaken in the medicine outpatients department of a secondary and tertiary care hospital. The patients belonging to Nepalese, Bhutias, Lepchas ethnic communities and others community (settlers from other parts of India) were included to analyzed the data based on the age and gender, ethnicity and ADRs, drugs and ADRs. Severity assessment was done using Hartwing and Siegel scale and causality assessment by Naranjo scale. Total 109 cases of ADRs, predominating in female were detected. Nepalese were the most affected and Gastrointestinal tract (GIT) being the most affected organ in them. Diclofenac showed maximum number of ADRs in all the communities. Maximum number of cases occurred on single day use (40.36%) of drugs. All the cases were belonging to the "possible category" and the maximum being the mild (72.48%) in nature. It is advisable to consider the ethnic/racial differences equally with other factors, to improve the safety and efficacy of a drug.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
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E047034037
1. IOSR Journal Of Pharmacy
(e)-ISSN: 2250-3013, (p)-ISSN: 2319-4219
www.iosrphr.org Volume 4, Issue 7 (July 2014), PP. 34-37
34
Comparitive study of nimodipine versus Nifedipine in the
treatment of hyperstion in pregnancy
Dr.Veena B.T.1
, Dr.Suvarna R2
1
Dr.Veena B.T., Assistant Proffessor of Obstetrics & Gynaecology, Kempegowda Institute of Medical
Science and Research Centre, Bangalore.
2
Dr.Suvarna R, Proffessor of Obstetrics & Gynaecology, Kempegowda Institute of Medical Science
and Research Centre, Bangalore.
ABSTRACT: Hypertensive disorders of pregnancy complicates about 7-10% pregnancy. Various anti-
hypertensives have been tried to control the pressure without much affecting the maternal and fetal health. The
present study, compare the effect Nimodipine and Nifedipine in controlling blood pressure during pregnancy.
Aims & Objectives: To control the efficacy of Nimodipine and Nifedipine in control of blood pressure during
pregnancy and to assess the effects of drug on maternal and fetal outcome.
Methodology: Eligible women are randomly assigned and treated with tablet Nimodipine 30mg 8th
hourly
(Group A) and Nifedipine 10mg 8th
hourly (Group B). Each group has 50 patients and further sub-divided as
diastolic BP between 100-109mm of Hg and 110mm Hg and above. Relevant statistical analysis was applied
and results were interpreted.
RESULTS: Both groups are comparable in terms of systolic and diastolic blood pressure control. Group A
had minimal side effects like headache, flushing and hypotension for about 2%. Perinatal outcomes were
comparable between the two groups with 96% carry home baby rate in Group A and 88% in group B, which are
also comparable.
Conclusion: Nimodipine is comparable with Nifedipine and can be used as an alternative drug in the treatment
of hypertension in pregnancy as it is safe, effective and with minimal side effects.
As it is more expensive than Nifedipine in country like India, Nifedipine continues to be the first line drug.
KEYWORDS: Diastolic blood pressure; Nifedipine; Nimodipine;
Brief Description about the need for the Study: WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT -
Previously illustrated literatures have demonstrated the effect of Nimodipine / Nifedipine with regard to its
action as anti-hypertensives, in pre-eclampsia or in chronic hypertension which is correlated in the present
study.Nifedipine is the drug which is very commonly used in the oral formulation, one of its known adverse
effects being sudden hypotension and hence not recommended in many countries and proved by many
literatures was also considered for study to formulate the drug regimens.
WHAT THIS STUDY ADDS: The present study is dedicated to consider the two (calcium channel blockers)
drugs in the form of oral preparations, their effect on prolongation of pregnancy and benefit to the fetus with
respect to the maturity along with its action as anti-hypertensive. This study also specifically shows that non-
proteinuric patients have better control of blood pressure than the proteinuric patients, hence can be used more
specifically in non-proteinuric patients.
Summary :This is a comparative study of Nimodipine and Nifedipine in the treatment of hypertension of in
pregnancy undertaken in Department of OBG at KIMS Hospital and Research Centre from Mar 2004 – Mar
2006.The study was to evaluate the anti-hypertensive effects of both the drugs, to reduce maternal complications
as a result of hypertension and to attain greater fetal maturity by prolongation of pregnancy without
compromising on uterine blood flow and fetalwell being. Nifedipine was taken as the reference drug to evaluate
the effects of trial drug Nimodipine in terms of the above parameters.A protocol was drawn for the
investigations to be done in these patients and the administration of drugs was standardized. The patients were
followed up until delivery.In the present study, it was found that there was an effective reduction in blood
pressures in both groups. There was no maternal mortality in either group. Prolongation of the pregnancy was
also possible in cases with mild to moderate hypertension and better neo-natal outcome was noted in both the
groups.
2. Comparitive Study Of Nimodipine Versus...
35
There were minimal and mild side effects in Nimodipine group and none discontinued treatment during the
period. Thus the compliance from the patient was good.
I. INTRODUCTION
Hypertensive disorders of pregnancy complicates about 7-10% of pregnancies1
. Severe hypertension
increases maternal mortality and morbidity due to cerebrovascular accidents, pulmonary oedema and placental
abruption. Several anti-hypertensive drugs have been tried in the pregnancy considering various factors in the
pregnancy. Methyldopa, Labetalol and Nifedipine(Dihydro-piridine group2
) are commonly in use at present. But
in developing countries, Labetalol is not used as first line drug due to cost constraints and Methyldopa, which is
an established first line drug takes longer time to act and on the other hand Nifedipine, which is used for both
acute and chronic hypertensions has long side effects like rapid drop in the pressure following medication,
complications like Myocardial infarction and Congestive cardiac failure3
. It has been banned in countries like
Australia.Nimodipine (Dihydro-piridine group) is one more anti-hypertensive drug with similar mechanism of
action as Nifedipine and lowers the blood pressure more gradually, hence overcomes the known side effects of
Nifedipine and also helps to increase cerebral perfusion pressure4
.
Aims & Objectives
[1] To compare the efficacy of Nimodipine and Nifedipine in the control of blood pressure during pregnancy.
[2] To assess the maternal and fetal side effects of the drugs.
II. METHODOLOGY
This study was completely in-patient based. Primary data was generated by studying patients admitted
for the management of pregnancy-induced hypertension (PIH) at the KempeGowda Institute of Medical
Sciences, Bangalore for a period of two years from March 2004 to March 2006.On admission, detailed history,
clinical examination and investigation related to PIH are done.Inclusion Criteria: All pregnant women with
diastolic blood pressure (DBP) more than 100 mm Hg on atleast 2 occasions 4 hours apart after 20 weeks of
gestation.Exclusion Criteria: Heart disease including ischaemic heart disease, Haemotological disorders, Liver
disease and History of intolerance / hypersensitivity to dihydropyridine groups of drugs.
Total of 100 patients with diagnosis of PIH were randomized in to 2 groups of 50 each. After informed
written consent, Group A received Nimidipine 30 mg 8th
hourly and Group B received Nifedipine 10 mg 8th
hourly alternatively with matching distribution. Each group was further sub-divided as DBP between 100-109
mm Hg and above 110 mm Hg.All patients BP measurement was done at rest, in sitting or 15 degree lateral
recumbency. Two consecutive readings 4 hours apart and with Korotkoffs phase-V were used to determine
DBP.Aim of the treatment was to maintain the DBP between 90–100. Patients with gestational age of less than
34 weeks, and those with impending eclampsia / eclampsia were given MgSO4 as per Zuspans regimen.
Decision to continue with conservative management of pregnancy or to deliver and mode of delivery was made
depending on maternal and fetal indications. Patients were followed until delivery, indication for induction,
mode of delivery, fetal and maternal outcome and side effects of the drug if any during the treatment were
noted.Relevant statistical methods were applied depending on the type of data that were generated. Chi-Square
test, Fischer exact test, Student t test (Paired), Effect size and Statistical software namely SPS 11.0 and Systat
8.0 were used for the analysis.
III. RESULTS
The age, parity, pre-treatment risk factors that affect the maternal and fetal outcome, NST, additional
drugs like MgSO4 and Phenobarbitone used on the patients of both the groups were matched. The gestational
age at presentation in either group is as follows.
Table 1: Gestational Age at Presentation
Gestational age at
presentation in weeks
Group A (n=50) Group B (n=50)
Number % Number %
20-24 - - 1 2
25-28 2 4 2 4
29-32 2 4 12 24
33-36 17 34 21 42
37-40 29 58 13 26
>40 - - 1 2
3. Comparitive Study Of Nimodipine Versus...
36
The maximum number of cases was between 37-40 weeks of gestation in Group A and 33-36 in Group B.
Table 2: Diastolic BP at Presentation
Diastolic BP in mm Hg
Group A (n=50) Group A (n=50)
Number % Number %
100-109 30 60 25 50
110 and above 20 40 25 50
Inference
Diastolic BP at presentation is statistically similar between two
groups with p=0.315
Table 3: Division of patients into Non-proteinuric and Proteinuric cases
Non-proteinuric and
Proteinuric cases
Group A
(n=50)
Group A
(n=50)
Number % Number %
Non-Proteinuric 32 64 26 52
Proteinuric (Significant
proteinuria ≥ 300 mg/L) 18 36 24 48
Inference Non-proteinuric and Proteinuric is comparable between the two
groups (p=0.548)
Table 4: Mean Pattern of Blood pressure (Post-treatment)
Study Period
Systolic Blood pressure mm HG
(Mean ± SD)
Diastolic Blood pressure mm HG
(Mean ± SD)
Group A Group B Group A Group B
0 hour 150.72±10.38 155.47±10.96 104.88±6.07 107.24±7.32
8 hour 143.28±9.04 144.61±6.72 97.76±6.48 98.24±6.81
24 hour 140.44±10.02 145.38±10.60 94.12±8.52 96.96±6.57
48 hour 138.55±9.66 141.71±13.08 91.70±7.01 94.29±10.46
72 hour 135.77±11.48 139.52±10.14 89.71±9.97 94.96±10.89
Student t
(0 hour - 72 hour)
t=7.406
p<0.001
t=4.838
p<0.001
t=9.755
p<0.001
t=4.613
p<0.001
Effect size 1.36 1.51 1.89 1.34
Table 5: Comparison Apgar score between groups
Apgar Score
Apgar at 1 minute Apgar at 5 minute
Group A Group B Group A Group B
N=49 N=46 N=49 N=46
> 7.0 40 (81.6%) 37 (80.4%) 44 (89.8%) 40 (86.9%)
7 - 4 7 (14.3%) 6 (13%) 3 (6.1%) 4 (8.7%)
< 4.0 2 (4.1%) 3 (6.5%0 2 (4.1%) 2 (4.3%)
Inference
Apgar score at 1 and 5 minutes are comparable between the two groups
(p>0.05)
Table 6: Birth weight distribution
4. Comparitive Study Of Nimodipine Versus...
37
IV. DISCUSSION
The present study compares Nifedipine, which is the commonly used anti-hypertensive with
Nimodipine in terms of control of blood pressure during pregnancy and their maternal and fetal side effects and
neo-natal outcome. The diastolic pressure at presentation was 100-109 mm Hg in 60% of the patients in Group
A and 50% of the patients in Group B. Diastolic BP of 110 mm Hg and above was present in 40% of patients in
Group A and 50% of patients in Group B with significant proteinuria in 36% in Group A and 48% in Group B.
Ferrazzani& Associates, 1990 showed that, risk of perinatal morbidity and mortality is increased when
hypertension in pregnancy is associated with proteinuria5
.In 10% of non-proteinuric patients and 12% of
proteinuric patients in Group A, BP was not under control even after 48 hours. In 8% of non-proteinuric and
20% of proteinuric patients in Group B, BP was not under control even after 48 hours. This is comparable in
both the groups (p=0.454). These patients with uncontrollable BP were given MgSO4 and pregnancy was
terminated.In Gita Banerjee and co-author’s study (2000)6
using Nimodipine, there was more fall in MAP after
72 hours in the non-proteinuric than in the proteinuric group. This study too has found similar results.Present
study using Nifedipine and Nimodipine can be compared to KaterinaFenakle at al study (1991)7
, who used
Nifedipine in their study.
There was adequate control of blood pressure (consistently below 160/110 mm Hg). Mean
prolongation in both the groups is around 6 days, whereas in the above study, it was 15 days. The longest
duration of prolongation of pregnancy was 30 days in both groups. Prolongation of pregnancy in days is
statistically comparable between both the groups with p=0.611.Minimal side effects like headache and flushing
were in Group A, which were tolerable. Group B did not have any side effects. Hypotension with Systolic BP <
90 mm Hg was seen in 1 patient after delivery.Post-treatment complications like hypotension were seen in 2%
and 2% patients had pleural effusion in Group A. Postpartum impending eclampsia and Abruptio Placenta
(Grade 0) were noticed in Group B in 2% of the cases.In majority of patients, pregnancy was prolonged for 1-3
days and it was prolonged beyond 2 weeks in 12% in Group A and 14% in Group B, which were comparable to
other studies8
.56% in Group A and 62% in Group B required induction, majority of them for uncontrolled
hypertension. Elective CS was done in 20% and 16% of patients in Group A and Group B respectively. Type of
delivery was comparable between the two groups.Over 80% of new born had Apgar score of >7. Apgar score at
1 and 5 minutes were comparable between the two groups with p>0.05. Proteinuric patients in both the groups
and low birth weight babies compared non-proteinuric patients. Birth weight distribution was comparable
between both the two groups. 40% and 44% in Group A and B respectively were admitted to NICU which are
comparable. Majority of the babies were admitted to NICU in view of preterm, intrapartum asphyxia and
meconium aspiration, which correlates with many other studies9, 10
.One baby in Group A died due to intra
ventricular haemorrhage. Two babies died in Group B were preterm, one had necrotizing enterocolitis and the
other had severe birth asphyxia.
V. CONCLUSION
In the treatment of hypertension in pregnancy, Nimodipine and Nifedipine were equally effective in the
control of blood pressure, both systolic and diastolic. This control was better in the non-proteinuric patients.
With effective control of blood pressure, the pregnancy could be prolonged thus enhancing fetal maturity.There
was no difference in both the groups with regard to obstetric interventions, NICU admissions and birth apgar
and birth weight.Hence to conclude Nimodipine is a safe effective oral drug that can be offered to an alternative
to Nifedipine in the management of PIH. As it is comparatively much more expensive than Nifedipine, in
developing countries, Nifedipine continue to be preferred first line drug.
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